Italy is the test case for being a day late and dollar short in voluntary social distancing—the steps people can take to reduce their risk of contracting and spreading the disease. But Italy may also be the first to emerge from the tunnel, with everyone having had their chance to get sick, and the country being able to get back to work.
Britain is wavering on what seemed a modified, limited Italian strategy. Until Tuesday, it was considering letting its health-care sector absorb as much stress as necessary to avoid a sweeping, draconian shutdown of the economy.
The U.S. may or may not be a test case of a large continental country where hot spots of contagion shock other places into buttoning up and hunkering down, curbing excess local demand for intensive-care beds. But the cost will be astronomical. Essentially we are killing other sectors indefinitely to manage the load on the health-care sector.
Understandably, politicians believe faith in government requires avoiding Italy-like scenes. But turned on its head here is the 50-year-old “QALY” revolution: the idea of measuring the burden of disease and benefit of health care based on “quality-adjusted life year,” typically valued at $50,000 to $150,000. In the present instance, the cost isn’t just medical intervention (e.g., ventilator use) but the cost of an economywide shutdown to limit the number of candidates for ventilation at any one time.