You know Trump is really frustrated when he uses all caps. The day before yesterday he tweeted in all caps that the cure should not be worse than the disease. He has a point.

The rest of us, those concerned about health and humans also have a point. We may soon be confronted with the choice: save the economy or beat the disease.

It is a legitimate quandary, the solution isn’t a simple one and there is opportunity buried in eh answer.

The president and congress are desperate to get people back to work and stop the impending financial doom. If the economy stays stopped for long getting it started again will be expensive, costly and take a very long time.

Goldman Sachs is predicting a 25% decrease in GDP next quarter, JP Morgan is predicting 15%. The worse the US has ever seen has been 10%. Unemployment is already on the rise and my back of the envelope calculations suggest that 25% Great Depression levels of unemployment are reasonable.

At first I thought that was absurd. Now I think 25% is optimistic.

So, the president is already talking about letting everyone go back to work next Monday. You would just have to wear a mask. Which we know is ineffective, but a least it will make people feel better.

The problem is: there is no way that the virus will be gone by next Monday. Hong Kong beat the virus after weeks of isolation only to have it come back again. So now they go back to isolation.

Despite the confidence that the president expresses in available drugs, there are not any that work for sure now. And they aren’t available in the quantities necessary to treat the US population.

They may be effective on the margins, but these are not miracle cures.

Unchecked the virus would infect about 210 million people according to CDC modeling and we could see a couple of million deaths. That assumes people can get care (I believe, I need to check that). But with just 2.8 beds per 1,000 people care will be hard to come by.

Letting the virus run rampant will be a disaster: people will die of the virus but also die from heart attacks, strokes, accidents and everything else that normally happens without a virus. They just wont have access to medical care.

A vaccine is months if not years away.

Also the new cases are increasing geometrically even with social distancing. The people sick now will be sick in a week and the virus will spread.

It is unlikely that in a week we will have the virus under control, but let’s image that we are able to manage this feat. As soon as we come back out of our houses then we will have another round of infections that will either send us back to our houses (like Hong Kong) or force us to live with the deaths and healthcare issues for a few months.

In order to get a handle on the virus we are looking at months of isolation. Not days and weeks, months and… well let’s stay optimistic and just say months.

(Read this amazing article by Tomas Pueyo on Medium about how this could be managed.)

Is that cure worse than the disease?

Despite the president tweeting this in all caps it is worth us considering. Will suffering be more or less with social isolation? If we can’t work and we see 30%, 40% unemployment over a long period of time, would that be worse? Would we see maybe MORE deaths? Trump compared this to the flu and suggested we may see more suicides.

Well maybe. But we are talking millions of deaths versus 40,000 for the flu, about that for car accidents and gun deaths and about 48,000 suicides. So even if suicides double we are still well below the alternatives. So this is kind of a silly argument.

But then again, with 30% – 40% of the population destitute and without jobs they will also not have access to healthcare. Even if we cover Covid-19 illnesses, what about everything else?

Even worse, this level of unemployment could lead to collapse of the healthcare system. Without money coming in how would doctors get paid? Why would they keep working? How would we buy the equipment that would be needed to treat patients.

I think this could, in fact, lead to a disaster as bad or worse than the virus itself.

I value humans over economy. So, my personal bias is that we do everything we can to stop the virus. But our response has been poorly coordinated and generally ineffective. So maybe we are better off ripping off the band-aid quickly?

Or maybe there is a third way

It is important to recognize that the economy is a human construct. We built the idea of economy. We created the rules. We can recreate the rules.

The choice between jumping into disease unarmed and letting it do as it will (the Trump/Fox News/Republican solution) or shutting down the economy as we wait to see what happens (everybody else) must be a false dichotomy.

We are more clever than that. We can start making some changes now:

We can recognize that a healthcare system that requires largess on behalf of an employer is silly and ineffective. Mass unemployment will show us exactly how bad an idea that is. So lets fix that now.

We can recognize that the engine of our growth and economy is at the bottom of the economic pyramid, not the top. Most people spend most of their money and that spending drives the economy. Putting money in the hands of the rich, props up the stock market but does nothing for the average person. So we support the bottom of the economic pyramid first.

We can recognize that a cash payment of $1000 is nice but woefully insufficient. What people need is the security that they will not lose their homes and that they can be fed. Landlords by the way also need comfort that they will continue to get rent – the rent of one is the income of the other.

And we can come up with solutions. Exactly what those might be, I just don’t know. Not yet anyway. But we can rethink this and come up with answers that are clever, new and productive.

Or we can force ourselves to choose between two terrible options.

What do you prioritize: health or economy?