It’s Not the Economy vs Public Health: Public Health IS the Economy

Julia A. Pulver, RN, MSN, CCM
8 min readApr 11, 2020


Taken from the Oakland County COVID Dashboard, last updated 4/10/2020 at 12:30 PM.

Dead people can’t work. Businesses can’t operate with sick and dying staff. COVID-19 doesn’t care what kind of job you do, it is maiming and killing indiscriminately. No job is “safe” or “unsafe” when it comes to working outside the home during this outbreak.

All jobs are all unsafe right now. But some are essential for survival.

We need food, we need clean water, shelter, and public hygiene infrastructure, including sewers that work (especially now that we’re all going to the bathroom at home, hence the struggle to keep TP on the shelf). We also need our critical infrastructure to continue―hospitals, power, gas, police, fire, etc.―to keep us safe while we fight this battle. Children still need to be cared for, seniors still need to be safe, our mental and physical health still needs to be maintained (yes, that includes going outside to get some Vitamin D).

Outside of that, non-essential activities and work need to be paused in order to save lives.

My State Representative doesn’t agree, however. He recently stated in an interview on 89.3 Lakes FM’s The Megacast, “I think luckily, we’re not at this doom and gloom scenario [where] people are dying in the street that [some] have predicted to take place.”

He’s right, people aren’t dying in the streets. They are dying in their living rooms. They are dying in makeshift ICUs. They are dying on FaceTime with their spouses crying and saying their final goodbyes. They are dying alone. Not dying in the streets is an extremely low bar to set for how we should be measuring the failure or success of our life sustaining interventions.

He continued, “I’m not discounting this virus at all. It’s deadly, absolutely. But we need to see the data that justifies the measures. Like some have said, is this cure, if you want to call it that, worth what we’re doing to the economy by putting in these measures and devastating people and families?”

The question here seems to be: “Are the lives of our friends, neighbors, co-workers, and front line workers worth less than our businesses profit margins?” I would answer a resounding NO! Emergency economic relief has been quickly offered to everyone, businesses and individuals, in an effort to keep everyone afloat as we weather this storm on multiple fronts. Unemployment benefits are being offered to nearly everyone who needs it, small business loans and the Paycheck Protection Program are being offered, and interest rates across the board are being lowered. Communities have stepped up to offer free meals, landlords and lenders are offering mortgage and rent relief. People struggling with an immediate need are being offered a life line. But this argument is not about surviving, it’s about continuing to make profits unfettered by anything. It’s no wonder all these arguments from Republicans about how to handle this pandemic are coming not from the CDC, AMA or any public health entities, but straight from the Chamber of Commerce.

My current state representative is not alone in this thinking. Michigan Republicans have been trying to bargain their way out of a pandemic. They want to hurry up and “restart” the economy as soon as possible, or at least resume some previously closed industries like landscaping, home construction, and, for some reason, golf. And even short of that, they want some guarantee of an end date or “exit strategy.”

Unfortunately, we can’t force pandemics to meet our desired timetables. And this pandemic is unlike anything we’ve ever seen. This infection is not following any known pattern of who gets infected, who gets symptoms, who lives and who dies. COVID19 doesn’t seem to care if you are older and ill or young and healthy. In fact, the majority of the cases are happening in adults between 20–70, with the majority of deaths coming from those still of working age or just near retirement. These are those same people who make up “the economy.” Their health and their ability to work and keep our economy going are inextricably linked.

Viruses need a live host to survive. That host is you and me. Our only chance now, in the absence of abundant testing (which is needed to focus isolation efforts), cure or vaccine, is to starve the virus to death. The only way to do that is by staying away from each other.

Every time we interact with each other, occupy the same spaces, or act as a link in the chain, we feed that virus. According to the New York Times, epidemiologists say, “If you could wave a magic wand and make everyone freeze in place for two weeks, sitting six feet apart from one another, this thing would sputter to a halt.” Clearly we haven’t done that, nor could we. So we will need to do the best we can, which is exactly what we’re doing. Gov. Whitmer quickly and wisely implemented measures that are designed to be a broadsword against this disease. Since we did not have rapid testing when this infection was first detected back at the end of 2019, we could not narrow the need for quarantine and provide swift assistance to specific areas like we have for other epidemics. We are now being forced to bite the bullet, and implement these wide sweeping measures in order to protect life. I wish the federal government had taken these quick and decisive actions to prevent the horrible situation we are in, but wishing won’t get us out of this situation. All we can do is limit our contact with each other as much as possible, give our front line workers the protections they need, and respect this very clear and present danger to everyone in our community.

