We Must Not Waste Our Sacrifice In Bending The Curve

The United States is well into the first wave of the COVID-19 pandemic. More than 562,000 Americans have tested positive for the novel coronavirus and more than 22,000 have died. All but a handful of states have implemented mandatory social distancing measures and much economic activity has been curtailed. Initial unemployment claims have shattered previous records and the unemployment rate may have already be the highest we have seen since the Great Depression.

The goal of social distancing and economic shutdown is to “bend the curve,” meaning to reduce the rate of infection to a level that our health care system can handle the need for hospitalization of many COVID-19 sufferers. Whether they are front-line workers in hospitals and grocery store or staying at home, millions of Americans have contributed to the fight, often at significant personal cost.

There are some early signs that these efforts are having success. In New York State, for example, new cases per day have been level or declining for nine days, suggesting the epidemic is no longer growing exponentially there.

The efforts we all have made have thus far saved many thousands of lives. However, our position is far from secure. If our sacrifices of these months are not to be in vain, there are two facts about the longer run we need to keep firmly in mind.

First, even if we are successful in arresting the spread of the epidemic this spring, the vast majority of the US population will still be vulnerable to infection. This means that an attempt to rapidly return to normal life would lead to a resurgence of the epidemic and many of the lives thus far saved would be lost. Until we have a vaccine or have achieved sufficient immunity in the population, and it may be years before this happens, we will need to continue to take measures to control the spread of the epidemic, and these measures will be burdensome.

Second, Americans who are no longer able to work need help in meeting their basic needs. While the CARES Act has provided funds to bolster and extend unemployment insurance, it is as yet unclear whether those who need help will be able to access it in time. There have been many reports of unemployed people being unable to contact state agencies because of the huge volume. Food banks are reporting record demand. If we don’t take care of those who are in need, the pressure to prematurely open the economy will become intense.

To succeed in the long term, we need to do two things. Both are critically important.

First, we must set up a monitoring mechanism that will allow us to reopen social and economic activity without triggering another outbreak. The goal should be to only have to shut down once and for as short a time as possible because shutdown is so costly and disruptive. China, South Korea, Singapore, and Taiwan provide examples of monitoring regimes that could be adapted to work here. All of these regimes require a much greater testing capacity than we have built so far and there has thus far been little movement by federal and state governments to build the kind of capacity we will need. We need to have this mechanism fully in place before we reopen, so the time to build it is now. Relying only on market incentives to build capacity will not get us there fast enough. Firms will not invest in setting up new plants for to meet demand that will likely be high only for a few years unless that investment is guaranteed. Only the federal government has the capacity to make such guarantees.

Second, we need to insure that help gets to individuals when they need it, and not weeks or months later. It may be that existing systems of verification and payment of benefits do not have the capacity to make payments fast enough. If that is the case, those systems should be bypassed and the risk of some fraud accepted. We may need to send money to people first and have them prove entitlement to it later. We don’t want people going hungry and losing their housing, and not only for direct humanitarian reasons. If we fail to provide for those in need, the tolerance for social distancing will erode and pressure will grow to reopen the economy before the epidemic is under control. Individuals can play a role here by helping local food banks or helping neighbors who have yet to access resources, but the scale of the problem is such that individual generosity can only be a stopgap.

We have the capability to do both of the actions, though moving quickly enough may require creativity, cooperation, and a willingness to do big, new things in a hurry. For example, expanding existing state unemployment insurance processing capacity may not be feasible, and an alternative method of moving funds to people, perhaps using payment processors like PayPal and Venmo, may need to be tried. We may need to ask Americans to consent to smartphone based location tracking while there is epidemic risk to enable contact tracing or otherwise to remain in home quarantine.

This is not a circumstance in which we can wait and see or get it right the second time. We must face the scale of the challenge in front of us and act.