dversity is an unexpected and unwelcome ingredient in life, and it necessarily prompts one of two responses, which shape our destiny. We can confront the challenge and work to redirect its negative effects, or we can capitulate to the intruder and accept the consequences. The COVID-19 pandemic presented that behavioral fork in the road, and Americans did what we have done for years. We set aside our squabbles and spirit of individuality and collectively took up the fight. For a period of more than three months, Americans did a remarkable job of recognizing the seriousness of the pandemic, isolating themselves from the illness and adopting masks and social distancing as the best medicine available.
We did what the doctor ordered, and the prescription was largely successful. But without such strict mitigation practices, we might have seen fatalities two or three times larger than the more than 120,000 deaths America has sadly experienced thus far. We have also learned that confinement can be unsettling for some and emotionally unhealthy for others. Even those fortunate enough to have a portable job, working from home can, over time, be considerably more stressful than a day at the office. And this says nothing of the horrendous impact on those who simply cannot do their work remotely or have no work at all. Lastly, the uncounted ways the pandemic and the consequential economic crisis have unevenly impacted disadvantaged communities and highlighted critical yet unaddressed issues must be explored in greater depth.
Understandably, Americans are ready to get on with their lives, but there are conflicting considerations that are getting in the way.
Fear. There are scores of medical experts, public health officials, and miscellaneous politicians who argue that “the battle is not yet won” and to re-open too soon is to reactivate the coronavirus and invite one or more “second waves.” This is, indeed, a worrisome and fear-inducing forecast that may well be correct in varying degrees, and is unfortunately amplified by a broadcast and print media that thrive on reporting death and destruction rather than resilience and recovery. There’s no better example than the recent New York Times front page article "U.S. Deaths Near 100,000, An Incalculable Loss” that appropriately recognizes the tragic loss of life, but consciously avoids highlighting the risk of age and infirmity since more than 80 percent of all fatalities were individuals age 65 or above or otherwise medically at-risk, according to the National Center for Health Statistics. And, responding to this uneasy environment and using the “abundance of caution” rationale, some major universities and other public services are already opting to curtail activities for unspecified periods through the Fall. There is a legitimate basis to be afraid of a deadly disease, but rather than being scared straight, we’re allowing ourselves to be scared to inaction.
Economic Damage. On the other hand, it is increasingly apparent to economists, business men and women, and even medical professionals that the longer society is locked down, the greater the damage to the economy and its citizens, and the longer the period of recovery. There are already more than 35 million Americans out of work; one in five small businesses are in danger of permanently closing in a matter of months; sustained unemployment has long been recognized as having negative impacts on worker skills, health and family stability; the national debt, as a share of GDP, will exceed the amount at the end of World War II; and reestablishing 2019 levels of prosperity is now being measured in years, not months. Even sheltering-in-place can trigger its own health conditions, as recently acknowledged by NIH’s Dr. Anthony Fauci, and this is further suggested by the report that the INOVA hospital system lost more than $100 million in revenue from elective surgeries not conducted due to COVID-19. And, the more than 90% of Americans whose health was never touched by the virus and those who live in the parts of the country where the disease never lingered can’t understand why it’s taking so long to move away from the temporarily helpful but economically damaging mandates of sustained isolation.
How to Re-open. Polls are beginning to confirm that a growing number of Americans are ready to get back to work, and all fifty states are re-opening in some fashion . . . but there’s a problem. It is generally agreed that the re-entry into life will be uneven because of geographic differences in the distribution of the disease and the need to deploy the appropriate precautions. There is a myriad of serious “recovery playbooks” from which to choose . . . but this is America, where everyone wants to do it their own way. Consequently, mixed signals coupled with mixed attitudes are the order of the day, with the result that no one really knows quite what to do.
