The U.S. shut down much of the economy, and still more than half a million Americans died from COVID-19 while children lost out on school, shops shuttered and Congress spent $6 trillion on relief, sparking a consensus that prolonged lockdowns cannot be the treatment of choice for future pandemics.
“It was never intended to be a long-term thing. I think politics, media hysteria just took over,” said Joe Grogan, who led the Domestic Policy Council under President Trump and served on his COVID-19 task force.
The original shutdown plans were supposed to last only a few weeks, he recalled.
“One thing to keep in mind is the shutdown started because the New York City health system was on the verge of collapse. At least that was what it looked like,” Mr. Grogan said. “Then we were worried about other health systems shutting down.”
The economic shutdowns reduced the number of cases but proved to be a blunt instrument, with massive job losses, permanent business closures and excess deaths from a host of causes as people put off regular health screenings or treatments. Restaurants and music and art venues are teetering, and drug overdose deaths are worse than they have ever been.
The situation forced the nation to reckon with a clunky approach that exposed years of failure to invest in tools that could head off desperate measures during a pandemic.
Lawmakers, doctors and disease trackers alike agree on one thing: They do not want to do it again.
“For future infectious disease emergencies, this cannot be the treatment of choice,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “We must fix the flaws in our public health system, empower scientific leadership to take proactive actions and have a delimited framework for how to use blunt tools when all other options are exhausted.”
As the 2020 shutdowns dragged on, hopes for widespread, rapid testing or other strategies that would disrupt chains of transmission never materialized. Schools weren’t ready to reopen in the fall as many hoped. Many governors, especially in blue states, fell back on societal strictures to restrain the virus, including forbidding indoor church services and limiting business hours and capacity, sparking record numbers of unemployment claims.
The rules at times seemed dictated by public or economic pressure rather than the virus itself, creating confusion. The news cycle tended to sort the debate into a binary choice between reopening the economy or combating the virus.
At some point, critics say, the U.S. should have an open and dispassionate debate about the impact of the shutdowns, which managed to break the economy — even as the death toll rose to a staggering 570,000 and counting — while devising ways to make federal agencies nimble enough to respond to emerging threats.
“When we look at the way the vaccines were developed as quickly as they were, why were we caught so flat-footed on the testing? And what can we do with the testing ecosystem to have a ready reserve that can be drawn upon?” Mr. Grogan asked. “This [pandemic] broke our bureaucracy in public health, and it revealed tremendous deficiencies in it. They need to learn some lessons. I think the media has a lot of soul-searching to do, too.”
Sen. Roy Blunt, Missouri Republican, is exploring ways the federal government can be a proactive partner in the research and development of disease-fighting tools, “instead of just a sponsor,” so the U.S. is better prepared.
President Biden’s request for $6.5 billion to create the Advanced Research Projects Agency for Health, which would investigate cures for cancer and other diseases such as diabetes and Alzheimer’s, could be the right avenue. The proposed agency would be housed under the National Institutes of Health, which collaborated with the private sector on rapid, point-of-care tests and COVID-19 vaccines that were developed and tested in record time.
“There’s an opportunity here to build on that successful model where the public-private partnership is able to dramatically accelerate the development and approval of new treatments and technologies,” Mr. Blunt told The Washington Times. “Every moment counts in a pandemic, and I’d like to see us maintain a permanent capability to leverage federal investment and expertise to better anticipate and respond to public health emergencies and other threats we face.”
Disease experts caution that the death toll, as bad as it was, could have been worse without limits on social interaction during the wait for pharmaceutical fixes, namely the COVID-19 vaccines. Sweden famously resisted a lockdown while peer nations clamped down, only for leaders to express regret when its death rate far exceeded those of its Scandinavian neighbors.
In essence, experts say, lockdowns can help reduce the number of cases and deaths but at a bitter cost compared with alternatives such as strict quarantines at the border combined with rapid identification of new outbreaks and contact tracing.
“Over and again, climbing case counts have been reversed by non-pharmaceutical interventions,” said William Hanage, an associate professor at the Harvard T.H. Chan School of Public Health. “However, non-pharmaceutical interventions should not be considered a solution on their own.”
The communist government in China used an early, draconian lockdown and then widespread testing to wrangle the virus after it was discovered in Wuhan at the end of 2019, but similar limits on public movement would have been unacceptable and too difficult to implement in the U.S. In some cases, only one person per household could leave every two days.
Taiwan, meanwhile, didn’t have to resort to shutdowns. It leveraged early testing and tracing, an integrated system of electronic health records and a culture of mask-wearing from the 2003 outbreak of severe acute respiratory syndrome (SARS) to protect its population.
The U.S. ended up in a kind of muddled middle. It shut off travel from China early but lacked diagnostic tools for many of the early weeks of the pandemic. The nation was flying blind while the government fixed a flawed test from the Centers for Disease Control and Prevention and drafted regulatory fixes to let private laboratories and universities develop tests.
The U.S. resorted to shutdowns because it lacked a public health system that could test, trace or isolate diseases, said John Hopkins’ Dr. Adalja.
“There was actually no impetus to even fix this, and that is why we had summer and winter surges,” he said.
The country flattened the curve after the spring wave but didn’t get to a safe baseline of transmission, resulting in a roller coaster of spikes that hopped around the country during the wait for vaccines.
“It was like a halfway, halfhearted shutdown,” Arthur Caplan, director of the division of medical ethics at the New York University Grossman School of Medicine, said of the early response. “The idea we’re going to quarantine Los Angeles is just not going to work in our society because we don’t have a government that is totalitarian that will literally lock you in.”
California and other Sun Belt states experienced surges in COVID-19 as American society reopened last summer, prompting governors to crack down or issue new rules. Since then, the link between transmission and government regulation has been murky at times, weakening the case for heavy-handed rules as opposed to voluntary or targeted measures.
Michigan retains a mask mandate and indoor capacity limits but until recently was swamped with cases fueled by variants and indoor youth sports. Texas has a lower case rate per population despite fears of a decision by Gov. Greg Abbott, a Republican, to fully reopen.
“All the states at the top are lockdown states,” Rep. Jim Jordan, Ohio Republican, said as he pointed to a case-rate chart at a recent House hearing. “Lockdown states have a much higher rate than the state of Texas.”
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Mr. Jordan that people might be ignoring the rules at this stage.
“You could have a situation where they say, ‘We’re going to lock down,’ and yet you have people doing exactly what they want to do,” he said.
Complicating matters are variables that determine a state’s pandemic trajectory, said Dr. Hanage, “like variation in climate, numbers of vulnerable individuals, and now more recently whether more virulent variants are transmitting.”
The impact on economic and social life is easier to follow because the damage is coming into sharp focus.
Rather than displacing deaths from other causes, federal data shows, the pandemic resulted in excess deaths from diseases such as Alzheimer’s and diabetes. The leading theories are that people deferred needed care and that some of the deaths were caused by COVID-19 but were misclassified.
The CDC this month revealed that 87,000 Americans died from drug overdoses from September 2019 to September 2020, a 29% increase from the prior 12-month period. The numbers showed a reversal in progress and confirmed fears that the opioids crisis worsened because of pandemic shocks.
The Biden administration is extending moratoriums on evictions and has pushed for massive spending to stem the fallout from the shutdowns.
The nearly $2 trillion package that Mr. Biden championed was muscled through on a partisan vote, with Republicans accusing Democrats of spending large sums on priorities that had nothing to do with the pandemic even as vaccines offered a path to a natural economic recovery.