In fairness to Trump, he hasn’t said that we are. But tweets like the one below, shortening people’s collective time horizon for how long it’ll take to get a handle on this, will do more harm than good by creating false hope. It’s like when he touts hydroxychloroquine as a potential magic bullet against the virus. People need hope from their leaders, and he’s right that anecdotal reports about the drug have been encouraging, but he doesn’t consider the side effects of the things he says. In the case of hydroxychloroquine, the side effect is a shortage that’s putting lupus patients at risk even though no one’s sure if it’s effective against COVID-19 yet. In the case of the 15-day period, the side effect is leading people to believe that a more extended period of isolation in the name of containing the disease is an overreaction and shouldn’t be followed.
WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF. AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!
— Donald J. Trump (@realDonaldTrump) March 23, 2020
It’s one thousand percent true that shelter-in-place orders can’t continue indefinitely. My favorite analogy for what we’re going through economically right now is a cancer patient getting radiation. The treatment is horrendous — but it might send the cancer into remission while saving the patient’s life. Needless to say, though, it can’t go on forever. If you give someone a Chernobyl-sized dose of radiation, it’ll kill the cancer by killing them. On the other hand, there’s no point in giving a patient a single dose of radiation haphazardly and then telling him “Good luck” and sending him on his way. You won’t have killed the cancer; all you’ll have done is expose him to radiation needlessly, making him sicker for no good reason. There’s a course of treatment. If you’re not going to follow the course, it’s foolish to start treatment in the first place.
When I see him retweeting stuff like this, I wonder if he has any handle on what the strategy is or even a solid grasp of what’s going on.
That sounds suspiciously like the British coronavirus plan that Boris Johnson had to hurriedly abandon when his advisors realized it would mean hundreds of thousands of deaths and bring the British economy to its knees. There was no 15-day lockdown in the British plan but the rest of it resembled the tweet above: Lock all the old people away for four months or so and let the healthier younger population carry on more or less as usual, infecting each other and building herd immunity. Then, once herd immunity is achieved, it’ll be safe for the old people to come out.
But the Brits saw two problems there. One: Even with the elderly in mass quarantine, there’d still be so many dire cases of COVID-19 among the “healthier” parts of the population that the health-care system would be overwhelmed many times over. It’d be wonderful if coronavirus were as ineffective against adults age 20 to 65 as it seems to be among children, but it isn’t. American newspapers are littered with reports right now of healthy younger people needing some form of hospital treatment. The Brits projected many thousands of people dying even among the “healthy” population before the quarantine for older people ended. Which brings us to the second problem: Most older people can’t manage life without younger people. Many of them need health care and other forms of assistance that are provided by the rest of the population. How are they supposed to get that care while the virus is spreading like wildfire among the “healthy” group? One British epidemiologist said, after being asked about the Brits’ plan to quarantine nursing homes, “Who do you think works at those nursing homes? Highly trained gibbons?”
The weirdest part of the “let’s get back to work” push is that it seems to imagine that coronavirus containment and economic recovery are a pure either/or choice. We can either continue to stay at home and watch the economy disintegrate or we can restore the economy (somewhat) and accept some higher number of deaths as the price. (Prolonged economic downturns have a body count all their own, after all.) But it’s not either/or. Paint me a portrait of the economy “recovering” amid an accelerating outbreak in which the entire labor force is suddenly being infected en masse and unable to come to work. What sort of lasting economic disruption might be caused by a mass die-off?
This isn’t either/or. We can have a slower economic catastrophe with fewer deaths by flattening the curve or we can have a faster economic catastrophe with many more deaths by carrying on as usual. I’m willing to entertain arguments that a higher body count that produces a smaller economic calamity is optimal from the standpoint of general human welfare compared to a lower body count that produces an economic calamity three times as large. But the higher the body count gets, the stronger those arguments need to be.
As I understand it, this is exactly what the shelter-in-place orders are designed to achieve. They’re not just a random “pause” to slow down the disease before we all run back to work and start re-infecting each other, turning a flattening curve into a sharp one. They’re a stalling tactic.
Whitmer: “This will be temporary. This intervention is important to buy time so we can create surge capacity in our hospitals, so we can ramp up testing and develop therapeutic drugs that may lower hospitalization and fatality rates." https://t.co/SqFnLAjEnD
— Melissa Nann Burke (@nannburke) March 23, 2020
More tests, more masks, more drugs, plus more draconian isolation measures for senior citizens once the rest of us have precautions in place. The sooner all of that happens, the less risk there is in unshuttering businesses. At the Blaze today, Leon Wolf argues that “At some point, President Trump will have to have the courage to tell the doctors, ‘No.'” But the doctors are well aware of the consequences of a profound economic contraction. That’s not just an economic problem, after all. It’s a public health problem too.
