Some Thoughts While Housebound
A new
coronavirus struck humanity late last year, so we call it COVID-19 to
distinguish the disease from other illnesses caused by viruses in the
coronavirus family. The virus passes
from infected persons to others via coughs, sneezes and touch. A cough, for instance, leaves micro-droplets
of fluid in the air, and the virus can live for hours, suspended in air, until
someone breathes it in. So the COVID-19
virus is highly communicable.
Most
infected people develop mild symptoms, and a significant percentage—perhaps as
high as 15%—show no symptoms at all. But
for another significant percentage of infected people, as much as 20%, the
disease requires hospitalization. With
good medical attention, most of the severely affected recover. The death rate may be as low as 1 or 2%.
Problems
arise because the disease is so easily spread.
When large numbers of people are infected, the number of people with
severe symptoms overwhelms the medical system.
We have already seen, in Italy and Spain, terrible consequences. There are not enough emergency rooms or life
saving equipment such as ventilators, so many people die who could have been
saved. With a shortage of protective
equipment (gowns, masks, etc.), medical personnel, catch the disease from their
patients.
Some
governments were slow to recognize the crisis, but by now it is acknowledged
worldwide. We have no vaccine. We have no drug proven to fight the
disease. So the main thing we can do is
try to slow the spread of the virus.
Governments everywhere have ordered people to stay home except for those
whose work is essential (medical people, grocery clerks, firefighters, etc.) or
for essential trips (to buy food or medicine).
The goal
here is not to stop the disease. Given
how contagious it is, it is extremely likely that virtually the whole
population will eventually be exposed to the virus. COVID-19
will spread everywhere. But if the
disease spreads rapidly, we won’t have the hospital resources needed for huge
numbers of people and many will needlessly die.
So around the world we are engaged in a desperate attempt to “flatten
the curve.”
Churches
and schools are closed. Restaurants
offer take-out only. Gyms, theatres,
bars, physical therapy centers, and many other businesses are closed. In the United States, about 10 million people
have applied for unemployment in just two weeks. Our unemployment rate, which was at a
historically low number at the beginning of the year—roughly 3%—will rise to
15% or 20% or even higher. We are
entering an economic contraction greater than any since the worldwide
depression of the 1930s.
The US
government has already responded to the economic crisis with mind-boggling
spending. The “CARES Act” authorizes
$2.2 Trillion to give directly to individuals, finance loans to small business,
and bailout big business. The Federal
Reserve has reduced interest rates to basically zero. Everyone expects even further government
spending to try to prop up the economy.
No one knows how effective these governmental actions will be.
Researchers
around the world are working frantically to develop a vaccine against
COVID-19. It will probably take from 12
to 18 months to find, test, and manufacture mass quantities of vaccine. Until then, we “shelter in place” and
practice “social distancing” to buy time for the hospitals and medical
professionals.
Health
consequences have to be weighed against economic consequences. We are entering an enormous economic
downturn. When poor people lose their jobs, they
die. A recession/depression kills
through homelessness, mental distress, drug abuse, lack of access to medicine,
and starvation. So there is a tipping
point—no one knows exactly—where the policies of keeping people home actually
kill more through poverty than they save from disease. At some point governments must encourage
people to go back to work.
When should
that be? I think the key variable is
hospital capacity. If we had an
unlimited supply of good ER beds, with doctors and nurses to work them, and
with an unlimited supply of ventilators, PPEs, and other supplies—if we had all
those things—we wouldn’t need to practice social distancing. Remember, this virus is so contagious that
virtually everyone will be exposed to it sooner or later. Without social distancing, the contagion
would race through our population. But
with a “super-adequate” hospital situation, every severely sick person could
still get the best care.
Of course,
we don’t have an unlimited supply of doctors, nurses, beds and machines. Our hospital capacity is far less than we
need. But it is growing. Industry
is ramping up to produce massive amounts of ventilators, PPEs, and other
necessaries. All the while, most people
who catch COVID-19 survive, and it seems that at least some of them do so
because they develop sufficient antibodies to be relatively immune to the
disease. Taken as a whole, the
population is slowly gaining immunity.
At some point, the increasing
hospital capacity will catch up to the need.
This will happen at different times in different cities and state. Governors and mayors will need to relax their
social distancing rules. Almost
certainly, when a state reopens for business, there will be a new surge of
COVID-19 cases, as previously unexposed people come into contact with the
virus. Even more certainly, state and
city leaders will be criticized for relaxing their rules. Such leaders need to state the case clearly
that poverty can kill as certainly as a virus, though in different ways.
I’m not an economist. Nevertheless, I think it would be disastrous
to try to maintain “shelter in place” until a vaccine is ready. Twelve months or longer of induced economic
contraction would be a worldwide catastrophe killing millions.
