When Virginia began lifting stay-at-home restrictions on May 15, local leaders from Northern Virginia initially pushed back on the plan, saying the counties closest to D.C. were the hardest hit by COVID-19.

But on Monday, Northern Virginia leaders wrote a letter to Gov. Ralph Northam saying the region had met four of the six metrics to begin a phased reopening, including a decline in positive tests and hospitalizations over 14 days, increased testing, and hospital capacity. (The region has not met metrics for contact tracing and the supply of personal protective equipment.)

And so today, the region is joining the rest of the commonwealth in starting Phase 1 of its reopening plan. (It begins a day after Virginia reported its highest single-day death count, tallying 57 deaths and 1,152 new cases on Thursday. Fairfax, Prince William, Loudoun, Arlington, and Alexandria counties continue to see the most cases across the state.)

Retail stores can now open at 50 percent capacity, restaurants can serve patrons outdoors at half capacity, and barbershops and salons are operating by appointment.

On Thursday, a series of experts weighed in on the economic benefits and health risks of reopening in a panel organized by George Mason University.

Victor Hoskins, president and CEO of the Fairfax County Economic Development Authority; Dan Houser, chair of GMU’s economics department; Sean O’Connor, executive director of the Center for the Protection of Intellectual Property at the Antonin Scalia Law School; Dr. Emanuel Petricoin, co-director for the Center of Applied Proteomics and Molecular Medicine; and Dr. Amira Roess, a GMU professor of global health and epidemiology, who has an expertise in infectious diseases epidemiology, gave their take on the questions of the day.

What health concerns remain as the region begins Phase 1?

Virginia has a goal of hiring 1,300 contact tracers, but earlier this week, epidemiologist Amira Roess says the state was only at about 300. Nonprofit organizations, like Neighborhood Health, and local health departments are ramping up efforts to make these hires, but a need remains, she says.

“[The contact tracing demand] highlights the great need in building up our public health response systems that have really been strained by this virus,” Roess says. “The contract tracing workforce is slowly being built up, so I can see that in a few weeks’ time, we will meet the demand.”

Meanwhile, Virginia has started hitting its goal of10,000 diagnostic tests per day. But while it is trending toward therecommended positive test rateof below 10 percent, it still isn’t there yet.  “I’d like to see that number … 10,000 tests a day and the positive rate—which is trending downward—get to below 10 percent if we could,” says epidemiologist Emanuel Petricoin. And “it’s not just about testing more, but testing more accurately.”

He also notes that it’s still too early to determine whether testing positive for COVID-19 antibodies results in long-lasting immunity. There’s no evidence that someone who has recovered can get reinfected, but “we don’t know right now how long immunity will last,” Petricoin says.

Roess says she’s worried the region will reopen too quickly, and that the next few weeks will be about maintaining a flattened curve: “We have to remember, this is a gradual reopening. Stage one, as some political leaders are referring to it, is somewhat of a ‘stay-at-home lite.'”

She emphasizes that the whole point of “flattening the curve” is to make sure there were enough hospital beds and resources to adequately respond to the outbreak. Tracking these resources will continue to be crucial to determining the speed at which the state moves between phases. Asymptomatic transmission has been a major factor of the pandemic, and so contact tracing, broader testing, and self-quarantining will remain necessary to avoid another major closure of the economy.

At the same time, the panelists say they are concerned that there will be long-lasting mental and physical health costs of people staying at home for so long.

Anxiety and depression rates are exploding, and emergency treatments are not being sought, the panelists say. Petricoin refers specifically to women with metastatic breast cancer who are afraid to go to trial sites, or patients with blood in their stools not getting colonoscopies they need for fear of contracting coronavirus. These issues won’t go away during a quarantine, he says.

“My hope is that we’ll see a reemergence of people getting their health and wellness taken care of,” Petricoin says. “We can’t be so scared of COVID-19 as to put off the other big things that could harm us as well.”

What does reopening mean for the economy?

The Virginia Employment Commission reports that nearly 200,000 Northern Virginia residents have filed for unemployment since mid-March, according to InsideNova. And Victor Hoskins, president and CEO of the Fairfax County Economic Development Authority, says that nearly half that number—91,000–are in Fairfax County. Unemployment went from 2 percent to 14.5 percent in the region in two months, a speed that felt like “falling off a cliff” for the local economy, he says.

“I’m so glad that we’ll be beginning reopening [Friday] with the first phase,” Hoskins says. “I love the fact that Maryland, D.C., and Virginia decided to coordinate on the reopening date—that is a profound thing.” (Note: Montgomery and Prince George’s counties won’t begin reopening until Monday.)

“There is an end point at which we just don’t have any economy left, and the government can only print and hand out so much money—which it’s not even doing enough of now,” says law professor Sean O’Connor. “So it becomes a bizarre reality of: How do we get things going again?”

O’Connor says the disruption to global and national supply chains is almost immeasurable. He recommends that the region consider building regional supply chains for food and other necessities: “In other words, each region may have to become much more self-sufficient, because we may not have a magic reopening day. We know it’s going to be phased in.”

The hard-hit hospitality and service industries, and low-income workers, will require the most assistance, according to the economists on the panel, who added that restaurants, bars, and hotels need to reopen, but only if it can be done so with new safety precautions. New norms should include wearing masks indoors, taking temperatures of staffers, reserving special hours for elderly customers, reserving elevator trips for one person at a time, and maintaining social distance, the panelists say.

“There are some basics that are becoming accepted as social norms,” Hoskins says. “If we’re going to get back together, we’re going to have to introduce some norms into our society that haven’t been here.”

But it’s clear that the economy isn’t going to rebound immediately.

“I think there’s a lot of hope that starting [Friday], or in the next week or so, we’ll get back to full employment. But if the reopening in phases happens the way it’s supposed to, that’s not what happens,” O’Connor says. “Instead, lots of people are still out of work.”