I’ve seen posts in which people say that masks do no good. That is wrong. They do both good and bad.
I’ve seen posts in which people say that masks do no good. That is wrong. They do both good and bad.
Discussing anything positive about COVID-19 amid the heartbreaking tragedies it has wrought will understandably be considered to be perverse by many. Letting that perversity prevent the good news spreading and calming fears is counterproductive. People need to be fully informed to make sound decisions about how to proceed. Closing one’s eyes to the light at the end of the tunnel is not helpful.
We hear, “COVID-19 is a unique virus” frequently. That statement is true but insipid (all viruses are unique ). Some of COVID-19’s quirks are especially bad, and others are especially helpful to the task of easing nonpharmaceutical interventions (“NPI”) to improve health outcomes and get the economy turned back in the right direction. Sooner is better than later. Let’s sort some of those out.
♦ The country has many more palatable options to ease NPI than would have been expected had COVID-19 pandemic been as predicted.
Who Needs Protection. Preexisting conditions are a considerable part of the COVID-19 story. COVID-19 is much more lethal to people with certain known preexisting conditions[x] than most cases of flu and kills a somewhat higher percentage of cases. As of April 10, when 96,000 people had died of COVID-19, less than 1% of them did not also have one or more comorbidities.[xi] As you can see from the chart below, the risk of death from COVID-19 in the absence of a preexisting condition is remarkably low. For example, the percentages of people 65-74 years old and 75+ years old who die of COVID-19 with no known preexisting conditions are 1.5% and 0.8%, respectively. Stated differently, 97.7% of the people over 64 years old with no preexisting conditions survive a COVID-19 infection. Of those people whose preexisting conditions were unknown, the vast majority likely had preexisting conditions.
Data Source: Worldometers
♦ We know who needs to stay at home, social distance, wash hands, etc. in order to save lives;
♦ We know who need not distance themselves from people similar to themselves;
♦ The additional COVID-19 risks to the 65+ crowd are almost exclusively about their preexisting conditions that put them at risk of death from COVID-19. The threat to healthy 65+ people is very low, and
♦ The exceptionally vulnerable people are disproportionally dying in the first (and hopefully only) wave of the virus. Conversely, the population that has yet to be infected is likely to be less likely to die than during the first wave.[xii]
As discussed in “It Was “the data,” the “Confirmed Cases” of COVID-19 used to devise the NPI strategy understated the number of infections in countries. COVID-19 death rates are the number of deaths caused by the virus divided by the number of people infected. When the number of infections in the denominator is too low, the death rate is overstated. (More validation of the claims in “It Was “the data” have come in.[xiii]) The US NPI strategy adopted to deal with a pandemic relied on an early Imperial College London model death That model depended on an understated denominator and lies[xiv] about the virus coming from China. TheICL model estimated that COVID-19 would kill 2-3% of infected people and 2.2 million Americans.[xv] The low end of its range is 100 times more than now expected.
Consequently, America’s NPI strategies assumed a pandemic 150 times as deadly as COVID-19 turned out to be. So, US NPI was significantly more aggressive than was necessary or appropriate—even in the nation’s hottest hotspots.[xvi] They were wildly more aggressive than were needed everywhere else in the country.
“Given the positive correlation between population density and influenza mortalities, cities are likely to have greater mortality rates than rural areas.”[xvii] Consequently, imposing, NPI appropriate for major cities in most states was based on fear, not facts and science. Universally applying that NPI anywhere for more than two or three weeks was unwarranted, if not absurd.
♦ COVID-19 is not nearly as deadly as the public has been led to believe.
♦ Easing of NPI designed for a much more deadly virus that COVID-19 is appropriate everywhere.
♦ Decisions not to ease off NPI that proved to be over-aggressive are neither data-driven nor scientific—although reinstituting some NPI in the unlikely event that a hospital becomes at risk of being overwhelmed might be necessary.
A surprising percentage of the population already has immunity from COVID-19.[xviii] As of 4/28/20, America had about 1 million “Confirmed Cases” of COVID-19. New York City and its surrounding area account for about 27,000 of those cases. “Hard-hit New York, the first state to do its own antibody testing, found an estimated 13.9% prevalence rate statewide, Gov. Andrew Cuomo said Thursday. The rate was even higher in New York City, at 21.2%.” The 13.9% prevalence is about 15 times the prevalence that the “Confirmed Cases” would suggest. Using the 15x multiple would indicate that possibly 15 million or more Americans have already had the virus. Two California studies found even higher multiples.[xix] Whatever the actual multiplier is, it is considerably higher than the multiplier used to impose the first NPI.
Antibody tests cannot be perfect, i.e., sometimes they produce false positives or false negatives. Not wanting to record or tell people that they are immune when they are not, antibody tests are designed to err on the side of producing false negatives.[xx] Consequently, more people have immunity than antibody testings suggest.
♦ We have an unexpected jump start on reaching herd immunity. A goodly percentage of people can neither spread the virus nor be harmed by it.
♦ The likelihood of people becoming infected today is lower than the probability of becoming infected was when the outbreak started.
♦ Most important, the nation’s vulnerable people are less likely to become infected now than they were when the outbreak began, i.e., the likelihood that the virus can avoid the multiple dead-end paths that prevent the virus from landing on vulnerable citizens has fallen significantly.
Many more pieces of good news could be chronicled. However, once honed by marketing professionals, the good news described above could empower the mainstream messengers to calm the unwarranted fears of healthy young people that are needlessly preventing them from reasonably safely getting on with their lives, and thereby increase protection of the vulnerable and get the economy turned in the right direction.
Let’s do what we can to get this good news message to the public.
 Dr. Birx and others have mentioned they do not have data to prove that COVID-19 infections confer immunity, but neither do they have data or analysis to confirm that the virus does not confer immunity. The possibility that it does not is unlikely.
[iii] “In New York City, the U.S. epicenter of the pandemic, the death rate for people 18 to 45 years old is 0.01%, or 10 per 100,000 in the population. People aged 75 and older, though, have a death rate 80 times that. For children under 18, the rate of death is zero per 100,000. That’s zero,” and “The data is in — stop the panic and end the total isolation.” and “Far more people may have been infected by coronavirus in one California county, study estimates.”
