Opinions and analysis

March 25, 2020

By Thomas L. Friedman *

These are days when you test every leader – local, state, national. Each is being asked to make huge life and death decisions, while driving through the fog, with incomplete information, everyone in the back seat shouting at them. My heart goes out to them all. I know they mean well. But as many of our companies are closing and millions are starting to lay off, some experts are starting to ask: “Wait a minute! What the hell do we do to ourselves? for our economy? for our next generation? Is this treatment – even for a short period – worse than the disease?

I share these questions. Our leaders don’t fly completely blind: they act on the advice of serious epidemiologists and public health experts. However, we still need to be vigilant about “groupthink,” which is a normal but dangerous reaction when responding to a national and global crisis. We are making decisions that affect the entire country and our entire economy – so small mistakes in navigation can have serious consequences.

Of course, as this virus may affect many Americans at once, we need to provide more hospital beds, treatment equipment for those who need it, and protective gear like N95 masks for doctors and nurses who care for patients with the virus. This is urgent! We need an immediate rectification of the massive failure to provide rapid and large-scale testing. This is urgent!

But we also need to ask ourselves — with equal urgency — can we surgically reduce the risk of this virus for those most at risk while maximizing the chances of as many Americans as possible to safely return to work as soon as possible. One of the experts I spoke to below believes this could happen as early as a few weeks — if we stop for a moment and think again about the coronavirus challenge.

Indeed, if my inbox is any indication, a thoughtful backlash is brewing over the strategy in which the country has faltered. And the bump is what inevitably happens when you have a president who goes from treating the coronavirus as a hoax to a war in a couple of days. Many health experts want to find a better balance of the medical, economic and ethical issues that concern us all at once.

Dr. John B. Ioannidis, an epidemiologist and co-director of the Center for Metadata Research Innovation at Stanford, noted in a March 17 article on statnews.com, that we still do not have a firm understanding of the coronavirus mortality rate at the population level. However, a look at some of the best evidence available today suggests it could be 1 percent and it could be less.

Ioannidis wrote: “If this is the true rate, then shutting down the world with its potentially enormous social and financial consequences would be wholly irrational. It’s like an elephant being attacked by a domestic cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.”

Dr Stephen Wolf, director emeritus of the Center for Community and Health at Virginia Commonwealth University, shared some of the ideas he was hammering in an article: “The community response to Covid-19, such as closing businesses and closing communities, may be necessary to limit community spread but can harm health in ways Others, leading to loss of life. Imagine a patient with chest pain or a stroke, where speed is essential to saving lives, reluctant to call 911 for fear of contracting the coronavirus. Or a cancer patient has to delay chemotherapy because the facility is closed. Or a patient with advanced emphysema who dies from not having an attachment with a ventilator. “

And imagine the stress and mental illness that will come – and have already come – from our shutdown of our economy, leading to massive layoffs.

March 22, 2020