In the past couple of days, stock markets around the world have rebounded owing to news that curves tracking the coronavirus pandemic have flattened in some of the worst-affected countries, including Italy and Spain, and tentative signs of progress in New York. “LIGHT AT THE END OF THE TUNNEL!” Donald Trump declared in a tweet. Larry Kudlow, Trump’s top economic adviser, told MSNBC that dealing with the public-health crisis remained the White House’s top priority, but he added that it was also examining how “maybe to gradually reopen the economy, open chunks of the economy, stay away from the worst hot zones.”
Given the enormous economic costs that the shutdown is imposing, the desire to mitigate the impact is understandable. Other Western governments are also preparing options for eventually reopening parts of their economies. “When we have the curve under control, we will shift towards a new normality and towards the reconstruction of our economy,” Pedro Sánchez, Spain’s Prime Minister, said on Saturday. “A specific team of epidemiologists has been working for two weeks now on a plan to restart economic and social activity.”
It is one thing to plan for better times. It is something different to suggest they are just around the corner, as Trump has done repeatedly since the outbreak began. Before any serious thought can be given to reopening businesses and getting people back to work, two enormous challenges have to be met: containing the virus’s spread and sharply reducing the number of new infections; and coming up with a safe and practical plan to relax the lockdowns. There is little indication that the United States and the Trump Administration are on top of either of these things.
In New York, Monday was the most lethal day yet, with seven hundred and thirty one deaths, Governor Andrew Cuomo said at a Tuesday-morning briefing. Based upon figures from the COVID Tracking Project, the number of infections in the state is now rising at a rate of about seven per cent a day. The good news is that this is roughly half of the rate from around a week ago. The bad news is that it still translates into the number of cases in New York doubling every ten days or so, and in other states, such as Louisiana and Michigan, the rate of increase is even faster. By Tuesday afternoon, there were 374,329 confirmed cases nationwide, which represented a doubling over the previous week. Given the very limited testing in many places, these estimates are almost certainly lower than the actual incidence of the disease.
If the immediate public-health challenge is still enormous, so is the task of preparing for a gradual reopening of the economy. The most detailed consideration of this subject I have seen comes from Germany, where at the end of last week a group of economists and public-health experts published a paper titled “Making the Fight Against the Coronavirus Pandemic Sustainable.” Noting the grave economic and social costs of an indefinite lockdown, the experts advocated a “gradual transition to a risk-adapted strategy” of reopening businesses such as highly automated manufacturing plants or firms located in areas with low rates of infection while also taking additional measures to protect the most vulnerable populations. But the most striking thing about the German study is the list of things that it identified as necessary for such a policy to be successfully implemented.
The list included “coordinated, large-scale testing to monitor the spread of the virus and the increase in immunity of the population”; the availability of “comprehensive and unrestricted medical care for the population”; “regional and supra-regional coordination of ventilation capacity;” and an effective communications strategy implemented by political leaders who are “considered credible and of integrity.”
The United States has none of these things. Despite widespread agreement among epidemiologists and economists that a massive increase in COVID-19 testing is urgently needed, it hasn’t been implemented yet. Although the over-all number of tests has ramped up, there is little consistency across states, which translates to huge uncertainty about the real rates of infection in different places. There is also no reliable, widely available test of immunity for asymptomatic people who may have the disease. Unless these harsh realities change, policymakers would be flying blind as they sought to manage even a limited reopening of the economy.
America’s health-care system is anything but “comprehensive and unrestricted.” One reason why the COVID-19 fatality rate in Germany is so low—less than two per cent—is that its universal health-care system provided widespread testing and high levels of care from the beginning. “When I have an early diagnosis and can treat patients early—for example put them on a ventilator before they deteriorate—the chance of survival is much higher,” the professor Hans-Georg Kräusslich, the head of virology at University Hospital in Heidelberg, told the Times. In the United States, hospitals in hard-hit areas can barely keep up with the most serious cases, let alone intervene early.
The coördination between the federal government and the states to insure the supply of essential medical equipment has been, at best, intermittent. The Governors of New York and California, Cuomo and Gavin Newsom, have become so frustrated at the lack of support and direction from Washington that they have called on states to get together and coördinate on procuring essential supplies. In the biggest crisis to face the country in decades, the failures of the Trump Administration are leading to a revival of federalism.
Finally, there is the chronic leadership vacuum at the very top. Any effort to partially reopen the economy would be inherently risky. The German report pointed out that it would need to be explained clearly to the public in a way that was realistic and made explicit that the new policy didn’t amount to a return to “business as usual.” Credible political leaders would need to “appeal to common values and emphasize moral standards” and “solidarity.” It would also help if the person communicating the policy “acts as a ‘role model,’ i.e., a person who aligns his or her own behavior with the measures.”
This reads like a definition of an anti-Trump. Throughout the crisis, the actual version has zigzagged between denial and reluctantly accepting the advice of his medical advisers. He has publicly squabbled with the governors of Washington and Michigan, two hard-hit states, and suggested that New York was exaggerating its medical needs. He has turned a daily medical briefing into a lengthy vehicle for his own political purposes, at which he routinely makes misleading statements and berates the media. He has even refused to accept the advice of the Centers for Disease Control and Prevention and wear a face mask.
Given this abject record, is there any reason to believe that this President, and this Administration, at some point in the not-too-distant future, could effectively manage something as complicated and perilous as a limited, data-driven reopening of a nearly twenty-two-trillion-dollar economy, with no cure or vaccine in sight? The question answers itself.
A Guide to the Coronavirus
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