April 2, 2019
I think we can all agree that the crisis we find ourselves in does not come with a step-by-step instruction book of solutions. The way out is complicated, includes self-sacrifice, social order of the highest degree, individual and societal self-discipline and the abandonment of political self-interests. You may observe this list of requirements and say, “good luck” with that.
We can all observe the very best and very worst examples of the execution of those requirements every day. We are Americans. We do not need to be thirsty to drink or hungry to eat. If we observe failure, our response is almost always to seek the cause of that failure and to place blame on the culprits. We often search for the blame in leaders and, in doing so, demand that solutions be found quickly and remedies developed to cure the situation.
COVID-19 is our villain and is neither a person, government nor corporate entity but rather a disease that is highly contagious and has elements to it that make it very difficult to deal with. What we have learned thus far is that consistent societal self-discipline seems to be the biggest contribution to slowing the spread of the infection. Things we thought we knew at the beginning of the pandemic are turning out not to be as true as we first believed. Deaths among younger and seemingly healthy patients reveal that age alone is not an insulator against mortality. The smug assumptions that we embraced about our country’s abilities to battle the disease more effectively than other countries have given way to the realities of lack of preparation, equipment, materials, protocols and national directives resulting in wide disparities of success at slowing infection rates among states, counties and municipalities.
Globalization presents many opportunities as well as challenges. As mobility accelerates, so too does the reality of global growth of health care challenges among all of the populations of the world. What infects in one country will infect in another. It is precisely one of the foundational benefits of the World Health Organization (WHO), whose mission it is to “Improve people’s lives, reduce the burden of disease and poverty and to provide access to health care for all.”
WHO was created in 1948 by the United Nations with the knowledge and perspective that increasing globalization would break down many barriers, one of which would be the increased global transmission of disease. WHO is a tremendous resource for medical science and a foundational partner with global Centers for Disease Control to help create research pathways to understand viruses and the respective cellular structures of those viruses no matter where they exist. It is this essential research that allows for the cycle of disease eradication to begin. With each disease identification, the scientific community begins the cycle of understanding the pathogen of the virus so that they can then create the antigen that will ultimately provide immunity to the pathogen (virus) through vaccines.
This cycle of research often takes years — not days, weeks or months. Currently, we are early in the research cycle for the COVID-19 virus. The research activity is amazingly active, if not frantic, and includes many possibilities that all have to be tested prior to being made available on the coronavirus battlefield. In normal drug discovery processes, new or novel drug therapies have to first prove to be safe. In other words, the proposed cure that is being injected does not kill the patient along with the disease. Secondly, the drug testing has to prove therapeutic efficacy, which is proof that the drug works. These tests are normally conducted in phases enrolling hundreds and sometimes thousands of patients, whose progress or lack thereof needs to be monitored and evaluated over months, not days.
Our CDC, National Institute of Health and the World Health Organization are all working with the pharmaceutical industry on novel disease research on a daily basis for many global virus pathogens of which COVID-19 is but one of them. It is good to have a realistic understanding of where we are with respect to vaccination because in its absence we will by necessity be reliant upon identification of those infected and proper treatment protocols to effectively cure them. Simultaneously, all of the anecdotal information underscores the benefits of social distancing, hand washing and quarantining those symptomatic and those who have been in close contact with any active case.
The duration required of the above disciplines is not knowable because we are early in the process calendar. What will be the indicators that the adherence to the identified protocols are working? 1.) When the number of new cases identified is less as a percentage of those tested than it was previously. Do not be fooled by aggregate numbers. It makes sense that more people will be tested as new testing becomes wide spread. The key will be that the percentage of tested individuals testing positively is being reduced on a daily basis. 2.) Are active cases slowing and discharged cases growing? Currently, the condition is the reverse. 3.) Are ICU admissions declining on a daily basis? To be clear, these indicators have to be replicated consistently and have a trend line going in the right direction for weeks, not days.
The facts must determine progress, not artificial timelines. It would make no sense to abandon the required social disciplines to defeat the spread of COVID-19 prior to the evidence that we are making progress.
The economic consequences of our collective will as a nation to be self-disciplined and practice the required protocols will be staggering and it makes sense to understand that reality. On a seasonally adjusted basis, 3,283,000 people filed for an initial unemployment claim over the past two weeks representing 2.1% of our current workforce. The March unemployment report will be misleading because it will not include all of the new unemployment claims. We must also recognize that these claims do not include self-employed or those working part time. Where the unemployment rate will top out is not currently knowable; however, if we were to experience the depth of the 2008 recession loss of jobs we could see a return to the 10% unemployment level yet in 2020.
As we know, the consumer drives GDP growth. Prior to the 20th of February, the consumer was employed, earning wage increases and confident. Current consumer sentiment, as measured by the University of Michigan survey, reveals a near 30-point decline in consumer confidence in the last sixty days. Economic recovery will not come before disease control is evidenced and confidence begins to be restored. Restrictive controls on international and domestic travel, lodging, as well as dining have economic consequences, all of them negative. It will be some time before the evidence required on disease control allows for those negatives to be flipped to a positive multiplier.
Government’s role has been to step in place of the consumer. Congress passed, and the President signed, the 2.1 trillion dollar CARES Act representing nearly 10% of the projected 2020 GDP forecast. Philosophically, the aid package was designed to get cash to consumers through a variety of cash payments, tax relief structures and small business loan programs. Additionally, several industries were targeted that have been devastated by the coronavirus restriction protocols. The speed of the legislation was important and will have a dampening impact on the near-term economic fallout.
The recovery from the 2008 recession was incremental, averaging 2.2% annually for ten consecutive years, not typical of a V-shaped recovery normally associated with usual business cycle recessions. There are assumptions to forecasting the economic recovery of the coronavirus that are simply not visible at this time. If the assumptions of disease control within a reasonably short time similar to China’s experience pan out and include only modest reoccurrence rates, then the probability of a late second-half of 2020 recovery have some validity. The fact is that we are in uncharted waters and we are early in the protocol adherence process.
What is true is that we are in unsettling times and the difficult path is still very much before us. There is much to be learned and we will learn and apply it. We are discovering heroes among us who are willingly serving those in the most desperate circumstances. Their stories are rightfully being told. Communities are coming together in ways not experienced since World War II. Students across the entire bandwidth of education are learning remotely. Employees of small and large corporations are adjusting to doing business in a way they have never done before. Families are together and discovering one another in ways that they had not experienced in their entire lives. Social networking support and care groups have developed across all platforms and content forums. Husbands and wives and significant others are walking together and those distantly separated are Skyping to maintain and build relationships. Virtual choirs have evidenced themselves, as have virtual team and staff meetings. During every aspect of this fight we are in, we are learning. We cannot put a dollar amount on that discovery, but it is real and important.
I am honored and humbled to have witnessed the actions of the Greenleaf Trust team during these past three weeks. Their collective wisdom, innovation and collaboration has truly been remarkable as they take great care of our clients, their own families and themselves. As we say and believe at Greenleaf Trust, “We are with you and in every measure give thanks to you.” We will prevail.