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Illustration: Sarah Grillo/Axios

Americans are looking for an exit ramp away from the extreme social distancing brought on by the coronavirus, but that will require steps we're not yet prepared for.

The big picture: Responsibly easing off of social distancing will only be possible as the number of new cases levels off, and will depend on extensive testing to avoid another surge in infections.

"The problem is that the next phase of containment is contingent on resources we don't have,” said Jennifer Nuzzo, senior scholar at the Johns Hopkins Center for Health Security.

Where it stands: If we're going to back off of aggressive measures like school and business closures, the next phase of the response would involve doing a lot of the things we should have done from the beginning.

  • That includes quickly identifying and isolating newly infected patients, and identifying others they may have infected.
  • Places that house vulnerable people, like nursing homes, would still need strong oversight.
  • “You need to bring down the overall burden and then you can get to the point where you can target the individual cases,” former Food and Drug Administration Commissioner Scott Gottlieb sad.

Yes, but: All of that requires fast, widespread testing, which the U.S. still can't do.

  • We’re still facing shortages of some supplies needed to make and conduct tests, and it still takes several days to receive test results.
  • “If we let up, we’ll be back to where we were before social distancing,” said Ali Khan of the University of Nebraska Medical Center.

What's next: Syndromic surveillance — testing a random portion of the community — might help the U.S. get a better handle on the true prevalence of COVID-19.

  • Seattle has launched an effort to do just that, adapting an existing program that checks for influenza prevalence.
  • And the FDA recently signed off on a test that can deliver results within 45 minutes, though it's only available to help diagnose very sick patients, not to catch cases before they become severe.

Life won’t go back to normal for a long time. Normalcy will return in doses, and at different paces in different parts of the country.

  • “It’s not like a switch that’s going to be flipped. It’s going to be much more gradual. And people that are high risk are probably going to be the last ones” to see relaxed restrictions, John Hopkins’ Joshua Sharfstein said.

The bottom line: “The worst-possible outcome would be a second epidemic, a second wave…we can’t afford to have this happen again,” Gottlieb said.

Go deeper

"Atmospheric river" swings Northern California from drought to flood

Satellite view of the bomb cyclone swirling off the coast of the Pacific Northwest and the atmospheric river affecting California on Oct. 24. Photo: CIRA/RAMMB

A series of powerful "atmospheric river" storms are delivering historic amounts of rainfall across parts of drought-stricken California and the Pacific Northwest — triggering widespread power outages and flooding.

Why it matters: The strong atmospheric river, packing large amounts of moisture, is causing Northern California to whiplash from drought to flood.

“You blew it”: GOP activist turns on corporations over vaccine mandates

The chairman of the American Conservative Union said on "Axios on HBO" he accepts "Joe Biden is my president, and I want him to succeed," but predicted Republicans retake the House and Senate in 2022 — with greater than 50% odds Donald Trump runs in 2024.

The big picture: In a joint interview with his wife, Mercedes, Matt Schlapp also refused to share their vaccination status. And he told corporate America "you blew it" by embracing vaccine mandates and liberal social stances that have alienated GOP voters and politicians.

4 hours ago - Politics & Policy

Pelosi expects “billionaire’s tax” to pay for Biden social spending

Photo: Yasin Ozturk/Anadolu Agency via Getty Images

House Speaker Nancy Pelosi (D-Calif.) said Sunday she expects the chamber to pass the bipartisan infrastructure plan by week’s end, and alternatives to corporate tax hikes and a “billionaires tax” will be used to finance President Biden’s promised expansion to the social safety net.

Why it matters: Pelosi’s comments come as House and Senate leaders try to wrap up a deal. What will get cut — and how the remainder will be paid — are linchpins to a final agreement.