Can taking ‘military’ approach help in re-opening the economy? Here are four suggested ‘taskings’

The news media is rife with experts debating the wisdom (or not) of various timelines to re-open the economy.  The military never really shut down, and while there currently are 5,888 COVID-19 cases among the more than 1,377,000 active duty troops, there have been only two deaths thus far.

Continuing operations safely presented some real challenges to the military,  Consider this caption from the news release for the photo on the right of the “masked” Airmen:

“Military training instructors lead graduating Airmen onto the drill pad during the basic military training graduation ceremony at Keesler Air Force Base, Mississippi, May 15, 2020. Nearly 60 Airmen from the 37th Training Wing Detachment 5 completed the six-week basic military training course. Due to safety concerns stemming from COVID-19, the Air Force sent new recruits to Keesler to demonstrate a proof of concept to generate the force at multiple locations during contingencies. The flight was the first to graduate BMT at Keesler since 1968.”

Can taking a ‘military’ approach on opening the civilian economy help?  Maybe.

Let’s start by identifying the objective.  Some might say it is to avoid any additional COVID-19 deaths.  To them, that may mean keeping the economy closed and simply absorb the devastating consequences.  A military perspective, however, might be to redefine the objective to be an open (or nearly open) economy where the citizenry is about as safe (or more) as it would have been had the economy remained closed.

How?  We need to look beyond just COVID-19, per se, and think – as military leaders would – strategically about what can reduce the total number of needless deaths the U.S. endures each year.  In Air Force jargon, this would be an effects-based approach that recognizes it is the health and welfare of the citizenry as a whole that really matters.

To do so, we should not, indeed cannot fixate on COVID-19, which in the absence of a vaccine or cure, presents a persistent peril.  Of course, efforts along those lines need to continue with dispatch, but applying a military approach would call for a “planning assumption” that no such fixes would be available in the near term.

Instead, military strategists would look at actions that are within our ability to take.  If we act decisively on them, we then may be able to ensure (despite any potential increases in losses to COVID-19 that re-opening might occasion), the saving of more people – and the economy!

Assessing the current situation:

Any planning effort should begin with a candid assessment of the situation.  Although models predicting the lethality of the virus have gyrated wildly over the past few months, it seems the best estimate now predicts 143,360 U.S. deaths attributable to COVID-19 by August 4.

This is slightly better than other recent projections and, importantly in terms of the risk associated with the mobility and easing of the lockdown produces, CNN reports:

“We were pretty surprised,” said Chris Murray, the chairman of the [University of Washington’s] Health Metrics Sciences department.  “We were expecting to probably go up because of the big surge in mobility.”

Murray told CNN’s Anderson Cooper they didn’t find a correlation between mobility and deaths.

There are also hopeful signs that a vaccine may be on the way but, at best, it is still months away from wide availability.

The economic devastation

Military planning generally considers all courses of action, and their potential consequences.  Can we just continue a mostly-closed economy?

Actually, the economic damage caused by stay-at-home orders and other virus mitigating efforts has been enormous.  With losses estimated at $300 to $400 billion each month, it’s hard to imagine how such economic costs are sustainable, even for a wealthy country like the U.S.

According to the New Yorker, the economic effects of COVID-19 is “killing the middle class.”  Especially damaged are young people.

Vox reports that the “Covid-19 economy is particularly devastating to millennials” as they are “still recovering from the Great Recession now face a downturn that’s being compared to the Great Depression.”

Vox also says the “[m]ore young people have been laid off — and many of those still with jobs have had to take pay cuts.”  It says a poll by the Pew Research Center “found American millennials to be the most pessimistic of any age group about the future of the economy.”

Also seriously impacted are school-age children.  For instance, The Economist warns:

“The extent and length of school closures now happening in the rich world are unprecedented.  The costs are horrifying.  Most immediately, having to take care of children limits the productivity of parents.  But in the long run that will be dwarfed by the amount of lost learning.  Those costs will fall most heavily on those children who are most in need of education.  Without interventions, the effects could last a lifetime.”