[iv] Until recently there were no remarkable exceptions concerning children. Recently (months into the pandemic), some concern about a possible association between COVID-19 and Kawasaki disease in children has arisen. “Kawasaki disease is a very rare, but treatable, condition that causes inflammation in blood vessels, and toxic shock syndrome is a life-threatening bacterial infection.” While “Three New York Children Have Now Died from Mysterious Illness Linked to Coronavirus,” the motivations of those who are making the link and why the link is made to COVID-19 is an important issue. How do they explain (1) why some children with the disease have not tested positive for either the virus or COVID-19 antibodies, and (2) why the disease is an issue in so few countries. In addition, it is likely to be a very long time before proof that the bacterial infection is not due to NPI deployed to fight the infection on account of being couped up in the relataively sterile envoroments rather than the virusCOVID-19. Right now, there is no science to say that the virus is even the likely culprit.
See, “15 Children Are Hospitalized With Mysterious Illness Possibly Tied to Covid-19” and
[v] Id. @15:54
[vi] Id. @17:39
[viii] Id. @21:15
[ix] Generally a losing battle: “The Real Issues Concerning COVID-19—Part IV, The Herd Immunity Messaging Problem.”
[xiv] “The Comprehensive Timeline of China’s COVID-19 Lies,” “US intel believes China hid severity of coronavirus epidemic while stockpiling supplies,” and “New Report Says Coronavirus May Have Made Early Appearance in France.” [We do not know when the Wuhan outbreak started.]
[xvi] An exception to this statement could be NYC, but its politicians urging people to stay the course, attend the Italian Festival, etc. were are large part of why its hospitals came close to being overwhelmed. See “The mistakes that turned New York into an epicenter of the coronavirus epidemic.”
[xix] “The study estimated that 2.49% to 4.16% of people in Santa Clara Country had been infected with Covid-19 by April 1. This represents between 48,000 and 81,000 people, which is 50 to 85 times what county officials recorded by that date: 956 confirmed cases,” and “LA COVID-19 antibody study adds further support for a higher-than-suspected infection rate.”
[xx] “State officials said the test had been calibrated to err on the side of producing false negatives — to miss some who may have antibodies — rather than false positives, which would suggest a person had coronavirus antibodies when they did not.”
Author’s Note: This post presents what I believe to be logical extensions of claims made by the epidemiologists, virologists, and statisticians herein cited. They appear to me to be very authoritative. Not having expertise in those fields, I cannot certify their accuracy, and my interpretation of what they said could be faulty. Nevertheless, if those experts and my interpretations and analysis are correct, the following discussion is critical in our efforts to protect the vulnerable and minimize economic damage from COVID-19. Spoiler alert, it is very different from the mainstream narrative.
Let’s sort out some of the problems concerning the mainstream messaging about COVID-19 that causes the public to believe that rising numbers of infection is bad and that a steady or falling number of infections will lower the number of people who eventually die from COVID-19. That messaging is non-scientific and is slowing the rate at which the country can get back to business, which is counterproductive. Let’s call it “The Herd Immunity Messaging Problem.”
Society should do what can reasonably be done to protect the people who are likely to be seriously harmed or killed by COVID-19. As discussed in earlier posts and below, no countries are doing a good job of protecting those people. New York Governor Cuomo presented a chart of data collected over the most recent several days showing from where hospitalized people came.
As you can see, 66% of people had come from home and 12% came from nursing homes and assisted living facilities. Clearly, lockdowns are not foolproof and people are not safe at home. Yet the “STAY AT HOME” messaging that was devised based on what was feared about a virus the designers knew little. The designers who constantly say, “we need more data” are simultaneously confessing that their plan was not based on the needed data. Let’s sort out the problems with staying on message after contradicting data has been collected.
THE ULTIMATE GOAL OF NONPHARMACUTICAL INTERVENTIONS (“NPI”)
When no one in a population has been infected, the vast majority of people on whom the virus lands are vulnerable to infection. NPI (stay at home, protective gear, washing hands, etc.) lowers the odds of infection some, but far from completely. In the early stages of a pandemic, anyone infected will likely pass the virus on to multiple other people, each of whom will likely infect multiple other people. That process creates exponential growth of infection (“the wave”), a normal feature of pandemics. Not long after becoming infected, almost everyone becomes immune to the virus or dies.[i] However, as the immune share of a population increases, paths to vulnerable people become more blocked by immune people who will kill the virus instead of passing it on. If enough people get infected, the odds the virus can find a path through the multiple blocked paths to a vulnerable person becomes slim that the virus can no longer find enough new victims to sustain itself. That level of infection in a population is called “herd immunity.”
“With all respiratory diseases, the only thing that stops the disease is herd immunity.”[ii] Consequently, achieving herd immunity should be the ultimate goal in the battle against COVID-19.[iii] The virus will continue to infect more people until herd immunity stops it. Perforce, any location that has not yet achieved herd immunity needs more infections. Yet the public has been led to believe that more infections are bad. Houston, We have a Herd Immunity Messaging Problem!
“Flattening the curve” has been a big part of the mainstream narrative. However, flattening the curve is not a tool to achieve herd immunity. On the contrary, it slows progress toward that ultimate goal. In theory, flattening the cure can save a few lives, but it also causes many problems, including serious illness and deaths. (See Part I, Part II, and PART III.) We are told to “listen to the experts,” but some epidemiologists say NPI will have little effect on the total COVID-19 deaths any country is destined to have,[iv] while others say the NPI in most places turned out to have been a huge mistake.[v]
Flattening the curve can help prevent hospitals from being overwhelmed. Otherwise, as Knut Wittkowski, previously the longtime head of the Department of Biostatistics, Epidemiology, and Research Design at the Rockefeller University in New York City, put it:
“[W]hat people are trying to do is flatten the curve. I don’t really know why. But, what happens is if you flatten the curve, you also prolong, to widen it, and it takes more time. And I don’t see a good reason for a respiratory disease to stay in the population longer than necessary…”[vi]
Stated differently: Flattening the curve with NPI when and where hospitals are not at risk of being overwhelmed is putting off the inevitable and putting the vulnerable more at risk. As it turned out, flattening the curve in most places wasted the opportunity to achieve herd immunity sooner. (For example, Sweden, which had relatively mild NPI, appears to be closer to herd immunity than other industrialized countries.[vii]) Social distancing by young healthy people has similar effects, but its tradeoffs are not quite as negative. For very old people and people with problematic preexisting conditions, social distancing likely remains a prudent course.
