To America’s leaders, innovators, and change makers: even as the COVID-19 pandemic continues, a return to a normal existence is in sight. Getting the end game eight could save thousands of lives.
We hope that 2021 will see the United States gain a decisive upper hand in its fight against COVID-19. The country is currently engaged in an unprecedented race to vaccinate as many people as possible while using public-health measures to minimize deaths in the short term. The situation is dire—more people died in the United States from COVID-19 in January 2021 than died in the last two years from the flu.1 Even as we work through the challenges of this ongoing tragedy, we argue that it is reasonable to hope that the first half of 2021 can be a bridge to what we term “normalcy” # when many aspects of social and economic life can resume without fear of excess mortality (when overall mortality exceeds its long-term average). The great news is that vaccines appear effective—seeing “shots go into arms” is heartening. The less great news is that new challenges are emerging by the day, including more contagious strains of the virus and a slow start to vaccine rollout.
Public policy can set the tone, but it only works with the consent of the governed. Containment of COVID-19 is about millions of individual decisions. In the United States, stringent policies about testing, tracing, and mask wearing have correlated only loosely with changes in epidemiology (Exhibit 1).2 This is not because testing, tracing, and mask wearing don’t help, but because public consent has been limited.3 Citizens’ behaviors are based on public sentiment; people modulate their actions in line with those around them.
Make no mistake: COVID-19 is first and foremost an infectious disease. The death toll in the United States is now over 460,000,11 and broader effects on health are substantial (Exhibit 4). But many of the interventions we are using to prevent the direct impact of COVID-19 have caused substantial secondary harm, including unemployment,12 learning loss, and increases in substance-use disorders.13 The bridge to normalcy needs to be a time when we address not only the underlying issue of SARS-CoV-2 transmission, but also the restoration of our economy and the secondary effects of COVID-19.
Simply returning to the same disease-fighting protocols and infrastructure that we used before the pandemic won’t be adequate. We have the potential to establish a next-generation disease surveillance and testing infrastructure, including wider access to genomic sequencing; 21st-century data management and analysis; and closer integration between health delivery and public-health capabilities.
Courtesy McKinsey & Co. by Matt Craven, Tom Latkovic & J. VanLare