Eyes on the Prize
Two of the most effective ways to screw up public policy are a failure to face facts and a failure to properly define objectives. No amount of execution will work if you are going in the wrong direction.
With respect to COVID-19, the facts are stark. Once travelers from China spread the virus all over the world, there was no chance it could be contained. We will be living with it until we get a vaccine or herd immunity. The second stark fact is that we cannot shut down the world’s economy until a vaccine arrives.
We got the first objective — flatten the curve — right. The health care infrastructure was unprepared to deal with a flood of highly contagious patients. The WHO and CDC failed miserably. We made some mistakes in the process. The ventilator frenzy may have killed more people than it saved. Cuomo’s decisions about sending infected people to long term care facilities was not his finest hour. That said, the curve did flatten. However, the objective was not clearly defined; mission creep set in. We started to conflate curve flattening with containment.
Our objective should be to minimize damage. That means opening the economy in a way that does not overwhelm the health care system and gets as many people reemployed as possible. There are several ways we can work toward this objective.
The first thing we need to do is to eliminate the political element. The same people who decried the “open it now” demonstrators, and want to prolong lock-downs, heaped praise on the massive BLM demonstrations. We should be able focus on the general welfare in this crisis. Mass gatherings of people in close contact are not a good idea, no matter how virtuous the cause.
We need to mandate practices that inhibit a rapid spread of the virus that might recreate the threat of overwhelming the health care system. Instead of focusing on “spikes”, we need to focus on hospital capacity. We can require masks, face shields, gloves and hand sanitizing in many situations and enforce the requirements. We can prohibit large gatherings indoors and enforce distancing for outdoor gatherings. The picture of the West Point graduation ceremony is an eloquent testimony to sane practice. The active duty military has suffered precisely one COVID death because they developed good rules and enforced them.
We can focus on the fact that mortality rates in our country have steadily declined over the last two months. That means that doctors have come up with better treatment options or the virus has evolved or both. In any event, the lethality level needs to drive public policy and we need to focus on the relative risk to various segments of the population. A majority of those who died were in two categories — residents of long term care facilities and those with one of a few very definable preexisting conditions (diabetes, obesity, etc.). We need to work to protect the most vulnerable and not apply the same shelter standards to those less vulnerable.
Most people who contract the disease do not require hospitalization. The symptoms can vary from very mild to horrible. In some cases, there may be lasting damage. We need to quickly (listen up FDA) translate what doctors are learning in treating hospitalized patients into remedies that can ameliorate the suffering of those who do not require hospitalization.
Mostly . . . the protected classes need to realize that a great many people cannot make a living by sitting in front of a computer screen in their home office or basement. Those people need to go back to work to feed themselves and their families. We have added trillions of dollars to our children's debt load to prop up the economy for a few weeks. That solution hits a wall very soon. We will destroy our currency if we keep it up. Open up NOW! Do it with gloves and masks and sanitizer, but open it up. Take extra precautions for those who are vulnerable and throw money at vaccine development. That would achieve the objective of minimizing damage.
