What undermined the economy: The virus or the government? Was the answer for government to lock down or to do nothing? Should people obey all of the government’s mandates or none of them? Should we unwaveringly trust “the experts” or discount them? These are all false choices about COVID-19. If we want to get our lives back, if we want to get the economy back on track while mitigating the damage of the disease, more people need to start thinking more seriously about the complexities at hand. Partisan jockeying and blame games do not magically kill the virus or bring back people’s jobs.
I was struck by the chasm of responses among my friends to video of the jam-packed C & C restaurant in Castle Rock, which opened for inside service against emergency orders on Mother’s Day. Nick Puckett’s video of the restaurant became a sensation, with 4.7 million views on Twitter alone the first day and national news coverage.
Many of my friends, and many people around the country, thought that the restaurant’s owners and its patrons acted wildly irresponsibly and put people’s lives needlessly at risk. Others thought they acted patriotically, heroically even, and acted within reasonable risks. House minority leader Patrick Neville was among those cheering on the restaurant in person.
I think the question is more complicated than should they open or not. In the current context, testing capacity remains woefully inadequate, and we have little idea of who’s sick and who isn’t. Given that, businesses have a moral responsibility to take reasonable steps to keep their customers safe, as by requiring staff to wear masks (which is legally mandated anyway) and by establishing some distancing protocols. I didn’t see any of that at the restaurant. By comparison, even if it were legal for me to drive without putting myself or my son in safety belts, it would be grotesquely irresponsible for me to drive without using them.
“Live without fear,” some people said, as if that justifies reckless behavior. Really? Should we consistently follow gun safety rules or fearlessly throw them out the window? Almost every time someone violates a gun safety rule, no none gets hurt. But every time someone gets hurt in an unintentional shooting, it’s because someone violated one or more of the basic gun safety rules. So let’s be smart here. There’s no glory in flouting “the rules” in blind rebellion. The key is to ground our fears in reality given the relevant uncertainties.
Consider this point of contrast. Quent and Linda Cordair briefly reopened their art gallery (where I’ve done business) in California in willful violation of the orders. Yet their aim was not a Dionysian, orgiastic flouting of the rules. Rather, they promised, “Appropriate and adequate social-distancing protocol will be in place and observed.” They also called for “continued and increased testing, and attentive monitoring” to locate and isolate the sick. I endorsed Cordairs’ efforts. Unfortunately, local government put pressure on their business associates to force them to close again.
Consider what one patron of C & C told Puckett for his follow-up news story: “I’m not afraid to be out. I’m not going to wear a mask. I’m healthy. I’m in good shape, and I don’t think it’s as serious as they say.” What’s missing here is any recognition that people can asymptomatically spread the disease. Young and healthy people are unlikely to die from the disease but likely to spread it to others if they are infected and out in public. Maybe no one at the restaurant was infected by the coronavirus, but the point is that no one knows.
What we do know is that some people will earn their footnote in history by becoming major spreaders of the disease. I don’t want to be one of those people—do you? Recently a large family in California got together for a birthday party, and one person who joked about coughing indeed infected several family members with the coronavirus. Ha, ha. The disease spread in a Colorado bridge club, eventually infected 300 people. Dozens of people got sick at a Washington choir practice. Recently a nightclubber in South Korea infected dozens of other people, leading to 54 new cases.
Let’s not forget the death toll. As of Mother’s Day, Colorado suffered 971 COVID-related deaths. Try telling someone in the hospital dying alone from this agonizing disease to “live without fear.” Or check in with the 3,631 people hospitalized in Colorado, or the parents of the children who developed rare but dangerous complications from the disease, and see if they were fearful.
Just as people who have no fear of unintentional shootings tend to be dangerous gun owners, and people who have no fear of car crashes tend to be reckless drivers, so people who have no rational fear of COVID-19 tend to put themselves and others needlessly at risk.
What about government action? Clearly the story that all government action is ineffective with respect to infectious diseases does not hold up. Consider South Korea. The country, which has nearly 52 million people, could have been a hotbed for the disease. At its February 29 peak, it recorded 909 new positive cases. By contrast, Colorado, with its population of 5.8 million, peaked on April 29 with 825 cases (discounting skewed April 23 data). The difference is that South Korea squashed disease spread through aggressive testing, tracing, and quarantining. On May 10, South Korea reported 34 new cases and zero new deaths. Meanwhile, Colorado has reported hundreds of new daily cases and several deaths. South Korea’s total death count was 256. In other words, South Korea has nearly ten times Colorado’s population but only around a fourth the number of deaths. And now South Korea’s economy has mostly opened back up.
Meanwhile, much of the United States went on lockdown, but without adequate testing, contact tracing, or isolation of the likely sick. Now, with businesses closing, bankruptcies looming, and people’s patience wearing thin, we’re struggling to partly reopen without letting the disease run totally away from us. We never had a realistic strategy to contain the disease without destroying the economy, and we still don’t.
