UNC panel: Using data to guide reopen decisions
A panel of experts from the North Carolina CEO Forum discusses how to use non-standard economic and public health data to guide critical policy decisions on economic openness.
today's conversation will discuss the data that we're encouraging policymakers and business leaders to utilize when considering reopening decisions, particularly as new cases of Cove in 19 continue to take up nationwide. We have a terrific slate of experts lined up, and I'm gonna let them take things over here shortly. But before they do a quick road, not for how today, today's conversation will go. We're gonna hand things over to our experts here shortly. Each of them will share a few insights from their individual areas of expertise during the first half of today's conversation. We're then gonna open things up for Q and A during the second half. You're welcome to submit questions any time during the conversation. You don't have to wait until the second house. So for reporters who are joining us via Webinar, you are welcome to use that Q and a function there in the bottom of your screen. For those joining us by phone, you're welcome to email me your questions by email. Address is Mackenzie Underscore Bab at Keenan dash flagler dot unc that et you and again, you're welcome to some of those. Any time so glad to have you all with us on with that, it's my pleasure to hand things over to our first speaker, UNC Kenan Flagler Business School professor and Keenan Institute research director Christian Lindblom, Christian. That's because he so, uh, I'm here to talk a bit about kind of what the N. C. CEO Forum is is envisioning. So this represents in a political, nonpartisan collection of business leaders from across our state working in concert with the Kennan Institute. Ah, and a central tenet of the forum. Mr Help policymakers, business leaders, other important decision makers navigate the trade offs associated with our economic reopening. And so economic activity is the lifeblood of American well being is important and that deserves consideration, right? So if the soul policy objective we're to limit the spread of our virus that we're struggling with and a lock down would be a remarkably effective tool. Um, however, while that was necessary, um, the lock down has exactly the significant human toll. I'm along some other important dimensions, right? So so reopening decisions. They've got to be made with an evidence based process that holistically internalizes the spectrum of health care and economic costs on, I would say even performs permits a certain degree of of informed risk. Take right. So so this has often been kind of classified as as lives versus lively hoods. I think that's entirely a distraction of language. It's overly political. I think the situation is far better characterized as lives versus lives. So you know much of the conversation in terms of the cost has sort of centered around the economic costs. But the direct, the direct health care costs, they're also quite significant. So we don't get really know the full long run consequences of unintended unattended to ailments, right? We don't really know yet. The full psychological costs associated with anxiety and depression and physical and emotional abuse. Certainly the explosion of employment unemployment that risks detaching millions of workers from much needed health insurance at precisely the moment when access to health care is incredibly critical. And and finally, you know, from the standpoint of the health of the health system itself, right in the face of limited elective procedures, these air central to revenue generation. For these organizations, I mean hospital budgets or rather dire, and this comes as many and especially rural hospitals. They already risked closure I'm from emerging financial pressures. I mean these air critical issues for our state and our country. Now, in addition to these notable healthcare implications, the economic costs, um, are also important. I mean, they demand serious consideration. There are, for example, in a very human costs associated with the long run consequences of worker dislocation. So displaced workers, particularly in tough times like recessions and crises, they often suffer persistence, earning persistent earnings losses when their host of other negative consequences food and security, divorced depression, physical health issues. And I think particularly important, given the conversation about our schools, a lower level of educational attainment for their Children. This has the potential to really exacerbate ah, rapidly growing problem of what economists in their recent book, Angus Deaton and Case called kind of quote deaths of despair, these air deaths that that are linked to alcohol and an opioid abuse that they attribute to diminishing economic opportunity. I'd say it's even more than this, however, so despite this sort of notion that's been floating around out there for the last few months, that were kind of all in it together. The frustrating reality is that these costs are very disproportionately felt across American society that the sectors, for example, that have been hit hardest. They employ a sizable fraction of vulnerable hourly workers, many of whom are working paycheck to paycheck. I think the uncomfortable reality is that laid off workers and as well as those that have been deemed essential and they're working and risk your environments. They're disproportionately African American and Hispanic. They have significantly lower household assets and base incomes. These are precisely the dimensions along which the disease and broader notions of injustice right now are being disproportionately experience. So so how best to think about these trade offs? You know, Look, if we're gonna be honest with ourselves and look in the mirror, the reality is that a vaccine may be a long way off. And so our objective to be perfectly frank, um, is not to minimize positive tests. I'm in the absence of a vaccine. This is ah, in illusion, right? Um, instead, it's entirely reasonable to expect that cases will necessarily rise as we work through the challenges of carefully facilitating critical economic activity. So what should our approach be in light of the very important health care costs associated with them with the virus. So we suggest that experimentation with opening should be subject to instead of all the hospital capacity. I mean, while the economic costs of the pandemic are valid and they do demand attention, no, no one should perish for lack of access to standard intensive care treatment. So instead, intelligent experimentation needs to carefully allow cases to rise without exceeding hospital capacity. And unfortunately, North Carolina, like other parts of the country right now we're experiencing is significant upward trajectory in cases. Um, this is in part to be expected. I'm as the viruses