What we do next will change our tomorrow. U.S. unemployment rates have reached double digits and could rise to depression-levels or more soon enough. Peak infection rates appear to be in reach, but leaders are weary to reopen regions of the country for fear of new outbreaks. We are inexorably locked between a severe economic crisis and a severe health crisis. Reopening the American economy would relieve some of this pressure, but this is not as simple as putting people back to work. We also need to reopen schools, airports, public venues and provide critical information to the medical community. How do we do that without putting lives at stake?
A patchwork of existing programs will, sadly, not get us there fast enough. Testing alone isn’t enough. Rolling shutdowns can be brutal. We are on verge of settling for less, when we don’t need to.
The economy will reopen in two phases. Phase one, we are in today, is marked by individuals who have had COVID-19 and recovered. These people will be our front-line “safe workers” who have acquired the antibodies through illness and can return to “normal life” with little risk. Of course, this list will grow as more people recover. Phase two will occur months from now when a vaccine becomes widely available and everyone else will have acquired the antibodies. Based on public timetables these two phases could last two years or more.
If we want to restart the economy sooner rather than later, we need a mechanism to know who has the antibodies and who does not. We need to certify individuals and share this certification as needed to return to work, school, travel, etc. We can also certify people who have tested negative for the virus. These people can be placed into jobs that are safe for them and the people around them. This distinction will help to quickly identify who needs the vaccine and who does not.
How will employers return employees back to work without knowing who is or is not immune? What policies do they need to implement and how will they keep other employees and customers safe? How will airlines return passengers onto airplanes safely and securely while keeping other passengers and airline/airport employees safe? When can students return to school? These are the tough questions leaders are facing.
The solution is the development of a coronavirus-immunity registry or CIR. Think of it like any app you have on your smartphone or a website you visit through a browser. You will download it from the app store and sign-in. It will be easy to use just like many apps we already use today. The app will protect your privacy and be compliant with important privacy laws like HIPAA. The medical providers will input your immunity records into a database and the app will provide you with an immunity certification when you authorize it. It will provide comprehensive anonymous reports that allow leaders and health officials to make critical, timely decisions and track changes in outbreaks. Americans will own the use of their own records.
Other countries, which are far less concerned with privacy have successfully “certified” safe workers in order to restart their economies after a period of quarantine. The results are dramatic. However, draconian surveillance tracing systems will not pass the approval of American citizens and those who fear the government will use a pandemic as an excuse to restrict civil liberties. Nor will they appreciate “contact tracing” which has been proposed by large tech companies to utilize low power Bluetooth technology on your phone to track people you’ve been in contact with.
Call centers have been proposed by Massachusetts officials that will employ 1,000 people to perform a different form of contact tracing, a phone call. This solution is quick to set up but will likely fall far short of providing an adequate response rate, accurate information and critical data that is needed to make important decisions.
Some states have suggested building their own systems or using legacy software that were designed for tracking children’s vaccines for schools. A patchwork of state and local data sets will take too long to build and deploy and require integrations with multiple legacy systems that will not adequately prevent hacking or allow for scale.
Unlike all of these ideas, a CIR works like a hub & spoke bicycle wheel. Important incoming information like COVID-19 test results, vaccination records, and contact tracing data are the spokes coming into the CIR hub, and important outgoing information like immunity certificates and high-level reports are the spokes going out.
We already certify workers for certain jobs including doctors, finance professionals, food workers, etc. and can leverage this infrastructure where appropriate. Having this system in place, will provide critical data that will help rapidly detect re-emerging outbreaks and reinforce contact tracing. We can do this in a matter of weeks.
Our actions today will define us. Building the CIR will allow all of us to mitigate the enormous impact to our economy and reduce the spread of COVID-19. Government leaders and technology executives must combine their ingenuity and resources to addresses perhaps the most critical need of our generation. The country is counting on us to get this done.