“Lockdown”

Robert

Robert

At the start of this, I told a friend that I predicted that the health crisis, which was palpable and real in late March as the threat of overwhelmed hospitals loomed across the country, would soon be overshadowed by a political crisis. I believe my exact quote was, “they’re going to try to keep this going until November.”

I also predicted “lockdown” would function as an excuse to expand the surveillance state, in a partnership between Silicon Valley and the intelligence community. We are now about to see proximity tracking applications begin to show up in the U.S. They have already been instituted in other countries, where civil liberties are not guaranteed, and people are more amenable to surveillance.

I was told that I was paranoid and irrational. Someone even accused me of spreading dangerous “misinformation” (a propagandistic term if ever there was one) to sow social discord. Perhaps I had been replaced, Phillip K. Dick style, by a Russian bot, and I didn’t even know it!

I will accept your apologies, but I’m not holding my breath.

Two months later, many areas of the country now stare down indefinite “lockdowns” with no clear public health purpose. The line has silently changed from “slow the spread” to “stop the spread.” If you question this orthodoxy, you “want people to die.” Stopping a disease that is extremely contagious and for which no cure exists is, of course, impossible – unless you isolate every single person on Earth while you wait for a vaccine. And indeed, that is exactly what is being proposed.

Dr. Ezekiel Emanuel, brother of former Chicago mayor and former White House chief of staff Rahm Emanuel, said on April 7th that he believes we must stay “sheltered” for “the next 18 months or more.” That “or more” hangs especially heavy, because it means indefinitely. It could be two years, it could be twenty. In his own words:

“Realistically, COVID-19 will be here for the next 18 months or more. We will not be able to return to normalcy until we find a vaccine or effective medications. I know that’s dreadful news to hear. How are people supposed to find work if this goes on in some form for a year and a half? Is all that economic pain worth trying to stop COVID-19? The truth is we have no choice. 

If we prematurely end that physical distancing and the other measures keeping it at bay, deaths could skyrocket into the hundreds of thousands if not a million. We cannot return to normal until there’s a vaccine. Conferences, concerts, sporting events, religious services, dinner in a restaurant, none of that will resume until we find a vaccine, a treatment, or a cure.”

Ezekiel Emanuel

Dr. Emanuel, the man who claimed one month ago today that we must maintain this “lockdown” situation indefinitely, is currently named as a member of Joe Biden’s insurgent “Public Health Advisory Committee” in a peculiar election year stunt. Public health committees are normally created by states and municipalities, but this one has been organized by the Biden campaign to challenge the White House’s handling of the situation. Before you get too excited, note that Dr. Emanuel wrote an article in the Atlantic six years ago about how he wants to die at age 75. What does that say about his plans for your elderly parents? (Zeke himself is currently age 62, in case you’re wondering – so he has time.)

The idea promoted by Emanuel and other is this: we must contain the virus until there is a cure for it, no matter the consequences to society.

These policies are most vociferously defended by those with the least to lose, typically people like me, who type on laptops for a living, with salaried income. We can afford to have food delivered to our homes. The “lockdowns” have been challenged by those whose livelihoods depend on being able to work within six feet of another human being, including everyone in the service sector.

It is sometimes stated that there are “two Americas.” In fact, there is only one. But there are two visions of America, which will become more articulated over the next few months as the election looms. Both visions are layered on top of the same base reality – i.e., the problem of the virus – but project wildly different outcomes for the kind of lives we will live for the foreseeable future.

  1. We accept disease as a risk, and allow people to go back to their lives, gradually. Those who are known to be at high risk of severe infection are advised to stay home. Nursing homes and hospitals remain “locked down” to avoid spread within vulnerable populations. Jobs gradually recover, although it may take quite a while before we get back to where we were in January. People continue to get sick, but at a sustainable rate that our hospitals can handle.
  2. We continue to legally restrict business and shut down schools indefinitely to avoid risk of disease. Those businesses deemed important enough to survive until next year will be propped up by stimulus money, while the rest will be allowed to fail, mainly local businesses and the self-employed. We get used to people living off benefits instead of earning a paycheck. People continue to get sick, but at a sustainable rate that our hospitals can handle.

I have tried and I can not longer see any rational purpose in choosing option 2. Option 1 has the smallest blast radius. It yields the least damage to the economy and the livelihood of average people, and allows those who cannot work with a laptop at home to get back their income. More importantly, it gives everyone back their freedom to raise their children, visit friends, participate in religious services, and do the things that give life meaning.

I say this as someone with elderly parents who does work from a laptop. I have an elderly aunt in a nursing home. Even if I lose my job, I can find another one working remotely from anywhere in the world. I could easily get by for years without leaving the house. And yet, I choose option 1.