Too Many Voices. Messages from the President, 50 state governors, and assorted other public officials and medical professionals on exactly what steps should be taken can be easily misunderstood as they use many of the same words and ideas but intend them to have different meanings. Some say re-open now; others say it’s too soon. Does a 50% capacity in a restaurant make it safe, or should they only serve outside? Social distancing makes sense but too few people carry a yardstick. If gloves really help, how do you take them off without re-contamination? And who knows who’s wearing an effective mask, or does it matter? Medical experts are quick to discuss various combinations of the 3 T’s—tracing, testing, and temperatures—as protocols for safely re-entering workplaces or other public spaces. But the same medical community also acknowledges that tracing is best accomplished in contained populations or at the outbreak of epidemics; that antibody tests, according to the CDC “. . . might be wrong up to half the time;” and, a former New Jersey Health Commissioner observed that “The absence of an elevated body temperature is not a seal of approval.” Finally, the tilt toward “one size fits all” is a shaky approach to guidelines when we’re not sure what we’re trying on.
So, what are we to do? Because the economic realities, medical anxieties, and inconsistent solutions are real, they must be harmonized in some fashion sooner rather than later. There’s an abundance of expertise but a paucity of consensus, and in the absence of clear direction we (and the stock market) take comfort in the persistent conversation about the development of a vaccine . . . because most want to believe it will, in one stroke, resolve all of the COVID-19 problems. It would be the proverbial silver bullet! We imagine that a vaccine will allow an accelerated re-opening of businesses without massive restructuring. It will relieve the need for so many every-day medical precautions except for the high-risk elderly. The threat of hospital over-crowding would disappear. Its mere existence would begin to alleviate the public’s fear of flying. We could once again go to football games and we could resume shaking hands and giving hugs. In short, it would allow the world to “return to normal.”
But there’s a rub. What if a COVID-19 vaccine is never discovered? Multiple pharmaceutical companies around the world are undertaking herculean efforts to solve the problem, but vaccines were never discovered for SARS and HIV, which have haunted populations in recent years. And as we know, it usually takes years of research to create a vaccine and even if one is developed it may not protect against all strains of a virus, as is the case with the old-fashioned flu shot that’s made available every season. In fact, former FDA Associate Commissioner Dr. Peter Pitts has observed that the coronavirus is particularly “wily” and is already mutating and may outrun immunological solutions. Finally, the hopeful conversations around a COVID-19 vaccine presuppose that the usually lengthy safety-ensuring clinical trials are somehow short-circuited, that massive manufacturing and stockpiling can be accomplished overnight, and that sophisticated and equitable global distribution systems will be immediately available to allow billions of people around the world to get a ten second shot in the arm. The availability of a vaccine in the near future is not impossible, but is certainly problematic.
But there is good news! There might not be a silver bullet but we have an ample supply of ammunition and it resides in the strength and skills and common sense that Americans already employ: we have learned to live with risk and make plans and employ strategies that “work around” it every day. We routinely drive carefully to avoid the risk of traffic accidents, which take the lives of about 39,000 people annually. Parents closely monitor summer swimming as pool accidents account for over 7,000 deaths (mostly kids) every year. We are increasingly screened for cancer, take statins for heart disease, and mitigate myriad other serious conditions from which hundreds of thousands of people perish every year. We wear hard hats at construction sites, erect barriers at railroad crossings, install metal detectors at airports, deploy fire stations in neighborhoods, and place smoke detectors on our ceilings. In the language of today, “We got it.”
Living with risk is the game of life. We do it every day in one way or another and, if necessary, we will learn to live with COVID-19. Immunologists will remind us that there are a variety of virus strains and other diseases with which we currently co-exist because they are not of pandemic or epidemic proportion. And COVID-19 may join that crowd as the curve flattens, outbreaks diminish, immunities are established, fatalities are brought under control, and therapeutics are developed that mitigate the severity of the disease and hopefully limit the number of fatalities.
We are now just beginning the process of emerging from the medical and economic tsunami—the twin tragedies of the global pandemic—without the aid of a vaccine or established therapeutics. And, with or without the silver bullet there are at least five already-learned lessons to be immediately considered by public officials and citizens alike in order to successfully move from re-opening to economic recovery:
• Take the necessary steps to protect the ill and the elderly, as recent experience has clearly shown that they are the primary target of this coronavirus.
