The coronavirus pandemic has upended the world. It’s hard to keep track of the enormous changes and make sense of the bigger picture. Massive uncertainties make it nearly impossible to see around the corner. Yet we must keep trying to peek into the future. As I do so now in the United States, I see something ominous: The tension between public health and economics is going to escalate into a war.
The sides will split, roughly, along partisan divides, fueled by alternate media filters and entrenched epistemic tribes. Different realities with different experts and leaders will march into battle in a war with deadly consequences. Federal, state, and local governments will be giving deeply mixed messages and directives. Businesses will be caught in the middle trying to navigate the urge to get back to work with those graphs showing the coming death toll if we succumb to that urge. The result will be fractious, even violent, civil strife overlaid atop economic freefall and a waking nightmare at hospitals. This political unrest will hit us just as police forces and the military will be weakened and stretched by the virus. In other words, this pandemic might bring not just a painful economic contraction and horrific casualties, but the demise of our nation.
The Making of a Tragedy
This story might unfold in any nation, to be sure, given that the virus poses so many difficult decisions and stretches the capacity of so many systems. Yet in a way this is a future that is uniquely ripe for America given its current leadership, its decades-long ideological attack on government, collective amnesia about past pandemics, and growing disdain for science and expertise.
Once it got into the human bloodstream, the virus was going to inevitably bring tragic consequences. Lives cut short, businesses upended, and jobs lost. Some level of damage was unavoidable. Yet what we have learned from countries on the leading edge of the pandemic is that damage can be minimized if swift and decisive action is taken. China chose a shutdown for large portions of the country. Notably, these actions were implemented when confirmed cases of Covid-19 totaled just 500. Their strategy is certainly not without its costs, but it has almost entirely eliminated new domestic infections. Of course, it is likely that as it ramps its economy back up, more outbreaks will occur. Still, though, starting to ramp up in March is remarkable and future outbreaks will hopefully be more manageable.
Singapore is widely hailed as the best example. Their approach was also swift and decisive, but different. Rather than big shutdowns, they went the route of aggressive testing, tracing, and isolating. They had the infrastructure and plans in place to undertake this approach, because they learned tough lessons from the SARS outbreak in 2003. They also have a different socio-political culture featuring more surveillance and fewer civil liberties than in the US.
Rather than swift, decisive action, the Trump Administration frittered away precious days, weeks, and now months. Unfathomably, testing is still limited and must be rationed carefully. There has been no federal-level mandate to implement a national shut down as we have seen in a growing number of countries. Instead, the early message was that we had this under control. That shifted, finally, to a recommendations for social distancing. And now, spooked by market collapse, Trump is already shifting again away from even those exceedingly weak guidelines.
In the vacuum of federal leadership, states, counties, municipalities, and businesses have scrambled to put in place a patchwork of restrictions. Yet without nation-wide uniformity, the effectiveness of such measures is severely weakened. New Yorkers are infecting Floridians and vice versa. Governors are competing for each other in spaces where FEMA should be coordinating. Meanwhile, the Commander-in-Chief has yet to mobilize the military despite desperate pleas from his hometown of New York City.
The cat is out of the bag. Domestic spread may be slowed by our existing sieve of localized control measures, but not nearly enough. As I write this, there are over 46,000 confirmed cases in the US (and remember how limited our testing is). Recall that China implemented its lockdown at 500 cases. Try to keep in mind those images of military vehicles in a long row carting away dead bodies from overwhelmed Italian hospitals. Yet rather than clamping down harder on the virus, we are about to let up.
The upshot is that we have severely damaged the economy, but not slowed the virus. This, then, is a different kind of tragedy – one of our own doing. The Trump administration has put us in a situation where we now confront both staggering public health consequences and unbelievable economic misery. It did not have to be this way, but now it is too late. We are watching the gruesome logic of exponential viral spread even as the gears of our economy come grinding to a halt. Trump has brought us the worst of both worlds.
