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6 steps to sustainably flatten the coronavirus curve

March 19, 2020, 9:00 AM UTC

We are in the midst of an unprecedented crisis. It started as a health crisis, within days became a real economic crisis, and is now on a swift path to becoming a massive fiscal challenge, as well. Spring may soon arrive on the calendar, but as a society—increasingly alone and stressed—we feel as if we are in the middle of winter.

While reserve banks and governments are reacting swiftly to try to stabilize the economy and financial markets, many government moves weren’t quick enough to slow infections of the coronavirus, which causes the COVID-19 disease. Unfortunately, efforts to stabilize the economy will be enormously costly because of that delay.

Without a vaccine for 12 to 18 months, we are facing not just a short-term crisis but a massive ongoing challenge both to protect health and preserve the economy—and the businesses and workers depending on it. The challenges we face are daunting. There are potential ways to control the virus without shuttering the economy, but we must begin working on them immediately.

The question that matters right now

To date, as the coronavirus has spread around the world, one question has been top of mind: How much can we flatten the curve of infection rates?

We have all seen the charts that show the value of spreading out infections in order to keep the peak within the manageable capacity of our health system. In Wuhan, China, and Italy—and soon parts of the U.S.—we’re seeing the enormous human toll when sickness exceeds what health systems can handle. Most of us look with great respect at how quickly China was able to add hospitals and health system capacity. But it will be challenging to replicate this feat all around a world often filled with constraints on cost, capability, and governance.

For the next 30 to 90 days, the degree to which we can flatten the curve is the most important challenge, and we’re seeing countries, U.S. states, and smaller communities start to respond aggressively. Unfortunately, many of these responses are happening about two weeks late, but they are still critical in limiting the impact of the disease and saving the lives of those most vulnerable to it.

The most obvious efforts underway involve social distancing, and every day brings more examples: school cancelations, remote working, sports leagues and commercial travel shutting down, Broadway going dark, bars and restaurants closing. This is painful on many levels, from the elderly left alone to students out of class to enormous economic damage. But we have no choice, particularly where the coronavirus has spread and where insufficient testing limits our ability to measure and isolate the problem.

The question that will soon matter most

If we succeed in flattening the curve, and I believe to some extent we will, we will be faced with an even more daunting question in 30 to 90 days that we have to begin addressing right away: How will we continue to flatten the curve, not for the next two or three months, but for nine months to a year or even longer?

The total economic distress from one to three months of social distancing will be enormous, but we can manage it—especially in richer countries. It will require bailouts and support for workers, zero to negative interest rates, and massive injections of cash into the economy.

But the cost of 12 months of aggressive social distancing is hard to fathom. How do we support airlines for a year of almost no passengers? What is the societal cost of keeping children out of school for that long? What happens to the service economy, even as digitization grows, when it offers the bulk of jobs? And how can this possibly be affordable when tax revenues are collapsing at the same time?

We need to limit the spread of the virus, but if the cost is an economic cancer, eating away at many industries and undermining financial markets and public sector finances around the world, how can we bear this? Right now, we have to focus on flattening the curve as much as we can, but very soon we must shift our focus to how we flatten it for a sustained period without destroying major parts of the economy in the process. There are potential answers, but we have to start now to make them workable.

Six steps to flattening the curve sustainably

All the business leaders I know are focused on supporting their people, sustaining business in the short term, and protecting the balance sheet. A few, particularly in China, are thinking about the rebound as their economy starts to come back, rethinking their business models for a different world.

Governments are trying to ramp up health care capacity as rapidly as possible, protect their economies with both fiscal and monetary levers, and get their citizens tested and protected quickly. Given challenges in the U.S. health care system, there is now a huge effort to help citizens avoid the direct and indirect costs of this illness.

These are all essential actions, but not enough. We need to mobilize now on six fronts to flatten the curve in a sustainable way. Some of this is U.S.-specific, but most applies around the world. There will be many ideas about how to do this, but I hope these can serve as a starting point:

Dramatically accelerate preparedness

We need to massively expand and speed up the testing process and provide related kits and supplies, as well as medical devices needed for care, protective equipment for health care workers, and expanded facilities for treating the ill. We should also invest in and distribute simple digital tools that can help people decide when to seek care and when to stay home. Over the next 30 to 45 days, we have to leverage our knowhow to spur rapid investment in building capabilities at whatever the cost.

Change the social distancing paradigm

Our goal should be to get most workers and students back up and running, ideally within 45 to 90 days. Of course, this will require new practices such as careful hand washing, no handshaking, and other protective activities. This will also likely require some measures based on risk stratification.

We know some of the risk factors now, such as age, comorbidities, and immunological compromise. With careful epidemiological analysis and modern analytical techniques, we should be able to create risk stratification methodologies to allow lower risk individuals to get back to work while responsibly decreasing the risk to themselves and society.

This strategy will not be easy to implement, but it’s an essential part of restarting the economy without ramping up the infection curve beyond health system capacity. It will allow us, over time, to build more herd immunity across the broader population and enable much of society and the economy to be operating at a reasonable level.

Change the operating model

We have to accelerate the use of digital and mobile technologies to make remote work and other activities easier. But more broadly, we will need to adapt to a more intrusive environment. Beyond the urgent need for greatly expanded testing, we must begin taking temperatures before individuals enter a school or place of work, go to a restaurant or other public space, or get on an airplane or train. We should use artificial intelligence to notify at-risk individuals to self-quarantine, so that we avoid outbreaks while respecting personal privacy.

In the next couple of months, we should also work aggressively to develop an antibody test for the coronavirus, allowing us to see if people have become immune to it. Knowing that people are no longer at risk for getting sick from or spreading the virus will give us an enormous advantage in reintroducing people to the workforce.

Adapt regulatory and support frameworks

Let’s give organizations the right to protect their businesses, workers, customers, and students with testing, as well as the obligation to require at-risk people to stay home. We should protect workers and parents with sick leave support and medical care when they or their loved ones get sick. And we have to create protection from coronavirus-related lawsuits for those medical professionals acting in good faith.

Invest in and support innovators

We will need a multipronged set of tools, including the development of diagnostics, antivirals, and vaccines, and we have to invest aggressively in capacity to deploy therapeutics at scale before we can be certain they will work. 

The economic assurances we provide to qualifying R&D companies must come with assurances of open intellectual property sharing. And we must be prepared with our therapeutics to respond quickly if there are further mutations in the virus, which will require adaptive frameworks.   

Increase communications dramatically

We need consistent, coherent, unified leadership that brings communities together and highlights what is required to navigate this enormous challenge. People need clear communication about what it means to travel and work safely, as well as how to engage in more careful social interactions and how to support at-risk populations who are still socially distanced, starting with our elderly.

In normal times, we would take years to debate some of these options, but we don’t have that kind of time. While we are focusing on the unprecedented and acute situation in front of us, we need to start thinking about how we will economically navigate the critical phase that follows the surge of cases we are about to get, as well as how to accelerate progress to our end game—when we have effective therapies, vaccines, and herd immunity to protect us from this new and dangerous novel virus.

These solutions will, of course, be technically, socially, and politically difficult. For the sake of our economy, the livelihoods of millions, and the health of our society, we have to get started. Winter will come again, and we must begin preparing now.

Rich Lesser is CEO of Boston Consulting Group.

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