“Your money or your life” is a phrase often attributed to highwaymen who, when robbing travelers, threatened to kill them if they didn’t hand over their cash. In general, victims would hand over their money and other valuables to avoid being killed. We seem to be faced with a similar dilemma these days: social distance to the max, i.e. give up money (your job, stock market investments, etc.) or die. I wasn’t going to write about the coronavirus again, but since it has been dominating the news and our lives lately, here goes (at least) one more time.
Deciding about how much social distancing is appropriate has become political, and has become ugly. For instance, a store employee was shot dead when he told a shopper his daughter needed to wear a mask in the store.
We’ve had some experience with this virus now, which should allow for more focused efforts at amelioration of this pandemic. Unfortunately, many questions remain unanswered (see below), but I think it’s time to step back and look at the situation dispassionately.
Below I have a graph summarizing the economy vs social distancing dilemma.
If we have no social distancing (substitute business/restaurant/factory/store/public gathering, etc. unabated, if you want) many people will die, and most people, as judged by surveys, will self-isolate out of fear. The economy will suffer greatly as employees die or refuse to work, causing manufacturing to shut down. Transport of goods will come to a standstill. Food and medicine will run out and medical care will be limited, with few health care providers still alive and willing to work.
On the other hand, if the economy is shut down to such a point that it is illegal to leave your house or go to work anywhere, the result will be similar. Somewhere between zero social distancing and one hundred (on a scale of zero to one hundred), the economic vitality (substitute stock market, GDP, or employment, if you like) will be maximized.
Unfortunately, the apex of the curve cannot be located accurately and is different for the various parameters, each of which has a differently shaped graph. I believe, however, it makes for a reasonable point to start a discussion.
The curve is reminiscent of the Laffer curve, popularized in the 1970’s, which shows a theoretical relationship between the tax rate and tax revenues collected. It shows that at a 0% tax, the tax revenues are, of course, zero, and at a 100% tax rate, the revenues are also zero because people won’t work if all their money goes to the government. The enigmatic sweet spot is somewhere in between. Along with maximum tax revenue at the apex, one might argue that as a bonus, the economy is also strong (the measure of economic strength, of course depends on what is being measured).
One can argue about the exact tax rate at which tax revenues are maximal. As in the first graph, the exact shape of the curve has not been determined. Interestingly, according to an economist who gave a lecture series I attended recently, most economists agree that the United States tax policy has always placed us on the left side of the curve, i.e., a place where raising taxes would always result in higher total tax revenues. The recent tax cuts under the current administration has, as predicted, resulted in lower tax revenues, giving us less of a cushion to support the economy during these trying times.
So – what is the right amount of social distancing? We have some data now. Sweden has provided us information on a European country which has not instituted much social distancing. The government has suggested people distance themselves and work from home if possible, although restaurants and bars remain open. The ultimate goal there is herd immunity. What has actually happened there is the following: many citizens have chosen to social distance on their own, their economy has shrunk (estimates for 2020 are between 6.9 and 9.7% GDP contraction), unemployment is up (7.2% current to possible 10.1% later this year), and their deaths per one million people are 319.
Denmark, which has the second highest death rate in Scandinavia at 91 per one million people (less than one third of Sweden’s,) did enforce social distancing successfully, has already reopened elementary schools and daycare centers, and is just now opening malls and shops, with restaurants soon to follow. Denmark’s unemployment has been four to five percent (the government paid employers to keep their workers on the payroll). Companies received government help as long as they didn’t have stock buy-backs and suspended dividends. The economy is predicted to contract three to 10 percent in 2020.
