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Column: Managing COVID-19 starts with managing expectations

Karl Kim, Ph.D., is professor of urban and regional planning at the University of Hawaii-Manoa, and executive director of the National Disaster Preparedness Training Center.
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Karl Kim, Ph.D., is professor of urban and regional planning at the University of Hawaii-Manoa, and executive director of the National Disaster Preparedness Training Center.

Responding to crises and disasters involves first and foremost the management of expectations. If we know what to expect, then we can design and implement effective solutions. With the coronavirus, there are many uncertainties — not just about the disease and its lethality, but also how quickly it will spread and what will be done to contain it.

The disease and its impacts are more likely to get worse than better. And it will take many months or longer to recover. Because there is no vaccine, we have been forced into the implementation of social distancing (reducing physical contact between people), quarantine (separation and restriction of movements of healthy people who may have been exposed to the virus), and isolation (separation and treatment of sick or infected people).

Unfortunately, we do not have much experience with these actions.

We need to prepare for possible closing of schools, cancellation of conferences, events and gatherings to prevent the spread of disease. There will be significant loses to our economy and tax revenues. Initially, there will be calls for voluntary actions, but it may be necessary to use public health laws and police power to enforce shutdowns and mobility restrictions.

We have gotten a late start in screening, testing and tracking the disease. We are scrambling to limit the movements of people coming into and across our state who may have been infected.

As the disease progresses, we will get more information, unfortunately, from those who get sick and from those who die. This is not the way to get information to manage a crisis. It is too little, too late.

What else can we expect with COVID-19?

The first to be most affected will be our emergency responders and those on the front lines of medical care. They are also at highest risk of exposure to the disease. We need to do more to protect and support them. Others more likely to die from COVID-19 include the elderly and those in poor health. We need to better protect these high risk groups and ensure that up-to-date training, equipment, supplies and resources are available to those working in care homes and congregate facilities where the disease can spread quickly. We need to support businesses, families and communities where the disease may be lurking and where it will have the deadliest effects.

We need local surveillance to increase reporting and sharing information about symptoms and contact with possibly infected people so that communities can effectively respond to and mitigate the damage. We should use the latest technologies, social media and communications platforms, as well as mapping and spatial analyses to support official and governmental programs. We need to do this in an open, transparent manner, yet follow laws regarding the confidentiality and sensitivity of personal health information.

People may be afraid to report their illness or contact with sick people for fear of losing their jobs or because of stigmatization or discrimination against people with infectious disease. Others living paycheck-to-paycheck may lack insurance or access to health care. We need to identify and assist low-income, disadvantaged groups as part of a larger strategy of public health response.

There are social and environmental factors related to globalization and urbanization, which explain how the coronavirus is spread. We need multiscalar, multidisciplinary teams to tackle and respond to this and other complex threats. It is what planners refer to as a “wicked problem” demanding more attention to science, research, innovation and investment in resilience.

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