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Win The Fight: Crush and Contain for Safer Reopening

Of the different patterns that have emerged in governments’ fight against coronavirus—crush and contain is the most effective. While many countries missed the initial opportunity to crush and contain, it is critical that governments prepare now to make sure they don’t miss the opportunity again.

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Win The Fight: Crush and Contain for Safer Reopening

  1. 1. Crush and Contain for Safer Reopening
  2. 2. The fight against COVID-19 will be long— we are still in its early days Source: BCG analysis. 1 Estimated timeframe for a safe and effective vaccine to be developed, manufactured, and delivered on a wide scale to minimize disease risk. Economic activity Health care system capacity Critical care patients Time We are here Flatten Fight Future Re-start: Mid-May/ late-June 2020 Disease risk minimized: Q1 2022 +/- 6 months1 Vaccine: Late 2020/ Early 2021
  3. 3. Three patterns have emerged in governments’ COVID-19 response—crush and contain is the most effective Virus was crushed and contained Flattened but cases resurging Cases still rising or at high levels Seven-dayrollingaverage Jan 01 Oct 01Jul 01Apr 01 Jan 01 Oct 01Jul 01Apr 01 Jan 01 Oct 01Jul 01Apr 01 South Korea New Zealand Taiwan Spain France Germany United States Brazil India Sources: Johns Hopkins CSSE, Our World in Data, BCG analysis. Note: China excluded from crushed and contained graphic due to a much earlier outbreak than South Korea, New Zealand, and Taiwan. 0 20 40 60 80 100 120 140 160 180 200 220 240 0 20 40 60 80 100 120 140 160 180 200 220 240 0 20 40 60 80 100 120 140 160 180 200 220 240
  4. 4. Many governments missed the opportunity to crush and contain. They should prepare now to make sure they don’t miss that opportunity again.
  5. 5. When governments need to bring the virus under control, they can crush it with short-term lockdown measures Source: BCG analysis. Limit interactions • Trigger localized general lockdown Ensure safer interactions • Develop guidelines by industry • Enforce mask wearing Protect borders • Prohibit traveling in and out of region Monitor the virus • Build virus monitoring system • Build testing and tracing capacity and process Amplify medical response • Increase hospital capacity, supplies, and PPE • Develop system to track demand and supply needs Protect the vulnerable • Make shelter-in-place more sustainable • Ensure vulnerable have income and food security
  6. 6. Limit interactions • Start opening low-risk activities with high economic or social value (e.g., restaurants with outdoor seating, public transport), then progressively open riskier activities Ensure safer interactions • Roll out activity-based guidelines (e.g., no tables of >5 in restaurants, continuous health screening when entering hotels) • Enforce mask wearing • Ensure physical distancing (e.g., six feet apart) Protect borders • Enforce mandatory quarantine for new entrants (except from green zones) • Test and trace travelers • Track itinerary and movement of travelers Monitor the virus • Conduct and optimize effective testing strategy (e.g., pooled testing, individual testing) • Implement full contact tracing using test and location data to trace, treat, and quarantine Amplify medical response • Effectively distribute medical supplies, treatments, and PPE, and ensure access for the most vulnerable Protect the vulnerable • Distribute masks to vulnerable • Prioritize testing for vulnerable • Make shelter-in-place more sustainable • Ensure vulnerable have income and food security • Enforce guidelines in congregate living facilities When cases are stable and manageable, governments can contain the virus with these policies Source: BCG analysis.
  7. 7. COVID-19 hits two groups of people especially hard HEALTH VULNERABLE UP TO People older than 65 with underlying health conditions (roughly 30% of the US population) Higher hospitalization rate for those older than 65 with preconditions versus healthy adults under 65 EXPOSURE VULNERABLE People living in dense settings or unable to work from home, especially in communities of color 30x Higher infection rate for persons of color versus white Americans, which explains nearly all of the difference in fatality rates ~2-3x Sources: CDC; BRFSS; COVID Tracking Project; BCG.
  8. 8. 1 Governments can protect the vulnerable by adopting six cost-efficient policies Reduction in hospitalizations (%) 5 6 4 3 2 1 Ideal1 Effective1 Mandate wearing face coverings in public spaces Provide high-quality masks to vulnerable people and ensure they are worn Skew sentinel testing to the most health vulnerable people, those in close contact with them, and communities of color Support sheltering in place by providing food, counseling, and social connections Accommodate vulnerable people who cannot work from home by enabling employer innovation and supporting shelter-in-place for the most vulnerable Enforce congregate living best practices and standards Combined impact of all six policies Sources: Ycharts Indicators; Gallup; PEW; NPR; BCG analysis. 1 Ideal represents 80% compliance of a given intervention for vulnerable people (50% for broader public), while effective represents 50% compliance for vulnerable people (33% for broader public); studies suggest current compliance range of 33%-50% for mask wearing. –47 –15 –27 –12 –10 –3 –3 –89 –40 –48 –25 –19 –10 –9 Policiestoprotect thevulnerable Broader public
  9. 9. Protecting the vulnerable could reduce overall hospitalization levels and enable widespread reopening Source: BCG analysis. 1 Assumes that schools and businesses reopen but basic social distancing measures (for example, limiting interactions to less than pre-pandemic levels and banning mass gatherings) remain in place throughout the duration of pandemic; this is a US average. 2 At 50% compliance. Studies suggest that current compliance with mask wearing ranges from 33% to 50%. Hospitalizations Reopening Full reopening Including mass gatherings Reopening1 schools and some businesses; no mass gatherings Five policies to protect health-vulnerable2 While reopening schools and some businesses; no mass gatherings Five policies to protect vulnerable, plus general face-covering mandates2 While reopening schools and some businesses; no mass gatherings ICU capacity Reopening requires some restrictions on general public and high compliance levels
  10. 10. If governments commit to this high-return strategy for a safer reopening, they can contain the virus without reverting to lockdowns.