The World after Covid-19

[Guest]

Reality check: Human beings have conquered the world, but we do not fully recognize what happens in nature. As parts of the world that have not been conquered are assimilated, we will continue to see diseases cross the line between species, presenting unique threats to a human genome that has not developed immunity.

When a disease comes along that not only does not play by the rules of other diseases, but requires human beings to fundamentally change the way we operate, we are faced with a systemic challenge, because the world we've constructed does not take into account the eventuality that something like SARS-CoV-2 will happen.

The question becomes: Now that it has happened, how will that knowledge change the way we rebuild the world in the wake of this Pandemic?

I keep think of H.G. Well's War of the Worlds, where Martians are well on their way to conquering the world when they are taken down by bacteria. Yes, we are the dominant creatures on this planet, but we are a part of a biological ecosytem, and economic and political systems that do not take into account the frailties are human biology are going to be inadequate.

How should we rebuild our Public Health System?

What role should the Federal Government play in future biological emergencies?

How do we deal with the disruptions in supply chains? How much food and medicine and medical supplies should the government stockpile?

Governments always speak of promoted health and safety, of promoting the general welfare. How do we address that commitment in a post Covid-19 world?

I think that Covid-19 brings up central questions about the role of government. The post Covid-19 world we be different. So should our thinking.

[_Chap]

How should we rebuild our Public Health System?

I'm not trying to be combative, but I have the impression that rather than the USA having something that could be called a 'Public Health System", the USA has a 'Health Sector' of the economy, parts of which mostly operate as separate business entities. Am I wrong about that? So I am a bit puzzled about what it would mean to "rebuild [the US] Public Health System", since rebuilding suggests such a system is already in existence.

The UK, on the other hand, has an integrated National Health Service, which has been in existence since the social settlement at the end of WWII. The NHS certainly has its faults and failures, but it is a very different kind of set-up from the means by which most US citizens access health care. It seems to me that quite a few Americans actually reject the idea of having any kind of integrated Public Health System, since they identify this with 'socialism'.

Please correct me if I am off beam.

[_honorentheos]

Around 2014 I was in a small meeting that included the City manager of one of the satellite communities of Phoenix. One thing he said in the discussion came back to me with huge question marks for what a post-Covid world might look like.

While discussing a subject that involved operational budgets, he shared data from the community's sales tax revenue during the Great Recession. Highlighting it, he remarked that given this was the worst recession we were likely to ever experience his office had used that baseline to establish the floor for what they could reasonably support in terms of annual budgets, capital improvements, general obligation bonds repayments, etc.

It came back to me as I was talking with a different City staff member on the other side of the County early this April and they went into the unprecedented drop in sales tax caused by the shutdown. Its a scenario I doubt any government, local, state or federal, had included in the playbook.

The world after Covid-19 is...well, not here yet so there's that. But I expect the first period of time will.be focused almost exclusively on how to keep the economy from going off a cliff when public perception is likely overly simplistic. The federal government is (rightly I think) piling on debt but unfortunately we had been eating through our seed stock before this trying to make sure Trump could look good come November. We cut taxes as we ramped up spending, we did everything backasswards from what we should have been doing and we haven't even begun to see that fallout really start to manifest.

I don't know. Consumer confidence and household debt financing supported by willing banks to hold onto risk for the good of the economy could result in a quicker recovery. But we could very easily end up spending a few years fighting to keep the wheels glued on as businesses that collapsed behind closed doors during the shutdown aren't there to simply reopen their doors. Or they collapse under the strain of trying to reopen, pay staff, and meet overhead all while sales are a trickle of what is needed. Their former employees aren't able to find new jobs. Local and State governments can't fund basic services on unprecedented cuts in tax revenue with equally unprecedented unemployment claim levels. And the federal government sees a debt to GDP ratio of 150 or more create more heat than energy hindering it's ability to help out.

I think arguing over whether or not our health care in the US needs to be nationalized is one debate among many that may be important...but the world after Covid might assert different priorities.

