Thursday, December 7, 2023
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Healthcare nightmare: COVID-19, flattening the curve and the economy

By Dr Alphonsus St Rose

Freedom can be the biggest threat to survival in a pandemic. People’s choices and behavior must be streamlined for effective control and containment of COVID-19. Dissent, on the other hand, speaks to tolerance and respect and is one of the most important pillars of any democracy. It allows for a measure of oversight and a very important check and balance on power.

Under a State of Emergency, for example, freedom, dissent, choices, and behavior all get managed accordingly. Once COVID-19 is declared a National/Global Health Emergency the public good takes precedence over some personal/private considerations. This is where public tolerance, maturity, respect, and responsibility are tested and the litmus test of social and moral conscience is applied. Navigating issues of patient privacy, confidentiality, human dignity and how much the public is entitled to know (in this COVID-19 pandemic) remains a vexing, ethical and sensitive matter.

“…What we do or fail to do will determine the extent to which COVID-19 transforms our lives and the direction of this country, perhaps forever…”

I see a real possibility of multiple waves of viral surges because of the unruliness and irresponsible behavior exhibited by some sections of the public instead of patience and tolerance. Even more unfortunate is the inability of the economy, and the growing unwillingness of the public, to withstand a prolonged but necessary social distancing/stay home/shut-down policy. In addition, our lack of capacity coupled with poor central organization and planning makes us all increasingly vulnerable to the spread of the virus.

Slowing the virus will only happen by reinforcing and maintaining social/physical distancing for a sufficiently prolonged period, increasing nationwide testing to identify positive cases and negative cases in order to understand the disease burden in our communities, robust contact-tracing for quarantine/isolation/treatment and monitoring/ surveillance and follow-up.

The period of time for social distancing is to be determined by real-time data based on the extent of testing done, the number of daily/weekly positive cases, the number of daily/weekly hospitalized cases and the number of daily/weekly deaths. The premature easing of the protocols can create a false sense of security in the public and the backlash of a secondary wave or waves of infection.

There can, however, be no substitute for a strong public health program and a government that conveys trust and confidence to its people and vice versa. Poor communication and decision making by the government can be a purveyor of fear and panic as we have experienced during this pandemic, and must not be repeated.

COVID-19 caught us like many others, undoubtedly unprepared, and so the people of this land are in for a very hard time, for a long time, unfortunately, because tens of millions of dollars that could have been invested in them now, were squandered in bad investments.

“…Decisions made on our behalf are driven by special interest concerns rather than sound judgement even at the expense of risking our lives…”

At what point does the government declare the country COVID-19 free and safe to commence a gradual rolling back of existing protocols and back to doing business with a semblance of normalcy? Only after proper and efficient containment, mitigation and management of our limited resources while preventing an over-heating of our frail healthcare system, will we be able to flatten the COVID-19 curve. This will then allow us wellness space to attempt reopening/rebuilding a better and more resilient economy, the timing of which is critically important. Any miscalculations here will be costly in human and economic capital.

The health of the nation is the single most important determinant as to when the country reopens for business and the economy taken-off hibernation mode. Until the COVID-19 pandemic is reduced to a pre-determined threshold, there can be no constructively meaningful recovery of the economy. Any premature attempt at such will be nothing short of a disaster in the making.

The essence (health) of any economy is prefaced by the basics of human interaction and behavior. Once that becomes weakened (COVID-19 pandemic) then your economy is weakened both at a micro and macro level and risks going into a recession and collapse. An economy that has no built-in resiliency, reserve or capacity to withstand the stresses of external forces (COVID-19 pandemic) brought to bear on it, is a weak economy.

Therefore, any attempt to restart our national economy by addressing symptoms (inflation rates, unemployment rate, growth performance/GDP, corporate greed and panic) rather than the root cause (COVID-19) is a burdensome misadventure. COVID-19 has paralyzed the economy which ironically, now has to take a proverbial bullet for the people; what a change of fortune.

Indeed, it is no easy act for any administration, most of whom now worry about the undeniable political and economic fallout with an economy in free-fall towards recession (Black Swan). Where does that critical point of overlap lie between the people and the economy within the politics of the COVID-19 pandemic?

This is a very compelling reminder of the contradictions and injustices of our modern-day society. Our lack of productivity, export, and increasing unemployment do create the danger of a negative output gap (recessionary gap) which, amidst mounting household and public debt and increasing inflationary pressures, is not a good platform for much needed sustainable growth (the preferred long-term approach and strategy) let alone jump-starting a COVID-19 battered economy.

Economic stimulation by way of monetary policy (Quantitative Easing), by its very nature, a short term/last resort printing of money and interest rate adjustments, remains an unpalatable option at the Eastern Caribbean Central Bank (ECCB) if the value of our EC currency (pegged to the US$) is to be preserved. Our fiscal policy space, on the other hand, has been abused and is now maxed out.

My inquiring mind tells me that this country is heading towards insolvency (bankruptcy). It is a very serious matter for any government to find itself running a country without any monetary or fiscal policy space to maneuver. Government’s expansionary fiscal policies (expenditure through borrowing) have recklessly escalated in recent times without being subjected to many policy-driven restrictions or creating of a diversified and sustainable economy.

We have little or no choice but to implement tight fiscal prudence, discipline and general public-wide austerity measures to attempt a turn-around of this mess. It is only a matter of time before these unforced errors, forcibly tilt our economic policy towards structural (re)adjustment programs, as our overstuffed public service (a real burden) and huge public debt are unsustainable. Public service and debt restructuring alongside debt forgiveness (from bilateral and multi-lateral creditors…CDB, IMF, World Bank) are unavoidable.

There must be some measure of social equity (justice) to calm the waters of potential social and civil unrest. The public must complain because nothing definitive is being said about eligibility and access to a clear, unambiguous and all-encompassing social stimulus package, as the government is broke; because the country’s scarce financial resources, it appears, have been squandered by poor fiscal discipline, unfettered borrowing and too many high risk/low return projects of which the public is not a shareholder, let alone part-owner.

This is where we are as a people, 41 years after independence; the fury of COVID-19, poverty, unsustainable debt, inequality, unequal access to and poor distribution of resources – all because our leaders have failed the people by enacting policies giving the wealthy (status quo) class a monopoly on power, growth, and progress to the detriment of the masses and the country.

Let’s all help by social distancing, staying home and following the health protocols. Saint Lucia, brace yourself, like Bob Dylan sings, “The Times They Are A-Changin’.”



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