Trade-offs

One of the most important lessons I learned in college was the importance of trade-offs. This is particularly true in the field of Computer Science: space vs time; development speed vs technical debt; and customization vs automation are all compromises that need to be considered. Almost nothing comes for free.

In business, too, there are trade-offs. A common aphorism is to "never let the perfect be the enemy of the good." You can almost always make something better, but you are often sacrificing time and resources. Past a certain point, the marginal costs exceed the benefits.

People are uncomfortable talking about trade-offs valued in human lives, but the world is quickly coming to the realization that a similar dynamic exists in the fight against COVID-19.

A recent article in The Economist illustrates the point (emphasis added):

The bitter truth is that mitigation costs too many lives and suppression may be economically unsustainable. After a few iterations governments might not have the capacity to carry businesses and consumers. Ordinary people might not tolerate the upheaval. The cost of repeated isolation, measured by mental well-being and the long-term health of the rest of the population, might not justify it...In the real world there are trade-offs between the two strategies...

The Economist is a centrist publication. But a consensus that unmitigated isolation and cessation of world economic activity might not be the right approach seems to be forming across the political spectrum, from conservative sources like The Wall Street Journal and Trump's Twitter feed:

To the more liberal opinion pages of The New York Times:

Particularly disturbing is the thought that the draconian measures being taken may not only be causing harsh economic and public health trade-offs, but also be of limited benefit:

I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself. The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.
 
Worse, I fear our efforts will do little to contain the virus, because we have a resource-constrained, fragmented, perennially underfunded public health system. Distributing such limited resources so widely, so shallowly and so haphazardly is a formula for failure. How certain are you of the best ways to protect your most vulnerable loved ones? How readily can you get tested? (Katz)

The benefits of "flattening the curve" to reduce COVID-19 infections are very real - but so too are the effects of people losing their jobs, watching their life-savings disappear, delaying treatments for other maladies, and being put into social isolation.

Even if you don't agree with the above, it's worth asking how things end once more restrictive measures are lifted. Do we quarantine the entire population for the next few years, and shut down the economy, every time the virus comes back (as it inevitably will)? Do we continue this process indefinitely if no cure or vaccine is ever found? Should only the opinion of public health officials (and not everyone else who has a stake in society) be considered?

These are tough questions - and I certainly don't know the answers. But from everything I've read, it seems like the most plausible scenario is:

  1. A lifting of restrictions on most quarantines / travel after 2 - 4 weeks.
  2. "Low-risk" / recovered people returning to work
  3. "High-risk" people (elderly, people with pre-existing conditions) staying isolated, voluntarily and depending on personal risk tolerance, until a cure or vaccine is discovered (likely 1-2 years)
  4. Better testing, tracking and isolation of infected cases by public health authorities to selectively contain hot spots
  5. A cultural shift in terms of behavioral standards for public hygiene (hand-washing, staying home when sick, wearing masks, fever screening at public events, not shaking hands, etc)
  6. And, unfortunately, many deaths and overwhelmed health care systems where difficult decisions will have to be made. The silver lining being that perhaps this will incentivize systems to improve, reducing the impact of future, more serious pandemics (this is what happened in Asian countries after SARS).

In other words, a less-than-perfect solution and gradual shift to normalcy, with most people accepting the risk of ailment for the trade-off of a semi-functioning world.

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