Stay In Lockdown or Reopen?
by Scott Krafft
I hope you're all making it through these challenging times keeping your spirits up as well as your health. If you’re on our email list, we recently sent out some information on the CARES Act, primarily related to small businesses and a link to the new video podcast from Buckingham called Ask Buckingham. Each video asks a specific question of one of Buckingham's many experts, maybe one that you have on your mind. Check it out!
Another resource that I want you to know about is a tremendously informative podcast called Doctor Doctor. It is hosted by a very good friend of ours, who is also a practicing dermatologist and a trained Mohs surgeon, Dr. Thomas McGovern. Not only is he a skilled surgeon but he is also a prolific podcaster and skilled interviewer, drawing keen insight from the diverse range of guests he has on the show. Since March 15th, Dr. McGovern has hosted over 23 shows on COVID-19, covering it from many different angles. If you wanna know anything about the pandemic, check out Dr. Doctor on iTunes Podcasts.
Let’s switch gears now. We recently heard from the President that the U.S. may have peaked in the number of cases, so we're praying that we're on the down side of a prolonged decline. The President also organized the great American economic revival industry groups, drawing members from a broad swath of American industry, academia, economics, science, and medicine. So we hope for some very good thinking on how to reopen our economy prudently from these working groups. We can't remain in this government imposed economic shutdown much longer. We don't want the consequence from the lockdown to overcome the harm of the pandemic we're trying to fight with the lockdown. Our local news just reported an increase in in-home deaths from heart attacks and other ailments during the stay-at-home mandate due to fear of going to the emergency rooms.
So how do we manage this unwelcome trade-off between two undesirable outcomes? Well, a few of the economists I read have been discussing some good ideas, such as implementing a reopening policy around the idea of distinguishing between high R0 people and low R0 people, as well as higher R0 activities, and low R0 activities. If the term R0 (pronounced “R naught'“) is unfamiliar to you, it's simply a measure of how contagious the virus is by measuring how many people a single infected individual would infect. The virus is thought to have an R0 of between 2 and 2.5. Meaning, the average person with the virus would infect between 2-3 people. But all of us aren't average. There are what epidemiologists call “Super Spreaders”—people who, for whatever reason, affect many more than the average 2-3 people. They may have an R0 of say, 10. If we can identify and contain the Super Spreaders, we can open up more quickly.
Activities can also be categorized as high-transmissible versus low-transmissible activities, allowing low R0 activities to go back immediately such as lawn care companies, and then redesigning the high R0 industries, think hospitality, to limit contact until the vaccine is available. Implementing around the idea of viral spread would seem far more effective than the blunt force lockdown of non-essential businesses, while allowing a central business to operate with little attention paid to the possibility of viral spread. The goal of policy has to be to get the R0 at less than 1, where the virus will die out at a minimum of economic cost, not at any economic cost. The government can't go on creating $1 trillion per month forever.
One of my favorite economists said it this way, "Cost-efficiency needs a scalpel, not a sledgehammer." It means lots and lots of little details, not one big plan. And since the government is closing us down, it is the government that needs to master this detail. What troubles me is I don't hear these kinds of ideas discussed during the task force briefings. They're still using the language of essential versus non-essential, and reopening on a rolling state-by-state basis. A sustainable NPI approach has to include screening, testing, tracing, maintaining healthy behaviors and distances. And someone has to be thinking about all the very little details to make this work.
I hope this gives you some ideas that you want. If you think they have merit, you can always reach out to your local state or federal representatives, and give them your thinking. We can make a difference. Stay healthy, safe, and always hopeful.