A serious discussion about re-opening a state's economy (using OH as an example)

Submitted by crg on April 22nd, 2020 at 4:27 PM

Note: This is not meant to be a political (read: partisan) discussion, but a practical discussion about how states are/can/should approach the issues of re-opening.  I believe that the board is (mostly) mature enough to limit the discussions to reasonable facts and opinions and not lapse into a political flame-war... maybe.

 

I just watched today's COVID update press conference from OH governor Mike DeWine (playfully known as "Wine with DeWine Time" around these parts - if only since the man is so bland when talking if nothing else).  The conversation was mostly about his plan to re-open businesses (to some extent... TBD) starting on May 1 and has been a bit... underwhelming.

For context, DeWine (a Republican) has been (possibly surprisingly so) one of the more pro-active governors in the nation about getting ahead of the crisis.  One good example:  on Sunday March 15th he ordered the closure of bars & restaurants statewide (well before most states had taken any significant action at all - I happened to be back in MI visiting family that weekend and they were shocked to see that such a drastic action was taken by anyone, let alone a Republican in OH).  DeWine received a great deal of criticism (in OH and elsewhere) for that action at the time (and other similar actions shortly after), but was vindicated by late March when much of the rest of the country had taken the same steps (he was even called out for praise internationally by the BBC, among other outlets).

 However, his current actions in pushing for a re-opening of non-essential businesses on May 1st seem in stark contrast to his prior string actions to secure public health.  In his press conference today, he (and his Lt. Gov) outlined various economic reasons why the state economy needs to be re-engaged yet failed to address many of the immediate health issues raised in doing so (let alone why the May 1 date was being strictly pushed).  Just a few of the issues that I saw (and some of the reporters called out in the Q & A):

1)  DeWine earlier this week said that OH would adhere to the guidelines issued by the White House, which include 2 weeks of declining daily COVID cases and deaths before a state economy can re-open.  As of yesterday, the 7 day average of both for OH are slightly increasing (https://www.nytimes.com/interactive/2020/us/ohio-coronavirus-cases.html) and thus could not mathematically meet that criteron - and the re-open date is 9 days from now (he said they have "flattened", which is not strictly true, but also his med chief said today that ICU admissions are trending up again).

2)  A question was asked if the supply chain (masks, disinfectant, etc.) would be ready to support businesses and individuals returning to work by May 1 - especially considering that people are having high difficulty in finding masks even now.  He had no answer to this.

3)  Another question was regarding child care and the practicalities of having working parents leave home when child care centers might not be re-opened to sufficient levels (let alone being deemed "safe" health-wise) and with all schools closed until Fall.

4)  Much attention was given to the financial/economic risks of maintaining the shutdown yet absolutely no numbers/models/estimates were provided about the expected increases in cases/deaths that were likely to be incurred with a May 1 re-open (let alone modeling how these increases would change as a function of changing the re-open date).

5)  Coordination/comparison with other states was not really addressed.  He has in the past emphasized coordination with IN and KY (which have lower cases than OH), yet hardly mentions any coordination with MI and PA (which have higher cases) - yet even in today's Q&A a reported remarked that a Jeep plant in Toledo is scheduled to re-open May 4th and a large contingent of its workers commute from Detroit.  DeWine commented that the plant would be monitored by the OH Dept of Health to keep safe operation but made no mention/discussion about the movement of possible cases across state lines (and how to address it).

6)  A day or so ago, DeWine said he had been approached by small businesses that it was greater concern to them about re-opening soon only to be forced to close quickly again upon any cases resurgence - a later re-opening date would be an easier pain for them to accept than a series of starts/stops.  No information/discussion was provided today (or thus far) about how this would be addressed and how a May 1 date is or is not optimal to avoid this.

These are simply the issues my wife & I noticed while watching today (I'm sure there are others), but it is rather concerning that the state officials seem to be pushing blindly (or perhaps half-blindly) toward this re-open date without crafting a more deliberate and coordinated response.  I know other states are facing the same issue (some more agressively, such as Georgia and S.C., and others more cautiously, such as most of the northern eastcoast, WI, IL and CA), but it just seems foolish to have such a patchwork level response to this issue nationally.

Also, I know that many on this board live/work in OH, may be from OH or have family there, and am curious what their opinions are of DeWine's response and how they would like to see the state government proceed.

Apologies to all if this seems too ranting, but I had been relatively impressed by Ohio's handling of the crisis to date  - yet this seems like a significant risk to take that could cost 1000's of lives unecessarilly.

BarryBadrinath

April 22nd, 2020 at 6:00 PM ^

Let me rephrase. 85% of those being punished live in Detroit. If you live in a part of the state that hasn't been impacted by the virus, I would not consider yourself punished but very lucky.