migrating to less affected areas, Um, and the critical economic activity begins to resume. But such a increased really only becomes highly problematic to the extent that it imperils the health care system from being ableto to sufficiently respond. So, in order to navigate these knife and tradeoffs, I'd say, you know, the government and particularly citizen, we have a responsibility. Teoh behave well. So there are seven caveats. I mean, as we as we imagine cases rising, there's some important caveats that I think deserve attention. Number one. We need to prioritize protecting the most vulnerable segments of our population so knowing which cases air rising is really important. And that gets to the question of data that's gonna be focusing in the latter half of our conversation. We need to also elevate the essential guide post of testing and tracing so that we can better anticipate and manage hospital capacity. Additionally, there has to be a robust workplace and storefronts safety protocol. Um, that's that's going to allow customers and workers not only to be protected as possible, but to feel protected. That's an important ingredient to getting out again and engaging in economic activity. And then again, we're asking more of some Americans than others. And so policy support should perhaps be targeted to the workers in the highest risk of professions. So this is the cost benefit framework that they were proposing, and it's informing several initiatives. So number one experimentation of this type in the absence of measurement is doomed to fail, right? So to execute on this approach, the critical component is data. We have to have the ability to measure in relatively real time how we're doing. And so you're gonna hear more from my colleague, Professor Greg Brown, on our data dashboard, which is designed to facilitate moderate a monitoring of some of these critical components that characterized this trade off. We're gonna provide guidance on other aspect. So we're gonna propose, for example, Andi easily digestible primer for business leaders on safety protocols. And further, we're talking about examining the disproportionate effects of the shutdown on different components of our state, perhaps with an eye to facilitating matches between state displaced workers and emerging opportunities. So, to sum up the health care and economic costs of this locked Huntley demand attention on the goal of any economic opening should be to mitigate these important human costs again. The trade off. It reflects lives in lives. And so the only path forward hinges upon a healthy dose of intelligent risk taking, informed by real time, high quality health and economic data. So with that, it's now my pleasure to introduce David Carroll. David was a long time leader at Wells Fargo and its present predecessor firms. Amongst other rules, David serves currently as a senior fellow at the Kennan Institute. I mean, he leads this RNC CEO forum. So the floors years. David. Thank you. Thank you, Christian and good morning. Thank you. all for joining us today is, Christian said. I'm a retired banker and currently the private equity investor, But more important to that, I'm a huge advocate for you and see and for North Carolina. I got involved in this work in March, when Doug Shackelford, the dean of the business school, called and asked if I would be willing to help pull together a diverse group of senior business executives from North Carolina to study ways in which we could leverage the intellectual capital and resource is at UNC and more specifically at the Canon Institute to aid business leaders and policy makers and dealers With Pandemic, we pulled together a group of 18 CEOs and senior executives representing industries including manufacturing technology, real estate, hospitality, financial services, health and human services, retail education and economic development. And I'm probably leaving a few out. The first thing that we did was we surveyed the group to find out what was top of mind. Where did they feel least equipped to deal with the pandemic? And perhaps most importantly, what did they need from policymakers? Earlier on, that effort resulted in about a dozen subject areas mostly focused on the impact of the economic shutdown in early April. It included things like What's the prolonged impact for elevated, exceedingly elevated unemployment levels. Supply chain disruption, impact on Children, mental health and drug abuse. The despaired impact on diverse populations. Testy and guidance for private enterprise on how to engage in that fundamental shifts in business practices, and even identifying economic development opportunities in the aftermath of the disaster impact on care givers. What will be the longer, longer term consumer, behavioral and social norm activities and then the economic consequences of the enormous step loads to be shouldered by both Probably dinner stop enterprise and governments as a result of the shutdown. So it was a long and very list of subjects that are group came up with. But there were recurring themes throughout, and the very 1st 1 was the one that Christian talked about. And it was what this through that's fine as a dichotomy is the help outcome versus the economic outcome, and that gave rise to the work that Christian just spoke about. And my hope is that this group, this work and subsequent war, will provoke a more informed, balanced and hopefully less partisan narrative between business leaders, policymakers dealing throughout. But I think it's important that we're all very clear the health care and economic impact of this pandemic. It's the most consequential event in the world is history in the last 100 years, and I would include the world wars in there if you think about the reach of it and the economic calamity that is causing my fear early on was that there was the potential for worse health outcomes from shutting the economy down and from the virus itself. While that's yet to be seen, actually, I still have a huge concern there. So this forum is focused on providing a fuller view of the impact of the pandemic, leading a more thoughtful and hopefully coordinated public and private of responses to them to the virus. Christian mentioned this, but there are two other focus areas that we began immediate to pay attention to, and the one that was returning from all of our CEOs was the stunning lack of data. And here I'm not talking about just infection rates and mortality data, but detailed economic, behavioral and social data to gauge the consequences of both the virus itself and the consequences of the economic shutdown, and we will have a response to that. Greg will talk about a little bit later, lastly, and we heard this from the start from health care professionals. This virus is likely to be with us for quite a while, not to mention the likelihood of future mutations, and that testing is key to managing, spread