Ending social distancing soon would be an economic and social disaster. Here’s why:

Social Distancing containment and prevention of infectious disease between citizens during global pandemic handwritten sign

Your money or your life!

Many Republican politicians believe that is the choice we face. They are arguing to end social distancing restrictions in order to bolster the faltering economy.

I understand the sentiment. All along I have been more worried about the economic impact of COVID-19 than the medical impact. Yes, I fear the disease, too. Even mild to moderate cases sound horrible and it’s not something I wish to endure. But it won’t be a victory if we survive the virus only to starve in a Great Depression.

Ending restrictions won’t allow us to forfeit our lives instead of our money; it would force us to forfeit both!

Yet a premature end to social distancing restrictions, far from providing a boost to the economy, will be the worst of all possible worlds. We will pay with our money AND our lives.

We’ve all heard about flattening the curve. That refers to the massive increase in the numbers of coronavirus cases that have been occurring and will continue to occur over the coming months.

It’s illustrated like this (from The New York Times):

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The same number of cases occur under the blue curve as under the red curve, just over a longer period of time. Let’s imagine that both curves represent a million cases of illness each. Why does that matter if both curves mean the same number of people get sick overall?

The longer time period is crucial because it means that our healthcare system won’t be overwhelmed. Therefore, although the number of cases of COVID-19 is the same in both scenarios, the number of deaths will be much smaller over the longer time period since we will be able to adequately care for everyone who becomes ill.

But there’s another curve which we need to bend and that has received less attention, but is just as critical. We aren’t fated to have a million cases (or more!); we could reduce the number to half a million, a quarter of a million or less. It’s possible to reduce the number of cases overall by limiting the ability of the virus to spread. That’s what happened in China. They didn’t merely slow the spread of coronavirus, they stopped it.

How? Their program of social distancing was far more rigorous than ours. The government monitored every individual and forcibly isolated those who showed signs of the disease. They segregated them from the rest of society until they recovered and could no longer transmit the virus. They literally ended the epidemic.

This graph provides the best illustration of the choice we currently face. It is taken from the Financial Times and I have highlighted the trajectory of coronavirus cases in the US.

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The graph uses a logarithmic scale to show the number of cases of COVID-19 over time in each individual country. The advantage of a logarithmic scale is that it illustrates exponential increase as a straight line; the steeper the line, the faster cases are increasing.

If you follow the trajectory of China, you can see that initially the number of cases of coronavirus were doubling every other day. In other words, the disease was spreading very rapidly. But then China began its aggressive quarantine of whole cities. Shortly thereafter, the curve begins to bend. Cases were doubling every 3 days instead of every 2 days. As Chinese policies became even more restrictive, the increase in new cases dropped even more dramatically, first to doubling every week and then longer, then no new cases at all.

Now look at the trajectory of US cases. We are still in the phase where cases are doubling every other day. And we can see an ominous development. The US trajectory has crossed the Chinese trajectory. In other words, although China began to bend the trajectory of disease increase at day 17 of their epidemic, we have failed to do the same. Despite the efforts we have undertaken thus far, as onerous as they have been, we have not yet changed the rate of spread of the virus.

In fact, the US now has the dubious distinction of being the country with the worst rate of increase in disease cases, worse than Italy — which is foundering — and worse than China. A democratic country cannot institute the draconian measures put in place in China, but Italy has finally begun to bend their curve by basically locking down the entire country.

The restrictions we have faced in the US to date — burdensome as they are and economically destructive as they are — have not yet allowed us to exert control over the spread of the disease. And until we do exert control, it will get much, much worse. The pandemic will hit us harder than any other country.

What does that mean for prospects of getting back to normal in the next few weeks? It means that it is literally impossible. Sure, we can reduce restrictions so workers can go back to work, but those workers will fall ill in massive numbers, basically shutting down the economy due to illness instead of keeping it shut down due to government restrictions. We will face the worst of all possible worlds: an economic collapse coupled with massive rates of illness and death.

Contrary to what many Republican politicians would have you believe, ending restrictions won’t not allow us to choose forfeiting our lives instead of our money. Ending restrictions would force us to forfeit our money AND our lives.

That’s not a choice; it’s a death sentence.