Also, you do realize that the stay at home order works both ways right? It is meant to stop the spread of the virus within the hot spots and from hot spots to other parts of the state. As someone who lives in Detroit but works outside of the city and travels often to visit family throughout the state, the lockdown is preventing me from possibly spreading the virus to places that don't have the same hospital capacity to handle. 

WesternWolverine96

April 22nd, 2020 at 7:26 PM ^

your thinking is wrong, no one is being punished.  Liberty isn't about guns and going on your boat,  it's about knowledge.

(my cynical side admits Liberty in USA depends on wealth)

We need a reality TV show to reach this people.  Film it in an ER room to help show this segment of our population how serious this is.

MGoBlue24

April 22nd, 2020 at 6:06 PM ^

So go with a domestic start line of zero (reported at the time) eight weeks ago and yesterday you get 45k+.  Two months, with some pretty extreme public prophylaxis.  Flu season runs ~November through May, with about 13 weeks considered high flu season, and outside of annual shots we pretty much discount safe behaviors.  Come back at 13 weeks minimum, and especially if we go to jagged edge reopening, try 16 weeks.  Also, get ready to meet at the intersection of COVID-19 and 20.

blue in dc

April 22nd, 2020 at 6:55 PM ^

The average from the flu is way under 60k   Low of 12,000 in 2011/12, high of 61,000 in 2017/2018.    In last 9 years, 2 years over 50K

https://www.cdc.gov/flu/about/burden/past-seasons.html
 

in 2017/2018 NY had 4749 deaths.  
 

https://www.cdc.gov/nchs/pressroom/sosmap/flu_pneumonia_mortality/flu_pneumonia.htm

So far, Covid has killed over 15,000.  If you go by worldmeters the number is currently 20,354, but other sites report lower numbers.   660 more people died in New York today, so that number is going to continue to climb.  If Covid hits an area badly, there is no honest, credible argument that it is like the flu.   While New York as a whole has had 3 to 4 times as many deaths as a bad flu season in just 45 days, the numbers are even worse in New York.

The Fertile Oc…

April 22nd, 2020 at 11:50 PM ^

The first death (or previously thought to be the first death) was recorded on February 29.  Since that time, more than 40,000 people have died. 

Here is some reading material (from a *right-wing* source, no less):

https://www.nationalreview.com/2020/04/coronavirus-kills-more-americans-in-one-month-than-the-flu-kills-in-one-year/amp/?__twitter_impression=true

Cc2010

April 22nd, 2020 at 5:53 PM ^

You sir, are my hero, someone who actually has thought about this rationally and is not just a fear monger like most other people.  

"The greatest thing we have to fear is fear itself". Fear is driving everyones reaction to this virus.  

I predict that this is one of the greatest overreactions in world history.  

Everytime someone posts something about a study regarding the a fact that disproves our previous assumption (like the one in LA where many more people actually have had the virus than they thought), they are shouted down by the fear mongers.

M_Born M_Believer

April 22nd, 2020 at 6:14 PM ^

You do realize the biggest difference between comparing totals of flu mortality and COVID19 mortality is that each flu season, life was the 'old' normal.  That virus got to spread uninhibited.

During COVID19, states have gone through great lengths to create social distancing, yet its total mortality number will surpass a flu season.

No one can put a number of "What if....."

But it is safe to say that HAD everyone went on with their lives over the past 8 weeks, the total number of COVID19 fatalities would be much higher.

Its a simple conclusion that one side just ignores over and over again.

blueday

April 22nd, 2020 at 5:54 PM ^

What lit Detroit up?  Maybe an international airport, a political gathering in early March, an already unhealthy population ... who knows.  All I have seen is the largest coordinated medical response this country has ever seen come together in 1 month.  Many heroes in all segments of the including government. 

It a global pandemic, finally actually called such in March, that the best scientists in the world still have not figured out.  But our government and the media has ... right.

Problem is, we are at a point the safety of others in the population are now at risk.  Not sure why we can't get back to some level of openness while being safe. There is a balance. 

The situation now is excessive and oppressive.  Unless people like government baby sitting and programs.  

TrueBlue2003

April 23rd, 2020 at 2:03 AM ^

I actually agreed with most of this until you said "Detroit fucked up"...sorry man, That's just stupid.  Detroit has an international airport, far more dense population than the rest of the state, higher use of public transport, and a whole slew of other factors that make it more vulnerable.  They didn't fuck up any worse than anywhere else in the state.

Morelmushrooms

April 22nd, 2020 at 4:39 PM ^

It will come down to personal choice.  You can open the door to the economy to everyone, but you still need to convince people its safe (which its not).  We are going to find out that we are only as strong as the weakest members of our society.  Want an economy that withstand such pandemics?  1- Universal healthcare 2- produce things for less profit, domestically, especially things that are vital to national security (medicines, ppe's, infrastructure materials, etc...) 3.  End the obscene inequality from a wage stand point. 4.  Re-tool education so it can adapt/be flexible 5. Universal child care

We have until the Fall to get some of these things fixed or it will be the same thing all over again or worse.  If I were a politician, I would be running under the mantra: "Not again".  Time to end the same old same old.  We have no choice. 