To me, the most interesting thing in this interview with Dr. Fauci is that he does not think it's at all unreasonable to consider the longterm economic harm of indefinite shutdowns. https://t.co/xldDCfC9eX pic.twitter.com/lOWdWFlFqL
— Robby Soave (@robbysoave) March 23, 2020
Scott Gottlieb, one of the most visible doctors on TV and print during this crisis, published an op-ed yesterday addressing the question, “How Long Will the Coronavirus Lockdowns Go On?” It depends on whether a particular city or state is a hot spot, he points out, but tests, masks, and drugs are an absolute prerequisite to containing the spread nationwide.
The population tactics are blunt instruments, necessary for isolating hot spots like New York and Seattle. Other places may be able to rely more on individual interventions, which cause less disruption and economic damage. Yet every state should be taking steps such as encouraging social distancing and preparing to expand hospital capacity. Some states and cities that haven’t seen as many cases yet—such as New Orleans—have been too slow to take the threat seriously.
For this to work, the U.S. will need widespread testing to know where and to what extent the virus is spreading. Testing capacity has increased significantly in the past few weeks thanks to relentless efforts from public, academic and private labs such as Quest and LabCorp. Producers of testing kits are also working overtime. A new test developed by Cepheid can be deployed in a doctor’s office…
Another step: serological surveillance, which means blood tests to detect antibodies developed to fight the novel coronavirus. These antibodies confer immunity and can reveal whether a person has been exposed. If a sizable portion of a local community has some protection, authorities can be more confident in relying on less invasive measures. Once deployed, serological tests are cheap, straightforward, and easy to scale.
Trump doesn’t think long-term, though. If he did, he wouldn’t have been touting the small number of confirmed cases in the U.S. three weeks ago. He thinks short-term, in response to news cycles, and the news lately has been consumed with apocalyptic unemployment numbers coming this week and an unprecedented economic contraction in the second quarter. He also changes his mind frequently depending upon what he’s hearing from experts and what Fox News and other members of his cheering section are telling him privately. It was just six days ago, remember, after being lobbied by Tucker Carlson to take the virus more seriously, that Trump talked about the virus potentially “washing through” America all the way into July or August. Steve Mnuchin was on TV as recently as yesterday projecting that widespread lockdowns could last 10-12 weeks, into June, with more assistance to come from Congress to help people and businesses manage until then. Now, this morning, there are reports of him talking privately about reopening the country for business sooner than doctors advise, potentially destroying the gains that have been made to slow the spread of the disease from the past week of aggressive social distancing.
There’s no strategy in any of that. It’s just box-checking. “Doctors told me to shut things down, so I did. Then my base told me to open things up, so I did.” The irony is that he doubtless helped spread the foolish willingness among some of his fans to end lockdown measures before it’s advisable by happy-talking the potential danger and suggesting that the spreading panic was Democratic/media alarmism designed to wound him. Now he’s stuck in a feedback loop: He told his fans not to overreact, then doctors warned him that the country would melt down if he didn’t react, now he’s acted and his fans are telling him not to overreact, so he’ll try to undo what he’s done and the doctors will panic, etc.
Here’s what’s going to happen. Next week he’ll start chattering about how the 15-day period is up and it’s time for Americans to start working again. Every epidemiologist in the country will summarily freak out, insisting it’s way too early. Trump will waver, but for reasons of pure face-saving will insist that *some* people need to go back to work ASAP. Americans won’t know what to do. Listen to Fauci or to Trump? Governors, especially governors in red states, won’t know what to do either. Keep things locked down like the doctors say or show partisan loyalty by reopening for business? Partisanship among average joes will get extremely stupid and dangerous, with Democrats wanting to self-isolate and Republicans insisting that it’s time to chill out and start working. There’s just one wrinkle: The scenes out of New York City during this same period will be very, very bad. As much as Trump may want to reopen for business today, it’s entirely possible (or likely) that the reports there will be so grim by next weekend that a sustained lockdown past the 15 days becomes a smart move even for someone like him who thinks short-term, in order to quell rising public panic.
And even if he’s still not convinced a week from now, there are fortunately some people in his orbit who remain admirably clear-eyed about the situation. Steve Bannon was on Fox Business yesterday insisting that we need a “full shutdown” to slow the virus’s spread as swiftly as possible: “Whether it takes two weeks or four weeks, we get through this hard and fast.” Lindsey Graham is entirely right here:
There is no functioning economy unless we control the virus.
— Lindsey Graham (@LindseyGrahamSC) March 23, 2020
Correct. It’s not an either/or question. You don’t either get a hold on the virus or have a functioning economy. You get a hold on the virus in order to have a functioning economy.
Here’s the president’s old friend, Joe Scarborough, also grasping the problem.
“I’ve said it for weeks now. Mr President, I’ll say it again: This is not an economic crisis; this is a health care crisis. If you will do everything that’s required to take care of the health care crisis, then the economic crisis will go away.” —@JoeNBC pic.twitter.com/pPBelxWu5T
— Morning Joe (@Morning_Joe) March 23, 2020