Mainstream messaging has been illogical concerning herd immunity. For example, when the mainstream media asks, “Sweden And Herd Immunity: Simple Math Or Plain Madness?” it does not provide an answer. It merely mentions a large number of deaths that might ensue and says something like:
“However, if forecasting the lowest estimated fatality rate of COVID-19 — about 1% — then a country like Sweden, with 10 million inhabitants, would reach 60,000 deaths before herd immunity is achieved.”
Set aside the fact that, based on recent studies and models, the 1% estimate is wildly too high. Focus on how the 60,000 deaths say nothing about the effectiveness of Sweden’s approach. The real issue concerning total deaths is: Will the ultimate death toll at the end of the pandemic be higher or lower with aggressive this NPI, that NPI, or no NPI? The above media “argument” for aggressive NPI ignores the possibility that Sweden’s ultimate COVID-19 mortality rate could be among the lowest in the world. Why? NPI is designed to manage the wave, not the ultimate number of deaths. Judging a country’s NPI regime when less than 10% of the country’s population has been infected is like taking a snapshot of a horse race before the first turn is reached. Well-respected epidemiologists believe that all the “horses” will “cross the finish line” in a fairly tight pack, i.e., differences in aggressiveness of NPI will have little impact on the ultimate number of deaths in a country.[viii] Worse, comparing the death rates of countries with very different percentages of immune people is either fear-mongering or ridiculous.
Easing NPI in a way that facilitates the invulnerable ninety-plus percent of the population contracting the virus would not be a perfect approach to the problem. No approach to COVID-19 damage mitigation will be. But no one knows that such a policy is not the best available and many epidemiologists believe that it is. Moreover, it is not as reckless as many believe. For the tiny fraction of young and healthy people who have severe symptoms, aggressive NPI will not necessarily save them and it will hurt them.[ix] If people are to get infected, it is likely best to get those problems behind them while the economy is relatively shut down than after they are back at work. In addition, those young and healthy people who are ultra-vulnerable to COVID-19 are extra susceptible to being adversely affected by the virus in any event.
Having the presence of mind to know at every instant what you must do to follow NPI (e.g., never absent-mindedly touch your face between hand washing) is nearly impossible. Can everyone stay 6’ apart from others everywhere and always? They will need eyes in the back of their heads and be quick. We must touch things that may be infected with COVID-9. For example, are you sure no one touched or coughed on your car door handle while you were in the store? Over an extended period of attempts to disinfect, spots teeming with COVID-19 will inevitably be missed. In short, the odds that people can avoid contact with COVID-19, are practically zero. (Cuomo’s chart bears this out.)
We are serious when we say “we must protect the vulnerable.” But, between now and when a vaccine can be deployed, vulnerable people in nursing homes and elsewhere will need multiple shifts of attendants, and contact with nurses, doctors, food and supply vendors, administrators, security people, maintenance people, repairmen, and others frequently entering the complex. If any of them are infected, the virus is on the inside. People inside will receive food, mail, supplies, and other items that may have COVID-19 on the outside of the package or on its contents. The odds that all of those people and materials will be 100% COVID-19-free 100% of the time is zero. Proof of this is born out by the statics that is coming in from around the world showing that nursing homes are often not able to keep the virus out. As Professor Johan Giesecke, MD, Ph.D. said about nursing homes, “We all fail…everywhere in Europe.”[x]
As illustrated in Cuomo’s chart above, a similar, if not worse story applies to people “sheltering” at home. In short, time is not on the side of vulnerable people. The longer we go without herd immunity, the greater the odds that COVID-19 will find its way to venerable people. As more and more people become infected, the more those odds favor the vulnerable. With herd immunity being the only way to stop the virus, the sooner herd immunity is reached, the better.
The mainstream messaging on infections is that more infections are bad. That bad messaging is a huge problem as states start easing NPI. Easing will cause COVID-19 infections to rise for a while. The mainstream response that the rising infection rate is proof that the NPI easing was a mistake is the opposite of the truth and highly counterproductive. So long as hotspots are managed so as to prevent overwhelmed hospitals, many benefits will flow from a rising infection rate. Among the benefits are increasing protection for the sheltered vulnerable and, if the messaging is done correctly, faster economic improvement. Serendipitously, human health concerning non-COVID ailments and human flourishing will improve as well.
The herd immunity messaging problem is that the mainstream media can, and probably will unnecessarily and tragically continue to misinform, confuse, and scare people with negligible risk of harm from the virus into staying at home. Let’s do what we can to help the vulnerable by changing that narrative.
Caveat Emptor. I feel compelled to repeat, the above observations and claims are not made by an epidemiologist, virologist, or statistician. Therefore, they may be wrong. However, if they are wrong, it is incumbent on those who are “informing” the public to explain why these logical extensions of what is being said are wrong. Otherwise, we will all reap the calamitous harvest of the confusion they are sowing.
UPDATE: During an interview with Mark Levin, Yale’s Dr. Katz captured susinctly the essential point of this post: “The Fauci and Birx practice of flattening the curve doesn’t stop people from dying, it simply changes the date of their death.”
 Generally, viruses require between 50% and 80% of the population to be infected, but no one can know the percentage necessary for COVID-19 to fade away to insignificance.
 I’m not faulting lockdown decisions made in a panic with little information, much of which was bad. All decisions are made without all the knowledge one would like.
[i] With COVID-19, the death rate is heartbreakingly large and statistically very small. Most who die of COVID-19 had deadly diseases before they were infected. “Nearly All Patients Hospitalized With Covid-19 Had Chronic Health Issues, Study Finds:” “Only 6 percent of patients at one New York area health system had no chronic conditions… [and] and most — 88 percent — had at least two.”
https://21stcenturywire.com/2020/05/01/coronavirus-epidemiologist-dr-knut-wittkowski-lockdown-has-no-benefit-only-negative-effects/[ii] “Epidemiologist Dr Knut Wittkowski: ‘Lockdown Has No Benefit, Only Negative Effects’”
[v] “Swedish Epidemiologist Johan Giesecke: Why Lockdowns Are The Wrong Policy”
[viii] See link in endnote i. Q: “So you don’t think the severity of these intervening measures are going to make that much difference?” A: “No. I don’t think so.”
