The Economy, the Virus and Us

Annie Lowery of The Atlantic says that economists have four major concerns regarding the US economy.

(1) The household fiscal cliff:  Government stimulus payments have kept the economy in fairly good shape this spring, despite massive unemployment. However, the stimulus is supposed to end a month from now. Republicans don’t favor renewing it. That will mean  “millions of families just keeping their head above water will sink”. Consumer spending will plummet.

(2) The great business die-off:  “This steep decline in consumer spending will hasten mass business failure… An estimated 100,000 small companies have shut permanently. On top of that, numerous businesses—airlines, restaurants, live-events businesses, hotels, private schools, oil and gas companies—face severe and stubborn slumps….Economists expect that 42 percent of people recently let go will not return to their former employers.

(3) The state and local budget shortfall:  Every state except Vermont is required to balance its budget, but “sales taxes, real-estate-transfer taxes, income taxes, fines and fees—they are all collapsing, leaving local governments with a budget gap expected to total $1 trillion next year. Without help from Washington, this will necessarily mean massive service cuts and job losses: namely, an estimated 5.3 million job losses.

(4) The lingering health crisis:  “The catastrophe of the American government’s management of the … pandemic …  has led to the unnecessary deaths of tens of thousands of people…. The country is reopening with the disease still spreading and maiming and killing, as several states experience a dramatic surge in caseloads. Never getting the pandemic under control means never unleashing the economy…. Ending the pandemic would have been the single best thing the federal government could have done to preserve the country’s wealth, health, and economic functioning. The Txxxx administration, in its hubris, obstinacy, and incompetence, failed to do it.”

“Congress could extend unemployment insurance, offer new help to flailing businesses, send monthly cash grants to poor families, offer fiscal relief to the states, and implement a nationwide test-and-trace program.” Or things may get a lot worse.

From Stat News:

The “respiratory” virus that causes Covid-19 made some patients nauseous. It left others unable to smell. In some, it caused acute kidney injury….The Centers for Disease Control and Prevention constantly scrambled to update its list [of symptoms] in an effort to help clinicians identify likely cases.

[But] in late January, … scientists in China identified one of the two receptors by which the coronavirus, SARS-CoV-2, enters cells. It was the same gateway, called the ACE2 receptor, that the original SARS virus used. Studies going back some two decades had mapped the body’s ACE2 receptors, showing that they’re in cells that line the insides of blood vessels — in what are called vascular endothelial cells — in cells of the kidney’s tubules, in the gastrointestinal tract, and even in the testes.

Given that, it’s not clear why the new coronavirus’ ability to wreak havoc from head to toe came as a surprise to clinicians. Since “ACE2 is also the receptor for SARS, its expression in other organs and cell types has been well-known”….

The assumption that infection would first and foremost cause respiratory symptoms was misplaced. In the week before they were diagnosed, Covid-19 patients were 27 times more likely than people who tested negative for the virus to have lost their sense of smell. They were only 2.6 times more likely to have fever or chills, 2.2 times more likely to have trouble breathing or to be coughing, and twice as likely to have muscle aches. For months, government guidelines kept people not experiencing such typical signs of a respiratory infection from getting tested.

Faced with a disease the world had never seen before, physicians are learning as they go. By following the trail of ACE2 receptors, they are more and more prepared to look for, and treat, consequences of SARS-CoV-2 infection well beyond the obvious.