To save lives, and save the economy, we need another
lockdown.
By Michael
T. Osterholm and Neel
Kashkari
Dr. Osterholm is director of the Center for
Infectious Disease Research and Policy at the University of Minnesota. Mr.
Kashkari is president of the Federal Reserve Bank of Minneapolis.
In just weeks we could
almost stop the viral fire that has swept across this country over the past six
months and continues to rage out of control. It will require sacrifice but save
many thousands of lives.
We believe the choice is
clear. We can continue to allow the coronavirus to spread rapidly throughout
the country or we can commit to a more restrictive lockdown, state by state,
for up to six weeks to crush the spread of the virus to less than one new case
per 100,000 people per day.
That’s the point at which we will be able to limit the increase in new
cases through aggressive public health measures, just as other countries have
done. But we’re a long way from there right now.
The
imperative for this is clear because as a nation what we have done so far
hasn’t worked. Some 160,000 people have died, and in recent days, roughly a
thousand have died a day. An estimated 30 million Americans
are collecting unemployment.
On Jan. 30, when the World
Health Organization declared Covid-19 a public health emergency, there were
9,439 reported cases worldwide, most in China, and only six reported cases in the United States.
On July 30, six months later, there were 17 million cases reported
worldwide, including 676,000 deaths. The United States had four million
reported cases and 155,000 deaths. More than a third of all U.S. cases occurred
during July alone.
And
the next six months could make what we have experienced so far seem like just a
warm-up to a greater catastrophe. With many schools and colleges starting,
stores and businesses reopening, and the beginning of the indoor heating
season, new case numbers will grow quickly.
Why
did the United States’ Covid-19 containment response fail, particularly
compared with the successful results of so many nations in Asia, Europe and
even our neighbor Canada?
Simply,
we gave up on our lockdown efforts to control virus transmission well before
the virus was under control. Many other countries didn’t let up until the
number of cases was greatly reduced, even in places that had extensive
outbreaks in March and April. Once the number of new cases in those areas was
driven to less than one per 100,000 people per day as a result of their
lockdowns, limiting the increase of new cases was possible with a combination
of testing, contact tracing, case isolation and extensive monitoring of
positive tests.
The United States recorded
its lowest seven-day average since March 31 on May 28, when it was 21,000
cases, or 6.4 new cases per 100,000 people per day. This rate was seven to 10
times higher than the rates in countries that successfully contained their new
infections. While many countries are now experiencing modest flare-ups of the
virus, their case loads are in the hundreds or low thousands of infections per
day, not tens of thousands, and small enough that public health officials can
largely control the spread.
In contrast, the United
States reopened too quickly and is now experiencing around 50,000 or more new
cases per day.
While cases are falling in the hard-hit areas of Arizona, California,
Florida and Texas because of the imposition of some physical-distancing
measures, they are rapidly increasing in a few of Midwestern states. In
Minnesota, we just documented the most new cases in a one-week period since the
pandemic began.
At this level of national cases — 17 new cases per 100,000 people per
day — we simply don’t have the public health tools to bring the pandemic under
control. Our testing capacity is overwhelmed in many areas, resulting in delays
that make contact tracing and other measures to control the virus virtually impossible.
Don’t confuse short-term
case reductions in some states as permanent. We made that mistake before. Some
have claimed that the widespread use of masks is enough to control the
pandemic, but let us face reality: Gov. Gavin Newsom of California issued a
public masking mandate on June 18, a day when 3,700 cases were reported in the
state. On July 25, the seven-day daily case average was 10,231. We support the
wearing of masks by all Americans, but masking mandates and soft limitations on
indoor crowds in places such as bars and restaurants are not enough to control
this pandemic.
To successfully drive down our case rate to less than one per 100,000
people per day, we should mandate sheltering in place for everyone but the
truly essential workers. By that, we mean people must stay at home and leave
only for essential reasons: food shopping and visits to doctors and pharmacies
while wearing masks and washing hands frequently. According to the Economic
Policy Institute, 39 percent of workers in the United States are in
essential categories. The problem with the March-to-May lockdown was that it
was not uniformly stringent across the country. For example, Minnesota deemed
78 percent of its workers essential. To be effective, the lockdown has to be as
comprehensive and strict as possible.
If
we aren’t willing to take this action, millions more cases with many more
deaths are likely before a vaccine might be available. In addition, the
economic recovery will be much slower, with far more business failures and high
unemployment for the next year or two. The path of the virus will determine the
path of the economy. There won’t be a robust economic recovery until we get
control of the virus.
If we do this aggressively,
the testing and tracing capacity we’ve built will support reopening the economy
as other countries have done, allow children to go back to school and citizens
to vote in person in November. All of this will lead to a stronger, faster
economic recovery, moving people from unemployment to work.
We know that a stringent
lockdown can have serious health consequences for patients who can’t get access
to routine care. But over the past six months, medical professionals have
learned how to protect patients and staffs from spreading the coronavirus;
therefore we should be able to maintain access to regular medical care during
any new lockdown.
This pandemic is deeply
unfair. Millions of low-wage, front-line service workers have lost their jobs
or been put in harm’s way, while most higher-wage, white-collar workers have
been spared. But it is even more unfair than that; those of us who’ve kept our
jobs are actually saving more money because we aren’t going out to restaurants
or movies, or on vacations. Unlike in prior recessions, remarkably, the
personal savings rate has soared to 20 percent from around 8 percent in
January.
Because we are saving more,
we have the resources to support those who have been laid off. Typically when
the government runs deficits, it must rely on foreign investors to buy the debt
because Americans aren’t generating enough savings to fund it. But we can
finance the added deficits for Covid-19 relief from our own domestic savings.
Those savings end up funding investment in the economy. That’s why traditional
concerns about racking up too much government debt do not apply in this
situation. It is much safer for a country to fund its deficits domestically
than from abroad.
Congress should be
aggressive in supporting people who’ve lost jobs because of Covid-19. It’s not
only the right thing to do but also vital for our economic recovery. If people
can’t pay their bills, it will ripple through the economy and make the downturn
much worse, with many more bankruptcies, and the national recovery much slower.
There is no trade-off
between health and the economy. Both require aggressively getting control of
the virus. History will judge us harshly if we miss this life- and
economy-saving opportunity to get it right this time.
Michael T. Osterholm is
a professor and director of the Center for Infectious Disease Research and
Policy at the University of Minnesota. Neel Kashkari is president of the Federal Reserve
Bank of Minneapolis.
