How many lives will we choose to save?

COVID-19 is raging across the country, and experts warn that without swift action, tens of thousands of people will die. 


photo credit: piron-guillaume
Matt Wellington

Former Director, Public Health Campaigns, PIRG

Regardless of the election’s outcome, COVID-19 will continue to spread unchecked without quick action to stop it. And while the country is bitterly divided, I’m confident that voters across the political spectrum care about the health and safety of their friends, neighbors and loved ones. Two things are as clear as they’ve been for months: it’s in our power to save lives, and taking measures to do so would help, not hurt the economy. 

Decisions made by state governors and federal lawmakers — both Republicans and Democrats — in the coming weeks will determine how many people will live through the winter. I wish that was hyperbole, but it’s not. No spin, no partisanship: just cold, hard fact. The White House’s own advisor Dr. Deborah Birx is sounding the alarm about what’s in store for us without swift action. 

A recent study suggests that as many as 210,000 people out of the more than 230,000 dead from COVID-19 wouldn’t have died from it if our national response had been as fast and as effective as other similarly wealthy countries. One influential model projects that we could lose about 170,000 more lives by Feb. 1, 2021, potentially even more if officials ease restrictions further. 

We have the power to save tens of thousands of lives. 

In response to its recent surges, France, Germany, and the United Kingdom have all announced new coronavirus restrictions, including closing most non-essential businesses and issuing stay-at-home orders to quickly break the chains of transmission of the virus. 

Should the United States follow suit? 

Let’s look at the numbers. 

  • COVID-19 cases have increased 54 percent over the last two weeks, with the country now averaging more than 90,000 new cases a day. 
  • Recent daily case counts dwarfed the summer peak — significantly more than 100,000 on both November 4 and 5 versus about 75,000 cases in mid-July. 
  • Hospitalizations are up in almost every region over the past two weeks –up 72 percent in Connecticut, 24 percent in Maryland, 39 percent in South Dakota, and 29 percent in Texas. 
  • Deaths are up nationally over the last two weeks, with significant increases in the hardest-hit states — 64 percent in Wisconsin and 43 percent in Montana. Past experience shows that as cases skyrocket, more deaths follow shortly after. 

Hospitals are overflowing in some parts of the country. In El Paso, Texas, local officials ordered more mobile morgues to hold all the bodies. The city recently issued a two-week shutdown to save its crumbling healthcare system. Utah hospitals report that they’ll soon have to ration care, meaning health care professionals will be forced to choose who gets life-saving care and who doesn’t, because demand is so high. When healthcare systems get overwhelmed, it puts everyone at risk, and it’s a harsh reality that we should not be facing again eight months into this pandemic. 

Several cities and states are implementing restrictions aimed at curbing the virus’s spread. Massachusetts recently announced a suite of measures to reduce transmission, including a business curfew and limiting the size of indoor gatherings. Illinois closed indoor dining and bar services across much of the state. That’s good, but recent history shows that these measures may not be enough. France, for example, layered restrictions including closing bars and establishing curfews to slow the virus over the last several weeks. It didn’t effectively slow transmission, so they took more drastic, universal measures.

We also have an example closer to home. Oahu, Hawaii’s most populous island, tried the “scalpel” approach of targeted restrictions during its outbreak late last summer. It didn’t work, and the state eventually issued another temporary shutdown and stay at home order. When that order went into effect, on August 27, Hawaii had a daily case count of 306 and a seven-day average of 246 new daily cases. Four weeks later, when the mayor lifted those restrictions, the daily case count was 88, with a seven-day average of 100 new daily cases. More than a month later, Hawaii has the second-lowest level (as of  Nov. 6) of covid cases in the country. That’s thanks to bold action from public officials to curb the spread and to ramp up their ability to test, trace, and isolate new cases. 

There are three steps we need to take now to save American lives and get through the winter as safely as we can. 

First, we need to break the chains of transmission for this virus. In most places, that means closing non-essential businesses and issuing temporary stay-at-home orders to get cases down low enough, quickly enough. We also need to mandate and enforce mask wearing whenever physically distancing isn’t possible outside, and whenever people are indoors. Universal masking alone could save 130,000 lives.  

Secondly, we need to ramp up our ability to test widely and to quickly trace and isolate contacts of positive cases. The Brown School of Public Health and Harvard Global Health Institute created a model that breaks down how much testing each state needs to do to effectively suppress the virus, meaning the level of testing where you can catch isolated cases before they turn into outbreaks. Only a handful of states have hit their targets or are close to them. And most states fall far short on contact tracers. 

Lastly, states should reopen slowly, in phases, after meeting the following benchmarks:

  • the rate of new daily cases should be less than 1 per 100,000 people in the population;
  • the state should hit its suppression level testing target, and fewer than 3 percent of people tested should have a “positive” test result because at that level of testing we can catch outbreaks before they happen.

There’s no question that another round of coronavirus restrictions such as closing non-essential businesses would be a hard pill to swallow. But economists have been clear that any attempt to reopen the economy without first controlling the virus will fail in the long run. That’s why in response to the new European lockdowns, Thomas Gitzel, chief economist at Liechtenstein’s VP Bank Group, said that a quick and strict lockdown could be less harmful economically than prolonged slumps in consumer spending because people fear the virus too much to engage in their normal economic activities.

Economists recommend that to make a successful shutdown possible, we should establish:

  • effective protections for essential workers in the supply chains that must remain open;
  • income support for those who are unable to work, sufficient to provide essentials; 
  • a continued strict freeze on evictions, foreclosures and utility stoppages, with a mechanism to work out the arrears once the pandemic is controlled.

How many lives we save rests on the shoulders of both Democrats and Republicans. State governors should move quickly to issue temporary stay-at-home orders and nonessential businesses to close to slow the spread of the virus. Federal lawmakers should provide financial support for increased testing and tracing capacity, and financial relief for Americans to be able to stay home.

Waiting to act until hospitals overflow all over the country with sick and dying people would be an insult to the memory of the thousands of families who will face empty chairs at their holiday tables this year. 

Photo credit: Piron Guillaume


Matt Wellington

Former Director, Public Health Campaigns, PIRG