Herd immunity is a distant and unrealistic prospect, but Americans still have the opportunity to mitigate the suffering and death caused by the disease. The reality is that the only way for the United States to get through Act II with low levels of morbidity and mortality is through more complete lockdowns than were previously implemented in areas with high incidence of infection. Currently, the upper Midwest is the “hottest” area in the country for community-wide transmission, but other areas will see increasing case totals deeper into the fall. The aim at this point, quite simply, should be to cut transmission of the virus as much as possible until the creation and distribution of an effective vaccine.
Such lockdowns should last six to eight weeks with a goal of reaching no more than one new case per day per 100,000 people. This low rate is necessary for testing and contact tracing to have any meaningful effect. Once that rate is achieved, however, local officials will be able to adjust lockdown measures more accurately and with the flexibility the pandemic demands. If the White House and federal government will not lead, which is unfortunately likely under the current administration, the governors of each state, in coordination with their neighboring states, must take the initiative themselves. Some might think this is unrealistic, but New York has been able to maintain this low rate of new infections for the past three months.
Stringent lockdowns, of course, would depend on the continued labor of essential workers, a category we estimate to be no more than 35 percent of the workforce and possibly less. What about other workers? As part of its broader anti-COVID-19 strategy, the federal and state governments should compensate both individual workers and small businesses that suffer substantial or irreparable economic loss as a result of lockdowns. Such support negates the false choice between public and economic health. If carried out successfully, the near-complete shutdowns would be not open-ended but limited in time.