David Katz has been promoting a risk tiered immunity approach to COVID for over a month, and I think it is something that progressives should investigate and even embrace if the data supports it.
Societal and Economic Problem
I think we on this site recognize the COVID public health problem that we are trying to solve, but there is also a very real societal and economic problem that also needs to be addressed as part of any public health solution. I have been looking for a progressive economist’s assessment of what an extended Lockdown would look like, and I can not find one. I am not a public health expert, but I have an MBA and a pretty good handle on economics. I believe that an extended Lockdown will be devastating not just economically, but from a quality of life perspective for the vast majority of Americans. 26 million unemployed is a heart-stopping statistic, and their loss of income will have a very real and visceral human impact for each one of those people, in addition to every business and service that those people previously supported. The pictures of lines at food banks are heart breaking. We should all be concerned about the human cost of America’s response to this pandemic.
Trumpian Approach
Trump’s approach, if someone was able to decipher a coherent thought from his ramblings, appears to be the Darwinian free-for-all that South Dakota and Iowa have pursued, Georgia and Florida are starting, and Texas will be doing soon. Trump wants people working because he wants better unemployment and GDP numbers so he can get re-elected. To achieve this, he is ordering his stooge Governors to recklessly re-open. This approach, together with the Trump Administration’s fundamental incompetence, is the reason America is handling the pandemic worse than any developed country by any objective measure.
Lockdown Approach
It will take at least 18 months to get a broadly available vaccine, and it is possible we may never have one. Unless a public health expert can provide an economic analysis to the contrary, a Lockdown that long is completely unrealistic. I fear that the social and economic foundation of our society will begin cracking if we try to run a Lockdown for half that long, or even less. We can argue about the precise timing of economic tipping points, but any extended Lockdown will result in a huge increase in poverty, a break down of our supply chains including the food supply chain which could result in food insecurity or worse for much of the country, and the permanent reduction of quality of life and life expectancy for a large percentage, possibly even a majority, of our population. The permanent implications on the economic and individual freedoms for each of us individually and our fellow Americans collectively are enormous. Maybe there is no other way for dealing with this pandemic, but we should recognize the choice that we are making if we decide that an 18 month or longer Lockdown is the way to go.
I think Fauci’s “open and close” approach which he refers to at times may be a worse idea than a permanent Lockdown. Re-opening then re-shutting an economy of our size and complexity will be incredibly damaging to all aspects of our economy. We are better off making up a new economic system on the fly than repeatedly opening and closing the one we have.
In addition to the economic damage that an extended Lockdown will create, and I also believe it will result in worse public health outcomes overall. From a public health perspective, social distancing for the entire population mostly likely only delays the date of the COVID infection, it does not necessarily prevent the infection from happening.
I believe that the Lockdown approach works if either:
- A vaccine is imminent, which it is not in this case. Trump thinks a vaccine is coming soon, but most credible public health experts believe a COVID vaccine is 18+ months away; or
- COVID can be isolated and killed off. The test, isolate and contact trace approach, such as the one Biden and Pelosi advocate, can be a viable strategy for isolating and killing off a pandemic. I have an open mind on this, but I do not think this strategy will work with COVID because COVID is too contagious and it is already too widespread.
Katz Approach
Here is Katz’s op-ed from March 20. Katz’s strategy is for a risk-tiered re-opening of society while continuing to protect the most vulnerable in our society. There are problems with this approach, but in a catastrophic pandemic where all the potential solutions are bad ones, Katz may have the best bad solution there is.
The most important thing to take away from Katz’s approach is that the two options for fighting this pandemic are not A) a Trumpian free-for-all or B) locking ourselves in our homes for 18 months or more until a vaccine is developed. There are other options.
It is worth noting that left-leaning public health experts like Osterholm believe that we will not beat the virus until 60-70% of the population have the virus. How are we going to get there without some people being exposed?
www.cnn.com/…
it surely is a virus that likely will have to infect at least 60 to 70% of the population before we see a major reduction in its transmission.
There has been a lot of debate about accurate mortality rates on this site over the last few days. I think getting accurate data on mortality and hospitalization is critical. I think the anti-body population studies like LA, Santa Clara County and New York are a great first step, and there needs to be a dozen more of these studies, done all over the country, as quickly as possible, because then it can be determined how much of the population in different parts of the country has actually been infected. Simultaneously, there also needs to be more accurate COVID mortality numbers by age group and by co-morbidities. I believe that New York reports presumptive positives as infections and therefore deaths, but most other states do not, and several of the Trump-friendly states appear to be deliberately suppressing their COVID data. If we can get a more accurate mortality rate by risk tiers, then we can make an accurate assessment of the actual mortality, and we as a society can make a more educated assessment of whether this approach will work.
I think there is an actual solution to this pandemic that does not destroy our economy and by extension, our society in the process, and Katz’s approach may be a starting point. I do think that the leading voice in American politics over the next generation will be whichever side comes up with a solution to this pandemic. Let’s hope it is progressives.