At a point in time, epidemiologists will be able to go back with sharp pencils and work the numbers. Was opening back up right now a brilliant idea or a terrible mistake? In this poker game, human lives are gambled against money. Was it the right bet? The answer will be fairly precise. The math will get done.
I fear it may be too early to reopen this much. So let’s start with the possible outcome in which I turn out to be totally wrong. What would that look like?
Even if I’m wrong and reopening right now turns out to be the right idea, there will be many more deaths from coronavirus after reopening. This was never going to be about eliminating all deaths.
Dallas City Council member David Blewett made a good point a couple weeks ago when he observed that the goal of the safety measures we have taken here — the distancing and the staying at home — was never to eliminate all deaths from coronavirus. No one ever saw that as a scientifically realistic or achievable endgame. The goal was to reduce the pressure on the healthcare infrastructure to a level that would not overwhelm the system and disrupt civil order.
But that gets us directly into the math. How many more deaths will occur in Texas and in the Dallas/Fort Worth metro area after reopening? How many would have occurred without reopening? And how will the number of additional deaths in either scenario stack up against the economic costs of the precautions?
We all know that collapsing the economy exacts from us a spectrum of costs, ranging from hunger, homelessness and the threat of riot at the dire extreme to simple inconvenience and loss of luxury at the trivial end. And people like me who think the reopening is premature can’t get away with saying, “Oh, that’s all just about money.”
Sure it’s about money. Life is about money. Money is food, shelter, security, dignity, hope. Money is serious. The whole deal runs on money, so it’s fatuous and evasive to say that reopening now is bad because it’s about money. You and I wake up in the morning either because we need money or because somebody already gave us some. Far be it from me to talk bad about money. Send me a personal note if you think you have a surplus.
Just as I don’t get to dodge the issue by saying it’s all about money, people on the other side of this debate, the reopeners, don’t get to dodge by saying that money is always the ultimate issue. That’s insane. Money alone is never the only question. Deaths alone are not the only problem. The issue is the ratio.
When we can finally do the math, the question will be how much money versus how many deaths? How much money will we gain by reopening now? How much money would we have lost had we stayed closed until we had achieved a measurable downturn in the disease?
If we reopen and I am wrong, if reopening cannot be causally linked to a spike in deaths, then all of the money we regain by reopening will be gravy. People will eat. People won’t get evicted. Lots of great things will happen. The young woman who borrowed from her parents’ retirement savings to open a trucking business will be able after all to pay them back instead of leaving them bereft in their old age (made-up story).
But what does it look like if I’m right? If I am right and we are reopening too soon, then there will be bad spikes in the death count. The people who attended services in the Catholic Diocese of Fort Worth last Sunday will have infected each other, and they will carry those infections home to the rest of their families and out into the reopened shopping malls and parks, where they will infect more people, some of whom will die.
How many more deaths will be attributed to the reopening? How many deaths are worth how much economic recovery? And, again, none of us gets to boogie out of this with hand-waving. It’s no good saying that everybody dies someday. It won’t work to say not a single life should ever be traded for the good of the economy. It's not that easy for either side.
The deaths caused by reopening will be counted and properly attributed. Some number of deaths will be deemed acceptable given what would have been the cost of staying closed down. Another higher number will be a tragedy. An even higher number may be a crime.
That’s where the pencils get sharpened. The full range of comparisons won’t be simple or obvious. Getting to apples and oranges won’t be easy.
Sweden, which never shut down fully, has a coronavirus death rate on a par with European countries like France and Great Britain that did shut down. But the death rate in Sweden is three to six times the rate in its more similar Scandinavian neighbors.
New York Gov. Andrew Cuomo last week laid down a marker of his own by claiming that New York already can count the number of hospitalizations it has avoided with social distancing measures. He said the number of avoided hospital cases attributable to the New York precautions is 100,000.
Cuomo didn’t offer a guess or projection of the number of deaths that would have occurred among those additional 100,000 patients who would have been sick enough to require hospital admissions. But at some point that number will be discovered by epidemiologists and statisticians and demographers. The number exists. People who know how to find it will find it. These questions will not go unanswered.
If there are no unacceptable spikes, then the testing numbers will be irrelevant and people like me will be Nervous Nellies, Chicken Littles, Jeremiahs and Cassandras. If that’s how it turns out, I would prefer to be called a Jeremiah, because I like the name.
Just as I don’t get to dodge the issue by saying it’s all about money, people on the other side of this debate, the reopeners, don’t get to dodge by saying everything is always about money.
But if there are bad spikes, then I and people like me will point out that an absence or shortage of testing was an awfully convenient fact for a governor ordering a reopening ahead of when experts said it was safe. Massive testing is the first thing that would prove Abbott wrong. Was it coincidence that Texas wasn’t able to put the testing in place, when South Korea could do it?
In fact, is there not a larger pattern here that we should pay attention to, depending on how this turns out? State officials in Florida got caught last week trying to hide their death rate by barring coroners from releasing data that had always before been public information.
Our president, Donald Trump, has been saying he doesn’t know if tests are all that important. Is it because he doesn’t want to know the results? Does he see the test results as his personal nemesis?
These are the kinds of things we can and do bat around on Facebook these days to pass away the long hours of isolation, probably accomplishing very little beyond passing the long hours. If reopening is a success, then all of these recriminations will either be forgotten, or they will become the basis for Trump’s reelection campaign and the resurgence of the Republican Party.
If reopening is a muddy mixed bag, then I suspect we will go on with the recriminations until we get bored, and the scientists and academics will be left to a very welcome peace and quiet to work on the problem at their desks and in their labs. At some point when today’s ninth-graders are grad students, the answers will be published and 120 people worldwide will read them.
But what if a significant spike in deaths occurs that could have been avoided, a death spike far outstripping the value of reopened restaurants, churches and nail salons? Then guys like me will wave the bloody shirt and call for war crimes tribunals. Count on it.
If this turns out to be a serious mistake, the difficult calculus for most people will not involve politicians or media people. The tough math will be done in people’s own hearts: Did somebody I know, somebody I care about, somebody I respect die because this reopening was premature? Did I in any way contribute to that death or those deaths by my own behavior, by the things I did and said or did not do or say at the time?
Did I benefit from the reopening, keep my job, pay my rent, put food on the table because I was able to go back to work? Was my personal benefit worth the cost in deaths? These questions will come knocking insistently on the doors of our hearts, whether we invite them or not.
And, again, there will be a number at which the answer will be yes. I’m sorry for those people, but I think they were old already. I think they had hard lives. But I have to survive and do what I have to do. I can live with that many deaths.
But how many deaths can we live with, exactly? Where is the line beyond which we must change human life to preserve human life?There is a number, and someday we will know the number.