"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Saturday, April 25, 2020

We Are All Adults Here–Risk Assessment, Personal Responsibility, And Opening The Economy

The Corona shutdown has lasted weeks, and people are getting restive – not because of selfish reasons, but because they see the damage being done to the economy, public and private institutions, and the social fabric.  Jobs are being lost, unemployment is at its highest rate in decades, personal wealth has been precipitously lost, churches and schools have been closed, and America has become a gulag. It is time to reopen America, they say and now increasingly shout.

Image result for images protests to open the economy corona

Opponents refuse to consider this option.  Americans can stay quarantined for as long as it takes to ‘flatten the curve’ and to see signs that the virus is slowing.  It is our collective responsibility, they say, to act together to protect each other.  Of course, there is a caveat – it is the government which must establish and enforce stay-at-home rules.  It and only it can be the arbiter of public health and welfare.

Progressives whose agenda has always been to increase the role of government in American lives are the driving force behind the policy to keep the economy closed and citizens locked down.  Corona has shown how the private health care system is broken, and how the fragmented bits and pieces can never come together in a crisis to deal concertedly in a crisis.  Only a national health care program – nationalized health insurance – can serve the needs of the American public.  The failure of individual enterprises both large and small and government financial support to them has shown the fragility of the private sector, and that only a more centralized, directed economy can assure the harmonious, collective promise of rational economic growth.  Last but not least, Corona has shown – especially recently – the danger of individualism; and how irrational populism can destroy the judicious programs of the civically more aware.

While there is no denying the importance of quarantine and initial government mandates to do so; and while it is clear that because of government’s decision to shut down the economy it is their responsibility to provide financial help to those who have suffered from it; and while government resources, both direct and indirect, are well spent on public health facilities, drugs, and supplies, there is a dangerous downside to this intervention.

First of all, such draconian measures were never necessary in the first place.  From the very beginning of the emergency, it was known that only certain people were at high risk – the elderly and those with underlying, compromising medical conditions.  As more detailed tracking was done, it was found that it was the underlying medical issues which where causing ICU admissions and death among all age groups.  If these people – those with compromised immune systems, a history of serious disease, or other chronic illnesses – were aggressively quarantined, then the pressure on hospital beds would be reduced, and the rest of the population – well over 80 percent by most recent estimates – could go about their business and the business of America.  As importantly it has been found after random sampling, that many people have been exposed to the virus but few have shown symptoms.

Those in this vast majority could decide for themselves whether they wanted exposure to the virus or not.  They could choose to wear masks, to wash their hands frequently, and to maintain social distancing.  They could choose to work or not.  In other words, they could decide for themselves, given the widespread information available, the actions they were willing to take, hence the now oft-repeated meme, “We are all adults here”.  While risk assessment is a tricky business, if it is serious enough, people will take it seriously.

Ah, say the naysayers, we cannot trust people to do the right thing.  They need to be guided, controlled, surveilled, and monitored.  They need to be cared for like children, hence The Nanny State. This is why it is called “public’ health, the Chicken Littles shout, not individual health.  We must see that you do the right thing.

Three states and some municipalities have decided to open their economy, free citizens from quarantine lock-down and get back to business – Georgia, Oklahoma, Alaska and at least the City of Las Vegas.  The Office of the Governor of Georgia has recently released pictures of Jacksonville beach and in interviews his deputies have attested to how well the re-opening is working.  People have not jammed the beaches, but have maintained their distance, taken appropriate precautionary measures, and have never abused the privilege.  The city and state have deployed monitors to advise people about the rules of engagement and to warn them where necessary.  In other words, people have been shown to do the right thing.

Florida hits beach while Texas protests coronavirus restrictions

Spas, beauty parlors, and barber shops are now open in these states, and all owners have been complying with public health guidelines.  They want to protect themselves and their customers and vice-versa; but given the assumption – that only health people will be customers and attendants, the risk is low.  Only reminders are necessary to help people observe proper caution, not threats.

Image result for images social distancing beauty parlors

Is there a danger of Corona resurgence?  Some medical advisors have warned that the virus could still mutate into something far worse than it is, and the results could be catastrophic; but these are the unknowns of the unknowns, to be taken into consideration and filed.

Given the epidemiological statistics, the success of those states partially re-opening their economy and their public spaces, the 100 percent saturation of information about the virus and the measures necessary for protection, there is no question but what the time has come for generalized re-opening of the economy.

There is no doubt that certain jurisdictions have suffered more than others, and had the government invested its resources in providing additional health care services, products, and personnel to those that most needed them, like New York City, the death toll might have been less.  In such a triage-led policy environment, public resources are used carefully, prudently, and efficiently.  The one-size-fits-all, the old and discredited, politicized public health approach during the AIDS epidemic (“AIDS is everyone’s disease”) has always been wrong.

If the US had not shut down the economy in such a draconian, authoritarian way, and had triaged, targeted, and focused its investments and public health interventions, the tax revenues from an operating economy would have financed public health efforts.

It is likely that more and more states, with the support of the Trump Administration, will carefully and progressively open their economies.   Deaths will continue to occur because of the major killers of cancer, heart and lung disease, associated pneumonia and infections, seasonal influenza, and Corona.  Reasonable precautions will continue to be taken after each individual assesses his risk.  Since risk assessment is never perfect, there are those who misjudge; but there are many more who take seriously their responsibility to themselves, their families, and their communities; and this sense of personal responsibility should be at the core of American civic life.

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