This is an enormous blunder caused by a failure to act swiftly and decisively. What we are seeing now from The Trump administration and Republican leaders like Texas Lt. Governor Dan Patrick is a strategic pivot. Patrick is now arguing that senior citizens have a patriotic duty to die so that their grandchildren have a functioning economy. That this kind of totalitarian-speak comes out of “freedom-loving” Texas and not China is a sign of our upside-down times.
Trump is now pivoting (waffling) as is evident with his tweet about “not letting the cure be worse than the disease.” Vice President Pence keeps counting down their 15-day clock, but given the complete inadequacy of their policies, this clock is meaningless. Worse than that, it becomes an excuse to declare some sort of victory just because an arbitrary deadline has passed. It’s like declaring a patient cured despite their worsening condition just because you administered 15 days-worth of aspirin.
Yet this is what Trump is now getting ready to do. At some arbitrary moment in the near future, he is going to push for America to get back to work. This will happen even as New York City struggles to find enough respirators. It will happen even as public health experts, armed with frightening models, call for sheltering in place. Even the experts pushing for more targeted approaches premised on greater testing and isolating vulnerable populations recognize that we need at least a two-week shutdown at this point before we a new paradigm of test, trace, and isolate can be effective.
Public health experts have been telling us that our objective is to flatten the curve to reduce and slow the spread of the virus. This can also buy time for the healthcare system to absorb patient load and ramp up capacity. We have all seen the graphs showing alarming spikes far exceeding hospital capacities. These spikes mean that people will die who would otherwise be saved. People of all ages. Doctors, nurses, police officers, grocery store clerks, and delivery drivers.
The federal government and many state governments are about to tell us to embrace those spikes. Give up the fight to flatten the curve and get back to work. Having allowed the virus to spread (still largely untested) and those spikes to grow higher, these leaders bear moral responsibility for the resulting carnage. Of course, they won’t acknowledge that – they’ll take credit for restoring jobs but they won’t take the blame when those workers end up at an over-crowded hospital.
If the stock market is going up in anticipation of an economic re-boot, that will only be a brief blip. People are going to go back to work. People are going to then get sick. People are going to not get healthcare. People are going to die who would have been alive had they been ordered to stay home and ride this out. The market will crash again. Had we all been given the order to stay home or had we started massive testing weeks ago, we might now be seeing light rather than deepening darkness.
How it Might Play Out
Here we are now. It’s “Flatten the curve” vs. “Get back to work.” Again, had we acted quickly and boldly weeks ago, this would still likely be a point of tension, but the stakes would be dampened. Instead, due to dithering, and denial, this tension for our country has only grown. It is building up steam and pressure as both the virus death toll and unemployment continue to mount with no end in sight. A fight is brewing, egged on by the unbearable anxieties caused by the virus and joblessness alike.
Soon, we will be “seeing double” as Thomas Hobbes famously wrote about the conditions of civil war. The Trump administration and some state governments will be telling us to go back to work. Meanwhile, public health experts (many functioning within government agencies) and other state governments will be telling us to hunker down. Add to this a cacophony of further mixed messages from city and county governments and employers. Think of it: employers might be fighting with employees about whether to go to work or not – each armed with their own official directives.
Of course, to some degree we are already in this situation of mixed messages. But over the past few weeks, the Trump administration has at least paid lip service to their experts and to social distancing guidelines. They have tolerated the more extreme measures taken by a dozen states and many local governments. But that truce will end. Trump will go to war against governors and mayors, who will in turn be fighting with each other.
Perhaps just as scary, Trump will turn his dictatorial will against his own public health experts. This, of course, is not surprising. It is what he does. But this time the consequences will be far more deadly and damaging. Dr. Fauci, who has put up a noble fight for facts up to this point, will be silenced. The CDC will be instructed to issue new guidelines about how to get back to work safely. These guidelines will contradict their own urgent calls for enhanced social distancing. Some in the CDC will resign. Others will learn doublespeak and comply. The guidelines will be issued, giving those who want it the sense of assurance that they are doing the safe thing by getting back to work. They will be listening to the science, never mind it is just politics by another name at that point.
From there, it gets harder to see. It’s just too dark.