The Greater Good Conundrum
The May 5 edition of The Signal included an interesting column written by Gil Mertz entitled “COVID-19 and the Greater Good for All Americans.” The column discussed the difficult decisions facing President Donald Trump in balancing restarting the economy with the consequential additional deaths that will inevitably result from doing so.
Gil analogized the current situation to that of three war-time presidents. However, there are fundamental distinctions between the decisions made by those presidents and the decisions faced by Trump. Each of them sought to end a war by pursuing courses of action that increased short-term casualties with the hope that the wars would end sooner with fewer overall casualties. None of those presidents put the U.S. civilian population at risk — the incremental U.S. casualties were borne principally by the military.
There is, however, historical precedent for a decision more comparable to those faced by Trump.
The financial Panic of 1873 started shortly after the start of President Ulysses S. Grant’s second term. The Panic was a sharp economic downturn comparable to that of the Great Recession. Just as we got out of the Great Recession by significantly expanding the money supply, the Grant administration sought to take similar action. Unfortunately, we were on the gold standard, which required that each U.S. dollar be backed by a finite amount of gold. The money supply was limited by the available gold supply.
The only source of sufficient gold was in the Black Hills of South Dakota, which was Indian land subject to protection by treaty. Seeking to take that land, Grant clandestinely created a group to do so without congressional oversight. The United States ultimately took the land from the Indians and mined their gold to solve the economic crisis, but not without inflicting significant suffering and mortality on the Native American population. Basically, Grant sacrificed the Native Americans for the “greater good” of the American economy. This was not one of America’s finest moments.
Like Grant, President Trump faces the choice of restarting the economy at a cost of civilian lives. In Grant’s day, the American populace deemed the Indians to be second-class people and it was more important to keep the economy going — even if Indians suffered. Today, some commentators, including Bill O’Reilly, dismiss COVID-19 victims as people who are on their last legs and are going to die soon anyway. That rationale is as contemptuous as the way Indians were viewed in the 1870s.
Today, accelerating the reopening of our economy potentially places more people at risk than the administration has admitted. Based on my readings and discussions with epidemiologists, we won’t achieve herd immunity until 40-70% of the population is immune through either infection or vaccination. That means that between 130 million and 230 million Americans must individually become immune.
Achieving herd immunity through vaccination requires inoculating at least 130-230 million Americans. We also will have to suppress the number of infections in the intervening period, thereby buying time to implement an effective vaccination protocol. Doing so requires testing at levels beyond our present capabilities.
Other countries have centralized testing efforts at a national level. Trump has abdicated responsibility for testing to state governments, thereby ensuring inefficiencies, delays and duplicative costs.
Furthermore, the administration does not have an apparent path to prompt immunization, except for hope. Although nothing is certain, there is a reasonable prospect that a vaccine will be developed in the near future. However, we do not presently have the capacity to deliver 130-230 million vaccines (or double that number if a booster immunization is needed). There are huge global logistical problems that must be anticipated and overcome. Has the administration appropriately addressed these matters?
Reopening the economy prematurely ensures that a greater percentage of herd immunity will result from infection rather than through vaccination. The stated mortality rate of about 4% calculates COVID-19 deaths as a percentage of confirmed infections. The true infection rate is probably considerably higher. For example, if 75% of cases are undiagnosed, the mortality rate drops to 1%. If we achieve herd immunity exclusively through infection and the mortality rate is 1%, as many as 1 million to 2 million people may die. Obviously, an effective vaccination protocol will reduce these numbers, but the civilian costs will still dwarf what Grant inflicted on the Native American population.
Gil hit the nail right on the head when he stated, “…we can succumb to our weakest instincts to manipulate this deadly crisis by dividing Americans through endlessly blaming, second-guessing and finger pointing as a perverted winning strategy to score the most depraved of political points.”
Unfortunately, this is in the eye of the beholder. Trump and his supporters believe this describes the Democrats. The remainder of the country believes this describes Trump himself.
Somebody must assume the leadership needed to ensure that herd immunity is attained though vaccination rather than infection.
To date that leadership is lacking.