Having failed to plan for the success of the stay at home order, California must now plan for the poverty pandemic and other crises that will soon follow.
History will not be kind to government at any level for its inaction in the face of COVID-19 during February 2020. Sadly, we have squandered our time in March and April as well. Our inability to plan for a timely transition into the next phase of the pandemic will cost California dearly in the weeks and months ahead.
On March 24th, I urged “the government [to] develop and model [public health] alternatives on the assumption that the stay at home order will successfully flatten the curve.” I reasoned that we should “enter our ‘new normal’ phase of managing the virus [through more narrowly-tailored stay at home orders for the most vulnerable and ongoing public social distancing measures] as soon as possible to reduce the massive collateral costs of near-maximum social distancing.” The government has failed us on both counts.
It has been obvious for two weeks that the statewide stay at home order has achieved its intended purpose – it has more than flattened the hospitalization curve. During this time, the Governor has announced that we will coordinate with Oregon and Washington (but not Nevada and Arizona?) on transitioning into the next phase of the pandemic, pivoted to six indicators that he said will guide his decision to lift the stay at home order, and stated that that “localism” will be “determinative” in transitioning out of stay at home order. Earlier this week, he made it clear that localism is a one-way street – localities can impose more severe public health restrictions than the statewide stay at home order, but they cannot adopt less restrictive measures to meet their unique circumstances because infected people may (continue to) travel across the State. In effect, the Governor is now telling us that despite our successes, we must all to stay home to prevent an “Escape from LA,” which accounts for a disproportionate share of COVID-19 fatalities and cases in California. After 34 days of staying at home, we are no closer to having an actual plan for exiting the stay at home order than we were on day 1, despite the fact that the fatality rate from the virus is far lower than previously estimated.
What is happening to California while the Governor fiddles? With each day that passes, the stay at home order is creating catastrophic collateral consequences. Our economy continues to sink to unprecedented lows. If it has not already done so, our unemployment rate will soon exceed the highest rate seen during the peak of the Great Recession. Some economists believe we may approach unemployment levels that rival the Great Depression. Either way, massive unemployment will push our poverty levels – already the highest in the nation – to astronomical new heights. The State is now burning from more than COVID-19.
With increased poverty will come a predictable and tragic parade of horribles – homelessness, food insecurity, and worsening physical and mental health for millions of Californians. Indeed, it has already started — many Food Banks are already straining to meet demand. With each day that passes under the stay at home order, we are damaging thousands of lives, often irreparably.
If we truly care about saving lives in California, we cannot continue to ignore the collateral consequences of our response to COVID-19. As the California Department of Public Health has recognized, “[p]overty is an important public health issue. It limits access to basic material necessities such as housing, food, education, jobs and transportation, and thereby impacts the ability to live a healthy life.” Our Food Banks put it more bluntly: “Food insecurity has serious impacts on an individual’s well-being, which may result in poor school attendance and performance, lowered workplace productivity, and physical and mental health problems. Individuals struggling with food insecurity have to make tough decisions that no one should face. No family should have to decide between buying groceries or paying rent, no senior should have to choose between food and medicine, and no parent should have to skip a meal in order for their children to eat.” Not surprisingly, given these agonizing daily choices, individuals thrust into poverty face serious mental health challenges as well, ranging from depression to anxiety to substance abuse.
Even for those lucky enough to escape poverty and COVID-19 over the weeks and months ahead, our response to the pandemic may yet cause them grave harm. As the Wall Street Journal and many others have recognized, people have been forced to forego critical medical care during the pandemic. Today, “[i]t’s impossible to forecast the human cost from this suspension of care. Aggressive cancers may go undetected. Chronic conditions that have been controlled with regular check-ups and medicines may worsen. While doctors can prescribe drugs over the phone or web, physical exams and medical imaging are needed to diagnose many ailments.” As one orthopedic surgeon in Chicago recently wrote, the toll from this suspension of care could exceed the toll from the virus itself: “As a nation, we are in grave danger of pushing aside every aspect of medical care that is not related to COVID-19, and if we do not act quickly to balance our efforts, the conditions we are ignoring may incur a human cost that could far overshadow that of the virus.” The bell may yet toll for those who manage to escape both poverty and the virus.
Our prolonged stay at home order has created many ticking time bombs in California. With our economy in tatters and more employers closing permanently each day, we cannot count on a quick rebound in employment when we finally transition into the next phase of the pandemic. The private sector will not be able to stem the poverty pandemic. With tax revenues plummeting, the State and Counties will not have the financial resources to combat poverty and improve public health. Will the federal government come to our rescue? How many more aid packages can it put together when it is drowning in debt? Will our nonprofits be able to offset the lack of government resources? Will our healthcare system be able to respond to non-COVID-19 illnesses in the months ahead? Although the challenges we have created for ourselves are predictable, the policy responses are anything but. So who is currently working on the “Marshall Plan” we will need to repair our State?
As a result of our failure to plan for the success of the stay at home order, we are gravely damaging the lives of potentially millions of Californians and creating public policy challenges that will likely have a greater impact on our State than the COVID-19 pandemic itself. We had better start planning to meet them. We cannot afford to make the same mistake yet again.