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  • BIOETHICS FORUM ESSAY

The Price of Going Back to Work Too Soon

Published on: April 6, 2020
Published in: Covid-19, Ethics, Hastings Bioethics Forum, Public Health

President Donald Trump had, until very recently, spent as much time in his public appearances proclaiming victory over the Covid-19 pandemic rippling across the nation as he had offering directives that would diminish it. Again and again, he promised that it would soon be over, especially as the weather got warmer, and that the worst would not happen or was already behind us. This triggered a widespread discussion that still is ongoing about how fast America could get back to normal and get the economy roaring again.

But even floating the notion of reopening the economy was grossly immoral. Why?

I take outcomes very seriously. Morally trying to do what is best for the greatest number is what guides my thinking about how to allocate ventilators or reopen the economy. But for me wealth maximization is not as important a goal as saving huge numbers of lives. And talk of back to normal to salvage the economy before the pandemic is stabilized does not add up.

It is true that Trump is not alone in plumping for the economy. A lot of serious people are concerned about the downstream effects of the economic shutdown. Many leaders around the world worry about how disrupted supply chains could lead to longer-term poverty, social turmoil and disease. Talk has resumed in China, Italy, South Korea, and the city of Hong Kong about releasing people from isolation.

The problem is there are still too many unknowns to predict the numbers of when it is time to put the economy ahead of the risk of further deaths. We don’t know if those who have been infected can be reinfected. We don’t know if the virus can incubate in a locality and then roar back. We don’t know what level of antibodies means you might be protected but still could infect others since we really don’t know what the safe incubation period is. And we still don’t have enough tests so that we can do the kind of constant checking and isolating of the positive that would let the desire to get back to business occur. Worse many parts of the world are still isolating or yet to be infected meaning at best a slow partial economic return is in store.

Those who dismiss the potential for mass causalities, nonexistent health care systems and huge numbers of dead police, firemen, truck drivers, and day care workers as opposed to putting the economy on hold for three more months are engaged in morally perverse mathematics. The price of going back to work too soon or reigniting the plague is not balanced by gradual and slow economic activity.

And there is a different damage caused by irresponsible talk of “back to business” in days, weeks by Easter or by Memorial Day. Such debate strongly undermines the resolve that Americans need to adhere to recommendations to stay at home as much as possible and maintain physical distance from others. If things will soon be better, then how bad can a trip to visit grandma be, heading down to the beach in big groups, inviting kids over for playdates or going camping with 400 other people be? Many Americans are not isolating and talk of starting up soon is not likely to motivate them to do so.

Rather than rebuild an economy on hiatus around the world for months, we will find ourselves trying to spark a wounded economy for years if we don’t answer the key viral infectivity questions first. A rich nation can work through an economic shutdown of months. A broken and devastated nation beset by new outbreaks and constant conflicting messages about the need for isolation will not regain a sound economy for years, if ever.

Arthur Caplan is the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics and the founding director of the Division of Medical Ethics at the NYU Grossman School of Medicine. He is a Hastings Center fellow and a member of The Hastings Center’s advisory council. Twitter: @ArthurCaplan.

 

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  1. Maryann Martinez on

    Provocative—a deeper meaning for everyone to understand.
    My hope is that our country and leaders are listening and capable of putting people before money.

    Reply
  2. Joanne Lynn on

    One more thing to remember – unless we have an effective treatment or an effective vaccine, what we are doing with staying home is spreading out the serious illnesses – not actually reducing their number. This is important so we don’t completely swamp the medical care system – but we need to be careful in distinguishing people who die because the care system could not cope, vs people who die because their illness was overwhelming no matter what care they got. So long as we stay under the limits of the care system, nearly all deaths are in the latter group. So, a piece of what needs to be planned and monitored as we start letting people leave isolation is to expect continued deaths and serious illness at about the same population rate, at least until we get to the level of herd immunity where the virus doesn’t find many new victims. As long as we stay within the capacity of the care system to provide support, the deaths are those of overwhelming illness that medical care could not manage.

    Reply

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