Counting the Cost

By guest author Andy Zehner

Andy is a data analyst with a background in public policy, economics and development, and higher education.

Imagine that experts in one specific field could take control over the world and could order and organize everything. Any homogeneous group might be in charge: octogenarians, high school principals, traffic engineers, organic farmers, constitutional scholars, kindergarten kids, ER nurses, life-style faddists, cloistered nuns, coffee shop baristas, etc. The only rule is the experts can’t be limited to their specialty field. They must have free rein to tweak every aspect of the society and the economy.

What would you expect from such a process? Would any of the groups I mentioned, or any other group that you can think of, prescribe a perfect society? Would any of them do more good than harm? Even supposing the organic farmers had good ideas about healthy eating and better land management, would they be competent to handle the space program? Would the constitutional scholars know what to do about rush-hour traffic, or education policy, or invasive zebra mollusks? No. Experts know one thing. The more vaunted their reputation as experts, the more specialized they are apt to be. Turning over the whole of society and the whole of the economy to any single group of experts is a bad idea. And that is what has happened during the present coronavirus crisis.

Medical knowledge is certainly important now. We need the expertise of Dr. Anthony Fauci and Dr. Deborah Birx and others like them. But their knowledge of epidemiology shouldn’t qualify them to dictate ethical choices about who gets protected and who must suffer. The state governors shouldn’t be deferring to them as completely as most of them are. For, just as we’d expect, the experts in contagious disease are recommending policies that brush aside almost everything else to accomplish what seems most important to them.

My complaint is not only that the quarantine hurts the economy and the community; it also discards an essential resource. I believe disciplined human engagement probably would help the medical outcomes. The stay-at-home directives send the message that people are the problem but not part of the solution, which is true from an epidemiologist’s perspective.

The quarantine will flatten the curve, but it probably isn’t good for human health overall. People are neglecting other medical needs because they are afraid to go seed a doctor. Pregnant women aren’t getting prenatal care. The Washington Post has reckoned how the quarantine is causing deaths as well as preventing them. People aren’t exercising as they should.

Consider broader social and economic wellbeing, and the quarantine has appalling costs. Millions of Americans’ lives and futures are utterly ruined by the economic destitution that elected leaders have chosen to inflict on them. Around the world, its estimated that 130 million people are at risk of starvation because of the global economic quarantine. And this is not just in third-world countries. People rely on people, and the quarantine has stopped the ordinary safety net of food pantries and soup kitchens, throwing millions of already needy Americans into immediate danger. Looking for silver linings? Traffic accidents are down and so is overall crime. But law enforcement says unreported cases of child abuse may be lurking.

Some might say that coronavirus must be the priority; other concerns must wait. But what of the concerns that have already waited far too long? And what about lesser priorities that are nevertheless necessary for an effective response to the pandemic? Puerto Rico has 600 deaths so far from coronavirus. But it can’t deal effectively with the epidemic because its health delivery system and its electric power grid haven’t been repaired in the two-and-a-half years since Hurricane Maria, when more than 3,000 died. Epidemiologists are not the only experts Puerto Rico needs or has a right to.

Some will persist in saying that survival is all that matters. They will say preserving human life must be the highest – and therefore the only -- priority in this crisis! But consider this question: Of what does human life consist?

If we asked this question at any other time, people would describe human life as a rich combination of perceiving, discerning, communicating, appreciating, loving, working, relaxing, rejoicing, and more. Human life, they’d say, is a rich experience and much more than vegetable or animal life.

But this vibrant conception of human life is held in contempt by journalists. This week I read in Slate the following from a man who recently returned home to Sweden:

What I quickly noticed during the ride to my Stockholm apartment was how things seemed exactly normal for this time of year. Spring, when the Swede wakes up from his winter depression and goes outside to manically face the sun with closed eyes, was the same as it ever was. No one I could see was minding social distance. Cafés were full to the brim, and people were picnicking in parks, on the same blanket. And within the first few hours back in Stockholm, I saw more handshakes and hugs in public than I had seen in two months in Los Angeles, where I had seen none.

The writer is angry that Swedes are picnicking and shaking hands. He sees their “same as it ever was” choices as “policies leading to large-scale death.” There is no evidence to support that. Sweden’s incidence of covid-19 and its death rate from the disease are no higher than in the US, and so far Sweden has flattened the curve as successfully as most other countries. The writer is just angry that people are enjoying themselves.

I disagree with the argument that coronavirus should be the only thing that matters right now. The things that mattered before the outbreak still matter as much as they did. And the cost of neglecting them is quite likely to be greater than the benefits of the quarantine.

It is nearly always a mistake to think one priority supersedes every other consideration. Long-term concerns matter as much in moments of crisis as ever. If America ever faced a real existential crisis, it was the civil war. And it was during the civil war that Abraham Lincoln authorized three of the most forward-thinking and progressive pieces of legislation of the 19th century: the Homestead Act, the Morrill (land grant college) Act, and the Transcontinental Railroad. Lincoln understood that he had to win the war to save America’s future. But knowing he would save it, Lincoln resolved to make it the best future possible.

In the current crisis, we are encouraged to fear death and to see it as a new, unique and fearsome threat to our existence. That is a lie. Death is ever with us. Every year, about 60 million people die around the world. About three million Americans die every year – nearly 8,000 every day.

Recently national news sources have confused themselves and their readers by musing whether or not coronavirus is the leading cause of death. Answer: yes, if you consider only a few selected days in March and April, but no if you look across the whole year to date. Being the #1 cause of death means covid-19 causes more deaths than drowning or dog bites or any other single cause. Being #1 still only accounts for one death out of every six or seven that happen in a day. Heart disease will almost certainly be the top killer for 2020.

The death statistics for America show a steady increase year after year. The upward trend is mainly a function of the growing population, but it wavers a bit year-to-year and we can read history in those wavers. There is a spike in 1917-19 corresponding to WWI and the Spanish flu pandemic. There is another bump in the 1940s. The steepness of the curve diminishes over the whole last century due to declines in infant mortality (from 16 deaths out of every thousand babies in 1900 to less than 1 death per thousand now). But the upward trend in death is inexorable. In three of the last five years on record, the death total has jumped by more than 50,000 over the year before. This number, of course, had nothing to do with the virus but reflects a combination of factors, not least the aging of the Baby Boomer generation.

Covid-19 has already killed 60,000 in America. The pandemic is a real crisis, and, while experts and others are making new predictions every day, we have no idea how it will turn out. The point is not to add to the predictions but to call for our attention and an appropriate response. The pandemic demands courage, sacrifice, community-mindedness, generosity, faith in each other, and an extra portion of every other human virtue. Is the stay-at-home-and-watch-Netflix regimen our leaders have imposed a manifestation of those virtues? Is the policy of sacrificing commerce, emergency services, food production, and human life just to flatten the curve the response we need? We should listen to our doctors, yes, but economists, ethicists, food producers, old people, young people, and everyone who has something at stake should also be part of the conversation and the decision of how to respond to this extraordinary challenge. We are wasting our human resources by trying to keep them safe.