Within the United States, the societal effects of covid-19 are becoming harder to ignore. Large-scale confabs like South by Southwest have been canceled. The ones that have already happened, such as the Conservative Political Action Conference and the American Israel Public Affairs Committee conference, led to at least five members of Congress self-quarantining as a precaution. Universities are starting to shut down and take classes online.
The president is taking none of this news well, leading to a few Twitter tantrums Monday. This tweet caught my eye in particular:
So I thought about that, and what I realized is that the president, like a lot of low-information voters, does not really grasp why the spread of the novel coronavirus is such a big deal.
To be fair to Trump, some of his puzzlement is understandable. In terms of mortality rates, covid-19 is much closer to influenza than to, say, Ebola. Thankfully, the novel coronavirus seems particularly mild in people under age 30. According to the Centers for Disease Control and Prevention’s risk assessment, “For most people, the immediate risk of being exposed to the virus that causes covid-19 is thought to be low.” Why, then, has it generated such an outsize reaction?
The answer to this is pretty simple, but it clearly bears repeating until the president and his supporters get it. First, the reason it’s referred to as a “novel” coronavirus is that it is, you know, new. There is no vaccine for it. There is no immunity to it. Unlike garden-variety influenza, it can and will spread quickly.
Even if everyone catches it, though, that’s not a big deal, right? Except that it is a huge deal. If everyone gets it at once, enough people will become seriously ill to exhaust a nation’s public health infrastructure. Covid-19 might have a low mortality rate in theory, but in practice the rate will go up if hospitals are overrun. Mortality rates for completely unrelated health issues will also spike, because all slack in the system will be redirected toward covid-19. Reports out of Italy suggest this is already happening there.
The goal of every American right now is not to contain the coronavirus — it’s too late for that. The goal must be to flatten the curve:
As the World Economic Forum’s Linda Lacina explains:
This chart shows two curves with two very different virus reproduction rates. In the steepest curve, the virus reproduces quickly in a short period of time. In this scenario, emergency rooms, intensive care units and other parts of the health care system are overwhelmed. In an overwhelmed system, mortality rates can be high and those infected may not get the treatment they need.In the second, flatter curve, controls help slow the spread of the virus. Infections occur, but over a longer period of time. Since health care workers and facilities are not overwhelmed, those infected receive better treatment and fewer deaths occur.Not overwhelming the healthcare system will be key to minimizing further impact.
This is why it seems to so many as though the precautions being taken are so disproportionate. What is being asked of healthy people — people who even if they contract the virus are unlikely to get too sick — is to nonetheless change their behavior in costly ways so they reduce the risk of spreading the virus to more people. Or as Johns Hopkins School of Advanced International Studies professor Johannes Urpelainen put it with respect to travel cancellations: “If you are a healthy adult, you are not canceling your event or travel or conference because of yourself — but because of the more vulnerable people who will suffer if you become a vector.”
Of course, all these cancellations and disruptions will have real-world economic effects. These cannot and should not be ignored, and measures need to be taken to ameliorate those effects. Still, the reason so many precautions are being taken is because health is more of a public good than is commonly realized. Making small sacrifices is a social tax that the healthy can and should pay so the vulnerable do not die.