Three months after the first case of Covid-19 was diagnosed in the US, has the time come to start paying more attention to the critics?
No, not the MAGA types foolishly protesting they have a constitutional right to endanger themselves and others by ignoring social-distancing rules. And not the “it’s-just-the-flu” crowd, either.
I’m referring to people like John Ioannidis, the Stanford University School of Medicine scientist who argued early on that the coronavirus was far less deadly than the models were predicting. Or the Swedish epidemiologist John Giesecke, who says that protecting the elderly and frail — and allowing the rest of society to go about its business — makes far more sense than lockdowns, whose efficacy, he believes, remains unproved.
I don’t agree with every claim the critics make. Some go so far as to dismiss the value of social distancing, the importance of which has become pretty clear since the coronavirus was first identified. But I believe it’s always worth listening to smart people with ideas that go against the grain.
As the online publication UnHerd put it recently, “The debate about lockdown is not a contest between good and evil.” In that spirit, I would like to offer four contrarian arguments that, at the very least, ought to be taken more seriously.
We’re still acting as if the original models were correct. In mid-March, a team at Imperial College in London estimated that 500,000 British citizens and 2.2 million Americans would die from an uncontrolled spread of the coronavirus. That estimate caused the governments of both Boris Johnson and Donald Trump to begin stressing self-isolation measures, according to the New York Times. In the US, state after state shut down their economies while a mad scramble took place to create hospital space for Covid-19 patients.
Since then, the major models have been revised downward significantly. According to data compiled by the Reich Lab at the University of Massachusetts-Amherst, models now estimate 67,000 to 120,000 Covid-19 deaths in the US. Yet strict measures like lockdowns, which were put in place based on the original modeling, remain in place, while hospitals around the country, many of which are largely empty, continued to be reserved for nonexistent Covid-19 patients.
New York is not the rest of the country. There is no question that New York State has borne the brunt of the crisis. The Times reports that one out of every three Americans who has died from Covid-19 has been a New Yorker — 17,000 in all. New York City is one of the few places in the country — along with Detroit and New Orleans — where the hospital system has been stretched to capacity.
New York is the densest city in the country, and density is a crucial factor in spreading the virus. Yet cities and states that are far less dense have imposed the same restrictions as New York State
Focus on the elderly. “Every piece of evidence we have suggests that the virus is mild for most people but can be devastating for those who are frail and vulnerable,” Ioannidis told me. That primarily means people with significant underlying conditions and the elderly.
The Kaiser Family Foundation calculates that at least 10,000 of the 50,000 Covid-19 deaths in the US have been nursing-home residents. The Centers for Disease Control and Prevention has estimated that fully 80 percent of coronavirus deaths have been people 65 or older.
It’s been said that lockdown critics are willing to sacrifice the elderly to more quickly develop herd immunity and defeat the virus. But the ones I’ve spoken to say just the opposite: that what the states need to do is put money and effort towards protecting the elderly and vulnerable — and keeping them as far away from the virus as possible. That may be a tall order given the way society depends on facilities to care for the elderly. But it’s not impossible.
How much damage are we overlooking in our single-minded focus on the coronavirus? When you get right down to it, this is the big question. The enormous damage being done to the economy because of the lockdowns is a given. Let’s consider some of the other problems that have emerged.
For instance, the New York Post posted an article by Daniel G. Murphy, an emergency room doctor in the Bronx. He wrote that since the coronavirus struck, people without Covid-19 were avoiding the emergency room. He added:
A large share of those staying home surely have emergency medical and surgical conditions not related to the novel coronavirus. The growing numbers dying at home during this crisis must include fatal myocardial infarctions, asthma exacerbations, bacterial infections and strokes.
How many people with cancer are not being diagnosed? How many operations are being put on hold — to the long-term detriment of the patient? For that matter, how many hospitals are teetering on the brink financially because patients who need to be in the hospital are staying home?
Here’s another question: Has the lockdown increased incidents of domestic violence? The answer, plainly, is yes; in New York, for instance, domestic violence so far in April is up 30% compared with incidents in the month a year ago. (New York responded by setting up a domestic violence hotline.) What does it mean for at-risk kids, some of whom view school as their “safe space,” now that they don’t have a school to go to now?
Indeed, there may be no bigger ancillary consequence than the closing of schools. It affects everyone. Children aren’t learning the way they should. Parents are struggling to juggle working from home with keeping their kids productively occupied. Other parents, whose jobs require them to be out of the house, have to scramble to find someone who can help out. Teachers are feeling even more stress, trying to impart lessons to kids who may not know how to use a computer — all while taking care of their own kids. And of course, even with online learning, interrupting school can only exacerbate the equality gap.
When I suggested in a tweet that government officials should make testing teachers a priority so that schools could reopen, I received plenty of positive responses. But others said that reopening schools could endanger the teachers because children can be asymptomatic carriers. “Are you insane?” one person wrote.
In fact, Denmark has already reopened its schools after calculating that doing so would lead to minimal new infections. The Lancet published an article that concluded that “school closures alone would prevent only 2% to 4% of deaths, much less than other social interventions.”
We know that children are largely unaffected by the virus; even if they’re infected, they are usually asymptomatic. We also know that people younger than 50 are far less likely to become gravely ill from Covid-19. Given how critical it is to get kids back to school, why couldn’t school systems institute a policy whereby teachers older than 50 could remain at home while younger teachers and the children could head back to the classroom? The teachers could remain socially distant from the students, and certain close-contact games, like basketball, could be banned temporarily during recess.
Would there be some risk in taking this approach? Yes. But life is full of risks that we try to mitigate while acknowledging that we can’t eliminate them entirely. Driving a car involves risk. Useful products that contain suspected carcinogens carry a small danger. Bypass surgery is risky. The point is that these are all risks we take willingly knowing that they will cause some people to die. We accept that consequence.
At bottom, that is what the critics are saying about the coronavirus. If only 50 people have died from Covid-19 in your state, isn’t reopening the economy worth the risk? If 80% of Covid-19 deaths are elderly, isn’t it worth the risk to return kids to school? With the expected number of deaths so much lower than originally expected, shouldn’t we take the risk that this virus isn’t going to be the second coming of the 1918 flu?
So far, the US has been unwilling to accept much risk in dealing with the coronavirus. Do we know enough now to change that calculus? The critics say yes — and they may well be right.
Bloomberg
