I didn’t want to let too much time go by without remarking on Tom Friedman’s New York Times column in which he outlines a plan for restarting the U. S. economy after the COVID-19 hiatus:
One of the best ideas I have come across was offered by Dr. David L. Katz, the founding director of Yale University’s C.D.C.-funded Yale-Griffin Prevention Research Center and an expert in public health and preventive medicine.
Katz wrote an Op-Ed in The Times on Friday that caught my eye. He argued that we have three goals right now: saving as many lives as we can, making sure that our medical system does not get overwhelmed — but also making sure that in the process of achieving the first two goals we don’t destroy our economy, and as a result of that, even more lives.
For all these reasons, he argued, we need to pivot from the “horizontal interdiction” strategy we’re now deploying — restricting the movement and commerce of the entire population, without consideration of varying risks for severe infection — to a more “surgical’’ or “vertical interdiction’’ strategy.
A surgical-vertical approach would focus on protecting and sequestering those among us most likely to be killed or suffer long-term damage by exposure to coronavirus infection — that is, the elderly, people with chronic diseases and the immunologically compromised — while basically treating the rest of society the way we have always dealt with familiar threats like the flu. That means we would tell them to be respectful of others when coughing or sneezing, wash their hands regularly and if they feel sick to stay home and get over it — or to seek medical attention if they are not recuperating as expected.
Because, as with the flu, the vast majority will get over it in days, a small number will require hospitalization and a very small percentage of the most vulnerable will, tragically, die. (That said, coronavirus is more dangerous than the typical flu we are familiar with.) As Katz argued, governors and mayors, by choosing the horizontal approach of basically sending everyone home for an unspecified period, might have actually increased the dangers of infection for those most vulnerable.
“As we lay off workers, and colleges close their dorms and send all their students home,’’ Katz noted, “young people of indeterminate infectious status are being sent home to huddle with their families nationwide. And because we lack widespread testing, they may be carrying the virus and transmitting it to their 50-something parents, and 70- or 80-something grandparents.’’
“O.K.,’’ I said, calling Katz by phone at his home in Connecticut after reading his article, “but we are where we are now. Most states and cities have basically committed to some period of horizontal social distancing and sheltering in place. So, can we make lemonade out of this lemon — and not destroy our economy?’’
I don’t see why not, he answered. “Now that we have shut down almost everything, we still have the option of pivoting to a more targeted approach. We may even be able to leverage the current effort at horizontal, population-wide, interdiction to our advantage as we pivot to vertical, risk-based, interdiction.’’
How? “Use a two-week isolation strategy,’’ Katz answered. Tell everyone to basically stay home for two weeks, rather than indefinitely. (This includes all the reckless college students packing the beaches of Florida.) If you are infected with the coronavirus it will usually present within a two-week incubation period.
“Those who have symptomatic infection should then self-isolate — with or without testing, which is exactly what we do with the flu,’’ Katz said. “Those who don’t, if in the low-risk population, should be allowed to return to work or school, after the two weeks end.”
Effectively, we’d ‘reboot’ our society in two or perhaps more weeks from now. “The rejuvenating effect on spirits, and the economy, of knowing where there’s light at the end of this tunnel would be hard to overstate. Risk will not be zero, but the risk of some bad outcome for any of us on any given day is never zero.’’
There are several issues with this, the most serious being that I don’t believe the virus works that way. My understanding is that the best intelligence we have is something like 68% of those infected show symptoms within a week, 95% within two weeks, 99% within three, etc. Said another way his plan is unlikely to have the desired effects.
I do agree that a “one size fits all” approach will probably maximize the economic harm without accomplishing the presumed objective. Here in Illinois the governor has shut down the entire state (population: 12.74 million) for 1,200 active cases (12 deaths). One of the casualties of this experience is likely to be the end of the notion of a risk-free life. Nowadays things that my grandparents took for granted are practically unheard of. “Ordinary childhood diseases” used to kill thousands every year.