Before states started easing non-pharmaceutical interventions (“NPI”) to “reopen” their economies, misguided, but empathetic prophets of doom (“Doomsters”) gnashed teeth, wailed, and jeered those who they thought were enabling COVID-19 to slaughter people for the sake of money, leisure, spite, or political gain. They declared that easing NPI would cause spikes in deaths. They never bothered to provide theories as to how slowing the spread of the virus might decrease the ultimate number of infections, much less how such slowing could save lives during times when no hospitals were at risk of being overwhelmed. Neither did they offer data showing that carefully easing NPI would cause the ultimate number of COVID-19 deaths to be higher. Instead, they validated their beliefs only with assertions, mantras, and chants and ignored the deaths and damage to physical, mental, and fiscal health inflicted by NPI.[i] (Sadly and irresponsibly, the people advising politicians and the public neither validated nor refuted the Doomsters’ claims — but that is the subject of a future blog post.)
Though epidemiologists who speak from government podiums have not weighed in on the Doomsters’ claims, all epidemiologists assure us that the truth is in “the data.” So, let’s look at how Doomsters’ claims fare in light of data on how the epidemic has played out in Texas before and after NPI easing.
Texas’s first confirmed COVID-19 death occurred on March 15. Dallas/Ft. Worth officials ordered some business closures on March 16. “Shelter-in-place” orders for Dallas and Houston came on the 22nd and 24th, respectively, when just a few COVID deaths had occurred in Texas.[ii] Texas’s COVID-19 dashboard started on March 26. (That dashboard has all the problems I previously described the COVID Map[iii] has plus some others,[iv] but it is the best available information.)
Interesting items revealed by the above data include: Texas’s daily confirmed infections at the end of the first were 3.35 times the rate on the first day. Deaths were 3.83 times higher. At the start of the epidemic, COVID-19 was rapidly expanding. Note also that from the end of the first week, both rates have steadily declined. The confirmed cases and deaths on May 30 were only 1.14 and 1.1 times higher than the week before. Until May 5, the percentage increases in deaths were consistently higher than the increases in infections. Since then, the opposite has been the trend.
What is most striking, however, is that when Texas began reopening on April 20, the increase in infections was 4% per day. Forty-two days and six phases of NPI easing later, the rate of growth had fallen to 1% for a week. During that time, Texans progressively relaxed their NPI practices more than recommended by NPI guidelines, and some people abandoned NPI altogether. In short, despite the progressively greater social interaction since NPI started easing, the rates of infections and deaths have fallen steadily. There is reason to believe that the reported daily infection rate will soon show falling rates of infections despite increased easing.[v]
In reality (as opposed to the reported numbers), if it were not for the significant increases in antibody testing in May.[vi] Part of the increase in confirmed cases was due to testing more people in the later period. In other words, in reality, Texas’s daily infections are likely falling rapidly right now. The Doomsaying has been debunked by the data!
What is especially remarkable about this news is that, while NPI has proven to be mostly ineffective in protecting the vulnerable (despite politicians solemnly swearing to protect them), progress toward herd immunity has advanced while infection rate increases have fallen. Wherever tried, reopening economies will hasten the day herd immunity is achieved. That will be the day people will be less scared to engage in normal commerce, and vulnerable people can finally breathe easy and be comfortable around their loved ones.
That the Doomsters vehemently continue to insist that not following NPI will cause more ultimate deaths makes clear they have been relying on emotions rather than data and analysis. To their great discredit, epidemic experts who have commanded the stage and bathed in its limelight have neither validated Doomsters’ declarations nor clarified what is wrong with them. Rather than debate the epidemiologists and others who do point out the errors in the Doomsters’ thinking, they stand idly by as YouTube, Facebook, etc. takedown contradictory content. (That they prefer silence to losing the debate is a fair assumption.)
Doomsters’ claims fly in the face of the too few experts who are brave enough and willing to counter the established groupspeak on these subjects. For example, Yale’s Dr. David Katz[vii] says, “If all we do is flatten the curve you don’t prevent deaths, it simply changes the date of their death.” Variations on that theme have been provided by Dr. John Ioannidis,[viii] Knut Wittkowski[ix] and Professor Johan Giesecke,[x] Professor Sunetra Gupta,[xi] and others.[xii] As the Doomsters shouted, “Wear a mask, save lives,” the data and many responsible experts are saying calmly and convincingly that the Doomsters do not know much about what they are wailing (while Dr. Fauci or Dr. Birx remain mostly mum on the subject).
The Doomsters’ “thinking” did include a true factoid. Until the virus fades out, increases in social interaction/contact will cause the rate of infections to be higher than would otherwise be the case — at least for a while. Easing NPI increases social interaction/contact. Increased social contact causes increased infections until a high enough percentage of the people interacting are immune to the virus, i.e., when herd immunity is near or achieved.
Unless a sound argument that NPIs still saving lives is made, worrying about increased infections is misplaced. It is like fearing that a bucket will drain faster if a hole in its bottom were enlarged. The same amount of water will leak out regardless of the rate at which the water leaves the bucket. The only sure way to drain COVID-19 from the environment is for the population to achieve herd immunity. Delaying easing is delaying the inevitable number of infections that are needed to achieve herd immunity will ultimately save no lives. However, NPI will ring up deaths until eased out of existence.
When fears of hospitals being overwhelmed, insufficient medical supplies being available, and/or doctors needed time to discover how to diagnose and treat the new virus, “lockdowns” may have been justified, i.e., the damage from “lockdowns” might have been less than the damage the lockdowns were inflicting while those problems persisted. Now that those reasons for aggressive NPI no longer apply, ignoring the compounding damage NPI designed for bygone concerns inflicts is irrational. By ignoring the damage NPI inflicts, Doomsters are blind to the goal the ultimate goal of epidemiology, “draining” the environment of COVID-19 as quickly as possible without overwhelming the healthcare system.
As is so often the case, Doomsters are harming (killing, sickening, weakening, and otherwise ruining lives of) people they believe they are helping.
[vii] David L. Katz, MD, MPH, FACPM, FACP, FACLM is a Preventive Medicine specialist and globally recognized authority on lifestyle medicine. He is the founding director of Yale University’s Yale-Griffin Prevention Research Center (1998-2019).
[xii] “Paul Romer on the COVID-19 Pandemic” See comment section. See also, “Reaching Herd Immunity Would Require Significant Deaths. Some Experts Think It’s Inevitable.”