Less than 24 hours after California governor Gavin Newsom closed ‘non-essential’ businesses and ordered Californians to stay inside to avoid spreading the coronavirus, New York governor Andrew Cuomo followed suit. ‘This is about saving lives,’ Cuomo said during a press conference on Friday. ‘If everything we do saves just one life, I’ll be happy.’
Cuomo’s assertion that saving ‘just one life’ justifies an economic shutdown raises questions that have not been acknowledged, much less answered, as public officials across the country compete to impose ever more draconian anti-virus measures:
- Is there any limit to the damage we are willing inflict on the world economy to mitigate the infection?
- What are the benefits of each new commerce-killing measure and how do they compare to the costs?
- What are the criteria for declaring success in the coronavirus fight and who decides whether they have been met?
To ask about the costs and benefits of the spreading economic shutdowns guarantees an accusation of heartlessness. But the issue is not human compassion versus alleged greed. The issue is balancing one target of compassion against another. The millions of people whose lives depend on a functioning economy also deserve compassion. Many of the businesses that are now being shuttered by decree will never come back. They do not have the reserves to survive weeks or months without customers. In New York City, many streets were already blighted by rows of empty storefronts. The virus shutdown could knock out the remaining enterprises, as customers acclimate themselves further to ordering on-line. Layoffs are piling up in restaurants, hotels, and malls; on Tuesday, unemployment claims in California were 40 times above the daily average, an increase greater than any coronavirus surge.
It is low-wage employees who are most being hurt. The knowledge class can shelter in place and work from their home computers. Their employers are not shutting down. Not so people who physically provide goods and services. The employees who have been let off now may not be able to find work again if the economy continues to collapse. While governors and mayors declare some businesses essential and some not, to their employees, they are all essential.
A prolonged depression will stunt lives as surely as any viral epidemic, and its toll will not be confined to the elderly. The shuttering of auto manufacturing plants led to an 85 percent increase in opioid overdose deaths in the surrounding counties over seven years, according to a recent study. Radical social upheaval is possible.
The arts world is being decimated. For the last two years the New York Times and other left-wing newspapers have been bashing the boards of major cultural institutions for being too white and too male. Those institutions had better hope that their ‘non-diverse’ trustees feel flush enough after the $5 trillion loss in the stock market to bail them out.
While the coming explosion of deficit spending — possibly $2 trillion worth — may be necessary to keep people afloat, government cannot possibly replicate the wealth-creating effects of voluntary commerce. The enormously complex web of trade, once killed, cannot be brought back to life by government stimulus. And who is going to pay for all that deficit spending as businesses close and tax revenues disappear?
Pace Cuomo, it is not the case that saving even one life justifies any and every policy. Decision-making is always about trade-offs. About 16,000 Americans are murdered each year. That number could be radically lowered by locking up known gangbangers and throwing away the key. The left in America, however, is on a crusade to empty the prisons and stop enforcing a host of criminal laws. Some of the de-incarcerated and decriminalized will go on to maim and murder. An influential criminologist once acknowledged to me that lowering prison sentences in order to end so-called mass incarceration would inevitably mean that ‘some guy will throw a little old lady off the roof’. The answer is not to back off of de-incarceration, he said, it is to explain that the community in the aggregate is safer with resources diverted into social programs instead of incarceration. That is a perfectly defensible line of argument, regardless of whether one agrees with the particulars in this case.
Around 40,000 Americans die each year in traffic deaths. We could save not just one life but tens of thousands by lowering the speed limit to 25 miles per hour on all highways and roads. We tolerate the highway carnage because we value the time saved from driving fast more. Another estimated 40,000 Americans have died from the flu this flu season. Social distancing policies would have reduced that toll as well, but until now we have preferred freedom of association and movement.
So it is worth reviewing what we know and don’t know about the coronavirus epidemic to assess the benefits and costs of the growing policies. The rising number of confirmed cases of COVID-19 is undoubtedly a function to a considerable extent of increased testing. We don’t know its transmission rate. We don’t know how much shutting down restaurants and air travel lowers that transmission rate. We still have no idea what the virus fatality rate is, since we don’t know how many people in the general population are infected. Early fatality estimates were undoubtedly too high, since they were derived from a small denominator composed of already identified, severe cases.
The only situation to date where an entire, closed population was tested was the quarantined Diamond Princess cruise ship, as Stanford epidemiologist John Ioannidis observed last week. Among seven hundred passengers and crew members, seven died, for a 1 percent mortality rate — low given the close and prolonged exposure among the passengers. A cruise ship’s population is much more elderly than the general population and thus more vulnerable to disease. Ioannidis suggests that a reasonable fatality estimate for the US population as a whole could range from 0.05 percent to 1 percent; he settles for 0.3 percent. If 1 percent of the US population becomes infected, under a 0.3 percent fatality rate, 10,000 people would die, a number that would not move the needle much on the existing level of deaths due to various types of influenzas, Ioannidis notes.
