We can protect the most vulnerable and reopen the economy

The struggle between President Trump’s drive to reopen the American economy as quickly as possible, and the insistence by his public health team and many others that this has to be delayed until further hurdles are overcome, is largely a false dilemma. We can simultaneously increase protection for those who are most vulnerable to coronavirus and, with appropriate precautions, reopen most of our economy and society. 

The key to unlocking this false dilemma is a clear understanding of who, in fact, is most vulnerable to death from this novel killer — and who is not. As data from the deaths of the more than 58,000 of our fellow citizens to date show, the answer is clear. 

Those at greatest risk of death from coronavirus are a subset of the 15 percent of Americans older than 65. More than 80 percent of all the deaths in America from coronavirus have come from this group. Moreover, the data show that vulnerability increases with age beyond 65, especially among individuals with one or more specific preexisting conditions. And among those who have died, three of every five have been males. In the death toll to date, how many were individuals under 25? Of the 200 million Americans under 45, how many have died from this novel virus? The answers are: fewer than 100 among under 25s and fewer than 1,000 under 45s. 

Thus, in contrast to the specter of a nation at risk, when properly understood, coronavirus should be seen as a big threat to a small percentage of our population and a small threat to the overwhelming majority. To clarify this increased danger, it is instructive to distinguish between BC (before coronavirus appeared) and AC (after coronavirus). The fraction of Americans who today face a significantly greater risk of death than they did BC is likely to be roughly 10 percent. 

Moreover, as we are debating choices about next steps up the staircase to reopening the economy, we should recognize that most of those individuals already had retired from the workforce before 2020 began. At the other end of the spectrum, risks of death from coronavirus among those under 65 essentially fall with age, risks for those in the earlier decades of life being substantially lower than many other threats they were living with BC.  

President Trump has taken a step in the right direction in issuing guidelines on April 16 that specifically single out “the most vulnerable.” What is needed at this point is for the White House Task Force to follow up with more specific guidelines that it might label “Smart Steps” encouraging governors to exercise their ingenuity. Historically, one of the great strengths of our nation is that we have 50 “laboratories of democracy.” They can learn from each other how best to operationalize smart next steps ahead.

Among a number of initiatives beginning to move in this direction, let me conclude with an example of the intelligent imagination we need now. Last week, the president of Purdue University, Mitch Daniels — who served as president of Eli Lilly’s’s North American operations, then in the Bush administration as director of the Office of Management and Budget, and later as governor of Indiana — made a bold announcement. Unlike most leading universities, including Harvard, where I’m a professor, that are now on a path to postponing reopening their campuses in the fall semester, Purdue will welcome students at the end of August for the fall term. Specifically, Purdue’s guidelines call for “protecting the more vulnerable members of our community by allowing (or requiring, if necessary) them to work remotely”; “spreading out classes across days and times”; and “pre-testing students and staff before arrival in August.” To make this feasible, the university is mobilizing its relevant scientific community, including its own BLS-2 level laboratory to ensure abundant testing and fast results. 

Explaining the reasoning that led him to conclude that this was the best way forward for his university, President Daniels wrote: “At least 80 percent of our population is made up of young people, say, 35 and under. All data to date tell us that the COVID-19 virus, while it transmits rapidly in this age group, poses close to zero lethal threat to them. Meanwhile, the virus has proved to be a serious danger to older demographic groups, especially those with underlying health problems.”

To this I simply say: right on. A report published this month by Harvard Kennedy School’s Belfer Center’s Center for Science and International Affairs analyzing all the data available from the U.S. and a dozen other nations provides more specifics but the same bottom line. If we can summon the combination of imagination and courage that Daniels has demonstrated, the U.S. now has an opportunity to reduce the risk of death from coronavirus for the most vulnerable, while at the same time allowing most of society to return to their livelihoods and lives. 

Graham Allison is the Douglas Dillon Professor of Government at Harvard Kennedy School. Follow him on Twitter @GrahamTAllison.