In fact, the only reason I would support option 2 (the “indefinite lockdown” solution) is if I believed it was very likely that a) the virus is killing perfectly healthy people at an alarming rate, and that b) it is out of control. Such a disease would completely decimate our population and have vast consequences felt for many years to come. Fortunately, that’s not the case with Covid-19, as of this writing. Let’s look at both of these conditionals separately and try to put reason into practice here using reliable data from public sources. And if you don’t agree with me, write your own article with data citations. I’d be interested to see rational counter-arguments.

Condition 1: Is the virus killing perfectly healthy young people?

The absolute worst experience I’ve had in my life was going to a child’s funeral. I choke up even thinking about it. Hearing the pain in the mother’s voice as she cried was just unbearable. I’d rather be hit by a car than have to listen to that sound again.

By contrast, when I went to my grandmother’s funeral, people were sad but resigned, in acknowledgment that this was a woman who had lived a long full life of joy, raised a family, and died with dignity. Sadness was the tone of the ceremony, not existential dread.

Children and young adults represent the future of any society. A threat to our youth naturally provokes a defensive attitude. A major concern in any crisis like this is that people who are young and healthy with no serious conditions – hypertension, heart disease, cancer, immune disease, etc. – might become seriously ill. The 1917 Spanish Flu killed children and young men in the trenches just as readily as it killed the elderly. By some accounts, this is what led to the end of the war – that’s how devastating it was to national morale.

The media has quite gleefully promoted stories of young people dying from Covid-19. The worst one I saw was that of a 5 year-old Michigan girl who was reported to have died from it. If you dig a bit, however, you find out the truth that shocking headline conceals: the girl had a rare form of meningitis. Meningitis has something like a 30% fatality rate. It’s serious business and if you have it, you’re certainly no longer considered in good health. This leads one to wonder if this poor girl’s death is better described as “dying of meningitis with Covid-19 complications,” but the headline writer, of course, chose the more click-baity description: “5-Year-Old Michigan Girl Dies from COVID-19.”

A handful of other reports of children falling ill were circulating back in March, but they seemed even more dubious than the Michigan case. In California, a child was reported to have died from Covid with no evidence at all – the Los Angeles County Department of Public Health seems to have just assumed it was Covid-19, lacking any other explanation.

Health officials later added that it was possible the death was caused by something else. But it was not clear what other factors could have led to the child’s death.

Source

All this even as the CDC reported than less than 1% of cases were among age 19 and below and that none had died. Such alarmism from the media is not unexpected, but also not entirely unreasonable in March, when the wave of cases had not yet arrived. Such conditions invite speculation.

Thankfully, we have some data now; we don’t have to speculate. The New York City Department of Health has published data that shows that the young, especially anyone under 18, are extremely unlikely to be affected by this virus. In fact, as of this writing, exactly ZERO people under 18 have died in New York City, the center of the outbreak in the U.S.

You have to actually download the CSV to see the zero. You can also see the rate here among other age ranges. Doing a little bit of basic arithmetic here, we can break this into two categories: those 65 and older, and those under 65.

Under 65 has a total of 168.23 deaths per 100,000. The 65 and older category has 1737.27 deaths per 100,000. In other words, if you’re 65 or older, you are more than 10 times as likely to have died from Covid-19.

To roll up this discussion into some useful figures for you:

  • 91.17% of deaths in New York City were senior citizens.
  • Zero deaths were children or teens.

In short, we can dismiss the claim spoken by the Los Angeles County Department of Public Health official that “COVID-19 infects people of all ages.” Yes, it does, but not in even proportion. It is not accurate to imply that the youthful of our population are as likely to be harmed by Covid as the elderly. That assertion is not bourn out by the data.

It’s interesting to ask why the media isn’t reporting something like this with a headline like “91% OF COVID-19 DEATHS 65 AND OLDER” but I’ll leave that speculation for another article.

Condition 2: Is the virus spreading at an uncontrollable rate that could overwhelm health systems?

One major worry at the beginning of this was that hospitals could become overwhelmed with Covid patients, and other ER cases would begin to pile up, so to speak, leading to preventable deaths as healthcare workers were unable to treat patients. This conjured up medieval images of bodies piling up in the streets. We were so worried about this possibility that we dispatched the U.S.N.S. Comfort, a giant medical ship, to provide support. Enormous field hospitals were set up in college campuses to handle the wave of sick. To quote Governor Cuomo on March 30th, “the tsunami is coming.” Two days later, a panicked Cuomo claimed that the state of New York didn’t have enough ventilators, special equipment reported to be required for the most severe cases. Cuomo predicted that the state would need an additional 30,000 to 40,000 ventilators, resulting in a predictable political squabble.

You can kind of see that Cuomo was panicking during these few weeks. A few days earlier, he had balked at efforts to “shut down” New York City:

Fear is as or more contagious as the virus,” Cuomo said on Thursday, adding that a shutdown would only propel fear.

