What the Government Should Be Doing NOW!

The header says it all. The government is way over their heads managing this crisis. They are focused on the wrong things. As I’ve said in prior posts, we have focused all our attention on managing the risk of a hospital bed shortfall.

That is the wrong approach. First, it completely ignores the economic impact. Second, it does nothing to restore confidence that people will actually leave their house when the all clear is given.

Test the Asymptomatic

The testing strategy we have been using has a major math flaw. In plain English, it ignores math!!! We have used testing to help calm potentially sick people down and reduce their anxiety. That is nobel but should not be the priority of testing (at least until testing materials are rampant).

No, the purpose of testing should be to contain the virus. The way to contain the virus is to test HEALTHY people! The government should send test takers door to door across the country. Randomly sample thousands of people per day.

This accomplishes two things. One, it lets us figure out the rate of asymptomatic spread which helps with modeling. More importantly, it lets us catch the asymptomatic spreaders sooner. This will drop the R0 of the asymptomatic materially.

The R0 of the symptomatic will drop to approximately 0, even without testing. How? Simple, you tell every doctor when someone calls you with symptoms to assume they have the virus and shelter in place. Now they can’t get anyone else sick (other than perhaps a family member). When their symptoms resolve, they can get a test to see if they are still contagious or not or we can tell them to shelter for another week post return to health as a precaution.

I’ve just bent the damned curve. It’s simple math. It’s stunning (and infuriating) that nobody in a position of authority has figured this out or had it explained to them. Iceland has already done this with much success. Why haven’t we followed?

Develop An App To Monitor People

I know this is going to sound like we’re taking away liberty and going authoritarian! No, that’s not what I mean. This app should have been created weeks ago. It’s purpose is simple: track outbreaks and identify high risk people.

How? Give people privileges if they are willing to volunteer information. Every day you go on and you answer some basic questions about whether you feel well or are exhibiting any symptoms. You also report whether there are any high risk individuals in your household.

If you have no symptoms, the app can analyze whether other people in your area are showing risk of infection or not. If your area is low risk, you have fewer restrictions on leaving your house. If infections are growing in your area, you are given a warning to be extra careful.

If you are showing symptoms, you are told to stay in your house. You agree to let your phone location be tracked to ensure compliance. In return, when you feel you are better, you get immediate access to a test to prove you are cured.

Deploy the Antibody Test

The antibody test is more important than the infection test. If you show the antibodies, you get a gold star on your phone and you have full privileges. Sure, we’ll be creating a COVID elite, but there is no reason to punish people who have no risk. Let them get back to work. There is no reason to put zero risk people through financial ruin.

Isolate The HIGH RISK Only

The lack of adequate testing has led us to take the “everything’s a nail” approach of isolating everyone which obviously brings a high economic cost. As testing capacity ramps up, we should be able to adapt our tactics.

We know about a third of the country is high risk. Seniors are 20+% of the population and the remainder are pre-existing conditions. Obviously people with pre-existing may live with people without pre-existing. Thus, the population of high risk or “low risk but in contact with high risk” is probably closer to half the country.

These people should have much more stringent standards than the rest of the country and should be more subject to app based monitoring. Rather than isolate everyone, we should isolate the half at greatest risk from the other half. Note, because probably half of the half we’re isolating are retired, this means we can allow 75% of the work force to return!

As an example, baseball players are a low risk population. Fans at the game may not be. The coaching staff may not be.

It is probably feasible to resume playing baseball with no fans and with the coaches isolated above the field in the box seats with wireless communication to one low risk coach in the dugout. Eventually, we let some low risk fans attend and once we have achieved herd immunity, then the high risk fans can come back too.

Tell the Truth About Masks

The global health community (WHO, CDC, etc.) has lied to the American people about masks. Masks work. They may not work perfectly, but they lower risk.

Instead of telling people to wear some form of facial covering until respirator production picked up, we chose to lie because of fears about hoarding and that people would ignore social distancing because masks would provide false comfort. I am offering to be the lead plaintiff in the malpractice suit against the WHO.

Sure, masks aren’t perfect, but there are so many things about this crisis that haven’t been perfect. Why would we ignore a useful tool because it was only useful, not perfect?

Deploy the Military Domestically

The military is our lowest risk population. They are young and fit. How they haven’t been on the front lines for the last month blows my mind. And no, a few hundred in a state here or there doesn’t count. I mean if we are calling this a war, then the military should not be ensconced on their bases. They should be on the front lines in our major cities.

We are asking civilians (e.g. nurses, Walmart cashiers, etc.) to be put at risk in a war instead of soldiers. This is morally unconscionable. The military should be doing everything from running checkout at grocery stores to driving ambulances to decontaminating hospitals. As people return to work, the military can be taking temperatures at train stations and airports.

I would guess if you asked a soldier would you rather risk getting corona or a deployment in Afghanistan avoiding IEDs, they’re going to happily volunteer for domestic duty. It would improve confidence substantially if high risk jobs were being done by the military instead of civilians.

Prevent A Bank Run

I hesitate to even bring this up at the risk of creating undue fear, but if we’re going to try to anticipate what comes next, we are going to be moving from looking for the peak of the infection curve to when is the peak of the unemployment curve.

Reading between the lines from comments by a number of economists, it feels like we are heading to unemployment near 20%. Add on those being paid not to work and we will effectively be in the 30s. Even when the movement restrictions are lifted, plenty of people will continue to work at home and refuse to get on an airplane or go to a movie. This suggests we will end the year with unemployment still in the double digits.

There will also be a lot of bankruptcies, regardless of stimulus. If we lift the restrictions too soon, there is a risk the virus re-emerges over the summer. Even if we defeat it now, the concern is it will return in October or November with the normal flu season.

While the banks began this crisis in great shape, we cannot ask them to forbear forever. A severe recession combined with asking the banks to be lenient on customers is a strain that can only be tolerated for so long.

If we take too long before letting people return to work and we don’t have the information tools to assess risk when we do to prevent a re-emergence, we will risk asking too much of the banks. Eventually they will buckle. We must prevent this! They are the last firewall.

Don’t Declare “Mission Accomplished”

That is why all these steps above are so important. It’s not just about flattening the curve. We need to do things to accelerate the return of confidence to lessen the time until economic activity returns to normal. There is a big difference between opening the economy and having a normal economy.

If public policy ends up at “hey, cases are declining, let’s lift the restrictions” with nothing else, we are going to be limping around for months with a lot of people afraid to resume their lives. That is actually the worst possible economic outcome because it makes it impossible for a lot of afflicted businesses to survive.

We need a policy not just for when to lift the restrictions, but how to do so in a way that creates the confidence for people (even if only some people) to go to a restaurant or a movie or get on a plane. Without that, we will have “won the war” but lost the rebuilding and end up in an economic quagmire.