It seems to me….
“If we can provide even a few months of early warning for just one pandemic, the benefits will outweigh all the time and energy we’re devoting. Imagine preventing health crises, not just responding to them.” ~ Nathan Wolfe.
Following my last posting regarding the COVID-19 pandemic, I received a response from a reader asking if I believed the world’s economy to “be strong enough to withstand the onslaught of an ancient microscopic organism that fights to live”. While hopefully not being overly technical, a virus is not alive and therefore cannot be killed. It is a nucleic acid molecule in a protein coat only able to reproduce within the living cells of a host. Given time, the human body normally produces enzymes that chemically modify viral genetic information rendering it unable to produce new virus particles.
Again, by definition, the world economy will survive – but that also was not what actually was being asked. The question is what will be the overall economic impact of the virus? But the magnitude of that potential impact seems to increase each day given the still exponential daily increase in new cases being reported. The longer it takes for the infection rate to be controlled, the worse the outcome.
In addition to any possible economic impact, events of this significance normally result in some long-term political and societal consequences. These types of changes typically are not necessarily immediate and possibly quite subtle but can effect greater long-term changes than those on the economy. Being unknown, these aspects are the most troublesome.
In the U.S., a revolt against big government invariably follows the expansion of the state. The bailouts during the financial crisis contributed to the rise of the Tea Party and the Occupy Wall Street protests. Going back further, the rise of Goldwater Republicanism, which eventually came to power in the form of Ronald Reagan, was in part a revolt against Lyndon Johnson’s Great Society programs. Historically, politically motivated responses to similar social, economic, or other challenges have included military action, not always warranted, as a distraction used by unpopular leaders to remain in power.
Unfortunately, the real extent of COVID-19 infections in the U.S. still remains unknown due to the lack of testing kits and analysis capability. The actual infection rate most likely greatly exceeds those so far identified. The U.S. was very unprepared for such an emergency and we now are paying the price.
While supporting the economy is extremely important, who is able to rationalize minimizing national economic degradation at the cost of human lives? I consider myself fortunate in that I am not responsibility for making that decision. If I did, a national lockdown would last for quite some time.
Initial response to most viral occurrences is normally somewhat cavalier as anywhere between 10,000 and 80,000 normally die, mostly the elderly or chronically sick, every year from seasonal influenzas. Skeptics apparently fail to understand basic math – fatalities from COVID-19 are about 20 times higher than normal rates. Additionally, infection rates are significantly less for seasonal varieties due to vaccine availability and herd immunization unavailable for COVID-19. Consequently, infection rates, and therefore ensuing fatalities, will be substantially higher.
Viral epidemics are difficult to control since as many as half of disease transmissions occur prior to when symptoms appear. They cause disruptions to work, living situations, schools, daily routines, and everyone experiences additional strains and stresses.
COVID-19 virulence greatly exceeds normal yearly viral occurrences and healthcare facility resources have been stretched or exceeded in numerous locations. There are insufficient quantities of personnel, facilities, medications, medical devices such as ventilators, personal protective equipment (PPEs): masks, gloves, gowns…. Though there were numerous warnings about the probability of a pandemic occurrence, there was a serious lack of adequate preparation.
These are trying times for businesses from Main Street to Wall Street and considerable time will be required prior to a return to normalcy. Many businesses having once shut their doors, will never have another opportunity. The virus has hit multiple industries resulting in an escalation of layoffs across the country. A Federal Reserve official warned the unemployment rate could reach 30 percent in the coming months – considerably higher than during the 2007-2009 recession.
Not all industry sectors are being affected evenly. While many are either experiencing layoffs or closures, for some it presents an opportunity. Those industry segments experiencing the greatest difficulty are food services, hospitality, and transportation.
Food services are our second-largest private employer with 15.6 million workers. Many workers are unemployed as restaurants have been mandated to only provide takeout or delivery service. Many restaurants have closed to follow stay-at-home guidelines or cannot afford to pay their workers. Of those remaining open for takeout orders, it is unknown how successful they will be.
About 4 million hospitality workers are expected to lose their jobs as lodging locations are experiencing unprecedented cancellations and closures.
Transportation is also impacted. About 750,000 airline employees are possibly affected as carriers reduce flights, park hundreds of planes, cut corporate pay, and request employees to volunteer for unpaid leave. Trains, buses, and commuter transportation have announced similar reductions.
Those considering it an opportunity include some manufacturing companies who are retaining employees but converting resources to produce PPEs and other item in short supply. Some designated as “essential services” are hiring. Amazon announced plans to hire 100,000 new employees, CVS 50,000, and Walmart about 150,000. Additionally, supermarkets, grocery stores, and delivery services have announced similar planned employment increases.
Food delivery services have increased by 72 percent, weapon and ammunition sales by 70 percent, and pizza sales by 53 percent.
