I thought this one worthy of a redux, here are a few segments:
First, most emergency rooms are not equipped to handle a very high volume of cases, especially infectious diseases…The general economic problem is that emergency rooms typically are not equipped with full surge capacity, nor are there enough emergency room add-ons or substitutes available on very short notice.
Very often, when a pandemic breaks out, talk turns to macro remedies such as air travel bans and quarantines, as China is instituting. Yet often the more important factor is the strength, resilience and flexibility of local public health institutions, and those qualities cannot be created overnight. Just as the Chinese health-care system is undergoing a major test right now, there is a good chance that the U.S. will too.
An additional test could concern child-care and telecommuting. Will U.S. schools need to be shut? At the very least it is something officials should have been planning for. Even if schools are not closed, some number of parents will keep their children at home, whether out of rational fear or not. Anti-vaccine sentiment is fairly high and rising, after all, and even the wisest parents will prefer to be safe than sorry.
Keeping one’s children at home means that fewer people will go to work. Even those with external child-care options, such as day care, may be reluctant to leave their children outside the home for the same reasons they fear the schools. The new question then becomes how robust are work plans, and U.S. supply chains, to a higher than usual rate of workplace absenteeism. There also may be an especially high level in China, which could strain U.S. and other supply chains relying on Chinese producers. Many businesses may need to amend their plans on the fly.
Once again, pandemic preparation is about the flexibility of decentralized institutions. These are not problems that can be solved by top-down planning. Instead, they rely on longstanding institutional capacities, high levels of social trust and improvisational skill.
If and when a good vaccine becomes available for the virus, that will again be about the improvisation and flexibility that will allow for scalability and eventual production and distribution. It is usually difficult to solve such problems quickly, but still there is better and worse performance — and that can make a big difference.
The very first problem the U.S. is likely to face is one of risk communication. Of course the correct message will depend on how the data evolve, but in general there is tension between warnings that get people to take notice, and those that scare them underground or into counterproductive forms of panic.
If you tell people how terrible things are, they feel a loss of control. Many will retreat into conspiracy theories, spread mistrust of health-care institutions, or withdraw altogether from social or professional activity. Those who are sick may be afraid to seek medical attention, for fear of having their movements constrained, driving the disease further underground and distorting the data. Again, trust is of paramount importance.