The month of May does not presently look to be a merry one for America, although that could change. After cooperating voluntarily with public officials implementing, what were supposed to be temporary, stay at home measures, a growing debate has begun to surface between the government and the governed about what comes next for the national interest.
It is important to remember that when all this started in February, public officials were hesitant and unsure about the threat posed by COVID-19. We knew it was causing problems in Hubei Province, China centered in the city of Wuhan, and not much more.
Governors and mayors were apologetic that they might have to inconvenience their constituents. The Washington elite political apparatus fed the mainstream media narrative with accusations that President Trump taking leadership initiative to close the US border was some sort of cover up for hate mongering against illegal aliens. What few COVID-19 infected persons were known to the US were treated like lepers to be contained in a desperate attempt to prevent COVID-19 from entering the US population.
Public health officials consulted by government officials warned of millions of deaths based on years of theoretical computer modeling, and as it turned out, but were not told at the time, more than a passing familiarity with sponsoring research into something called “gain of function” virus bioengineering.
What we did not also know in February was that COVID-19 had likely entered the US population as far back as December 2019, maybe even earlier. Something called the R-zero factor of this virus made it amazingly infectious. Its perfect match to the ACE2 receptors in human lungs meant all you needed to do to spread it was breathe on someone. It’s ability to show no signs of infection, or very few signs of serious effects, known as being asymptomatic, further helped to hide COVID-19 inside what was already a heavy 2019 influenza season.
But something about the suspicion that a virus erupting next door to the Wuhan Institute of Virology in China spooked the combined medical establishment that deals with the science and research of pandemics enough to trigger alarm. While conjecture abounds, the objective reality is that we still do not know.
It probably did not help that the only specific report published on the episode by the WHO-China Mission report on Wuhan explicitly said that, as of the time of that report, the Chinese had no idea what the actual origin of the epidemic was. The report stated, “COVID-19 is a zoonotic virus. From phylogenetics analyses undertaken with available full genome sequences, bats appear to be the reservoir of COVID-19 virus, but the intermediate host(s) has not yet been identified.”
In a world where “I don’t know” too often translates into “I’m hiding something”, the safest space move is naturally, to panic.
Official Panic, Cooperative Public
As fear spread, any location on the planet that had significant airline travel traffic with Hubei province, where Wuhan is the capital industrial center, was beginning to reveal COVID-19’s infection rate and morbid preference to try to kill the old, the compromised, and the obese. The worry, based on theoretical pandemic models relied upon by the “plan for the worst” public health community, was that the pandemic would explode and the entire medical services capacity would be overwhelmed. The mantra became flatten the curve! Do whatever it takes to flatten the curve!
This is all the emergency management advisers of the United States had to go on. In hindsight, it was a flimsy thread. In the moment, it was the best guess they had. They asked the American people for their indulgence and cooperation to please do the only thing the medical community pleaded with us to do. They asked could we please distance ourselves from each other, relinquish the very essence of what makes humans the apex social creature of planet Earth, and temporarily live the life of a bunch of rats in a laboratory. There’s a concept in management science called “thrown and bounded”. It roughly translates, “when in doubt, do what you know”.
If we did this that would flatten the curve they said. It wills not last long they said. Only until they were sure we were no longer going to overwhelm the hospital system care they said. Ok we said. Because we know nothing more than what these models are projecting, we will try it. We all tightened our belts, went deeper into national debt, and climbed into the ark.
Time to Take Stock
Personally, I never panicked. At the very start of this thing, I ran some comparative calculations between the Chinese scenario in Wuhan and the status of the United States’ preparedness. What was interesting was looking at the numbers of physicians per capita and hospital beds per capita. Buried in the numbers was the reassuring figure of merit that the US starting position of medical infrastructure in February 2020 was higher, before the build up that was to come, than what had been available to the Chinese in Hubei province. In fact, the numbers from the Chinese response in Hubei showed that they had built-up resources in that region to respond to COVID-19 achieving a physician and hospital capacity rate just underneath the normal day to day levels in the United States. The data said we were starting the US episode with COVID-19 already standing at China’s goal post.
