The Partisan Politics of COVID-19
Note: I didn’t particularly want to write another blog post about coronavirus, but what other story is there right now? It’s all anyone is talking about and apparently all anyone wants to read about as well. My previous blog post on coronavirus is approaching 2,000 views — more than 4X my second most popular article. So here’s my take on the latest developments.
As we come to grips with the widespread implications of our societal response to COVID-19, it has been notable how the pandemic has been politicized by both sides. Past times of crisis have brought the country together, unifying us to face a common adversary. That has not happened this time. Perhaps this isn’t surprising considering this administration could turn the weather into a deep-state, left-wing conspiracy theory. (Sorry, that was political.)
Like every other topic, COVID-19 is getting distorted through a political lens of blue vs red.
The difference in perception based on political persuasion may also be a result of the pandemic hitting so-called ‘blue states’ harder than ‘red states.’ As of this writing, the top three states for coronavirus deaths, Washington (83), New York (56) and California (24), each blue states, had more than double the 77 deaths in all 30 states that voted for Trump. Santa Clara County alone has 196 cases and 8 deaths. That’s more than the death totals in every single red state except Florida, Georgia and Louisiana. It’s easier to believe the virus is a liberal plot when it’s not happening in your neighborhood.
But I believe the main reason this issue has become a political lightning rod is the different ways liberals and conservatives think about risk trade-offs. There is no doubt that, if we manage to avoid the most calamitous projections of this virus, it will be in no small part due to the swift, extreme actions we are collectively taking to “flatten the curve” of infection. In times like this, it often pays to expect the worst — even to be alarmist. Doing so elicits the reaction we need as a society: to knock people out of their complacency and radically change their behavior. Like buying every single roll of toilet paper in a three state radius.
But all these actions, taken in the name of reducing the toll of the epidemic, also have a cost — the costs of being "on the safe side.” Conservatives tend to measure these costs in dollar terms. There have been numerous media stories about the economic impact of coronavirus avoidance measures — the precipitous drop in the stock markets, the decline of business activity, the despair of local businesses forced to temporarily shut down. A conservative considers the economic impact pragmatically — “why are we hurting our entire economy over a bad flu season?" A liberal hears that and interprets it as callous - “you can’t put a price on a human life.” The response from blue state leaders doesn’t even really weigh the economic costs. Tacitly, the policy is no price is too great to pay to save lives.
What is derailing our policy response into the usual blue-vs-red ditch is that we lack a consistent framework for thinking about the trade-off. We have deaths on one side and dollars on the other. To truly compare risk to response, we must convert the economic downturn into its human cost. When the economy goes down, people don’t just lose money, they die. The policy question we must answer is what will cost more lives — the reaction to COVID-19 or the virus itself?
Calculating this trade-off is difficult. Actual deaths from the virus are the easiest and most reliable variable to measure — a number that currently stands at 12,755 deaths worldwide and 278 in the US (latest numbers here). Of course, what matters is the forecast of total deaths which vary so widely, it’s hard to know what to believe. But even with a relatively modest assumption of 15-20% infection rate and 0.5% mortality rate (you can vary those assumptions yourself here), COVID-19 could kill as many as 300,000 Americans this year, more than every other disease except heart disease and cancer.
Estimating the loss of life on the other side of the equation is even more difficult because these deaths will largely be indirect and require bigger assumptions to forecast. That said, we can learn from the 2008 economic crisis to identify several ways our response to coronavirus itself could cost lives, including:
Under-response to other health conditions — most hospitals are already responding to coronavirus by discharging low-risk patients, postponing routine procedures, and declining to admit patients with minor symptoms. Every person who doesn’t go to the hospital due to chest pains that turn into a heart attack, or who delays a CT scan that could have detected a tumor early enough, is a death that should be attributed to the COVID response.
Loss of health coverage - unfortunately, when people lose their jobs, they often lose their health insurance. An estimated 5 million people lost their health insurance in the 2008 financial crisis. Granted, that was before the ACA, so it’s more likely people can keep their insurance now. But many people will die because they can no longer afford the treatment that would save their lives. One research study published in the Lancet estimated an admittedly difficult-to-believe 500,000 additional cancer deaths after the 2008 financial crisis.
Increased health risk — It is very likely that an extended period of self-isolation will have deleterious effects on both our physical and mental health — from increased depression, anxiety and obesity, to increased smoking, alcohol and drug use. A University of Oxford study attributed 10,000 suicides linked to the 2008 recession.
Violence resulting from economic uncertainty — with layoffs from the corona crisis already happening (the Labor Department reported a spike of 281,000 jobless claims last week alone, a weekly increase of 30 percent!), we can expect to see correlating incidents of workplace violence, as happened in 2008. Though such acts tend to be isolated incidents and are impossible to correlate or forecast, they will happen. A prolonged coronavirus quarantine could even lead to wider civil unrest. With concerns about looting and other opportunistic crimes already driving a reported increase in gun sales.
Whether the cumulative toll of these indirect causes of death reach anywhere near the number of deaths we will endure from the virus itself seems unlikely. Certainly, in Italy, which now exceeds China in total deaths with 4,825, over 700 of which happened yesterday alone, the argument in favor of prudence is indisputable. At the current US casualty rate, however, the numbers in each column may be closer. Regardless, we cannot allow our response to this crisis to become colored by our red and blue teams. We need true leadership and strong institutions now more than ever. But even if our politicians fail us, now is a time to come together, to balance the risks on all sides, to err on the side of caution yet not over-react, and to help each other. So stay safe, stay healthy, and stay optimistic. Don’t let this virus further divide us.