Mental health cost

The lockdown is having cascading effects on more than just economic matters, per se.  Vox says that “[i]In general, recent polls reveal that millennials — of all backgrounds — are experiencing high anxiety around how the coronavirus will affect their economic realities.”  A brief from the Kaiser Family Foundation (KFF) reports that “COVID-19 pandemic and resulting economic downturn have negatively affected many people’s mental health.”

With respect to economic matters in specific, KFF indicates that the health risks are quite real:

Research also shows that job loss is associated with increased depression, anxiety, distress, and low self-esteem; and may lead to higher rates of substance use disorder.  Additionally, as unemployment rises and a recession nears, suicides may increase.  During the Great Recession, the U.S. unemployment rate rose to 10% and was associated with increases in suicide rates.

Furthermore, Harvard Medical School said recently that the social isolation COVID-19 preventatives can cause operates to increase the risk of opiod addiction.  The isolation may increase the risk of overdose deaths.  In short, COVID-19 isolation can prevent deaths from the virus, but may put others at risk.

Are there any mitigating factors? 

A complete assessment must include the unintended (and perhaps unexpected) benefits that have occurred from the lockdown beyond just stifling the pandemic.   The “bill” for these benefits has already been paid, so to speak, but they do appear to be yielding some mitigating benefits.

These include fewer fatal respiratory illnesses because industry closures have dramatically cut air pollution; a lesser number of crime victims because malefactors have not been circulating as frequently; and a diminished number of vehicle accident victims due to restricted travel.

No one would want to achieve these benefits through a pandemic, but the fact is that collectively these effects will likely diminish the number of deaths and injuries that would have resulted otherwise.

Information like this could help boost the public’s morale, and any military leader would tell you that helps to give people confidence to soldier through a difficult and dangerous circumstance.  It’s essential to diminish the despair some are suffering (and the media sensationalizes).  Giving people fact-based reasons for the optimism and confidence is critical to reviving the economy.

Four suggested taskings

All military plans involve specific taskings.  Here are four things leaders and Americans at every level ought to be hawking loudly:

1)  Permanently incorporate the sensible health and disease-avoidance measures imposed for COVID-19 into daily life.

The military has the relative luxury of requiring its members to do things to achieve objectives.  For the most part, however, civilians need to adopt voluntarily habits and norms in their own best interests.

In this crisis it means the public needs to make a habit of such things as frequent hand-washing, as well as sanitizer availability in public places.  Plexiglas dividers will likely appear in many venues.  Maybe buffets and salad bars should see their last days in their previous iterations but be re-imagined in different ways.

Additionally, certain populations especially vulnerable to COVID-19 – the elderly and/or those with pre-existing health conditions – may need to consider carefully the necessity of public excursions to crowded locations.

Masks?  My bet is that we’ll see lots of them, and in the near term requirements in locations like barber shops and salons – and perhaps permanently in places like hospitals.  Vulnerable populations (and maybe others) may want to wear them virtually everywhere outside the home.

Preventative actions can operate to decrease not just the chances of COVID-19 infection, but also – as the Centers for Disease Control (CDC) tells us – are “effective in reducing spread of other viral respiratory diseases.”  Thus, if we internalize the COVID-19 measures we could hope to see a significant decrease –- in the 60,000 fatalities the U.S. suffers each year from seasonal flu.

Besides permanent COVID-19 measures that would also reduce the spread of seasonal flu, a required (or hyper-incentivized) flu vaccination program could be a literal lifesaver for thousands. Unfortunately, less than half of adult Americans currently get vaccinated for seasonal flu. That needs to change.

Preventive actions and greater vaccination could produce benefits as early as this fall with the onset of the 2020-2021 flu season.

2) Plan for the worst-case scenario

Military planners obsess about logistics – and for good reason: success or failure may hinge on the sufficiency or insufficiency of logistics.  In this case, the adequacy of logistics is critically important to giving the public confidence in the re-opening – something that is lacking in many places.  One way of doing that is to assure people that if something does go wrong, there are adequate resources to address it.

Accordingly, a tremendous effort is needed now to build the stockpile of necessary medical supplies should there be a resurgence of COVID-19.  On May 14 the White House released “a plan to restructure the Strategic National Stockpile (SNS), implementing lessons learned from recent pandemics.”