(Edit- I realize some of these suggestions are political in nature, but Covid has been politicized, no doubt)

Watching From Afar

April 22nd, 2020 at 5:24 PM ^

Are there protections for employees who don't want to go into a 500 person office/factory and risk transmission?

If my employer calls me day 1 of reopening and says "come in" my choice is do it, or potentially get let go. Fortunately I've been allowed to work at home and keep my full pay, but I know others aren't so lucky.

Now, I'm 29 and very healthy. No underlying conditions. Active, never smoked. My fiancee on the other hand has serious asthma. And her mother has a heart condition (along with asthma) that required an ICU visit last winter which included being on a ventilator for 24 hours. I don't know if I want to hop on the train and go to an office in Boston.

The Mad Hatter

April 22nd, 2020 at 6:18 PM ^

We are in similar situations, although I'm older and not quite as healthy as you are. Both my wife and son have very severe asthma and we all get bronchitis at least a couple times each year. Sometimes pneumonia.

So we've been taking every precaution and barely leaving the house.

Regardless of whatever else is allowed to reopen, those of us willing and able to work from home must be allowed to continue to do so. Reopening the cubicle farm is a recipe for disaster.

Roanman

April 23rd, 2020 at 8:25 AM ^

I don't think it's fair to say that "nobody" will be forced to work. Someone, and likely quite a few someones absolutely will be forced back to work. Having said that, employers will be scared shitless of the potential for law suits heading in their direction from future Covid victims who will absolutely say that they were infected at work.

I'm thinking that the Fieger Laws of this world can't wait for this thing to play out no matter which way it goes, as the action will be excellent ... from their standpoint.

But the fact is, that when opened, everyone will have a choice to show up or not, and of course there will be consequences regardless of the decision. It strikes me that opening the economy while providing workers with protections concerning their choices is the way to approach this.

At the moment, you do not have choices. And the huge problem is that you can be reasonably certain, if you want to try thinking your way through this, that everybody with a political or financial interest in this thing is lying like hell, all day, every day. This includes professionals within every political party, Republicans, Democrats, Chinese Communist and the rabid fans of every political party who are to my way of thinking dipshit haters, and yes as much as you don't want to even think about it, researches, many of whose livelihoods and fundings come directly from government and whose financial futures may very well depend on how this thing shakes out in the end.

With what we've seen with large institutions, banks, universities, corporate entities, grabbing off the poorly thought out stimuluses, little people are getting crushed in this thing.

The fact is that livelihoods and lives of working people are being wrecked from the economy being shut down.

Alpaca

April 22nd, 2020 at 4:49 PM ^

In my opinion, instead of looking at the White House guidelines for reopening we should be looking at other countries. Our white house has mostly failed us in handling this situation including the preparations, the bailout, the production, and is now actively working to cause a strife in the public by having us go against each other. If we want to re open we need mass testing, we need to see how many already have antibodies, and like you said increased production in hand sanitizers ppe for not only the hospital which is still lacking but the general public. We also need bailout money not for business that have been making profits in the millions with tax havens and buybacks but small businesses and those who cannot go back to work. We still need a limited work force and continue work from home where possible and as much as possible. There are a lot of things that need to be done before we can open the country let alone the world and currently our government does not have YOU as an infividual as high of a priority when considering opening things back up. 

crg

April 22nd, 2020 at 4:52 PM ^

I specifically avoided any judgement here regarding how appropriate the White House guidelines are (or are not) since that is too political.

I brought it up since DeWine (and other governors) have explicitly stated that they will abide by those guidelines, yet the facts show it will be difficult to do so in the timeframe he is suggesting.

 

The solution should be to 1) establish unambiguous criteria for re-opening and 2) let the date be determined mathematically by the criteria.

The problem I see now is that people are setting re-open dates by decree and massaging the criteria to fit them.

HenneGivenSunday

April 22nd, 2020 at 8:50 PM ^

The mental gymnastics that it takes to type this phrase is amazing.  Yes, CNN created the guidelines, then 2 days later was lobbying for Michigan (a hot zone state) to reopen on Twitter.  Great call.  It’s OK to support a political party or a particular politician, but also criticize them (and vice versa!).  Please go ahead and congregate with other like-minded individuals in close proximity.  

BlueInGreenville

April 22nd, 2020 at 4:49 PM ^

Mitch McConnell saying today that he's in favor of letting states go bankrupt might have had something to do with this.  The state governors have been living in a fantasyland where they get to shut down their entire economy and then ask the Feds for a check to pay for it.  How long can states in the Midwest sustain 25% unemployment rates before raising taxes, cutting services or cutting pay and benefits for state employees (including ending pension plans)?  The most at-risk people - the elderly - can continue to shelter in place regardless.  This is the way it should have been from the very start.

Alpaca

April 22nd, 2020 at 5:06 PM ^

You do realize that its not just the elderly that are dying. This was a mistake by the media as portraying covid as a "boomer" disease. People in their 40s and 50s are dying. If you are obese you have a significant mortality rate from Covid. And last I checked we are the fattest country in the world 

MileHighWolverine

April 22nd, 2020 at 10:44 PM ^

@Alpaca - It's mostly the elderly that are dying. Virtually every state and city data confirm it and I'll use just Colorado, NY and then Spain and Italy as the two countries in Europe with the worst cases and where media age of death is 80.

Right here is the statistical study from Spain that shows the following for fatality:

https://as.com/diarioas/2020/03/26/actualidad/1585242301_035736.html

< Aged 60, the fatality rate is 0.35%.
Aged 60-69, 1.83%. 
Aged 70-79, 4.52%.
Aged 80+, 14.96%

This one is outdated but for Italy: https://www.bbc.com/news/world-europe-51777049

Here it is for Colorado where 75% of death is in the 70+ category and it goes to 90% if you include 60+:

https://covid19.colorado.gov/data/case-data

In NY it's 74% coming from age 65 or older (their age groupings are huge, age 45-64 for example) so I couldn't break it down much better than this: https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04222020-1.pdf

Yes, some younger people are dying from this as well, and that is unfortunate, but the vast majority are older.

 

 

blue in dc

April 22nd, 2020 at 5:16 PM ^

I think many underestimate how many are at risk.  

Here are two estimates that suggest 38% and 52% of the population.

https://fivethirtyeight.com/features/the-young-americans-most-vulnerable-to-covid-19-are-people-of-color-and-the-working-class/

https://www.kff.org/global-health-policy/issue-brief/how-many-adults-are-at-risk-of-serious-illness-if-infected-with-coronavirus/

While I agree that we need to figure out how to open the country up, people who suggest that it will be a simple matter to isolate the at risk are greatly underestimating the challenges that presents and based on the number of deaths we’ve seen in retirement homes are also  greatly overestimating our capacity to do it.

 

 

ScooterTooter

April 22nd, 2020 at 11:07 PM ^

And yet:

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html

The CFR for Michigan is under .4% for people under 40 years old (and probably way less because I'm being generous with the <1% in the 0-29 bracket).  

The average age of death: 74

The median age of death: 75

If your goal is to flatten the curve, keeping those over 70 out of harm's way is the single biggest factor in doing so. 

TTT

April 22nd, 2020 at 4:51 PM ^

“I don’t want this to be partisan” 

“For context, DeWine (a Republican) has been (possibly surprisingly so) one of the more pro-active governors in the nation about getting ahead of the crisis. “

Lol

crg

April 22nd, 2020 at 4:56 PM ^

I only highlighted DeWine's party affiliation to show that a pro-active response to the crisis is not inherently a partisan issue.  I could just have easily used the MD or MA governors (both Republicans) to demonstrate this instead - in contrast to other Republican governors that have taken a more limited approach.

kejamder

April 22nd, 2020 at 4:53 PM ^

Some predictable comments so far... I think your #3 is key and easily understandable. People want to work and get back to normal & I understand all of that, but nobody wants a 6-year-old dying because she was in a daycare with 9 other kids. 

I get it's unlikely and that kids spread diseases all the time, but this is just different than the flu. If you open up and people are expected to report for work, you need to account for parents who have to stay home with kids with symptoms or contact with others kids with symptoms until they're all tested and clear. This thing just spreads too easily. 

Mitch Cumstein

April 22nd, 2020 at 5:24 PM ^

I’m not trying to be flippant or to even make a specific point, sometimes tone is hard to convey in writing.  This is an honest question. I was under the impression based on the stats and recent research that kids were the lowest risk demographic in terms of negative outcomes, and that they actually spread the disease less. If true, wouldn’t that point to opening schools and daycares earlier in the progression relative to other sectors? Obvious caveats around teacher safety need to be thought through. 

here is the article I recall discussing spread from kids: https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa424/5819060

 

Mitch Cumstein

April 22nd, 2020 at 6:21 PM ^

So if the implication is that no risk is acceptable for kids, you’re proposing that we wait for a vaccine before schools open? Couldn’t that be 4+ years (I recall reading that the fastest vaccine ever developed And distributed was mumps at 4 years). Doesn’t seem like we have a lot of good options here. 
 

I agree on the 1 kid sample size, which is why I said “if true”. We’d have to see more to make actual policy decisions based on that, but I think that study could highlight an area to study further.