It has been over forty days and forty nights since we prepared for the COVID-19 equivalent of Passover. American’s, for the most part, did a remarkable job participating in a grand petri dish experiment in curve flattening. By all accounts, the medical system did not get overwhelmed. In most parts of the country, not even close. Bravo for us. We should be celebrating that we were able to set aside so many angry political differences and do something together, because we all made a common choice. But we are not. Instead, we are doing the one thing we Americans do best, passionately disagree.
Americans are a remarkably predictable lot. It was always clear to me that public officials never had more than about thirty days of universal cooperation from the American public from the time they made their first ask for people to stay at home. That is about the limit before the least patient among us throw the sheets to the wind and individually initiate a return to normalcy.
Right on time, in California and Florida, people went to the beach. In New Jersey, Pennsylvania and Michigan, they started protesting in the streets. Predictably, others took issue with it.
Another group of Americans are more cautious. Their patience with being turned into lab rats tends more towards sixty to maybe ninety days depending on how long they can avoid being adversely economically impacted. They can afford to wait, literally in the depth of their pocketbook sense. That economic safety and security, and its lack of survival desperation, tends to place these persons in the camp willing to wait until public health officials have done every test and rule out analysis diligently.
It is a different America for those who are not losing their homes or livelihoods. Well, not yet anyway. Eventually, as the economy craters, they are losing the tax base that employs them and even government workers will learn that furloughs can become unemployment.
But their fears that COVID-19 will surge again have a grain of truth. Actually, future surges are a certainty. That is how viruses work. The Spanish flu of 1918 to 1920 took two years and had a pattern that looked like the teeth of a shark’s jaws. Wave on wave on wave. This is a hostile planet that demands respect. A planet doesn’t actually care what happens to humans, or any other creature really. The question for us is not that there won’t be waves, the question is the same as one we asked in February 2020, “Will the next wave overwhelm our medical capacity?”
The Chinese, whatever you want to think of them have had almost ninety days to observe and adapt. They are at the point that they have implemented all the recommendations of the WHO-China Mission report on their plan to re-open their economy, protect vulnerable persons, and actively manage emerging infection clusters. The average daily number of new cases in China reported by China Daily is between 30 and 40, for the whole country. Of course they are boasting. Rubbing it in our faces. They figured something out before we did. Specifically, “The third stage of the outbreak focused on reducing clusters of cases, thoroughly controlling the epidemic, and striking a balance between epidemic prevention and control, sustainable economic and social development, the unified command, standardized guidance, and scientific evidence-based policy implementation.”
We have had forty-five days in America to observe this question and adapt strategies to assess our chances. The curve is flat and we aren’t quite sure what to do next. We are kind of floundering. Why?
There is a reason for America’s lack of consensus. It’s because, our medical and economic systems failed to coordinate with each other to create a unified strategy. We blew it with each specialty concentrating only on what they knew. Our government leadership, particularly at the state level where most of the emergency dictatorial power in America is concentrated in times like these, failed to pay attention to the co-equal importance that both agendas needed tangible plans and solutions.
The Whitehouse recognized the problem early on. President Trump said so in his “I won’t let this country’s economy fail such that the cure becomes worse than the disease” remark. He was, like when he closed the border in February, ridiculed for suggesting that he wasn’t committed to the importance of the medical side of the problem.
I will note again from the WHO-China Mission Report on Wuhan that the Chinese made a major point in that report that they did recognize it as a matter of existential important that they needed to solve the economic re-opening problem just as badly as the medical treatment problem BEFORE economic collapse caused an even more dire secondary disaster. The Chinese were worried, and openly said so. They didn’t want a two-year recovery cycle with the hardship and starvation such a thing implies in a cascading systemic failure in a country with 1.3 billion mouths to feed.
To the President’s credit, it looks like at least he and his team understood what Xi XInpings’s contingent meant.
As the 30-day grace period approached, the Whitehouse issued guidelines for the states to observe in re-opening their economies. I found it remarkable that Trump recognized and respected that every state in the union walks its own path, however tumultuous. Every governor gets the chance to try to do what is best for their state; or earn the ire of their citizenry for blowing it.
