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Chris Anderson: So our first speaker
gave a TED Talk at TEDGlobal

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I think seven years ago.

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His name is Professor Uri Alon,

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at the Weizmann Institute of Science.

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Now, he and his colleagues there
have come up with a powerful idea

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that addresses this key question:

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How on earth do we get back to work

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without creating a second surge
of the infection?

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Uri Alon, welcome to TED.

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Uri Alon: Thank you.
Nice to be here again.

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CA: It's great to see you again.

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So, I guess the key to your idea

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is this obsession with
the reproduction number R, R-naught.

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If that number is less than one,

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then fewer than one person
is infected by a typical person,

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and eventually, the epidemic fades away.

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People are worried that
as we come back to work,

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R will shoot up above one again.

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You have a suggestion
for how we might avoid that.

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What is that suggestion?

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UA: Exactly.

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So, we are suggesting a strategy

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that's based on a weak spot
based on the biology of the virus,

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which is a cycle of work and lockdown.

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It exploits the vulnerability of the virus
in that, when a person gets infected,

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they're not infectious
for about three days.

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So you don't infect others
for the first three days,

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and after another two days,
on average, you get symptoms.

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So we're proposing a strategy
which is four days of work

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and then 10 days of lockdown,

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and the next two weeks, again:
four days of work, 10 days of lockdown.

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And that way, if a person
gets infected at work,

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they reach their peak infectiousness
during lockdown, and that way,

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they avoid infecting many others.

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This restricts the viral transmission.

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Also, just working four days
out of two weeks

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restricts the amount of time
the virus gets to see many other people,

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and that's a very powerful effect.

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So everybody works on the same four days,

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kids go to school on the same four days,

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with all the measures
of social distancing and masks, etc,

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and then there's a lockdown period.

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CA: So if you take
the worst-case scenario,

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where you come to work on a Monday morning
at the start of your four days,

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and you're infected on the subway,
say, on the way to work,

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the theory here is that even
by the end of that four days,

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you're not really starting
to infect your coworkers?

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UA: That's correct.

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So you're infected on the subway,

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and so for the first three days or so,
you're in your latent period,

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you don't infect your coworkers,

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you reach your peak
infectiousness at home,

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there will be secondary
infections at home,

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and people with symptoms
can self-quarantine,

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and over the long run, you have
a reproduction number less than one,

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so the epidemic,
if you continue these cycles,

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will go away.

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CA: I mean, is it frustrating

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at the thought that people
are going to say,

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"Wait -- I don't want
to infect people at home,

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I'd rather infect people
at work than at home."

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What's the response to that?

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UA: Yes, absolutely.

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So we have to consider the alternatives.

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If you open up the economy
and there's a second wave,

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you'll get all those infections anyway
during the lockdown that happens,

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along with the devastating effects
on the economy, etc.

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And so, in the long run,

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if you do a cyclic strategy like this

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but with a reproduction
number that's less than one,

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you avoid, at least with these
mathematical models and considerations,

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the much larger number of infections
you'd get if there's a second wave.

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CA: Right. You're serving the needs
of your family by -- sorry, go on.

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UA: Even people who are infected
don't infect everyone at home.

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The attack rates are 10 to 30 percent,
according to several studies.

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CA: Right.

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But the hope is that you're
serving the needs of your family

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by engaging in a strategy
where very few of your fellow workers

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are going to be infectious anyway,

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so that's the plan, but um --

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UA: That's right.

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CA: Tell me this, though --
because four days out of 14,

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someone's going to say, "Well, great idea,

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but that implies, like,
a 70 percent loss of productivity

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in the economy,

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so that can't possibly work."

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I think you think that
the productivity loss

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need not be anything like that much.

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UA: That's right,

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and of course, most people
don't work weekends,

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so it's four days out of
the 10 work days in the two weeks,

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and once you have
a predictable schedule

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of four days at work,

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you can work longer hours,

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you can design shifts
and get higher productivity

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by prioritizing in those four days

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much more than 40 percent of the workdays.

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CA: Yes, so talk through
how that could work.

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I mean, let's imagine,
first of all, manufacturing,

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which is currently shut down.

