As the COVID-19 pandemic spreads, it is not too early to start planning for the future. How do we keep people safe, continue to treat those effected by the virus, and yet make plans for emerging from the crisis?

A report released yesterday by Scott Gottlieb, M.D. and colleagues at the American Enterprise Institute outlines a plan to transition out of the crisis. (here) Dr. Gottlieb is the former head of the Food and Drug Administration and remains very active in the world of health care policy.

The authors list their plan in four phases:

• Phase 1 – Continue the aggressive current treatment plan, including social distancing, expanded testing, massive increase in equipment production, and the necessary support for hospitalized patients.
• Phase 2 – Gradual reopening of regions of the country. The authors support a state-by-state plan, but this could also be a county-by-county or city-by-city reopening. The critical considerations are that testing must be very robust and that the virus must have run its course in that particular region. Schools and businesses could reopen during this phase, although precautions such as vigorous hand washing and common sense social distancing should continue.
• Phase 3 – This is really the critical phase. This is when it is safe to lift all social distancing restrictions. The authors believe that this phase is dependent upon the use of effective treatments and potentially the use of an effective vaccine.
• Phase 4 – This is the long-term phase where the country plans for better preparedness for the next crisis.

These are common sense recommendations and provide a road map for elected officials and the medical community. The United States is currently heavily involved in Phase 1 and the reality is that there is no predictable time line in the crisis. Yet if we look at the experience in China, we know that the crisis will pass. It is reasonable and forward thinking to have a plan for the U.S. once the number of new cases of COVID-19 tapers down.