My colleague Jared Sichel wrote an interesting article yesterday posing a number of important questions about the government’s response to the China Virus. He says that most Americans fall into three groups on this issue: those who think we need to lock everything down, those who think we should go about our normal lives and treat the virus exactly like the common flu, and those who think it is a serious threat but also believe our response to the threat is an overreaction and will do more harm than good. He classifies himself as a member of the third group.
As most of his questions seem to be targeting mainly the first group — the “shut it all down” folks — I’m not sure I’m the best one to answer them because I actually fall into a fourth camp of those who really aren’t sure what the hell is going on. I suspect my camp is rather crowded. I find myself persuaded by the report from the Imperial College of London predicting a catastrophic loss of life and an unmanageable strain on our health care system if extreme measures are not put in place. But then I read arguments from epidemiologists and other experts arguing that this is all overblown, or at least that we don’t have enough data to justify the extraordinary steps that have been taken, and I am at once reassured about the health threat and terrified that we are crashing the economy for no good reason. So far as I can tell, either side could be right. I don’t think I’m equipped to competently argue against one group of experts or for another.
Many of Jared’s questions are very good — What is the plan, exactly? How will we know if the plan is working? How do we know the virus won’t tear through the population whenever we get back to normal life? — and I join him in hoping someone can answer them. But this is the part that stood out especially to me:
To those who support cities shutting down businesses or even ordering residents to shelter in place, as San Francisco has done, do you acknowledge just how much pain this will create in many people’s lives? At what point of economic pain would you say we are going too far? You agree there is a point at which the government is going too far to save one life, or even a thousand lives.
After all, you don’t think all speed limits should be 10 MPH, except for emergency vehicles.
Where is that point for you in this situation? How bad will the economy – and thus people’s lives – have to get?
I can at least answer the first: yes, I do acknowledge the pain it has created and will create in people’s lives. And if this brings about a Great Depression, as some have predicted, I think almost all of us will feel it eventually.
The rest of this line of questioning is fair but incomplete because he looks at the problem only from one end. I don’t know when exactly the economic pain goes too far. It’s possible that it already has. It all depends on how many lives are actually being saved and whether the dire warnings about a collapse of the health care system were accurate or not. Was this a choice between crashing the economy to save the health care system or allowing the health care system to crash so as to preserve the economy? Is it probable that the economy was going to crash in any case, either from the cascading effect of the shut downs or the cascading effects of an out of control pandemic? Again, I don’t know.
Jared points out elsewhere that doctors and medical experts may understand science but they don’t necessarily appreciate the economic factors involved. True enough, but many of the people warning about the economic consequences don’t understand the science. They are assuming that models like the one from the Imperial College of London aren’t accurate, but how do they know? Or maybe they believe that even if those models are right — hundreds of thousands or millions dead, hundreds of millions infected, etc — it still wouldn’t justify the cost of the draconian response. That’s why I think these questions need to be turned around and asked the other way as well.
To those who think this is an overreaction, how many would need to die, or would need to potentially die, in order for you to support extreme measures? Jared is correct that I would not support a plan to shut down the economy to save one life. So it is true that there is a point where the body count, or potential body count, is too small to warrant the response. Where does it cross the line from too small to justifiably significant? I don’t know. But I think those who are firmly in the “overreaction” camp should also be asked to answer this question. If this is not enough death, not enough of a threat, what would qualify? At what point would the need to preserve human life override the need to preserve the economy? This might be an unanswerable question. But if it is unanswerable, then isn’t it impossible to argue with any confidence that the government is overreacting? If you say X doesn’t justify Y, but cannot say what would justify Y, how do you know that X doesn’t justify it?
We often hear the comparison to the common flu. As the argument goes, the flu kills 60 thousand Americans a year. This virus has killed only a tiny fraction of that number. Why treat this like a national emergency if the flu has never provoked that kind of reaction? Let’s grant the (I think probably false) assumption the this virus is like the flu, or “just the flu,” as the refrain goes. Even in that case, why shouldn’t we treat it like a national emergency? 60 thousand deaths is a lot, isn’t it? If we’re looking at the potential of something else like that, why shouldn’t we do everything in our power to stop it? If we could go back in time and stop the common flu, wouldn’t we do it? Even through extraordinary means? Think of how many lives that would save.
Why should a death toll from one disease be considered less severe just because another illness has a similar or higher death toll? Why is 8,000 China Virus deaths less of a big deal because so many other things kill so many more people? Isn’t that an odd way of measuring the value of human life? Again, I concede that we can’t lock down the whole planet every time someone dies or might die. But we all agree that dramatic steps can be justified, theoretically, in some circumstances. Why should the fact that other things are deadlier mean that this is automatically not one of those circumstances? Why set the bar for acceptable number of deaths at whatever level some other illness happens to be? Isn’t that arbitrary? Isn’t that like saying we shouldn’t go to war to stop a country from bombing one of our cities because that many people already die each year of heart disease anyway?
Another question to consider: are we being deceived by phrases like “common flu” and “flu-like symptoms”? What if everything about the virus was the same — same mortality rate, infection rate, etc — but instead of having flu-like symptoms, the infected bled out of their eyes? And what if those who died didn’t die of “respiratory complications” but instead convulsed violently on the floor? These are merely cosmetic details. People are dying all the same. People are sick all the same. But can anyone deny that there would far fewer people in Camp 3 if the symptoms presented themselves in a bizarre and frightening way? What does that tell us? Maybe it tells us that we’ve gotten used to people dying of flu-like illnesses and so we’re less likely to take it seriously. That’s understandable on a visceral level, but is it rational?
This could all be an overreaction. I am not making the case that it isn’t. But I don’t think anyone can make the case that it is unless they are willing to grapple with the same questions they expect everyone else to be able to answer.