Source, (Emphasis added)

In the beginning, Cuomo was against the “lockdown” and it led him to butt heads with the mayor. Yet that very fear affected Cuomo himself in the final days of March, and he would shortly thereafter issue a “shelter in place” order. Everyone reading this remembers the palpable fear across the nation as we imagined the impact of this huge surge of severe disease would have.

And yet, not even one month later, we’re giving away ventilators to Mexico even as we keep stockpiling them. That medical ship was barely used. In short, the “tsunami” was just a moderate sized wave. In fact, some doctors have stopped using ventilators. Perhaps they weren’t so critical after all.

But the surge could still be coming, right? Uh, no. Here are the total reported infections for New York City. I keep picking NYC just because it’s the “worst hit” area, and most of the rhetoric in the media is centered around NYC. We also have really nice data for NYC thanks to the city’s Health Department website.

The New York City Health Department data referenced below shows that new Covid-19 hospitalizations in NYC are at a low level not seen since early March. This strongly suggests that the rate of severe cases requiring special equipment like ventilators has tapered off. In short, there is no evidence of a “new surge” – at least, not as of this writing.

Conclusions From Data

Given that the virus is clearly NOT killing healthy young people, least of all children, and given that it is clearly NOT overwhelming healthcare systems, I must reject the notion of a sustained, indefinite “lockdown” as a reasonable solution. Not because I “want people to die,” nor because of any particular political inclinations, but because it doesn’t make sense and the cost is extremely high.

You’re asking for millions of people to be reduced to serf-like conditions for “18 months or more” which means “forever” since we have no timeline for a vaccine. We’re not talking about just closing bars and restaurants for a while, but also schools. All schools would be closed, forever. It is clear that this is not a reasonable solution. The cure cannot be worse than the disease. You can cut off someone’s foot to save them from gangrene, but you can’t cut off their brain to save them from a brain tumor. Actual medical workers I’ve spoken with – not political goons like Ezekiel Emanuel, but real nurses – know that we have to just move on and find ways to cope that don’t look like a “lockdown.”

That said, I am not especially excited about the idea of pulling off the blinders and seeing what happens. But frankly, I think the people are already there. The American public has proven very compliant, ready to do whatever it takes to help prevent disaster when the rules make sense. The outrage comes when it stops making sense – and it has stopped making sense.

It’s very disconcerting to me that nobody else is looking at this data or calling out the media and public personas like Dr. Ezekiel Emanuel for their alarmist cherrypicking, such as building models around an assumption that people will do literally nothing in response to a public emergency. We live in the Information Age, and yet nobody is trying to use the information at our fingertips to check the fear and paranoia. Making decisions driven entirely by emotional impulse is a sure way to make some big mistakes.

There are a couple reasonable conclusions we can make from the data and what we have learned since March. I think that these are reasonable, apolitical inferences from what we know now versus what we feared five weeks ago based on dubious models. I will make my case for each of them in turn.

  1. The time for containment is long past.
  2. The time for protecting the hospitals from the initial surge has passed.
  3. “Sheltering” does not seem to be especially effective vs. “social distancing.”

1. Containment is a lost cause

I dispute the use of the term “quarantine” to describe the conditions that we find ourselves in. A quarantine is a targeted isolation of individuals known to have come into contact with a contagion. This is useful at the beginning of an outbreak, and when the mode of infection is known, and those exposed can be traced.

Yet most of us who are “quarantined” are not known to be sick with Covid-19. We might very well be asymptomatic carriers. But then, so might everyone else. The “lockdown” solution is not so much a quarantine as it is house arrest.

Containment is only possible if you can not only slow the spread but accurately track down everyone exposed. Even if we get these proximity tracking apps out onto everyone’s iPhone, they won’t be available until June or July. That’s waaaay too late, especially if it’s true that asymptomatic cases are orders of magnitude higher than the reported cases. If literally anybody might have it, containment is no longer possible.

2. Hospitals are not overwhelmed

I spoke with a nurse here in Texas recently. She told me that a lot of her friends had been furloughed. “I haven’t even seen a Covid patient,” she said. Hospitals here were at about 40% capacity last week. Yes, believe it or not, nurses and doctors are being told to stop working because there is simply nothing for them to do. Hospitals have been forced to turn away surgery patients in anticipation of Covid patients that never came. Some more remote parts of Texas are even worse off.

The original purpose of shelter orders and social distancing was to “flatten the curve” so that hospitals would not be overwhelmed. And Americans jumped into action to accomplish that over the second half of March and into April. They are now left wondering why they’re still “sheltering in place” if there is no known treatment.

