Families are hunkered down at home. Workplaces are shuttered. Handshakes and hugs are out. The 6-feet rule is common. But for how long? Credit: Newsday / Thomas Maier

Social distancing — the most effective weapon so far in combating the coronavirus — will be at the heart of a public health gamble designed to guide Long Islanders' return to work, school and other vital aspects of life without driving up the death toll.

Families are hunkered down at home. Workplaces are shuttered. Handshakes and hugs are out while masks and gloves are in. The 6-feet rule has become commonplace. But for how long?

Without a vaccine or effective treatment for COVID-19, public health experts expect authorities to allow people to venture out gradually after infection rates drop to levels deemed acceptably safe — provided extensive social distancing policies remain in effect, many of them fundamentally altering the quality of life.

At that point, authorities will measure the effectiveness of social distancing against admissions to hospital intensive care units, researchers say. If admissions of severely ill people spike after restrictions are eased, then more lockdowns would likely be required.

Pandemic researchers have estimated, for example, that people will have to reduce their social contacts with others by 65% to 75% from pre-COVID-19 levels.

That would translate to continuing steep reductions in everything from family time together to airline travel — especially for those at the highest risk of dying from the disease because they are older than 60 or have underlying health problems.

At the same time, the use of masks and hand-washing would remain ever present, and mass gatherings at arenas would, for the time being, remain a thing of the past.

“We’re going to be living with this for at least the next year, and people’s lives will be shaped by it, and impacted by it, for many months to come,” says Joshua Michaud, associate director for Global Health Policy at the Kaiser Family Foundation in Washington, D.C. “I think this will have a lasting impact on our lives until we get to the point where we have a vaccine.”

The Centers for Disease Control and Prevention’s social distancing guidelines urge Americans to avoid gathering in groups, work from home when possible and stay away from crowded places.

To avoid unnecessary contact, the CDC recommends that people consider using mail-order medications and a grocery delivery service for food and that students rely on “digital/distance learning” by computer arranged with schools and teachers.

“Since people can spread the virus before they know they are sick, it is important to stay away from others when possible, even if you have no symptoms,” the agency advises. “Social distancing is especially important for people who are at higher risk of getting very sick,” such as the elderly and those with an underlying illness.

Though their timetables differ, federal and state officials say they expect the return to work to be phased in slowly, with small businesses joining those “essential workers” already at grocery stores, gas stations and other vital services that never closed.

Maura Calsyn, managing director of Health Policy for the Center for American Progress, a progressive nonprofit think tank, worries that America may be ripe for more infection if social distancing rules are relaxed too quickly.

Because New York has been a hot spot for more than a month, it's smart to plan an end to the social-distance lockdown, despite not having enough data "to say when," Calsyn said.

"You can't just open up on hunches," she said.

Former Food and Drug Administration Commissioner Scott Gottlieb and colleagues at the American Enterprise Institute foresee extended use of face masks.

"Everyone, including people without symptoms, should be encouraged to wear nonmedical fabric face masks while in public," they have recommended.

"The CDC should issue guidelines on the proper design of such nonmedical fabric face masks. Consumers may be able to fashion these masks themselves using available washable materials, or they may become available in the consumer marketplace."

A national supply of more sophisticated N95 masks, gloves and other protective equipment must be ensured for everyone working in a health care setting to avoid infection, they added.

Overall, Gottlieb's group says the elderly and other vulnerable people with underlying disease or suppressed immunity need to be more carefully protected.

Earlier this month, Calsyn's Center for American Progress noted that America was slow to act on physical distancing measures to keep the virus at bay, with "deep differentials between states that have implemented stay-at-home orders and those that have not."

Her group sees the need for even greater physical protections as infection rates fall. For instance, they said, bus drivers must have a protective separation from riders, and airports must limit terminal access to ticketed passengers only.

"Transportation workers — including ticketing agents, Transportation Security Administration (TSA) screeners, flight attendants, bus drivers, and subway workers — are essential front-line workers who must be provided with N95 respirator masks, gloves, and paid sick leave," Calsyn and her colleagues wrote.

Calsyn's group cited studies showing that standard surgical masks provide about twice as much protection as homemade masks, and that N95 respirator masks provided about 50 times as much protection as homemade masks.

In an interview, Calsyn said a resurgence of cases is likely later this year and that the public has to “realistically expect we will have additional close-down measures” if that occurs.

Keeping up the current social distancing rules will be crucial, she said.

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