The AEI’s “road map to reopening” details what’s next for America

Americans are eager to know when they can resume their normal lives. When can they visit coffee shops, bars, and gyms? When will schools reopen? When will life return to what it once was? However, these reopening dates remain uncertain and keep changing. Some schools that were supposed to reopen this week are now expected to stay closed for the rest of the year. No one seems to have a clear answer on when—or if—things will go back to normal. The reason is simple: we first need a strategy to safely reopen the economy. To address this, the American Enterprise Institute (AEI) released a report authored by five leading figures in medicine, public health, and law: Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis, and Crystal Watson. This four-part plan aims to guide the U.S. toward a strategic recovery, but it's not designed to rush the process. Its goal is to proceed cautiously and thoughtfully. Currently, we're in Phase I of the plan. In Phase II, individual states will reopen gradually. According to the plan, a state can transition to Phase II when it can effectively diagnose, treat, and isolate COVID-19 cases and their contacts. Life in Phase II will resemble pre-pandemic times but with significant changes. People will be encouraged to wear non-medical fabric masks in public. Public hygiene will improve drastically, with regular deep cleanings of shared spaces becoming the norm. Shared surfaces will be sanitized more frequently, among other measures. Words like "sharply," "isolate," "limit," and "routine" indicate that we will be living in a "new normal." Phase III remains vague, involving the lifting of social distancing once "safe and effective tools" for reducing COVID-19 risk are available. Examples include broad surveillance, therapeutic treatments, and a vaccine. Phase IV is far off, but the AEI recommends ensuring America is better prepared for future infectious disease threats by developing systems for rapid vaccine development, modernizing healthcare, and establishing the "National Infectious Disease Forecasting Center." There is no fixed timeline for reopening the economy. Instead, the AEI suggests "triggers" to move between phases. Meeting the criteria of one phase will trigger a gradual shift to the next. If progress falters, we may revert to the previous phase. Ideally, this process will continue until we reach Phase IV. To exit Phase I, a state must show a consistent 14-day decline in cases, avoid crisis-level hospitalizations, and conduct widespread testing. The AEI estimates that achieving at least 750,000 weekly tests could enable us to move to case-based interventions needed for Phase II. The U.S. healthcare system has struggled to handle the surge in COVID-19 patients, so the report recommends expanding ICU beds to 2.8 per 10,000 adults and increasing ventilator availability. Before triggering Phase II, we must increase PPE supplies, develop robust surveillance systems, scale up contact tracing, offer voluntary isolation and quarantine, and encourage mask-wearing. These steps sound straightforward, but they require significant effort. If we adopt the AEI's recommendations, reaching Phase II will allow most businesses, schools, and universities to reopen, provided they maintain social distancing. Work-from-home setups should continue where feasible, and social gatherings should remain limited. Reopening will be cautious, with increased surveillance as restrictions ease. If outbreaks recur, we'll revert to Phase I. Reaching Phase III requires a safe, FDA-approved vaccine or effective preventive treatments. Following the AEI's guidance to Phase IV will fundamentally transform American healthcare—cleaner, more sanitary, more surveilled, and centralized. Whether our leaders heed this advice remains to be seen. If they do, the path to reopening will be long but potentially effective.

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