Project Syndicate: The Trump Administration’s Epic COVID-19 Failure https://www.project-syndicate.org/commentary/trump-covid19-testing-failure-by-j-bradford-delong-2020-03: 'Whereas many other countries afflicted by the COVID-19 pandemic have pursued mass testing, quarantines, and other measures to reduce community transmission, the Trump administration has simply dithered. Although America could still shut down for a month to overcome the crisis, the sad truth is that it won't. BERKELEY—Even to US President Donald Trump’s most ardent critics, his administration’s disastrous response to the COVID-19 pandemic has come as a surprise. Who would have guessed that Trump and his cronies would be so incompetent that merely testing for the disease would become a major bottleneck?
When the Chinese government shut down Wuhan on January 23, quarantined another 15 cities the next day, and then extended a nationwide social-distancing mandate until the end of the Lunar New Year, it was clear that the world was in trouble. By as early as January 31, Western health officials—including Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases—had acknowledged that the coronavirus could be transmitted by people without symptoms.
As officials at the US Centers for Disease Control and other public-health bodies surely must have recognized, asymptomatic transmission means that the standard method of quarantining symptomatic travelers when they cross national (or provincial) borders is insufficient. It also means that we have known for almost two months that we were playing a long game against the virus. With its spread more or less inevitable, the primary task was always to reduce the pace of community transmission as much as possible, so that health-care systems would not be overwhelmed before a vaccine could be developed, tested, and deployed.
In the long game against a contagious virus, how to mitigate transmission is no secret. In Singapore, which has largely contained the outbreak within its borders, all travelers from abroad have been required to self-quarantine for 14 days, regardless of whether they have symptoms. In Japan, South Korea, and other countries, testing for COVID-19 has been conducted on a massive scale. These are the measures that responsible governments take. You test as many people as you can, and when you locate areas of community transmission, you lock them down. At the same time, you build a database of all those who have already developed immunity and thus may safely resume their normal routine.
In the two months since the threat of a pandemic became obvious, the United States has tested an estimated 484,062 people—South Korea has tested tens of thousands in a single day. There has been no nationwide random-sample time series constructed for the US. Many people who have shown up in health-care settings with symptoms have not been tested, and have instead been sent back into the community. Judging by the rate of growth in the number of reported cases, the US has performed worse than any other country, including Italy, Spain, and possibly even Iran.
Worse, the 80,000 cases reported in the US (as of March 26) are just the tip of the iceberg. From the 1,046 US deaths so far recorded, we can infer that 15,000-50,000 cases were active at the start of March, and that this figure will reach anywhere from 120,000 to one million in the next week. But that is just a guess; in the absence of testing, we really have no idea where we stand.
As such, the US has few options. The longer the government delays imposing a Wuhan-style lockdown, the less effective future social-distancing measures will be in the weeks and months ahead. Trump and Secretary of the Treasury Steven Mnuchin appear to want to roll the dice, placing an existential bet on America’s future by hoping that the pandemic will peter out with warmer weather. A more likely outcome is that many states’ health systems will collapse before that happens, leading to a spike in the COVID-19 mortality rate as the number of symptomatic cases soars—perhaps to as many as 50 million—in the coming months.
This potential disaster is entirely unnecessary. A lockdown could be rolled back within just three or four weeks if it is properly implemented. During that time, the public-health system could do its job: testing a random sample of the population, tracking the contacts of those with symptoms, and resupplying an already sapped health-care system while scaling up efforts to develop a vaccine and more effective treatments.
After a month or so of this, the businesses that were functioning as of March 1 could probably restart. The policy response could ensure that nobody loses their livelihood as a result of anything that happened between March 1 and May 1. In the meantime, the production and distribution of medical tests, food, utilities, and activities that do not involve human contact would represent the full extent of the economy. Absolutely everything else would be temporarily shut down.
After a month would come a Jubilee: the government would assume all debts incurred during the shutdown, sparing businesses from bankruptcy. The significant increase in government debt would then justify a highly progressive tax on income and wealth, both to reassure investors that long-term public finances are sound, and to recoup some of the unearned gains of those who have managed to profit from the lockdown.
Unfortunately, what the US should do is not what it will do. The country is desperately short of tests and other critical supplies, and the Trump administration has shown no inclination to do anything about it. Here in Berkeley, hospitals are running short of surgical masks and asking for donations. Their plight is symptomatic of an underlying condition that has inevitably aggravated the current public-health crisis.
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