The Silent Crisis

 The Silent Crisis

With over 200,000 souls lost, COVID-19 has had a devastating impact on the United States. Since the pandemic hit these shores in late January, America has faced its greatest medical challenge since the Great Flu Pandemic. Despite the fact that the United States has about four percent of the world's and roughly a quarter of the world's positive tests, there isn't an overwhelming sense of fear or panic throughout the nation. 

This national optimism is due in part to poor messaging through the media, elected officials, and social media. The press, depending on its affiliation, is stressing that the virus is deadly or that it is benign. Additionally, there is a false sense of national confidence that America is immune to this plague and that we are somehow protected from its impact. Part of this confidence is based on our legacy in fighting flu epidemics, polio, and HIV-AIDS. People like to point out that the Great Flu Outbreak occurred during World War I and the nation was able to fight a war and simultaneously defeat a virus. Similar sentiments suggest that Polio was defeated during the Korean War, and HIV-AIDS was conquered during the first Gulf War. 

Sadly, history books do not convey details of pain and suffering. Numbers of infected and dead are no longer bitting reminders of what happens during a national or global tragedy. Similarly mathematical comparisons between COVID dead and those killed by firearms, in traffic accidents or even by the flu do not capture the full impact of this pandemic. In analyzing the COVID pandemic, most Americans are underestimating its potential lasting impact. Few of those that have recovered do not have long term problems.

Much of the ambivalence towards COVID is a matter of age, gender, race and class. Our strategy is discriminatory because rather than seeing a disease that affects all, we choose to see COVID solely attacking COVID high risk populations. In the process, Americans outside of those groups have been able to take neutral positions towards full-throated treatment and policies. This makes us feel immune to the virus and less likely to take it seriously. If people of color and senior citizens remain its greatest victims, agism and racism will dictate its next stages of policy.

As it already stands, there is a growing general consensus that Americans have to die for the nation to flourish. While the overall conclusion might ring true, this logic does not consider the impact or the ultimate costs. We must develop strategies around critical questions including: how many people are infected, how many can or will lose their lives, and how will the nation recover? And these are just some of the things that must be considered. In reality, given the advanced state of the medical profession, I would argue that COVID is proving to be a much stronger foe than any of the previous diseases. I would also counter that the average American is less willing to demonstrate the needed discipline and patience required to defeat this medical emergency.

At the same time, the nation has also confronted situations vastly different than in the past. The last nine months of COVID have witnessed extreme climate issues which have resulted in numerous wildfires, hurricanes, tornadoes, and several earthquakes. Outside of natural occurrences, there have been several highly publicized police actions that have led to massive protests and subsequent violence and looting. Protestors have remained in the streets for over four months. Almost weekly another police action, often resulting in a fatality, is recorded and then televised, ensuring that the protests will have no ending. Unlike the modest descriptions of the past, this American generation is more openly fragmented and confrontational.

In the face of these challenges, one of the things that is constantly on my mind is the collapse of the nation's infrastructure. A medical challenge like COVID expands to all parts of the nation's structures. This includes the development of products needed to confront a medical emergency, the need for even more first responders and scientists, creating safe environments including schools, corporate facilities, hospitals and factories, and the education of all citizens to understand the nature of the pandemic and to continue daily life in safety. Just the inability to provide safe schools has led to remote education in all of the nation's largest school districts. And by creating remote schools, the nation's Internet capacity has been strained to its limits.

America has done very little to bolster its broadband network, the Internet, or its public health system. Homelessness is increasing and is creating a public health challenge. Some incarcerated persons have been released and their presence in their new communities is causing a stir. High rates of unemployment are creating a strain on the tax base including Social Security and the welfare safety net. Government institutions have become politicized and less trustworthy. A vaccine, whether weeks or months from production will not be available to the general public before 2021. Vaccination of the nation will take months to occur. It is likely that COVID 19 will be with us for three to five more years. More importantly, COVID is not going to simply disappear. Implementing herd immunity of any type will result in thousands more dead with estimates of close to a million losing their lives before the disease is finally defeated. 

All of this is leading to the advent of a silent and more powerful threat. One that is far greater than faced by any president in our history. America needs to heal and mourn at a time when distrust is at its highest levels and Congress is at its most dysfunctional. As our democracy is being challenged, the ability to rebuild is rapidly diminishing. Internally and externally, Americans are unaware of the dangers and unprepared to cope with what is happening. If a military power attacked the United States, would its citizens rise to the occasion? Would America have the resources to fight an enemy? If a cyber enemy attacked the United States, would the public accept the fact that such an attack actually occurred?

Voting, the key element to democracy, does not seem possible during this pandemic. State systems and the Post Office, both of which knew that they would be relied on during this crisis, are seemingly not ready. Federal funds to shore up deficiencies are not forthcoming. In fact, there are constant rumors of postage sabotage to tilt the election. The operation of courts and government agencies are equally compromised. The lack of centralized COVID policies aids the increase of spikes in various states, cities and industries. The absence of a national policy ensures that states will determine the flow of the disease. State quarantines for out of state visitors limits interstate commerce especially tourism which benefits local economies.

