An ocean liner is now quarantined off the California coast. A county government in Washington state intends to purchase a motel to house those who are infected with the coronavirus, and so can’t go home. Or have no home to go to.
The stock market crashed, rebounded when the Federal Reserve slashed interest rates, then slid again as Wall Street decided it wasn’t enough to stave off what comes next.
Precisely what “next” is, we don’t know. I needed someone to tell me that there is a degree of rationality lurking behind the current chaos. At least in a scientific, policy-wonk sort of way.
“We want to know the end of the story before the end of the story,” said Tom Price, the physician and former congressman who once ran this nation’s health care machine. “We don’t know how long this is going to go, we don’t know if the virus will mutate, or whether the death rate will stay about where it is, which is in the 2 to 3% range, or whether it will increase or decrease.
“The reason that folks have this gnawing sense in their gut is that everybody wants this to be a certain story, with a certain outcome and a certain path that we take. And that’s not how disease works.”
For the first nine months of the Trump administration, Price was secretary of the U.S. Department of Health and Human Services. He oversaw the U.S. Centers for Disease Control and Prevention in Atlanta, as well as the National Institutes of Health. He received daily briefings on disease “hotspots” at home and abroad.
In May 2017, Price went to Liberia to pay his respects to federal workers combating an Ebola virus that had killed 4,800. And shook hands with disease’s survivors – a visual statement that it was safe to touch them again.
At a G-20 summit, he war-gamed a pandemic with other health care ministers and learned something important. “There are some nations that don’t share the kind of information that’s important to share,” Price said. “China was one of them. They tend to be an insular society, a protective society.”
Price left Washington on less-than-ideal terms with President Donald Trump. But the former congressman from Roswell isn’t given to backbiting, and can go 30 minutes and more without referencing his former boss.
Price has this advice for those trying to cope with the first major global epidemic in an era of social media-driven misinformation: Trust the science. And trust the institutions that we have built from the ground up over the last century and more.
“It’s incredibly important for people to appreciate that this is a new virus, yes, but it’s not absolutely unknown,” Price said. “The coronavirus family is the same family that produces the common cold virus. It’s the same family that produced the MERS (2012) and SARS (2003) epidemics that we saw. From a scientific standpoint, we know a lot about this family of viruses.”
That knowledge makes a vaccine a near-certainty, though – again – the timing is less so.
Then there is this nation’s public health apparatus – the centralized portion that he once headed up, and the de-centralized system of state, county and municipal offices.
“One of the reasons we’ve extended life expectancy by decades is due in no small part to public health activity – whether it’s clean water or waste disposal or widespread diseases,” Price said. “Public health is something we know how to do.”
The aggressive travel restrictions and quarantines, mandatory and voluntary, have “helped dramatically,” Price said. They have been enacted with little opposition from health care officials familiar with the drill.
One can’t ignore the fact that COVID-19, the designated name for the disease caused by this new coronavirus, has struck in the middle of a presidential campaign – and has the potential to reshape our debate over health care.
In 2018, more than 1.4 million Georgians, or 13.7% of the state’s population, went without health insurance, according to the U.S. Census Bureau. It would be impossible to contain an epidemic while ignoring them.
As HHS secretary, one of Price’s primary assignments was to persuade Congress to dismantle the Affordable Care Act. Excessive travel expenses were an overt reason for Price’s departure, but he exited only three days after Senate Republicans gave up their assault on Obamacare.
I asked Price about the impact the current pandemic might have on the topic. “The conversation on those things is probably as uncertain as the conversation about what the virus is going to do,” Price said. What he said next was important.
“I would just stipulate that there isn’t anybody at HHS, there isn’t anybody at the Georgia Department of Public Health who at this point gives a whit about whether somebody who is ill or having a suspected challenge from this virus has any resources whatsoever,” he said. “We’re going to take care of people.”
“Is the debate to make certain that everybody has health coverage important? Absolutely,” he said. “Does it help to attack individuals who are trying to solve this current urgent and new challenge? Absolutely not.”
Yet the 2020 presidential campaign can’t be kept out of the Petri dish that this coronavirus swims in. According to a national survey of 886 registered voters, released this week by Public Policy Polling of North Carolina, 53% disagreed with President Trump’s assertion that his administration has done “a great job” in dealing with the virus.
On Wednesday night, in an interview with Fox News’ Sean Hannity, Trump accused the World Health Organization of over-hyping the danger of the coronavirus, and suggested that those with the disease could be safe going to work.
Even as many sectors of corporate America were issuing work-from-home orders.
“We have thousands or hundreds of thousands of people that get better, just by, you know, sitting around and even going to work — some of them go to work but they get better,” the president said. Asymptomatic carriers of the virus actually worry epidemiologists. They aren’t necessarily a bright spot.
Tom Price and I spoke the next morning. And at the end of our conversation, I noted that Trump would visit the CDC in Atlanta on Friday. Which prompted Price to carefully offer one more piece of advice — based on his own personal experience.
“There is a penchant by policymakers to run into the burning building and determine how to fight the fire, when in fact the best thing for policymakers to do is to provide the appropriate resources necessary, and the appropriate support and encouragement — but to allow the firemen to fight the fire.”
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