Anomalies in the Coronavirus Pandemic Debate
Transpartisan Note #124
by A. Lawrence Chickering and James S. Turner
To mask or not to mask, that is the question. The current public debate on the Coronavirus Pandemic features two conflicting narratives: 1) Minimize infections to prevent as many deaths as possible; 2) Let infections spread to build “herd immunity”. This narratives-clash makes it difficult to know how to think about the virus – how to fight it. How we might manage our concerns about it. What ‘public policy’ makes the most sense.
The two narratives, now politicized into partisan cudgels, run in absolutely opposite directions. Before summarizing the clash we note that there appears to be significant agreement (hope) that when (if) we discover a vaccine the problem ends.
President Trump says we will have a vaccine by the end of the year. Public health experts widely agree that this is extremely optimistic. The polio vaccine took five years from recognition of need to creation. Any serious strategy on the Pandemic must move forward without counting on a vaccine anytime soon.
Experts suggest a second intervention – a quick test for infection – might be nearly as effective as a vaccine. Such test might largely overcome the major impediment to re-opening major industries, like sports venues, airlines, restaurants, etc.
If everyone seeking to enter a restaurant, airplane, or ball game is tested, the argument goes, and only those testing negative for the virus are admitted, the problem vanishes in those industries. The discriminatory potential in this approach looms ominously.
The political tension in the conflicting narratives becomes obvious in the current environment. Minimize infections – close, wear a mask. Free access to the virus, build herd immunity – open, no mask. In current polls 80% of the public supports a managed opening – back to work with masks?
The partisans appear something like this:
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- Minimizing infections. This is the dominant narrative on, e.g., CNN. The touchstone of success is the focus on minimizing the deaths caused by the virus.
- ‘Herd immunity’. This approach is based on the widely-accepted theory that infected people build up antibodies to fight the virus. In the covid-19 pandemic, it is best known as the Swedish solution – voluntary lockdown. [1]
So, we have two narratives, one to minimize infections to maximize prevention of individual deaths from the virus and the other to increase infections so that we can more quickly reach the 70% infected that some projections estimate will allow herd immunity to solve the problem.
David L. Katz founding director of the Yale-Griffin Prevention Research Center, entered the national debate with a third way in a March 20 New York Times Op-ed “Is Our Fight Against Coronavirus Worse Than the Disease?” He argued the U.S. should adopt a milder strategy than total lockdown to preserve the economy while stopping deaths from COVID-19. Katz sparked opposition from current Yale University epidemiologists – some of whom were quick to refute what they saw as his suggestion that the US lockdown was an overreaction to the pandemic.
Katz and others propose that serious research focus on who is dying from the virus. Vulnerable people include the elderly, people with serious health issues, and people with high blood pressure (one study shows 75% of deaths in this group). The proposal here is to protect these vulnerable groups and open the economy for less vulnerable populations. This proposal moves closer to a controlled opening strategy favored in polls by 80% of the public.
Our point here is less about what is the “right” policy than to suggest a more transpartisan way of thinking about the problem. To imagine any controlled opening strategy will require less pious certainty and more pragmatic honesty about the public policy trade-offs of death and disability between mortality created by the virus and mortality created by a closed economy.
While doctors committed to the Hippocratic Oath protect every life as sacred, many policies favor ‘efficiency’ and work to reduce the resulting increase in deaths. Highway speed is an example. No one seriously advocates reducing speed limits to 20 miles-an-hour even though it would enormously reduce traffic deaths. Still over the last fifty years public policy has helped reduce auto accident deaths from 5.21 per hundred million miles driven in 1968 to 1.22 in 2018—a more than 75% reduction. [2]
We have no proposed “right” answer to the pandemic. We do suggest a form of thinking about an issue that integrates clashing narratives rather than forcing people to choose sides. A controlled opening may mean targeted pragmatic policy that risks lives from the virus in order to save lives from a dead economy.
One integration might be to wear a mask, go to work. Could it even mean choosing to go to a ball game once in a while?
This note suggests a form for thinking about the pandemic problem, or any problem, in a transpartisan way. Another important part of the issue lies in changing the language we use to discuss the trade-offs. We will address this language issue in another Note.
[1] Herd immunity is discussed in Is Herd Immunity Our Best Weapon Against COVID-19?
