The Residential Library

The sometimes demented, frequently irreverent, and occasionally stupid musings of Ron Hargrove

Restarting America Means People Will Die. So When Do We Do It?

Five thinkers weigh moral choices in a crisis.

By 

The politics of the coronavirus have made it seem indecent to talk about the future. As President Trump has flirted with reopening America quickly — saying in late March that he’d like to see “packed churches” on Easter and returning to the theme days ago with “we cannot let this continue” — public-health experts have felt compelled to call out the dangers. Many Americans have responded by rejecting as monstrous the whole idea of any trade-off between saving lives and saving the economy. And in the near term, it’s true that those two goals align: For the sake of both, it’s imperative to keep businesses shuttered and people in their homes as much as possible.

In the longer run, though, it’s important to acknowledge that a trade-off will emerge — and become more urgent in the coming months, as the economy slides deeper into recession. The staggering toll of unemployment has reached more than 16 million in just the last three weeks. There will be difficult compromises between doing everything possible to save lives from Covid-19 and preventing other life-threatening, or -altering, harms.

When can we ethically bring people back to work and school and begin to resume the usual rhythms of American life? We brought together by video conference five different kinds of experts to talk about the principles and values that will determine the choices we make at that future point. One of them, the bioethicist Zeke Emanuel, led a group from the Center for American Progress that earlier this month presented a plan to end the coronavirus crisis. First, the group said, the country needs a national stay-at-home policy through mid-May. (Eight governors still haven’t issued such orders statewide.) In the intervening weeks, testing would have to ramp up to test everyone who has a fever, or lives with someone who tests positive for Covid-19. Contact-tracing — identifying and notifying people who have been in proximity to someone infected — would become comprehensive. People who have the virus or a fever, or those in proximity to them, would be isolated. There would also be testing of a representative sample in every county, to determine the rate of infection in the population, as well as mapping and alerts to inform the public about the location of Covid-19 cases.

If these efforts are successfully put in place, Emanuel hopes the current restrictions could begin to ease in June. At that point — or later, if the necessary steps have not been taken — we will need to rethink how we manage risk, recognizing trade-offs among various harms and benefits. That’s what the panel discussed.

Emily Bazelon: Zeke, how are we doing on reaching your goal of beginning to partly reopen in June?

Zeke Emanuel: I’m not wildly optimistic, would be my answer. We still don’t have a consistent shelter-in-place policy nationally; there are too many exceptions allowed in different states. We haven’t normalized things like wearing masks outside. We need infrastructure for testing in real time, so you don’t get results 5 or 6 or 7 days later. We need real contact tracing that uses technology so that you can do it very rapidly. Getting the ball rolling on this, I’m concerned about.

Bazelon: If we have to restart the economy step by step, not all at once, does that mean deciding whether a workplace can do social distancing safely?

%d bloggers like this: