This post is an expanded and modified version of a comment I left in an earlier post. Here in bullet form are some of the reasons that I do not think that the U. S. will control the spread of COVID-19 using quarantine:
- Support for quarantine measures would need to be bipartisan with both Republicans and Democrats championing the measures. Within the Democratic Party alone both Joe Biden and Bernie Sanders would need to support them.
- Democrats’ distrust of Trump is such they would be loath to allow him the power to implement a practical quarantine. You can hear the attacks without trying very hard.
- President Trump would need to be convinced that he has more to lose by failing to control the spread of COVID-19 through quarantine than by the decline in economic output resulting from quarantine and the attendant undermining of a prime argument for his re-election.
- While the federal government has the authority to quarantine the United States from travel and shipments from abroad, I believe that states would need to implement most local quarantines
- Many measures would require a nationwide declaration of martial law. Under present circumstances I cannot envision that being accepted meekly.
- Not all companies and individuals will be willing to self-quarantine
- Compliance is sufficiently low quarantines will not be effective. Hereabouts you just need to look at the large number of people speeding, running stop signs, turning left when “No Left Turn” signs are prominent, or going the wrong way on one way streets to recognize that.
- Various kinds of contractual obligations would need to waived.
- Court challenges would result in judges being moved to issue nationwide injunctions vitiating the effectiveness of quarantine.
and so on. My guess is that quarantines can be successful in small compact countries, in countries with high social cohesion, in places with high willingness to comply, and in authoritarian countries. None of those characterizations applies to the U. S. Singapore—yes (small, compact, and authoritarian). Canada—yes (higher social cohesion and willingness to comply). U. S.—no.
Consider Italy. They’re preparing to quarantine a third of the country. But they’re relatively small and compact, have higher social cohesion than in the U. S., and a more compliant population. Here in the U. S. the complaints that quarantines are racist or only directed against the poor would be heard practically immediately.
I think it’s worse than that. I the last week, I’ve been to five high school BB games. Every person I interacted with seemed completely unaware of virus risk, lots of handshakes and close face to face laughter and conversation.
It’s going to take a lot of deaths for people to serious up.
Your last sentence says it all. This outbreak is being viewed in media, social or otherwise, as a political event and opportunity, not as a serious public health crisis.
Recalling a couple of your previous posts, we are by default opting for take our chances. People won’t self quarantine. We are not prepared to declare martial law. Trump has an impossible task – balancing sober statistical and disease control communications with hysteria producing over reaction, all in a witches brew of mob reporting with political agendas.
As a practical matter I can only see the common sense precautions being of use for the 60 and up set, avoid public venues if possible, and vigilant hygiene.
I dont really see Democrats having a problem with quarantines, Judy Chu (Congressional leader of the Asian-Pacific caucus supports them). All you need is for the medical experts to say quarantine is needed and Democrats will support it. What I think they will continue to have problem with is the lousy messaging and inconsistencies coming mostly from Trump.
For example, we haven’t really had a travel ban for China. We banned non-US citizens from coming to the US. So, a US citizen can fly back and forth to China with no limits. Not clear why a US citizen would be immune to Covid-19. So, to date, no congressional leader or candidate for president that I am aware of accused Trump of racism with the travel restriction, though some lower level people did (one or two). Meh.
Trump needs to make it clear that he is following recommendations from people with expertise in the area. His saying he is following a hunch or he is being bold and getting out ahead of his experts is not reassuring for most of us. His need to be seen as in charge, his need for adulation and to have everything he does be seen as perfect is detrimental. Really, this is a new disease. No one will get everything correct. Stop telling us everything is perfect, just respond and make appropriate changes as needed. All of this is especially important in the context that he loudly opposed and criticized the handling of the Ebola crisis, where they followed best expert advice and had a good outcome.
As to the quarantine more broadly, the biggest issue by far is not going to be the stuff at the top of your list, it is compliance, both at the individual level and the corporate level. Some companies are not going to be understanding about people staying home. They will fire you if you dont show up to work just because you had a fever and were coughing up blood. People need jobs so they will go to work. On the individual level too many people have been taught to mistrust government and the media. They wont believe this is real until it is too late, and even then they wont believe that the quarantine applies to them.
https://www.factcheck.org/2020/03/the-facts-on-trumps-travel-restrictions/
Steve
You have more confidence in Democrats than I. Or maybe Democratic leaders where you live are different from those here. Pop quiz. Was the person who said “Never let a good crisis go to waste” a Republican or a Democrat?
