Posted by “Strategic” and “Targeted” Opening of the Economy Isn’t An Option Right Now, No Matter What The Kvetches Are Saying
Photo: Li Ying/Xunhau via Getty Images
These days, lots of folks argue that the economic cost of containing covid disease isn’t worth it. The latest advocate of this view is Washington Post contributing columnist Gary Abernathy.
His arguments are in line with majority thinking in this section of the opinion-sphere: let’s close up shop in “hot spots,” protect those “at risk” and let the rest of America go about its business working, making money, and keeping the economy humming. He argues for “targeted mitigation focused on the most vulnerable, without the extremes of mass closures.”
What was needed was a strategic response that would allow less-impacted areas to keep their economies running, which would not overwhelm the health-care system.
Gary Abernathy, WaPo columnist
He’s dead wrong, and his argument flies in the face of established facts. But facts aren’t what he’s after. What he’s after is the emotional power of false choice — typically that means creating an impression of only two choices when, in fact, there are more.
But what I mean here by “false choice” is that he’s offering something that isn’t a really choice, because it’s impossible. He’s offering hope where it doesn’t exist. Offering a solution that’s pure fantasy.
His dream of “strategic” and “targeted” management of covid is just that: an illusion that defies both facts and common sense.
These commonly floated ideas of “strategic” closures and “targeted mitigation” may have been viable options back in early January when the first covid cases were reported in America, but we’re way beyond that now.
“At Risk” Is A False Meme — We’re All At Risk. It’s Dangerous to Say Some Are and Some Aren’t.
First, it’s a false choice to believe that you can divide the population and identify some people who are “at risk” and that others aren’t, or are even “low risk.” Everyone is “at risk.” Being exposed to this virus is like a game of Russian Roulette: you just never know who is going to get walloped and who isn’t. Most covid mortality is concentrated among the elderly, but a 102-year old man in Pennsylvania recovered from it.
And America’s “younger” population is at high risk for very very serious disease. This data should be frightening for anyone advocating business as usual for “low risk” Americans: 38% of hospitalized cases are between the ages of 20 and 54; and 48% of ICU cases are between the ages of 20 and 64.
Double or triple the number of “low risk” people engaged in “high risk” behaviors and you’re right back where you started in terms of a steep sickness curve. Letting the virus rage out of control among a supposedly “younger” and “low risk” population can still overwhelm the healthcare system. Not to mention that highly social young people can be effective super-spreaders of the disease, especially children.
“Hot Spots” Is A False Meme — Once They’re “Hot” It’s Too Late for Containtment.
Second, it’s impossible to count how many times expert talking heads on TV (e.g., epidemiologists, public health professionals, biostatisticians, doctors, etc.) have told us over and over and over: the best time for containment is when cases are low.
This virus spreads quickly; it’s about three times more virulent than influenza, and pre-symptomatic people are big spreaders. By the time any region sees a spike in cases, it’s already on the steep, exponential growth curve; the virus is already endemic in the community, and it’s spreading like wild fire. At that point it’s too late for any kind of “strategic” containment measures.
New York used a “strategic” response, keeping businesses and schools open for weeks, when “confirmed” cases were still low. But covid was spreading silently across the state, and suddenly cases mushroomed. On March 20, Gov. Andrew Cuomo ordered the closure of all non-essential business. He said it was a strategy of “closing the valve.”
The case rate on 3/20 was 5,600, and it was already too late for New York.
Cases exploded. As of this writing, just two weeks after Cuomo “closed the valve,” cases in New York State stand at 102,870 and still doubling every six days.
So much for “strategic” management of economic closures. By the time cases spike, the community spread has become so bad that the only viable option is complete economic lockdown. So why not just bite the bullet, do it early, and save the lives???
Florida took an even more “targeted” hands-off approach and is now reaping the rewards: the state went from 51 confirmed cases on March 13 to 10,268 cases on April 2. Florida is now flying up the exponential growth curve, and it’s unlikely even the most draconian social restrictions will be able to tame the viral wild-fire raging across the state, at least not for weeks, or maybe months.
Florida’s Agriculture Commissioner Nikki Fried put it this way, after Gov. DeSantis finally issued a stay-at-home order, after weeks of pleading from state officials and healthcare workers:
“The piecemeal approach wasn’t working. I’m glad the governor finally came to this realization and decision. I hope it was quick enough.”
Nikki Fried, Florida Agriculture Commissioner
“Less Impacted Areas” Is A False Meme — We’re All Connected
Georgia resident Nicholas Hickman went to Disney World on vacation in early March, while covid was spreading across the U.S. out of control. This is what happened next:
A day after he returned home to Ringgold, a north Georgia city of fewer than 4,000 people near the Tennessee border, he learned that Walt Disney World planned to close its doors over coronavirus fears.
Three days later, he fell ill: head and muscle aches, dizziness and a fever that shot up to 104 degrees. After two trips to hospitals and a battery of tests to rule out other infections, doctors relented and tested him for covid-19.