As discussed in Part I and Part II of this series, the nonpharmaceutical interventions (“NPI”) deployed in America to fight the pandemic are doing some great good and causing some great harm. The harms include: (1) deaths and a weakening of the immune systems of sheltered people[i] (weakened immune systems open the lid of a pandora’s box of illnesses beyond COVID-19), (2) people have been so frightened by the one-sided messaging about COVID-19 that they choose not to seek needed medical attention, (3) “elective” surgeries to relieve pain and suffering are not being performed, and (4) loss of income, life savings, reserve values of pension plans, and falling home values render buying needed medicines too big a financial risk to take.
Sadly, the record of coronavirus vaccines (which have been a problem for about 20 years now), however, has not been very successful. Since Part II was published, I have learned: (1) “There are six human coronaviruses (HCoV) to date; HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1, severe acute respiratory syndrome (SARS)-CoV, and Middle East respiratory syndrome (MERS)-CoV” and “Currently, no effective licensed treatment exist against coronavirus infection;” and (2) finding a cure for COVID-19 is unlikely (some virologists say it may be impossible[ii]). And, of course, vaccines kill some people.[iii]
A growing chorus of respected epidemiologists says that other than NPIs designed to protect the people in categories known to be especially vulnerable to serious illness or death from the virus (old, infirm, and other specific preconditions), NPIs are doing more harm than good.[iv] Findings like “Experts surprised to find no evidence of COVID-19 spike from Wisconsin’s in-person voting” are mounting. (Can you imagine how dispirited those researchers were?) Protests against NPI, and their irrational/arbitrary rules— abortions are essential but most other “elective” surgeries or procedures, e.g., colonoscopies, are nonessential, and authoritarian enforcement are growing.[v]
In addition to the above, the negatives of: (1) suicides go up one percent for every one percent increase in unemployment,[vi] (2) more deficit spending and creating money/inflation,[vii] (3) normalization of totalitarian style edicts,[viii] (4) mass surveillance,[ix] and (5) people choosing government handouts over jobs[x] have come to the fore. Maintaining currently deployed NPI risks sending the country into an economic death spiral, which, if it happens, will multiply our miseries and deaths.
In short, much misery and death will ensue if the country continues aggressive NPIs, discontinues NPI, or anything in between. If the county’s economy remains too throttled too long, more misery and death will be caused by the throttling than would be caused by COVID-19. Consequently, the current NPI regime must be eased at some point and waiting for a vaccine, which may never come, is untenable in light of the uncertainty and waiting times for a vaccine and the mounting negative consequences of NPI.
The foregoing assumes the economy has not already gone beyond the tipping point. Though it may have, there are good reasons to doubt NPI has already sent the economy into a death spiral. The Spanish flu and its NPIs caused more economic destruction than the COVID-19 virus and its NPIs have caused so far. In terms of life-years lost,[xi] there is and will be little comparison between the Spanish flu and COVID-19. Nevertheless, within two years after the Spanish flu pandemic, the US economy came to be fairly described as “The Roaring Twenties.” During that period, workers’ wages rose significantly and the economy boomed.[xii]v
The above analogy will not apply if the government too actively tries to fix the economy once the NPIs are removed. In 1921 President Coolidge sprang into action to prevent the federal government from much involvement in fixing the economy, and entrepreneurs and workers took it from there.[xiii]
When does “throttled too long” happen? No one does or can know. All of the practically infinite variables affecting that outcome cannot be identified and the identifiable ones that cannot be sufficiently quantified to confidently predict either the time or the conditions that would cause a death spiral. We do know, however, that every minute the economy remains throttled nudges the economy closer to the cliff, and every minute people remain shielded from pathogens and beneficial bacteria and viruses weaken immune systems—thereby rendering Americans more vulnerable to other viruses and bacteria, including possible mutations of COVID-19. As I said, waiting for a vaccine is untenable.
On the other hand, the reopening of businesses will do little good if too few erstwhile customers are willing to engage in enough commerce to keep businesses afloat. Reopened businesses can survive only if enough people believe either that patronizing business is “safe enough” or that they should patronize businesses despite the safety risks.
We’ll sort out both of the above points in upcoming posts.
UPDATE: An important negative consequence of NPI not mentioned in the original post is the fact that people sheltering are in stress. The Mayo Clinic puts it this way: “Chronic stress can wreak havoc on your mind and body.” (Click on the text for details.) Sources of stress are many without a pandemic. To add to those stressors things like sheltering fearing that, at any moment, a family member or one’s seld could contract a horrible, if not deadly, disease is a huge stressor. To add even more to that stress, one sitting at home with little to do leaves lots of time to stress oneself out more by focussing on the problem.
 The “death spiral” is predicated on the expectation that when business failures cause massive job losses, collapses of 401k, other retirement savings, and pension fund assets, and out-of-work people, including retirees, have insufficient assets with which to buy their necessities, (and ripple effects of all of that), the government will create more money/inflate the currency/reduce confidence in the US dollar, as it tries to sustain a population that does not produce as much as it consumes. Eventually, buyers for US bonds will dry up because of the declining prospects of US bonds being the safest investment in the world. With bond sales being no longer available, the government will have not option but to create more money to fund its unfunded liabilities and desires to spend even more. The consequences of that spiral are hyper-inflation, panic, and the collapse of the economy. Those events will cause civil disruption, further taxing the government and serial decimations of the quality of life, which will span more civil disruption.
[ii] “We Might Never Get a Good Coronavirus Vaccine:” “COVID-19 could be a virus that proves resistant to vaccination. ‘This may be one,’ [Rachel Roper, a professor of immunology at East Carolina University who took part in efforts to develop a SARS vaccine] says. ‘If we have one, this is going to be it, I think.’”
[iii] “Deaths following vaccination: What does the evidence show?” While this article’s title indicates the it will tell the reader how many people are killed by vaccines, the article is mostly about the data that supports the notion that vaccines are a good idea. As true as that may be, the fact that the article doesn’t not say that “the evidence shows” that no people are killed by vaccines (a fact that would be in the opening line of the article if it were true, is not included in the article.