• Broadly advertise the fact that with proper precautions we can simultaneously manage a stubborn virus and go about living and working in a relatively normal fashion.
• Study a couple of the best “recovery playbooks” (one of which is the U.S. Chamber’s Digital Resource Center work on “Reopening Business”), tailor the most appropriate suggested practices to the state or local circumstance, and widely communicate these as your “approved recovery guidelines” to ensure that most everyone is following the same script.
• The response to a second or third wave of COVID-19 infections—which will likely occur in some places to varying degrees—should be to immediately quarantine the problem, be they individuals, business facilities, or even neighborhoods, and follow the established protocols, but not again lockdown an entire community or a state as a twice-shuttered economy, large or small, will likely never fully recover a second time.
• Finally, since a “return to work is the return to life,” federal, state, and local officials must do everything to enable business recovery and three key steps would be to agree that facilitating “guidelines” are not intended to be mandatory regulations, provide liability protections for those businesses that “play by the rules,” and resist the temptation to tax businesses and individuals whose budgets are already broken.
Experts tell us that there will likely be other epidemics, if not pandemics. At some point we will encounter COVID-20, Ebola 2, or some other form of Swine Flu for which there will be no vaccine, and we will be expected to live with it because turning the lights out on business around the world will no longer be an option.
The United States leads not only the global economy, but the liberal world order and mindful of those responsibilities, Andrew Wilson and his team at the Center for International Private Enterprise (CIPE)—the international NGO whose mission is to advance free market economics and democratic governance—have developed six essential themes and other factors that will not only assist governments throughout the world with the ongoing recovery, but anticipate post-recovery global risks which the United States and others will need to address in the years ahead. These big ideas and more are explored in the chapters that follow.
a global affairs media network
Living with COVID-19
June 22, 2020
There is an uncomfortable possibility we may have to accept: COVID-19 may be with us for some time to come.
A
dversity is an unexpected and unwelcome ingredient in life, and it necessarily prompts one of two responses, which shape our destiny. We can confront the challenge and work to redirect its negative effects, or we can capitulate to the intruder and accept the consequences. The COVID-19 pandemic presented that behavioral fork in the road, and Americans did what we have done for years. We set aside our squabbles and spirit of individuality and collectively took up the fight. For a period of more than three months, Americans did a remarkable job of recognizing the seriousness of the pandemic, isolating themselves from the illness and adopting masks and social distancing as the best medicine available.
We did what the doctor ordered, and the prescription was largely successful. But without such strict mitigation practices, we might have seen fatalities two or three times larger than the more than 120,000 deaths America has sadly experienced thus far. We have also learned that confinement can be unsettling for some and emotionally unhealthy for others. Even those fortunate enough to have a portable job, working from home can, over time, be considerably more stressful than a day at the office. And this says nothing of the horrendous impact on those who simply cannot do their work remotely or have no work at all. Lastly, the uncounted ways the pandemic and the consequential economic crisis have unevenly impacted disadvantaged communities and highlighted critical yet unaddressed issues must be explored in greater depth.
Understandably, Americans are ready to get on with their lives, but there are conflicting considerations that are getting in the way.
Fear. There are scores of medical experts, public health officials, and miscellaneous politicians who argue that “the battle is not yet won” and to re-open too soon is to reactivate the coronavirus and invite one or more “second waves.” This is, indeed, a worrisome and fear-inducing forecast that may well be correct in varying degrees, and is unfortunately amplified by a broadcast and print media that thrive on reporting death and destruction rather than resilience and recovery. There’s no better example than the recent New York Times front page article "U.S. Deaths Near 100,000, An Incalculable Loss” that appropriately recognizes the tragic loss of life, but consciously avoids highlighting the risk of age and infirmity since more than 80 percent of all fatalities were individuals age 65 or above or otherwise medically at-risk, according to the National Center for Health Statistics. And, responding to this uneasy environment and using the “abundance of caution” rationale, some major universities and other public services are already opting to curtail activities for unspecified periods through the Fall. There is a legitimate basis to be afraid of a deadly disease, but rather than being scared straight, we’re allowing ourselves to be scared to inaction.
