Anthony Michael Kreis

Not since 1918 has the United States faced the kind of wide-scale public health crisis that Americans face today. The novel coronavirus pandemic of 2020 jeopardizes multiple millions of Americans’ lives, especially the elderly and immunocompromised. It also stands to cripple the American economy with the real prospect of the nation plunging into a depression. The virus itself is more easily transmitted than other seasonal diseases like the flu. Each non-isolated case of novel coronavirus will infect 2 to 2.5 additional people compared to the flu, where each additional case will infect 1.3 other people on average. Moreover, it is more deadly than the flu. As I write, nearly 85,000 Americans have been infected, and over 1,000 lives have been lost to the pandemic. These numbers will surely grow as the challenges to respond to the crisis mounts. Public health resources are strained, and the testing capacity of the United States lags behind other nations. 

Public health experts and government officials face a stark choice: swift crackdowns on private movement or the possibility of mass mortality. To “flatten the curve,”i.e., slow the exponential growth of new infections and avoid overwhelming the healthcare system, governors and mayors have mandated social distancing and instituted stay-at-home orders. And while the pandemic has touched every state in the nation, certain states like New York, New Jersey, and Washington have acute outbreaks. In response, some governors have instituted de facto travel bans for short-term visitors. The governors in Alaska and Hawaii issued mandatory self-quarantine periods for all persons entering either state for 14 days. Travelers whose final destinations are Florida or Texas coming from New York, New Jersey, and Connecticut must quarantine for 14 days, as must persons traveling from New Orleans to Texas. Rhode Island has instituted a similar policy directed at New Yorkers, including police stops of non-commercial vehicles entering the state with New York license plates, that has come under fire from the state American Civil Liberties Union chapter.

Dan Solomon and Paula Forbes

We’ve seen chains struggle with the challenges the current crisis presents. Some stores are instituting policies limiting the numbers of shoppers allowed in at a time, creating long waits to enter. Perhaps even worse, other stores are not, leaving their shops a free-for-all without adequate social distancing measures. Staples like flour and yeast, to say nothing of hand sanitizer and toilet paper, are proving difficult to find on shelves. Supply chains are taxed. And the conditions faced by employees vary wildly by chain, with stores developing new (sometimes controversial) policies around sick leavefor the workers who have proved themselves essential, and often doing so on the fly.

San Antonio-based H-E-B has been a steady presence amid the crisis. The company began limiting the amounts of certain products customers were able to purchase in early March; extended its sick leave policy and implemented social distancing measures quickly; limited its hours to keep up with the needs of its stockers; added a coronavirus hotline for employees in need of assistance or information; and gave employees a $2 an hour raise on March 16, as those workers, many of whom are interacting with the public daily during this pandemic, began agitating for hazard pay.

This isn’t the first time H-E-B has done a good job of managing a disaster—it played an important role in helping the Gulf Coast recover from Hurricane Harvey in the immediate aftermath of the storm—which led us to ask: How did a regional supermarket chain develop systems that allow it to stay ahead of a crisis as big as this one? We spoke with nearly a dozen employees, executives, and customers to better understand—in their words—how H-E-B has taken on its unique role in shaping its business around the needs of Texans in the midst of trying circumstances.

Larry Kummer:

The age-old race for leadership between East and West may have begun a new phase, as revealed by the response of each to COVID-19. East Asia was hit first, having neither warning nor knowledge of the threat. China, a large and relatively poor nation, was hit first – while in the midst of a flu epidemic (both have roughly similar symptoms). The epidemic quickly spread to its neighbors, and became an epidemic in South Korea. All successfully fought it off despite lacking any pharmaceutical tools – and in China, without the lavish supply of advanced medical equipment (e.g., ICU units with ventilators) taken for granted in the West.

They used the ancient tools of lavish testing (using both clinical methods and kits), contact tracing to identify who was exposed, quarantines for the sick and exposed, cordons sanitaire around areas with raging infections (to prevent spread). As the leaders of WHO have repeatedly said, China’s response was record-setting. Compare this timeline of China’s respsonse to COVID-19 with the CDC’s timeline of the US response to the 2009 H1N1 (swine flu) epidemic – remembering that the US has almost 4x China’s per capita income and spends 2x to 3x more of its GDP on health care than its peer nations. The Swine Flu epidemic emerged in the US and spread across the globe.

“From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus. Additionally, CDC estimated that 151,700-575,400 people worldwide died from (H1N1)pdm09 virus infection during the first year the virus circulated.”

The West began vastly better prepared than China for an epidemic. The US was considered the best prepared in the world (see here). We had two months to prepare and the models of East Asia’s successful defenses. Yet we appear to be on track to suffer far more from it. After action analysis will determine why, but three things are now obvious.

First, we were arrogant. Asia was hit but we are great, without need to mobilize or even plan. The rest of the world used effective kits, but the CDC and FDA had to produce their own better kits.

Joel Kotkin:

Living in dispersion may not save you from contagion, but being away from people, driving around in your own car, and having neighbors you know, does have its advantages in times like these. Even the urban cognoscenti have figured this out—much as their Renaissance predecessors did during typhus and bubonic plague outbreaks, wealthy New Yorkers today are retreating to their country homes where they struggle with the locals over depleted supplies of essentials.

Back to the Dark Ages?

In classical times, plagues devastated Athens, Alexandria, Constantinople, and Rome. Along with barbarian invasions, they reduced the population of the Eternal City from 1.2 million at its height to barely 30,000 by the sixth century. Outside Europe, pandemics devastated cities such as Cairo, Canton, and Harbin. Following the conquest of the New World, the indigenous population suffered massive casualties from exposure to European diseases like smallpox.

Claire:

Fang Fang is the pen name of Wang Fang, a Chinese writer based in Wuhan. Some of her works include the novel “Feng Jing” and “Wan Jian Chuan Xin” She was the chairman of the Hubei Writers Association and won numerous accolades for her writing. Now, she is one of the 11 million people under strict quarantine in the capital of Hubei province due to the recent deadly coronavirus. Since the first day of the city-wide lockdown, Fang started a journal detailing life under the quarantine, publishing it on the Chinese social media site-Weibo, but the sensitive content is quickly deleted.

Yuval Noah Harari:

Under-the-skin surveillance

In order to stop the epidemic, entire populations need to comply with certain guidelines. There are two main ways of achieving this. One method is for the government to monitor people, and punish those who break the rules. Today, for the first time in human history, technology makes it possible to monitor everyone all the time. Fifty years ago, the KGB couldn’t follow 240m Soviet citizens 24 hours a day, nor could the KGB hope to effectively process all the information gathered. The KGB relied on human agents and analysts, and it just couldn’t place a human agent to follow every citizen. But now governments can rely on ubiquitous sensors and powerful algorithms instead of flesh-and-blood spooks. 

Carol Hymowitz

A sneaker designed for runners who want to move slowly, rather than sprint. An app that helps caregivers keep track of their schedules and communicate easily with their older clients. A company that helps retirees who want to reenter the labor force — and encourages employers to give them a chance.

These are just a few of the existing products and services that MBA students analyzed in a new Stanford Graduate School of Business course, “Longevity: Business Implications and Opportunities.” The course — likely the first given on the subject of the longevity economy at a business school — explored why business executives and entrepreneurs should focus on the 50+ demographic.

“Whether you want to launch a start-up or work for a large established company, the longevity market is a huge and still mostly overlooked opportunity,” said Robert Chess,  a business school lecturer and serial entrepreneur who co-taught the course this winter with Laura Carstensen, director of the Stanford Longevity Center.