June 18, 2020
At the same time, unemployment in Utah is higher and labor force participation is lower today than it ever was during the Great Recession, and estimated state tax revenues from Utahns’ incomes and spending have gone from $1 billion in surplus to a deficit of $850 million in a matter of months.
Are a proper public health response and a strong economy mutually exclusive?
No. Even as the disease spikes, we now have enough data to know more – and do better – in our public health response. We also have enough evidence to recognize that disease and a strong economy can, and regularly do, go together.
American Enterprise Institute scholars Scott Gottlieb and Yuval Levin argue: “This new phase of the pandemic doesn’t pose a binary choice. … It requires leaders to respond to both scientific evidence and public opinion in measured, flexible ways.”
At the most basic level, improving our public health response to COVID-19 while encouraging economic recovery requires understanding and applying five fundamental facts.
- Public health and economic growth are complementary.
For more than a decade, Utah’s economy has had the nation’s best economic outlook despite the ongoing existence of highly communicable diseases that can be lethal to high-risk populations. Examples include influenza and strep throat. Of course, this does not mean that the flu and strep throat are the same as COVID-19 – there are distinct and important differences between all three of these diseases. But there are some significant similarities.
Ignoring those differences or overemphasizing the similarities are both dangerous for Utah communities. The former leads to reckless behavior that causes unnecessary and preventable deaths. The latter stokes community-wide fear that destroys lives by driving excessive social isolation (e.g., simply refusing to leave one’s home until a COVID-19 treatment or vaccine exists) and creating greater poverty through economic recession.
- The free market and health researchers are discovering treatments for COVID-19.
British health researchers recently reported that an anti-inflammatory drug already being mass produced in the prescription drug market reduced deaths of COVID-19 patients in hospitals on ventilators or receiving supplemental oxygen treatments by 35% and 20%, respectively. The drug is a commonly used steroid whose generic version costs as little as $8 for 30 tablets. Similarly, European Union researchers believe that a common and affordable osteoporosis drug may stop the virus from replicating in asymptomatic or mild cases, and are moving toward testing.
In Utah, more than 60% of deaths of those with COVID-19 have occurred among hospitalized patients. If further use and study of this steroid verifies the British results – which is not guaranteed – the worst impacts of COVID-19 could be reduced significantly. If tests prove the European researchers’ hope to be true, it might place COVID-19 into a similar medical realm as strep throat: a contagious illness that in some cases can be fatal if left untreated, but for which there are effective treatments.
On the vaccine development front, seven vaccine candidates have risen above the rest and are currently being mass produced, so if rigorous testing proves one or several to be safe and effective at building immunity and preventing infection – neither of which are certainties – they can be offered to the public without further delay. There has also been speculation among vaccine researchers that existing, commonly available vaccines could build COVID-19 immunity.
Most Utahns need not fear anything as significant as hospitalization or death from COVID-19, while some specific groups of Utahns should. But whether in the form of a drug or a vaccine, the free market in prescription drugs and health researchers are progressing toward COVID-19 treatments that can protect many, even in high-risk populations, from unnecessary deaths caused by the disease.
- COVID-19 does not kill most people, but it does kill certain groups of people.
Two important ways that the facts illustrate a similarity between COVID-19 and the flu are (1) the vast majority of people will survive both diseases, and (2) they are more fatal to specific groups of people. Utah’s COVID-19 mortality data illustrate this well. Of the roughly 15,000 cases of COVID-19 in Utah as of mid-June, about 1% (152) have died with COVID-19. More than 9 in 10 of those deaths have been high-risk individuals: over the age of 65 and/or with an underlying health condition. Less than 1% of Americans with the flu die of the disease, and more than 8 in 10 flu deaths are over the age of 65.
In other words, some people in specific demographic or health categories are in danger of dying with COVID-19, while the overwhelming majority of Utahns who contract the disease will be ill for a period of time and then return to good health. Elected and public health leaders should always offer this kind of balanced consideration of the facts in public statements. Instead of thinking that we ought to err on one side or the other – thinking which encourages either unnecessary fear or preventable recklessness – the goal should be an adequately informed public who can act based on the facts.
- Utahns are well-versed at factoring health risks into their daily lives.
The possibility of sickness and even death due to disease are risks that Utahns understand and live with every day. Part of every person’s life includes factoring those risks into their thinking and taking adequate precautions for their unique personal and family circumstances. How to respond to a health risk is not a decision that Utahns need elected officials or appointed experts to make for them.
They do, however, need accurate information and public statements free from bias towards predetermined outcomes. In the end, no amount of coercive public policy or manipulated expert opinion can control free people determined to move in a different direction. For example, people on their own decided to reduce economic activity in the early stages of the pandemic before any lockdowns were ordered by government officials. Similarly, people began resuming more normal levels of economic activity prior to any lockdown orders being lifted.
In both cases, Utahns incorporated the health risks that they understood into their daily decisions. As those risks became better understood, or as health risks reduced in magnitude relative to risks created by extended social isolation and economic recession, Utahns adapted their decisions accordingly. They have successfully balanced health risks from highly communicable disease and the economic needs of their families and communities for decades, even centuries. We can be confident that they will be able to do so with COVID-19 as long as they have the unbiased facts.
- Targeted, effective public health measures will be generally better than lockdowns.
Because the data show that COVID-19 fatalities are not a general-population concern, targeted public health policy approaches are generally a better fit for the facts on the ground. Targeted public health approaches also have more targeted economic impacts, reducing the size and scope of negative unintended consequences for public health measures.
For instance, state and local governments in Utah have already begun contact tracing programs (hiring and training individuals to trace the contacts of COVID-positive individuals) in order to contain potential COVID-19 outbreaks. An additional element to improve the effectiveness of such targeted measures could include financially incentivizing contacts to isolate for a period of time, as some countries have successfully done.
However, differences between COVID-19 and diseases like the flu suggest some more general public health approaches may better fit the on-the-ground realities. COVID-19 may be more contagious or transmissible than the flu, for instance, justifying general guidelines such as social distancing and/or wearing masks in public spaces. As we learn more by gathering more data and as treatments develop, general guidelines can be adapted, becoming more targeted.
If Utahns – including elected leaders and public health experts – can focus on the facts, we can recover economically and socially from the pandemic while we battle this disease. It will require concerted efforts from leaders and experts to inform the public in an unbiased manner and avoid the temptation to subtly manipulate their behavior or take the easy route of simply telling them what to do.
This is part of the greatness of America. President Ronald Reagan said, in his 1981 inaugural address, that “we must realize that no arsenal or no weapon in the arsenals of the world is so formidable as the will and moral courage of free men and women.” If we approach both the pandemic and the economy based on the principles of freedom, the economy and public health will grow together.
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