A US administration whose incompetence is borderline criminal squandered the time bought by the experiences of China, Italy, and other countries instead of working seriously to prepare for what was coming. 1/n
We are now staring at the prospect of the US economy and society having to go into the type of lockdown that Italy has already been experiencing for days, with costly consequences of all types. 2/n
We all would have liked the US to start stockpiling test kits immediately, to prepare drive-through testing stations, to find the way to use technology, to implement the type of response that has been very successful in Korea. 3/n
Sadly, US authorities moved way too late and nothing short of a miracle will now prevent many large American cities and surrounding areas from finding themselves in the same situation as Milan and Lombardy, and the entire country from facing very difficult conditions. 4/n
For those of you who still don’t know it: Milan and Lombardy have a top-quality health care system. This virus has quickly taken it to the brink of collapse, straining ICU capability to its limits. US inaction will be paid for dearly with the pain and lives of many Americans. 5/n
Many out there are thinking a lot about the “here and now” of the response to the situation. I want to think about that too, but I also want to keep at least the medium term, if not the long run, in mind. 6/n
US authorities should work tirelessly to make sure that the lockdown the US is falling into is combined quickly with the Korean strategy of large-scale testing and use of technology. 7/n
The US (like other countries) will absolutely need the capability to rely fully on Korea’s approach once lockdown is relaxed and, eventually, removed. 8/n
I am no virologist, but what we are experiencing may well be only the first battle of a war against this virus, at least until a vaccine is widely available. 9/n
I am not going to be surprised if the war ends up consisting of cycles of apparent eradication of the virus (“Victoryyy!!!”) followed by new cases only a few months later (“Ooops!”). 10/n
Everything possible must be done to avoid cycles in which “Ooops!” quickly translates into new “Paniiic!!!” and lockdown. 11/n
The purpose of lockdown is to flatten the curve of cases and protect hospital capability while medical resources (ICU beds with ventilators!!!) are ramped up—a process that doesn’t happen instantly (God, we wish those morons in charge had used the time they had!). 12/n
It is imperative to preserve the viability of the health care system, because—let’s remember this—it must face not only #COVID19 but also remain in condition to continue taking care of a large number of other urgent cases. 13/n
But meanwhile, it is crucial to make preparations to implement Korea’s approach as soon as possible. 14/n
Will it work? Success in Korea was also the result of a culture, a way of handling social interactions, and respect for instructions from authorities that Western societies may not possess. 15/n
Maybe this disaster will have taught all of us that there are circumstances in which adjusting our behaviors significantly and even accepting intrusion into our privacy is really crucial for the good of everyone. 16/n
So, I am (to say the least) very skeptical of this administration, but I sure hope that plans and preparations for adopting the Korean model alongside the current strategy, and then for making it our main weapon in this war (until we have a vaccine), are already happening. 17/n
As for the economy, the costs of shutting down large parts of the US economy, if not most of it, even for a short time will be huge. 18/n
But they must be borne if the alternative is the complete collapse of US health care, with *much* larger economic and social costs in the longer run. 19/n
Everything possible must be done by policymakers to reduce the costs of what needs to be done now. Many colleagues have contributed their proposals. 20/n
The appeal below was written with Europe in mind. Leaving aside institutional specificities of Europe, I find that a lot of the appeal is extremely relevant also for the US.
voxeu.org/article/europe… 21/n
voxeu.org/article/europe… 21/n
I will add that this is a time for the US and Europe, and others, to set aside stupid trade wars and useless rivalries. This is a time for cooperation. 22/n
Finally, I also think we are living a time of incredible uncertainty, in which it would be dangerous and wrong for any policymaker to say “We will certainly do ‘X’ in ‘Z’ days.” 23/n
All governments should be making careful plans for multiple contingencies that may or may not happen, and they should communicate those plans clearly and coherently to the citizens of their countries. 24/n
If we succeed at preserving the viability of the health system, if we can remove the lockdown in a relatively short time and transition to the Korean model, and if this helps us consolidate battle victory into winning the war, 25/n
I think the costs for the economy will have been worth paying. All this assuming that policymakers will make good use of the resources at their disposal to minimize those costs. 26/n
Apologies in advance if it ends up that I do not reply to questions or comments on this thread. Like everyone, I am drowning in the circumstances created by this crisis. 27/n
Best wishes to everyone! Do all you can to protect your health and that of your loved ones. Heartfelt condolences to those of you who have already experienced the pain of losing a relative or a friend to this virus. 28/28
