It seems that every hour brings more news of outbreaks, cancellations, and economic turmoil including volatility of the stock market and oil prices. The fabric of our neighborhoods and communities that rely on local patrons for their livelihood are struggling to survive the social distancing and work from home directives.
The Policy Circle team, like most of you, has been trying to keep abreast of the evolving impact of the Coronavirus Disease (Covid-19). There is an ongoing global effort to investigate and determine as much as possible about this novel virus and its impacts around the globe. While much is still uncertain, we wanted to provide the most up-to-date information from some of the experts on public health and economic policy.
Impact on Health
You’ve probably heard a lot about the precautions and steps to contain the spread of the virus. “The number one goal for everyone is to contain the spread of this threat so that medical facilities are not overwhelmed,” American Enterprise Institute Resident Fellow and Former Commissioner of the Food and Drug Administration Scott Gottlieb, MD stated recently in an op-ed. So these steps, though seemingly dramatic, are necessary to mitigate the speed and scope of the virus.
The U.S. healthcare system is already running at capacity, so a surge of cases could overwhelm our already overwhelmed system. The danger in this increase of capacity is that it could exhaust the resources of our healthcare system. For instance, take the spike in cases in Wuhan, China: fatality rates increased to 5% because the system couldn’t keep up with the peak in virus spread. We’re currently seeing this as well in Italy, with widespread spikes in cases reported. 90% of Italy’s confirmed cases were diagnosed in just the last two weeks, in fact, showing that containment efforts weren’t successful in the country.
Skepticism has been expressed surrounding the accuracy of the numbers released by the Chinese government, which causes uncertainty in understanding the path of the virus and timeline. Based on the spread from both China and across Europe, however, the trend for the virus seems to run a four-month course from the first widely reported cases to after peak.
Gottlieb has noted that the U.S. is on the cusp of this same epidemic spread with clusters of illness appearing in places like Washington State and Santa Clara, California. Americans are becoming more aware of the risks and are engaging in better hygiene, limiting attendance at large events, teleworking and limiting work groups when indoors.
You have likely seen the social media posts and read the term “flatten the curve” of spread. This is a valuable chart that illustrates why slowing the spread of the infection is nearly as important as stopping it. Here are best practices as outlined by the Centers for Disease Control (CDC) and health professionals around the globe:
- Wash your hands properly for 20 seconds or more with soap.
- Cover coughs and sneezes. Use tissues and immediately throw them away, then wash your hands before touching anything else.
- Stay home if you feel sick.
- Social distancing:
- Prevent people from congregating indoors at work or in large crowds.
- Telework when possible.
- Postpone or cancel events with crowds larger than 50.
- For older populations, limit how often you go out in order to avoid contracting/coming into contact with virus and spread.
- Children have seen sub-clinical or mild symptoms and aren’t showing the sickness at levels seen by adults. Even so, it’s fair to assume “that children can transmit the disease,” according to Gottlieb. “Even people who have mild symptoms are “shedding” just as much as those diagnosed, which is how it’s spreading more quickly and virally.”
- If you must fly domestically (internationally is not advisable at this time), the largest risk is from fomites, which are particles likely to carry infection that might stay on surfaces or be transferred. Clean seats and surfaces, be careful at taking things from flight attendants and wash hands properly and often to lower risks.
- If you believe you are showing symptoms of Covid-19, first call your doctor to discuss your symptoms, and confirm before you go to the hospital. You could spread the virus to someone at higher risk even if you have mild symptoms. Most cases (80%) are mild enough to be cared for at home with over-the-counter medicines.
- Postpone elective surgeries until the fall, when the virus is expected to be less intense.
These steps are especially important for those who are at higher risk once being diagnosed with the disease: those with pre-existing conditions and those advancing in age. Gottlieb said that when looking at 60 to 70 year olds who have contracted the disease, fatality rates are about 4%. For 70 to 80-year-olds, it rises to about 10%, and for those above 80, it rises to 14 or 15%.
