Fauci, doctors warn Trump: It’s too soon to reopen for business

A sequel to this post from earlier this afternoon. One way to approach the question of “Should we reopen next week?” is to rephrase it this way:

If we’re going to reopen after two weeks, why did we shut down at all?

You might say, “Well, we slowed it down a bit.” Right — temporarily, for two weeks, with little change in U.S. capabilities between the start of the shutdown and the end apart from a modest increase in daily testing.

We forced millions of people to lose their jobs for that? If we’re going to tell Americans to go to work and assume the risk of infection, we shouldn’t have shut down at all. Let ’em keep earning those paychecks until everyone at their business is sick and/or dead and the business collapses because it can’t be staffed anymore.

Plus, if we hadn’t bothered shutting down, we wouldn’t need to worry right now about that $2 trillion relief package that Congress is debating. I thought that was going to be the first payment in a series to come, to support Americans while they’re being asked to stay home for a month or more while testing capacity improves and masks hopefully become more widely available. The feds would keep taxpayers going with checks plus relief for businesses while a strategy is developed to gradually reopen parts of the country. Areas with low rates of infection will go first, with frequent testing and contact tracing there, then areas with higher rates of infection will open up.

Does Trump have a strategy like that already in place for next week? Does he have any reason to believe testing will be ready by then in the capacity we need? That masks will be available? Or is the plan just to send people out there to take their chances — in which case, again, why did we shut down at all?

If he follows through with this, literally every doctor in the country next week will be shouting “BAD IDEA BAD IDEA BAD IDEA” into any microphone put in front of them. Starting with the doctors who are around him right now:

Fauci, a member of the president’s coronavirus task force, and other leading public health experts have told administration officials and Republican lawmakers that prematurely scaling back social distancing measures would hamper efforts to contain the virus and devastate U.S. hospitals, according to the people with knowledge of the conversations who, like others, spoke on the condition of anonymity to describe the private deliberations. More than 30,000 people in the United States have tested positive for coronavirus, a number expected to dramatically increase in the coming days and potentially overwhelm America’s health care infrastructure…

Public health experts are strongly warning against the idea of loosening social distancing measures. Marc Lipsitch, professor of epidemiology at the Harvard T.H. Chan School of Public Health and director of Harvard’s Center for Communicable Disease Dynamics, said “every well-informed infectious epidemiolist I know of” believes the United States should be tightening the restrictions.

“We haven’t yet even seen signs that the growth is slowing, much less reversing. Now is the time to tighten restrictions on contacts that could transmit the virus, not loosen them,” Lipsitch said. “If we let up now we can be virtually certain that health care will be overwhelmed in many if not all parts of the country. This is the view of every well-informed infectious epidemiologist I know of.”

Supposedly the administration is looking at options “such as whether people can go back to work if they are able to avoid public transportation, or if they can go back to work if they are not in areas with high infection rates.” Maybe age will play into it too, with older people asked to stay home. Although there’ll still be plenty of people at the hospital in that case.

Here’s another question related to “Should we reopen next week?”: If we do, how resolute will Trump be in sticking to *that* plan once the media is filled with apocalyptic reports about the scenes in U.S. hospitals? We’re destined to hear about some apocalyptic scenes in New York City soon either way but Trump can respond to those by saying that he and Andrew Cuomo have done everything they can think of to limit the damage. The president called for widespread social distancing; he and Steve Mnuchin are onboard with a massive fiscal relief package. He’s doing what he can, however belatedly, to put out this fire as it starts to burn. What happens once the policy changes, though, and he decides to risk letting it burn in the name of sending people back to work early? Media will be littered with comments from epidemiologists warning that we relaxed our measures way too soon. Lots of Americans will soon have firsthand experience with loved ones dying. The economy will tank anyway as deaths begin to thin out the labor force.

Imagine, say, a week of coverage like that next month. Or, if you want something less apocalyptic, imagine that the White House encourages only those states where the infection rate is currently low to go ahead and reopen for business — again, against the advice of every epidemiologist in America. Then, within three weeks or whatever, the infection rates there explode and suddenly local ERs are overwhelmed. Trump will be blamed. What does he do then? Does he … reverse the “reopened for business” policy and go back to condoning shutdowns? If so, how long will it be before he’s complaining about an economic slowdown in those states and starts thinking about reopening them for business again?

That is, when does this cycle of him underreacting, then supposedly “overreacting,” then underreacting etc end? I think his actions to this point (as in most things) are mainly a function of “What can I do at this particular moment to minimize my own blame for what’s happening?” In February the answer was happy talk about the threat from the virus and the health of the economy. He didn’t want to risk tanking the Dow by leveling with people; he spent too much energy over the past three years taking credit for the rising stock market to risk spooking it. Then the calculus changed: Coronavirus was here and it was spreading and it was serious, so suddenly he took it seriously and begin ordering shutdowns to limit the disease’s spread, which was both the responsible and the blame-minimizing thing to do. But now the shutdown is causing economic devastation and he knows who’s likely to bear some blame for that in November. So rather than stick to the responsible course of action and try to ease the economic pain with federal relief, he’s suddenly scrambling to limit his blame for the coming recession by reopening businesses too early.

And so I say again: What happens if people go back to work next week and infections explode while doctors howl that Trump moved way, way too soon? Whom do you think the public will blame for the mass deaths that result? And what will Trump do once that becomes clear to him?

The wrinkle in his “let’s go back to work” push is that lots of people won’t comply. His base may take their cues from him on all things, including epidemiology, but everyone else will be watching figures like Fauci and Scott Gottlieb for their cues on when it’s safe to go out again. That’ll slow growth. Some governors will also find themselves in a terrible dilemma over whether to contradict the presidential signals on whether it’s safe to reopen. It may be easy for someone like Gavin Newsom, whose home state is solidly blue, to defy Trump and keep California locked down. But Republicans like Mike DeWine who grasp the threat may insist on a prolonged shutdown. And Ron DeSantis might be truly stuck, torn between MAGA fans who want things reopened because Trump says things are more or less cool now and doctors who are screaming at him that it’ll be a cataclysm for the elderly to have people out and about spreading infection.

What if most governors just ignore Trump and maintain the lockdowns in the name of public health? If they do, what will Congress say when it comes time for a new fiscal relief package for residents of states where the shutdowns persist?

I sense from some of the grumbling online about Anthony Fauci today that he’s being set up as the fall guy in MAGAworld for the protracted economic pain. Fauci didn’t help himself by giving an interview recently in which he dared to suggest that our president often says things that are “unhelpful” (“I can’t jump in front of the microphone and push him down”). But before we blame this week’s unemployment numbers on him, let’s please note that there’s virtual unanimity among doctors and other experts that aggressive social distancing is the right move — including Trump’s own former head advisor on pandemics:

I continue not to understand what the “let’s get back to work” people imagine will happen to the economy if Trump starts relaxing restrictions next week. There’ll be an initial surge on Wall Street, hiring will restart, and then … what? What happens to the Dow and to GDP as the illness spreads and starts taking people out? What’s the “let’s get back to work” solution when millions are too sick to physically go back to the job? And I don’t just mean office workers. I mean cops.

But yeah, of course we can’t stay in a deep freeze forever. That’s why boosting detection in the form of more testing, urgently, is so important. Exit quotation from this depressing Times piece: “If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt.” Good luck with that.

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