In Chester County, PA, we are beginning our fourth week of “Stay At Home” orders (which began March 23). The entire state went under Stay At Home orders on April 1st. It is April 13, 2020. As I write this, 560,433 Americans have been diagnosed with COVID-19, and 22,115 Americans have died of COVID-19.

Over 500,000 Americans have been diagnosed with an illness that has a fatality rate as high as 10% (in Spain, Italy, France, UK and Netherlands, the fatality rate is already over 10%). That isn’t the scariest thing about this pandemic.

The scariest thing is that even though we have three times more infections than any other country in the world, and more fatalities than any country in the world, we have no plan. Sure, we wash our hands and some of us are practicing social distancing, but in a country with the resources that we have, we have no plan.

A plan has to include elements of containment (testing and masks), treatment and prevention. None of these are in place today. A plan has to be national (if a plan exists in South Dakota, but North Dakota isn’t following it, there is no plan. A plan against an invisible virus only works if everyone follows it).

Here are some basic elements of a plan that don’t exist today:

Testing: every person in the United States has to be tested, so that we know who is infected right now, who was infected (that may be useful for treatment later), and who is not infected. When I say “every person in the United States”, I mean every person. People you like, and people you do not like. People in mansions and people who live on the street. People who are free, and people we have put in cages. Every single person. Because until we know who is infected and who is not, then we have to assume that every person may be infected, and we stay in lockdown. Every person who is infected keeps this pandemic going, and until we know who is infected, this pandemic keeps going.

This means that we need at least 350 million tests, and probably more than that, because some people may need to be tested twice. It means we need to make that many tests, and process them, and store the results, and report them.

Masks: every person in the United States needs a mask. Every single person. Because until we know who is infected and who is not, we have to assume that every person may be infected, and we stay in lockdown. That means masks for everyone. Every single person. 350 million masks.

Prevention (vaccines) and treatment (drugs): there is no treatment for COVID-19 right now, and there is no vaccine. Until there is an effective treatment and an effective vaccine, we have to continue testing and continue with 100% masking in public. Prevention and treatment are not going to happen in 2020.

How do we implement testing, masks, prevention and treatment quickly? That is what a national plan would do. If we had effective leadership (remember folks, elections matter), our leaders would use the Defense Production Act, and start making tests, masks, and start clinical trials for drugs and vaccines. It’s complicated, but that doesn’t mean we don’t do it. It means we do it with people who have experience doing complicated things, so that we save lives. That is what leaders do.

Until we do that, we don’t have a plan. And until we have a plan and use it, thousands of Americans will die every day from COVID-19.