Eventual reopening of Delaware projected to be gradual

As Delaware begins its second month of social distancing, school closures and only essential businesses operating, the return to how things were as recently as February won’t happen in a snap.

“I think it’s going to be more gradual,” said Jennifer Horney, professor and co-founder of the University of Delaware’s epidemiology program. “We talk at UD about, as the university begins to open and students return, we’re going to be online for all of our classes in the summer, but we’re not just going to open one day at 8 a.m. and say, ‘OK. Everyone come back.’”

More likely, she said, it will be at a slower pace: people may be more cautious, the governor may not open all businesses at once and some of the practices people are growing accustomed to may linger on.

“Should emergency authorization expire on the 15th [of May], I think [Gov. John Carney] will more likely alter the authorization,” she said. “As he’s been doing over time to make it more stringent, I think he’ll slowly alter it to make it less stringent over time.”

She added that large gatherings may not be coming back very soon either.

Jennifer Horney

“People have changed a lot about their lifestyle and their habits and I think they’ll continue to at least be thinking about social distancing and gatherings,” she said.

Individual actions, like continued hand washing, not touching one’s face and using masks may also continue.

Traditionally, she added, masks have been used for people who are symptomatic.

“In your doctor’s office, if you come in with flu-like symptoms for example, in flu season, you’d be asked to put on a mask,” she said.

She said gloves, masks and other personal protective equipment require training to be used properly.

“We don’t want people to feel that they have a level of protection that they may not,” she said.

“I think we need those individual level actions in concert with these community-level actions for it to continue to be effective, and we’ll ease our way out of both of those, slowly and together.”.

But before we even get there — there are a few things that are necessary before recovery can begin, Dr. Horney said.

Most research is pointing to four criteria for recovery, she said: two weeks with a decline in the number of cases being reported, rapid testing capability, personal protective equipment when additional cases occur and public health capacity to trace positive individuals to prevent further community spread.

Dr. Horney said positive cases don’t have to be at zero, “but we need to see a lot fewer cases so we’ll know that we’re on the other side of the epidemic curve,” she said.

Rapid testing capability will help health officials determine if someone is infected quickly, to keep them from going out and transmitting the disease. That ties in with the ability to trace those who a positive individual may have interacted with.

“We need to be able to quickly trace their contacts and quarantine them for the 14 days to wait to try and prevent any sort of community spread,” she said.

Dr. Horney said health officials know details about the virus, like the incubation period and the amount of time it typically takes people to recover, which all goes into the data they use for models.

“We can certainly use information from other countries who’ve been ahead of us, but again, it’s going to have some uncertainty because their population is different, their health system is different,” she said. “I think all those types of variables go into it and that’s one of the reasons why, when we’re looking at models, there’s a lot of uncertainty and a wide range of dates or outcomes that might be possible, because none of the information that we have is perfect.”

The governor’s announcement Monday that he would work with five other states — New York, New Jersey, Pennsylvania, Connecticut and Rhode Island — will also contribute to the data being collected about the virus.

Across the country, governors in Washington, Oregon and California announced similar plans.

The more data, the better, Dr. Horney said. She noted that much of the data being used comes from China and Italy. The more data that can be aggregated, “we’ll have a better insight into what the future holds,” she said.

“I think it’s absolutely essential to look at this on the regional basis because our community in Delaware really expands beyond the state borders,” she said. “No one is going to be able to reopen safely, unless everyone in the adjacent states is on their way to recovery as well. It’s simply too easy to go back and forth for work or school or other sorts of activities.”

She said there is also the concept of “rolling closures,” which could play out locally, too.

This could mean cycles of opening and more strict social distancing in Delaware, or nearby states working together to open up different entities, like businesses or schools, “in a rolling way to ensure that there is enough public health and hospital capacity across the region to address any clusters that may arise with opening,” she said.

Dr. Horney said a pandemic to this scale hasn’t occurred for more than a century.

“Some people talk about a second public health transition that happened when diseases and people were able to move so quickly around the world,” she said. “I think in that sense, it’ll be very different.”

Modeling recovery off previous pandemics — or something like a natural disaster — doesn’t entirely fit.

“Natural disasters tend to be more localized,” she said. “So in that sense, you will see some similarities because the timeline for recovery will look different. For example, the West Coast seems to be further ahead on their timeline, because they had more cases first in Washington state.”

As the state works its way to recovery, Dr. Horney asked that people “be patient, and trust in the public health response.”

“We still have a ways to go,” she said. “I am optimistic that we are making progress.”


Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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