public health v. economy

The U.S. is dealing with two distinct but related crises. The first is a public health crisis: the spread of a pandemic virus. The second is an economic crisis precipitated by our efforts to mitigate the public health crisis. The public debate around these crises purports to be a debate about competing values: economics versus public health.

Some argue that the economic crisis has become so grave, with unemployment surpassing 20%, that governors should lift restrictions on businesses and accept the public health fallout as an unfortunate consequence of salvaging our economy. After all, they argue, we regularly sacrifice human life on the altar of economic gain. We don’t shut down the entire economy during flu season even though tens of thousands die from flu-related complications every year. We could reduce traffic fatalities to roughly zero if we lowered all speed limits to 15mph; but we don’t do that, either.

On the other hand, public health experts insist that resuming our economic activity now would be an unmitigated disaster. Without rigorous testing and contact tracing, the exponential spread of the virus would overwhelm our healthcare system. Hospitals would be flooded with COVID–19 patients, many of whom require intubation. Without adequate protective equipment, doctors and nurses would get sick (as many already have). Routine medical procedures like appendectomies and bypass surgeries would become increasingly difficult to manage. As local healthcare systems reach the limits of their capacity, doctors would be forced to deny treatment to those who are least likely to benefit from precious resources—gradually reducing the age at which patients are given access to ventilators and ICU beds, from 70 to 65, then 60, and so on.

dire warnings and bad science fiction

Public health experts are issuing dire warnings about the consequences of lifting social restrictions without a rigorous plan for testing and tracing. Meanwhile, some politicians and other non-experts regale the public with stories about a parallel dimension in which we all agree to put on our big-boy pants and go to work. As a cost of doing business, Grandma might be stricken with an exotic plague. These stories are pure science fiction—more precisely, bad science fiction, insofar as they are premised not on surpassing scientific consensus but completely rejecting it.

For the sake of discussion, suppose the experts are correct. (This supposition shouldn’t be too difficult to entertain—they are, after all, experts.) Within months of returning to work, there would be thousands more COVID-19 patients over the age of 60 slowly suffocating to death, without medical intervention, every single day. The death toll would grow exponentially, until either the virus runs its course—claiming somewhere between 1 and 2 million lives—or we relent and agree to start the process of social distancing all over again, at which point the number of COVID–19 deaths would continue to rise for at least a couple of weeks before receding.

Does anyone genuinely believe, even for a moment, that we would have a functioning economy in such a scenario? Of course not. It’s inconceivable. So the narrative about bravely risking our health for the sake of the economy is mere fantasy: there is no possible state of affairs in which our economy flourishes amidst the kind of devastation forecasted by experts.

the folly of “economics first”

The Chinese government learned this the hard way. They tried the “economics first” approach in Wuhan and it failed so spectacularly that COVID–19 is now a pandemic. Strangely, the most severe critics of China’s approach in Wuhan are among the loudest voices promoting the very same “economics first” strategy in the U.S. The economic lesson to be drawn from Wuhan is that the path to economic recovery runs inexorably through public health.

We will not be saved by showmanship or marketing gimmicks. The pandemic is indifferent to public opinion. And a miracle cure is not forthcoming. So, as we await the results of clinical drug trials, we need exactly what we needed a month ago and the month before that: testing and tracing. We must embrace the hard work of doing the right thing, at the right time, in the right way—in a word, we need virtue.

wisdom, courage and temperance

Plato’s Republic addresses this matter at length. He divides the members of a political community into three estates: political leadership, soldiers, and everyone else. In a good republic, each of these classes exemplifies a cardinal virtue. For obvious reasons, the political class must have wisdom and warriors require courage. To the rest of us he assigns the virtue of temperance. For if the general public becomes addicted to the trappings of wealth, the wisdom of our leaders will be overtaken by the tyranny of collective appetite; and insatiable consumption will waste the courage of our soldiers on wars of conquest.

For present purposes, our political community can be usefully divided into three groups: political leadership, essential workers, and everyone else. Our lives depend on the courage of our essential workers—from doctors and nurses to deliverymen and grocery store clerks. And if we proceed with an intemperate “economics first” strategy, the courage of our medical professionals and other essential workers will be wasted on preventable waves of illness.

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