Reopening, Political Parties and Deadly Tradeoffs

To date in this pandemic, American institutions have failed to insure safe working conditions for those on the front lines of the pandemic. They have failed to protect the elderly, the disabled or the chronically ill from this outbreak. They have failed to stand up the adequate tracking and tracing capacity needed to identify and stop future outbreaks.

As citizens — who are supposed to bear some nominal responsibility for those institutions — these failures seem to confront us with a deadly, and damning, tradeoff.

Progressives have correctly argued that “reopening the economy” effectively sacrifices the lives of many of our fellow Americans. The disease’s impact thus far indicates whose lives would be lost to a headlong return to work. In conditions of community transmission, working outside the home increases infection risk. When more recalled workers unknowingly bring the virus back to a crowded home or apartment building, the risk grows further. Insofar as the working class in our cities is disproportionately black and brown and more likely to live in crowded living conditions, the virus will continue to strike hard in these communities.

We can expect, then, that many of the neighborhoods hit hardest by the initial wave of coronavirus will continue to be decimated in a reopened economy. But now, the contagion is also beginning to strike the small towns and rural areas that escaped the first few weeks of the pandemic. In the months ahead, more Heartland nursing homes, jails, prisons, and meatpacking plants will experience outbreaks. In turn, their workers will bring the contagion back home to their families and to communities that lack the public health and health care capacity to manage outbreaks.

But this progressive narrative only tells one side of the story.

Conservative proponents of reopening have their own point. Secretary of Health and Human Services, Alex Azar, took to the pages of the Washington Post to argue this “isn’t about balancing health vs. the economy. It’s about balancing health vs. health.” He concludes we “cannot allow the virus to impose intolerable costs in terms of drug, suicide and alcohol deaths; forgone health care; and more lost jobs.”

When you look at scientific evidence, he’s right.

Job losses are associated with risk of suicide, addiction and domestic violence. The unemployment associated with the Great Recession contributed to the epidemic of addiction and overdose across the country and particularly in the regions that handed victory to the current President in 2016. The difference between a quick economic recovery and a more extended recession could be measured in tens of thousands of lives. So insisting on continued lockdowns could end up sacrificing the lives of these citizens just as a too-rapid reopening would for others.

Framed in this way, it is as though each party were demanding that the other party accede to the death of its constituents.

That is a no-win scenario both for our present safety and our future politics.

I can see only one thread of hope — namely that elected leaders in Washington will somehow find a way to reject the terms of this intolerable choice and chart a different path forward.

Below, I offer a few of my own thoughts on the way out of this challenging situation. (These ideas are far from comprehensive!)

Health: One necessary step would be to surge federal support to the health care infrastructure in those American communities that had been left behind long before the coronavirus. This does mean the federal government must extend a lifeline to primary care practices, mental health and addiction providers and health centers as well as those hospitals largely left out of early federal relief. But we also will need those same providers in the pandemic’s economic aftermath and any future outbreak. So we also must assure the sustainability of this infrastructure. New resources to shore up state Medicaid programs in every one of our states and territories (red and blue alike) will be particularly needed.

Work: A second necessary step would be to put hundreds of thousands back to work, first tracking and tracing down coronavirus outbreaks, and then ensuring that those with underlying chronic conditions have the education and resources to manage their health at home. Such an effort could generate uneasiness about federal intervention from economic libertarians and intrusions to privacy from across the spectrum. To partially mitigate these concerns, it would be useful to rely on community health workers, deployed first to their own hometowns and neighborhoods, and to partner with churches, community organizations and other trusted institutions.

Faced with the threat of further contagion and 40 million unemployed that the private sector cannot quickly reemploy, a serious tracking and tracing effort can bolster the health of our families and our economy. Moreover, this approach offers partisans of left and right alike a chance to live up to their professed commitments to the American people’s health and the dignity of work.

Safety: By now, we all ought to acknowledge that essential workers deserve more than our applause. In fact, faced with this pandemic, all workers returning to work deserve some assurance of protection. That means an enforceable right to workplace safety and the right to take paid sick or family leave when illness strikes. If we hope to avoid putting the lives of our working neighbors and their families at risk, enacting these protections becomes a moral imperative. Satisfying this imperative, however, comes with real political problems. Conservatives and business interests reject any such expansion of workplace rights out of hand. So necessity might demand that these protections be paired with some limited concession to the Senate majority’s top ask: targeted liability protections during the pandemic.

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Hoping for a deal this ambitious is asking a lot from our frequently stalled political system. After twelve years in the Washington policy world myself, I know that the political economy of advocacy seldom rewards organizations that moderate their particular demands for a common good. I know also that party leaders are reluctant to deal any defeat to their organizational constituents.

But the alternative, trading one group of American lives for another, is unconscionable. With all our families’ health and livelihoods at stake, we citizens must reach for the hope available to us … and then demand that our elected leaders do the same.