A COVID-19 "exit" strategy to end lockdown and reopen the economy

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

I think seven years ago.

That is Professor Uri Alon

at the Weizmann Institute of Science.

Now, he and his colleagues there

have come up with a powerful idea
that addresses this key question:

how on earth do we get back to work

without creating a second surge
of the infection?

Uri Alon, welcome to TED.

Uri Alon: Thank you. Nice to be here.

CA: It's great to see you again.

So I guess the key to your idea

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

If that number is less than one,
then fewer than one person

is infected by a typical person,

and eventually the epidemic fades away.

People are worried that
as we come back to work,

R will shoot up above one again.

You have a suggestion
for how we might avoid that.

What is that suggestion?

UA: Exactly.

So we are suggesting a strategy
that's based on a weak spot

based on the biology of the virus,

which is a cycle of work and lockdown.

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

they're not infectious
for about three days.

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

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

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

and then 10 days of lockdown,

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

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

they reach their peak infectiousness

during lockdown,

and that way they avoid
infecting many others.

This restricts the viral transmission.

Also, just working
four days out of two weeks

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

and that's a very powerful effect.

So everybody works on the same four days,

kids go to school on the same four days,

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

and then there's the lockdown period.

CA: So if you take the worst case scenario

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

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

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

you're not really starting
to infect your coworkers?

UA: That's correct.

So you're infected on the subway,

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

you don't infect your coworkers,

you reach your peak
infectiousness at home,

there will be secondary
infections at home,

and people with symptoms
can self-quarantine,

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

so the epidemic,
if you continue these cycles,

will go away.

CA: I mean, is it frustrating
at the thought that people

are going to say, "Wait, I don't want
to infect people at home.

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

What's the response to that?

UA: Yes, absolutely.

So we have to consider the alternatives.

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

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

along with the devastating effects
on the economy, etc.

And so, in the long run,

if you do a cyclic strategy like this
but with a production number

that less than one, you avoid,

at least with these mathematical
models and considerations,

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

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

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

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

CA: Right. But the hope is that
you're serving the needs of your family

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

are going to be infectious anyway,

so that's the plan.

UA: That's right.

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

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

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

in the economy,

so that can't possibly work."

I think you think that
the productivity loss

need not be anything like that much.

UA: That's right,

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

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

and once you have
a predictable schedule at work,

and once you have a predictable schedule,

four days at work,

you can work longer hours,
you can design shifts

and get higher productivity
by prioritizing in those four days

much more than 40 percent of the workdays.

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

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

which is currently shut down.

Is the implication here
that a manufacturer

could set up two, possibly
even three shifts of four days,

maybe 35 hours or something of work
over those four days,

and still get a lot of productivity,

basically having the lines
almost running continuously, that way?

UA: Exactly. So this is
a staggered version of this idea,

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

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

Then the other group kicks in.

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

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

There's two groups.

There's half the density
and less transmission.

And you can keep production lines
working almost continuously like that

using this staggered idea.

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

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

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

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

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

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

the discussions, the brainstorming,
all that good stuff;

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

that we've been doing
the last few weeks,

kind of working solo.

How much have you thought about that,

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

and actually use a strategy like this

to maintain almost full
or even better productivity?

UA: I agree. For many sectors,
people work at home very effectively,

and we've heard from several industries

that productivity actually
went up during lockdown

and people working at home,

so if you have a schedule,

you can restrict the amount,

you can plan the work
where you need to be together

in a very effective way

avoiding a lot of time lost,

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

and more effective at work
and get high productivity.

I should say that some sectors
really need to adjust,

like hotels, tourism, dining.

Several industries will require
more thought in adjusting.

But other industries are almost
built for ideas like this.

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

because productivity can be [?]

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

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

I mean, for one thing,

there's this question
about extroverts and introverts.

Some introverts, if they were honest,

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

They've found work less stressful.

They've been able to focus and so forth.

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

perhaps you can imagine a work world

that's optimized for both
introverts and extroverts?

UA: Absolutely.

I mean, I feel it also.

Me and my partner,
with different personalities,

we both teach in universities

and teaching through [?] has become
productive in certain ways.

So I agree completely,

and I think harnessing the creativity
of people at workplaces,

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

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

again, if you're delivering goods

and you can't do that virtually,

is there any thought about

how a four days on
and then isolation strategy,

how that off time could be used

to nonetheless contribute
to that person's work

through some form of training?

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

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

but it's better than complete lockdown

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

UA: That's right.

So on a society level,

it's better than opening up
and seeing another surge

which would require complete lockdown.