This being America, we are sure to see a plethora of examples of both. The noisy arguments of May 2020 will surely involve the boundaries of emergency power versus civil rights. The month has already begun with protests, court cases, and Twitter storms galore. That is expected.
It is also not what I am watching most earnestly. What I am watching for is when the medical panic will equalize with the economic panic.
It’s an issue most poignantly made by the fact that over 900 workers at a Tyson Foods processing plant in Indiana tested positive for COVID-19. These plants are now designated as strategic and essential under the Defense Act. We need to deliver almost nine-hundred thousand tons of food per day to keep America from starving, the worst-case scenario that the Chinese were worried about. The medical pandemic models of the public health system may need to replace hospital and ICU medical treatment capacity worries with food riot worries as “worst case” scenarios if the domestic supply chain for food breaks down.
There is No Such Thing as a Non-Essential Worker
What “most vulnerable” means going forward is not just those most likely to be attacked hardest by COVID-19 the disease, it also means those who’s ability to resume their chosen lifestyle has been destroyed by the government response to COVID-19, the economy killer.
That would be the millions of Americans deemed non-essential to supporting the government’s agenda to narrowly manage the crisis. There are the Americans risking extinction. Their values. Their way of life. They are watching these things evaporate in front of their eyes as people not at economic risk avert their eyes from their plight. Their only sin was to have chosen to work in industries that do not depend on tax dollars to pay their salaries.
For that sin, they have had to forego earning money. They have had to beg for forbearance from their creditors. They worry about the balloon payments they will not be able to afford. Their fears for the future are depressing. If you look at the data coming out of the financial world, bank provisions for loan losses are rising. The prediction is that these people will default into ruin in droves. National economic collapse sized droves. That does worry me.
It is cruel. Dystopian cruel. They have done nothing wrong to deserve the distress forced upon their lives with the simple strokes of pens based on being asked to, and graciously agreeing to participate in a theoretical petri dish experiment based on pandemic models of death rates that have not come to pass.
Contrary to the prejudicial label that they presently are stigmatized by, these Americans are not non-essential to the economy. They account for as much as forty-two percent of the US GDP counting just the small businesses and their workers in this country alone. More if you add the non-essential major corporations and the agricultural sector.
This other America does have a right to say no to government telling them they are expendable for the greater good. And the government has an obligation to hear their plight and make them as important as the elites they seem to listening to far too exclusively during times of uncertainty. Will the governors recognize that the demands of all citizens are equally valid? If this doesn’t happen, the cure will be always be worse than the disease.
Things are moving very fast in America as fifty governors struggle to strike a balance the lives up to the best “third stage of outbreak” solution outcomes for their states. The first full week of May will reveal much about whether or not America has the fortitude to tackle controlled risk taking. No doubt, pride, prejudice and soul searching will play prominently into the debate. What we must not fail to do is maintain that middle ground cohesion that has gotten us through this so far. It is important to remember that government can only ask people to cooperate, and only as long as those asks are reasonable.
As to the economics, the federal government has its work cut out for it creating a forbearance plan that can absorb the economic damage we’ve done by shutting down. It’s all about how an artificial pause can be undone without crashing the system. And for that, the greatest enemy is not COVID-19, it’s American politics.
America needs to find a balance between the damage of COVID-19, a medical disease, and the damage of COVID-19, an economic and quality of life threat. This in turn demands that public health officials advising state governors shift from a simple medical model focused on care facility capacity and treatment methods to the more complex, unintended consequence effects of policy timidity type of analysis. It means a more multi-disciplinary approach to things. That means more than just listening to elites. It means listening to ordinary people.
*A note about “Ordinary People Matter”. In 2011, during the middle of the sub-prime financial crisis, I penned another article with the same title. Its purpose then, similar to this one now, was to point out the hubris of government officials who callously dismiss those with whom they consider their lesser is wrong. In that first article, an official in the administration of that era has said recently made a statement that ordinary people’s assets might need to be sacrificed in order to save the large systemically important banks. I did not agree.