Health, Human Rights, Politics, Populism

Stop Saying That Everything Is Under Control. It Isn’t.

Mar 17 2020

By The Editorial Board* – The New York Times

Tackling the pandemic will require a new, collective way of thinking about public health and society as a whole.

In 1941, with war tearing through Europe and Asia and America on the precipice of joining the conflict, President Franklin D. Roosevelt compelled and inspired industries and individuals to rally for the greater good. Food was rationed without rioting, and car plants all but stopped producing automobiles in favor of tanks and fuselages. By 1944, American factory workers were building nearly 100,000 warplanes a year — or about 11 per hour.

The United States is again faced with a crisis that calls for a national response, demanding a mobilization of resources that the free market or individual states cannot achieve on their own. The coronavirus pandemic has sickened more than 180,000 people around the globe, and claimed more than 7,000 lives already. Based on what they know about the virus so far, experts say that between two million and 200 million people could be infected in the coming weeks and months, in the United States alone. If the worst came to pass, as many as 1.7 million of our neighbors and loved ones could die. How many people are affected depends on the actions that we as a nation take right now.

Understandably, many American leaders have been focused on shoring up an economy that’s hemorrhaging money and trust. Many of the measures being advanced by Congress, like paid sick leave, are crucial. But the best hope for the economy, and the nation as a whole, is a strong public health response to the coronavirus.

Confusion has reigned, among health care professionals and laypeople alike, over when or whether to test patients, quarantine the exposed and isolate the sick — even over how worried to be. Part of the problem is a supply shortage that is already growing dire in some places. But another problem is the lack of consistent messages from leaders, President Trump in particular. For weeks now, clear statements — for example, that the worst is yet to come — have been undercut by blithe assurances that everything is under control.

It isn’t.

Wartime Production

Much of the country is facing a grave shortage of ventilators, intensive care beds, the equipment and chemicals needed for testing and all manner of medical supplies, including gloves, masks, swabs and wipes. More space is also needed to put these supplies to use healing patients. That means isolation wards for the sick and quarantine facilities for people who are exposed to the coronavirus.

A number of hospitals and state and local governments are working to secure those resources. Some cities and states have purchased hotels and turned them into quarantine facilities. Others are in bidding wars with one another for ventilators, I.C.U. beds and other essential equipment. If the current projections hold — and if countries in Europe and cities in China are any indication — neither these siloed efforts, nor the nation’s federally maintained stash of medical supplies, will be enough to face what’s coming.

Worse still, pitting states against each other for limited and essential supplies leaves poorer states at the mercy of the rich ones, and the states hit first against those that will be hard hit in the coming weeks. Yet on Monday, Mr. Trump told a group of governors desperate for equipment like ventilators, “Try getting it yourselves.”

Instead, the federal government needs to step in to dramatically ramp up production of all these goods, just as it ramped up production of munitions during World War II. That will likely necessitate the use of the Defense Production Act, a law that enables the president to mobilize domestic industries in times of crisis. President Trump has not demonstrated the democratic instincts or administrative competence to inspire the confidence that he ought to be trusted with even more executive authority. But he’s the only president America’s got, and this crisis requires White House action. It’s not hard to imagine, with proper organization and support, American factories producing ventilators, masks, hand sanitizer, coronavirus tests and other medical equipment at a scale that would meet what the crisis demands. But it won’t happen overnight, and it certainly won’t happen without leadership.

“We could increase production fivefold in a 90- to 120-day period,” Chris Kiple, chief executive of Ventec Life Systems, a Washington State firm that makes ventilators used in hospitals, homes and ambulances, told Forbes last week. Kiple estimated that current worldwide production capacity for ventilators is about 40,000 a year.

The government will also need to deploy the National Guard or the Army to convert facilities like convention centers, hotels and parking lots into testing sites, isolation units and humane quarantines.

In the absence of government leadership, companies can still take it upon themselves to help the effort. In France, for example, LVMH, which owns luxury brands like Louis Vuitton and Christian Dior, announced Sunday it was repurposing perfume production lines to make hand sanitizer and other anti-viral products.

Front-Line Fighters

Once supplies and space are secured, human capacity will need to be addressed. There are not enough health care workers who are trained and equipped to treat emergent, contagious lung infections in intensive care units. If those workers fall ill and are themselves quarantined and isolated — as some of them almost certainly will be, given the present lack of protective equipment — more will have to be trained and prepared.

That challenge will be exacerbated by the fact that large conferences and training sessions are likely to be verboten in the months ahead. The federal government can help by conveying the urgency of the need — and calling on health care workers to volunteer for such training — and then by creating the necessary virtual modules and webinars.

Federal leaders can also help by calling on states to waive licensing requirements for out-of-state medical workers, as Massachusetts has already done. There will not be one giant outbreak here in the United States, but rather many smaller ones that will vary in scope, size and duration. That means some parts of the country will have much greater need than others. The ability of any worker to deploy quickly from a low-need area to a high-need one will save valuable time as the number of confirmed cases surges in the days ahead.

Public Works for Public Health

During World War II, housewives, students, retirees and the unemployed moved into the labor force to help build tanks, planes and armaments. It was a full-scale national effort — and something similar is called for today.

This will take some creativity. In Spain, final year medical students are being pulled into clinics and hospitals for more routine tasks to allow staff to focus on critical cases. In the United States, retired hospital workers are being urged back into the work force to provide needed expertise.

But the larger community can also pitch in. The government could train America’s newly unemployed to sanitize hospital equipment or to deliver food to the elderly and the immune-compromised. Child care for hospital workers on the front lines is desperately needed. Through a new public works program, corps of people could implement infection control in nursing homes and other high-risk facilities — or teach workers of all kinds how best to protect themselves. There could even be a network of individuals tasked with making phone calls to combat loneliness for people in nursing homes and prisons while they’re unable to receive visitors.

These are just a few possibilities for putting people to work confronting the crisis, to be sure. Any such programs stand a much better chance of success if the federal government encourages them and directs them through the Centers for Disease Control and Prevention.

A Clear, Strong Call to Action

In recent days, the president has begun calling on industry leaders to help: to develop vaccines, diagnostic tests and treatments for the virus, to develop websites that might clarify and expedite testing and to cede their parking lots to the needs of the public.

It’s time for him to call on the rest of the country as well. Not just to scrub hands and forego basketball games, Broadway shows and the local bar — but to meet this moment with urgency and altruism. Many Americans are anxious to help their fellow citizens. Would they ration their own consumption to help save them, if that’s what things came to?

During World War II, the American government raised corporate and personal income taxes, pushed the business community onto a wartime footing, drafted millions into the military or civilian defense forces, rationed civilian goods in service of military goals and drastically reorganized society by offering jobs to women and minorities who had long been excluded from them. The society that emerged from the war was different — stronger — than the one that went into it.

It is remarkable what the country can do when the lives of its citizens are in peril, and the final outcome is uncertain. What it takes is leadership to summon that spirit to act in the national interest. March 17, 2020

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*The Editorial Board is a group of opinion journalists whose views are informed by expertise, research, debate and certain longstanding values. It is separate from the newsroom.

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