and ultimately, shutting it down. There doesn't appear to be watch Fred literacy even six months into this around testing about what it means, what it does, how it works or have to run a comprehensive testing regimen across our state and across our country. And grave also will touch on some work that's being done in that area as well. Those are the work streams that these 18 CEOs have given us their time and attention for most grateful for that. This work will morph over time, and we look forward to reporting back to you. But from here, I'll turn it over to Hope Ryan from persists. Thanks, David. I'm Hope Bryant, vice chair for Citizens Bank, were headquartered in rolling with Carolina. We have over $40 billion of assets. We operate more than 650 offices in 19 states across the country. And I can tell you that there's virtually no aspect of our business that hasn't been impacted, occurred in 19 since March. And frankly, we don't expect things to get back to business as usual. Maybe ever. I'd like to share with you today three of the lessons that we've learned thus far and give you some insight in tow How we see this impacting our business. You know, our first lesson was really to set clear priorities. And for us, our top priority was the safety of our associates that we believe that that if they're secure in their jobs, then they can better help our clients get through this crisis. So, um, that goodness we'd invested in technology heavily over the last several years and our I T team was able to send more than 2500 associates to work from home virtually overnight. We currently have 70% of our more than 7000 associates are working from home with a really high degree of productivity, and our next challenge was really cheeping branches open and staffed and safe as well as compliant across the country. Lots of challenges in this regard, with shortages of supplies and the complexity and variability of state and local balls regarding re opening and closing. This continues to be a challenge with covert cases spiking. Our second priority was really the care for our clients, and we lent more than 3.5 $1,000,000,000 in the payroll protection program to keep jobs, um, and businesses open. We approved more than 23,000 loans and about six weeks. And to give you some perspective on this, this is more than our annual loan volume. You know, we also knew that many of our borrowers would be stressed, and we preemptively offered loan deferrals processing over 20,000 loan of them in a matter of weeks. We had a streamlined process that was very helpful for our clients as well as our associates. So our second lesson was get the fax, use common sense and empowers leader and empower our leaders to make decisions we quickly found that are incident escalation, process and disaster recovery program was a little bit overblown. So we switch horses and quickly set up a small team giving them very timely data on many aspects. of our business. We used infrastructure, was originally designed for stress testing, shifted it to make dashboards on all pounds of metrics from credit portfolio analytics to instance of covert amongst our associates branch transactions. You get you get the picture. These dashboards help specifically identify where he had risk so we could shore up those areas. But it also enabled us to keep many parts of our operation going business as usual to better serve our clients. We made leadership calls daily covering all kinds of of topics. And after covering the issues, we really empowered our local leaders to make the best decision they could to deal with matters that were most pressing to them. And what we found was doing in this fashion was was not particularly disruptive and far more effective than making sweeping corporate policies. Here in Raleigh. Our third lesson was innovate and work on continuous improvement. As I said, we were participating in the payroll protection program. We had to quickly build processes for approval, booking, closing and now collection and forgiveness. While the rules of the processes from the S P A and the government were still being crafted, it's hard to even imagine the magnitude of this challenge. But I'll give you some perspective. On day one, we approved 150 lines. It's 20 minutes each to get them into the S B A platform. And this was clearly not gonna work as we were trying to serve tens of thousands of clients across the country. Um, at the end of phase one, we were processing about 500 loans a day, and we approved about 5000 loans in that face. Well short of the need, we kept refining our process with some improvement. But it really wasn't until a young i t. Professional games a breakthrough that he figured out that we could batch load, um loans onto the SP a platform. This was a game changer by the second week and face to were proving 3000 loans a day. And we have a process to close the loons in house that we could we could close them within days in our branches. It was a miraculous achievement, but it took many hours over many weeks with many associates across multiple departments to get this done. And really, agility was key. It's just amazing what you can do when you really feel like that, you have to. Um well, I think our process improvement was great. I would not give us great marks on communication. Internal communication was I was very proud of that. But externally, particularly for those clients that were participating in the payroll protection program, we fell well, short. They experienced frustration and anxiety are priority was on getting those loans approved because we were so fearful that the funds were going to run out. Um, but we left him in the dark, and it was a nightmare for both our associates and our clients as we were working through the process. And thankfully, the second round of finding was ample to serve all of our customers that applied for need. Yeah, I'd like to shift gears a little bit and talk about our impact on our associates and from our perspective, how businesses and consumers are coping across our markets. It really appears to be a bar bell that on one hand, many consumers and businesses have been severely, negatively impacted. But then on the other that they're finding great opportunities. Both have a sense of urgency. Um, in the recent JD Power Cove. In 19 consumer survey, 25% of respondents said that the crisis had severely hurt or devastated their personal financial situation, with consumers aged 18 to 44 B most severely impacted. On the other hand, mortgage volumes are exceptionally hot as consumers take advantage of the current very low interest rate environment. The fight mortgages are up 18% over last year, and refinances are up 76% from a year ago. Deposit levels are exceptionally, huh? Get driven by unprecedented savings rates by consumers and a desire for businesses to have more liquidity during a time of uncertainty. And we'll see what