I don’t like military metaphors for a public health crisis, but the Trump administration’s new slogan about COVID-19 they aired over the weekend, ‘We need to live with it‘, is nothing more than an admission they won’t do anything significant to combat COVID-19, and that they’re just leaving us to get injured and die (and, sorry, while mask wearing is important, it’s going to take a lot more than that). It’s the epidemiological equivalent of how Trump and Republicans treated Puerto Rico after hurricane Maria.
That said, in retrospect, we probably should have seen this coming. The first fatal flaw is that the policy response framework was driven by the American Enterprise Institute. To be charitable, there is no way they could support the necessary economic framework for crushing COVID-19:
The problem is that the AEI plan is fundamentally affected by policy constraints. There are certain policies that a group like AEI can not and will not consider, and those policy constraints affect the range of policy responses.
Consider what a program put forth by a lefty think tank would look like. On the left, construed somewhat broadly, there was a general consensus on four policies:
- Rent and mortgage suspension, for businesses and residents.
- Temporary universal healthcare coverage, including for those who lost their jobs.
- Some kind of significant income supplements for households.
- Mandatory sick leave, so essential workers wouldn’t feel obligated to work when they are symptomatic.
There were other things too, but the overall goal was to use massive federal spending to place significant swathes of the U.S. economy into what multiple commentators, including Paul Krugman, referred to as a ‘medically induced coma.’ And not for a month either, but for as long as it took.
If that is your framework, you stop worrying about fourteen-day declines which allow you to tentatively reopen some businesses in order to keep them afloat. Instead, you focus on crushing the curve, and, critically, the prevalence of COVID-19 (the proportion of the population that is currently sick)…
Since an AEI-backed plan that would result in massive federal intervention in the economy is an impossibility, we’re left with second-best options of relative improvements leading to partial reopenings. When massive federal intervention is off the table, then we’re left with these other metrics, such as decline for a couple of weeks followed by hoping for the best, because there’s no way to support the economy long enough to reach a meaningful low level of prevalence.
And prevalence, not bending epi curves like Beckham, is key:
If people want things to ‘return to normal’, or some semblance of normal, then we need to dramatically lower the prevalence of infected people. When COVID-19 is very rare, one is far more likely to survive higher risk activities. That means masks and physical distancing for an extended period of time–the first, sort of shutdown didn’t cut it, and we left far too early.
Once we get it to Oslo levels (and we could, if we had a competent and coordinated response), life will be far more like normal.
Economist Paul Krugman made a similar point his very own self (boldface mine):
Nor can we simply hit the reset button. Activities we could have safely resumed two months ago, when infection rates were low, aren’t safe to continue given today’s much higher Covid-19 prevalence. That is, we’re in worse shape, even economically, than we would have been if Trump and his allies had taken the pandemic seriously early on…
Right now we should be going all-out to bring the Covid-19 surge under control and making sure that Americans keep getting the economic aid they need. In reality, neither of those things is likely to happen. Infections and hospitalizations will soar further, and millions of Americans will lose crucial economic lifelines in a few weeks.
What’s pathetic is that we could still crush the curve, even though it will take much longer now (something I’ll discuss tomorrow). Instead, the administration is just giving up because there is no way they can propose the policies we need.
So, yes, while the metaphors of ‘Wars on Things’ (poverty, drugs, etc.) aren’t helpful, the Trump Administration has decided that they’re just going to give up and hope people become numb to the American Carnage.
That is a shameful and humiliating surrender. And anger is the appropriate emotion.