Public health officials and political leaders are hesitant to re-open the economy because there is not enough testing to track the path of COVID-19 or understanding in behavior for Americans to feel safe to return to work or what they consider “normalcy”.

President Trump is eager to re-open the economy and predicts a quick economic “boom” once the economy re-opens “perhaps like never before” according to an article published in the New York Times. 

At a White House briefing on Monday,  Trump said the administration was “very close to completing a plan to open our country hopefully even ahead of schedule,” saying they would “soon finalize new and very important guidelines to give governors the information they need to start safely opening their states.”

Mr. Trump added that “we want to be very, very safe” in terms of lifting restrictions, but said that Americans were eager to get back to work.

“I think we’re going to boom” once the economy reopens, he said.

Predictions made by business owners like Walter Isenberg, a hotel and restaurant owner, who has seen a drop in revenue from $3 million a day,  to $40,000 a day, for the same day last year, predicts a slow recovery until a vaccine is present.

“It’s just going to be a very long and slow recovery until such time as there is a therapeutic solution or a vaccine,” Isenberg, who has furloughed more than 5,000 of his 6,000 employees, said in an interview. “I’m not a scientist, but I just don’t see the psyche of people — I don’t see people coming out of this and rushing out to start traveling and having big conventions.”

An 11-year economic expansion has ended in an abrupt halt due to the pandemic.  Millions of people are out of work and companies that have been affected by the shutdowns say restarting the economy will not be as easy as predicted by President Trump. 

Survey data suggests the economy will recover slowly even after the government begins to ease limits on public gatherings according to the NYT article. The evidence suggests that even before the stay-at-home orders were implemented the behavior of many workers and consumers were to stop any future plans that they may have had scheduled for the week in fear of contracting the virus.

Data shows, according to the NYT article, that unemployment claims rose and restaurant reservations vanished even before stay-at-home orders hit and they also show consumers are unlikely to return to airports, restaurants and sporting venues en masse any time soon.

“You can’t just turn the light switch on and have everyone go back to work, as much as businesses would love to do that,” Suzanne Clark, the president of the U.S. Chamber of Commerce, said in an interview. “It’s going to be the opposite of a green light. It’s going to go from red to yellow and then green.”

“It would be good to get a yellow light from the president to reopen,”  Clark said. “But then on the ground it’s going to matter, how safe do people feel?”

In the last three weeks, 16 million people have filed for unemployment.  A report by the National Bureau of Economic Research released on Monday by economists from Northwestern, Stanford, the University of Chicago and Boston University predicts the economy will shrink by 11 percent by the end of the year making it the sharpest contraction since 1946.

According to the NYT article, stay-at-home orders haven’t been evenly applied across America.  Some states imposed them early, some imposed them later and some states still have not imposed them.  However, every state has experienced an increase in unemployment claims.

Adam Ozimek, the chief economist at Upwork, found a pattern in restaurant reservation data from the online service OpenTable showing declining activity even before restrictions were in place. He found that the falloff began several days before local officials first imposed restrictions on dining out in their cities.

“How safe people perceive it to be,” Mr. Ozimek said, “matters independently from the shutdowns.”

Healthcare providers say widespread diagnostic and antibody testing will be crucial for determining a number of factors: How many in a community are infected but asymptomatic? Who has protective antibodies that might allow them to go about their lives without fear? Are workplaces and schools safe? 

“It is great that we are flattening the curve,” said Dr. Mark McClellan, director of the Margolis Center for Health Policy at Duke University, who worked in the George W. Bush administration and is advising state and federal policymakers on the virus response.

“But for this next phase, where we are really aiming to detect and stamp out smaller outbreaks before they get so big, testing is critical for that,” he said. “So we have to plan ahead now for much larger capacity.”

By the end of May, McClellan added, “we will maybe be up to two million tests a week, but we are definitely not at that level now.”

The biggest challenge state health officials and medical providers around the country say they are unable to test as many people as they would like, and not having the supplies to process the diagnostic tests, like chemical reagents, swabs and pipettes, according to a NYT article published on April 15.

Manufacturers haven’t been able to catch up to the world-wide demand as every country fights the pandemic.

“We’re at a really critical juncture and the supply chain has not yet caught up,” Scott Becker, chief executive of the Association of Public Health Laboratories, said on Wednesday.

While there are locations in California, Florida and New Jersey, where there are people waiting hours for drive-through testings, some laboratories reported they have capacity to test more than what they are receiving. They are reaching out to state health departments, doctors and nursing homes.

Reportedly, minority communities are hit the hardest with lack of tests available.

According to Dr. James E.K. Hildreth, president and chief executive of Meharry Medical College in Nashville, one of the nation’s largest historically black medical schools.

“Testing should be a priority for vulnerable populations — that would be prisons, nursing homes, assisted living facilities and, last but not least, minorities and disadvantaged communities,” said Dr. Hildreth, an infectious disease expert. “Because in those communities, we know there are many individuals with underlying conditions, and they are more likely to get severe disease and die.”

The next wave that specialists are gearing up for is antibody testing, which will detect whether someone has been exposed to the virus and generated an immune response which could protected them from further illness, according to the NYT article published on Wednesday. 

“Antibody testing is not a cure-all,” Republican Gov. Doug Ducey of Arizona,  said on Tuesday as he announced a partnership with the University of Arizona to provide antibody tests for 250,000 health care workers and emergency responders. “But learning more about it is an important step to identifying community exposure, helping us make decisions about how we protect our citizens and getting us to the other side of this pandemic more quickly.”

Most of the currently available antibody tests can only detect whether somebody has them but cannot say how strong they are.  Some tests have shown individuals with antibodies when they, in fact, didn’t and according to the NYT article published on Wednesday, the F.D.A has granted emergency approval to three companies to begin selling the tests.

“We have to to make sure it’s an accurate test with good specificity,” said Dr. Rachel Levine, Pennsylvania’s health secretary. “And we really need to know that antibodies are truly protective and how long-lasting they are.”

Dr. Jon R. Cohen, the executive chairman of BioReference Laboratories, which is processing tests at drive-through sites in New York and New Jersey and other locations around the country, said he was still evaluating different antibody tests but planned to begin offering them soon. Other large laboratories said the same.

“It’s a huge factor, we believe, in terms of people regaining confidence and jump-starting the economy,” he said. “To me, it’s an absolute moral imperative.”