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Is the implication here
that a manufacturer could set up

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two, possibly even three
shifts of four days,

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maybe 35 hours or something of work
over those four days

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and still get a lot of productivity,

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basically, having the lines
almost running continuously that way?

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UA: Exactly.

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So this is a staggered
version of this idea,

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where you take the population,
divide it into two groups or three groups.

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Let's say one group works four days
and then 10 days of lockdown.

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Then the other group kicks in.

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This idea was proposed by colleagues
at Bar-Ilan University.

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Then you get added benefit
that during workdays there's less density.

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There's two groups.

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There's half the density
and less transmission.

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And you can keep production lines
working almost continuously like that

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using this staggered idea.

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CA: And applying it to thinking
about offices coming back --

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I mean, it seems to me that,
as we've already seen,

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there's a lot of productivity
that can happen when you're at home,

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so you could picture on this idea
of people doing one set of things

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during the four days when they're,
say, back at the office,

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doing the exposure to each other,
sparking off each other,

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the discussions, the brainstorming,
all that good stuff,

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while at home, they're then
doing all the things

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that we've been doing
the last few weeks,

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kind of working solo.

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How much have you thought about that,

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whether it's possible, effectively,
to divide work into different types

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and actually use a strategy like this

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to maintain almost full
or even better productivity?

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UA: I agree -- for many sectors,
people work at home very effectively,

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and we've heard from several industries

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that productivity actually
went up during lockdown

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and people working at home.

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So if you have a schedule, cyclic ____???
[cyclic exit strategy]

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you can restrict the amount,

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or you can plan the work
where you need to be together

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in a very effective way

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avoiding a lot of time lost,

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if the person's work
can be more effective at home

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and more effective at work
and get high productivity.

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I should say that some sectors
really need to adjust,

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like hotels, tourism, dining.

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In several industries, this will require
more thought and adjusting.

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But other industries are almost
built for ideas like this.

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Maybe it's even something
you can consider after the epidemic,

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because productivity can be
at least as high.

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CA: I mean, I read this and I started
thinking about our own organization, TED,

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and how, in many ways, you could argue
that could work really well.

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I mean, for one thing,

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there's this question
about extroverts and introverts.

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Some introverts, if they were honest,

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might say that this pandemic
has been manna from heaven for them.

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They've found work less stressful.

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They've been able to focus and so forth.

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With this sort of four days on,
four days off type strategy,

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perhaps you can imagine a work world

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that's optimized for both
introverts and extroverts?

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UA: Absolutely.

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I mean, I feel it also.

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Me and my partner,
with different personalities,

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we both teach in universities,

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and teaching through this [?]

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has [helped me] become
productive in certain ways.

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So I agree completely,

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and I think harnessing the creativity
of people at workplaces,

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we're only at the beginning
of what these kinds of mixtures can offer.

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CA: But for people who are
on the front line,

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again, if you're delivering
goods and so forth

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and you can't do that virtually,

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is there any thought about

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how a four days on
and then isolation strategy,

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how that off time could be used

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to nonetheless contribute
to that person's work

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through some form of training?

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Or is it more just that people would work
very intensely through the four days,

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and maybe people still aren't quite
earning their full pay in this scenario,

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but it's better than complete lockdown,

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and it's better than going back to work
and seeing another surge?

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UA: That's right.

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So on a society level,

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it's better than opening up
and seeing another surge,

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which would require complete lockdown.

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For people like hospital shifts,

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some hospitals adopted
this kind of program

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so we can protect shifts and avoid mixing.

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It also creates a lot
of simplicity and clarity.

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So you understand when you're working,

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and you have some confidence because
this is based on scientific modeling

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about the effectiveness of this plan.

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It's also equitable in the sense
that everybody gets to go to work,

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[but only?] [in only?][not only?]
certain sectors.

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It's transparent, etc.

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[Cross talk]

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CA: And is it something
that is best implemented

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by individual companies?

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Or is it actually much better
implemented a city at a time

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or even a nation at a time?

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UA: We think it can work [?].

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So at certain companies,
it's very natural to adopt,

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or at hospitals, schools, etc.

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It can also work at the level
of a town or a region,

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and then we would advise
trying it out for something like a month,

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seeing whether cases rise.

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In that case, you can dial down
the number of workdays.

