A Warning for the United States From the Author of ‘The Great Influenza’

 Author: John M. Barry
Source: The New York Times
Date: Aug. 18, 2020

If we don’t get the virus under control, the devastation will get worse.
“Humankind cannot bear very much reality.”
So said the poet T.S. Eliot. It’s an apt explanation for the White House’s failure to respond adequately to the pandemic that has swept across America and the rest of the world.
Even as reality continues to intrude, President Trump has either largely dismissed or ignored his science and medical advisers. And the result is that the economy, the one thing he seems to care most about, and which he hoped would escort him to a second term, has been devastated.
As both history and data from today demonstrate, health and the economy are not antagonistic; they are dance partners, with public health taking the lead. The safer people feel, the more they will engage in economic activity.
A recent study of the 1918-1919 influenza pandemic by a member of the Federal Reserve board and economists at the Fed and M.I.T. compared cities that imposed stringent public health measures — including school and church closings, public gathering bans, quarantines and restricted business hours — with cities that opened faster and imposed fewer restrictions. The more stringent cities not only had fewer deaths but experienced “a relative increase in economic activity from 1919 onward.”
Containing the virus has allowed many European economies to recover far better than the U.S. Look at Germany, which has an unemployment rate of 6.4 percent. The rate in the U.S. is 10.2 percent. In March and April, according to OpenTable, the reservation booking company, business in restaurants in Germany and the U.S. were in the identical place, down over 90 percent year over year. Since then they have diverged widely: data for Aug. 16 (the latest data at this writing) shows German restaurants enjoyed 9 percent more business than last year, before the pandemic, while U.S. restaurants were down around 50 percent.
And in a report last week, the National League of Cities said that precipitous declines in tax revenues were forcing cities to “severely cut services at a time when communities need them most, to lay off and furlough employees who make up a large share of America’s middle class, and to pull back on capital projects, further affecting local employment, business contracts and overall investment in the economy.”
In June the World Bank estimated that global G.D.P. this year would decline by at least 5.2 percent and possibly much more. The Congressional Budget Office expects G.D.P in the U.S. to fare worse, down 5.9 percent for the year, even after factoring in projected third quarter growth of more than 20 percent. But that projection assumes the containment of the virus, a huge assumption.
Indeed, a Morgan Stanley model predicts that under current policies the U.S. is currently on track to have 150,000 new cases a day later this year. And that number is not even a worst case. If we do suffer case counts anything like those, dramatic growth in the economy simply won’t happen.
Bad as the virus has been this summer, it actually spreads better in low temperatures, and when temperatures fall, more people will be inside in poorly ventilated areas where transmission is also more likely. If the U.S. goes into the fall with new daily cases in the tens of thousands, as they are now, then the numbers could explode and the Morgan Stanley prediction could come true. Considering our containment efforts to date, there is little reason for optimism.
If that occurs, the economy will not come back. Jerome Powell, the chairman of the Federal Reserve, said as much recently. “The path forward for the economy is extraordinarily uncertain and will depend in large part on our success in keeping the virus in check,” he said at a July 29 news conference. He added: “A full recovery is unlikely until people are confident that it is safe to re-engage in a broad range of activities.”
But containment, and the confidence that goes with it, is not remotely where we are at the moment. Among developed nations, the U.S. ranks first in categories one would prefer to be last in: number of cases and number of deaths. It lags well behind in economic recovery as well. As of this writing, the European Union and Britain combined have a population of about 510 million, and 1,924,569 Covid-19 cases. They have had around 8,000 cases for the latest daily count. The United States, population 328 million, just passed 5.4 million cases, with 42,303 the latest daily case count.
Bringing the economy back requires precisely the same three measures that controlling the virus does: First, better compliance with social distancing, wearing masks, personal hygiene and avoiding crowds; second, finally — finally — getting the supply chain and personnel infrastructure in place to support the necessary testing and contact tracing; and, third, the bitter medicine of regional shutdowns.
The same Morgan Stanley model that predicts that the U.S. is on track to reach 150,000 cases a day also has a “bullish” scenario in which the U.S. case counts decline to European levels. But for that to happen, the modelers assumed “more strict restrictions and broader interventions” such as lockdowns “similar” to those imposed by China and major European Union countries.
Without active, aggressive White House leadership we cannot achieve that and — reality again — there isn’t the slightest hint that will happen. But in 1918 leadership came from cities and states. If governors and mayors act aggressively, especially if they act jointly, we can still make significant progress.
In April, I predicted that summer would not bring relief from the virus, and that we would experience not a second wave but continuous swells, depending on how well we complied with public health measures. Unfortunately too many states eased up too early or did little or nothing to control the virus. On the day that prediction was published, April 30, the seven-day average of new cases was 28,943. On Aug. 16, the seven-day average was 51,523
I also warned of not simply swells but a viral hurricane-like storm surge if the country does not act aggressively and the public fails to comply. I stand by that prediction. Tens of thousands more will die on top of the more than 170,000 already lost in the U.S., and millions will suffer economic devastation.
And, in reality, all of it will be unnecessary. God help us.
John M. Barry is a professor at the Tulane University School of Public Health and Tropical Medicine and the author of “The Great Influenza: The Story of the Deadliest Pandemic in History.”
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