As the Vineyard and the rest of the United States consider how and when to begin a return to our pre-coronavirus lives, we must carefully consider our next steps or risk a devastating resurgence of the disease.

The current limited testing for Covid-19 is the main problem. To find out the prevalence of the disease or percentage of the population infected, we need to test a large segment of the public — not just the symptomatic people. We have underestimated the true number of infections because an unknown portion of those infected have no symptoms, or when pre-symptomatic viral shedding occurs days before in a person who later presents with the typical symptoms of aches, pain, fever, and shortness of breath, etc.

This means that the contacts of an infected patient who is not ill at that time may not learn of their risk of infection for a week or more, even when they are in communication with the patient. The contact who has only a random interaction and no communication with the patient may be infected without warning. This potentially allows transmission to multiple other persons. That is why tracking contacts of known Covid-19 patients is critical: on our Island, in our state and around the world.

The countries that have been successful in reducing the rate of infection have done large numbers of tests, allowing them to come closer to estimating the prevalence of Covid-19 or accurately gauge the true percentage of the population infected. Without this data we cannot assess the pandemic and limit the spread. Increased testing, early supportive treatment of the ill, and isolation of the minimally symptomatic and asymptomatic infected patients is essential. It must not only flatten the curve of symptomatic infections but start a downward slope in the true incidence of disease for 14 to 28 days, if a region is to have a chance of success in ending this pandemic.

We already have information that shows we should not reopen the economy because many people who have been working continuously in health care, public service, transportation, the supply chain (e.g. truckers, meat packers, grocery store workers, etc.) have recently been infected at an increasing rate. They have not been well-protected (inadequate personal protection equipment, social distancing, etc.) during what is really a limited shutdown.

Many of the supply chain workers have lower incomes and an inability to distance themselves from others. It is clear that some of those pushing for early reopening of the economy are not as aware of the health risks of this population (especially as it impacts blacks, Latinos, immigrants, the elderly and other lower income citizens). They are driven by financial stress and financial interests while not realizing that everyone is more likely to be infected if the viral infection rate increases. This speaks to racial and social class bias within the society. (The South Dakota meat packing industry is one glaring example.)

Our patience is being tested, given the crushing economic and social effects of isolation. Many who are presently healthy and clamoring to open the economy early are in desperate financial condition, fighting to survive. Everyone is trying to survive the impact of the shutdown.

Better access to government assistance is essential during this time for small businesses and workers.

But there are others who don’t understand or believe in the science of public health, and are less concerned about the disproportionate pandemic effect on them compared to others, particularly minority and lower income citizens. They believe in the mixed messages coming from some of our leaders pushing for the premature opening of the economy. This places business and economic concerns above the health of the population. Poor compliance with the shutdown prolongs the pandemic.

The price of a premature reopening will be paid by everyone. There will be more infection, second and third peaks of the epidemic, and prolonged viral presence resulting in catastrophic shutdowns. More time in the current shutdown now allows the health care system to compensate through more testing, tracking, and possibly achieving new results on current treatment trials. A careful, staged and gradual reopening of essential services is going on in the parts of the world that have limited or stopped the pandemic. We can learn from their experience in the next few weeks.

A uniform national strategy is needed. Uneven early opening of economies around the country will allow new peaks in viral infection which will spread to other neighboring states, given how connected our country is. Areas currently minimally infected will miss out on the chance to dramatically limit viral spread and prevent local epidemics.

We are all interconnected for various public health and economic reasons. This is the time for consistent messaging based on science and the public needs from our leaders. The window for a change and a national policy for testing leading to the end of this pandemic is closing. We cannot afford to miss our best opportunity to control it.

Dr. Ron Dunlap is a cardiologist and seasonal resident of the Island. He is a member of the Martha’s Vineyard Community Services board of directors.