Small businesses, companies of 500 employees or less, are responsible for 64% of new jobs created in the US each year.
For every one person who has died from COVID19 roughly 1,000 Americans have filed for unemployment (based on the data that 17 million Americans have filed although another 3 million are probably backlogged).
A recent meta analysis of 42 studies conducted in 15 countries on the relationship between unemployment and all-cause mortality found that unemployment increased the risk of dying by 63% (Roelfs et al. 2011), most commonly by heart attack, suicide, homocide, and cirrhosis of the liver.
The Disaster Distress Hotline, a federal crisis hotline run by the Substance Abuse and Mental Health Services Administration, saw an increase of 891% in March of this year versus March of 2019. A nation already dealing with a mental health crisis saw a spike 9 times the average number.
The Recession of 2008, which caused an unemployment rate of approximately 9.6%, pushed an additional 2 million children into poverty. With a 20-30% projected rate of unemployment, 4-6 million children could fall into poverty.
Job loss was found to increase rates of problematic drinking, and alcohol-related morbidity and mortality (Moniek et al. 2017). A rise in alcoholism precedes a rise in spousal and child abuse.
Both the poverty rates and rise in abuse contribute to an increase in foster care causing an already overwhelmed system to fall further into crisis.
All of this is to “flatten the curve” so US hospitals are not overwhelmed; but across the US, hospitals are slashing pay, laying off workers, reassigning people to other departments, or cutting hours. The Medical University of South Carolina in Charleston started temporarily laying off 900 workers this week, a move it expects will last through June. Salaried employees are facing a 15% cut, and hourly workers who don’t care for patients will be working fewer hours. Without staffing changes, MUSC projected a $100 million loss through June 30th. (Leonard, 2020). Also in SC, Prisma Health furloughed or reduced hours for 3,900 of its workforce. (Bustos, 2020).
As of this moment, many of those who filed for unemployment have jobs to return to but as the shutdown continues, more and more of the small businesses that are the backbone of our economy will close.
While American politicians attempt to preserve the lives of those infected with COVID19, we must not forget to preserve the lives of those affected by COVID19. Some of those most vulnerable to COVID19 may never come in contact with the disease itself. Wanting the American economy to get back to work is not about greed and money, it’s about recognizing that more lives are at stake than just COVID19 patients. A broad, “one size fits all” approach may have been appropriate at the outset as data was gathered, but an individualized, localized response is now necessary.
I suggest each state develop an “Infectious Disease Commission” composed of state leaders in mental health, foster care, family life/faith, business/economics, the medical field, and medical supply production who will develop an “Infectious Disease State Protocol”. These men and women would help:
1. Ensure the hospitals are fully equipped with the necessary supplies/staff and establish an emergency supply chain within the state to fulfill any needs that arise. These plans may include car manufacturers that produce ventilators and/or clothing companies that produce PPE for hospital staff. In the occurrence of any future health crisis, the emergency plans would allow these companies to quickly mass produce the necessary, FDA approved equipment and then transport it to pre-approved Emergency Response Locations.
2. Establish specific rural hospitals as “Emergency Response Locations” where all infected patients can be safely quarantined and where emergency equipment is quickly transported. Also create an “Emergency Medical Response Team” comprised of medical personnel who willingly sign up and will earn hazard pay.
3. Create an emergency housing solution near the “Emergency Response Locations” for healthcare workers by asking local churches/charities to provide housing. Many churches/charities have access to campers, RVs, apartments, houses, etc. that could be stocked and utilized as emergency housing at no cost to the “Emergency Medical Response Team” nor government.
4. Institute an appropriate number of antiviral/antibody testing centers throughout each county. Texas recruited Walgreens pharmacies for this testing with the ability to perform 3,000 tests a day with a 15 minute turn around.
5. Provide emergency infectious disease plans for local businesses. Create guidelines regarding infectious disease control for every type of business environment possible. This helps complying businesses to remain open and helps businesses develop their own emergency response plan for future crises. These guidelines should include what types of work environments are most at risk and, conversely, those that are safest. In the case of future shutdowns, these guidelines should also include a staggered approach to shutdowns and re-openings allowing the maximum number of businesses to remain open as long as possible according to their risk factor. This also enables businesses to re-open quickly and seamlessly at the appropriate time without undue harm to employees or the public. I specifically refer to these as “guidelines”, not state laws, in order to protect our rights as business owners, but I do suggest these guidelines be made public so employees can be aware of the safety of their workplace . . .
Now the root of the problem with COVID19 was a lack of medical supplies. Remember the purpose of the shutdown was to “flatten the curve” in order to slow down the influx of cases our hospitals might experience. Deregulation at the federal level and the return of American manufacturing from abroad are the ideal long term solutions. If the healthcare crisis is mitigated, then by default a nationwide shutdown causing massive unemployment is avoided; thus, many vulnerable lives are protected from the impact of an infectious disease. While President Trump is cutting a myriad of regulations, a massive return of American manufacturing to US soil is unlikely, which is why I outlined the steps above.
The answers to this pandemic are not easy, but they are necessary. We cannot continue attempting to solve this problem with a sledgehammer, that smashes our God-given rights, when a scalpel is required to help preserve our liberties. Sometimes a rudimentary field dressing is necessary in the heat of battle, but we are rapidly moving past the hottest point of conflict with COVID19. America must get back to work and we must establish a plan for the future. Unfortunately, the US was caught wholly unprepared by COVID19 and we are already too late for steps 1-3 of the “Infectious Disease State Protocol” I outlined above, but we can help re-open American businesses now by expediting Step 4 and 5. The guidelines produced would be rudimentary due to time constraints but protecting vulnerable lives by creating a definitive procedure to get Americans back to work is achievable.
Remember, this is about both preventing infection by COVID19 and protecting those vulnerable to the COVID19 impact. It’s not an either/or dilemma; it’s a both/and situation and as Rosie the Riveter said, “We can do it!”
Hannah R. Miller
Host, The Hannah Miller Show