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Next steps for Montana and the country

Montana has been fortunate so far during the Covid-19 epidemic but as the Zen master said “we’ll see”. Some of this is likely because of low population density but most is because of rational well executed public health responses to the threat.

If our numbers of new cases remain low (knock on wood), we can likely move the state strategy further towards “containment” and away from “mitigation”. As the responsible news media have outlined, this requires the capacity to trace contacts of cases, test them, and isolate them until they are not a risk to others. I have no idea of the current capacity of Montana to contact trace and test contacts but the absolute amount of resources necessary is small. Montana had 4 new cases yesterday while New York had 5000. New York is obviously still dependent on mitigation.

If we had a national strategy, we would move resources for containment to low incidence states. Skilled contact tracers would go to Montana as needed. Resources needed for mitigation would move to high incident states. Ventilators, physicians, nurses etc would go to New York or Massachusetts.

In a containment phase reasonable economic activity should be able to resume although physical distancing and limiting contacts would still be needed for a period otherwise you may move back into mitigation (shutting down nonessential economic activity, etc).

While states are still in mitigation, aggressive recruitment, resources and training for contact tracers needs to be stood up as well as the testing needed for contacts. I have heard estimates that the nation has 2000-3000 contact tracers and may need well over 100,000. As mitigation reduces the numbers of new cases and the resources necessary for successful containment increase, more states should be able to move to a containment strategy. As their economic activity increases the overall economic crisis should abate.

Some may rightfully say this is a theoretical approach that hasn’t been “proven” in this situation which is correct. However, this approach would allow the resumption of economic activity while minimizing the loss of life.

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