After The Coronavirus: Who’s Going To Get The Money?

By

Leonard Zwelling

         This blog is in response to criticisms I have received regarding my willingness to accept the fact that the coronavirus threat is a major catastrophic pandemic. Some of my readers disagree and believe that this may be no worse than seasonal flu despite the position of most leaders around the world that this is a serious pandemic and getting worse in the United States. Surely, the national response has been unique, if not hysteric.

         Both opinions were expressed in The Wall Street Journal on March 18:

https://www.wsj.com/articles/questioning-the-clampdown-11584485339
https://www.wsj.com/articles/american-hospitals-can-avoid-italys-fate-11584468045

The CDC estimates that routine seasonal influenza is responsible for 9-45 million illnesses per year in the United States. There are between 140,000 and 810,000 hospitalizations and 12,000 to 61,000 deaths annually. These numbers are courtesy of a blog reader, but straight from the CDC web site. The death rate from flu, by the way, is higher in Italy in the most recent years in which it has been quantified.

         As of March 18, there are under 200 deaths in the United States attributable to covid-19. So how are we to know if this new virus is a real threat or if it is a blip and if it’s blip and all this economic damage was for naught, who pays? Is a blip even a possibility?

         Let’s start with China where more than 80,000 cases were reported of the new virus and over 3000 died. In South Korea there were fewer deaths (84), but Italy had 31,000 cases and climbing and 345 deaths in a day, which is probably greater than the number of deaths from flu in Italy over the same time span. However, Italy has lots of smokers and their flu death rate is usually high. Today, March 18, the number of total cases in the world is about 200,000+. How many cases of influenza have there been over the same period? But that’s not the question. The question is, is this worse than common flu? Will someone please chart the rate of infections from both viruses on the same set of axes?

         I personally would like to see the federal government align their statistics for coronavirus with the same measures for seasonal flu. These curves need to be compared. Admittedly, the illness from the new disease is over and above that of the seasonal flu, but is it greater than the seasonal flu or considerably less? Experts tell us it is the former. What is the slope of the new cases of covid-19? How does that curve compare to the one for influenza? It should be steeper if the predictions of the government are true.

Much has been made of the fact that covid-19 is new. New does not mean deadlier. Italy may be our first indicator and the indications are grave so far.

         The reason this matters is that the degree to which the government has asked us to respond to the threat from the new virus and the intrinsic problem of having to respond long before the data are in. The data from China, South Korea and Italy suggest that a brisk response in the form of containment may make a difference. Wuhan was surrounded and that seemed to suppress spread to the rest of the country. There were no new cases in China yesterday, March 19. Italy did next to nothing and it seems to be overrun with cases. South Korea did well in its response and may well be on the downward side of the curve. Taiwan and Singapore did great, but that does not mean the new illness is worse than the flu. I wonder if the flu rate in Taiwan and Singapore is less this year, too.

Mitigation, what we are doing now in the U.S. with the suggested social distancing, is less clear as a valuable tool, but again, not doing it is too risky, it must be done. This is a respiratory virus, likely to be communicated through interpersonal contact. These mitigation strategies are wise until we know more.

         But, what does this mean for the country?

         First, is it possible that this was all for nothing?

         Answer, we won’t know until it’s over so the response had to be what it is. Political leaders had to take these measures given the fact that they had little real local data on which to base their judgments. With the limited testing to date, the actual prevalence of the virus and incidence of covid-19 is still not clear.

         Second, was this an over-reaction given that it may well have taken down thousands of small businesses and done irreparable harm to almost all commerce? In other words, was it worth it? What was the cost of a life-year saved?

         Answer, again, we won’t know until it’s over, but there was little choice. Crowds had to be avoided and closing the bars and restaurants was the right move despite millions losing their jobs.

         Third, who pays and gets the government money?

         This is a bit easier to address.

         The entities most harmed by this pandemic are those that depend on close contact among people—restaurants, bars, the entire service sector, and gyms plus all of those businesses that depend on travel and hospitality. They need to be supported by the government. At least the small businesses do.

         Does that mean the first dollar of federal bail out funds ought to go to the airlines?

         I think not.

         The major domestic air carriers have been gouging the public for years with increasing fare prices, charges for everything from peanuts to an extra checked bag to change fees. They have crammed more of us into smaller spaces as well. If American Airlines and my personal fave United are in trouble, declare bankruptcy and reorganize. After all, they bought back their own stock with the cash they got from us. Tough toenails if the stock collapsed. We should not deal with the airlines the way we dealt with the banks in 2009. They need to fly on their own power or go away. I do believe that is capitalism, but if Mr. Trump wants to throw money at the airlines, I hope he makes the restaurants whole first and the airlines wait on TSA lines to get their hand out.

         This threatened pandemic has exposed large cracks in American society. Politicians don’t like to be guided by science. Scientists may have over-reacted, but given the degree to which the country was not prepared for such an outbreak, there was little else the public health leaders could do, but ask for extreme measures.

         Supply chains are world-wide and thus an interruption in Asia can create a shortage in Kansas.

         Hand sanitizer can become more precious than gold and a run on toilet paper is a presidential pronouncement away. Buddy, got any chloroquine?

         The number one lesson of this crisis, and it can be learned now, long before this is over, is that the U.S. was as ready for this as it was for 9/11 and that’s a damned shame. Once again our failure has been one of imagination, but in this case, many people have been warning of this for years. Both the CDC and the FDA performed at about a C level. Maybe, below C level.

         Immediately, Congress should demand the formation of a committee of the National Academies to suggest solutions to the government of how the country can be ready for any “imaginable” disaster from Ebola in Central Park to an invasion from Mars.

         What the coronavirus incident has shown us is that we got complacent again. We still don’t know how bad this is or isn’t and we were ill-prepared in any case. The Trump Administration did disband the office that was overseeing our response to such matters. It bears some blame, but the larger blame is on us all. Who would have thought someone would fly airplanes into buildings? Some novelist did (Tom Clancy, Debt of Honor, 1994). And outbreak scenarios have been the stuff of movies for years. Coronavirus was predicted by Hollywood.

         I am getting all sorts of emails. Some full of dread. Some full of numbers. What we need is a cogent, insightful argument from our leaders about what to do and why and whether this is really as bad as they say and how the country will be made whole. That’s a lot. But it’s the least the government can do, but still more than it has done.

         Put this all in context. Worse than the flu? If so, let’s see the numbers. Let’s see the curves. Probably, this is indeed bad. Certainly, I hope I am wrong, but you can’t bet on that. What the public health officials have asked of us is reasonable, but also a bit frightening.

         America has come up short in the imagination arena. Given we gave the world Hollywood, that’s hard to take.

         There is one more fact, even more worrying than all the rest. This also comes from a blog reader. Public health emergencies often mean that citizens are asked to give up some rights. They cannot travel. They cannot congregate or assemble. They cannot go out at night. If this coronavirus emergency turns out not to be one (wouldn’t that be great?), then we really have to consider how little it took for us to all give up some fundamental rights and what the consequences of that are.

The country came to a halt and no one fired a shot. Better communication, better data, and better context plus some real national readiness might have allowed us to keep a few rights or know better why we are giving them up.

Leonard Zwelling