Massachusetts has moved into Phase Two of Governor Charlie Baker's reopening plan, but there is still a lot of concern over a possible second wave that could prompt closures once again. WGBH News' Morning Edition host Joe Mathieu spoke with STAT senior writer Helen Branswell about what lessons we can learn from our intial response in order to improve outcomes in the face of another outbreak. The transcript below has been edited for clarity.

Joe Mathieu: This, of course, presumes we screwed it up the first time. Is that the consensus in the medical community?

Helen Branswell: Yeah, it didn't work very well here. It really didn't.

Mathieu: Of course, the president likes to talk about the perfect response. But we have more than 100,000 dead.

Branswell: Yeah, the United States has nearly 28 percent of all confirmed cases globally and 27 percent of all deaths despite having a population that represents about 4.25 percent of the global population. So, yeah, [the] numbers aren't in sync there.

Mathieu: You spoke to experts in a number of fields for this piece to basically build a list of ways to help us move forward — the proper way with what we've learned so far — and not so we're forced back into isolation again. You begin with early warnings, and you mentioned something called waste water surveillance. I've heard about this before. How does it work?

Branswell: So this is an approach that's been used for years in a bunch of places to do surveillance for other kinds of pathogens, including things like polio viruses. You could actually set up a system where you sample what is considered sort of a representative amount of wastewater coming out of a community and look for viruses. And if you start to see the amount of viruses that are in your wastewater rise, then you know you're having a problem. One of the things that has become clear is that people shed viral debris through stool, so it really could be potentially an effective way to sort of keep your eye out for what's happening in a community because, as you know, by the time a COVID-19 outbreak becomes really apparent, health care systems start to crash. You really want to get on top of it before you get to the point where all sorts of people are flooding your emergency rooms looking for help breathing.

Mathieu: Right. And an early warning system, as you say, would that basically point officials to a geographic area and say Boston is seeing a bit of an uptick, or maybe New England as a greater region. How carefully can they pinpoint that?

Branswell: Well, certainly within a community, you could do it. And in fact, probably within broader neighborhoods depending on how your wastewater system is configured. But I could imagine you would be able to get a sense [that] the wastewater coming from South Boston or Back Bay is starting to tick up. We need to get on top of that.

Mathieu: That's pretty specific. That sounds pretty effective. And you say next, pay attention to small numbers.

Branswell: Well, yes. Obviously the places that have done the best are the ones that were able to get on top of this and find all their cases, find the contacts of those cases and keep them under observation — quarantine them — to keep the outbreak from getting out of control. There've been a number of places that have managed to do that. New Zealand announced yesterday that they have no active cases. They've managed to drive their case count down to zero, which is really astonishing. It's a ton of work, and New Zealand is a much smaller population than the United States so they have that advantage, but if you get to the point where you have small numbers, you can do things much more effectively and much less painfully. It requires people who've been exposed to go into quarantine, but it doesn't require mass numbers of people to start to change their behavior.

Mathieu: You quote a physician at Harvard to say, "if you wait for big numbers, it will be too late." That's what we just did, isn't it?

Branswell: Yeah, that's right. We got overtaken. Your listeners will remember that in the early part of the year — January, February — testing wasn't really available in the United States. The CDC developed tests that didn't work in the hands of many local and state labs. As a consequence, CDC had to do most of the testing for a while, and it really put a constraint on how much testing could be done and the virus got seeded into the United States. It was also at the time when borders started closing and Americans who were abroad started flooding back into the country. A number of them were infected in Europe or in China, the virus started spreading and no one really had an eye on it. We couldn't really tell where it was until health care systems started to collapse.

Mathieu: You have a number of other items on this list, but we only have a minute left and I want to ask you about resisting magical thinking. What did you mean by that?

Branswell: I was really stunned in the early days of this year when the evidence was coming out of China that they really had a big problem to the point where they were putting cities of tens of millions of people on shut down and the rest of the world responded pretty slowly. It was almost like there was this thought that it won't happen here. And of course, there was no reason to believe the virus wouldn't behave exactly the same way outside of China as it did. You can't assume that you're going to catch a lucky break. You have to make sure that you're prepared.

Mathieu: And can't assume that you're going to have a vaccine, as well, you point out.

Branswell: Well, we can hope there's going to be a vaccine at a point. I don't know how soon.