Steamboat Board Member Grace-Marie Turner on the Coronavirus

Grace-Marie Turner, president of the Galen Institute and board member at The Steamboat Institute, wrote the article below comparing Italy and South Korea’s responses to the coronavirus and indicating what lessons can be learned for the U.S.

A Smart, Targeted Approach

by Grace-Marie Turner

Different countries and different states in the U.S. are taking differing approaches to try to contain and defeat this “novel” lethal virus. Italy and South Korea are two examples. In this challenging and fast-moving environment, learning from other countries can help U.S. policymakers at both the federal and state levels improve our response.

Italy has been hit hard. The country has an aging population and multiple generations often live in the same household. That means if one person is infected or even just a carrier, they will be more likely to pass along the virus to more vulnerable family members. The northern part of the country had the earliest outbreak. One reason can be explained by this 2018 article in The New Yorker: The region has a large number of Chinese immigrants, hired to make the handbags and other designer products that bear the coveted “Made in Italy” label.  Many traveled home to celebrate the Lunar New Year with their families in January and, it appears, brought the virus back with them. The economy is virtually shut down. People are told to stay home, and local mayors literally are yelling at them in the streets if they leave their houses.  Hospitals with too-little-capacity even in normal times are overwhelmed, even being forced to ration life-saving ventilators to younger patients. South Korea, in contrast, has kept its economy much more open by using aggressive testing and containment measures to identify those infected and isolate them to contain the virus spread. So what does this mean for the United States?  The head of the Coronavirus Task Force, Dr. Deborah Birx, challenged the doomsday models during yesterday’s White House briefing, indicating that she is studying the data and looking at hot spots. She appears to be signaling an approach that would involve a more targeted social isolation strategy in areas where the problem is most acute. That could mean beginning with a county-level loosening of restrictions in those areas with few reported infections. More testing, as the South Koreans demonstrated, clearly is key to isolating those infected. The FDA is rapidly approving test kits, with 18 different makes now in commercial use.  Soon personal kits will be available so people don’t have to go to facility to be swabbed. It isn’t feasible to keep most of the U.S. economy shut down for months, as some public health experts advocate.  Does that mean we have to keep older people isolated for longer avoid contact with younger neighbors and even their grandchildren? Probably, for a period of time, given that the evidence that COVID-19 most lethal for older people and those with underlying health conditions. Also, based upon the South Korean model, the new 1000-bed medical hospital being created in New York City at the Javits Center could be used to keep infected people isolated until they get well, allowing hospitals then to focus on the critically ill. President Trump is sending the U.S. Naval Ship Comfort to New York harbor, expected to arrive on Monday. He indicated it could be used either to house only virus patients or only patients with other ailments, but the point he hinted at was to keep the populations separated. This makes sense. This is a vast, divergent country.  The next step may well involve a combination of all of these strategies, with higher-risk people, especially those over 65 and with underlying medical conditions, told to stay home longer, but with more flexibility to open the economy by state or by county.  Better and more widespread testing is key to better isolate those who are infected. As today’s Wall Street Journal writes, “The coronavirus outbreak has reminded Americans that we live in a federal system. Despite the press fixation on Washington, state governments set many of the policies that most affect daily life.” “The truth is that it may be useful for states to try different models. The virus won’t be eradicated in the coming weeks, and the U.S. will need flexibility,” such as more targeted stay-at-home policies for those at higher risk, the Journal writes. Better hygiene, much more testing and abundant personal protective gear are also vital. “Once testing is more widespread, the U.S. may be able to tailor mitigation measures by region, with stricter measures in hot zones than outside them—and perhaps regulations on travel like Florida’s quarantine on travelers from New York.”

The private sector response to fight this invisible killer has been astonishing. President Trump has said he has had little need to use the Defense Production Act to procure vital health equipment because thousands, maybe hundreds of thousands, of companies are reconfiguring their plants and assembly lines in an almost World War II-level response.

But that doesn’t stop governors like New York’s Andrew Cuomo from demanding it. Joe Antos of the American Enterprise Institute writes in The Defense Production Act Is No Cure for Coronavirus that the private sector can respond more quickly and with more agility without the government’s intervention. Companies “do not need an order from Washington to respond to the obvious business opportunity and public health need,” Antos writes. “In the short term, manufacturers are willing and able to ramp up production of masks and gowns by running their factories 24 hours a day.  Companies that produce other types of clothing are likely to shift production because demand for healthcare products is high (while demand for their normal clothing lines is depressed), and no significant investment in equipment or training is needed.” He also responded to a Washington Post editorial arguing for federal procurement of ventilators.  “Federal control won’t solve the supply problem. It’s likely to be made worse,” Antos argues. “This is a way to ration scarce resources, but it cannot meet the needs of the health sector if our worst fears about the coronavirus epidemic are realized.”

And Nina Owcharenko Schaefer argues in The Daily Signal for Removing Obstacles, Cutting Red Tape, and Staying Flexible in Responding to COVID-19.

Early signs show that the key to success includes the government, both federal and state, removing obstacles, cutting red tape, and staying flexible for private sector innovators, she writes.  This includes more telehealth, loosening medical practice restrictions, and reforming certificate of need laws. “Before going back to ‘normal,’ maybe policymakers at the federal and state level should consider maintaining these principles and policies moving forward,” she writes.

Here are two very relevant pieces by Galen Senior Fellow Brian Blase that we circulated earlier.  Just in case you missed them, they are well worth your time:

• Congress Must Cut Red Tape that Reduces the Effectiveness of Our COVID-19 Response
• Cover Coronavirus Treatments, Don’t Expand Medicaid