[iv] “WHO hails Sweden as a ‘model’ for fighting coronavirus without a lockdown” (pulling the rug from under Swedish model bashers), “Why lockdowns are the wrong policy – Swedish expert Prof. Johan Giesecke,” “Perspectives on the Pandemic | Dr. John Ioannidis Update: 4.17.20 | Episode 4,” “Perspectives on the Pandemic | Dr. David L. Katz | Episode 3,” and “Perspectives on the Pandemic | Professor Knut Wittkowski Update Interview | Episode 5.”
[vi] “Psychology Today,” “Unemployment is a well-established risk factor for suicide. In fact, 1 in 3 people who die by suicide are unemployed at the time of their deaths. For every one-point increase in the unemployment rate, the suicide rate tends to increase .78 points. One of the silent drivers of our current suicide crisis is the high percentage of working-age men not participating in the labor force.” “Dr. Ioannidis on Results of Coronacirus Studies.” @6:35
[xi] “How Economists Calculate The Costs And Benefits Of COVID-19 Lockdowns” and “Solving the Mystery Flu That Killed 50 Million People,” “Spanish Flu of 1918 that “disproportionately took the lives of men and women in their 20s and 30s, while often sparing the very old and the very young.”
[xii] “Economic Effects of the 1918 Influenza Pandemic.” “Using state-level personal income estimates for 1919-1921 and 1930, the authors do find a positive and statistically significant relationship between statewide influenza mortality rates and subsequent state per capita income growth… Some academic research suggests that the 1918 influenza pandemic caused a shortage of labor that resulted in higher wages (at least temporarily) for workers…”
The goal of this series of posts is to explore ways to strike a workable balance between the dueling concerns about health and the economy that are raging. We must deal with the Gordian Knot that while businesses need to reopen, reopening businesses is futile if customers are unwilling to engage with the businesses. Let’s lay the groundwork for that discussion by noting how we got to where we are and then sorting out where we are.
To scare people enough to get them to follow NPI suggestions and orders, the government officials, with the aid of experts and the mainstream media, launched a massive and biased publicity campaign using the scariest numbers to which credible academics would affix their names. More honest and realistic messaging, however, likely would not have worked as well in getting people to follow recommendations and orders. Governments must work with the overly fearful[i] and innumerate citizenry they have, not the citizenry they wish they had.
Consequently, a good case can be made that the deceptive and hyperbolic fear campaign was warranted. Bereft of reliable data concerning the virus (other than it was deadly and coming), full of uncertainty as to how Americans would adhere to NPI orders or recommendations, and confronted with the possibility of inestimable horrors, doing nothing would have been untenable in America’s fearful and disunited society. The campaign met its objective of preventing hospitals from being overwhelmed—even in the hardest-hit New York City. Achieving that objective likely saved many lives and kept doctors from having to decide who lives and who dies, as was the case in Italy. (The NPIs have and will continue to cause deaths as well, but whether the lives taken by the NPIs will exceed the lives saved by the NPIs is academic at this point.)
The stated objective of the NPIs was to “flatten the curve” (slow the pace of infections) so (1) hospitals would not be overwhelmed, (2) the number of people infected during the winter would be reduced (in hopes that warmer summer weather would suppress the virus while scientists gathered and analyzed data to device more informed strategies to deal with the virus when as it spreads across the population). Note, however, that flattening the curve had mostly to do with when the maximum number of people would get infected, not if. It was and is assumed that the virus will continue to spread across the population until enough people are infected to achieve herd immunity. Although one should acknowledge that NPIs might cause there to be fewer deaths if treatments and devices are found to lessen the severity of illnesses and/or reduce its mortality. While the need to get started on vaccines was a topic of conversation, virtually, no one expressed confidence that a vaccine would be invented, tested, approved, and administered within a year, and experts knew that a vaccine might not happen.[ii]
As discussed in Part I, sheltering in place waiting on a vaccine to save the day wasn’t, isn’t, and won’t be a sound strategy. On the contrary, among other things, doing so would cause many illnesses, financial ruin, spousal and child abuse, and deaths. A very relevant example is that people who shield themselves from viruses and bacteria are weakening their immune systems, i.e., making themselves more vulnerable to illnesses[iii] and not doing their part to achieve herd immunity for many diseases, including the possible winter wave of COVID-19.
Looking at vaccines in the context of “herd immunity” is essential. Is herd immunity a big deal? Yes:
“With all respiratory diseases, the only thing that stops the disease is herd immunity. About 80% of the people need to have had contact with the virus…”[iv]
According to theory, vaccines are a relatively low-risk way to help achieve herd immunity. However, in terms of the health and wealth of a population, the sooner the herd immunity exists, the better. Given that, if there are other low-risk ways to reach herd immunity, waiting for anything, including a vaccine, is a bad idea. That would be true even if there were no high costs inflicted by imposing NPI on people who, with very little risk, could help gain herd immunity sooner, be more productive, enjoy camaraderie, and have more fun. As discussed above, however, being isolated in a relatively sterile lonely house, however, does inflict high costs.
While herd immunity is the best weapon available to defeat COVID-19,[v] consider these important facts about herd immunity:
Given that the goal is to achieve herd immunity, the longer most people stay at home, the more slowly the country will reach “herd immunity,” which, save a miracle, is the ultimate goal of all efforts to deal with the pandemic. It stands to reason that the likelihood of being infected decreases as the percentage of infections increases, i.e., the benefits from more people being infected begin before herd immunity is reached.
So how do we cause young healthy people comfortable enough to engage in commerce? We’ll begin sorting that out in Part III of this series.
 If one does not understand the concept of odds or is not proficient in its application, one can have no clue what to make of risks. Stupidly avoiding small risks and stupidly taking large risks are both counterproductive and dumb. Suffering from innumeracy results in dangerous mistakes and causes people to favor foolish government policies.
 People who are exceptionally venerable COVID-19 should not be expected to expose themselves to exceptionally dangerous risks, including exposure to the herd.
[i] “Safety has become a cultural obsession to the point that many institutions and policymakers have adopted the ideal of a “harm-free” world as a realistic objective, a fantasy perhaps most strikingly expressed through intolerance toward risk and accidents” “The Paradox of Our Safety Addiction” and “”If we can save just one life!” is a terrible justification for change.”
[v] “If the virus keeps spreading, eventually so many people will have been infected and (if they survive) become immune that the outbreak will fizzle out on its own as the germ finds it harder and harder to find a susceptible host. This phenomenon is known as herd immunity.” [This MIT article is sowing unwarranted fear about the state of affairs (i.e., following the establishment line), but provides a credible explanation of herd immunity.)
