This is not an article in which I am going to question the wisdom and expertise of doctors in their own field. Although most epidemiologists admit that there are many things about COVID-19 that they currently don't know, I take it as a given that what we do know about the disease is alarming and that it is potentially the worst public health threat in decades.
I also take their word that, in the absence of extraordinary measures to combat the spread of COVID-19, more people will die from the disease than otherwise would.
All of that having been said, there is going to come a time — perhaps very soon — where President Donald Trump is going to have to look these doctors in the eye and tell them, "No more," for the sake of avoiding a worse catastrophe than the very worst predictions for the unchecked spread of the disease.
You know the old saw about doctors: They have knowledge that is a mile deep but a foot wide. This is an oversimplification in many cases, because doctors do tend to have above-average intelligence and usually have reasonably good awareness about some fields outside their expertise. However, they sometimes are prone to tunnel vision and overestimation of the importance of their own particular field in the grand scheme of the world.
So when they say that failure to continue social distancing indefinitely might cause severely negative consequences for the American health care system, we should take them seriously, and ignore their advice only in dire circumstances.
Unfortunately for us, one such dire circumstance is lurking around a corner, and that circumstance is the inevitable total collapse of the American and global economies if the current COVID-19-inspired social isolation continues.
See, while doctors might be exactly right about what might happen to the health care system if we don't all stay home for the next six weeks (or three months, or 18 months), they don't seem to be taking into account what will happen if all economic activity grinds to a halt for an equivalent period of time.
And lest you think I'm saying that we should prioritize money over people's lives, let me assure you that I am not. I am not saying that we shouldn't make people poorer in order to save lives; in general, trading money for human life is something most people would do happily. Rather, I am saying that the measures we are taking to stop COVID-19 are going to cost human lives. The cost will be realized more slowly but just as surely.
What will be the cost in human lives if families that are currently middle- or lower-class are suddenly no longer able to provide adequate nutrition for themselves and their children because they are out of work for weeks or even months? What will be the cost in human lives if the disruption to the economy causes disruption to our increasingly fragile supply chains in life-saving medications for other deadly diseases, as we are already seeing after less than two weeks of shutdown? What will be the cost in human lives if, as is now widely predicted, 30% unemployment (or higher) comes to America and is met with widespread civil unrest and violence? What will be the cost in human lives due to the loss of research and development into future improvements in human life due to a protracted economic downturn?
This is to say nothing of the obvious and inevitable deadly side effects of every economic downturn, which include increased suicides, increased alcoholism (which is deadly), and increased mortality from chronic health conditions (especially among children and the elderly) due to poorer nutrition.
All of which is to say nothing of the effects of a prolonged global depression on the overall quality of human life for those of us who are still alive. And that does and always has mattered from a public policy standpoint. About 40,000 people die every year in America in automobile accidents (which is, if you are counting, more than twice the number of people who have died worldwide due to the coronavirus so far). But the automobile is considered so vital to both modern quality of life and the orderly function of the economy (which is also necessary for life) that any person who suggested outlawing the car in order to save 40,000 lives a year would be run out of town.
Right now, the choice that is being publicly presented is a choice between saving lives and saving money. This, however, is a false choice. There is no option on the table that will not cost lives. Granted, the lives that will be lost due to COVID-19 are likely to occur sooner and get far more media attention, and so politicians are highly incentivized to prioritize those lives at all costs, and to leave the problems caused by any measures taken to control the spread of the disease to future politicians and future election cycles.
But make no mistake: a steadily growing economy (both in America and across the globe) has been the single biggest factor in saving and extending human lives in human history. It is the reason American life expectancy has risen by over a decade just since 1950. That economy relies upon interaction and commerce as its lifeblood. If that blood stops flowing for even a short period of time, it can die or become irreparably damaged. And that damage will, in fact, be deadly.
The shocks to the American economy have already been astonishing, after even a relatively short period. Every week that goes by where a huge portion of America isn't going to work increases the chances that those shocks will produce a prolonged depression as opposed to a short recession. The government cannot print money forever to keep these businesses afloat, particularly when there are so few businesses that are actually producing taxable revenue.
Getting people back to work must be a critical priority for President Trump, as America enters the month of April. And it seems highly likely that there is going to come a point, somewhere in that month, where doctors are going to continue to refuse to say how long the economy must remain shut down, but will only say with their myopic focus on their own industry and the problems of right-this-second, that it would be safer to leave it all shut down until we can all be sure. And Trump will need to have the courage to look them in the eye and say, "No. I'm going on TV and asking the American people to go back to work, taking every possible precaution as they do so."
He will be harshly criticized and mocked in all the usual quarters for doing so. But it will still be the right thing to do. Because the choice at that point will not be between fat-cats on Wall Street getting richer and people dying of COVID-19, the choice will be between kids and adults literally not having enough available food and basic other medicine, and people dying of COVID-19.
The choice to continue to allow cars, in spite of all the deaths they cause, is an easy one because it's already been made, and we barely think about it. Cars, and the increased quality of life they bring, are baked into the public consciousness to a degree that we couldn't imagine living without them.
The choice for Americans to get back to work, at the soonest moment possible and perhaps before the COVID-19 threat has completely passed, will be a much more difficult one, because people also don't think about how vital global prosperity is to their health, lives, and quality of life. But it is. And if the world is allowed to cease doing commerce until the end of July or longer as some doctors are now advising, we are going to learn in both the short and long term that economic depressions are just as potentially disastrous as pandemics.
I am not saying that the inflection point is already here, and I don't know for sure when it is going to come. I am sure I am going to be harshly criticized for even raising these objections in the midst of what can only be described as a full-blown panic. I only hope that someone who is advising the president is looking at this and understanding the urgency of getting the economy going again — not from an economic standpoint, but from a public health standpoint.
And I hope that when that inflection point comes, President Trump has the courage and leadership to encourage Americans to get back to work, and in so doing to begin repairing the damage this terrible disease has caused.
There are already encouraging signs that the president understands this. Just last night he tweeted his understanding that, at some point, the problems caused by coronavirus restrictions will get worse than the coronavirus itself.
Recognition of this fact was met with howling outrage from the usual quarters, but also some unease from people who are otherwise inclined to support him. When and if President Trump does make this decision, it will be up to him not just to implement it but also to sell the American people on its necessity. As long as he allows the issue to be painted as one between money and lives, his call to go back to work will be ignored and governors across the country will keep businesses shut down anyway.
And so, President Trump will not only need the courage to do what is right, but the eloquence and ability to explain to people why it is right, beyond the dollars and cents aspects of the issue. At that point, the country will need stronger leadership than it has needed at any point since probably the end of World War II. And for the sake of us all, everyone — right, left, and libertarian — should be praying that he is up to the task.