COVID-19 watch: Change is constant

Written by Derek Monson

July 8, 2020

Editor’s note: This article was published prior to the WHO formally recognizing COVID-19 can be airborne indoors.

The watchword for the novel coronavirus pandemic in the last week is straightforward: change.

In the past week alone, we have seen significant signs that the pandemic is evolving. We learned that the strain of COVID-19 currently sweeping the United States is different than the one that initially reached America’s shores. We have seen signs that the virus is increasingly infecting younger and healthier Americans. We have seen the pandemic surge in Utah potentially begin to plateau, while rates of hospitalization and death have continued to fall despite the ongoing surge.

What does all of this mean?

Here’s what we know

We have learned a great deal about SARS-CoV-2 since the first cases began appearing in the U.S. For example, medical providers have been learning what helps hospitalized COVID-19 patients (e.g., prone positioning, blood thinners and a particular steroid medication) and what does not help them (e.g. anti-malaria drugs). The public health community has also become more certain about the primary ways that COVID-19 spreads (when an infected individual coughs, sneezes or talks and spreads the virus into the air, which then lands in the mouths and noses of those in close contact with that individual).

Here’s what we don’t know

There is still much about COVID-19 that we do not yet understand. Will it become a new disease that must simply be lived with and adapted to, similar to cold and flu viruses; or will it be a disease that becomes treatable with effective drug treatments or a vaccine? And could COVID-19 mutate in ways that increase its severity or lethality in healthier groups of people?

These and other important questions remain unanswered – a reminder that many uncertainties remain.

Legislating amid uncertainty

In addition to the questions that we know to ask but are not yet answered, there are likely pertinent yet unknown questions that we do not even realize we ought to be asking. They will come to the fore if the pandemic takes another unexpected turn in a way that illuminates something we cannot recognize today, or when research about the virus produces unexpected results.

Because the pandemic’s future is unknown and unpredictable, policymaking to address the pandemic – such as the upcoming negotiations for another federal COVID relief bill – ought to reflect this uncertainty with a modest scope and programs that can be adapted to ever-changing circumstances. In other words, policymakers should recognize that since they, the public and even the experts are working off a limited pool of knowledge, seeking broad and definitive policy solutions is a fool’s errand.

Lawmakers should – and they will – legislate in response to the needs of their constituents. But they should do so with an aversion to misleading the public; they must refuse to overpromise what new pandemic relief legislation will accomplish in an uncertain situation. When political leaders act with an unjustifiable certainty, they risk further alienation of an already polarized, disillusioned public.

The more time goes on, the more we are learning that the pandemic presents a fluid and changing economic and public health landscape. Since good policy reflects current realities in addition to time-tested principles, future pandemic response policies should include healthy limits on their scope and modest rhetoric about their effects.

Right now, the only thing that’s certain is change.

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