Ohio is opening back up. While our state garnered national and international praise for its initial handling of the coronavirus crisis, we have experienced some notable bumps in the road on the way towards reopening ranging from crowded patios that skirt rules in place to questionable definitions of “mass gathering” that seem to make such skirting unnecessary in the first place.
Probably most troubling for public health advocates and those threatened by COVID-19 during this phase of reopening is how nakedly political the process has been. While the swift enactment of social distancing measures in March operated under the auspices of scientific credibility, even the governor acknowledges the timing of the lifting of these measures has not aligned with White House guidelines for relaxation of social distancing measures.
To say we followed the playbook in March and threw it out in May, however, is wrong. There was no playbook in March. There was no national, White House protocol provided for promoting social distancing. There was no CDC guidance for what should trigger business closings and shelter-in-place orders in the face of a novel coronavirus or any other highly communicable disease for that matter.
While we like to think of pandemic response as a carefully-scripted play, in reality it’s a lot more like taping an episode of “Curb Your Enthusiasm,” where actors have a general idea of a plot but are making up their lines as they are hit with new conflicts in every successive scene.
That being said, the DeWine administration’s aggressive action against coronavirus was vindicated early. There was no formal cost-benefit analysis conducted prior to the administration’s decision to close large sectors of the economy for months, but subsequent national studies of social distancing measures all suggested that the national-level social distancing measures generate trillions of dollars in risk of death reductions and would almost certainly outweigh the severe economic damage they may create. Subsequent research studying the impact of stay-at-home orders seems to support this analysis, suggesting that stay-at-home orders had a significant impact on reduction of spread of disease in Illinois compared to no-stay-at-home Iowa counties across their border.
Both friends and foes of state social distancing measures have characterized the current moment as a conflict between public health and the economy. This, however, is a false dichotomy. We know that economic factors impact health at the community and individual level. We also know that health impacts economic success, whether it means taking off sick days today or missing school and losing out on human capital accumulation.
Ultimately, the DeWine administration is dealing with an uncomfortable truth: If we didn’t have a script for closing, we certainly don’t have a script for reopening. Sure, the White House has issued a series of recommendations based off an American Enterprise Institute report thrown together in the first weeks of Ohio’s stay-at-home order by a team headed by a former FDA administrator. This is better than nothing but still leaves a lot to be desired, especially considering that original report on how to reopen the economy had no economists among its five coauthors.
No script can’t mean no guidance, though. Policymakers need to listen to public health researchers who continue a familiar refrain: distancing, screening, treatment, vaccine. Ohioans should be asking if mass gatherings for weddings and graduations are necessary in the short-term. Ohioans should be asking why places like Vermont have universal COVID testing while Ohio doesn’t. Ohioans should be asking if we have enough ventilators so we don’t become the next Lombardy or New York City in the case of a second outbreak. And Ohioans should be asking what little things we can do to chip in to speed the development of a vaccine for COVID-19.
In the meantime, we need to preserve our economy, not as some abstraction that correlates with electoral outcomes for incumbents, but as a system that we use to get people things they need and want. This means measuring what matters comprehensively and using these measures to guide our policymaking. There is no tradeoff between economic activity and public health: They are two enterprises inextricably linked. It’s up to us to make sure they walk forward in tandem, supporting one another, with a script or without it.