If reason finally prevails over panic, policy makers will reopen schools and focus on the vulnerable.

By Joseph A. Ladapo
Sept. 16, 2020 11:58 am ET

The battle against Covid-19 is entering a new phase, and the choice for society is whether to live with the virus or to live for it. This new phase has been marked by four developments: Many states have weathered post-shutdown outbreaks and case counts are falling; the percentage of Americans saying the pandemic is worsening peaked in July and is trending down, according to Gallup polling; the culture wars over lockdowns and distancing mandates are cooling; and inexpensive rapid testing and a vaccine will soon be available widely. These developments create an atmosphere of possibility—and an opportunity to pivot away from the fear-fueled policy-making that has characterized the pandemic.

Policies forged in fear and panic have wrought tremendous damage in exchange for benefits that were attainable at a much lower cost. Over the past six months, we have managed to sow vicious conflict over health mandates among people who would otherwise be cordial; erode age-old social customs, like visible smiles and human touch, which are critical to social cohesion and personal well-being; and condemn millions of Americans to financial instability, depression and even domestic violence.

The collective goal of this new phase should be to avoid repeating the mistakes of the past. When faced in March with the choice between imposing limited shutdowns to buy hospitals time and increase capacity, and enormous, indefinite shutdowns that ignored societal and economic costs, most political leaders chose the latter. When faced in May and June with the choice between embracing policies that balanced Covid-19 prevention with the activities that give life meaning and policies that sowed distrust and stirred fierce passions over civil liberties, most political leaders chose the latter. We have the opportunity to choose differently this time.

Some signs point toward institutions shifting away from fear-fueled decision making. The Centers for Disease Control and Prevention issued guidance last month that contacts of persons with Covid-19 “do not necessarily” need testing if they are asymptomatic. Early testing among those infected with the virus may yield false negatives, and testing vulnerable adults and their contacts is far more valuable than testing healthy young adults. The CDC now recommends focusing tests where they are likely to yield the greatest public-health benefits.

The good sense of this recommendation is so plain, it is almost stupefying. Where is the controversy in placing disproportionate energy and attention on populations that are disproportionately at risk for harm from Covid-19? Residents of nursing homes and other long-term care facilities—who represent less than 1% of the U.S. population—have comprised nearly half of deaths from Covid-19. A recent study in Annals of Internal Medicine reported that the infection fatality rate in noninstitutionalized persons under 40 was 0.01%, compared with 1.7% among people older than 60—a nearly 200-fold difference. Sensible policies focus special attention on populations facing the greatest harm.

The criticism the CDC has received underscores the determination of too many leaders and health officials to continue choosing fear-fueled policy-making. Consider the facts: The average Covid-19 transmission rate to close contacts is roughly 10% or 15%. The actual number of infections may be six to 24 times the number of reported cases, according to a July study in JAMA Internal Medicine. It would be impossible to close the wide gap between detected and undetected cases without resort to authoritarianism. It’s clear that testing low-risk contacts is a low-value activity.

But critics of the CDC’s new recommendation subscribe to the belief—knowingly or not—that all attempts to stop Covid-19 transmission are worthwhile, no matter how small the benefit or how high the cost. Increased public recognition of—and scientific support for—sensible policies will steer us away from destructive decisions fueled by fear.

There is also an opportunity to revisit decisions about schooling made by educational institutions at every level. College administrators in Ohio are expending substantial energy trying to stop young people from socializing; high schools in Georgia are being pushed toward closure due to mass quarantining; and intricate plans are being drafted for young children—for whom the virus is less harmful than seasonal influenza—in districts such as Los Angeles.

Placing disproportionate focus on Covid-19 transmission in low-risk populations leads to unwise decisions that do more harm than good. A wiser investment would focus on protecting vulnerable populations, including older teachers, family members and essential employees, by directing testing and personal protective equipment to them and their close contacts. Early outpatient therapies for Covid-19 may also prevent serious illness in these populations, as described in a recent American Journal of Medicine article.

The CDC’s quarantine guidelines for healthy, low-risk students should be revisited in light of the outsize effect quarantines have on their educational experience—and the possibility of perpetual quarantining for exposed students if testing is performed frequently. University policies for Covid-19 prevention also have an edge of cruelty: Many of these administrators suspending students “caught” socializing would have been doing the same 30 or 40 years ago.

The point of life is living, and everyone is better off with policies that focus on protecting the most vulnerable populations. That doesn’t take universal rapid testing or never-ending mandates. It requires only abandoning fear, being sensible about who is targeted for testing and protections, expanding treatment capacity and therapies—and choosing to live with the virus, rather than to live for it.

Dr. Ladapo is an associate professor at UCLA’s David Geffen School of Medicine.