At this writing, the US unemployment rate is 14.7%, and the GDP has dropped 4.8% in the first quarter. Estimates I’ve read range between 25% to 40% decline for the year. It is unclear if the same parameters are being looked at in predictions for US and other countries, but it seems that we are doing much worse than many countries. Our deaths per I million are 244 (less than Sweden, but more than 2.5 times that of Denmark). Our higher death rate than Denmark is likely due, in part, to the difference in the medical systems (all Danes receive free healthcare), something I will not elaborate on at this time. The Danes, by the way, are probably the unhealthiest of the Scandinavians. In Finland and Norway, which also supply healthcare to all their citizens, the deaths per million are 48 and 40, respectively. BTW, “welfare states” is an unfortunate misnomer we’ve given to Scandinavian countries. A more accurate translation, I have learned, is “well-being state.” Citizens there have a feeling of well-being, as they are not burdened with worry about their health care or living expenses if they lose their job.
Unemployment, economic contraction, and death rate vary from country to country, depending on steps taken to limit spread of virus, and government economic/social policies. In one country that appears to have done almost everything right, South Korea, the death rate is 5 per 1 million, unemployment is 4.8%, and GDP is predicted to range from a small decrease to an increase of 0.9%.
I do not subscribe to the notion that we should just let a lot of people die so we have herd immunity. Rather, I believe that intelligent relaxation of restrictions makes the most sense. I do not know of anyone who has gotten COVID-19 who, like me, is not working outside the home, shops for food only when necessary, and practices some sort of decontamination of everything brought into the house.
Most cases (if not all, see below) are likely spread by person-to-person contact, so, like grocery stores, I believe that other stores could open up to shoppers (as long as they don’t try on clothes) if everyone wears a mask and does their best to distance from each other. Ditto with places of work, where people can maintain their distance while wearing a mask.
Temperature checks of all people entering places of business could be done easily with thermometer guns. Employees could be checked fairly regularly for COVID-19. It may not be practical to check them every day. Perhaps a screen where samples of, say, twenty people are screened in one batch could be devised to save money. Only if there is a positive, would each individual in that batch be tested. Contact tracing for employees is a must. People laid off could be trained to do that.
Gyms? Beauty shops? Tattoo parlors? Let’s get some data from states that are opening up. I suspect that with reasonable screening and wiping down of equipment, these can be opened safely. Restaurants, bars, entertainment venues and other large gatherings, unfortunately, probably can’t safely open for a while. Perhaps not until we have a vaccine, which will probably be at least a year from now.
Now I have some questions which I believe should be answerable at this time, but haven’t been addressed to my satisfaction. Knowing the answers to these simple questions would go a long ways towards helping us come up with a rational plan.
1. Can you really get COVID-19 from fomites (inanimate objects)? I know it’s theoretically possible to get a COVID-19 infection this way, but does it actually happen? If you can’t get COVID-19 from such objects, or only very rarely, it would be really good to know. We wouldn’t need to waste time and money disinfecting things. If we can get the virus from a doorknob or other things frequently handled, perhaps we should have tissues and nearby trashcans in public places so we can touch things safely with the tissue.
2. Can you get COVID-19 from food? Authorities say you can’t, because it’s a respiratory virus, which is destroyed by stomach acids. However, these same people tell us we can catch COVID-19 by touching our mouth with our fingers that have virus on them. So why can’t we catch it from food with the virus on it?
3. Has anyone who is sheltering in place (which includes people shopping while using recommended precautions), without outsiders coming into their home, gotten COVID-19? I don’t know of any.
4. What about delivered newspapers – are they put into plastic bags by humans (which carry a contamination risk to the newspaper surface) or machine? Are mail carriers instructed to keep the mail clean?
5. Can people who have recovered from COVID-19 get the disease again? C’mon, there have been a lot of people who have recovered by now. We should be able to get information on this. A related question is: what information do we have about antibody titers to COVID-19 over time?
6. Do we really need to wear masks AND stay six feet apart when in public? Maybe only one or the other is good enough.
If you’re still with me, sorry I went on for so long. Still lots more to question/discuss, but I’m calling it quits here. I’ve got other stuff to do, like going outside and enjoying the unpolluted air, thanks to decreased vehicle traffic. Hope I don’t run into any murder hornets.