Among other things, it says the “next generation SNS will be improved by increasing supplies of critically-needed items, integrating predictive analytics to determine needs, leveraging technology to provide real-time visibility of supply chains, and reducing dependency on foreign supplies.”  In addition, it “will provide financing to key industries producing vital goods and services.”

All good, but time is of the essence as some experts are predicting the U.S. only has a few months to build up supplies before another pandemic wave hits.  Thus, states should re-build their own stockpiles, and innovative approaches should be welcomed.

For example, “the Air Force is piloting an initiative called the Rapid Agile Manufacturing Platform to leverage the full capacity of the U.S. manufacturing base.”  The Air Force ”decided to turn to nontraditional suppliers — like car manufacturers and 3D-printing factories — to explore how they can contribute in making different products for the Department of the Air Force.”  Additionally:

“The envisioned process goes like this: Non-traditional companies apply through a central portal where they are evaluated using a suite of digital tools and validated against needs that are collected directly from end-users. Then, an initial sample purchase takes place where the company sends a small batch of equipment to a unit for evaluation before a larger purchase takes place.”

This is just one example of the kind of innovative thinking that is so necessary now.  There are, however, more tasks to execute.

3) Root out medical errors

Many military strategists think in terms of Liddell Hart’s indirect approach.  Looking in an unanticipated direction may provide an opportunity to reach our objective which is, you’ll recall, reducing the overall number of unnecessary deaths in the U.S. despite any increase in COVID-19 fatalities opening the economy may cause.

In that vein consider this: according to a 2018 CNBC report, “doctors don’t want you to know about the third leading cause of death” in the U.S.: medical errors.

Amazingly, CNBC says a “Johns Hopkins study claims more than 250,000 people in the U.S. die every year from medical errors,” and adds that “[o]her reports claim the numbers to be as high as 440,000.”  As one expert put it to CNBC: ““Medical-care workers are dedicated, caring people,…but they’re human. And human beings make mistakes.”

According to Dr. Martin Makary, who led the Johns Hopkins’s study such deaths include:

“[Those] caused by inadequately skilled staff, error in judgment or care, a system defect or a preventable adverse effect.  This includes computer breakdowns, mix-ups with the doses or types of medications administered to patients and surgical complications that go undiagnosed.”

CNBC references solutions that can involve better technology, more training for medical providers, less unnecessary surgery, and ending the over-prescription of medications.  CNBC quotes Dr. John James, a patient-safety advocate, and cites his website, Patient Safety America.  It lists:

“[T]he three levels in which patients can protect themselves. These include being a wise consumer of health care by demanding quality, cost-effective care for yourself and those you love; by participating in patient-safety leadership through boards, panels and commissions that implement policy and laws; and by pushing for laws that favor safer care, transparency and accountability.

Now may be the ideal time to get the funding for technologies to help minimize medical errors, monitor and scrutinize prescriptions, analyze unneeded surgeries, and to exploit rapidly developing teaching methodologies and platforms to get the providers the necessary training.

Leadership in the military is essential to operational success.  There are different kinds of leadership, both in and out of the armed forces, but the next recommendation requires the very best.

4) Initiate a major campaign to encourage (and incentivize) Americans to embrace life-saving healthy lifestyles 

As noted above, the military has the relative luxury of requiring its members to do things. For example, it can equip its members to exercise and control their weight – in essence; live a healthy lifestyle – or at least a healthier lifestyle than many civilians.

If the COVID-19 crisis can awaken Americans to the value of a healthier lifestyle, tens of thousands of lives can be saved – and not just in the near term.  Leaders ought to issue a simple call to action: take control of your life because changing lifestyles saves lives.

Leaders may want to start with helping Americans appreciate that other than a vaccine or a cure which may be – at best – months distant, a healthier lifestyle is the best way to bolster the body’s defenses against COVID-19.  Consider this news report:

“David Quimby, a doctor who specializes in infectious diseases, said those looking to better their chance of surviving the coronavirus should follow some basic rules to create a healthier lifestyle: eating plenty of fruits and vegetables, getting enough sleep and exercising.”

Furthermore, even the grimmest predictions of the lethality of COVID-19 do not begin to approach the deadliness of heart disease and cancer – the top two killers of Americans: heart disease (647,457) and cancer (599,108).

