May 6, 2020

Should We Tone Down Social Distancing to Help the US Economy?


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This video was recorded on March 27. The transcript has been edited for clarity.

Hi. I’m Art Caplan, from the Division of Medical Ethics at the NYU Grossman School of Medicine. I’m speaking today in a special [at home] edition on the COVID-19 crisis.

I want to say a few things about this policy debate that has broken out between the economic damage caused by self-isolation/quarantine and the need to get a handle on this pandemic. Some people have been arguing.

The president has suggested that we have to get the economy humming again soon. Different governors, particularly the governor of Texas, suggested that we can’t stay cooped up; we have to come out and get the economy going again. Conservative economists have argued that the damage done by shutting down the economy is perhaps not worth the gains of staying isolated in quarantine.

I happen to think that the argument is specious, dangerous, irresponsible, and wrong that we need to get the economy rolling right now in the middle of a plague. It doesn’t make any sense. I’m not indifferent to the idea that there’s economic damage galore out there. There are plenty of people without a job. There are plenty of people who are worried about putting food on the table.

There are even people who are quarantined or isolated and are suffering psychological issues, such as those who are normally going to AA and can’t easily get to their meeting, or people who have mental illness issues for whom being alone in an apartment is not the best way to live.

There are real costs. I understand that. But this is a virulent viral plague that we’re just at the start of watching roar through our country, which could take hundreds of thousands of lives, by some estimates, if not contained. It could leave many of us sick and buckle the healthcare system completely as it gets overwhelmed with patients so that there’s no place for people with heart attacks or broken arms, or anything else, because the whole health system is broken down and the staff is totally infected and out of it.

We have to be able to go 30 days minimum to see where we’re at with respect to the spread of the virus. Minimum. Probably longer. Before we talk at all about starting up the economy or people coming out of quarantine, distancing, and isolation, we have to understand that this is not akin to the flu, as President Trump said. It’s not like tolerating car accidents throughout the year, as others have suggested.

This is something that surges. It causes thousands of people to show up [in hospitals] in days. We’re starting to see that in the New York City area, a little bit in New Orleans, a little bit in Los Angeles, and it overwhelms the healthcare system.

Flu and car accidents are spread out throughout the year. They’re terrible and we need to do more to prevent them, but they don’t all hit at once. This thing does. It surges. That’s why we talk about flattening the curve. If we don’t do that, then we get a gigantic flood of people like Italy saw, or we come out prematurely like Hong Kong did.

We’re going to have a tipped-over healthcare system and people sick everywhere. If we went back to work, we’d have to step over bodies to do it. If we go back too fast, we’re going to be contending with the epidemic not for months, but for years.

We may not get a vaccine on this thing. I hate to be grim about that, but we may not. We’ll see. I hope we do. But if we don’t, the only weapon we’ve got is isolation, distancing, and trying to manage the communicability and infectivity of the disease.

I don’t think it’s wise to tell anybody that maybe we’ll be out in 2 weeks. That suggests that maybe they don’t have to stay in at all if it’s only a 2-week thing. There are plenty of people who aren’t distancing and isolating already. We have to get them to do it, even though where they are they may not see any illness yet. But it’s coming.

The responsible thing to do is bail out our citizens, using this mighty economic engine of the United States, to get people some money to bail out the companies so that there are jobs to go back to after a month. We have to grit our teeth, bear it, and try as best we can to get through this without worsening the plague.

This is Art Caplan at the NYU School of Medicine. Thanks for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

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