America is a free society, and in a free society, the exercise of personal choice is dependent upon both the opportunity to make choices and the ability to take responsibility for the choices we make.
Choice and responsibility are conceptually inseparable.
In the midst of the COVID-19 pandemic, there is another fundamental truth: We are all in this together.
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As we sort through the challenge of responding correctly to the pandemic, it’s appropriate to consider the role of choice. No matter how the pandemic affects us or how we pursue the recovery of our social and economic life, we are confronted with choices.
For our public officials, both in the federal government and the governments of our states, the most important choice facing them is now approaching.
In the coming weeks, they must decide how best to balance the competing needs of public health and our severely damaged private economy.
Public officials have had a huge challenge. At the very beginning of this pandemic, they had to make a choice between the policies of confinement and mitigation. Since the proverbial horse was already out of the barn, confinement did not seem the preferable strategy.
When we were faced with a highly contagious disease, they realized that the spread could quickly overwhelm our health care delivery system. That system was not designed for that type of shock, and we knew it.
Therefore, it quickly became obvious that the need to “flatten the curve”—spreading out the surge of large numbers of infected individuals into our health care delivery system—was paramount.
Considering the mechanics of mitigation, federal, state, and local officials had to decide how severe their mitigation policies would be; namely, how far they could go, for example, in mandating lockdowns and social distancing.
Likewise, American citizens also had a choice—either to comply with those orders or not.
To their everlasting credit, overwhelmingly, the American people made the clear choice to comply and cooperate with the recommendations of the president, the governors, and their scientific advisers. They maintained social distance, practiced good hygiene, and stayed at home.
The result: America was able to sufficiently “flatten the curve” and prevent the virus from overwhelming our health care delivery systems, no matter how difficult that became in certain peak areas of the country.
We are now entering a new phase of the pandemic crisis. It has been shaped by the choices our federal, state, and local leaders have already made.
They have generally concluded that continuing the lockdown is financially unsustainable. After deciding to begin reopening the economy, they had to choose whether to pursue a “one size fits all” approach for all of the states and locales, or whether to stagger the recovery response according to the particular needs of individual states and large cities.
Under the U.S. Constitution, the president, in cooperation with the governors of the states, made the right decision; namely, allowing states to determine for themselves what path to follow in reopening their economies, while keeping in mind the overarching guidelines provided by the federal government.
They decided to have the federal government as the backstop in fighting this virus and letting the states make the key decisions based on more localized information.
As American citizens, we are facing other choices, and some of those will be difficult.
Medical professionals must decide how they are going to deliver medical care most appropriately. How can hospitals best apportion their resources, such as hospital beds, intensive care unit beds, infectious disease pavilions, and elective procedure capabilities?
Many hospitals, doctors, and other health care professionals are near bankruptcy because of the shutdown of routine, “nonessential” services outside the COVID-19 pandemic. While state governments relax the mitigation restrictions, how can hospitals and doctors prepare for a future spike in infections?
In the midst of a peak influx of very sick patients, there’s always the threat of a limitation of resources that can put physicians in a very difficult ethical position in delivering care.
That occurred in Italy. Happily, it did not generally happen in this country. Physicians in some facilities, however, came very close to having to make uncomfortable choices.
Employers also have to make crucial choices. They have to decide who, among their employees, they should bring back on board as the recovery gets underway. Are there new models that will allow restaurants to recover? Is there enough demand to bring hotels back online or to bring airplanes back into service?
Finally, and most importantly, we as individuals and families are going to have to make some big decisions for ourselves. Is it safe to send your children back to school or should you continue to homeschool them?
If you are in one of the more vulnerable groups, such as the elderly, how much should you venture out? If you have comorbidities, such as cardiac or respiratory conditions, that decision becomes easier. If, however, you are elderly but active and in excellent health, do you stay locked down? Do you venture out timidly? Or do you return to full activity in your community?
In the final analysis, our personal and public choices are equally crucial. But our choices also depend on our knowledge. We are dependent on robust, reliable, and understandable data.
We have much to learn about this coronavirus. Certain facts, however, are clear: a large and growing database tells us that the overwhelming majority of people who contract the disease have mild forms of it and many may not even know it.
Some become uncomfortably ill. Some become terribly ill. A very small number become critically ill. Almost all in that last category have one or more other known serious conditions that help precipitate their very bad situation.
In making the right choice, it’s incumbent on each one of us—whether in public or private life—to examine the data and evaluate the risk to others and to ourselves.
Taking the opportunities available to us and taking responsibility for our decisions, we must choose what makes sense. If we do so, we can defeat this insidious enemy.