Health authorities battling the coronavirus outbreak are trying to figure out how and when social distancing restrictions that have shut down many things across Washington state can be modified or ended.

``That’s what a lot of us are working on now: What’s the end game?’’ said Dr. Elizabeth Halloran, an infectious-disease specialist and modeler at Fred Hutchinson Cancer Research Center who advises the federal government on outbreaks. ``What can we do short of keeping everything shut down for 18 months or longer until we have a vaccine?’’
While an influential University of Washington model suggests deaths and hospitalizations may have peaked in the state, health officials say lifting restrictions to soon could cause cases to surge.

The Seattle Times reports the basic approach to controlling COVID-19 is the same for other epidemics: Identify infected people, as well as those who have been exposed, and isolate them.
But that would mean a huge scale-up of testing and contact tracing, at a time when even nursing homes still can’t get enough test kits and public health agencies are swamped.

More than 10,200 people in Washington state have tested positive for COVID-19 and at least 491 have died. The virus causes mild to moderate symptoms in most patients, and the vast majority recover. But it is highly contagious and can be spread by those who appear healthy and can cause severe illness and death in some patients, particularly the elderly and those with underlying health conditions.

The economic impact of the virus-related shutdowns has been severe. More than 170,000 people filed new claims for unemployment benefits in Washington last week, bringing the total number of initial claims filed in the state to nearly half a million since mid-March, when businesses started closing or limiting operations due to the coronavirus outbreak.

Employment Security Department Commissioner Suzi LeVine said she expected claims to surge again in the coming weeks as previously ineligible employees can start applying for benefits.

Trevor Bedford, a computational biologist at the Fred Hutchison Cancer Research Center, says what’s needed to help fight the outbreak is new technology, including simple home tests and the use of cellphone location data to alert people who may have been exposed. Some epidemiologists say it could even be necessary to impose intermittent lockdowns through the end of the year, to keep hospitals from being rwhelmed with coronavirus patients.

``People really do need to understand the sad truth here, related to the fact that we’re not going to be able to stop this outbreak,’’ said Dr. Jeff Duchin, health officer for Public Health - Seattle & King County. ``We’re trying to manage it, but people will continue to get sick. People will continue to get critically ill. People will continue to die.’’

With Washington’s ``stay home, stay safe’’ order in effect until May 4, Duchin said he and his team will work elected officials over the next few weeks to figure when _ and how _ to begin easing out of the lockdown. The first condition will be a steep drop in the number of new infections, he said. Hospitals must also have reliable supplies of protective equipment and the capacity to handle the expected influx of patients.

``We want to get back to our normal lives as quickly as possible,’’ Duchin said, ``but we have to do this in a very measured way, without overwhelming our health care system.’’