[vii] “Preliminary evidence suggests that, particularly in young individuals, many, perhaps most do not develop enough antibodies to be detected, but nevertheless clear the virus with full recovery.” “Perspectives on the Pandemic | Dr. John Ioannidis Update: 4.17.20 | Episode 4.” @33:39
The day to day skirmishes about (1) whether the non-pharmacologic interventions (“NPI”), i.e., quarantine, travel bans, shelter in place orders, social distancing, hand washing, etc. were or are being handled well or poorly, and (2) when and how to “reopen” the economy are interesting and have some importance, but they pale in comparison and are sideshows to the main event. They distract us from attending to the real issues concerning COVID-19. Let’s sort out what those real issues are.
The uber-issue is how best to balance the dual goals of minimizing the damage that will be inflicted by COVID-19 and preventing the economy from falling below the point of no return (I’m not talking about a return to the robust economy the country had before. I’m talking about returning to a smaller, but sustainable economy—assuming the deficit spending fueled economy we had before was sustainable) with a chance of resuming growth. The cacophonies that have arisen around each of the two goals clouds the real issues concerning the balance that must be struck. Let’s start cutting through the haze.
Both goals are of paramount importance. Sadly, however, to a very significant extent, the two goals are in tension, i.e., the more we do to address one the more the other is impeded:
Economy. Effective NPIs are necessary, but they suppress economic activity. Economic activity stifled too much and/or too long will result in losses of:
To boot, there will be more illness and deaths from stress, depression, and related illnesses as people’s life savings or life work evaporates.[i]
COVID Damage Mitigation. Epidemiologists appear to be convinced that the COVID-19 is exceptionally contagious[ii] and discriminating as to which groups are spared consequences and the degree to which other groups are ravaged. To not take reasonable steps to mitigate the damage that will be inflicted by the virus would be inhumane.
While taking reasonable steps to address both goals is imperative, taking unreasonable steps would, of course, be unreasonable. That is the easy part. The hard part is figuring out what is reasonable while we have insufficient data from which to determine what works and doesn’t work, and never will.[iii] What experts cannot know is overwhelming:
Economy. There are too many unknowable variables to allow anyone to know how long the economy can continue to be stifled before it reaches the tipping point of no return. For a hint at why that is, consider this: Whether the US can continue to deficit spend (which it has been and is doing to a high degree) depends on foreigners’ willingness to continue to purchase US bonds. The more bonds that are sold, the less demand for additional bonds there is likely to be (the US becomes less creditworthy and the demand for bonds is satiated somewhat with every bond sold). The more the US continues to create money (which it has been and is doing to a high degree), the more likely the value of US bonds will fall because the inflation-adjusted profit from holding US bonds is reduced. As the US imports less as a result of having stifled its economy, the less US cash foreigners will have to buy US bonds. In light of these and many other imponderables, no AI-augmented human mind can calculate where that tipping point is or how soon it will come. Economists can, however, tell us that every day the economy is stifled will likely bring the tipping point more than a day closer. The damage done to Americans and everyone else in the world if America’s economy collapses will result in much more damage than could be caused by the worse scenarios for COVID-19.
Despite the above realities, some people are proposing that aggressive NPIs must be aggressively imposed everywhere until a vaccine is invented, proven, validated by the FDA, manufactured, and widely administered. Here are a few of the problems with that proposition:
Obviously, input from experts is essential to tackling the problems created by COVID-19. Sadly, however, experts have two unhelpful habits. They tend to myopically focus on their own areas of expertise[v] and, because they have little to say and are motivated not to say anything about the problems associated with their proposals, they say things that distract the citizenry from what it needs to know. If we are going to reasonably address the COVID-19 pandemic, we must listen to the experts but seek information on what we are really up against.
[iii] For example, serious and lively debates among expert economists continue to this day as to which, if any of Hoover’s and FDR’s actions, which were quite similar, to recover from the crash of 1929 did more harm than good.
In “Coronavirus Proves It: We Need Medicare For All?,” I discussed some general problems with a ubiquitous claim coming from the left that COVID-19 proves America needs Medicare For All. The gist was that for the COVID-19 pandemic to prove that America needs universal healthcare, one must demonstrate that universal healthcare systems handled the pandemic better than America’s system. While I presented some evidence that America was doing better than European healthcare systems, I did not present data on what I believe to be the ultimate test of the healthcare system: Deaths per capita. This post presents data comparing COVID-19 deaths per capita in the US and in the 15 European counties that had the most “Confirmed Cases” of COVID-19 as of April 2, 2020. Data for April 2nd, 9th, and 16th, 2020 is analyzed.[i] A comparison of deaths is used because the number of deaths is less subject to false positives, interpretations, and vagaries, and, as I have discussed before, “Confirmed Cases” is mostly a meaningless number.[ii] Confirmed Cases do, however, sufficiently correlates to the relative intensity of the problem among countries to be a reasonable means to select the sample of countries to be analyzed.
I had expected the numbers to show more convincingly that America’s healthcare system is handling the COVID-19 pandemic better than the universal healthcare systems of Europe. While the analysis shows evidence of that, the deeper one digs into the issues, the more questions arise. A comprehensive and fair comparison is impossible* because of the many variables involved, and the data compiled on most of those variables are not consistently compiled by all countries.[iii] For example:
On the other hand, a completely objective and fair comparison is not required to address the issue at hand, whether the available data, compromised as it is, is sufficient to conclude: “Coronavirus Proves It: We Need Medicare For All.”
The data here presented reveal that such a claim is not supported by the numbers available to those who make that claim. (Ironically, those who are the first to declaim as “science deniers” anyone who does not accept every aspect of every assertion and proposed solution concerning climate change is not basing their conclusions on data or science).
Here is a table that compiles some available relevant data:
The first column lists the US separately, as the control, and the 15 European countries with the most Confirmed Cases of COVID-19 (per the COVID-19 Map) as of April 2, as the comparison countries. The second column shows each country’s population.
The first two columns of each of the three sections of the table (for April 2nd, 9th, and 16th) show the relatively unreliable, and therefore unimportant, “Confirmed Cases” and Confirmed Cases per capita. The important and relatively reliable data, the number of COVID-19 deaths and deaths per capita for each country, are in the right two columns of each of the three color-highlighted sections.
