Don't cancel summer plans except foreign travel: Thoughts about when we might be able to restart the economy.

A lot of people have been thinking about the massive wave of Covid-19 to come in the next month in North America. It is sure to be as horrific as it currently is in Italy and Spain in the USA (New York is already there).

But it is not too early to start thinking about the longer term and the decisions we would need to take to start moving back towards 'normal'.

Note: I have read a lot and know how to do data analysis. But I do not have epidemiological or medical expertise so what I say below should just be considered food for thought.

I am not thinking in Trumpian terms here and putting the economy ahead of lives. But there is, I think a risk of over-reaction. It may be that we need to socially distance until September, but we hopefully do not. And I think we need to prepare to push on the accelerator at the earliest time when epidemiologists give the go-ahead to avoid massive economic and social destruction, and excess deaths due to the fight against Covid-19 (rather than due to the disease itself).

I am reading about organizations cancelling activities in the summer and even well into the fall. My thought is DON'T CANCEL TOO SOON unless it involves overseas travel. I have, for example been urging my own faculty at the University of Ottawa not to cancel summer camps. They may eventually need to be cancelled, but we should wait to the absolute latest possible date before making that decision (even if this puts extreme pressure on the teams organizing them). The argument given for cancelling summer activities now is that it takes 'planning' time to ramp up, hire people and train them. This is reasonable. But it would be much better cancel on short notice (despite the pain of that), than to pre-emptively cancel. I have suggested only cancelling summer camps 30 days before they are due to start (so July ones would be cancelled progressively during June if necessary). If we and other organizations can pull off even half a summer of camps, it will allow parents to get back to work and kids to have less stressful lives. And the employment of staff would not be lost to the economy.

I have heard of whole summer theatre seasons being cancelled, even for August (see https://www.osfashland.org/en/tickets-and-calendar/covid-prep.aspx). Yes, it takes months to ramp up for a large production, but all of these artists are going to be potentially destitute as a result. It might have been better to suspend and then pick up after a 70-day hiatus.

For activities involving international travel, such as conferences, it does seem reasonable to make no plans within a 4-to-5 month time horizon, since nobody will want to commit to flying until some certainty returns, too many people have lost money on travel, and insurance won't cover cancellation any more. Besides, the airlines are going bankrupt. This, of course, poses incredible risks for the September semester at Universities that have a lot of foreign students, or even students from other provinces and states. Hopefully epidemiologists will be able to give good advice near the end of May so overseas travel can resume to some extent in September.

The following scientific paper by Glea et al, entitled "Estimated Deaths Attributable to Social Factors in the United States". Discusses death rates in the US in NORMAL times:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134519/

The paper calculates that in the US the death rate among people with low social support has been calculated at about 33% higher than among people with adequate social support), with about 21% of the US population aged 25-65 suffering from this. That means that about 65000 extra deaths arise from this cause in this age group each year. Another excess 97,000 deaths are caused by excessively low social support among seniors. So the total amounts to about 160,000 excess deaths in normal times. The paper also shows 130,000 excess deaths among people in poverty, compared with what would be the case if poverty could be eliminated. Clearly many people in poverty also have low social support, so we can't add these figures, but it seems fair to say that these social factors account for something like 200,000 excess deaths a year in the US.

If the poor social support rate or poverty rate go up substantially, say by 33% due to massive job destruction and other factors flowing from how we handle the Covid-19 crisis, that perhaps might cause many tens of thousands of excess deaths.

Total Covid-19 deaths in the US are projected to be something between 36,000 and 150,000 according to this site: https://covid19.healthdata.org/projections
I think we have to look at these figures and realize that after the peak passes, we ought to put our feet on the economic accelerator.

The above figures are for the US, but divide by 10 for Canada perhaps (or maybe by a somewhat larger number since we have a better health care system, better political system, and better social safety nets).

So what policy decisions can be made so that the sum total of deaths from both Covid-19 and the fight against it is minimized. We obviously need to keep up strict social distancing until the peak is well past. But then what?

The longer people are not paid and business cannot function, the greater the destruction of the economy. A year of this and I suspect we would be in a deep depression that would take a decade or more to dig out of. Many societal systems would collapse. Millions of people would die due to causes stemming from poverty and other social issues. Even people in countries with socialized medicine and other safety nets would be massively affected. So a year is out of the question, no matter how bad the epidemic. That leaves three possibilities:

Option 1: Get people back to work and kids back in daycare and school at the earliest point that would avoid overwhelming the health care system, perhaps in the last week of May if current peak projections are accurate. This would likely cause more Covid-19 to spread than in the other options, and some people would be extremely angry when they suffer from Covid-19 after this date or have their relatives die. Many people would have lost two months of income, but we might get away just with a severe recession. Government bailouts might be able to save the majority of businesses, so most people would get their jobs back. On the other hand there might be another wave of social distancing needed for a month or so later in the year or in 2021.

Option 2: Wait a bit longer until case numbers dwindle much lower, perhaps near the end of June when active Covid-19 case rates might go back down to where they were in early March in North America. Kids wouldn't be back in school this academic year, but summer camps could be run so people could get back to work, and some forms of low-travel tourism could resume (camping, local attractions) in the summer. There would likely be some outbreaks here and there and a steady flow of Covid-19 cases everywhere, but many businesses may be able to pull themselves back from the brink. But hardship would be very deep for many people. Even with government support, there would be a lot of economic destruction.

Option 3: Be very cautious, trying to completely eliminate nearly all Covid-19 cases, maintaining most forms of social distancing until late in the summer. I think this would be a disaster. A high percentage of companies, large and small would be bankrupt, with impacts lasting many years. We would be in a depression, not a recession. There would be extensive social unrest and mass migrations; many governments would be insolvent too. Real estate prices would crash. Most people's life savings would deeply depleted if not entirely lost.

For each option, the exact dates would depend on epidemiology, and the possibility of being saved by anti-viral drugs is also something we could hope for. In all three cases, social distancing for the elderly and other vulnerable groups would need to continue for longer.

My thinking is this: Governments should plan for Option 1. i.e. release social distancing and shutdown limitations after about 65 days (or when we get back to the level of infections seen in early March in North America) as is happening in China. Hopefully by this time massive-scale testing will be working well so we can track remaining cases, and also maybe start testing to find out who is immune due to having silently had Covid-19. If this happens in late May, that means that people can ramp up for normal economic activity for the summer months (minus international tourists).

Bottom line: Keep summer plans on hold without cancelling (other than foreign travel) at least until early May, when the situation might become clearer.