happens next week when tax payments come. Teoh Um, surely they will shrink. But I think that what we all realize is that people have been staying home. They have not been experiencing lives as they've done in the past, and you see that in their spending in April and May, merchant volumes were significantly lower. Uh, because card users switch lower. This appears to be changing. New merchant sales data for June shows this actually higher than a year ago, and I think we all saw the pictures from the fourth of July that consumers are definitely out and about since we see our loan a pipeline strengthening quite a bit, you know, I'll close with three challenges that I see as we move ahead. The first is operational izing digital capability. What? We've made great strides. There is so much to do on this front, and we've got much greater clarity about the magnitude of that challenge. Number two is we're gonna have to adjust to a new normal. This will not be business as usual, and we will not go back to businesses as we knew it. For one thing, we will see greater work from home, which means that we'll have to manage for productivity differently. And we'll also have to figure out how to maintain our culture. People are working remotely. Are the requirements from our workforce will be very different? They will have to be more tech savvy good news for new entrants to the job market, but certainly a wake up call for those of my generation. And then my final observation is that good data is key to success. We're moving with an increased sense of urgency with more agility. We'll be reviewing operating models in exploring ways to do things better. But we need much better data, and this is not just true for our organization. But I think really across the country that if we're going to reopen our economy, our schools, and move our last forward, we must have better data and unexcited about the work that the Canon Institute is doing to address this need in North Carolina. I'm hopeful that the model can be replicated in other states as we reopened economies there, and I'm gonna turn the microphone over to Professor Greg Brown to tell you more specifically about what they're doing, right. Uh, thank you very much of impersonal. I just want to reiterate that, and we find ourselves in a very tough situation. By itself, the pandemic is a difficult problem to address their many facets to the health care crisis before us. But as each speaker has already mentioned, the associate economic crisis adds a whole other layer to the challenges that we face. And it's very important for so many people for the whole populace that we consider all facets of both crises and that we do this in an objective, a nonpartisan way We don't claim to have any expertise on the healthcare side. We're not medical doctors, are epidemiologists or public health experts. However, I will make a case shortly that more granular data on the health care front would be useful for everyone. However, we can provide substantial insights into what's happening with the economy and the broader socio economic impact by carefully analyzing data from a wide variety of government and private sector sources and then making these data available on a dashboard for both business people and policy makers, the one unanimous opinion from business leaders that we talked Teoh is that there is a need for more data. You've heard that from Hope and David today. Many feel that they're flying blind, given the limited amount of granular real time data they have access to. So I'll make several specific comments below. But I want to begin by emphasizing that this is just version one point. Oh, our effort. We very much want people to suggest additional data that would be useful to them, and then we can go about collecting and curating that data. So this effort is entirely about providing a resource for other people to make better decisions and lowering the overall cost of data collection and sharing. So we really appeal to the public at large. Police send us some specific ideas or general ideas of things that would be useful, um, and furthermore in and as hope mentioned, we really see this is a proof of concept a so other states might pursue with their universities, private sector business leaders and state governments on. So, of course, we're making all of our methodology and code public so well that I want to touch on five main points that came out of the data that we've analyzed on that are on the first version of our data dashboard. The first does concerned the healthcare data. So if we look at and say North Carolina at deaths and hospitalizations and new positive tests there really telling us different stories as to what the current trend is of the pandemic. So, for example, death rates are telling us that the situation stable or maybe even improving slightly hospitalizations are telling us that the situation is getting worse, sort of slowly but steadily, and new positive tests are telling us that the situation is getting worse. Pretty rapidly. So what's really happening in North Carolina on? And I should add that quite a few other states have divergent trends in health care data as well. Well, honestly, it's it's hard to tell. Death rates might be falling because of better treatment or different types of cases. For example, younger people rather than fewer cases. Hospitalizations may be increasing because of more new cases being admitted or is a month or two ago. Some marginal cases might have been turned away, given concerns about capacity. We know that the number of new positive tests is very highly correlated with the number of total tests being done. Uh, yet the positivity rate has remained fairly constant recently, which suggests that isn't just better detection. That probably is on increase in cases. A swell. But again, it's It's very hard to tell with the data that we have access to, we need much more granular data to unpack what is happening. Ideally, we would know the age and location at the individual test and death level Ato Hospital level. We would know the count in each hospital through the age on status of patients, uh, least on average, on by status. I mean, whether they're in a normal better and I see you bed, this lets has much better gauge capacity, and capacity is the second point that I want to come to. So in our framework, capacity is the key variable that drives openness of the economy. So, for example, if we look in North Carolina right now, we're somewhere in the seventies, maybe close to 80%. Hospital capacity is as stated by DHHS. However, it's important. Remember that relatively small percentage of current hospitalized patients in North Carolina are cove in patients. We still have several empty beds for every hospitalized Coben patient, North Carolina. Likewise, the ventilator capacity is quite good. In North Carolina. We're using about 25% of available ventilators, so