Consider This from NPR - The Cost Of Social Distancing

Episode Date: March 23, 2020

How do officials weigh the economic cost against the public health benefit? Plus a report from the hardest-hit area of Italy, and a sampling of free things that you had to pay for before the coronavirus. Planet Money's episode 'How To Save The Economy Now' is here. Here's a list of things that weren't free before the coronavirus from NPR's Brakkton Booker. Email the show at [e-mail]. This episode was recorded and published as part of this podcast's former 'Coronavirus Daily' format.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

For many of us in the United States, this is the beginning of a second week of social distancing, the halfway point in the president's 15-day plan to slow the spread of the virus. But are enough people taking it seriously? I want America to understand, this week, it's going to get bad. U.S. Surgeon General Dr. Jerome Adams said this morning on the Today Show that if you or someone you know has not been staying home, it is time to start. You just see it looking in California, people on the beaches. You see it in Washington, D.C., the people out looking at the cherry blossoms.

We need to take this seriously. But the economic impact is also weighing heavily on the White House. At the end of this 15 days, we're going to get with our health experts. We're going to evaluate ways in which we might be able to adjust that guidance for the American people. But those measures right now, we're all in the belief that we could impact the trajectory of the curve of the coronavirus.

More about the economic cost of social distancing coming up. Also, the high cost Italy is paying for not moving fast enough. I'm Kelly McEvers. This is Coronavirus Daily. It is Monday, March 23rd. Okay, so picture a pile of $1 million. And now picture a million piles of $1 million each, and then take all of that money and double it. That would be $2 trillion, or what the economic rescue package that's currently being negotiated in Congress could add up to. Who gets that money and what would need to be repaid

is what's being debated on Capitol Hill right now. The final package is expected to include cash payments to individuals and families, more money for unemployment insurance, aid for hospitals, and bailout cash for airlines and hotels. But what is super important about all this is that it happens fast. I mean, if the government is going to try to vet thousands of small businesses, tens of thousands of small businesses to determine, is your coffee shop shut because of the virus? Or is your coffee shop shut because you make bad coffee? If they try to make those distinctions, it's going to be way too late. Neil Kashkari, president of the Minneapolis branch of the Federal Reserve, ran the last big economic bailout, TARP, in 2008 for big banks and car companies. The American people were angry about bailouts and they said, we don't want our neighbor who is irresponsible getting a bailout.

So we had lots of screening criteria. Well, because of all that, very few homeowners actually got helped by all of our programs. And in my opinion, the housing downturn was more severe than it needed to be. And so today, Kashkari says, one of the best ideas might be one lawmakers are already considering. And that is to simply send checks to Americans. And maybe it's $1,000 to everybody below a certain income level. And then if the virus perpetuates for months, you do it again next month and you do it again next month. And then you recognize some people are going to get it and they're not going to need it or they're not going to spend it.

And that's OK. You just have to be OK with that. Because if you take the time to try to figure out who really needs it, it's going to be too late. Basically, just carpet bomb the country with money. Yes. Neil Kashkari talking to Jacob Goldstein of NPR's Planet Money. The story comes from an episode called How to Save the Economy Now. You can find a link to the podcast in our episode notes. So the reason the government is talking about such a massive amount of money

is, of course, because the economy is scree about such a massive amount of money is, of course, because the economy is screeching to a halt. To slow the spread of this virus, we are staying home from work, school, restaurants, bars, stores, libraries. We are staying home from everywhere. Non-essential businesses and government services have been ordered closed in many states. But how long can we keep this up? And what will be the cost? Morning Edition host David Green put these questions to NPR's global health correspondent, Narit Eisenman. So you've been talking to people who actually research this kind of thing, social distancing. I mean, what are they thinking about here when it comes to the trade-offs we're all making?

Yeah, there is a lively discussion underway. One influential researcher of disease prevention, Dr. John Ioannidis of Stanford University, published a provocative editorial. His take is that, okay, these social distancing measures might be warranted in the very short term, given that we're in an emergency. We've seen what happened in China and Italy, the spike in infections, their hospitals overwhelmed. So we're trying to move fast to avoid that. But Ioannidis says the world also needs to start thinking very soon about the cost of these preventive measures. So you're saying like these preventive measures have caused businesses to shut down. And that means people unemployed.

And that means the unemployment rate going up. I mean, there are real impacts here. Exactly. And that then leads to all sorts of other health problems, suicides, diseases that are related to poverty. Here's Ioannidis. I'm not saying that we should not do everything that we can, but we should be very careful and measure very carefully what we're doing and what we are achieving with that. Because we are risking billions of lives while what is at stake may be, at the worst scenario, millions of lives. So he's actually saying that these strict measures could end up harming more people than we save from coronavirus. Right, worldwide.