[_honorentheos]

I'd add, while unlikely the probability of this fracturing our society is greater than 0. In some ways, the crisis showed that our federal system makes a great buffer against incompetence at the Federal level of government. Governors and mayors have stepped up to function as leaders in the vacuum left by the Trump Hot Air show and Congress retreating.

But societal collapse looks like that, too. As people lose confidence in their governments at the larger scales, they reorganize at smaller, more local levels. So who knows? We could decide we need a more robust federal structure with the ability to manage resources and direct traffic...or the opposite, deciding California is better off without Louisiana, Texas doesn't need New York and since they are competing for resources already why not stop all sharing, period?

Or nothing changes because at some point when uncertainty is rampant people crave stability and the familiar. Who knows.

[_honorentheos]

In less negative news, I have seen red Cardinals in the park near our place this week for the first time since we moved here. Maybe the nature of our conquest will evolve to more shared space with, well, nature again.

[_EAllusion]

I'm skeptical of there being significant changes until I see them. Some things seem certain - more businesses deciding to make working from home permanent for a greater % of their workforce, for instance. But a lot of the think-pieces I see predicting large-scale social change seem more like the wishes of the author than something that seems especially likely. My default is to expect things to eventually return to mostly normal. I'm not even sure we can get rid of handshakes, which we should.

There's probably a tail-risk chance of the pandemic and its spiraling economic devastation leading to international government instability or increased hostility between the authoritarian governments that are taking over the globe (including here in the US) that trip wires a horrific world war, but that doesn't seem *likely* at the moment. Though if anything this pandemic has taught people, it should be that taking into account low-risk, high harm events should be included in how you think about and plan for the future.

[_MeDotOrg]

How should we rebuild our Public Health System?

I'm not trying to be combative, but I have the impression that rather than the USA having something that could be called a 'Public Health System", the USA has a 'Health Sector' of the economy, parts of which mostly operate as separate business entities. Am I wrong about that? So I am a bit puzzled about what it would mean to "rebuild [the US] Public Health System", since rebuilding suggests such a system is already in existence.

The UK, on the other hand, has an integrated National Health Service, which has been in existence since the social settlement at the end of WWII. The NHS certainly has its faults and failures, but it is a very different kind of set-up from the means by which most US citizens access health care. It seems to me that quite a few Americans actually reject the idea of having any kind of integrated Public Health System, since they identify this with 'socialism'.

Please correct me if I am off beam.

I would agree: in many ways calling access to medical treatment in the United States a "health care system" is being generous. At the very least there has to be some greater integration or interface between the public and private sectors of health care.

[_Jersey Girl]

Here's my first and perhaps only contribution. Use the NHANES data collection that takes place every 10 years in alignment with the census, as a national testing facility for COVID-19. What NHANES does for it's data collection is set up mobile labs in parking lots at places like malls and Walmarts.

Assign or reconfigure their mobile lab facilities to include COVID-19 testing immediately. Go from there.

They've already got the trailers. Why not expand the number of trailers and use them to test for viruses like COVID-19?

ETA: Wouldn't it be useful to deploy the trailers to rural communities? Walmarts?

[_Jersey Girl]

How much food and medicine and medical supplies should the government stockpile?

Is there some reason that the US can't manufacture it's own surgical masks and gowns again? Apparently we had to rely on China this go round. There's folks all over the country making supplemental surgical masks, gowns and bonnets--and we don't have the manufacturing plants to make them?

[_MeDotOrg]

Just as we have a strategic oil reserve, I think we need a strategic medical reserve, stockpiling PPE and ventilators. Trick is, all of that stock needs to be rotated out, so we're not sitting on a bunch of expired equipment. We obviously need to be thinking about our capacity to manufacture essential medical equipment when our world suppliers are cut off. What we have now is woefully inadequate. This is an essential element of Homeland Security. Lockheed Martin does not build the F-22 in China.