We need an exit strategy from heavy-handed COVID-19 pandemic isolation. We need it because soon enough, every developed economy will have passed peak infection and minimized the number of new cases, and it will be time to get the economy started again, so that we can pay for the extraordinary measures we have collectively invoked to keep people alive, with a roof over their heads, food on their table and hopefully jobs. Endless isolation is not viable, and the sooner we can (safely) end it, the better.
First, lets all agree that the strategy needs to be based on empirical data and science. That means, for example, that we cannot use data from China, Iran or other regimes which may be dishonest, which have limited testing capacity or whose healthcare system has minimal capacity. This means that useful data can only come from developed, democratic states.
Some early public policy decisions in Western countries were made based on official reporting from China and advice from the WTO, which appears to have no bullshit filter when accepting data from member states. Lets not do that again.
So what does the exit strategy look like?
Here are some thoughts:
The pandemic will likely continue to rage in some parts of the world, especially those with weak healthcare systems, low incomes and high population density. Restrictions on travel and isolation for international arrivals are likely to remain, at least for travelers coming from some countries. A "white list" of countries you can come from and not be subject to such controls would be much safer than a "black list" of countries which are considered to be unsafe.
We need to continue to protect the vulnerable -- meaning the elderly and people with relevant pre-existing conditions. These folks will probably have to remain in isolation until a vaccine is developed and deployed.
Speaking of protection -- it would be a good idea to continue with some measure of social distancing, even as we relax restrictions. We also have to worry about pets - cats, at least, are carriers of COVID-19 and dogs haven't been ruled out entirely.
We need an antibody test to be deployed widely. Anyone who is positive for the relevant antibodies has presumably already had the disease and can work and travel without endangering themselves or others. Perhaps people who have developed immunity should wear a green wristband or something to signal to others that they are safe to be near. It might be necessary to maintain a "trustworthy" public database of people who have been tested are are presumed immune, because it would be pretty easy for people to self-mark as immune when they are not.
We must continue to test for the disease aggressively. Anyone who is symptomatic should be tested promptly and isolated if positive.
We have to automate contact tracing. Manual contact tracing is too slow and too costly. If I think I *might* be infected, then I should be able to notify everyone I've been near in the past few days that they might also be infected - either they may have caught it from me or perhaps I caught it from them. If my infection is confirmed via a test, I should be able to signal that to people who have been near me. Conversely, if I get a test and it's negative, I should be able to notify people who I've been near that my earlier warning was a false alarm.
This assumes that everyone carries around a mobile phone, which is not a bad assumption, especially after you remove from consideration the elderly, because they need to self-isolate anyways.
Whether to make such an app voluntary or mandatory will depend on jurisdiction. The goal must be high user adoption rates, and I'm not sure which approach will work better. It's probably a question for culture and legal framework anyways.
This may sound like a privacy invasion ... because it is! But health and safety have to come before privacy. Some simple ways to mitigate the privacy problems are to define an end-date for the surveillance and to monitor opaque identifiers rather than people by their name or other PII.
Moreover, there are two ways to think about automated contact tracing:
Use Bluetooth to track proximity between my phone and yours. This only captures who has been near whom, not who has been where. In other words, potentially contaminated *places* are not identified by this approach. Singapore has developed an app for this approach.
Use a mapping app (I suggest Google Maps) to track where people have been and ask them to flag themselves as possible-infected, definitely-infected and not-infected, so that where they have visited can be flagged with the same information, and people who have visited the same places can be notified if a location is suspected to have been contaminated.
I think it would be best to deploy both approaches.
Wait for treatments and a vaccine, almost certainly in that order. Once there are effective treatments, we can relax the social isolation protocol, because presumably people who are sick enough to visit a hospital can be treated and released quickly. Once we have a vaccine, then hopefully this whole mess can be ended.