But then other people who study this point out that, look, some models suggest that if we don't take the strict action, as many as 2 million Americans could die. And the ramifications of that many deaths to our economy, to our health care system will extend way beyond just the COVID-19 casualties. One of the thinkers in that camp is Danielle Allen. She directs the Edmund J. Safra Center for Ethics at Harvard University. If your health system collapses, a lot of other problems of social collapse follow. This pandemic is so significant that it is much better to analogize decision-making to what you would have in the context of a war. I mean, I've heard this analogy that we need to be on a wartime footing, but does that really

change anything? Yeah. Allen says that it means that you ditch the usual method that we use for deciding what public policies to pursue, the way of tallying up costs against benefits. She argues that instead, when you're on a war footing, you get into this triage mode. You identify your top priority, which in this case, it really is the preservation of our health care system. She says if it collapses, our society is in peril. And so you keep that as your focus while you find creative, but maybe less than ideal workarounds for keeping up all the other services that we need, education, business. So I want to ask you the question. I feel like it's the impossible question, but everyone seems to be asking it right now. How long will this last? I mean, when it comes to the social distancing,

how long might this go on? You know, I'm hearing a range of opinions. On the more optimistic side is Dr. Ashish Jha. He's professor of global health at Harvard Medical School. He says right now the U.S. is playing catch up. There still aren't enough tests. Hospitals are going to have to really ramp up their capacity to provide intensive care. But he says once the U.S. gets to that point, let's have a listen. I don't see the need for nationwide lockdowns for any extended period of time. You can imagine short periods where if it starts circulating at high levels, we may have to intervene. But my guess is we can, once we get ahead of it with testing, isolating people who are sick, we have a lot more tools at our disposal. But other people I spoke to were less confident, including Mark Lipsitch, who is also at Harvard,

and he's part of a team who run models that suggest as soon as officials lift the social distancing, the virus flares up again, and they'll need to impose social distancing all over again. That was NPR Global Health correspondent Narit Eisenman talking to Morning Edition host David Green. The consequence of piecemeal action by governments is clear in Italy. It is also devastating. The Italian government started by isolating towns and then regions. And on Saturday, the government shut down all factories and non-essential production and urged everyone to stay home. But still, the virus spread.

More than 1,400 people died just over the weekend. NPR's Silvia Poggioli reports that even cemeteries are overwhelmed. This video shows large army trucks moving through the town of Bergamo in the dark of night. They're carrying coffins that have been piling up unburied in the city cemetery to other towns. Bergamo's crematorium, even working non-stop, can't handle more than 25 bodies a day. Bergamo has a population of 120,000. Obits in the local daily used to take up a page. Now they fill at least 10. The numbers of deaths are unimaginable,

says Francisco Aleva, spokesman for the town mayor. But he stresses the city is handling them with dignity. Brother Mario, an 80-year-old Capuchin friar, says Aleva, blesses each coffin before it's loaded on a truck. Even in this emergency, we want to show respect for the deceased and for the religious beliefs of the living. The situation in Bergamo hospitals is dire. Images broadcast on Italian TV show medical staff wearing hazmat suits, scrambling in waiting rooms turned into ICUs, while patients are gasping

for air. In desperation, Stefano Fagioli, head of the medicine department of Papa Giovanni Hospital, turned to social media. Our health personnel, nurses and physicians are working round the clock, countless hours, to fight this incredible situation. We do not know how long this pandemia will last. A major TV channel posted a video diary of an unidentified doctor at Treviglio Hospital, also in Bergamo. Speaking emotionally, the doctor says a 47-year-old man with severe breathing problems was brought in last night. My father-in-law just died of this virus, the man told me. It's my turn, so doc, my life is in your hands. I made a pledge to that man, the doctor adds,

I'm not sure I can keep. That was NPR's Silvia Poggioli in Rome. All right, so it has been one week since the White House urged all Americans to stay home, if possible. If you've been able to do that and you have burned through your first batch of books, TV shows or music, over at NPR.org, we have compiled a list of things that are now free that weren't free before the coronavirus. The Seattle Symphony and the Metropolitan Opera are offering online performances. Ivy League schools are making hundreds of courses available free online. You can download the Gold's Gym app for free, and some paid yoga sites like Core Power Yoga and Down Dog have select classes available. And if you are missing sports, the NHL, the NBA, and the NFL are all making some past games available online to stream. And a favorite in my household, Ken Burns' documentary Baseball is now free to stream from PBS.

There is a link to the full list with even more stuff in our episode notes. We will be back with another update tomorrow. Until then, keep up with all of NPR's coverage at npr.org or by tuning in to your local public radio station. I'm Kelly McEvers.