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There are many uncertainties and details. How fast can the
system track and isolate infected individuals? What limits on big
gatherings should remain to prevent “super-spreading” of the
virus? Yet the basic logic should be clear: the lockdown phase must
be followed by a containment phase based on the public health
system. There’s also the important factor of asymptomatic indivi-
duals, who, could make up as much as25%of all infected indivi-
duals, according to the director of the Centers for Disease Control
and Prevention.
While some of these people may be caught by contact tracing
and tested, others will not. To compensate for asymptomatic trans-
mission, a high proportion of the symptomatic individuals must
isolate early, either through contacts by the public health system or
by their own initiative.
Europe and the US did not have effective public health systems
in place at the start of the pandemic. In contrast, some countries in
East Asia, such asSingapore,Hong Kong, and Taiwan,have highly
effective public health systems, with experience after the2003
SARS outbreak.By taking a proactive approach to testing and trac-
king the infection, and by promoting personal hygiene (such as
hand washing) and widespread temperature monitoring, they by
and large succeeded in isolating a significant share of infections.
As a result, they have so far kept the confirmed cases per 1 million
populationfar belowthe levels of the US and Western Europe.
The great challenge for the US and Europe, in addition to saving
the lives of those infected with Covid-19 and helping society to
adhere to and cope with the lockdown, is to shift from lockdown
mode to public health containment mode as rapidly as possible.
During the coming weeks we must build up the public health sys-
tems across the nation. Every city, every community, needs to scale
up the capacity to test, trace and isolate infected individuals. The
federal government needs to create incentives (such as guaranteein-
gpaid sick leaveto cover all working people with no exceptions)

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