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Since the first U.S. case of Covid-19 was confirmed Jan. 20, the coronavirus pandemic has dealt the nation a triple blow: afflicting our health, undermining our economy and tearing at our social fabric.
In recent weeks, the pandemic has taken tens of thousands of lives and millions of jobs. And, according to recent reports, deaths of despair, such as overdoses and suicides, are on the rise amid tight social restrictions.Amid these threats, many states have begun a phased reopening of businesses and public places.
Influential figures in healthcare, business and politics have played a significant role in plotting the path forward.
But rather than working together on a comprehensive plan for a safe and successful reopening, these groups have maintained competing interests, bringing to mind the parable of The Blind Men and The Elephant. Each touches only one area and describes that part as if it were the whole.
1. Public health experts fear more than anything the ongoing spread of disease and, therefore, insist restrictive steps must continue.
2.Small businesses, fighting for their own survival, have joined conservative news outlets in calling for an aggressive reboot of the economy.
3.And with rising levels of domestic violence, alcoholism, and depression, both mental health experts and elected officials fear the threat of keeping social restrictions in place.
Though there is merit in each fear, and wisdom in each approach, our nations leaders have blinded themselves to a disconcerting reality: Maximizing success in one area will inflict even greater damage on the others.
Continuing aggressive shelter-in-place orders, for example, will further aggravate mental health issues just as throwing open the doors to the economy will cause a resurgence of infection. To save lives, we need a more focused strategy that blends the best of all three approaches, and removes the greatest threats from each. The question is: How best to a accomplish this goal?
Calling Professor Pareto
In the 19th century, Italian engineer and economist Wilfried Fritz Pareto observed that 20% of Italians held 80% of the countrys wealth. Expanding on his law of the vital few, Pareto held that a multitude of different events and social structures follow this same principle.
Now known as the 80/20 rule or the Pareto principle, the theory has proven incredibly accurate and insightful across nearly every facet of human existence, helping organizations and institutions strategize for success the world over.
Today, it is responsible for the well-known business adage that 20% of your customers produce 80% of your sales. Though actual data may vary by industry and business unit, this helpful nugget of wisdom allows sales and marketing teams to target a small group of customers rather than diluting their investments by trying to reach everyone. Likewise, knowing that 80% of all healthcare costs are consumed by 20% of Americans allows insurance executives to pool resources and build health programs aimed at keeping their sickest enrollees out of the hospital.
Using The 80/20 Rule To Battle The Coronavirus
Applying the Pareto principle to our nations coronavirus response offers a much safer and more effective set of solutions, maximizing the number of lives saved while ensuring the cure isnt worse than the disease itself.
Our nations current approach to the pandemic fails to acknowledge the fact that 80% of coronavirus deaths have occurred among the 20% of the population that is 65 years and older. Similarly, a study in New York City, the epicenter of the U.S. outbreak, found that 88% of of hospitalized coronavirus patients had at least two chronic health conditions.
If we know that the vital few are being disproportionately affected by the coronavirus, then why do shelter-in-place and social distancing orders apply to everyone, regardless of age or health status? Why are offices and small businesses reopening their doors to all workers and customers, rather than beginning with the 80% of people least likely to die?
By treating everyone the same, our nations policies are overly restrictive of people who are relatively safe while providing not nearly enough protection for the individuals at greatest risk. Rather than shaping policies based on facts, weve applied a one-size-fits-all framework to the entire nation. As a result, weve not only failed to corral the virus but also inflicted excessive economic and interpersonal pain on everyone.
By applying the 80/20 rule now, we can reshape U.S. policies governing our health, economy and society in ways that better protect all of us from the virus.
1. Helping our health
For months, the media has obsessed over the national Covid-19 death rate, wondering: Is it as low as 0.66% or as high as 5%? It doesnt matter. What matters is that death rates vary considerably by demographic. Among children, the chances of dying are extremely low, less than 0.01%, while the mortality rate among the elderly can reach double digits.
Therefore, reducing deaths requires us to segment the nation into two groups: Those in the high-risk 20% (seniors and people with two or more chronic conditions who must avoid contact with infected persons at all costs) and those in the lower-risk 80% (everyone else).
To understand the need for such a policy, look at nursing homes, which house less than 0.5% of the U.S. population but account for approximately 25% of Covid-19 deaths. All facilities should, therefore, separate residents (all of which fall into the 20% group), test staff frequently and strictly limit visitation.
The 20-percenters who live at home should avoid contact with family members who are not regularly tested or proven to have antibodies. At the same time, we need solutions that help seniors and people with chronic illnesses avoid the psychological consequences of extreme isolation.For example, recognizing how difficult it has become for grandparents to stay away their grandkids, we should provide technological assistance and support to connect families during this time of great social need.
And until there is a vaccine, we must allocate significantly more resources toward providing the 20% with sufficient food, access to medical care and safe housing. Compared to the trillions of dollars were spending to address the consequences of our current approach, investing in proactive assistance and prevention would prove far more cost effective.
2. Bolstering our economy
The American public, which has been subjected to an abundance of pseudoscience and political disinformation, continues to hold on to the false hope that the coronavirus will magically disappearthe result of effective social distancing, warmer weather or a wonder drug like hydroxychloroquine or remdesivir. If any of these outcomes were likely, or even possible, we could afford to blunder along for a few more months.
The reality is that this disease wont go away until there is an effective vaccine, which will be no sooner than January 2021, even by the most hopeful estimates. And because this is a marathon, not a sprint, we cant afford to let our economy crumble or put vulnerable people in the virus cross-hairs.
For our nations economic well-being, the time has come to open stores, restaurants, schools and services to the 80-percenters. At the same time, we must maximize the health and safety of workers and consumers. In public places, all people should wear a mask or facial shield, observe the six-foot rule, wash their hands frequently, and be tested at the first sign of symptoms. We should also ramp-up contact tracing to quickly and safely alert and isolate those who have interacted with infected persons. These measures are far less restrictive and, yet, far safer than the rules currently in place.
3. Bringing society closer to normal
Some situations are still too dangerous for anyone, regardless of age or health status (see: Game Zero, the Champions League soccer match in Spain that epidemiologists refer to as a biological bomb).
Until there is a vaccine, in-person conferences, major sporting events, large summer festivals, and even packed dance floors should be outlawed.We must remember that the 80-percenters are not immune to the disease. They can transmit it even if asymptomatic.
Ultimately, the 80/20 approach doesnt ensure 100% protection, 100% economic revitalization or a 100% return to normal. But it gives us the best opportunity to maximize success in all three areas.
Of course, anyone who prefers to continue sheltering, even those in the least-vulnerable 80%, should be able to do so. Generous work-from-home policies should continue for those who wish to stay as safe as possible. And telemedicine should remain a legal and reimbursable alternative to in-person care.
Ultimately, some 20-percenters would rather risk their lives than remain under house arrest. A clear, comprehensive strategy, properly communicated to all, would allow these individuals to make an informed decisionfully aware of the potential consequences.
Theres a reason extreme diets fail. To lose weight and keep it off, people need a plan they understand and can maintain for the long term. Our current coronavirus crash diet is the worst of all extremes. By following the Pareto principle, we could define a new normal that everyone could live withat least until a vaccine arrives.
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How The 80/20 Rule Can Save Your Life During The Coronavirus Reopening - Forbes