this does suggest additional capacity. But again, we have to be really, really careful not to end up with spikes that threaten this capacity. We've seen this now in Florida and Texas and Arizona and California, where hospitals can pretty quickly reached capacity. So again, what drives our ability to understand capacity? I'm better data the third for 31. I want to make eyes coming back to something that that Christian mentioned that there are pretty significant disparities and how people are being affected. I'm not just by the disease itself, which is now pretty well documented, but also the broader economic impact. So more than 1/3 of the population is, uh, deferring on health care needs. About 20 to 25% of population is experiencing moderate or severe anxiety or depression to try to get a better handle on this and exactly who is being affected Disproportionately, we've created an index that measures socio economic adversity. So the idea is that this will track a composite of mental health, other health care needs food security and that we can see how certain groups are being a facing more adversity than others. So in particular, what we find and these air data that are on the dashboard, uh, is that people, uh, with the following demographics are disproportionately affected. Those with less than a high school education. Blacks and Hispanics households with Children, uh, younger and middle aged people, which may seem counterintuitive given that the disease impacts uh, disproportionately older people. But younger and middle aged people tend to be less financially secure, on more dependent on wage income, those with lower income in lower income households and finally, single versus married people are facing more adversity. The fourth point I want to make is that even though the trajectory of the pandemic for North Carolina was quite a bit different than the trajectory for the pandemic in the rest of the U. S, economic activity in North Carolina tracks U. S economic activity very, very closely, remarkably closely. So this this is understandable when you look at what's happened in the economy to date, there was this logical response of a rapid and widespread closure of the economy on, Of course, this is gonna result in very similar outcomes for North Carolina in the US this was necessary was the immediate need to prepare the health care system. So I didn't get overwhelmed nationally as it did in some cities. But going forward, this is almost surely not the optimal outcome. We need to have more localized solutions for how economic activity progresses, but again, do this reliably do it with policy makers and business leaders understanding the environment in which they're operating. My my fifth and final point is what I think is really one of the most interesting issues around the economic reopening, and it's it's related to consume I hate. It's well documented now that many consumers, and especially older and wealthier consumers, are making their own decisions about safety, regardless of whether establishments are open. So we first saw this as the pandemic unfolded and consumers pulled back on non essential activities well before stay at home order is closed businesses. We've also seen it in ah, Many attempts term be open for governments of blacks restrictions. But well heeled consumers have stayed home. So uh so while bars and dance clubs you might have a surge in demand by young people, Traditional higher end establishments and retail establishments in particular will continue to struggle to capture the sentiment of consumers. We've created what we're calling a consumer consternation index, which essentially measures people bulls willingness and ability to undertake nonessential activities away from home. So as you would expect, consternation skyrocketed in March and peaked in mid April. Again, the jump preceded the shut down of most businesses, so the behavioral aspect is really more important than the policy aspect. Since April, consternation has fallen to about half its peak, but consume Spurs are clearly still worried. Furthermore, that Index looks as though it's beginning to tick back up, both in North Carolina and nationally likely related to the recent spike in new cases in the South. So so what will make typical consumers less concerned? It's simply a matter of feeling safe when they go out. So to this end it's really imperative that there be a containment of community spread and this means a much more compliant public is Christian mentioned mentioned. We really need to have people taking public, uh, measures to ensure safety and a lack of transmission, as well as an effective test and trace program. By our estimate, there is still a very large testing gap in North Carolina and across the country. So with that, I'm going to turn it back over toe. Mackenzie, who's going Teoh moderate Q and A. Thank you, Greg. Um, and thank you so much to all of our experts. Very happy toe be moving into the Q and a portion. I just want to remind folks who have just joined our conversation that you are welcome to submit your questions any time using that Q and a function at the bottom of your screen. Upper reporters who are with us. We are going to be giving preference to your questions, um, and and will be prioritizing accordingly. You know, we have a number of researchers and other community members with us as well. We're gonna do our best to get to all questions, but prioritizing those from reporters who are welcome to seventh, um again via Q and A or via email to me at Mackenzie Underscore Bab at Keenan Dash Flagler at unc dot eu Our first question to open things up is for Christian Christian. What is the data showing us so far in terms of the most vulnerable populations? And how should policy target support for those segments? Yes, so So what? We see in terms of you know who has been deemed essential. Aziz. Well, as the folks that are, I'm kind of coming back to work. To the extent that the opening facilitates, you know, this is disproportionate along educational dimensions. Eso you know, that's that's on distant some sense based on the kinds of jobs we're talking about. It's also disproportionate in terms of important ethnic dimensions, a swell as a Z age and others. And so you know, basically what that means, that is, that is the folks that are kind of keeping our economy together, as it were, um, are not all of us. And some have have enjoyed very much the move to remote learning or remote. Sorry, coming from academic institution remote working that ah, that has not been mirrored necessarily in what what others are experiencing in terms of what they're seeing in terms of their day to day lives. And so that's where then cases air spiking, that's where for some the economic impact has been has been particularly challenging. And so the question is, what can one do about about policy, for example? You know this. This may be reasoning