We’ve Flattened the Curve; Now What?
Coming to Terms with the Socio-Economic Fallout of an Extended Pandemic
Over the past three weeks, the American people agreed to ‘flatten the curve’ in a nationwide effort of solidarity to slow down and stop the coronavirus. Through a combined effort of federal and state governments, we gradually bought into the facts that 1) COVAD-19 was real, 2) the mortality rate was higher than we were willing to accept, and 3) we would collectively play our part to stop the spread.
We were told that once the curve was flattened, we would be able to stop the spread and get back to work. But is this true?
Focusing on the Right Data
We are inundated with media and charts. Some governors focus on the virus doubling rate; important when assessing ventilator needs. Mortality rates fluctuate from country to country or state to state for many reasons and hopefully our mortality rate will go down with better care, earlier testing and more testing. But what we don’t often see is the only important number in assessing how long the virus will continue: the daily rate of new cases. If the daily reproduction rate of a virus is >1 (in other words, if the percentage of new cases each day is greater than 100%) the virus is in its growth cycle. If the daily reproduction rate is around 1, the virus is stabilized and continuing at approximately the same rate, and if the daily reproduction rate is <1, the virus will eventually go away.
Western scientists realized by February that the high increase of daily new cases would quickly overwhelm our resources, with more people needing hospitalization than could be provided. Initial charts showed that mitigation would allow approximately the same amount of people to get the virus, but it could be spread over a larger period of time thus allowing everyone to get medical care.
Across Europe and the United States, countries that adopted lockdowns and stay-at-home mandates have stopped the high rate of increase of contagion and have managed to stabilize the spread to around a 100% daily reproductive rate or just below. The sad news is that there appears to be no plan to actually stop this virus in the near future, short of a draconian and complete lockdown as seen in Wuhan, China which no country in the west has attempted.
The charts below show how the daily rate of new casesin six countries from approximately March 1 to April 6 have slowed the increase to around 1 (100% daily reproductive rate) or even marginally less in some countries, which is the most important factor to consider in turning the corner on the spread of the virus. However, the rate needs to be clearly and consistently below the rate of 1 to gradually stop the virus, which is not what we are seeing. Underneath each chart are the potentially misleading daily new cases that we see so often.
If you look closely at the last week for the daily rate increase in the above countries, you will see it around or just below the 1 mark (100%) in Italy, Spain, and Germany. Austria, where they are planning to lessen their lockdown and let some sectors to back to work next week, shows a fairly consistent decline of the spread with the rate below the 1 mark, and the UK and the USA are not yet below the 1 mark. Hong Kong was the first territory to lessen their lockdowns and planned to have children go back to school and people back to work, but after one week their cases rose sharply and they immediately went back into lockdown. China is slowly opening up, but our numbers from China are not necessarily reliable. Austria is about to lead the way in west, but there is no reason to believe that the lessening of the lockdown will result in anything but a spike in new cases unless they have a clear and consistent plan to keep the spread in check. In any case, the virus is not going away in Austria, Hong Kong, the United States or anywhere else in the foreseeable future.
Addressing the Long-Term Situation
The US government is doing a poor job of preparing us for the amount of time it will take for our country to get back to normal because the above data shows that the tail of recovery from the virus is much longer than is being articulated or planned for. If the trend continues, and there is very little to suggest that it won’t, the economic cost will be incalculable and perhaps untenable.
There appear to bethree options going forward:
1) Find a cure and/or vaccine immediately
2) Continue in our western version of lockdown until the virus is gone, realizing the time frame will extend for months and the economic costs will be devastating
3) Live with the virus as a “new normal” until a cure is found and address the issues one by one with as many proactive solutions as possible
While we hope for the cure/vaccine, we cannot wait for it. Given the extreme lack of preparedness by virtually all countries in the west, the initial lockdown was necessary at the outset, however, going in and out of lockdown is a haphazard answer that may temporarily solve the problem for some, but certainly not for a majority of people and will create untold economic hardship and psychological deflation. The remaining answer is to create a temporary way to function until the cure/vaccine is found, which could serve as the model for pandemics to come.
Any new normal must encompass the following premises:
1) Public/private solutions
a. Tests must be accelerated and pervasive. The best test would be one that could be taken at home like a pregnancy test and the results posted online. That would give the scientists national data almost overnight – and that data could be examined down the individual level and aggregated to provide insight geographically and economically by business.
b. Provide guidelines and expertise on the spread of the virus and success of mitigating measures
c. Financially assist high-risk individuals
d. Financially assist those who cannot work and repurpose workers
e. Provide bankruptcy/subsidy/loan options
f. Provide a healthcare system for those affected by the virus that is financially independent from the current healthcare system
g. Eliminate the use of cash and need for a bank account and provide a digital payment system to all people with or without bank accounts
2) High-risk individuals must self-isolate for the entire period of the pandemic. Solutions must be found for them for
a. Healthcare
b. Cost of living
c. Education (if the high-risk individuals are children)
3) People must work as much as possible
a. Individuals must
i. Wear masks at all times and learn to not contaminate others
ii. Learn how to keep contamination from others to a minimum
iii. Keep socialization to a minimum, following all local guidelines
b. Workplaces must
i. Mitigate workspaces to reduce the possibility of contamination
ii. Be creative in allowing for work-at-home and/or distance working
iii. Find alternative markets and repurpose workers to address changing needs
The scientists were correct. In order to get the buy-in necessary from the American people, the message of an initial 15 days supplemented by another ‘30 days to slow the spread’ were the first and necessary steps. But now there must be a clear and effective plan to get back to work and build back the economy – even in the midst of dealing with the reality of a virus curve that may be flattened but will not diminish anytime soon without some unexpected medical breakthrough. The loss of businesses, jobs, education are incalculable at this point. The effects of school closures are way beyond the loss of education. Private citizens all over the country are scrambling to feed children and families in their counties. Now is the time to move forward as a nation with a clear and effective plan for the future – a plan that needs addressing now that provides the American people with a clear and transparent message about the new normal and its implications for our ability to quickly get back on our feet. Our resilience, economic strength, and national security are at stake.
