I’m having a very difficult time knowing how to think about our nation’s splintered response to the coronavirus.  My thoughts, which continue to evolve with each passing day of home confinement, are too muddled to draw any firm conclusions about the economics or ethics of the viral conundrum, which continues to dominate the news and disrupt our lives.

Editorial opinions and questions abound:

Is the cure worse than the disease?  The longer we’re shutdown, the more damage there will be to global, national and corporate economies, as well as to our personal finances.  Illinois’ Governor Pritzker seriously weighed the choice between saving people’s lives and savings people’s livelihoods before deciding to lock down the state. Explaining his decision, he said, “ultimately you can’t have a livelihood if you don’t have a life.”

Is the shutdown keeping us safe?  While most experts agree that social distancing will help prevent the spread of the virus, they also agree that America isn’t taking adequate steps to swiftly and effectively combat it.   Bill Gates, who has pledged over $1 billion to fight malaria, said that nothing short of an enforced federal shutdown of the entire country for at least a month will stop the virus.

Does America have the capacity and political will to get ahead of the virus?  China and South Korea both stopped the virus by taking a highly invasive Big Brother approach.  They implemented:

• Randomized testing of sick and symptom-free individuals to determine how far and fast the virus spread. South Korea performed about 10,000 screenings a day, which allowed it to tackle new sources of infection early
• Contact tracing
• Enforced quarantines of everyone who tested positive in isolation facilities away from home and family.

While China locked down Hubei Province, home to 60 million people, South Korea did not impose large-scale quarantines.  Instead, it quickly applied lessons learned from the MERS outbreak of 2015.

Give our lack of federal leadership and resources, I’m concerned that the random shutdown of cities and states — for indeterminate lengths of time — could lead to economic ruin for millions of Americans and businesses without effectively stopping the virus.  I wonder if the well-intended strategies of governors and mayors, who are rightly putting public safety and health first, could backfire by prolonging the economic pain without making significant healthcare gains.

Pikes Place Market, Seattle 

Left: Coronavirus shutdown. March 19, 2020.  Right: Normal Day

In spite of my skepticism, I’m heartened by the relaxation of certain rules and regulations in response to the virus that seem unfair, burdensome, or just plain discriminatory.  Here are just a few examples:

• TSA now allows 12 oz bottle of hand-sanitizer in carry-on luggage, which is significantly more than the 3.4 ounces previously allowed. (Does this mean travelers have been unnecessarily inconvenienced by the 3 oz limit for years?)
• The SBA is issuing disaster relief loans to small businesses. Business owners must qualify; however, the application and review process have been streamlined and underwriting criteria have been relaxed.
• The FDA issued new guidelines to help accelerate the COVID-19 testing capacity of the Unite States.
• Medicare waived its three-day rule for admission to nursing homes. For the past 50 years, Medicare has required patients to stay in a hospital for three days before it would pay for follow-on care at a nursing home or rehabilitation facility.  Now hospitals can discharge patients to nursing homes after one day.
• President Trump said that, yes, undocumented immigrants can get tested for coronavirus without fear of arrest or deportation. (In spite of his assurances, many legal as well as illegal immigrants are more fearful than ever because of the “public charge rule” that went into effect March 1, 2020, which makes it harder for immigrants who have used public benefits to get a green card.)

While many people are yearning for a return to the normal of just two or three weeks ago, I’m looking forward to the possibility of a new normal that takes a more humane and rational approach to public policy, as evidenced by the above changes.  If we can lower barriers to participation and inclusion in times of crisis, why can’t we do it in “normal” times?

The two-trillion-dollar emergency relief package which congress passed and the president signed into law proves to me that when there is a will, there is a way.  I’m convinced that if we could muster the political will, we could marshal the resources to seriously address some of our most intractable problems, starting with healthcare.  If all other industrialized countries insure all of their people at lower cost with better outcomes, then why can’t we?

Once the immediate crisis passes, I wonder what lessons will we take away from this learning moment.  Will we return to business as usual?  Or will we consider more practical, fair-minded solutions that benefit the greater good?

Consider this.  The Trump administration has scared away millions of undocumented workers from public services, including healthcare.  If they’re sick with the virus, they’ll go undetected.  If they’re a carrier, they’ll go undetected.  If they come in contact with someone you know, you’ll be at greater risk of infection.

In this case, we truly are only as strong as the weakest link in the chain.