America has mobilized against the coronavirus in some impressive ways. Although we have faced problems and failures—the botched testing rollout, the immense challenges now confronting the health system—we have also seen an extraordinary transformation of our way of life in short order. People have largely accepted the necessity of social distancing and the burdens of shutting down huge swaths of the economy. We have seen real models of leadership, particularly at the state level. And even members of Congress have been working together and negotiating.
But so far, that mobilization has lacked a strategic framework—a clear medium-term purpose toward which our efforts are aimed and against which they are judged. Policy makers need to think about our response to the virus in terms of two steps: a hard pause, followed by a soft start. The pause is absolutely necessary, but so is the careful and gradual return to normalcy.
We know we need to keep people at home to slow the spread of the virus and ease the strain on hospitals. But then what? This is where a general definition of success can help, allowing decision makers to prioritize among discrete political, scientific, economic, and logistical steps.
In the absence of such a framework, the purpose of some of the government’s policy responses has been unclear, as has the relationship between the public-health and economic measures Washington is taking. Policy makers are acting as if we face a binary choice between letting a deadly disease run rampant or strangling our economy, making every proposed course of action seem irresponsible. In fact, their objective should be precisely to avoid such a trade-off, by defining the relationship between our aims.
The purpose of our strategy should be to create a sustainable way to live with the virus, not secure its total defeat. We could not have achieved that sustainable balance by gradually gearing down our society from normal life, because in the meantime we would be erring on the side of danger and exacerbating the enormous burdens on our health system. Instead, we need to gear up from a drastic shutdown of American life. That drastic shutdown is what we are now engaged in, and it makes sense. But gearing up from that, starting relatively soon, has to be our goal.
Right now, we need to pause. In order to restrain the spread of the virus, we have put our lives on hold—with work, school, and play all shut down to let us keep our distance from one another. That means that public policy intended to enable this phase must aim to let people keep their place in our national life until they can return to it.
But this isn’t how policy makers have approached the problem. Their response to the immense economic costs of the public-health policies we are pursuing has instead focused on providing economic stimulus, an approach reflected in some parts of the bill negotiated in the Senate in recent days. But stimulus is the wrong way to think about what’s needed. We need to make the pause sustainable until economic life can resume. That means we should prioritize ways of preventing a loss of place in our economy—especially by helping businesses maintain payrolls, hold on to facilities, and meet economic obligations while they are effectively closed.
The British, for instance, have launched a job-retention policy, with the government covering 80 percent of the salaries of workers furloughed because of the pandemic (up to the median income) provided employers do not fire them. This creates a massive incentive for employers to hold on to their workforce during the crisis. It won’t be cheap, but it is a more effective use of public money than direct payments to households to sustain demand, when such demand can have no real outlet.
We should think along similar lines, and also find ways to help companies pay rent and meet other financial obligations while the public-health emergency persists. The legislation hammered out in recent days does some of that, and will be helpful. But more will be needed, and further steps should more explicitly help people keep their place in the economy. Although we are probably in for a significant recession, our economy is not best understood to be contracting. It is paused.
Along with making the hard pause bearable, we also need to enable a soft return toward normalcy, starting soon. That return will be slow and gradual; it will look different in different places, and it will mean living with the virus, not putting it behind us. The scenario President Trump has fantasized about, that “it’s going to disappear; one day—it’s like a miracle—it will disappear,” is not going to happen.
At the same time, however, the pause we are in cannot last, even for the medium term. The notion that this is how we handle the virus until a vaccine is available—that the most intense social distancing with no school or work for large segments of society will go on for many months—is absurd. No policy maker should take it seriously. Rather, the purpose of the hard pause is to enable the gradual resumption of life to start soon.
That should help us think about how to use this period in terms of public health as well as economic assistance. This is a time for building capacity for testing and treatment, expanding ICU beds, and focusing our efforts on prevention and containment.
We need to invest in a massive, ongoing testing regime. In addition to today’s RNA-based throat-swab diagnostics, which can spot active infections, we need to deploy blood tests for antibodies. Such tests, which will be available soon, would tell us who has been exposed and recovered and might possess some immunity. That would allow for a much more fine-grained sense of where the epidemic is raging intensely and where loosening some restrictions would be safe.
At the same time, both public investments and regulatory exemptions need to prioritize the exploration of treatment options that could reduce the severity of the worst cases and lower fatality rates. And we will need to think about prevention in terms of how to enable people to resume their lives, rather than just how to encourage them to stay home.
Telling the public that face masks don’t work, for instance, makes sense when you’re trying to avoid false confidence and to save masks for health-care workers. But simple masks actually can reduce transmission dramatically, and the language of public-health experts around such measures will need to start changing. When you ease into taking the subway to work again, or nervously attend that first baseball game over the summer, you may well want to wear a mask.
Measures such as these, and the return to a degree of normalcy that would be their aim, will increase the risk of infection. They are more dangerous than staying home. But they can keep that risk manageable. And the risk will grow easier to bear as a vaccine becomes available, and as our knowledge of the virus grows and lets us adapt to its distinctive dangers.
It is not yet possible to move from the hard pause we have taken to the soft and gradual resumption of normalcy. But it is essential that such a resumption be the goal of that pause. We all need to do our part to let the health system make it through the hardest, most intense period of critical cases. But the aim of public policy should be to have this period last weeks, not months; to let people keep their place while we go through it; and to enable a gradual, soft, uneasy return to work, school, commerce, and culture.
Some of what policy makers have already done has helped advance this cause, and some of it has been confused about its purpose. A clearer, well-articulated strategic framework for policy could help decision makers tell the difference, assess their options, make hard choices, and lead the way.