Another threat is of a major financial collapse. There are prominent financial difficulties that are directly related to the COVID pandemic and its associated costs as well as collateral expenses caused the national and state-wide shut downs. While the average American may believe that the CARES legislation addressed many of these problems, the real cost of COVID has yet to be assessed. 

At this point, I would argue that our recession is much closer to a depression than few are willing to admit. There are going to be financial problems in state budgets which will greatly affect public education, mass transit, law enforcement, and roads and highways. This will trigger budget cuts and massive layoffs of state and municipal workers.

For example, the massive hospitalizations and medical care of the infected with and without medical insurance was estimated in the billions. In April, CNBC calculated the cost of insured patients to be about $30,000. As the pandemic progressed, Fair Health suggested that the average cost to an insured patient was $38, 221, but to an uninsured hospitalized person it was $73,300. Since that time, the media has shared stories of individuals receiving bills over a million dollars. When the crisis comes to an end, we should expect the closure of smaller medical facilities throughout the nation.

Unfortunately, most Americans do not realize that the pandemic is driving hospitals into bankruptcy. Hospitals make money from elective procedures and COVID is taking over more lucrative hospital beds. This issue is masked by the number of COVID patients in hospitals. The more COVID patients, the less profit is available to the hospitals. However, the actual number of COVID patients is not clear. In July, the Trump Administration asked medical facilities to stop reporting the number of COVID admitted patients to the CDC and direct their data to the Department of Homeland Security. While some might see this as a way of better collecting information, critics have posited that it was a way to minimize the numbers of people affected. Either way, this process had a significant impact and the actual number of hospitalized Americans is unknown. In late July, ProPublic estimated that over 70,000 Americans have been hospitalized. Upon examining the CDC websites, the information was only assessed to mid-July and in contrast, the Homeland Security websites, while current from June, only provide estimates of hospitalized through percentages of used hospital beds of reporting facilities. In essence, HHS does not provide numbers but wants researchers to guess from a lot of data points.

COVID has also threatened the nation's mass transit networks. In March, California's BART reported a 70% loss of ridership and New York City's MTA reported a 90% drop in subway ridership. By early April, the New York Metropolitan Transit Authority calculated it could lose $7-8.5 billion in lost mass transit and toll revenues. In September, New York's bus riders, who were not charged fees to protect drivers, were still down and paid subway ridership was less than 20 percent of normal patronage. Even as the city resumed charging all patrons, the MTA still forecasted a catastrophic loss by the end of the year. Recently Baltimore declared that it will have to trim its light rail service, and Pennsylvania manufactures cited billions to be lost as transportation projects in New Jersey and Pennsylvania will be cancelled. Across the nation, transit agencies were forced or are being forced to close down or limit service. Without needed revenues, these networks are jeopardized. When restarting they are unable to regain patrons as many fear that public transportation is not safe. Similarly Uber and Lyft have also suffered significant loses due to COVID.

Retail sales (corporate and small business) and dining have also been hard hit. Mail and Internet based companies can no longer promise overnight delivery and supplies of certain goods are low or non-existent. Lysol, pain pills, and paper towels, for example are still hard to find. Local and regional chain stores have declared bankruptcy and probably will not reopen. The best case is Lord and Taylor which is regarded as the nation's oldest department store. Particular clothing items like men's suits and ladies fine dress wear is not in high demand as many are now working from home. Mall traffic has declined and mall supports like movie theaters, gyms and food courts have been closed in numerous states. 

In conclusion, regardless of location, America's response to this pandemic has been less than desired. Allowing the states to determine their own policies has failed to address the increasing social and economic problems. A Republican victory in the fall will lead to a deeper recession and certain depression, while a Democratic victory will continue the recession with a troubled Stock Market.

Simple economics points to two certain conclusions: 1) cities and states will have to raise taxes to avoid shortfalls and 2) producers will raise prices on all consumer based goods. Some states like New Jersey have already increased taxes on a gallon of gasoline and have increased highway tolls. Millionaires taxes are being considered in every blue state. Junk taxes will have to emerge in red states. All states will have to look towards the federal government for bailouts. How they will develop under Republican or Democratic administrations is yet to be determined. None-the-less, the result will not stop layoffs of public and private workforces. Highly volatile sectors will include banking, transportation, leisure and travel, manufacturing especially the automotive industry, and retail. 

What should the federal government do? Given its own financial predicament, the federal government should probably generate its own series of new and increased taxes. It should develop its own Marshall Plan to rebuild America-considering the ideas of a Green New Deal to defend the infrastructure against power outages and natural disasters. America should create a pandemic and post-pandemic task force with a national recovery policy. 

What will probably happen? My guess is too little, too late! But you better pick your poison sooner rather than latter. Otherwise you will be the victim of some 70 year old who is probably too old to be president.