Not just any doctor. It’s Ezekiel Emanuel, brother of Rahm (and Ari) and an architect of ObamaCare.

RCP summarizes his position here as “U.S. Must Stay Locked Down For 12-18 Months Until There’s A Vaccine” but I don’t think that’s right. Granted, he’s deliberately vague in the clip about what he has in mind. And he sure sounds ominous:

Realistically, COVID-19 will be here for the next 18 months or more. We will not be able to return to normalcy until we find a vaccine or effective medications. I know that’s dreadful news to hear. How are people supposed to find work if this goes on in some form for a year and a half? Is all that economic pain worth trying to stop COVID-19? The truth is we have no choice.

If we prematurely end that physical distancing and the other measures keeping it at bay, deaths could skyrocket into the hundreds of thousands if not a million. We cannot return to normal until there’s a vaccine. Conferences, concerts, sporting events, religious services, dinner in a restaurant, none of that will resume until we find a vaccine, a treatment, or a cure.

Sounds lockdown-ish. Judging by some of what he’s written lately, though, what he has in mind is more a series of lockdowns than one sustained lockdown, which would be completely infeasible for economic and psychological reasons. A few weeks ago he offered a plan for reopening parts of the country on June 1 — if certain things can be done before then, like expanding testing and rolling out a “certification system” to designate people who’ve recovered from the disease as immune. He’s not talking about a perpetual lockdown.

He does, however, imagine lockdowns happening intermittently to quell new outbreaks as they arise over the next 18 months. They might not be as draconian as the current one since people who’ve recovered should be immune going forward, but if this fire is destined to start spreading again every time the country resumes economic activity, it’s inevitable in the absence of a prophylactic drug that some will begin isolating themselves again as the case numbers rise. As one economist said of the progress being made in New York right now, “what flattened the curve was no more than the naked truth” about the epidemic rampant in the city. That’ll continue to be true for the next 18 months, with people retreating into their homes/bunkers as needed in order to protect themselves and their families as infections climb. If it’s not a top-down phenomenon via orders from local officials, it’ll be a bottom-up one.

The pertinent question in the near future isn’t “How often will we lock down?”, it’s “What needs to happen to spare us from lockdowns?” Every scientist with a background in infectious diseases seems to agree that the three key components are ubiquitous testing, the ability to monitor those who test positive, and contact tracing. Contact tracing can be done the old-fashioned way with a huge bureaucracy of people interviewing patients and reaching out to those with whom they’ve been in proximity lately, but that takes a lot of manpower and there’s little time. We seem destined for a more high-tech version in which Americans agree, tacitly or formally, to let their movements be tracked via their smartphones in exchange for the lockdowns lifting. If you have the bad luck to come into contact with someone who’s tested positive, you’ll get an alert and be told to self-isolate for a few weeks. There’ll be economic pain from that too, but much less than there’ll be from city-wide lockdowns.

Singapore offers perhaps the most likely model for the West. Residents can download an app called TraceTogether, which uses Bluetooth technology to keep a log of nearby devices. If somebody gets sick, that user can upload relevant data to the Ministry of Health, which notifies the owners of all the devices pinged by the infected person’s phone…

Germany, which is helping to lead Europe’s tracing efforts, is looking to tweak the Singaporean model in a way that might make it more amenable to Western sensibilities. Buermeyer told me that one possibility is to program phones to broadcast a different ID every 30 minutes. So, for example, if I went to Starbucks in the morning, my phone would broadcast one ID over Bluetooth to all the other phones in the café. An hour later, at lunch with a friend, it would broadcast a different ID to all the other phones at the restaurant. Throughout the day, my phone would also receive and save IDs and log them in an encrypted Rolodex.

Days later, if I were diagnosed with the coronavirus, my doctor would ask me to upload my app’s data to a central server. That server would go through my encrypted Rolodex and find all of the temporary IDs I had collected. An algorithm would match the temporary IDs to something called a push token—a unique code that connects each phone to the app. It could then send each phone an automated message through the app: PLEASE BE ADVISED: We have determined that in the past few days, you may have interacted with somebody … At no point in this entire process would anybody’s identity be known to either the government or the tech companies operating the central server.

Another measure that’ll be needed sooner rather than later is centralized quarantine centers so that people with families have a place to go to recover in lieu of hunkering down at home and spreading the disease to their spouse and children. Families are a key vector of the contagion; the more thoroughly isolated an infected person can be, the more outbreaks will be reduced. Where and how the physical space to do this will be created, I have no idea. If business is slow enough at hotels, they might be repurposed somehow. Maybe what New York City did to the Javits convention center, converting it into a hospital ward with hundreds of beds, could be reapplied to convert convention centers into a series of small rooms with beds for people to convalesce. Having to spend a month in, say, a 10×10 space in the belly of a huge warehouse-type building would be grim, but maybe it’s unavoidable.

This isn’t going to be fun.