The spread of the coronavirus throughout the South and Southwest, and the emergence of pockets of infection in Northeastern states, attest to the difficulty in controlling a pandemic during the summer and to diminished expectations for a quick turnaround in the economy.
What if a vaccine is developed, and people refuse to take it?
Though the rate of spread appears to have subsided somewhat, the number of infections remains staggering and it will likely take months before infections and deaths subside to levels that are manageable for hospitals and caregivers, much less the normal operation of local economies.
The pandemic’s toll on the economy is evident in the 54 million initial claims for unemployment benefits filed during the 19 weeks since the virus outbreak, and in the increase in the ratio of continuing claims to initial claims. This suggests that workers are moving into the unemployed ranks faster than they are leaving.
The result has been an unprecedented drop in household income and spending, a decline in business investment, and drops in imports and exports that reflect a global economy holding its breath until a vaccine is discovered.
But even if a vaccine is developed, there is a question that looms over the economy and the chance for a full recovery: What if people refuse to take it?
This question has taken on greater urgency amid the remarkable worldwide effort to discover such an antidote.
Last week, the federal government announced a $2.1 billion deal with the French pharmaceutical company Sanofi and its British partner, GSK, for development and delivery of 100 million doses, as reported by The Washington Post. This came on the heels of billions spent to support the development, or the pre-purchasing of doses, from Johnson & Johnson, Moderna, Movamax, Pfizer and AstraZeneca, the Post reported.
Yet, even if a vaccine were discovered by a U.S., British or French pharmaceutical firm, or by a firm backed by another country, will the public quickly accept the findings and allow the economy to return to whatever the new-normal might be? Opinion polls suggest otherwise.
A recent Politico//Morning Consult survey suggests that 60% of the public would prefer that the vaccine be fully tested before rolling it out, even if the delay resulted in more infections. And though 82% would take a U.S.-produced shot, 18% say otherwise. Politico/Morning Consult cautions, however, that it is not clear “how much public attitudes about a vaccine could change if a shot becomes available.”
A CNN poll taken in May – before the spread of the virus throughout the South and Southwest – reported that even if a coronavirus vaccine were cheap and easy to get, one third of Americans indicated that they would not try to get vaccinated.
There is precedent for concern over vaccines. During the initial rollout of the Jonas Salk polio vaccine in 1955, defective production caused 11 deaths and several infections before being halted, corrected and then restarted. By 1960, Albert Sabin’s oral vaccine replaced the Salk needle version, and polio was wiped out in the U.S., by 1968.
Complicating matters is that there is a strain in U.S. society that mistrusts government health officials, and the authority of science itself. This is evident in the growth of the anti-vaccination movement and the re-emergence of measles, which had been wiped out in the U.S. by 2000.
Is there a solution that balances personal freedom to get sick with society’s collective decision to survive a pandemic?
Economic thought might suggest a market solution to accepting or not accepting vaccination.
First, let’s start with a simple analogy. Everyone would agree that while it’s okay to go 80 miles per hour across the Montana plains, that’s not going to happen on the Dan Ryan Expressway in Illinois. We accept that driving at excessive speed in congested areas is more likely to lead to death than it would driving to Missoula or Las Vegas. Our society does not allow reckless decision making if it involves the safety of others, and there are costs if you violate those laws.
Economic thought (out of the University of Chicago, hence the Dan Ryan reference) in other areas might suggest a market solution in the age of the coronavirus to accepting or not accepting vaccination. If you choose not to get a shot, and if you were to infect someone else, then you are responsible for that person’s medical care and loss of income. The analogy would be crashing your car into your neighbor’s house; you would be responsible for rebuilding the house and providing for temporary shelter.
But what about the people who still refuse to vaccinate? Can employers disallow those who do not vaccinate in the workplace? Do we need to establish a separate but equal system of public schools for children who are not vaccinated?
In the meantime, retail businesses are left to enforce mask wearing and social distancing within their establishments and people are left to decide whether or not to attend large gatherings in some states.
A pandemic creates questions about both the problems and benefits of federalism and the sanctity of personal choice.
Assessing the status of the pandemic
The data provides the best avenue for policymakers for decide how best to safeguard the public and when to reopen business as usual, and then when it might be necessary to reinstate restrictions.
In the six states with major metropolitan areas (New York/New Jersey, Boston, Philadelphia, Chicago, Los Angeles) that were the initial centers of infection, the number of coronavirus cases per day reached as high as 20,000 in the second week of April. We show this in the figure below. Since then, and because of public acceptance of social distancing practices and public policy, those cases subsided to fewer than 6,000 per day at the start of summer, but have since reached back up to 13,000 per day (most of them in California) as the public let down its guard as summer progressed.
In contrast, coronavirus cases in all other states never moved much below 12,000 per day from their peak in April, which may or may not have contributed to policymakers’ giving greater weight to the health of their economies in May.
Cases accelerated after the Memorial Day weekend, reaching 54,000 per day after the July 4 weekend. Cases have since receded to 50,000 per day in the last weeks of July.
The public’s response to those policy decisions is evident in the divergent trends in deaths. In the major-metropolitan states, shown in the first figure below, deaths attributed to the virus have declined from 1,500 at their peak in April to fewer than 200 per day at the end of July.
In all other states, COVID-19 deaths declined from 800 per day in April to 300 per day early in July. This early decline in deaths was attributed by policymakers to the younger age of those infected, giving impetus to further relaxing of standards. But deaths in the non-metropolitan states have been accelerating since July 6, and now account for 900 of the national average of 1,100 deaths per day.
Nationally, there are 65,000 newly reported cases of coronavirus infections as of the end of July, double the average at the peak outbreak in April, as shown in the first figure below. Given the current exponential rate of spread and unless additional restrictions are imposed, the cumulative number of U.S. cases of infections could approach 5.2 million at the end of the first week of August, shown in the second figure.
The third figure shows the national increase in deaths attributed to COVID-19 infections, now averaging 1,100 deaths per day.
State-by-state analysis
Of the six states with major metropolitan areas that were hit hardest in the initial outbreak of the virus (New York, New Jersey, Massachusetts, Pennsylvania, Illinois and California), only California and Pennsylvania are reporting increasing number of cases since Memorial Day.
Nationally, 40 states are reporting increasing average weekly growth rates of infection since the Memorial Day weekend, as listed in the table below.
For more information on how the coronavirus is affecting midsize businesses, please visit the RSM Coronavirus Resource Center.
