Opinion | The United States Needs a ‘Smart Quarantine’


If we inspire, inform and mobilize the public, we can accomplish the needed separations mainly voluntarily and always in a way that respects civil liberties to the highest degree possible while protecting the public’s health (and the nation’s economy).

In a smart quarantine, anyone in a family who is not well — and if you’re sheltering in place, whomever you are with is considered “family” — must get tested and be separated from the family until results return. While awaiting results, the separated family member can move into temporary accommodations overseen by medical professionals and be tested.

Those that test negative remain in quarantine in their accommodations, and if they test negative again at 14 days, they can return home, where they must continue to shelter in place. Those that test positive leave their temporary accommodations and enter a more formal Covid-19 recovery facility. Most of these people will recover and will be sent home in about two weeks after testing negative at least twice. People who get worse will be sent to an acute care facility.

In a tiered system like this, only those that need critical care would be sent to regular hospitals and intensive care units. This would allow us to avoid many of the serious shortages — I.C.U. beds, ventilators, personal protective equipment, health care workers — that we’ve seen in places like Italy and New York City.

Currently, most people in the United States with Covid-19 are not offered care until their condition is critical, which is often too late. A smart quarantine, by contrast, allows people to receive medical care in a professional facility as soon as they feel ill. Because severe cases are identified and treated earlier, fewer people die.

Beating the coronavirus will take great effort and require deep sacrifice and rapid mobilization — and doing so properly requires a smart quarantine. Any other approach exacts a price none of us wants to pay.

Harvey V. Fineberg is the president of the Gordon and Betty Moore Foundation and a former president of the National Academy of Medicine. Jim Yong Kim is an infectious disease doctor and a former president of the World Bank. Jordan Shlain is an internist and entrepreneur.

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