Over the next 10 days, there will be a massive clamor to remove restrictions on social distancing and “re-open” certain less impacted states. Putting aside what we need for “re-open” to occur (much ink has been used for that), what does “re-open” mean for regular life?

Can kids go to birthday parties? Can we have dinners with friends? Can people go to church? Well this MMWR study from the last few days implies no. A single index case in Chicago led to 16 infections and 3 deaths with an incubation period of 4 days.

The precipitating events were 1) sharing a takeout meal 2) attending a funeral 3) attending a birthday party 4) attending church services https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e1.htm

That’s pretty much the average weekend (ok maybe not the funeral) for 70 percent of the US population. So when people talk about “re-open” what do they actually mean practically?

I’m purposefully avoiding topics like antibody “passports” and ubiquitous 3 hour testing and vaccines because that ain’t around the corner - sorry to be the bearer of bad news. So then re-opening means some people go to work in masks and gloves? They don’t socialize with others?

Anyway, our minds love binary concepts like “open” and “closed”. I would just suggest that there is no such thing as “re-open” even in states like Wyoming or Minnesota with low case numbers. There is only a new concept of what open means. And it’s not at all life as usual.

This will be very challenging for governors and local public health people to create policy around and to convey - especially in lesser impacted states at present. In the current fractured environment, it will derive from and itself lead to even more polarization.