the controversial, but I think one immediate thing one can do is if we're gonna talk about federal stimulus. I think there's an opportunity to simply cover all the health care costs associated with anyone that's struggling in in a covert related situation. And so a said. One of the big challenges here is is, you know there are a number of folks that have been disconnected from their work that has healthcare implications through insurance there a number of other folks who were asking an awful lot of that air now, perhaps suffering with the implications of coded, Um, we're asking a lot of certain components of our society. I think one possible policy, uh, tool, is to immediately address the health care considerations of those that have been disproportionately affected. Excellent. Thank you, Christian. Our next question comes from Aaron Sanchez Gara from the News and Observer. What are the panels? Observations of Governor Cooper's reopening slash the economic shutdown. How could our North Carolina leaders used data informed decisions to save the economy while protecting help? So I'm gonna open that up for all over experts and let folks jump in with different observations as they like. But I'll go back to some of the day that we've been looking at, which suggests that there are sort of ways that the government could clamp down on economic activity so you can pull on the string. But in some cases, it's part to push on a string in the sense that opening the economy back up does it necessarily guarantee that people are applying Teoh participate. So you live. I think that it's it's When we think about what the policy response should be, it needs to be more than just sort of the proverbial turning the dimmer switch. It needs to be understanding from a full spectrum. What are the things that matter to people in the economy and feeling safe is a big is a big part of that. So I think any comprehensive policy solution needs to really take seriously how people are behaving in the the economic side as well as on the healthcare side. God Mackenzie. It's David. I. I would add two things. One is way only to recognize that we're all making this up as we go along. No one's had any experience doing this, and it's so easy to second guess the authorities and what they've done and what they're not done. And I would give the governor and the state high marks for doing the absolute best they can and have to requests. One is that they endeavour to give the public and businesses as much advance notice to their policy decisions. I've talked to businesses large and small and getting the rules of the game so speak very late, make for very difficult implementation very inconsistent implementation. And the last thing is to just to consider, uh, this notion of one size fits all probably is not applicable here. The risks in different parts of the state, the risks to different cohorts are different. And so endeavoring to deal with inconsistencies, going both ways would be really useful. But I don't think it's helpful. Toe. See the the political rancor out there. By being critical, I give the state the governor high marks. I do think we can do better the longer we're at this. And unfortunately, it looks like we're gonna be at for a while. Absolutely. Thank you, Greg. Thank you, David, as well. Um, our next question comes from holding for wiki with CBS 17. Many businesses have moved to work from home business models. Is that model economically viable long term? Or do you lose the level of productivity without workers in a to traditional workspace? I know who you were mentioning this earlier. The second part of his question is, would new hospitalizations each day the irrelevant measure of severity and be more time accurate than overall hospitalization numbers? Last rate. So I hope you may want to take first stab it at the first part of that question and others they want to try that as well. But maybe we can start with you and thank you, Mackenzie. And I'm happy to, um I think that, um we will be very surprised at how high productivity can be from work from home. I I think we may have a little bit of a bias that face to face interactions are significantly better. But in our business, we we have been very much surprised the other way that, um, client interactions sales activities have really worked very well. I will have to say that productivity those departments that had, um, better metrics going in have have done better. And we've surveyed our associates, and sometimes the they think that they're a little bit more productive working from home than we think that they are. But I think that, um overall, yes, that that work from whom, um in many other aspects of our business model will be a sustainable initiative. And we'll just have to figure out structures to put in place to make it work better. And but I do think that we'll have to work through how do you foster teamwork? How do you build culture and and those kind of softer things that people aren't aren't interacting in a face to face manner. Yeah, I would add to that. So there was an interesting commentary from men the Manpower group the other day on Bloomberg. So they have the finger on the pulse of older this, right? And they were sort of contrasting what they viewed. As, you know, productivity versus President T is, um are you are you actually present on dare Take away is on average exactly this this conclusion that the degree of productivity is gonna be pretty interesting that we're gonna learn from all of this that having been said again, there's a lot of heterogeneity within the experience, So if it's you know, someone like me with older kids and they run off and play video games or something, that's fine. But if it's somebody with a child under foot, you know, we're talking about, you know, fundamental negative hits. So So it's it's correlated with other things that are going on that are sort of governing our experience right now, And part of that is, um, you know the reason we're forced to conduct this experiment is because our kids aren't in school and things like that. So if you sort of look at this in isolation, I think we're gonna learn some pretty interesting lessons. I mean, I'm not sure when is the next time I'm gonna get on an airplane and travel around the world and that's been the better part of my experience over the last two years. But, uh but right now it is commingled with some different challenges I think they were facing. And I think the other thing that Teoh the highlight is that it is very job and industry specific as well. So there is some emerging research already looking at productivity by type of worker and by industry and importers. Some job you can do remotely some you can't summer more efficient to do, um, remotely. And so if you look the aggregate, it looks like, you know, maybe the optimal that there is some benefit toe working remotely, but there's some interior