This is part of our Coronavirus Update series in which Harvard specialists in epidemiology, infectious disease, economics, politics, and other disciplines offer insights into what the latest developments in the COVID-19 outbreak may bring.
Harvard economist and former U.S. Treasury Secretary Lawrence Summers panned America’s COVID-19 response this week, decrying misplaced priorities and missed opportunities even when viewed through an economic, rather than public health, lens.
“I think the risks that we will look back at this moment and say, ‘We didn’t try enough. We weren’t aggressive enough. We didn’t do enough,’ are an order of magnitude greater than the risks that people will say, ‘They spent too much money. They were too ambitious. If they just let things go, it would have been OK,’” said Summers, who served as Harvard’s president from 2001 to 2006 and is currently the Charles W. Eliot University Professor.
Summers was Treasury secretary during the Clinton administration, director of the National Economic Council under Obama, and served as chief economist at the World Bank in the 1990s. He said the pandemic is costing the U.S. $10 billion — and the world $200 billion — a day. With that cost in mind, he said, it makes sense to provide additional incentives and guarantees against losses to boost private efforts — which are both expensive and risky — to develop and distribute tests, treatments, and vaccines.
“I think we’re neither providing enough insurance against failure nor enough reward for success,” Summers said. “And therefore, we’re getting insufficient effort on testing in particular, but also on vaccines and therapeutics.”
Summers said companies that could be producing billions of tests are sitting on the sidelines, discouraged by the prospect of a quick vaccine that will render tests unsellable. That is an area where the government can step in, he said.
“If we buy $5 billion worth of tests we don’t need, it doesn’t matter, it’s not an important error,” Summers said, “whereas if we slow things up for an extra several weeks, it’s an enormously consequential error.
Summers fielded questions on Wednesday during a webcast event on business and public health sponsored by the Harvard T.H. Chan School of Public Health and the New England Journal of Medicine. “When Public Health Means Business: A Virtual Fireside Chat with Lawrence H. Summers and Ali Velshi” was introduced by Chan School Dean Michelle Williams and moderated by Velshi, an NBC journalist and MSNBC host.
Summers also criticized government spending on economic stimulus and helping corporations while skimping on expanding COVID-19 testing and hiring workers for contact tracing efforts that could help curb the pandemic.
“It is insane that we spent more than $3 trillion on economic stimulus but we haven’t been able to spend $30 billion on putting testing in place. It is crazy that we are investing as much money as we are in bailing out the largest corporations in the country and investing so little money in providing jobs as contract tracers to those who are unemployed,” he said. “There are aspects of this that are the biological equivalent of rocket science. But there are aspects of this that are entirely straightforward, that are entirely a matter of will and competence, and we are not doing them.”
Summers laid a large share of the blame for America’s halting pandemic response at the feet of the Trump administration, saying stable leadership that engenders trust and confidence in strategies like mask-wearing, widespread testing, and other steps is crucial during crises. He didn’t let previous administrations off the hook, however, saying they were warned about the likelihood of future pandemics, but took few steps to prepare.
“We have lost tens of thousands of lives because of mistakes we made in the past, and we are in the process of making more mistakes that will cost thousands — probably tens of thousands — more lives in the future,” Summers said. “We can do better as a country … but it requires a stable, steady commitment to truth-telling.”
Summers said the focus now should be on defining the steps to move forward, and warned that government incentives for developing a vaccine should not amount to control. Market systems and democratic societies are messy, but have been responsible for many advances in public health, pharmaceutical innovations, and benefits like the environmental movement, he said. Market mechanisms will also likely be the best way to distribute an eventual vaccine because a company that stands to make a profit will ensure its product gets produced, marketed, and distributed.
“We have to be very careful about letting easy moralisms trump what we know works,” he said. “We have to find a balance here, it’s a balance that respects stakeholders, but it’s also a balance that reflects that market incentives are very, very strong. …
“The worst thing you can do, if you want this pharmaceutical intellectual property to find widespread application, is to just toss it over and make it completely available to everybody for free.”
Summers said that statistics about health care disparities are startling, but that messages speak louder when they come from unexpected sources. The voices of community organizers complaining about inequality are expected and too often ignored, he said. If, however, for the next two years every leader of a Fortune 500 company spoke as much about health care disparities as they do about rising health care costs, it would change the national discussion on the subject.