The Road Ahead

It is obvious that we are not yet through the terrible ramifications of our pandemic and resulting economic crisis.  Public health concerns need to be balanced with economic concerns in order to reach some kind of “new normal.”  I am sure that none of us know what our country will look like in the next six to twelve months but what is clear is the need for some kind of road map for our national recovery that is consistent with the necessary steps to keep all of us safe and to prevent a second major wave of disease that could result from lifting current restrictions too soon.

The president is, according to his remarks on his daily Trump Show, looking forward to reopening the country to business as usual with a “big bang.”  Aides suggest that the date will be roughly 1 May or perhaps earlier in parts of the country.  This makes it sound like some kind of ribbon cutting at the grand opening of a new mall rather than a sober analysis of the pros and cons of particular actions.

As the death toll passes 16,000 Americans, we are still deep into this crisis.  The good news, if it can be called anything like that, is that models seem to indicate that the total death toll by August will “only” be about 60,000.  Imagine.  Only 60,000 Americans dead. That is down from 100,000 to 240,000 but nothing to rejoice about or to suggest that we have this crisis under control.  We are not even a third of the way towards that horrible number and the president seems to want to do away with the measures that have helped to get a small grip on the horrors of this pandemic.

Americans of all political stripes, age groups, ethnic groups and socioeconomic means seem to have come together to embrace, for the most part, social distancing and accepting that things will be tough economically for awhile but that the only way to get this outbreak under control is by working together.  Patience is a virtue.  The results of what we do today will not be seen for two or three weeks down the line.

I have no trouble with the president and his administration looking ahead to what we should be doing in the next month, six months or a year.  I hope that someone or some group of professionals is in fact doing that.  But I see no evidence of a coherent, realistic plan.

During his daily reality show, the president seems intent on focusing only on the next 15 minutes rather than the next 15 months.  He continues to spread lies and misinformation.  For example, health care professionals uniformly declare that the only way to get the country back on its feet is to have a robust testing regime in place to determine who is sick, who is not sick and who may have already recovered from coronavirus without ever going to a doctor or indeed, without ever knowing they had it.

The Trump Administration has made continual promises on testing that have come nowhere near being factual.  As just a few examples, remember that on 10 March Vice President Mike Pence said that over a million tests had been distributed and that by 14 March four million more would be available.  A few days later the president said that 5 million tests were available.  And of course a week before that on 6 March the president said that, “Anybody that wants a test can get a test.  That’s the bottom line.”

A month later roughly two million tests have been administered so far in the entire country.

The president continually points out that the United States has tested more people than any other country in the world, and he is correct.  But he misses several key contextual aspects to that. The state of New York has more confirmed cases than any country on earth.  All by itself.  Obviously the United States as a whole is the sickest on earth so far.  This includes China (which nearly certainly under reported the number of cases), India, Indonesia and several others with much greater populations.

Most importantly, per capita we are failing badly.  Well less than one percent of our country has been tested.  In my state only medical personnel on the front lines and those with a referral from their doctor based on symptoms can get tested.

Just by the force of numbers alone, it is clear that the United States, the greatest country on earth, badly bungled this crisis.  Dithering and wishful thinking frittered away a chance to get ahead of the pandemic and here we are.

So, my question.  What is the long-term strategy?  I have heard nothing from this administration that looks ahead to how we know we are “winning.”  What are the measures of effectiveness (MOEs) that will determine how we are doing and whether it is safe to open up parts of the economy?  So far we only hear about flattening the curve — an indicator that social distancing is working — but not what “safe” numbers of infected may be.  If the curve flattens out at 1500 dead a day is that a good thing?  I think not.  The numbers are not dropping everywhere and across the country the totals continue to increase.

Numbers are great.  To say we have tested more people than any other country is nice, but meaningless. Since this all began, we have tested roughly 2 million people.  Total.  If we test one million Americans a day — a day mind you — it will still take roughly nine months to test everyone.  And a test only shows whether you have the illness at the time of testing.

Am I advocating for every American to be tested and until then we keep our daily lives on hold?  No.  Not realistic.  But what is realistic?  What are the MOEs?  When is the risk/reward equation in our favor?  How do we know when it is safe to eat in a crowded restaurant or go to a sold out college football game? What percentage of testing is adequate to give a good sense of the pervasiveness of the disease in a particular area?  What number of sick people in an area is an indicator that it is safe to go out in a crowd? Are certain precautions sufficient to reopen a particular business that may not work in another?  Until we have some measurable indicators beyond the number of people currently in the hospital we don’t really know where we stand.  This is especially true as we know that some people are asymptomatic carriers that unknowingly pass the virus to others who then become very sick.

Psychologically I think it will take a long time for many of us to feel totally safe in a crowd.  Having actual data from the experts rather than “cheerleading” “aspirational” statements that turn out to be false from the president would go a long way in helping each of us to understand where we stand.

Life has risks in everyday endeavors.  Nothing is perfect.  However it is possible to understand our world around us when presented with facts, not lies, or wishes or wannabe situations.

Many pundits in the right wing media are starting to attack the medical professionals claiming that they are part of the Deep State or to opine that some kind of Social Darwinism is at work with COVID-19 and it should be allowed to run its course. Weed out the weaklings. The president has at times opined that it is not as bad as the media says it is and that they are only trying to hurt his re-election.  Might I suggest that those people go to work in a hospital or a grocery store or a pharmacy without proper protection?  Or perhaps the president could visit a COVID-19 ward without PPE?  Cheer up the troops.  Oh right.  No one can now come into contact with the president and vice president without being tested for COVID-19.  Yesterday they even required testing of the White House press pool before they could attend his daily reality show.

Nothing is impossible for the people that don’t have to do it.

It is time to listen to the experts.  Health care professionals should take the lead and economic professionals base their analysis on what is healthy — literally impacting one’s health — for the country as a whole.  Perhaps a regionally focused approach would work, although I would be concerned that folks with “cabin fever” in stay-at-home states would gravitate to those open for business.

A national approach, based on facts and realistic MOEs is the only way we will find our way out of this crisis.  The worst thing that could happen is to prematurely lift the measures we know are working only because the president is impatient and has a gut feeling that everything is good to go.  A second wave of pandemic would do even greater damage to our country.  If there is a time for a very conservative approach, this is it.

Patience coupled with verifiable facts is the only way to go.