optimal there. It's not 100% remote. It's maybe 30 or 40% remote because there's some things you do better if you're not disturbed or, you know by having toe bear the the cost of commuting or whatever. But other things you need to be in person for definitely thank you all so much for those helpful answers. That next question that I posed just is a bit different than I will. I'll pose it back to the group and Greg and Christian. You may be the best to take first stab at this. Would new hospitalizations each day the irrelevant measure of severity and be more time accurate than overall hospitalization numbers? And we're rate. But I think those are measuring two different things. So the overall hospitalization is is telling you something important about capacity utilization in the health care services sector, so you really don't want to ignore that? But looking at the trends could give you a better indication of what's happening, Um, with cases, then testing if you don't have a good testing regime, so so that the challenges that we know that the disease affects different populations very different, right? So, for example, it's quite severe for for, uh, older parts of the population and less severe for younger parts of the population. So if you have a massive spike in new cases among young people. They may not show up in hospitalizations. And that and that's likely what we're seeing right now is young people get anxious and, you know, I think it's you less of a risk for them and not appreciating the broader context in which their behaviors might have have an impact. Great Christian. Did you want to add anything to that? Or with that you're gonna cover? There's two dimensions that are complementary, and I think that regret stated, corrected. Fantastic. Our next question comes from Rebecca Martinez with W UNC, and it's for Greg. Where can we access the Consumer Consternation index? Does the caution of well heeled consumers outweigh other groups who want to resume visit the usual? And then finally, what is the role of government in containing community spread while reopening you on A Me? Yeah, so the index in is available on the dashboard. Um, we have, ah plot of it there, and you can download that if for it specifically for us and for North Carolina. And there is a ah, data methodology that describes what the inputs are for that index and how they're weighted. So in terms of um, of, sort of which which consumers are important and matter in such. You know, it's I think the problem is that in order to get back to the level of economic activity that we have pretty crisis, we need everybody, right? So everyone in some sense needs to return to something like normal, whether the new normal is whether fully be engaged with the economy and so the reluctance of older and and seemingly wealthier participants in the economy. They're quite an important part of the economy, so that it isn't for their benefit that we care about sets for the broader economic on benefit. And in fact, another one of the statistics that we have on the dashboard shows what's happened to employment by the ZIP code. Um, where ZIP codes air, low income, medium income, high income. And what you see is that the impact on low income households is more severe in high income zip coats because that's where spending pullback more. There's more discretionary spending among these higher income groups, and so if you think about retail in restaurants and other things where a lot of this discretionary spending happens, it's gonna be in higher income ZIP codes and that fallout from that actually has a bigger impact on lower income people and higher income people brought it. Thank you, Greg, for that, Um our next question comes from Rose Hoban with North Carolina Health News. Um, she says if you're looking at reopening and other states such as New York, what lessons from other states would you advise Governor Cooper to adopt? And I'll open this, um, out shoppin Mackenzie and tight since we're opening offices across the country that it it is some of everything there. There is no, um, rulebook game plan, that it is very situational. And we have offices in Washington state and Oregon. They were early, into the into the pandemic. They, um, shut down things early. They're coming back much more quickly. We have offices across Florida, and that is not the case. We actually have closed more offices today because of challenges with covitz spiking there that, um, that have been interesting. In addition to the pandemic, civil unrest has had as nearly as big an impact on our reopening a za pandemic. So you really can't take a broad brush approach. I think that Governor Cooper's ability toe look at riel data and get into the specifics of it and craft a plan that is maybe more specific to individual counties or communities. Versus looking at at the state as a whole may be more effective. Great. Thank you so much for that. Um, our next question, uh, comes from Edwin Burnett. It supposed to Christian and the panel? Is there a consensus yet on where the two or three mistakes that were made early on in the cove in 19 response were and are any still being made? I wouldn't say there's a consensus on anything, but of course, that's because it's muddied by tremendous political nonsense, Right? Um I mean, I think, Look, I mean, I I second exactly what David said, which is, you know, we all got whacked with this thing and we way we responded in in the way that we were best able to, which was first with shock. And then we shut down and so on and so forth, I would say, um, you know, I think 11 personal view I have on this the danger is that it's it migrated from a management process into a categorical illusion of safety, which is impossible amid simply and mirage. And so again, I come back to kind of the framework that we presented in that light, which is, um, not fully agreed upon, I think, by everybody. And so I view that Dennis, if you want to call it a mistake or at least a misconception that needs to be a, you know, sort of addressed is that we've got to tackle a number of challenging things at the same time which are pulling in different directions, right? So I think that's, um that's that's the lesson. I think that we should be learning from all of this rather than generally mistakes, so to speak. So it again. If anything, there's kind of a brewing misconception or a changing narrative. Safety is achievable and it's not. Yeah, um, Kinsey, I would add to thoughts from this is Teoh. Christians Point. There's very little consensus on anything regarding this subject. One thing comes to mind that startling that there has been a very consistent refrain from health care officials around the world, and I read data that would suggest that that over 75% of the spread can be contained with three things. Three simple behaviors that we're all capable of. Participating. Social distancing, wearing a mask and