The essence of creative solutions comes from being able to look at something from a completely different perspective than everyone else. Let’s apply that to the COVID-19 pandemic, the idea of a quarantine, and the tourism-centered nature of San Diego’s economy.
Let’s start with what is happening to the hotel industry. According to the San Diego Union-Tribune, May’s revenue collapsed 90%, June’s was projected to be down 68%, and July’s by 38%.
That story was written in May, so with the post-Memorial Day increase in cases, it is reasonable to think those estimates will end up being overly optimistic. A SANDAG report predicts hotel occupancy will remain low throughout 2020. This spills out into a wide range of other tourism-related sectors.
While there likely is little we can do across the wider tourism economy, the high vacancy rate in our hotels — along with expectations of a second wave, or of a difficult flu season, offers us an opportunity for a creative approach.
Quarantine Those Most Likely to Get COVID-19
While our understanding of the virus is still incomplete, we know far more now than when this started. Data from worldometer.info for New York, for example, shows that those 75 and older account for almost half of all COVID-19 deaths. Most of the remaining half is split almost evenly between those 45-64 and 65-74.
According to the CDC, consistent evidence exists that the following underlying conditions put people at risk: heart disease, kidney disease, obesity, sickle cell disease, organ transplants, and type 2 diabetes.
Now if we go back to thinking about the hotel industry, they have a supply which can meet a demand — if we just think differently about a doctor’s prescription for a prophylactic and the way we pay for it.
When doctors prescribe a prophylactic, they are prescribing “a medicine or course of action used to prevent disease.”
So consider: Dr. X is caring for Patient Y who is on Medicare (meaning they would be in the 65+ age group). Patient Y is also being treated for a heart condition that places her at further risk. She lives with her family, so the risk is high that a younger household loved one would be exposed to the virus and bring it home.
So Dr. X prescribes a hotel room as a prophylactic.
Reimbursements from Medicare and Health Insurance
We are already familiar with what happens when a doctor prescribes a typical prophylactic. We take the prescription to the pharmacy and make the co-payment according to our insurance policy. The pharmacy is reimbursed according to their agreement with our insurance company.
What if Medicare were to negotiate with our San Diego hoteliers for a reimbursement rate for their vacant rooms?
Dr. X prescribes Patient Y a hotel room during the crisis. This, then, allows Patient Y to live separated from her younger family. It also allows that younger family to remain economically productive. The risk still exists that the younger ones will get sick, but we now know the likelihood they will end up in the hospital and on a ventilator is much lower at their age unless they have an underlying condition.
What if the state of California required health insurance companies to do the same?
The experience of having COVID-19 patients in nursing homes has already proven to be a disaster. Heating, ventilation, and air-conditioning systems in nursing homes and hotels are engineered in the same basic manner. If we use hotels to quarantine the sick, we are risking the same disaster we have seen in nursing homes.
If, on the other hand, we take advantage of an excess in supply of hotel rooms and quarantine the negative-testing but otherwise at-risk population, we accomplish the following: We avoid further unintentional harm to those already infected or sick; we free the younger population to remain economically productive; we bring back at least some of the jobs lost to the hotel sector; and we provide for a revenue stream to our hoteliers, allowing them to remain viable during the emergency.
The dignity of our aged loved ones should be of special concern. We are not pawning that off; we will see entirely new and creative ways of serving people in what is essentially a service-sector part of our economy. Our hoteliers and their employees will rise to the occasion and creatively arrange safe ways for younger family members to remain engaged in the lives of their at-risk aged loved ones.
John H. Horst, together with his wife Pauline, owns Xanesti Technology Services LLC, a San Diego small business providing cyber security services to the Department of Defense. Horst is a longtime community volunteer in Mira Mesa.