They point to the grave uncertainties surrounding mortality estimates, and the staggering destruction now being wrought on the economy. Surely, as a libertarian, I am familiar with the concept of “unintended consequences” and should consider the possibility that the waves of layoffs and business failures will ultimately cause more suffering than a covid-19 epidemic would?
Of course. What we’re doing now is bad policy. It is also the best policy available, at least for the short term.
We don’t have enough information to establish exactly how deadly covid-19 is, and we probably won’t for quite some time. But the experiences of China and Italy have established one thing pretty clearly: If you don’t take aggressive containment measures, patients will overwhelm your hospitals, and then your intensive care units, and then your morgues.
Consider an optimistic scenario, one in which the actual mortality rate of this disease is only 0.5 percent, and the disease burns itself out after infecting 25 percent of the population. In that case, letting it progress unimpeded would mean allowing the virus to kill about 400,000 Americans.
Millions more would require hospitalization, including mechanical ventilation, which can feel like you’re choking, except for weeks on end. Even after patients come off of the ventilators, a study out of Hong Kong indicates that some may experience a 20 to 30 percent loss of their lung function, possibly permanent. Meanwhile, some incalculable number of people sick with other diseases would die because there was a covid-19 patient in the ICU bed they needed.
To put those numbers in context, 400,000 is the number of soldiers we lost during World War II. It is almost three times the annual number of “deaths of despair” that have so worried commentators in recent years. It is one-sixth of all deaths in the United States in a typical year.
Without aggressive restrictions on interpersonal contact, it also seems wildly overoptimistic.
The United States does have some native advantages, such as a lot of ICU beds and relatively little public transit (a plus in this situation). But when you’re dealing with exponential growth, those numbers matter less than you might think. It just takes a little longer before the health system collapses.
So though it may be reasonable to think that the economic disaster will kill some people (even that isn’t certain), any projection of that economic death toll is many times lower than our most optimistic hopes for unmitigated covid-19.
Even if we ignored the emotional toll of the suffering and looked just at the economic consequences, it’s not clear that relaxing social distancing would be warranted. A minimum of hundreds of thousands, and possibly millions, dead would be very expensive in terms of lost productivity and economic disruption, as would caring for any people who ended up debilitated by permanent lung disease.
More fundamentally, if we simply stood back and allowed that to happen, we would permanently erode the social trust on which all modern economies depend. If you think the market is frightened now, imagine what it would look like if everywhere was Northern Italy.
To which the skeptics might reply that the object isn’t to let the virus proceed unmitigated but to find less drastic measures that can slow the spread without shutting down the economy entirely. The problem is, we tried such less drastic steps and found, just as Italy and France did, that ignorant bosses insisted on “face time” and reckless or misinformed people thronged beaches and bars. Hence the steady ratchet upward to “cancel everything.”
There’s reason to hope that the measures now in place can be temporary, as can the economic damage. If we can reduce the rate of new infections to something closer to the rates of South Korea, Hong Kong, Singapore or Taiwan, we should be able to relax our current draconian regime. In the meantime, the doctors and researchers on the front lines may figure out treatments to make covid-19 less fatal; eventually, we hope, they will deliver a vaccine. For the rest of us, our most important job at the moment is to buy them as much time as we can.