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The agonizing tradeoff between the disease and the cure

Economic calamity or human tragedy? Health specialists say President Trump’s fixation on setting a fixed date to reopen for business, especially one just weeks away, is wrongheaded when we still know so little about COVID-19.

Vice President Mike Pence and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, listened to President Trump during a news conference at the White House Tuesday.Doug Mills/The New York Times

What is the price of normalcy: 100,000 deaths, or 1.1 million?

How many lives should we put at risk to prevent the worst economic collapse since the Great Depression?

This the central question President Trump put on the table Tuesday when he said that he’d like the country “opened up and just raring to go” by Easter. It’s the stuff of Philosophy 101, except real lives — and livelihoods — are on the line.

His wrongheaded fixation on a specific date has turned attention away from discussing ways to improve our coronavirus strategy — starting with getting a better handle on the fight we’re in.


A model developed by experts at Imperial College in London suggests that as many as 1.1 million people in the United States could die within year if authorities don’t move quickly and more aggressively than they have to contain the spread of the novel coronavirus. Conversely, a Beijing-style national home confinement could sharply limit the death toll, but last into the summer.

“If the United States intervenes immediately on the scale that China did, our death toll could be under 100,000,” Ezekiel J. Emanuel, vice provost of global initiatives at the University of Pennsylvania,” wrote Monday in The New York Times. “Within three to four months we might be able to begin a return to more normal lives.”

For Trump, the trade-off to the economy is too costly. Otherwise, he said, a “massive recession or depression” that would cost even more lives and lead to “instability.”

Public health experts dismissed Trump’s Easter deadline as reckless. It would require cities and states to lift drastic but necessary restrictions they put into place to slow the spread of the coronavirus while the pandemic was still raging. Surging deaths and an overwhelmed health system would wreak economic havoc.


Even Trump’s coronavirus advisers tried to walk back his comments.

But no one dismisses the severe economic damage already being caused by the stay-in-place and social-distancing measures ordered by states including Massachusetts, New York, and California. Yes, Wall Street is getting pummeled, but so is Main Street, and millions of Americans could soon be out of work.

Is three or four months of home confinement across the country our only option?

Perhaps not, even if Trump’s Easter rebellion is doomed to fail.

The fight against coronavirus has been hampered by the lack of comprehensive data. Experts are still not sure how fast it may spread through the country and how many deaths it will cause. That has left political leaders and public health officials little choice but to err on the side of extreme caution.

“We need really good data on who has the disease — their ages, their gender, their conditions, morbidity rates,” said Brad Cornell, a consultant and emeritus professor of finance at the University of California Los Angeles. “And we need all the testing we can get and data on who has recovered and could go back to work.”

That data could be available, and the number-crunching started, in a matter of weeks, not months, Cornell said. Then mayors and governors could within weeks begin making informed trade-offs between choking off the virus and giving the economy some breathing room.

“I am sure it will be somewhere in the middle” he said. “The million-dollar question is where in the middle.”


Cornell is a business guy, not an epidemiologist. What do the medical pros say?

Respected Trump adviser Dr. Anthony Fauci said Tuesday that blanket restrictions across the country aren’t necessarily the only approach. Parts of the country with relatively minor outbreaks could return to normal faster than hot spots such as New York City.

“You may not want to essentially treat it as just one force for the entire country, but look at flexibility in different areas,” Fauci said at the White House. “So I think people might get the misinterpretation you’re just going to lift everything up. … That’s not going to happen. It’s going to be looking at the data. And what we don’t have right now that we really do need, is we need to know what’s going on in those areas of the country where there isn’t an obvious outbreak.”

But, Fauci has yet to commit to a timetable.

Fauci has become adept at maneuvering around his boss’s blunders, but his comments are more than damage control. They suggest that containing the COVID-19 isn’t necessarily a one-size-fits-all-the-country solution. What worked in China isn’t the perfect model for the United States.

“Every sector of society would like to hasten the easing of the current restrictions, and for many good reasons,” said Dr. Robert W. Amler, dean of the School of Health Sciences and Practice at New York Medical College. “It seems too early to tell how much longer the rising tide of cases will obligate us to continue these restrictions ... but I do believe it is vital to reassess the situation on a daily basis and consider the pros and cons of alternate strategies at every juncture.”


Pretending the worst is over by throwing a national Easter party would only deepen the human and financial toll of the pandemic. But that doesn’t mean it’s inevitable that we will all be stuck at home until July 4.

Larry Edelman can be reached at larry.edelman@globe.com. Follow him on Twitter @GlobeNewsEd.