Some work-related effects will be permanent. Companies have required about 88 percent of employees to work from home and 97 percent have canceled work-related travel. 70 percent plan to make more effective use of technology. It will be interesting to see what additional adaptation occurs or what percent of workers revert to prior work practices when the threat is past.
Financial inequality primarily affects the least wealthy who always are the most negatively impacted by any type of economic or social impact: they have been the most distressed by this pandemic. COVID-19 has once again shown the inadequacies of current U.S. healthcare and welfare safety nets: 78.8 million (24 percent) of those employed lack sick leave. 27.5 million (8.5 percent) do not have health insurance. Only 23.1 percent of unemployed workers are eligible for unemployment benefits. Schools and already inadequate childcare facilities were suddenly closed without any provision for children whose parents still have to work. Supposedly highspeed Internet bandwidth has in many areas been insufficient to support the increase in stay‑at‑home workers and students.
Local infrastructure may be particularly at risk. Continuity of municipal services such as electricity, water, and trash collection must be ensured. Paramedics and EMTs are also frontline providers but many EMS personnel are now under quarantine threatening a collapse of the 911 system.
Hospitals and healthcare facilities unable to accommodate the increased demand for services are being forced to triage patients. The New England Journal of Medicine laid out an ethics framework for resource allocation decisions with recommendations favoring those with better prognoses, prioritizing healthcare workers needed to take care of future patients, and additional consideration for people who do not have COVID-19 diagnoses. Regrettably, medical personnel will likely need to make such decisions if resource scarcity continues to worsen.
Policies dismissed or strongly criticized by Republicans during the financial crisis of 2008 were now endorsed by the Senate where they now have a majority approving emergency assistance by a vote of 96 to zero. It is unknown how beneficial the $2 trillion pandemic aid package passed by Congress will be. Also unknown is how it will ultimately be paid for though now is a good time to borrow since with current interest on a 10-year U.S. Treasury note at 0.75 percent, investors are loaning money to the federal government at a loss after accounting for inflation. When the economy is threatening to come to a stop, it admittedly is not the time to worry about government debt levels. The U.S. GDP to national debt ratio was already extremely high and this could easily push it over 150 percent. Hopefully, politically motivated solutions will not jeopardize already limited health and social welfare programs.
As for the original question, the U.S., as well as much of the world, is now in a significant economic downturn. At a time when it is most needed, there has been a decline in U.S. leadership upon which the world has depended since the end of World War II adding to the uncertainty. Nationally, unprecedented levels of debt accumulation across all economic sectors: national, corporate, and personal; will take time to unwind.
It remains premature to predict the full extent of the virus’ eventual impact. An early lack of screening in the U.S. allowed the coronavirus outbreak to spread largely undetected for weeks and, consequently, the New York City area may suffer a worse outbreak than Wuhan, China, or the Lombardy region in Italy with other U.S. metropolitan areas now appearing to be on a similar trajectory.
While much has been learned about COVID-19’s virulence, its overall impact will depend upon the duration until it is brought under control. If it can be controlled within the next month or two, social and economic recovery could be relatively rapid. It still remains unknown whether COVID-19, similar to other coronaviruses, will be seasonal; diminishing during the warmer summer months only to reappear when the weather turns cooler. If so, it will provide valuable time to develop treatment and vaccines prior to its reemergence.
Additional future pandemics can be expected. There are numerous guides and recommendations for personal preparation but as COVID-19 has clearly shown, most people neglect to do so until feeling personally threatened (and then resort to panic buying and hoarding). Governmental pandemic preparation places extraordinary and sustained demands on public health and healthcare systems and providers of essential community services. While the U.S., as well as most other countries, have attempted to plan and to increase capacity for global pandemic response, those preparations have been clearly demonstrated by COVID-19 to have been totally inadequate.
Optimistically, this will serve as a sufficient wakeup call and result in more adequate preparation in the future. I’m admittedly skeptical – we will wait and see.
That’s what I think, what about you?
 Nathan D. Wolfe is a U.S. virologist who was the founder and Director of Global Viral and the Lorry I. Lokey Visiting Professor in Human Biology at Stanford University.
 Coronavirus Economic Impact Report, Yelp, https://www.yelpeconomicaverage.com/yelp-coronavirus-economic-impact-report, 24 March 2020.
 COVID-19 Effect: Majority Of Organizations Have Encouraged Or Required Employees To Work From Home, IT Next, https://www.itnext.in/article/2020/03/20/covid-19-effect-majority-organizations-have-encouraged-or-required-employees-work, 20 March 2020.
 Emanuel, Ezekiel J., MD, PhD, et al. Fair Allocation Of Scarce Medical Resources In The Time Of Covid-19, The New England Journal of Medicine, https://www.nejm.org/doi/full/10.1056/NEJMsb2005114?fbclid=IwAR1kA7VMtv-G6ZX1N-xl1yMpqS_bOGosIk9ySNbhCGcUWkj7UNUuL9J-2MQ, 23 March 2020.