Texas officially went to “phase one” on Monday, and my county still has less than 2000 cases, as you might predict, most of them in nursing homes. Assuming everything goes according to plan, Texas will be back to “normal” by the end of the month, with heightened sanitation and safety requirements in place.

Could we have another outbreak? Maybe. Who knows? There is one thing we know for certain no matter what we do: there will be more cases, hospitals will treat them, some more severe cases will die, and others will recover.

3. Sheltering is not more effective than CDC guidelines

Governor Cuomo noted in a press briefing yesterday on May 6th that over half of new hospitalizations in New York were people who had been “staying home” during the shelter order. Almost 20% were in nursing homes. Cuomo himself described this fact as “shocking.”

In the governor’s presentation he revealed that the majority of new cases were predominantly older, minority, not working, not traveling, and staying at home. On all of these Powerpoint slides, we still have the “STAY HOME, STOP THE SPREAD” mantra passed around as a sort of moral ward, even as the data indicates that “staying home” is actually kind of dangerous.

There has never been any evidence that “lockdown” – i.e., not being allowed to leave your home for any reason other than getting groceries or medicine – works any better than the social distancing guidelines already in place by the CDC. Shelter orders may have helped to “send a message” early on that social distancing was serious business and not just bureaucratic nonsense. But the actual evidence that sheltering “saves lives” compared to the CDC’s recommendation is severely lacking.

The Political Crisis Begins

There was a time and a place for the kind of response that is still being trumpeted in cities like Chicago that are still threatening to arrest people for not following orders. That response may have been justified six weeks ago, when there was no information about the virus and a plausible reason to think containment was possible, and indeed necessary to prevent hospitals from being overwhelmed.

At this point, though, it is clear that with asymptomatic spread, we’re still going to see new cases for the foreseeable future. “Stopping” the spread is impossible now. We also know that the majority of severe cases are those 65 and older, especially those in nursing homes, which, as my nurse friend told me “are basically like hospice care.” In other words, you don’t check into a nursing home and then get better and go on to become one of those cool jet-skiing grannies on TV. You’re in a nursing home because you’re already in very poor health.

Yes, there are some younger people that will succumb to the disease, and I don’t want to be one of those people, but the data shows that 91% of deaths are 65 and older. Young people are suffering more from the economic and social consequences of these extreme measures than they are from the actual disease. This is indisputable. We are going to have 30 million unemployed soon, but only 1.3 million cases. What happens when we have 80 million unemployed? At that point, you’re entering into riot territory.

Most importantly, hospitals in the U.S. have certainly not been overwhelmed. The “tsunami” predicted never happened except in our dark imaginations. The emergency tent hospitals we built in record time have been mostly unused and are only being maintained as backups. We have capacity. We have equipment. So why are we still “locked down”? Why is anyone still arguing in favor of the Dr. Emanuel argument to maintain a “lockdown” until there is a vaccine? We won’t survive years of isolation and joblessness. So there is only one thing to do: end the “lockdowns” and handle new cases as they happen while keeping new hospitalizations at a manageable rate – by encouraging people to follow the CDC guidelines.

Surely those in power have seen all of this data and reached similar conclusions. Therefore I have to conclude that this isn’t a health crisis anymore. The motive for the “lockdown” strategies is no longer a matter of protecting people. It is now about milking the crisis for all it’s worth.

In my birth state of Illinois, a state that has imprisoned two of its governors just in my lifetime, politicians are now asking for $10 billion for “pension relief”. Illinois’ pension problems have been ongoing for decades and are infamous to anyone who has lived in the state. So dire was the situation recently that the state’s bonds were almost rated ‘junk’ status in 2017. In other words, the state was considered to be a deadbeat who couldn’t pay his bills. Illinois’ budget problems have no relationship at all to Covid-19 or any public health issues at all, period. And yet you can bet that the current governor Pritzker, who recently got caught removing toilets from his new mansion house during construction to evade taxes , will be in the news crying his crocodile tears about how the federal government has abandoned poor little Illinois during the pandemic. One can only dream that Illinois’ corpulent governor will soon join the ranks of his imprisoned predecessors.

Looking to the future

Viruses have been part of human life since the beginning of history. Pandemics are not even a new thing. Even as recently as 1968, flu pandemics have caused millions of deaths around the world. Getting mad about viruses is like yelling about the weather. These are forces of nature that humankind must deal with, not curses from a vengeful God. Moral posturing doesn’t get us anywhere.

We’re not entering “a new era” requiring a completely new economic system or the dissolution of the pillars of society. If anything, this experience should leave us confident that Americans are capable of adapting to new problems without the need for authoritarian control. In the face of an unknown threat, we all managed to stick through it and helped one another. For many, there was a brief glimmer of hope that civility, a virtue long besieged by the dark forces of 24/7 news and Twitter, might make a resurgence in American life.

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