This notion that COVID-19 is only worrisome to a few, and that healthy people can or are even able to safely self limit their exposure is incredibly dangerous. Take, for example, Rep. Berman’s idea of acceptable risk during this deadly outbreak:

“For those people that are worried or who have immuno-compromised systems or not willing to take those risks, then when you go outside wear your gloves, wear your masks, limit your exposure. Maybe quarantine yourself. That’s my take, and not let’s quarantine the 98% of healthy people who don’t necessarily want to be stuck in their homes.”

That may be his “take,” but it doesn’t align with the public health experts who helped inform Gov. Whitmer’s “Stay Home, Stay Safe” executive order. This is a time when we need to defer to the experts. And the experts are all telling us that normal protocols and guidelines to slow the spread are not sufficient.

Standard guidelines to protect people who are most at risk are usually effective. Under normal rules of public health, we generally tend to protect the extreme ends of the life spectrum: babies, young children and the elderly, while also protecting those who are immuno-compromised (cancer patients, HIV/AIDS patients, those taking medications for autoimmune disorders, etc.) That’s why we immunize starting just after birth, complete the full series before kids start kindergarten, and remind seniors at every visit to get their booster shots. That gives us broad “herd immunity” to protect those who could not (or would not) complete their vaccination series and prevent unnecessary illness and death from all these known infectious diseases.

For most of our recent infectious disease history, if you didn’t fall into any of those groups, and you “had all your shots,” you were good to go! You were our hearty, school/work age citizens and your goal was to be out there living your best life, working your job, running your business, enjoying your community and making good life choices to keep you going as long as possible (seat belts, helmets, sunscreen, don’t smoke, etc). These common sense approaches used to be good enough. (And worth pointing out that these precautions were the results of long fought public health campaigns.)

But this current epidemic is different. We are seeing staggering numbers, unlike anything we’ve seen before. This is not just affecting those at the extreme ends of life, it’s affecting, and killing, those of us in the middle, too.

Some people are carriers with no symptoms who can spread it to others without realizing it.

Some people feel minor symptoms akin to regular cold and flu season ills.

Some people get severe symptoms, and even previously young and healthy people can go from minor symptoms to fatal outcomes very quickly.

And it’s nearly impossible to predict who will react to this disease fatally.

This virus doesn’t play fair. The rules have changed. We can no longer rely on the notion that all our personal responsibility and lessons learned about hand washing are enough to protect us. They absolutely are not, and our actions have very real life and death consequences not just for us, but for everyone around us as well. We are all linked together, no one is an island. Even activities we believe we do alone are often made possible through a chain of other peoples’ work.

Take a lone landscaper for instance. Let’s assume they were an asymptomatic carrier of COVID19: They had to stop for gas to fill up the lawnmower. They used a pump that later could have been used by a nurse heading to the hospital, and that nurse has now been exposed. The landscaper had to drive on the road to get to your house, risking a car accident that would then use up police and hospital resources and exposing everyone involved in that incident. And even if everything went well, that landscaper risks coming within six feet of everyone out taking a walk in that neighborhood, never mind what happens when the landscaper needs to use a restroom. It’s just not worth the risk, and by keeping this person out there doing non-essential work, the virus continues to feed.

We’ve never faced this virus before. We have no natural immunity to it, we have no herd immunity. We have no defense against it. We can only try to withstand the body blows it deals out and hope it doesn’t kill us.

While I disagree with my opponent’s take on how to best address our current public health crisis, I do agree with one thing he said: “When you are talking about protecting people, protecting our society, the [emergency] rules that are put in place right now have to make sense. They have to be tailored with the harm that they’re trying to address.”

The emergency rules in place right now by Gov. Whitmer are doing exactly that. They make sense and they are tailored to reduce harm. The unpredictability of this virus, along with our complete lack of easy, quick, widely available measures to stop the spread, has brought us to where we are today. We only have hardship measures now to stop it. I know the unknown is one of the most dreaded things in life. But I can tell you what IS known right now: the longer we feed this virus, the longer this will go on, and the more people will die.

And our economy can’t survive without people. Swift, wide spread measures that adequately address this extremely contagious, sneaky, and deadly virus are exactly what are needed right now to slow the harm we are trying to address and save our people. I refuse to see my fellow citizens as acceptable collateral damage in a misguided notion that we can have our cake and eat it too when it comes to starving this virus and resuming life as it was just a few short weeks ago, even if there may be fewer hugs and handshakes going forward.

Bottom line: We cannot afford, in any sense of the word, to re-open any non-essential businesses right now. Our economic crisis is real, and the longer we keep feeding the virus, the worse it will be.



Julia A. Pulver, RN, MSN, CCM

Julia A. Pulver has been an RN for over 17 years. She has spent her career working with the most at risk populations in Southeast Michigan. #PostRoeHarm