March 25, 2020

 

By Thomas L. Friedman *

 

These are days that test every leader — local, state and national. They are each being asked to make huge life and death decisions, while driving through a fog, with imperfect information, and everyone in the back seat shouting at them. My heart goes out to them all. I know they mean well. But as so many of our businesses shut down and millions begin to be laid off, some experts are beginning to ask: “Wait a minute! What the hell are we doing to ourselves? To our economy? To our next generation? Is this cure — even for a short while — worse than the disease?’’

 

I share these questions. Our leaders are not flying completely blind: They are working off the advice of serious epidemiologists and public health experts. Yet we still need to be careful about “group think,’’ which is a natural but dangerous reaction when responding to a national and global crisis. We’re making decisions that affect the whole country and our entire economy — therefore, small errors in navigation could have huge consequences.

 

Of course, because this virus is potentially affecting so many Americans at once, we need to provide more hospital beds, treatment equipment for those who will need it and protective gear like N95 masks for the doctors and nurses caring for virus-infected patients. That is urgent! And we need to immediately rectify the colossal failure to supply rapid, widespread testing. That is urgent!

 

But we also need to be asking ourselves — just as urgently — can we more surgically minimize the threat of this virus to those most vulnerable while we maximize the chances for as many Americans as possible to safely go back to work as soon as possible. One expert I talk to below believes that could happen in as early as a few weeks — if we pause for a moment and think afresh about the coronavirus challenge.

 

Indeed, if my inbox is any indication, a thoughtful backlash is brewing to the strategy the country has stumbled into. And stumbling is what inevitably happens when you have a president who goes from treating the coronavirus as a hoax to a war in the space of two days. A lot of health experts want to find a better balance to the medical, economic and moral issues now tugging at us all at once.

 

Dr. John P.A. Ioannidis, an epidemiologist and co-director of Stanford’s Meta-Research Innovation Center, pointed out in a March 17 essay on statnews.com, that we still do not have a firm grasp of the population-wide fatality rate of coronavirus. A look at some of the best available evidence today, though, indicates it may be 1 percent and could even be lower.

 

“If that is the true rate,’’ Ioannidis wrote, “locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.’’

 

Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, shared with me some thoughts he was hammering into an essay: “Society’s response to Covid-19, such as closing businesses and locking down communities, may be necessary to curb community spread but could harm health in other ways, costing lives. Imagine a patient with chest pain or a developing stroke, where speed is essential to save lives, hesitating to call 911 for fear of catching the coronavirus. Or a cancer patient having to delay chemotherapy because the facility is closed. Or a patient with advanced emphysema who dies for lack of a facility with a ventilator.’’

 

And imagine the stress and mental illness that will come — already has come — from our shutting down our economy, triggering massive layoffs.


The New York Times 

March 22, 2020