Economic Damage. On the other hand, it is increasingly apparent to economists, business men and women, and even medical professionals that the longer society is locked down, the greater the damage to the economy and its citizens, and the longer the period of recovery. There are already more than 35 million Americans out of work; one in five small businesses are in danger of permanently closing in a matter of months; sustained unemployment has long been recognized as having negative impacts on worker skills, health and family stability; the national debt, as a share of GDP, will exceed the amount at the end of World War II; and reestablishing 2019 levels of prosperity is now being measured in years, not months. Even sheltering-in-place can trigger its own health conditions, as recently acknowledged by NIH’s Dr. Anthony Fauci, and this is further suggested by the report that the INOVA hospital system lost more than $100 million in revenue from elective surgeries not conducted due to COVID-19. And, the more than 90% of Americans whose health was never touched by the virus and those who live in the parts of the country where the disease never lingered can’t understand why it’s taking so long to move away from the temporarily helpful but economically damaging mandates of sustained isolation.
How to Re-open. Polls are beginning to confirm that a growing number of Americans are ready to get back to work, and all fifty states are re-opening in some fashion . . . but there’s a problem. It is generally agreed that the re-entry into life will be uneven because of geographic differences in the distribution of the disease and the need to deploy the appropriate precautions. There is a myriad of serious “recovery playbooks” from which to choose . . . but this is America, where everyone wants to do it their own way. Consequently, mixed signals coupled with mixed attitudes are the order of the day, with the result that no one really knows quite what to do.
Too Many Voices. Messages from the President, 50 state governors, and assorted other public officials and medical professionals on exactly what steps should be taken can be easily misunderstood as they use many of the same words and ideas but intend them to have different meanings. Some say re-open now; others say it’s too soon. Does a 50% capacity in a restaurant make it safe, or should they only serve outside? Social distancing makes sense but too few people carry a yardstick. If gloves really help, how do you take them off without re-contamination? And who knows who’s wearing an effective mask, or does it matter? Medical experts are quick to discuss various combinations of the 3 T’s—tracing, testing, and temperatures—as protocols for safely re-entering workplaces or other public spaces. But the same medical community also acknowledges that tracing is best accomplished in contained populations or at the outbreak of epidemics; that antibody tests, according to the CDC “. . . might be wrong up to half the time;” and, a former New Jersey Health Commissioner observed that “The absence of an elevated body temperature is not a seal of approval.” Finally, the tilt toward “one size fits all” is a shaky approach to guidelines when we’re not sure what we’re trying on.
So, what are we to do? Because the economic realities, medical anxieties, and inconsistent solutions are real, they must be harmonized in some fashion sooner rather than later. There’s an abundance of expertise but a paucity of consensus, and in the absence of clear direction we (and the stock market) take comfort in the persistent conversation about the development of a vaccine . . . because most want to believe it will, in one stroke, resolve all of the COVID-19 problems. It would be the proverbial silver bullet! We imagine that a vaccine will allow an accelerated re-opening of businesses without massive restructuring. It will relieve the need for so many every-day medical precautions except for the high-risk elderly. The threat of hospital over-crowding would disappear. Its mere existence would begin to alleviate the public’s fear of flying. We could once again go to football games and we could resume shaking hands and giving hugs. In short, it would allow the world to “return to normal.”
