thoughts on planning for the next phase of the COVID-19 pandemic

CAMBRIDGE CITY COUNCIL Quinton Y. Zondervan City Councillor MEMORANDUM To: Cambridge City Council From: Quinton Y. Zondervan, City Councillor Date: April 9, 2020 Subject: Thoughts on planning for the next phase of the COVID-19 pandemic Dear Colleagues, As ​explained​ by our own local expert, Juliette Kayyem, the COVID-19 pandemic is going to last for at least another 18 months, as October 2021 is the earliest possible date we could hope for a widely available vaccine. Until then, our only choice is to use mitigation ​strategies​, also known as “nonpharmaceutical interventions” or NPI, per the U.S. Center for Disease Control (CDC). When there is widespread community transmission, as is currently the case in the U.S. generally and in Massachusetts and Cambridge specifically, these strategies include “suppression” actions that seek to prevent transmission by maximally limiting physical interactions between people. Right now we are in this suppression phase, where we need to starve the virus of human bodies to infect by socially isolating, thereby hopefully flattening the ​curve ​and keeping our hospitals from running out of supplies and healthy staff. We have shut down our lives to prevent as much widespread transmission of the virus as possible, and it may be ​working​. Soon hospital case loads will reach a “peak”, the severity and duration of which will be determined by how well social distancing measures were and are being implemented. The better we follow social distancing measures, the more the peak will be spread out over time, but at a lower (and hopefully manageable) intensity level than if we had not followed or poorly followed those measures. The virus spread rapidly in New York City, and they are now ​entering​ their peak. In New Orleans, the annual Mardi Gras celebration that went on as planned may have ​facilitated​ a more rapid spread of the virus. At some point, case loads will start to decline and we will be able to enter a less intense mitigation phase where we will have the option of relaxing some of the important social distancing measures that have 1

CAMBRIDGE CITY COUNCIL Quinton Y. Zondervan City Councillor devastated our lives and the economy. However, we will have to be extremely careful. If we do suppression well, we will leave the peak with around 95% of our population remaining ​unexposed​ to the virus. This means that as we loosen restrictions, almost everybody will remain vulnerable to infection, should it be reintroduced or remain in circulation at a low level. This also assumes that people who have recovered are somewhat immune to reinfection, which is also not fully ​established​ yet. As a result of this reality, things simply cannot go back to our previous normal, at least not until we have a widely available vaccine. Our new normal will require us to keep a sharp eye out for the virus, through extensive testing and limited travel. We will have to quickly isolate any new cases that are introduced, and it will be important to protect our most vulnerable residents by limiting their potential exposure as much as possible. We will also need to continue limiting our social contacts to some extent, not only to reduce the chances of transmission, but also to make it easier to track down and isolate new infections via “contact ​tracing​”. If the virus were to start spreading widely again here in Cambridge or in nearby communities, we would immediately need to shut everything down again and go back into suppression in order to prevent disaster. The collective sacrifice that is necessary during a suppression phase is simply untenable if repeated too many times in quick succession. Therefore, it is crucially important that we implement the right mitigation strategies post suppression. Since it won’t be completely our call as to when things will begin to rev back up, it is important that we begin considering what every aspect of our life needs to look like during this new normal, in order to prevent another outbreak requiring suppression while we await a vaccine. We need to be ready to implement that new normal the day the Governor decides to lift his Stay at Home order, whether that be on May 4, 2020 or some later date. As chair of the Public Safety Committee, I intend to schedule a series of virtual committee hearings to begin exploring options and strategies for organizing our community during the mitigation phase so as to minimize the need to go back into suppression. We need to work with public health, public safety, and other experts to deeply explore various topics related to our daily routines and how they may need to be altered. I plan to start with our food supply chain and distribution system, which is obviously critical to our health and safety. Right now we have a good solution in place for people who are food challenged, if we can reach them, thanks to the hard work of Councillor Mallon and our partners at Food for Free. We have the beginnings of a solution for high-risk individuals who are unable to safely go shopping themselves, 2

CAMBRIDGE CITY COUNCIL Quinton Y. Zondervan City Councillor thanks to the Cambridge Mutual Aid network. But for everyone else, the situation is untenable. Grocery delivery and pickup services have struggled to keep up with demand and the stores themselves are not able to provide a safe and comfortable experience for workers and shoppers, no matter how hard they try. Grocery store workers around the country are ​beginning to die​ from exposure to the virus, and a Whole Foods employee here in Cambridge recently ​tested​ positive for the virus. How do we get from here to a place where everybody can safely obtain the food they need, and where the workers are not being put at extreme risk every shift? That is what we will explore in this hearing. We need to rethink a lot of assumptions and figure out how to organize a food distribution system that ensures equitable and safe access to food for everyone as we transition from suppression to mitigation of the covid-19 coronavirus pandemic. I hereby invite my colleagues’ thoughts and suggestions on this proposed hearing and on future hearing topics so that we can begin to plan ahead for the new normal that we are anticipating will arrive hopefully soon. Other standing committees may also want to explore related topics as appropriate. Best, Councillor Quinton Y. Zondervan 3