Saturday, 21 March 2020

What Victory Looks Like in the Coronavirus War

We can try to stop time until a vaccine is ready, but the result might be identical to defeat.

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A woman in a mask walks through Grand Central Terminal in New York, March 16.

PHOTO: JOHANNES EISELE/AGENCE FRANCE-PRESSE/GETTY IMAGES
A telling moment came on CNBC Thursday. A host gently shushed the learned Jim Grant, editor of Grant’s Interest Rate Observer, saying discussion of trade-offs was not encouraged.
On TV, delivering up unpleasant choices is bad for the brand. Unfortunately policy discussion is about trade-offs, especially in the hardest of circumstances. Fortunately, the dam would break on CNBC a day later, thanks in part to an editorial in this paper.
In our coronavirus quandary, the cure may not only be worse than the disease. The cure is likely no cure at all. We might hold off an expected surge in coronavirus cases for two or three weeks with the kind of extraordinarily destructive economic lockdowns seen in California, New York and elsewhere. But unless warmer weather is coming to our rescue, Americans probably won’t accept the social devastation that would be inflicted by a five-month or 18-month campaign of virus suppression of the sort promoted, variously, by the U.K.’s Imperial College London, Germany’s Robert Koch Institute and other public-health think tanks.

Mandatory social distancing might well break down. (Look for speakeasies to re-emerge in New York and other shut-in cities.) The government might well face a choice of coercion or seeing its authority collapse. I’m not being alarmist.
This is a lesson the World Health Organization’s Bruce Aylward brought back from Wuhan. People with flu-like symptoms had to be isolated in dormitories, hospitals and stadiums. Asking them to self-isolate voluntarily didn’t work. “After a couple of days people get bored, go out for a walk and go shopping and get other people infected.”
And he was talking about people who knew they were sick. We would be asking apparently healthy Americans to surrender much of what makes life interesting and meaningful for an indefinite period.
Bad decision making, as shown in research, often begins with reducing a complex problem to the single variable with the biggest emotional wallop. That’s what’s happening here. All of us sense the opprobrium and disgrace that would descend on our elites if Italy-like scenes of a health-care system meltdown played out on our TVs. But we may get the bad result anyway and worse if we overtax the willingness of Americans to isolate themselves indefinitely.
We also may be underestimating their ability to adopt effective voluntary distancing even as they proceed with their economic lives. Each of us knows our own situation in a way no top-down directive can. This is a virtue to leverage.
I respect those experts who say we should suppress the virus until a vaccine arrives in 18 months or two years even at the cost of a global depression. Their job is to save lives, while the larger trade-offs are the province of voters and elected officials.
When experts predict that 70% of people will get the infection, they are estimating at what point the virus no longer finds enough uninfected people to sustain its transmission in a world where behavioral change is not restricting its access to fresh hosts.
The epidemic stops. People who aren’t yet infected but susceptible are spared (at least this time). We can make this work for us. We want three curves: a flattened curve for the elderly, a steeper one for the young, and a third curve showing the virus’s infectivity being reduced by isolating those who test positive and by encouraging everybody else to take care with their sneezes, hand-washing, etc.
Inconveniently for my argument, the U.K., a pioneer of such thinking, is now shifting to an accept-a-depression-and-wait-for-a-vaccine approach. The medical experts and their priorities are hard to resist. Resisting their wisdom doesn’t come naturally in such a situation.
Happily, I have confidence in the American people to let their leaders know when the mandatory shutdowns no longer are doing it for them. Strange to say, I have confidence in our political class to sense where the social fulcrum lies. A reader emails that Donald Trump could declare victory at the end of 15 days, claim the blow on the health-care system has been cushioned, and urge Americans, supercautiously, to resume normal life. This idea sounds better than waiting for spontaneous mass defections from the ambitions of the epidemiologists to undermine the authority of the government.
Because—make no mistake—there are things worse than the coronavirus. You think our politics are irrational now? You haven’t seen anything. The 1918 flu was far worse medically than what we’re about to experience, slaughtering even young people with strong immune systems. Yet we can end up a far more damaged society as a result of the 2020 coronavirus. The America of 1918 won a world war and launched technological and commercial revolutions that created the modern world. We may not be saying anything as flattering about the America of 2020 if we handle this badly.

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