Irwin Redlener directs the National Center for Disaster Preparedness and is a pediatrician, a professor at the Mailman School of Public Health at Columbia University and president emeritus of Children's Health Fund. He is a member of the Biden Campaign's Public Health Advisory Committee. Twitter: @IrwinRedlenerMD. The opinions expressed in this commentary are those of the author. View more opinion articles on CNN.
(CNN)While acknowledging (finally) that re-opening the economy and lifting some of the social distancing restrictions is not really his decision, President Donald Trump gave US governors a clear message on Thursday: time to start getting the country back to normal within the next couple of weeks.
Unfortunately, we are far from being able to do so without risking a major resurgence of Covid-19.
Even if we assume that sometime this summer — maybe June, perhaps as late as August — the first wave of Covid-19 will have tapered down, the world will likely see a second wave of the deadly virus in the fall or winter, perhaps extending into the early months of 2021.
As much as everyone would like to be back to some kind of normalcy by next month, the chance of that materializing is slim to none.
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We have a lot to learn from countries that initially seemed to have the outbreak under control but are now beginning to see a resurgence. Singapore and Hong Kong are already experiencing new outbreaks of Covid-19, possibly due to travelers returning from other parts of the world. In Hokkaido, Japan, strict control strategies have been re-introduced because of a new surge of Covid-19.
Other factors may be at play, as some scientists now believe the disease could be far more infectious than previously thought. The original understanding was that every person infected with the virus could pass the infection on to another two to three people; now, that number might be more than five secondary infections.
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We may well see a significant drop in hospitalizations and fatalities by sometime in May or June. But we cannot let up on the only effective tools we have to fight Covid-19: First, we must continue to shut down the venues where we used to gather, including schools, nonessential workplaces, sporting events, theaters and business meetings. And second, we must remain sheltered in our homes, using social distancing and face masks when we do venture out to buy groceries or essential medications.
Failing to continue these strategies could result in a "deadly resurgence," as the World Health Organization recently warned. Until we have widespread rapid and reliable testing, aggressive contact tracing and an effective vaccine, the coronavirus may be "hiding" and mutating in people who have few or no symptoms — and we can't even be certain that those who had the infection once will be resistant to a second bout of the disease.
There remain many places where the pandemic has not yet erupted but almost inevitably will, including in rural and medically underserved communities in the United States. There is absolutely no reason to believe that places as diverse as Southern Arizona or the entire state of South Dakota have reached their peak incidence of Covid-19. And there will undoubtedly be outbreaks in economically fragile, conflict-prone regions like Northern Syria, the slums of Nairobi, much of Sudan and many other developing nations around the globe. These are the very places that may well ignite new waves of Covid-19 that could spread like wildfires, swirling around the world among populations where effective immunity had not been established during the first round of the pandemic.
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How long can we sustain this surreal, hunkered-down existence while the American economy continues to deteriorate? The battle is on between public health advocates who fear a prolonged threat of Covid-19 and those who see overriding concerns of a failing economy. That's precisely why massive federal economic relief is needed until we definitively control the pandemic. Before this is over, we may invest multiples of the $2 trillion already committed to pandemic-related economic support of businesses and, especially, families.
For the foreseeable future, we will surely experience profound changes in our lives and relationships. We are transforming the ways we work, learn and find diversion and pleasure. Despite these challenging times, we may also see great advances in our ability to manage or prevent outbreaks of infectious diseases as well as technological innovations in how we communicate with each other. All of this will be part of the "new normal."
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Meantime, the governors -- all 50 of them -- would be wise to ignore the President's advice until we can do at least one to two million rapid diagnostic tests per week, widespread testing for antibodies, high level contact tracing and develop detailed "new rules" for the workplace.
Remember, too, that real control of the pandemic will not happen until an effective and safe vaccine is ready for general use. Hopefully we'll see that come to market by mid-2021. That's the light at the end of the tunnel, but it may be a very long tunnel.
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