Note that for every date, the deaths per capita in the US are markedly lower than the average deaths per capita in the 15 universal healthcare countries (e.g., On 4/2/2020, America’s deaths per million were 16 and the European average was 79 ). Only three of the fifteen countries in the first section had lower death rates than the US, and the majority of states did worse than the US in every section. Individually, each section would support the proposition that the US healthcare system is better suited to deal with pandemics than are the listed universal healthcare systems. The data offers no support for the opposite proposition.
An objection to the above comparisons might be that the waves of virus infections started earlier in Europe than in the US. Consequently, some might say that using the same starting date for Europe and the US is to compare incomparable numbers. For reasons described below, there are problems with such an objection. For now, however, let’s assume that the objection is fair.
If one were to try to line up the dates to correspond to comparable points in the waves of various countries, how many days to shift the numbers is the critical question. In March, the US Surgeon General said that the US’s wave was two weeks behind Italy.[vii] However, note the following:
If, despite reality, one were to go with the idea that Europe’s average wave was two weeks ahead of the US, note that on April 2, Europe’s average COVID death rate per capita was 79, and that the US COVID death rate was 95, i.e., 20% higher. However, consider the following:
Even if one were to suppose the CDC definition of “COVID Deaths” is proper or that the number of “COVID Deaths” in the US are even higher than deaths counted by the CDC method,[xiii] claims that the pandemic proves that America needs a universal system would still be unfounded. To make that claim based on the reported number of COVID deaths, one must also prove that the listed European countries are not reporting more accurate death numbers. In light of this, one should acknowledge that the CDC deemed “COVID Deaths” are likely to overstate deaths caused by COCID compared to methods used by more reasonable countries (as Dr. Birx confirmed. See endnote iv). More to the point, one cannot validly assume that the US COVID death rates are not overstated compared to the 15 European countries—thereby reducing the nominal 20% difference in death rates to a lower, possibly negative percentage.
Contra facts exist, e.g., the median age of Europeans is higher. Pointing out the contra facts in the absence of accurate identification and quantification of all relevant data would not alter the facts that (1) America’s healthcare system is not demonstrative worse than Europe’s universal systems,** and (2) the jury will remain out for a long time while the final tallies of the relative merits and demerits of the two kinds of systems concerning dealing with pandemics. Until then, no proof will exist concerning the pandemic that a universal healthcare system would be better for America.
There is a high correlation between (1) the people who claim that America’s handling of the COVID-19 pandemics is proof that America’s healthcare system is inferior to universal healthcare systems, and (2) the people who claim that the reason America is handling the pandemic so relatively poorly is because of the incompetence of President Trump and his administration. If Trump is doing as poorly as they claim and America’s COVID Death rate per capita is not substantially higher than the rates of countries with universal healthcare systems (something not supported by the data), then the healthcare system must be outperforming the other countries sufficiently to overcome the calamities they say Trump is inflicting. In other words, the more say the country’s COVID-19 problems are attributable to Trump, the more they are making a case that America’s healthcare system is superior to European universal healthcare systems—the exact opposite of what they claim when talking about America’s allegedly bad healthcare system.
Aside from the data and the fact that most research, innovation, and development of medical devices, drugs, and techniques, upon which all healthcare systems rely, have been and are funded by Americans paying higher prices for those things than foreigners do,[xiv] if it were shown that America’s healthcare system was inferior to universal healthcare systems when it comes to pandemics, that would not prove that universal healthcare would necessarily be better. With a government competing to be the wokest government in the world and a citizenry that supposedly loves its universal healthcare system, Canada’s healthcare system was not as prepared and is not outperforming America’s.
“Even in normal times, the average wait in Canada from referral to treatment by a specialist is 20 weeks, compared to less than four weeks in the U.S. Long before COVID-19, an estimated 1 million Canadians languished on waiting lists, waiting in pain or flying abroad for faster treatment… Per capita, Canada has one-third as many ICU beds as the US and about the same number as ravaged Italy. In some provinces, including Alberta and British Columbia, ICU beds number fewer per capita than Iran.”[xv]
Sadly, we are still nowhere near the end of the COVID-19 saga. It is possible that things could turn much worse for America and much better for the European countries in ways that show America’s healthcare system is relatively inferior. (I doubt it, but who knows at this juncture?) However things turn out, based on the data so far, no one can reasonably say that “Coronavirus Proves It: We Need Medicare For All.”
UPDATE: The table below adds data as of 4/27/2020.
* This is not to say that much scientism will not be devoted to the attempt.
** NOTE: When people talk about America’s healthcare system, all too often they confuse the healthcare system (which has to do with the quality and availability of medical care) with accessibility which primarily has to do with the ability to pay for healthcare. That some people do not have sufficient wealth to buy the healthcare they want is a welfare system problem. It is not a healthcare system problem. Measures to improve the quality and delivery of healthcare have no necessary connection to improving the economic conditions of poor people can, and often are, in conflict, i.e., trying to address both issues in a single package can making solving problems in either system more complicated, if not impossible.
[i] As reported by the Johns Hopkins COVID-19 Map reports for April 2 [LINK], 9 [LINK], and 16 [LINK]. [A note about the April 2 data: It did not occur to me to take screenshots of the COVID-19 Map data to document the April 2 numbers in the table. Fortunately, I happened to take a screenshot of the map on April 4, which shows that the April 2 numbers are, at least, in the ballpark. (Not only are they in the ballpark, I attest that the numbers were taken directly from the COVID-19 Map website.)]
[iv] Id. and “New ICD code introduced for COVID-19 deaths,” “COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death.”
|First Case||Days Behind|
|AVERAGE DAYS BEHIND THE U.S.||23.2|
[x] Obesity by Country
US/Eur Avg. 163%
[xiii] “Why the true COVID-19 death toll in NYC could be much higher: Only those tested BEFORE they die are counted as virus victims, says Big Apple councilman, as the city records 3,400 fatalities.” NOTE: NYC is addressing this “problem.” “N.Y.C. Death Toll Soars Past 10,000 in Revised Virus Count.”
