We Need a Balanced Approach to the Pandemic

The Covid-19 pandemic is a tragedy in two parts. It has affected our health and our economy. Policy seems to be driven by the former and the government shutdown of business and unprecedented stimulus are the by-products. Our society cannot continue down this path and policies must change for the sake of the long-term economy and the overall well-being of the population.

This may appear contradictory at first blush. Don’t we need to first ensure the physical health of our population if we are to be “safe?” Certainly one national imperative is to secure the health of the citizens.

In this respect, there is a coherent argument in in imposing “stay at home” orders and curtailing our rights to assemble. The concept is that individual behavior has a potential and significant negative impact on others. If you exercise your freedom of action, you could spread a disease that impacts many others.

However, it is the single-minded perspective that medical “science” ought to drive policy that concerns me the most. What exactly is the “science” part of policy and what are actions driven by fear, politics and the search for a great news story. I fear that we have distorted the concept of “science” to meet the latter actions, then call to task anyone who challenges this prevailing notion.

Science is defined as the observation, identification, description, experimental investigation, and “theoretical” explanation of natural phenomena (my emphasis). The work done by the Centers for Disease Control and the National Institutes of Allergy and Infectious Diseases (the organization that Dr. Fauci heads), as well as numerous research institutions clearly fall under this definition.

The word “fact” does not appear in the definition. We do ourselves a disservice when we believe that science equals truth. Science is far better than superstition or ignorance, but the best that science can do is layout the results of the research and make educated guesses (some better than others) about the future. Such predictions are based on models (not facts) and we should treat them accordingly.

Furthermore, the science has greater and lesser degrees of certainty in its component parts. Some of the science on Covid-19 is clear. It is a highly contagious virus. The disease spreads through droplets from an infected person’s cough, sneeze, or breath in the air or on a surface that you touch. It causes respiratory distress and complications that can be deadly particularly to persons impaired with other medical conditions. The death rate varies by age and physical condition, but the vast majority people recover.

There is less certainty about the trajectory for spread, certainly far less than portrayed in the histrionics of the media. These are models, projections. They are not absolutes and with the limited data we have, the validity of their output is inexact. The fact that the results from the models keep changing is evidence of their current lack of reliability and precision as predictive tools. This is not to say that we shouldn’t use them to help understand the situation and influence policy, but we must reject the simple-minded notions portrayed in the media that they represent the God’s honest truth.

In addition, these models are mono focus; they do not address the other significant area of importance, the economy. There is no coherent process for understanding the tradeoff between medical risks and their effect on the broader economy. Rather than a unified approach to national policy, media hysteria and political ideology have driven action far more that reason.

My greatest concern is for the long-term status of our society, of which public health is but one component. It is easy to get caught up in the individual tragedies and lose sight of the broader picture. If we remain locked-down and continue the monumental hemorrhage out of the national coffers, our economy will ultimately stagger with the concomitant negative impact on employment and personal well-being. Without a steady reopening of the economy, the massive stimulus only delays the inevitable collapse.

Yes, it requires risk; yet I am astounded at how little we acknowledge the trade-offs of life. Every day we make dozens of risk-reward calculations in our decision-making. Why is the notion of risk trade-off so abhor to us in the case of this disease when we make the same type of calculations every day?

When we go to the grocery store, we implicitly decide that a bag of groceries is worth the (admittedly very small) possibility that we will die in an automobile accident. When we go hiking or ride a bike, we accept the risks of injury. If you go to work with the flu, someone else may get deathly ill. The current situation is different only in the potential magnitude of the risk calculations, not the process.

We must reopen the economy. The procedures that have been set up by most states appear balanced in making the trade-off between public medical health and public economic welfare. In fact, I would consider most of them conservative. Clearly, crowded urban areas like New York City should have different policies than rural areas in Tennessee. National policy should not be made at the lowest common denominator.

As we resume business activity and return to the task of living our lives, we must understand and accept the fact that there will be more death, some from traffic accidents and some from contagion. This is simply a part of life. It is time to get on with it.

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