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March 28, 2020 01:00 AM

Divided nation, divided response to COVID-19

Merrill Goozner
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    Merrill Goozner

    Merrill Goozner

    The coronavirus couldn’t care less if you live in a red state or a blue state. Yet states across the U.S. are taking dramatically different approaches to controlling the spread of the highly contagious COVID-19.

    Republican governors in densely populated states like Texas and Florida are resisting imposition of stay-at-home orders, even as their caseloads equal or exceed states like Illinois and New Jersey, which have taken such steps.

    President Donald Trump has tacitly endorsed their approach by repeatedly saying he wants the country to get back to work by Easter. “Look, you’re going to lose a number of people to the flu,” he said on Fox News. “But you’re going to lose more people by putting a country into a massive recession or depression.”

    That startling assertion is flat-out wrong. The worst-case scenario offered by epidemiologists suggests an uncontrolled pandemic with a 1% fatality rate could kill over 1 million people in the U.S., most of them elderly.

    Let’s compare that to the worst-case scenario for a sharp economic downturn. Vanderbilt University economist W. Kip Viscusi, who conducts cost-benefit analyses on government regulations, estimated that every $100 million in lost economic activity will trigger an additional death from suicide, stress-induced heart attack and the like.

    Do the math. That comes to 20,000 deaths from a $2 trillion or 9% decline in our $22 trillion economy. At deadline, Congress was finalizing a $2 trillion-plus stimulus package to avoid those 20,000 deaths. What has it done to avoid 1 million deaths?

    For starters, it responded late, with the White House’s pandemic preparedness office having been downsized and folded into another office in 2018. Then the administration bungled the rollout of testing.

    The president still dissembles about the availability of testing. “We have tested more than anybody,” he said. In fact, on a per capita basis, we’re behind most countries with significant outbreaks.

    People in every corner of this country want to get back to work and for life to return to normal. But the only way for that to happen is by limiting the spread of the virus. In New York, the state with the worst outbreak so far, there are signs the virus’ spread is slowing just one week after Gov. Andrew Cuomo imposed aggressive shelter-in-place and social distancing measures.

    But if a significant number of states refuse to follow what medical experts consider the most prudent strategy for containing the virus, those efforts will be for naught. People will gather. They’ll fly to other states. They’ll spread the disease. People will die unnecessarily.

    Recalcitrant governors should take a close look at the pictures of elderly, desperately ill Italians lining the hallways of hospitals waiting for ventilators. Is that what they want for America?

    People want to know when this will this end. “It’s not about a particular date,” said Dr. Patrice Harris, president of the American Medical Association. “It’s about making sure that the science and data informs our decisions. We need people to stay home and practice physical distancing.”

    Just a start

    The economic rescue package nearing passage last week contained what the American Hospital Association says could be as high as $117 billion for hospitals fighting the COVID-19 pandemic. The bulk of the funding will come from postponing the 2% sequestration cuts in Medicare payments, eliminating the Medicaid disproportionate-share hospital cuts, and lifting reimbursement for infectious disease treatments by 20%.

    But much more needs to be done. Medical supply shortages, inadequate surge capacity and ongoing public confusion amid a leadership vacuum reveal the nation was totally unprepared for this pandemic.

    It will happen again unless the U.S. adopts measures and independent chains of command comparable to what was done after 9/11 to protect air travelers. The time to begin preparing for the next pandemic is now.

    Modern Healthcare is providing COVID-19 coverage for free as a public service and a show of gratitude for frontline workers. Support essential journalism. Please subscribe here.

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