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Or, if cases are declining quickly,
you can add workdays

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and therefore adapt to the climate
and the location where a person is.

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So it's quite adaptable.

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CA: But by aligning work schedules
with schools, for example,

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that suddenly allows parents
to go back to work

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on the days that their kids are at school,
and you'd have to try --

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UA: Absolutely.

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CA: I mean, is the best
instantiation of this

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that countries literally divide households

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into different A and B categories,
or something like that,

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so that that kind
of alignment could happen?

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UA: Exactly.

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So you can align different
households, Group A and Group B,

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and then the children go to school,
the parents go to work

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in a synchronized way,

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and the other group,
let's say, the alternating weeks.

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A certain amount of people
need to work all the time.

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Maybe teachers are, like, essential
workers and need to work throughout.

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Just like during lockdown situations,

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a certain fraction of the population
still works throughout.

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But a region that does this
should be protected, in a sense,

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because it has a replication
number of less than one,

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so imported infections
also can't spread very much.

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CA: And here is the aforementioned
David Biello. David.

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David Biello: Yes. Hello, everybody.

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Uri, as you can imagine,
there are lot of questions

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from the audience,

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and we have a first one

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kind of about those workers
who have been marked as essential.

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Can you comment on how this would impact
the health care professionals and others

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who may not have time
or the flexibility to quarantine

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in the way you suggest.

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UA: That's great.

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I want to say that
there's essential workers,

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there's people with low income,
that just can't adhere to lockdown

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because they have to make a living.

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And studies show that mobility
[among] people in the low-income sectors

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is larger during lockdown.

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And also, in developing countries,
people just have to go out of the house.

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You can't enforce lockdown.

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So this four-10 kind of strategy can
actually make lockdown easier to bear

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for people who can still
make a living during those days,

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or at least make their own choices

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about what fraction to work
and what fraction to stay in lockdown.

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Some countries can't get
R less than one even with lockdown,

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because of this adherence problem
[in formal sectors] [because of informal sectors,] etc.

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We believe that a four-10 cycle
might make it easier to do lockdown

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and maybe get our infection
level less than one.

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That affects billions
of people in the world.

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I hope I answered your question.

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DB: I think so,

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and we have another question, I believe,

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if that can be queued up,

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which is:

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Any chance you can do the math

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and quantify the increased risk
of this four-10 cycle?

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UA: So the increased risk,
we're saying in our scientific paper,

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we did all the sensitivity analyses, etc,

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and the question is, it's comparing
increased risk comparing to what?

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So, to the economy:

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it's possible there will be a second wave.

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I mean, I hope there won't be,
but it certainly is possible,

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and in that case, it's clear
that a second wave and another lockdown

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will have worse consequences on health

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than a cycle of four-10.

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And so it's really a question of
what you're comparing to.

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DB: Sure.

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Well, thank you so much
for sharing this idea, Uri.

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CA: Indeed.

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David, stay on.

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But just before you go:

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Have any governments
expressed interest in exploring this?

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Do you see people considering
actually implementing this

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as national policy?

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UA: Yes, we're in touch
with several European countries

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and countries in South America
and Israel, of course.

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Austria has adopted a similar program
for their school system,

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which is five school days every two weeks.

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And several companies and hospitals, etc.

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And so we're very interested
to see how this will play out.

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CA: Well, I love the basic start point

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of starting by looking
at the enemy's weakness.

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And you've got this four-day period

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where it's not necessarily
that dangerous after an infection,

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if you could figure out
a way to work then.

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I assume that testing would actually
enhance this idea as well a lot, right?

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To test people before they come back --

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UA: It's not predicated on testing.

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You don't have to have
testing for this idea,

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so that can apply to regions
without a lot of testing.

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If you do have testing, it could help you
use testing in a more effective way

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by concentrating testing on people
at the end of their 10 lockdown days,

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just as they're about to go to work;

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that could make
each test more impactful

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in terms of reducing
their reproduction number.

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CA: Indeed, instead of having
to test the whole population

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every three or four days,

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it's just once every two weeks.

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That's a much more imaginable goal.

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UA: Sure.

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CA: Yeah.

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Well, Uri Alon, thank you so much
for spending this time.