But there’s a rub. What if a COVID-19 vaccine is never discovered? Multiple pharmaceutical companies around the world are undertaking herculean efforts to solve the problem, but vaccines were never discovered for SARS and HIV, which have haunted populations in recent years. And as we know, it usually takes years of research to create a vaccine and even if one is developed it may not protect against all strains of a virus, as is the case with the old-fashioned flu shot that’s made available every season. In fact, former FDA Associate Commissioner Dr. Peter Pitts has observed that the coronavirus is particularly “wily” and is already mutating and may outrun immunological solutions. Finally, the hopeful conversations around a COVID-19 vaccine presuppose that the usually lengthy safety-ensuring clinical trials are somehow short-circuited, that massive manufacturing and stockpiling can be accomplished overnight, and that sophisticated and equitable global distribution systems will be immediately available to allow billions of people around the world to get a ten second shot in the arm. The availability of a vaccine in the near future is not impossible, but is certainly problematic.
But there is good news! There might not be a silver bullet but we have an ample supply of ammunition and it resides in the strength and skills and common sense that Americans already employ: we have learned to live with risk and make plans and employ strategies that “work around” it every day. We routinely drive carefully to avoid the risk of traffic accidents, which take the lives of about 39,000 people annually. Parents closely monitor summer swimming as pool accidents account for over 7,000 deaths (mostly kids) every year. We are increasingly screened for cancer, take statins for heart disease, and mitigate myriad other serious conditions from which hundreds of thousands of people perish every year. We wear hard hats at construction sites, erect barriers at railroad crossings, install metal detectors at airports, deploy fire stations in neighborhoods, and place smoke detectors on our ceilings. In the language of today, “We got it.”
Living with risk is the game of life. We do it every day in one way or another and, if necessary, we will learn to live with COVID-19. Immunologists will remind us that there are a variety of virus strains and other diseases with which we currently co-exist because they are not of pandemic or epidemic proportion. And COVID-19 may join that crowd as the curve flattens, outbreaks diminish, immunities are established, fatalities are brought under control, and therapeutics are developed that mitigate the severity of the disease and hopefully limit the number of fatalities.
We are now just beginning the process of emerging from the medical and economic tsunami—the twin tragedies of the global pandemic—without the aid of a vaccine or established therapeutics. And, with or without the silver bullet there are at least five already-learned lessons to be immediately considered by public officials and citizens alike in order to successfully move from re-opening to economic recovery:
• Take the necessary steps to protect the ill and the elderly, as recent experience has clearly shown that they are the primary target of this coronavirus.
• Broadly advertise the fact that with proper precautions we can simultaneously manage a stubborn virus and go about living and working in a relatively normal fashion.
• Study a couple of the best “recovery playbooks” (one of which is the U.S. Chamber’s Digital Resource Center work on “Reopening Business”), tailor the most appropriate suggested practices to the state or local circumstance, and widely communicate these as your “approved recovery guidelines” to ensure that most everyone is following the same script.
• The response to a second or third wave of COVID-19 infections—which will likely occur in some places to varying degrees—should be to immediately quarantine the problem, be they individuals, business facilities, or even neighborhoods, and follow the established protocols, but not again lockdown an entire community or a state as a twice-shuttered economy, large or small, will likely never fully recover a second time.
• Finally, since a “return to work is the return to life,” federal, state, and local officials must do everything to enable business recovery and three key steps would be to agree that facilitating “guidelines” are not intended to be mandatory regulations, provide liability protections for those businesses that “play by the rules,” and resist the temptation to tax businesses and individuals whose budgets are already broken.
Experts tell us that there will likely be other epidemics, if not pandemics. At some point we will encounter COVID-20, Ebola 2, or some other form of Swine Flu for which there will be no vaccine, and we will be expected to live with it because turning the lights out on business around the world will no longer be an option.
The United States leads not only the global economy, but the liberal world order and mindful of those responsibilities, Andrew Wilson and his team at the Center for International Private Enterprise (CIPE)—the international NGO whose mission is to advance free market economics and democratic governance—have developed six essential themes and other factors that will not only assist governments throughout the world with the ongoing recovery, but anticipate post-recovery global risks which the United States and others will need to address in the years ahead. These big ideas and more are explored in the chapters that follow.
