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Thursday, March 19, 2020

Coronavirus public policy

I have no public health expertise (e.g. MPH), I'm just thinking out loud here:

1. As far as public policies go, I think it's a bad idea to have a one-size fits all policy. I think it's better to tailor a policy to certain locales. Some locales might have low risk of coronavirus transmission while others are hot zones of coronavirus. As Steve has pointed out in the past, we should treat like cases alike, but unalike cases unalike.

2. What's more, there'd be less harm to our economy overall if many or most places can keep things "business as usual". For instance, not that I'm necessarily advocating this, but I'm at least using this as an illustration: if only impacted areas in a city shut down, but other areas remain open, then the city could still be productive and our economy less hurt overall vs. the entire city on lockdown.

3. I guess there's a tradeoff between how much we should take preemptive measures vs. how much we should take reactive measures. Perhaps there's no need to take preemptive measures if there's zero evidence of anyone sick with the coronavirus in the area. Perhaps places with no evidence of coronavirus can get ready so if there is eventual evidence of coronavirus in their community, then they can react with speed and purpose.

4. People argue there could be asymptomatic coronavirus carriers walking around in our communities. However, should we take preemptive actions like closing down stores and restaurants for this possibility? Isn't that sort of like worrying there could be a serial killer in one's community, therefore shut down everything, and let's start a man hunt?

Granted, it's an imperfect parallel. For one thing, there (hopefully) aren't many serial killers as a percentage of the population, whereas I've seen high percentages of how many could be asymptomatic carriers. Still, I presume that would more likely cluster rather than be diffused across the entire nation. More likely be nearer to where the outbreaks and hot zones are rather than across the entire country or even regions of the country. At least at this point.

Of course, if the virus has spread across the entire country, then that may call for different strategies. My concern is people are already fearing this without hard evidence of this. My concern is we're getting ahead of ourselves. My concern is that people are acting like there's an asymptomatic carrier hiding behind every tree or bush when that's not entirely clear to me.

5. At most, if we want to take preemptive measures, then why not far less dramatic or drastic preemptive measures? For instance, point-of-care testing at clinics alongside wider surveillance of affected regions. Stuff like that. And otherwise more or less business as usual.

2 comments:

  1. I dunno. Looking at the J-curve on this thing and a current calculable mortality rate of about 4.1% (I say calculable because clearly the actual infection rate is higher than known) it may not be much of an overreaction.

    Or maybe it's a massive overreaction and we're burning down the global economic house to deal with the termites.

    It's the fog of war analogy.

    Many unknowns, many decisions made with only the data available. Ad hoc adjustments to an invisible enemy that has infiltrated behind our lines and has donned our uniforms.

    I thought the post "Destroy the Village to Save the Village" was an instructive counterpoint, but it seems to be a "damned if you do, damned if you don't scenario".

    Competing voices, competing models, competing agendas. What's the top, the secondary, the tertiary priority? Public health? The economy? Partisan gamesmanship and posturing?

    One can't but help admire the sheer beautiful, chaotic complexity of it all.

    It's as it were our generation's "War of the Worlds" sprung to microscopic life (assuming one grants virusus are "alive" in any meaningful sense of the word). If only Orson Wells were here to give it voice.

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    1. All I really want to say is I love the analogies you've made and the images you've crafted in this reply, CD (e.g. War of the Worlds, fog of war). :)

      I totally agree there are a lot of unknowns. Lots of limited data. And the like. I guess time will tell.

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