I agree that Trump’s reliance on his gut and distrust of experts is problematic. I’m not sure what messaging would have survived an oppositional media.
Yep.
And my list wasn’t a prioritized list—it was stream of consciousness.
“You have more confidence in Democrats than I. ”
It’s kind of hard to criticize Democrats as overly reliant on technocrats as is often made, then say they arent going to follow the advice of experts. So you are going to hear some criticism about implementation. Heck, you heard criticism from Republicans when Ebola was handled very well, but there will be broad support for the principle. Why do we suddenly forget that Democrats are the ones who generally support government intervention?
“I’m not sure what messaging would have survived an oppositional media.”
He could have tried honesty for a change. OK, that made me laugh. He could have stepped back from his role of liar in chief and put someone with medical credibility in a more prominent position of communicating. He could stop minimizing the risk of this outbreak and place our safety ahead of his poll ratings.
Steve
It is with politicians on both parties.
Washington State is still holding sports events with crowds (like MLS) even in the midst of an outbreak and scientists saying it is likely to have been spreading in the community for 6 weeks.
And then I shake my head at the Italian quarantine. The WSJ is reporting flights and trains are not fully stopped.
Maybe we should ask the question, what would a practical quarantine in the current situation look like?
Practical? We could accomplish some of what Italy is doing I think. Dont leave home except to get food, but voluntary. No public gatherings for sports events. No conferences. With our separation of church and state I dont think we could prohibit people from going to church and no one would fine or put people in jail for that anyway. (Jails could end up pretty awful for that matter.)
I think the big question would be people going to work. I dont see state governments being willing to shut down people going to work until things were already pretty bad.
Steve
Only if the states were to do it. The federal government could only accomplish it legally by declaring nationwide martial law and sending in the National Guard. That would be a big hit.
Italy’s provinces are departments of the national government. It’s a very different organization.
My wife and I could self-quarantine without much inconvenience as long as water, gas, electricity, and Internet connectivity stayed up. We’ve got enough food for a month, easily. Fresh vegetables would be nice and my beloved Happy Foods delivers. I could work from home without difficulty. The only reason I go in is that top management has directed everybody to come into the office. I could get away with non-compliance but I come in anyway because I think it’s better for morale and my public image.
Seattle “recommends†work from home if possible. There is pretty good compliance. That is the easy part.
The hard ones are schools (who is going to take of health care workerâ€s kids), restaurants / gyms (who will make up the lost money?), and public transport (vital in NYC, SF, Seattle).
Dont forget manufacturers. If they risk losing a contract because they dont have their 2 thousand widgets ready in time, do they still let workers stay home? The entire food industry is an issue. All of the trades (electricians, plumbers, etc). Who pays the penalty if you dont finish that new building on time? Retail stores.
Finally, do you lose your work based health insurance if you stay home?
Steve
Interesting meeting this morning. We only have something in the neighborhood of 65,000 ventilators in the country, excluding Ors I believe. If we get hit as hard as Italy we will have people ventilating patients baby hand like we did in the polio epidemics. We dont have nearly enough of the good masks. No one does.
Steve
A interesting interview of former FDA commissioner Scott Gottlieb on the current situation and what could / should be done.
https://www.cnbc.com/video/2020/03/09/united-states-coronavirus-outbreak-public-health-measures-squawk-box.html
I like the emphasis that it is not a binary choice — do nothing or stop everything. And that everyone in society can take initiative.
We had a fairly large family gathering yesterday. I got all the children trained that all they get from me is a fist bump, They thought it was funny and it caught on well.
Steve of course is right, (BTW, I hate people who are always right), we can’t stop the spread but we have to slow it anyway we can because of practical and insurmountable limits on hospital beds and supplies.
I don’t think you lose your group coverage from your job until you are severed . But sick days are limited, and many jobs don’t have them, so you have to use vacation days. With half of Americans living paycheck to paycheck, when it comes right down to it, they’ll work sick because they have to.
I think that’s what we learned when so many people went on SSDI during or after the last recession. A lot of people work sick.