[xiv] “High Drug Prices Are Bad. Cutting Them Could Be Worse,“”Despite these glaring problems, current policy choices must confront the real world we are living in. In the current situation, drug pricing and research funding are intertwined;” and
“The Link Between Drug Prices and Research on the Next Generation of Cures,” “Market conditions not only affected the size of research spending, it also affected its location. Looking at other sets of data, they found biopharmaceutical research in the EU countries exceeded research conducted in the United States by 24 percent in 1986. But by 2004, U.S. levels were 15 percent greater than EU levels.82 This is mostly due to EU spending stalling between 1997 and 2001, roughly the same time the two price indexes diverged. Total U.S. biopharma research by foreign firms has been growing at a faster rate than foreign research by U.S. firms, largely because U.S. prices for on-patent drugs are higher than those in Europe. Higher prices have therefore caused foreign companies to divert their attention to the U.S. market, thereby strengthening the U.S. domestic industry.”
The title to this post is the title (sans the question mark) of a Common Dreams article dated March 25, 2020.[i] Similar claims have become a regular feature of leftist commentary on the pandemic. For many decades, a primary goal of leftists is for America to replace its healthcare system with a universal healthcare system. They were quite disappointed when Obamacare turned out not to be a universal healthcare system of their dreams but hoped that it could be used as a stepping stone to Medicare for All (‘MFA”). Trump pretty much dashed those hopes. Now they are attempting to exploit the COVID-19 pandemic to convince Americans that MFA would be better than America’s more capitalistic healthcare system. I hate to give them any tips, but it would help if they came up with some logical arguments to make their case.
I’ve regularly asked people who claim MFA would be better than America’s system to explain what the pandemic has to do with their claim. I’ve yet to get a credible explanation (most seem to think berating me or ridiculing the question is an explanation). I am compiling evidence that I believe will demonstrate the reverse of Common Dreams’ claim. I expect to publish that analysis soon. In the meantime, let’s sort out some other things that are wrong with Common Dreams’ claim.
Shockingly absent from the Common Dreams article and similar articles that I have read is a sound argument that MFA would work better against pandemics than the existing system. Their “arguments” typically boil down to something like this: “The U.S. was unprepared, slow off the blocks, and somewhere between ham-handed and idiotic in its decisions and responses.”
While those things are largely true, those things were also true of all countries (with possible, but unverifiable exception of China[ii]). On the other hand, American doctors, unlike Italy’s universal healthcare doctors, have not experienced this: “There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody.” More generally, pointing out the shortcomings of America’s healthcare system is not proof that MFA would be better. For the COVID episode to prove that the pandemic proves that America’s system should be replaced with MFA, one must at least provide some solid evidence that MFA systems have performed better against the pandemic. Let’s explore what the Common Dream article did instead of offering such proof.
Common Dreams’s claim was not based on evidence. It was based on predictions that have since proved to be false. For example, the article says:
“…the U.K.’s National Health Service is well-positioned to cope. It has a clear and comprehensive emergency planning structure with the ability to optimize resource use, even after years of government budget cuts.”
Only a few days later, The Guardian published an article entitled, “A public inquiry into the UK’s coronavirus response would find a litany of failures.” That article reported, “During the last decade, funding for public health has been fragmented and downgraded.” It went on to list a long series of shortcomings of the system. (As is typical of MSM, The Guardian placed much of the blame on government incompetence and that the socialized healthcare system was not socialized enough—with no appreciation of the irony of the claim.)
Common Dreams then moved on to cite unverifiable evidence from totalitarian China as if it were true. Fail.
It also cited S. Korea’s relative success in battling the virus. So far it appears S. Korea is doing relatively well (good for them). However, among other things, South Korea (1) had a different history (e.g., SARS),[iii] (2) used a different pattern of containment strategies than most Western democracies (that worked comparatively better—possibly by luck), (3) had IT and infrastructure to trace infected people that few, if any, other countries had, and (4) has a culture, government, and other characteristics that are very different from those of Western countries. To base sweeping claims on one data point (S. Korea) is weak at best. To pick one healthcare system that happens (for who knows what all reasons) to be the best the world (some country had to be that) concerning one incident is not science, it’s cherrypicking. It is certainly no proof that MFA would work better in America than its existing system.
Having exhausted her imagination as to why Coronavirus might prove America needs MFA with such weak arguments, the author of the Common Dreams article moves on to something completely irrelevant to her argument for MFA. To wit, MFA would be cheaper. The issue of which system costs more has nothing to do with which system can best handle pandemics.
In short, the article titled “Coronavirus Proves It: We Need Medicare For All” proves nothing.
UPDATE: “CORONAVIRUS & SOCIALIZED MEDICINE: Why Healthcare in the UK, Italy is FAR Worse than America” provides some great additional observations.
[ii] China’s reported data will never be verifiable: See “Chinese scientists destroyed proof of virus in December” and “Where it all began: Wuhan’s virus ground-zero ‘wet market’ hides in plain sight.”
Author’s Note: Dr. Birx, Dr. Fouci, and others continually talk about “the data,” its importance, and what they have learned from it. I know too little about epidemiology to offer commentary concerning what is discoverable from sound data concerning COVID-19. I do have some largely unreported reasons not to believe “the data” upon which the country is relying is as sound as some would have us believe.
The data depicted above is from John Hopkins’s much-referenced COVID-19 Map. The information is chocked full of misleading information. Let’s sort out a few of the big ones.
The most prominent number on the map is “Total Confirmed,” the total number confirmed COVID-19 infections worldwide. The fact that the “Total Confirmed” number is reported at all, much less touted, implies that it is valuable information about how contagious/dangerous the virus is. Not so fast! The number is far less informative than it is cracked up to be and it is being misused[i]:
Consequently, the “Total Confirmed” number omits many, perhaps a majority of infected people. In terms of the more relevant (but unreported) number of severe illness and death per person infected, the “Total Confirmed” number is seriously flawed and misleading. It leaves the impression that COVID-19 is much more dangerous than it is.
This list could go on indefinitely. Hopefully, this list is sufficient to convince you that “the data” upon which the country is relying to make monumental decisions about the extent to which and for how long the economy should be stifled is not all that it is cracked up to be. [See also, “Dr. Fauci Follies.”]
[v] “KCUS tested 48 samples, seven positive, doctors test negative.” [Google appears to be deep-sixing this kind of information. How this article slipped through Google’s filters is a mystery to me.]
[xiv] See endnote ix.