We need a plan to move the country forward and need one now. I am tired of hearing arguments based on “breaking news,” supercomputer modeling or economic formulas. I am therefore proposing this simple way to allow most people to lead normal lives while avoiding most (94%) deaths from COVID-19.
There is now a significant experience with COVID–19 infection, and we know that almost everyone without health issues and under the age of 60 does not get seriously ill from the virus. In addition, the methods of virus transmission from person to person are defined. Consequently, we should then be able to protect whomever is at high risk for death from this infection. We actually have now proven this with the shelter in place experience.
Given this knowledge we should be able to divide the country into two groups; those under 60 without health problems and those at risk for serious illness and death (everyone else). In order to release the first group of people to their routine activities without restrictions, we simply have to protect the latter group, which includes 94% or more of the deaths from COVID-19.
Therefore, these are the steps that I would recommend that allow us to normalize the country while at the same time preventing almost all of the excess death associated with COVID-19.
1) Release anyone under the age of 60 without a preexisting medical condition to totally normal activity. Do not screen anyone in this population for COVID unless they are symptomatic and require medical care, or they have a job that interfaces with the at-risk population.
2) Insist that social distancing, mask use, and other precautions continue for at-risk individuals over 60 and all those with medical issues.
3) Initiate emergency production and stockpiling of remdesivir and develop protocols for its early and immediate use in at-risk individuals.
4) Anyone over the age of 60 or anyone with a pre-existing medical condition must be seen by their physician and have blood pressure, heart disease, and diabetes management optimized before having restrictions eased.
5) Anyone who is still at medical risk must sign a waiver that they understand the risk if they normalize their activity.
6) Continue periodic screening (weekly would be optimal) for COVID-19 virus (not antibody) in healthcare workers and all other workers who come in contact with senior citizens. Those shedding virus are restricted from work for 14-21 days or until they have had two consecutive negative tests.
7) If by incredible good fortune a vaccine is developed, this vaccine should first be given to elderly and people at risk from the infection. Subsequently the rest of the population could be immunized to develop herd immunity and end the pandemic for good.
While using this approach would mean that some young people will still get sick and may even require hospitalization, this would not result in the type of tragedy we have seen with the massive deaths of elderly in our major cities. While this is a fairly simple proposal, it requires discipline and the ability to test at-risk individuals in a uniform and reasonable way.