American carnage

Epidemiologists estimate that around 70% of Americans would need to be infected before the population has achieved herd immunity

  
Drone pictures show bodies being buried on New York's Hart Island where the department of corrections is dealing with more burials overall, amid the coronavirus disease (COVID-19) outbreak in New York City, U.S., April 9, 2020.

Drone pictures show bodies being buried on New York's Hart Island where the department of corrections is dealing with more burials overall, amid the coronavirus disease (COVID-19) outbreak in New York City, U.S., April 9, 2020.

REUTERS/Lucas Jackson

BERKELEY – On April 23, 2020, the United States crossed the threshold of 50,000 confirmed COVID-19 deaths, making it the world’s worst-hit region. The US has half the population of continental Europe, but three-quarters as many daily deaths.

I am not an epidemiologist. But if I had to guess, I would say that after correcting for undercounting, the true number of US deaths that can be attributed to the coronavirus is closer to 75,000. Meanwhile, other countries have managed to put the daily number of new cases on a downward trajectory. If they keep it up, within a few months, they will reach the point where they can keep the virus more or less contained through vigilant testing, contact tracing, and isolation measures.

As of April 28, the daily COVID-19 death toll in Italy and Spain had fallen from above 700 to around 350. Germany, Canada, and Turkey appear to be turning the corner, with less than 200 deaths per day. Ireland’s daily toll looks unlikely to exceed 60 for now. Japan is at around 20 per day, Austria is at 12, and Denmark is at 10. Countries with single-digit daily death tolls include Norway and Greece (four), Australia (three), and New Zealand and South Korea. And no one is dying in Hong Kong.

As for the US, new confirmed cases per day have remained at around 30,000 for three weeks now, while COVID-19 tests administered per day have hovered at around 150,000 (with roughly 20% consistently coming back positive). The US thus appears to have stopped the epidemic’s acceleration within its borders: the average number of new cases stemming from each infected individual (R[t]) is no longer much greater than one.

But the ratio is not yet less than one. So, rather than fading away, the epidemic is chugging along at a steady pace.

In the absence of a vaccine, epidemiologists estimate that around 70% of Americans (230 million people) would need to be infected before the population has achieved herd immunity. If the virus turns out to have a 1% mortality rate, the eventual death toll would not be 50,000-75,000, but rather 2.3 million. And that is assuming that the US health-care system holds up under the strain of new cases. If it doesn’t, the death rate will rise from 1%, but to what? 2%? 3%? 5%? If it were 3%, the final nationwide death toll would be nearly seven million.

By contrast, if the epidemic was on the decline, we could begin to plan for what follows society-wide lockdowns: mass testing for the virus and its antibodies to determine who may already be immune. Those who are deemed resistant to the virus could perhaps receive green wristbands or some kind of digital token. They could be put to work doing essential jobs that involve human contact, while those who are still susceptible to infection would stay at home, wear face masks in public and keep six feet apart from others, wash their hands and wipe down surfaces frequently, and so on.

In this next stage, employment and the economy could begin to recover, and new cases would be kept down. The coronavirus will always represent a tragedy for the loved ones of the deceased, but in aggregate terms, it would become more of an annoyance – a risk to minimize until a vaccine arrives.

Unfortunately, America is nowhere near this more hopeful scenario. The epidemic in the US is not on the decline, and the Trump administration has given no indication that it will have the crisis under control within the foreseeable future. Instead, US President Donald Trump’s confidant and bagman, Rudy Giuliani, has dismissed the necessary testing-and-tracing protocol as “ridiculous.”

Worse, at a recent press conference, Trump himself suggested that the virus might by treated by injecting poisonous household chemicals, or by irradiating oneself with ultraviolet light (which happens to be how the behavior-altering parasites are killed in the 1967 Star Trek episode “Operation – Annihilate!”).

In response to these absurd utterances, mainstream media outlets such as the New York Times initially continued to abet Trump’s deadly rumor-mongering by implying that only “some experts” consider his quack musings to be dangerous. The Times later felt compelled to clarify that, in fact, no experts would argue otherwise.

Trump also reportedly greenlit a plan proposed by Georgia’s Republican governor to reopen that state’s economy. He has since backpedaled, arguing that it is “too soon” for a reopening, but the message to his political base has already sunk in.

Republican Governor Kristi Noem of South Dakota, a state that is quickly rising in the rankings of COVID-19 cases per million, claims that social distancing does not work, because “99% of infections” are happening not in workplaces but in people’s homes. Noem has denounced those in other states who would “give up their liberties for just a little bit of security.”

Like the US political system, the American public sphere is broken. Sadly, with Senate Republicans having already decided this past February that Trump’s high crimes and misdemeanors do not warrant removal from office, the US lost the last chance it had for sound, rational policymaking.

For now, the epidemic will grind on, claiming around 4,000 lives per day and sending the unemployment rate up to an unprecedented 20%. With a 1% mortality rate, 4,000 deaths each day means 400,000 new people per day encounter the virus and begin developing at least temporary resistance to it, which means that we will come 0.2% closer to herd immunity each day. In the meantime, things could change, perhaps for the better, but more likely for the worse.

J. Bradford DeLong, a former deputy assistant US Treasury secretary, is Professor of Economics at the University of California at Berkeley and a research associate at the National Bureau of Economic Research.

© Project Syndicate 2020

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