Donald Trump Thinks His Willpower Can Restart the Economy, It Can’t

A daily Covid-19 update from Andy Slavitt, former head of the Centers for Medicare and Medicaid Services

Photo by Win McNamee/Getty Images

First of all, let me start on how things look. I get a report early in the morning summarizing case growth with a bunch of other global and US data. It’s a tale of two halves of the country.

I talked to a doctor in Orange County, CA and heard from someone who talked to another doctor, that there were only 3 new cases yesterday. California has 21k confirmed cases with 40M people — that’s 52 infections per 100,000 people (if my math is right).

Now we know there are many more cases because they are under-tested. But so are many other states. Northeastern states infection rates (per 100,000):

970 New York

696 New Jersey

370 Massachusetts

338 Connecticut

252 Rhode Island

178 Pennsylvania

Compared with 52/100k for California — even if there’s more testing in the Northeast — it’s a big difference.

We know this because if you look at hospitalizations, CA has 132/1million. New York has 2,189/1million. New Jersey has 865/1million etc. Point being 16x more hospitalizations in NY than CA, and 19x the cases in NY than CA, the difference is not testing.

Governor Gavin Newsom in California acted 6 days earlier than East Coast governors. So the tale of the West is one largely of planning. And in the East, it’s largely one of heroics.

In my morning reports, I usually don’t entirely trust the Monday report of Sunday because I think reporting could be light, and yesterday was Easter, but on face value the numbers were flattening. The “how we’re doing” message on that front is #StayHome has saved a lot of lives in the West and is now doing the same in the East after a struggle to keep a lid on things.

The hard thing for everyone to grasp sometimes (including me, including Fauci — everyone) is the invisible nature of the virus.

~50% with no symptoms

5 day dormancy

The virus lingers on surfaces

2 week delay in hospitalizations

Point is when you think you’ve won — you don’t know it.

We’re going to get smarter as we have more tests (more on that shortly) and learn the virus better. But for now, it is easy to make mistakes that can cost you dearly. And that’s if you’re a thinking person. If you’re an instinctual person, even worse.

How else are we doing? Well, on the heroics front, New York and New Jersey — with the support of other states and yes, FEMA and the Army Corps — have done amazing things. Beds, ventilators, more but not enough PPE. Yes it’s been chaos. Yes there’s been frustration. But the states have rallied.

However, as a country, we will never ever be able to live down what we did to our front line health care workforce. Throwing them in unprepared. It will be one of several lasting shames of this era in my opinion. The same is true for vulnerable populations; nursing homes, communities of color, and the social service agencies who help them. So far, we have let them down.

It’s also true that people have been suffering economically. Small businesses, contractors — all of us really — have been hurt. Many may feel that they have sacrificed too much to save the lives of just a few. That’s a lot like how this country works at its best. For our soldiers. For our Veterans. For our seniors. What’s different about this suffering is it’s invisible results. The sacrifices of those in CA make it appear unnecessary to the naked eye.