washing your hands and forth, not touching your face. It's within this. It's insane, and that has been very consistent. It's been reinforced the further along we've gotten with the pandemic. You know, I find it unsettling and, uh, peculiar that the missus, largely local authorities phenomenon Local authorities seem very reticent to enforce, uh, the guidelines. And I doubt anybody on the call here has not witnessed group functions in public, as if it were a year ago. I'm just startled that local authorities don't go in with some modest loved one not being unaware of the other social issues going on in country. But I've seen hundreds of people packed in lines that parents venues around the state and in other states that been that, so I would I would think we can all do a better job individually with reinforcing this. Yeah, I again I would exactly second that. I think the navigation of this set of trade offs is not as daunting as it seems when there are some clearly, you know, prescribed things that we could do I think one of the earlier questions and we didn't get to the second part of it, I'm just reminded of it is you know, what can the government do? Teoh mitigates, you know, sort of community spread. These are things which work on the government or local governments can certainly act in this way, but I, if you allow me to editorialize for a moment like this, is our compact with one another. That's what a society is. That government is simply a reflection of all of us. And I think it's the responsibility of the citizenry, frankly, to step up and take care of one another. It's baffling to me that Americans have relatively fell short. All in short, in with respect to, say, our European counterparts, which seem to be doing far better along some of these dimensions. I'm equally befuddled. And as I was sharing with some of my colleagues this morning, a dear friend of mine gave birth over the weekend wearing a mask. So my my new mantra is, if she can do that, then people can hop on a mass to go to the Piggly Wiggly, right? Um so our next question comes from Chantal alum at W UNC. Excuse me at WRL Tech wire. Will North Carolina be ready to go to phase three on July 16th? Um, and what can we expect economically? Christian and Greg, you may want to take first out. I hesitate to open. I'm not just given how rapidly the pandemic seems to be evolving nationally as well as in North Carolina. I don't I don't feel like I can look at the data that we have access to and say clearly what's happening in North Carolina. Um, so I think we're just going to have to wait and see. We'll get quite a bit more information about current trends. Uh, and you know, again, I think, What does that really mean for the economy? Again, I don't want to keep beating the same drum, but there is this notion that people have toe have to be willing to participate in the economy and feel safe going out of conducting business for opening to really be sustainable at effective. So I don't feel like we're there. You had to go back to the previous question. Yeah, I think there was a mistake made. I don't know. who made the mistake but do not fully appreciate the importance of testing that that the only thing the only way to really get a handle on on the pandemic is to eliminate community spread. The only way to eliminate community spread is toe have extremely widespread testing and tracing. And this is really, I think something that it's crucial. And we're really not going to be able absent a vaccine. Not gonna be able Teoh conduct business the way that we would like to and have the economy reopen the way we like to until we can get testing. And I'm tracing to the point that we're eliminating community spread. Great. Thank you, Greg. Um, it one other question that was posed earlier, and I and I don't think we got a chance to cover it. It is, does the caution of well heeled consumers that way, Other groups who want to resume business as usual and I feel this group would be well suited toe to reply to that. I'll open it up for the panel. Um, I don't know. I think we've We're in an interesting situation where, um, those folks have greater degrees of freedom to disengage from the economy for the moment, and to the extent that there, you know, relying on, you know, delivery services and whatever. That's also then imposing again this disproportionate costs on the other components of our societies. So I don't think that's going to be alleviated any time soon. That that impulse it's gonna be mitigated because of the reasons that Greg articulated, which is, um, if you don't have to go out and then perhaps you won't until you feel that it's safe to do so. But it doesn't mean they're still not engaging in some level. With the economy so to speak and the extent of those engagement points, um, touching on and other folks in our society that are being asked to do a lot, I think that's that's That's a pretty tricky equilibrium to be in for for too much longer. Absolutely. Um, in the last question I think we're gonna have time for is a follow up from Rose Hovan. Um, who says they seeing is back in the news as the administration has asked the Supreme Court to strike down the entire law. Has anyone modeled what adoption of Medicaid expansion in North Carolina would have on economic health. Does anyone have thoughts on this policy again? I'll open that for the panel, but I think people have done that analysis and we're not the right people to ask. But it would be happy toe refer folks toe other experts that you and see that have done that. That sounds good. Weaken, weaken, definitely make that happen. And that that leads us right toe right to closing. So I want to thank everyone So much for participating again. Ah, the link to the data dashboard that we've been discussing today, which was just launched this morning at 8 a.m. Is available both in the media advisory that has been Sharon with folks. A swell is on our home page. If you visit Kenyon institute dot unc dot eu, you can access that data dashboard. As our Panelists have said, we welcome input. We welcome your ideas about what additional data points could be useful in making these vital decisions moving forward. So please feel free to be in touch with your thoughts. Additionally, for reporters who would like to schedule any follow up interviews with any of our experts, I'm happy to set those up. I know that we did not get to all of your questions today, but I want to thank you for for asking so many thought provoking ones that we ran right out of time. Please feel free to be in touch. Happy to set up additional conversations with you. Um and and with nothing more I think that now that we're officially over, time will wrap. We hope to see you again. We'll be doing another press free thing later this month. So please stay tuned for more information on that and told, then stay stays. Stay healthy and take good care. Thank you.