Killing COVID-19 without killing the economy
Our situation would seem to be this: the price of fighting COVID-19—the price of the massive social distancing the U.S. and other countries are now deploying against it—is almost certainly a recession and possibly a global depression. And global depressions have, among other downsides, something in common with COVID-19: they kill people.
In the New York Times, David L. Katz, a physician, argues that there’s a way out of this dilemma—a way to avert economic collapse without paying a massive toll in death and suffering.
The basic idea is to apply social distancing more selectively but more intensively: identify the most vulnerable (older people, plus younger people with such conditions as diabetes), and strengthen the rules that protect them from infection, while relaxing the rules for the less vulnerable, and thus allowing them to participate in the economy.
In this scenario, the contagion would continue, but it would continue within corridors that would keep the death rate low—that is, corridors occupied by relatively young and healthy people. The typical experience of people infected would range from feeling no symptoms at all to having something like a bad case of the flu. And after infection they would presumably be immune, at least for a while. Eventually America would achieve “herd immunity”: a high enough percentage of the population would be immune so that the virus would quit spreading.
Most people, including me, find “herd immunity” scenarios a bit chilling, as they entail unflinching resignation to a certain level of death, however low, within a certain part of the population. And that just seems less humane than trying to save everyone, even if that effort is doomed to fall well short of its goal. But before dismissing Katz’s idea, you should read his op-ed, because he notes downsides of the current approach (including lethal ones) that go beyond flirting with economic apocalypse.
Besides, you can imagine more moderate versions of his plan. We could, for example, try to slow the rate of transmission within the corridor of contagion, thus providing more time for a vaccine, or at least powerful anti-viral treatments, to emerge. (The standard expectation is that we’ll have anti-viral treatments that save at least some lives before we have a vaccine.) We might even draw on the growing population of immune people to fill jobs that involve lots of public contact, like supermarket checkout clerk, waiter, or postal worker. And we could encourage some measure of social distancing even among the young. (And, of course, anyone of any age would be free to exercise as much social distancing as they wanted.)
I think the broad-gauged social distancing we’re practicing in New York, California, and other hot spots makes sense for the time being. It’s our best chance to slow the epidemic before it overwhelms hospitals, and it will give us time to get a clearer sense of where things stand—how prevalent the disease is, and how lethal it is. (Various pieces of evidence suggest that the death rate may be significantly lower than the rate reported in China, and the lower it is, the less chilling is Katz’s proposal.) And if we do decide that a model like Katz’s makes sense, we need time to set it up.
My father grew up in west Texas amid the Great Depression. His father was a sharecropper, and good medical care was remote, and by the time my father was 14 both of his parents and three of his siblings had died. I’ve always assumed that affluence would have saved some of them, but I’ve never known for sure whether it was accurate to say that the Great Depression killed some of my ancestors. In any event, we know for sure that it killed some people and inflicted deep suffering on others.
We tend to assume that there won’t be another such calamity—that even if there is something that qualifies as a global depression it won’t be as cruel and lethal as the last one. But the truth is we don’t know what a worldwide economic collapse in the modern era would be like. I’m willing to entertain even chilling ideas if they offer a way to avoid finding out.
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