Government failed massively in this effort. I was struck by something that global health expert Beth Cameron told David Quammen: “You’re not going to stop outbreaks from happening. But you can stop outbreaks from becoming epidemics or pandemics.” It certainly didn’t help that China initially dithered and obfuscated. Nor did it help that Donald Trump long turned a blind eye to the problem. Nor did it help that the CDC and the FDA, between them, effectively destroyed early testing efforts in the U.S. By contrast, writes Quammen, “South Korean officials, after confirming their initial case, met promptly with medical-supply companies and urged them to develop test kits and start mass production.”
In the first week of May, Colorado finally got over 5,000 tests in a day. (An earlier spike was due to delayed reporting.) But I hear anecdotally that some hospitals are administering three tests to the same person due to test unreliability; I don’t know how widespread that practice is or whether the Colorado figures weed out the redundancies. In a May 11 online talk, Kyle Brown of the state’s COVID Innovation Response Team said that the state aims for 10,000 daily swab tests by the end of May.
That remains a tiny fraction of the number of tests that Paul Romer says we need to reopen. He thinks we should test everyone twice a month, which amounts to nearly 240 million tests per day nationally and over 400,000 in Colorado. The Harvard Global Health Institute thinks we can get by with a mere 900,000 tests per day nationally, which translates to nearly 16,000 tests per day in Colorado, still well above our target.
True, the United States has tested more people per thousand (26 as of May 10 data) than South Korea has (13). But, as Jennifer Nuzzo points out, the number of tests you need depends on the spread of the disease. The U.S. let the disease get wildly out of control, and our testing capacity has not remotely kept up. What really matters is finding those asymptomatic spreaders, and for that we need to test mostly people who aren’t sick. As of May 9, the U.S. was finding a positive case for every 7 tests; for South Korea it was 61. Colorado’s goal is to hit one in ten as per the guidance of the World Health Organization, Brown said, as it has already done, but that’s a pretty low bar.
What about contact tracing? With Romer-scale level of testing, we could get by with relatively less contact tracing. But we don’t have anything remotely close to that level of testing, nor does it seem likely that we ever will. The less testing we have, the more important it is to trace the contacts of those who test positive, to see if they too are sick. So does Colorado have a robust tracing capability in place to compensate for our paucity of testing? No.
As Colorado Public Radio reports, the National Association of County and City Health Officials says Colorado needs (in CPR’s words) “about 1,740 people” for contact tracing, “about six times a rough estimate of the current contact tracing now working in state and local health departments.”
To recap, Colorado does not have adequate ability to test people for the coronavirus, does not have adequate ability to trace the contacts of those who test positive, and therefore does not have adequate ability to isolate those who are infected. And this, in a nutshell, is why our economy has been shattered and why we are “asked” to continue to reduce our social interactions by about two-thirds relative to pre-pandemic levels. This is not sustainable, and more people are getting fed up by the day.
The shameful, catastrophic failure of government to contain the spread of the coronavirus is why many people openly talk about the possibility of herd immunity. But make no mistake: Reaching herd immunity, especially if we do it in a stupid way, which appears likely, means a stressed healthcare system and many more deaths and long-term health problems in Colorado and across the country. If we reach herd immunity, that means we failed. And it still appears to me that we are failing.
Unless we can reverse this and build a serious test-trace-isolate capacity, our choices are basically to keep the economy largely on ice or to open up and suffer more disease on our way to herd immunity. It seems clear that a substantial minority of Coloradans simply are not going to wait indefinitely for elected officials and bureaucrats to lift the restrictions. And, to put the point bluntly, there’s not a hell of a lot that government can do to squash that sort of rebellion. Sure, government can send in armed agents to shut down particular businesses and drive select individuals into bankruptcy and perhaps even to jail, but on the whole government cannot enforce social distancing mandates on people who have had enough.
Again, this is not fundamentally the fault of the people; it is fundamentally the fault of the government, which destroyed much of the economy for a month while utterly failing to develop a realistic exit strategy. I do realize that Colorado’s government was and remains severely constrained by the federal response and had little choice but to hastily react to a developing crisis.
If we’re going to avoid herd immunity by keeping the effective rate of spread under 1, then we should develop realistic means to do that while freeing people to produce and otherwise engage socially. Telling people they’re “safer at home,” with no end in sight, is an evasion, not a strategy.
If we are going to fail our way to herd immunity, let’s at least do it gracefully. That means continuing to cocoon the elderly, taking reasonable steps to keep disease spread low through moderate social distancing and public mask wearing, and, as I’ve argued, putting intentional, doctor-monitored infection (variolation) squarely on the table. The only thing worse than reaching herd immunity in a controlled way is reaching it in an uncontrolled way.
I’ve been fortunate through this. I am working from home, my wife is able to work from home, and I enjoy a basically happy home life. My experience is not representative. Many people literally are losing their life’s savings, losing their business, losing their career, losing their home, and facing severe emotional strains. It’s easy enough for the fortunate to sit on our Twitter perches and mock people for packing into a restaurant. It’s a lot harder to give people real solutions.
I hope that those heaping abuse on the owners of the C & C restaurant save some of their indignation for the government that put them in the position of losing everything. And I hope that there is still the time and the will to get real about the problems before us.