My proposed treatment for our COVID-19 pandemic

The impact of the COVID-19 pandemic across multiple spheres of American society is a novel event. Some have used the term black swan, Taleb's term for an event that can't be anticipated because it is outside the realm of experience. I prefer to think of it as a gray rhino, Michele Wucker's term for the big and obvious thing coming at you that you don't want to acknowledge. I think of this as a threat to our society writ large, not just as a threat to our economy or even just to public health. I think those narrow framings guarantee inadequate analysis and response.

COVID-19 is unravelling many aspects of American life at the moment, and there is general agreement that the damage will be severe and rate of disruption is going to increase before it levels off and decreases.

Everyone has an opinion about how to respond - including here on Facebook. Here's mine.

  • This event is unprecedented, at least in the last 150 years, in size, scope, and speed.
  • It is going to involve serious health challenges for 12-18 months with parallel economic shrinking and stress.
  • It is also going to stress our social and political systems and cultural norms.
  • There are no great historical events to use as comparison. *The 1918 influenza pandemic has in common a biologic trigger, worldwide spread, and mass casualties. However, medical science, transportation and travel, the economy (at all levels), and communication were radically different then.
  • Other posited comparisons fail: 1957 influenza, MERS, SARS were biologically quite different; 911 was triggered by a very narrowly threat; the 2008 market collapse was an economic event rather than a pan-systems event.
  • We are in uncharted territory. Many PhD theses and books will be written about what we did, should have done, shouldn't have done, and why. (Assuming those processes survive this.)
  • Because of the breadth and severity of the impact on all aspects of human life (health, education, economic, transportation, interactions...) the response needs to be one of multiple components.
  • The FIRST principle is that this is PRIMARILY a human public health crisis. No other solution or solutions will succeed if the public health issues are not adequately addressed. This requires 'war time' mobilization of money and other resources for testing, tracking, isolating, treating COVID-19 patients.
  • The SECOND principle is that the next priority is supporting the population. So they survive. So they believe in our society. So they believe in each other. And, not incidentally, so they can participate in society now and resume an active and secure life down the road. This includes things like making sure people who can't work because of the pandemic have an income to buy food, pay rent, and meet basic needs. It includes making sure everyone has acces to medical care - because a core public health principle is that we are only as healthy as the least healthy among us. It probably means supporting and expanding current safety net programs - they already exist. It means defering or erasing some kinds of debt, forbidding evictions. It means making sure the suport and resources are directed **disproportionately** to those with the greatest need and fewest resources.
  • The THIRD principle is that we need a middle class and a robust small business economy to survive long term - and the small business economy is at huge risk. We need to do things like small business loans, helping small businesses pay to keep their furloughed employees some percent (enough to get by) of their normal income. It might mean putting a hold on loan repayments. We want our favorite restaurant to be open in 3 months. We want our local medical and dental offices and vets to survive. (Primary care offices are laying off staff because their volume is down 50% or more. Unless supported by a big institution, most will be in the red in 2-4 weeks.) We want our local plumber, roofer, massage therapist, sports store, prinbting business, to survive. And many will not unless we act.
  • The FOURTH principle is to support large businesses. (Notice that it comes after three much more important things.) Many (such as big publicly traded entities) should be encouraged to borrow or otherwise raise capital to stay afloat. There may be some areas or industries where active intervention (bailouts) are necessary. But, there should be major strings attached.
  • The FIFTH - but not the least important - principle is that the odds are very good that even if we screw this up and make it last longer or cause more damage than it should the pandemic will ultimately end, and societies and industries will ultimately rebuild themselves. However, the odds are also very good that if we give up our democratic principles or social values, we will never be able to recover them.

As an afterthought, not necessary for this moment in time but essential down the road - we need accountability and consequences. There are many people in many roles who have been stupid, incompetent, dishonest, self-serving, damaging, or even malevolent. They should pay the price when we reach the other end of this nightmare.

Stay safe. Stay home. Stay in touch but keep your distance. Wash your hands.