The ‘new normal’: A mask-wearing, young workforce?

Business coalition calls for huge increase in COVID-19 tests, tracing

A POWERFUL COALITION of Massachusetts business leaders has laid out an extensive roadmap for reopening the economy – but not, they warned, to return to what used to be considered normal life.

Younger, healthier people could return to work first. People able to work remotely would continue to do so. Masks would be critical, as would self-reporting of illnesses. Testing for COVID-19 would need to be drastically ramped up, so sick people – and those they contacted – could be identified and isolated.

“Our challenge is how do we reduce the rate of transmission while getting more economic activity,” said Megan Greenfield, a partner at McKinsey & Co. who helped develop the proposal.

The proposal was written by a group of health and life sciences experts and business owners, coordinated by the Massachusetts High Technology Council. The 70-page document, which was discussed Friday in a webinar with Greenfield and Steve Pagliuca, co-chairman of Bain Capital and co-owner of the Boston Celtics, lays out a framework for how to reopen the economy without leading to a second wave of illnesses that would overwhelm hospitals and require another lockdown. The group has shared its findings with a task force led by Lt. Gov. Karyn Polito that is overseeing the state’s economic reopening.

The plan is based on understanding “supply and demand” – in this case, measuring the supply of hospital beds and medical capacity against the demand of coronavirus cases. It aims to avoid a scenario like what happened in Spain, where the country reopened too quickly, then saw a spike in new cases, and shut down again.

Today, Massachusetts continues to hover around its peak of hospitalizations, and the medical system has adequate capacity, with only 54 percent of intensive care beds filled with COVID-19 patients. But Greenfield noted that that level of capacity has been possible only with a near-total economic shutdown. “We have some capacity, but we need to be very careful,” she said.

In the long-term, it will likely take a vaccine to come close to eradicating the virus, which could easily be seven to 18 months away. In the meantime, the goal is to develop treatments and keep the number of cases manageable so they can be handled without overwhelming the medical system.

A major part of safely returning to work, the business owners say, will be “segmentation” of the population, based on age, health status, and job.

Younger, healthy people would return to work first while older adults, who are most at risk of hospitalization and death from COVID-19, and people with underlying medical conditions, would continue to stay home.

There would be a gradual reopening, with a heavy emphasis on remote work. Individuals working for essential sectors – like grocery stores and transportation – are mostly already working. People in other jobs who cannot work remotely, like non-essential retail or restaurants, might return to worksites soon, while people in sectors like finance or professional services who can work from home would be encouraged to do so. There will need to be discussions about safety in businesses that require close contact, like barber shops, gyms, or nail salons.

The business officials said the process will not be straightforward. There are myriad legal questions related to non-discrimination, privacy of medical data, disability rights, and liability.

There are also practical considerations. Around 40 percent of the over-65 population lives with someone who would return to work, which could require the creation of alternative living arrangements in coronavirus hotspots. Schools and childcares must reopen to allow parents to go back to work, but those institutions will have to introduce safety precautions to avoid virus transmission and will have to figure out how to safely transport children.

Pagliuca noted that any reopening will have to account for transportation and how to limit capacity on public transit. “It’s going to be very hard to have people packed into mass transit,” Pagliuca said. There could be an effort to move people out of trains and into carpools and vans. Other countries have done things like requiring masks on public transit, something Gov. Charlie Baker ordered on Friday) or limiting capacity while letting people reserve space with an app.

Pagliuca said there is likely to be a broader reconfiguration of workplaces – for example, companies now encouraging remote work might shrink the size of their offices.

As people return to work, steps will need to be taken to reduce the spread of the coronavirus. One of the lowest cost and most effective policies would be requiring the widespread use of masks. Also important are policies that get sick workers to stay home, which could be facilitated by requiring employees to self-report any symptoms daily and by requiring employers to provide paid sick leave.

In both China and in Colorado, the government is mandating daily temperature checks for workers. Amazon and some grocery chains are taking similar steps. But the report said that instituting widespread temperature checks could be expensive and will not catch all cases. The report estimated only 64 percent of people with COVID-19 have a fever.

The other major way to reduce the spread – but the hardest to accomplish – is a massive ramp-up of testing and tracing programs, to identify who has COVID-19 and who they have come into contact with.

The report describes Massachusetts’ current testing capacity as “bare-bones”: spending around $6 million a month to conduct 10,000 tests a day primarily of people with strong symptoms. The report models several scenarios, setting as a goal a policy similar to one used in Canada of testing anyone with mild symptoms and their contacts. This could require 100,000 tests a day and cost $60 million a month.

Meet the Author

Shira Schoenberg

Reporter, CommonWealth

About Shira Schoenberg

Shira Schoenberg is a reporter at CommonWealth magazine. Shira previously worked for more than seven years at the Springfield Republican/MassLive.com where she covered state politics and elections, covering topics as diverse as the launch of the legal marijuana industry, problems with the state's foster care system and the elections of U.S. Sen. Elizabeth Warren and Gov. Charlie Baker. Shira won the Massachusetts Bar Association's 2018 award for Excellence in Legal Journalism and has had several stories win awards from the New England Newspaper and Press Association. Shira covered the 2012 New Hampshire presidential primary for the Boston Globe. Before that, she worked for the Concord (N.H.) Monitor, where she wrote about state government, City Hall and Barack Obama's 2008 New Hampshire primary campaign. Shira holds a master's degree from Columbia University's Graduate School of Journalism.

About Shira Schoenberg

Shira Schoenberg is a reporter at CommonWealth magazine. Shira previously worked for more than seven years at the Springfield Republican/MassLive.com where she covered state politics and elections, covering topics as diverse as the launch of the legal marijuana industry, problems with the state's foster care system and the elections of U.S. Sen. Elizabeth Warren and Gov. Charlie Baker. Shira won the Massachusetts Bar Association's 2018 award for Excellence in Legal Journalism and has had several stories win awards from the New England Newspaper and Press Association. Shira covered the 2012 New Hampshire presidential primary for the Boston Globe. Before that, she worked for the Concord (N.H.) Monitor, where she wrote about state government, City Hall and Barack Obama's 2008 New Hampshire primary campaign. Shira holds a master's degree from Columbia University's Graduate School of Journalism.

“In a perfect world, there would be a home test every person could take before they went to school or work using saliva,” Pagliuca said. Practically, he said, that is unlikely to happen, and the state will have to look into creating centralized testing centers and keeping an eye on new technology to find tests that are accurate, fast, and minimally invasive.

Massachusetts is already developing a contact tracing program to identify who has come into contact with someone who has COVID-19 and instruct them to self-quarantine or get tested. Today, the state has 1,000 tracers. The study estimates it will need between 5,000 and 10,000 for a full-fledged program to be effective. Digital tracing using cell phone technology could be more effective but also raises privacy concerns.