“They told me that they felt like they were wasting a test,” he said, “because they only had four or five tests in the whole hospital. They kind of diagnosed and treated me for bronchitis. They said ‘really we think you just have bronchitis.’ ”
He self-quarantined, even though it would be days before he got test results confirming he had covid-19. One of his biggest fears, he said, was that he might spark an outbreak in his city — one that would start with his parents, with whom he lives. As Hickman’s symptoms began to abate, his parents felt unwell.
“They’ve been sick for the last week. My mom has been tested for it, but her results haven’t come back,” Hickman said. “No one will even test my dad. They’re like ‘your son’s got it and your wife’s got it’ so it’s not even worth [doing the test].’ ”
Washington Post
Now Hickman and both his parents are sick. All three are out of work on quarantine. And Hickman is terrified he will be the “patient zero” who sparked a local covid cluster in his rural community. He says now: “If we were told not to go to Disney, we definitely would not have gone.”
This is exactly what “strategic” and “targeted” management of covid gives you: everyone at risk, bad (and ineffective) advice on how to stay safe, zero control of the epidemic, unpredictable spread, lots of sick people, and yes, dire economic consequences.
Economic “Cost” Is A False Meme — EVERY Approach Comes With A Cost
Advocates of a “strategic” opening of the economy — one focused on “low risk” regions and people — all tend to ignore, or conveniently forget, the points above. They also conveniently ignore the potential consequences of business as usual: economic collapse because America is awash in corpses, hospitals are bursting with supposedly “low risk” patients, and people refuse to engage with each other at all.
Rep. Liz Cheney, no shrinking liberal wallflower, made the case succinctly and with the common sense so valued by Abernathy and his ilk:
There will be no normally functioning economy if our hospitals are overwhelmed and thousands of Americans of all ages, including our doctors and nurses, lay dying because we have failed to do what’s necessary to stop the virus.
Liz Cheney
New York and Florida (not to mention Italy, Spain, and the UK) are evidence that slow response and loosey-goosey “targeted” management have been an abysmal failure in Europe and America. “Strategic response” and “targeted mitigation” do not work the way we have tried them: i.e., without adequate testing, surveillance and quarantine.
At this point in America’s covid nightmare, arguing for a continuation of the current “strategic” approaches … advocating for failed strategies in the face of lived experience that tells us exactly the opposite… is quite frankly, delusional.
The fact is, in an open economy with high social mobility, the virus WILL spread, and every open economy WILL eventually become a “hot spot” of illness and death. These are the choices:
- Close the economy early when there are few cases and here’s what you get: unbearable economic cost and limited illness/loss of life
- Don’t close the economy early, wait until you have a “hot spot” with high case counts, and here’s what you get: unbearable economic cost and exponential community spread and massive illness/death and overwhelmed healthcare systems and sick/dying healthcare workers and shortages of equipment/supplies and exorbitant medical costs for caring for sick & dying covid patients.
There is no choice that doesn’t have an unbearable economic cost. The real question is: How much illness and death are you willing to tolerate along with your economic pain?
The Only Way It Can Work
This may sound like backtracking, but eventually re-opening the economy may be possible even before covid is vanquished. The caveat is: right now, a radical, concerted, national containment effort is the only way to get the covid nightmare under control. The time for strategic and targeted approaches is long gone, even if we had had the tools to implement those approaches effectively (which we never did).
Strategically, and in targeted fashion, opening up the economy requires three essential tools, all implemented in large enough scale to clamp down on the outbreaks that will surely follow any “peak” in the infection curve.
Those tools are: testing, contact tracing, and isolation. Using these tools, several Asian economies rapidly got a handle on infections and started the process of re-opening their economies.
TESTING: We need effective tests to identify covid cases, especially pre-symptomatic covid cases that may be spreading the virus in the community unbeknownst to the infected, their loved ones, friends, colleagues and healthcare providers.
CONTACT TRACING: We need to able to quickly and efficiently find unknown cases based on tracing the contact networks of newly confirmed cases. (Relatives in Ireland who work for the HSE (Ireland’s national health service told LiteralMayhem that furloughed government employees from other agencies are being trained in contact tracing and tasked to the HSE for this job. America should do the same.)
ISOLATION: Whether it’s converted college dorms, converted motels and hotels, or other public facilities, covid patients need a place to convalesce where their condition can be monitored, medical care delivered, quick interventions applied if their conditions deteriorate… and most important, where they can be safely quarantined from spreading the disease to family, friends, co-workers, and the general public. (If you think this is communism, for God’s sake get a life.)
Our problem is that America has failed in every one of these areas, and we will need them all if one day we hope to take Abernathy up on his expert economic advice. Until then, following the lead of Abernathy and those like him is a false choice leading nowhere, except toward a healthcare catastrophe — one that would, in the end, wreck the economy much worse than any mandated shutdown ever could.