Federal and state agencies are working together to respond to the pandemic, taking action on ensuring people are able to get the proper care when needed, particularly in these higher-risk demographics. The Centers for Medicare and Medicaid Services (CMS) for example is taking action to protect the health and safety of providers and patients, including those covered by Medicaid and Children’s Health Insurance Program (CHIP). CMS Administrator Seema Verma (our first Policy Circle member in Indiana), said recently that the Trump Administration “is actively working with governors to provide flexibility in Medicaid and CHIP programs, so states can respond effectively to this virus.”
“We are especially mindful of our beneficiaries with underlying health conditions that make them more vulnerable. CMS is doing everything in its power to help states eliminate any barriers or delays in their care,” Verma said. The Administration is also working to ramp up availability of tests for the disease, which currently isn’t at full capacity.
Testing for the disease is a fairly simple throat or nose swab like the flu test, but currently only one test is available, and testing centers are concentrated in certain areas. Gottlieb said capacity is ramping up to accommodate more, which will be helpful moving forward as cases are expected to increase throughout March and April.
Clinical trials are ongoing with some data to be distributed by April. “An antibody prophyllatic is the most promising innovation to tackle the virus,” Gottlieb has said. “Even with world-wide research and trials, a vaccine will likely not be available for one to two years.” By this fall, however, Gottlieb expects the U.S. to have enough tools to manage the virus more effectively.
Since humid months slow the transfer of viruses like these, the summer months should offer a backstop on the spread. One other interesting note on the virus: researchers believe that once 30% or more of the American population has it, at least partial and possible life-long immunity is possible.
Economic Impact & Disruption
On the economic front, AEI Director Michael Strain has noted there is a “significant impact on financial markets [resulting in a] tremendous amount of volatility.” Strain stated, “There’s still much uncertainty as this volatility is tied directly to the severity and length of time the virus is out in the population, keeping people away from work and feeding into supply chains.”
In our neighborhoods, small businesses are hurting. Local coffee shops, restaurants and retailers aren’t sure if they have the financial backbone to stay open. The Small Business Administration is offering low interest loans to business but that won’t bring customers through his doors. Here’s the press release on the SBA website, it may be a good idea to spread the word.
Economic relief negotiations have also begun with a bipartisan effort, raising hopes that a deal will be struck soon before lawmakers leave for recess. Speaker of the House Nancy Pelosi and Senate Majority Leader Mitch McConnell have both said they would either delay or cancel the scheduled break in order to reach an agreement. As Congress tackles how to allocate this additional spending, the Wall Street Journal notes, we should be “laying out some principles to sort the good from the bad and the ugly.”
What else should Congress do? Strain sees “no evidence that we need a macro-economic stimulus package. But I would support assistance to low-income households. Hourly rate workers can’t stay home. Finding a way to help them stay home if they are sick to advance public health and the economy is a needed social safety net.” He also noted that a coordinated global response would be a reassuring signal to markets that the U.S., Europe and Asia have a coordinated strategy.
What Can You do? How Can You Help in Your Community?
This situation is global, national, state based, local and individual. We are asked to step up our sense of responsibility to practice good hygiene to stave off the spread, but also to be good neighbors. Here are some additional ideas on how you can lead:
- Contact neighbors who may be elderly or sick who are afraid to leave their house and ask what they need and if you can help support them by delivering food or supplies.
- Talk to your local business owners about their ability to survive the social distancing. Perhaps you could share the SBA loan program with them. Continue to be a patron, they stitch the fabric of our communities.
- Host a virtual Policy Circle discussion on The Fabric of Neighborhoods, Healthcare and this post on the Coronavirus.
- Help organizations who supply meals for low-income families.
- Visit your state government or state department of health websites on the policies in place, for example the State of Nebraska has a comprehensive page on their state policies.
- Visit the Centers for Disease Control website for further guidelines on preventing illness and spread, symptoms and situational updates.
- Visit the World Health Organization for more information and guidance regarding the current outbreak of coronavirus disease (COVID-19).