A healthier lifestyle is something that could save an astonishing number of lives.  In 2013, ABC News reported on a CDC study that found that “[a] least 200,000 deaths each year from cardiovascular disease could be prevented.”  Last November, Harvard Medical School published an article that explained:

“Nearly half of all premature deaths may be due to unhealthy lifestyle choices, such as insufficient exercise, poor diet, and smoking. These risk factors increase the risk of high blood pressure, diabetes, heart attack, and stroke.

The good news is that lifestyle changes can make a difference. In a study analyzing over 55,000 people, those with favorable lifestyle habits such as not smoking, not being obese, engaging in regular physical activity, and eating a healthy diet lowered their heart disease risk by nearly 50%.”

Studies also show that “[o]ne-third of all cancer deaths in the United States each year are linked to diet and physical activity, including being overweight or obese, while another third is caused by tobacco products.”

In addition, “deaths of despair” stemming from mental health issues, loneliness and drug and alcohol abuse are robbing our society of valuable lives as well.

How far should authorities go to induce people to abandon “unhealthy lifestyle choices”? 

That’s a difficult question, but currently a whole array of intrusions into civil-liberties are being considered (or even accepted) beyond just the lockdown to prevent COVID-19 deaths.  Many are advocating, for example, contact-tracing technologies intended to reveal when (and possibly where) individual citizens might have been exposed to COVID-19.  Such intrusiveness clearly implicates civil liberties is a major way, but the opposition to these proposals seems muted.

A recent poll by the University of Chicago “revealed ‘remarkable’ level of tolerance for restrictions on liberty” for government actions designed to halt the pandemic.” The openness was bipartisan as the poll found that “Democrats and Republicans are equally open to many government measures that could slow the spread of the novel coronavirus but may also undermine civil liberties.”

Sure, it could be that if the public were convinced that better lifestyle management could save significantly more lives than any stay-at-home order or invasive contact-tracing technology could do for limiting COVID-19 deaths, then it might tolerate rather aggressive action towards that end.  It might be possible to do what might have been unthinkable before the COVID-19 crisis.

But do we want government intervening in our personal life choices and liberties?  How can we accomplish the balance of protecting our liberties and encouraging healthy lifestyles?

What if we as individuals, as Americans, begin to translate the current compassion and concern for others into personal, chosen action to encourage the promotion of healthy lifestyles in ourselves and in those we love?

Ask not what your country may do, but what we can choose to do! 

Concluding thoughts  

If these “tasks” only succeed in saving only a small percentage of those who theoretically could benefit, that’s still likely to be more lives saved than deaths caused by opening the economy.

In an interesting op-ed in the National Catholic Register Monsignor Charles Pope worries that a “practical vigilance has given way to paralyzing anxiety.”  He said he was “sympathetic” to concern that the “cure should not be worse than the disease.”   While he insists that the “lives of those afflicted by or particularly susceptible to the new coronavirus matter, but so do the lives of others who are experiencing mounting losses and struggling to provide for their families.”

MSgr. Pope added this thoughtful observation:

“Many with this concern are demonized and told that they are selfish and don’t care if other people die. This is, of course, an unfair accusation. Those who are calling for a gradual reopening want people to live, too. Living consists of more than having a pulse. Living involves thriving, interacting with others, cultural enrichment. Living involves the dignity of work, contributing our labors and sharing in their fruits.”

So we must ask ourselves – why did we accept the extreme actions taken to shut down the economy and change our daily habits for COVID-19, but yet we continue to accept the status quo as to violent crime, suicide, mental illness, drug and alcohol abuse, diabetes, heart disease and cancer?

Is it because of fear generated by media and the messages for Covid-19?  Is it because of we feel immune to those other illnesses?  The stigma with some of them?  The fear of contagion and that it could affect us or loved ones?

Is it because it was easier to shut down than to stand up?   

If we truly are “in this together” as so many have proclaimed, shouldn’t we voluntarily take actions that help not only ourselves, but our families, our communities and our country?

We know we can pull together as a nation to create healthier environments and to encourage one another in the pursuit of a better tomorrow.  But will we?

Remember what we like to say on Lawfire^®: gather the facts, examine the law, evaluate the arguments – and then decide for yourself!