COVID-19 CREATES A MODERN DAY SOPHIE’S CHOICE

The crisis management of coronavirus (COVID-19) has devolved into a debate between the scientists (more specifically the infectious disease experts and frontline physicians) and the economists (more specifically the conservative think tanks and leaders of corporate America).  The scientists have dedicated their professional careers to developing schemes to mitigate and control public health emergencies like the coronavirus.  The possibility of a total economic collapse was not on their radar. 

Conversely, the economists have spent a lifetime building economic models to maximize prosperity through market-based capitalism.  Shutting down all economic activity, to protect a vulnerable portion of the population, knowing that a deep recession would result, was never a consideration. 

Welcome to the newest incarnation of Sophie’s Choice: save lives or save the economy. As in the novel and Oscar winning movie, both results are desirable and the alternative is fraught with human suffering. Our initial reaction is rightly to save as many citizens as possible. However, no one knows the long-term economic hardships of an extended dislocation that requires paying people not to work.

Such a dilemma did not exist a hundred years ago, at the time of the flu pandemic of 1918. In the early 20^th century, the economists trumped the scientists because epidemiologists were in short supply.  The population was largely rural and agrarian.  In the U.S., about 28% of the population of 105 million became infected, and 500,000 to 675,000 died (0.48 to 0.64 percent of the population). Because the pandemic passed relatively quickly, there was little hysteria or media coverage and the economy suffered minimal damage.

 Some historians believe the most lasting effect of this pandemic was the substantial increase in the number of nurses entering the medical profession. Physician training alone proved inadequate in addressing the needs of large numbers of infected patients.

In hindsight, our modern day Sophie’s Choice could have been largely avoided. I have previously discussed the initial missteps of the Trump administration, which insured a disastrous outcome, and will not repeat them here. At this juncture, finger pointing at government’s failure to act appropriately is not helpful and should be left for the voters in the upcoming election.

The fast moving reality on the ground must now be addressed in a rational manner.  The first meaningful effort by the White House was a call for a lockdown that would last for 2 weeks, with a quick V-shaped economic recovery. Within days, the scientists had data from other countries and more testing from urban areas. They determined that the most positive outcome was a 2-3 month lockdown followed by a much slower U-shaped recovery.  

President Trump initially resisted the science and used his daily press conferences to push for a reopening of the economy on a rolling basis in areas less affected by the virus.  Over time, he has reluctantly come to accept the need for a longer lockdown in order to avoid mass fatalities.

It would be a mistake to not consider our Sophie’s choice between the science view of saving lives and the economist view of saving the economy in political terms.   Democratic states with highly vulnerable urban populations like New York and California rushed to lock down their populations.  Conversely, governors from less populated red states initially took little or no action to isolate their citizens. Liberty University, the private evangelical Christian university in Lynchburg, Virginia, was the only large academic institution to welcome students back from spring break to the horror of local officials.

Traditionally, conservatives worry about massive governmental intervention and its long-term impact on the economy.  The pandemic has been no exception.  Many Republicans believe it is better to suffer some immediate casualties (It is only the flu.) rather than to risk the consequences of economic meltdown. 

On the other side of the political spectrum, those on the left are all in with the scientists.  Why wait to save lives? Moreover, shutting down the economy for an extended period has lead to government intervention in the form of a massive rescue plan and social safety net package.  Progressives know it is difficult to remove benefits that favor workers once they are in place. 

Helping the scientists to win the day over the economists has been the undeniable fact that hospitals and medical staff were unprepared for the onslaught of infected patients who require long ICU treatment on ventilators. Eventually, the President and the economists conceded that a more aggressive lockdown was necessary.  When the hospitals gain the upper hand, the economists will seek to shorten the lockdown and resume economic activity.

The nonpolitical response going forward would be a national effort to optimize public health while minimizing economic harm. This thinking often seems in short supply. To succeed, scientists and economists must get on the same page and be prepared to compromise on their life’s work to help the nation recover.  

There are two critical non-partisan governmental actions that now make sense. 

First, as we make our way through the lockdown period, there must be a national consensus on what economic activities are the most essential to getting the economy back on track.   

Second, we must assume that the virus will return later this year as other pandemics have done in the past.  This will require an “all in” testing, contact tracing and isolation program that can quickly be implemented across the country.

Our early missteps from January must not be repeated.  Following an initial recovery, the only way to avoid a return of Sophie’s choice will be to avoid a recurrence of widespread infection.  This must be the singular goal until a universal vaccine is developed.