Defeating Coronavirus: How Massachusetts Can Increase Protection for the Most Vulnerable While Reopening the Economy

From the revolution that began in Concord in April 1775, to the mobilization of America’s scientific community that produced the A-bomb and radar in World War II, when the nation faced grave crises, Massachusetts has often led the way to victory.

As Washington now stumbles from one misstep to the next, Massachusetts has an opportunity to show how intelligent choices can allow us BOTH to increase protection for those most vulnerable to this novel killer, AND, with appropriate precautions, reopen the economy and society for the overwhelming majority of our citizens.

To do that, we must begin by getting clear about the nature of the challenge posed by this novel virus—specifically: whose lives are in the crosshairs of this virus and whose are not. In the blizzard of numbers about this novel threat that leaves most of us a bit dizzy, it is worth beginning with a brief quiz that reminds us of the central facts. As the daily death toll approaches 73,400, how many of those have been Americans under 35? Among deaths under 25, which has been the larger killer: coronavirus or the flu?

Fewer than 500 of the deaths have come from the more than one third of Americans who are under 35. And for the under 25s, the flu has killed twice as many people as coronavirus.

Here in Massachusetts, 4,400 have died to date. But among those under 30, the death toll is just 3. And the average age of coronavirus deaths in the bay state is 82. Properly diagnosed, those at materially greater risk of death from coronavirus (than they faced in the world before it appeared) are a subset of the 15% of our population over 65. Those at extra special risk are the over 75s, particularly those with one or more of the relevant preexisting conditions. More than 80% of all the deaths in America have come from that population, 3 of 5 of these males, and 94% of all the dead with at least one pre-existing conditions. 

In Massachusetts, the risk to the elderly is even more pronounced. 99% of the coronavirus deaths have occurred in the one-third of the population that is over 50, almost two-thirds of those deaths in nursing homes.

With a clear focus on who this novel killer has in its crosshairs, the challenge becomes to find ways to increase protection for this most vulnerable minority as we take smart steps up the staircase to reopening the economy and society for the overwhelming majority. Consider for example, the half of our population under 35 who are in day care, kindergartens, schools, universities, and starting out in the workplace.

How difficult would it be for Massachusetts to create our own version of what Purdue University is now doing to welcome back its student body of 40,000 in August for the fall semester? As announced by its president Mitch Daniels last week, Purdue has developed guidelines to “protect the most vulnerable members of our community by allowing (or requiring, if necessary) them to work remotely;” “spread out classes across days and times;” and “pre-test students and staff before arrival in August.” Rather than waiting on Godot—either from Washington or Indiana’s state government—for testing, the university is mobilizing its own relevant scientific research community, including its own BLS-2 level laboratory “to ensure abundant testing and fast results.”

And what about the over 65s, both in the professoriate and the university’s staff of 20,000? They have to be effectively separated from the rest of the community, professors zooming into classrooms in which younger faculty members and graduate students are getting the opportunity to manage the classroom, administrators working remotely from home. And in the community around the campus, ways are being developed to provide for them that don’t require them to come face to face with the infected as they now do when working as front-line health providers, checkout clerks in supermarkets or takeout restaurants, or pumping gas at filling stations.

There are, of course, many devils in the details. But imagination in solving complex problems has historically been a great source of patriots’ pride. Aspirations to escape these challenges by counting on the imminent arrival of a vaccine or even anti-viral to save us are escapist. For the year ahead, the challenge for Massachusetts and the nation will be to mitigate and manage risks.

Properly conceived, the coronavirus crisis presents an extraordinary opportunity for Massachusetts to demonstrate that the struggle between President Trump’s drive to reopen the economy as quickly as possible, and the insistence by many public health experts to delay until further hurdles are overcome, is in fact a false dilemma. We can both reduce the likelihood of death from coronavirus for the most vulnerable while simultaneously reopening the economy for the vast majority of our citizens.