This past month Americans did something great and good and remarkably non-partisan. We changed the COVID disease’s infectivity – the dreaded “R0”. And we did it by an act of will.
Very few politicians or journalists will admit this. The habit of finding fault – or more precisely, rival political parties to blame – is just too strong. All the same, recall what the government and TV’s talking heads were saying only a month ago. Back then they told us that the lockdowns were needed to keep the hospitals from crashing. But very few said anything about the plan beyond that, and those who did mention “herd immunity” seldom spelled out the implications. That would have meant at least 200 million Americans catching the disease. Even if doctors could push the fatality rate well below one percent, the simplest prediction would have been a million dead.
We had a taste of that scenario in New York City. As of April 7, COVID cases there were fatal 5.7 percent of the time. Compare that to 2.2% in the rest of the State. If the City’s hospitals didn’t actually reach their breaking point, they must have come close.
But the country outside New York tells a different story. Most places ordered the lockdown just in time. The result today is that the US death toll is roughly 14 per 100,000. That’s a tragedy. But it’s still much better than Belgium (53 deaths per 100,000), Italy (41), France (31), or even the UK (26).
The question is what to do next. By now, everyone knows that there are two possible and indeed necessary goals. The first is to save lives. Here the best strategy is to keep social distancing “as is” and drive the new case rate down until better treatments and, with luck, vaccines finally end the crisis. For now, we still don’t know how much lower the case rates can go. But we do know that the cost of stopping now and reverting to a herd immunity strategy would be horrendous. Suppose for the sake of argument that America has fifty times more COVID cases than the reported numbers. Even then, the nation would still only be one-fourth of the way to herd immunity, implying that today’s 50,000 deaths would eventually reach 200,000.
The second goal, of course, is to restore the economy. Here the best strategy is to loosen the lockdown just short of the point where the new case rate takes off again. But that, too, is a step into the unknown. Just which parts of social distancing will we be able to relax, and how much?
The temptation, inevitably, will be to temporize and wait for better choices down the road. And it’s true that beefed-up testing and contact tracing will improve the tradeoff. The question is how much. Meanwhile waiting is expensive. We knew very little about what today’s level of social distancing could do until we tried. Today we are similarly ignorant about how much we can safely relax distancing. Should we keep masks but loosen the six-foot rule? Reduce office density by insisting that everyone work from home one day per week? Keep movie theaters at half-capacity? Each of these measures is different. Yes, we can make shrewd guesses about likely impacts — but that is all they are, and in the end someone will have to do the experiment.
This gets to what might be the only grain of truth in the otherwise silly observation that the nation is “at war” with the virus. Normal civilian government can usually experiment in ways that keep the potential losses from each individual step small. The difference for both war and COVID is that the required experiments – and risks – are almost always enormous. But this has never been an excuse for leaders to stand still. No serious historian blames Eisenhower, let alone FDR, for the casualties at Kasserine Pass, or the Hurtgen Forest, or Holland’s notorious “Bridge Too Far.” Because in wartime waiting is never an option – there comes a point when you must advance, and prudence is reduced to choosing whichever spot offers the best odds on limited knowledge.
Needless to say, that was a long time ago and most modern politicians are a cautious lot. Their logic is obvious. Suppose you are a governor watching another State make decisions. No matter what happens, you will never get credit if they succeed. But if they fail you can at least say that you warned them.
The difference today is that our hypothetical governor now has a second calculation to think about. Sooner or later, at least one of the fifty States will have to step up and go first. So does it really make sense for governors in the most populous States to discourage them? This is especially true since infectivity – the famous “R0” – depends not only on testing and contact tracing but also population density. This implies that each factor is fundamentally a substitute for the others. In this sense, at least, trying out looser distancing in rural settings shows us what these measures will do when the populous States possess more testing and contact tracing resources than they do today.
I don’t want to be cavalier about this: Reckless re-openings will teach the wrong lessons and might even delay further experiments. Even so, merely daring experiments are in everyone’s interest. Rather than criticizing, blue state politicians should encourage States willing to go first. And not just rhetorically. Test kits can be rerouted, and contact tracing can be done over long-distance telephone lines. It wouldn’t be hard to surge these resources to whichever States try the experiment first.
The reason should be obvious – We are all Americans, and it hardly matters whether our politics are red, blue, or purple. We all have a direct, material interest in seeing these experiments succeed.