Those fatalities would be highly concentrated among the elderly and the already severely sick. In Italy, as of March 17, there were 17 virus deaths under the age of 50, out of a little over 2,000 total deaths. Eighty-eight percent of those deaths were concentrated in just two adjacent regions — Lombardy and Emilia-Romagna — out of 20 regions, rather than being spread throughout the country. Five males between the ages of 31 and 39 had died, all had serious preexisting conditions including cardiovascular and renal disease, diabetes, and obesity. The fatality rate for those under 30 was zero. The median age of Italy’s COVID-19 decedents was 80.5. They had a median of 2.7 pre-existing health conditions: 33 percent had coronary artery disease, 76 percent suffered from hypertension, 35 percent were diabetic, and 20 percent had had cancer in the last five years. Just 3 decedents had no pre-existing conditions.
Italy’s demographics are different from our own — it is an older population with a high concentration of Chinese workers, especially in the north. On February 1, the mayor of Florence called on Italians to hug a Chinese person to fight virus-induced racism. According to a propaganda video put out by the Chinese government, many Italians complied. Nevertheless, American virus deaths so far mirror the pattern of Italy: geographically clustered in three states and concentrated among the elderly or those with serious chronic medical conditions. In South Korea, too, deaths have hit the elderly, whereas as many as 99 percent of all infections have been mild.
Nevertheless, government authorities at the federal, state, and local levels are seizing powers unheard of in peace or even wartime. Many on the left want an even greater assumption of power. Michael Dorf, a Cornell University law professor, has urged the suspension of habeas corpus, to eliminate the possibility of a legal challenge to a national lockdown. It’s hard to avoid the impression that some see the current moment as a warm-up for their wish-list of sweeping economic interventions.
The New York Times has touted the benefits of social distancing and curtailed commerce for global warming and air pollution. ‘Never waste even a tragic crisis,’ the director of the Center for Infectious Disease Research and Policy at University of Minnesota told the Times with reference to global warming policy. (This is the same sage, Dr Michael Osterholm, who early on criticized President Trump’s prescient travel ban from China as more of an emotional or political reaction than a sound public health one.) European leftists are noting with delight that large-scale state intrusion into the economy is being normalized. Times columnist Farhad Manjoo gloated that ‘everyone’s a socialist in a pandemic’. Actually, we had better hope that everyone’s a capitalist, since it is the extraordinary flexibility and fecundity of America’s private businesses that are continuing to restock grocery shelves after the panicked hordes strip them bare. It is private businesses that are retooling themselves to produce much-needed medical equipment.
The press is working overtime to ensure maximum hysteria. The New York Times outdid itself on Saturday, following a weeklong run of terrifying front-page banner headlines. A blood red map of the US above the fold purported to show infections by July 1 if no restrictions were imposed on public life — a completely counterfactual projection, since numerous restrictions have already been imposed and more are being added daily. The headlines above the fold contained the usual blend of Trump-bashing and fear-mongering: ‘PRESSURE ON TRUMP AS MILLIONS ARE KEPT HOME’, ‘Mixed Signals From President Sow Confusion’, and ‘Virus Tightens Grip on Nation’. This at a time of 214 deaths and 17,000 infected, compared to the 36 to 51 million infected by the flu this season, and the 140 to 350 flu deaths a day.
‘America plunged into a deeper state of disruption and paralysis on Friday,’ opened the lead story. But that disruption and paralysis were man-made, caused by the stay at home orders, not by the actual medical consequences of the pandemic. It was not the virus that was tightening its grip on the nation, it was policy and fear.
To be sure, we are facing a daunting public health challenge. Thousands will die; every death will be a harrowing loss for the victim’s family. Our medical personnel are already being severely taxed; they deserve proper equipment and facilities. The government is right to coordinate and boost the effort to supply them with desperately needed protective gear. But the rush to impose sweeping restrictions on public and commercial life across the entire economy should be more carefully evaluated. We have no ability to test the efficacy of those measures and no criteria for lifting them. The downside risk to their being over-inclusive could well outweigh the upside risk.
Moreover, a certain percentage of social distancing is virtue theater. While the elites stay at home and carefully maintain their cordons sanitaires, they expect their food and other necessities to magically materialize from a vast and complex supply chain whose degree of social distancing is out of sight and out of mind.
We should focus our efforts on our known vulnerable populations — the elderly, the infirm, and those who care for them. The elderly should be protected from unknown contacts. Nursing homes must be immaculately maintained. But until there is clear evidence that canceling commerce is essential to preventing mass casualties, the stampede of shutdown oneupmanship should end.
Heather Mac Donald is the Thomas W. Smith fellow at the Manhattan Institute and the author of The Diversity Delusion.