There’s a lot I disagree with and a few things I agree with in Holman Jenkins’s latest Wall Street Journal column. Here’s the part I thought worth passing along:
In the New Yorker’s recent Covid opus, which took up an entire edition of the magazine, these lessons don’t appear. It cites two “missed opportunities†to defeat the virus: China’s failure to fess up about human-to-human transmission and the early U.S. testing fiascoes.
It’s wrong about both. Covid was out of the bag globally before Beijing even knew it existed. And U.S. testing could hardly have isolated early Covid sufferers when 59% of spreaders have no symptoms and most of the sick have symptoms indistinguishable from the colds and flus millions suffer every day.
The new coronavirus was an efficient spreader and was not going to be stopped, as much as politics resists the idea of realities that can’t be changed by politics.
A third “missed opportunity†was mask adoption, but masks are only one element of social distancing. Research by the Covid States Project shows that, starting early last summer, Americans donned masks but curtailed their physical separation, contributing to the year-end surge.
We can intelligently say only that America’s social distancing could have been better. It also could have been worse.
Governing is the hardest thing people do, period, so don’t take this the wrong way. All along messaging has had to target two bogeys, a political one and a public-health one, but the distortions are adding up.
It’s absurd that only now the CDC, very quietly, has begun recognizing, as it does with the flu, most cases go unreported. As of Dec. 31, when the media was highlighting 19.7 million “confirmed†cases, the CDC now estimates 83 million were infected.
The consequences will never be acknowledged. We prioritized a vast testing enterprise that could not possibly help us control the spread. We failed to invest in antibody studies that might now be helping us guide early vaccine doses away from 100 million or so who already have some natural immunity.
A long-running University of Southern California survey shows that risk perceptions have been distorted in exactly the way you would predict: Americans overestimate their risk of dying from Covid and underestimate their risk of catching it, with the result that millions likely have been selecting a level of risk that ill serves them, their families and society.
What can you say other than that publicity works? Whether you call it “fake news” or “partisan press” or just plain yellow journalism being taken uncritically, we’ve had a pretty solid diet of it for the last year.
He is probably correct about it spreading too early to be stopped. Best we could have done is slow it a bit. He is partially correct about testing. In the ideal we would have had good tests available a month sooner than we did and we could/should have done surveillance testing. We couldn’t even test admitted patients for quite a while due to lack of tests.
Where I will disagree is that in fact many parts of America did not wear masks. IN coal country we still have signs that either say masks are not needed or not allowed. Those areas overlap heavily with not social distancing. Those areas also were free with having large indoor group gatherings.
As to the CDC I would note that virtually anyone who is knowledgeable writing about Covid has noted that we are probably way under reporting the number of cases. Antibody tests have seemed to be the ones with the least degree pop accuracy so not sure they would help that much in determining who should be vaccinated. We dont know if vaccination for Covid will give us a better response than natural immunity but we do know in other cases vaccination is better.
I dont know about the yellow journalism/partisan press claim. I do read more journals and medical literature than most people but most of what I have read in popular mainstream press sites has been pretty accurate. What people decide to take from it has been very, very skewed. Look at the Imperial College report early on. It actually said that the number of deaths could be anywhere from a few thousands to 2.2 million depending on the R value and measures taken to minimize spread. What got spread in certain areas of the press was the 2.2 million number. As to risk I think there eis no lack of evidence that in general people do not accurately understand the risks of a lot of things so I dont really find this unique. Iraq War anyone?
Steve
BTW, early estimates on suicide rates at link. The Covid deniers have been claiming a big rise in suicides, among other causes of death, as the reason for the increase in deaths rather than Covid. However, at the clinical level we just haven’t been seeing this. Prelim report, it could change, but not likely and pretty much rules out a large rapid change.
https://twitter.com/tylerblack32/status/1357765466601775106
Steve
Media likes to keep things simple for us, vaping deaths and overdose deaths are out of the news. Down but not out.
On topic, what can you really do in a free country with people who don’t believe or won’t comply or continually forget to comply? I walk away, but that’s hard when it’s friends or family.
Some friends seem to feel that to wear masks or social distance is attempting to thwart God’s will.
They remind me that we all have to die, my response is always,
But not today, alright?
First, the East Asian rice paddy ecosystem naturally generates viral diseases like covid and influenza on a regular basis–no need for labs.
Second, slowing it a bit was the purpose of the masks and distancing–it probably worked. But the ultimate total depends on the original number of susceptibles. Also, like influenza, covid appears to be somewhat seasonal, and it might be dying out for this round. Expect another next fall.
Third, the real screw-up is the inability certain state governments to get people inoculated. The problem seems to be the excessive number of restrictions on who/when. And the problem appears to be limited to Democrat-run states. I just got my first injection yesterday. I was on the waiting list one day.
We have an online registration where. You list your age and exaggerate your co-morbidities.
They’ve done 5,000/day, 80+ years for three days now.
All now depends upon supply.
They’re using an auditorium.
Park and walk, or wheelchair.
I guess that’s faster than a line of cars with the wait and observe requirements.
We have been operating in an environment of terribly soft statistics. Between unreported, functionally asymptomatic people and over amplified cycle tests we don’t have a clue what the true infection rates are. We guess.
As for public policy such as masks, or heightened awareness, or shutting down businesses its also a crock. All you have to do is use your eyes. In FL perhaps 50%, maybe more, of people do not wear masks at all. And they don’t social distance for squat. GA is similar. SC has mask mandates, unenforced, and useless in many retail settings. Social distancing? Floors have distance markings. No one uses them. Yet go to Boston, New York, NJ, Boulder, LA etc and you have the mask zealots scolding people for not wearing outdoors, instructing people where to stand, or cautioning in hushed tones: “be careful out there.â€
Meanwhile, in the real world, and where the rubber meets the road – deaths – you have the following stats per 100,000:
NJ, NY, MA at #1, 2, and 3. IL ranks fairly high. You have SC, GA and FL at #19, 21 and 25. In case you were unaware, FL has a lot of especially vulnerable people. They call them old people. And yet….
Look at the top counties for deaths and you have your real answer. LA, Cook, Kings, Queens, Bronx, Miami-Dave. All those masks, all those deaths. But at least NY has the greatest corona fighting Guv in the world. I heard it on CNN.
Public policy has been a third order effect, people. At such a cost.
Sigh. Ok lets remember that those deaths in NY, etc occurred when the death rate from Covid was about twice what it is now. The majority of deaths in the southern states cited above occurred much later, after we got much better at treating Covid. **So take the NY and NJ death rates and cut them in half from their current 245 and 228 . They end up at about 123 and 109. Take South Carolina and Florida at 145 and 127 and double them. You get 290 and 254, well ahead of NY and NJ. You also need to figure out how N and S Dakota end up in the top 10 without any significantly large cities.
** The huge majority of deaths in NY/NJ etc were before July 1. For SC, GA, Fl they occur after July 1.
https://www.statista.com/statistics/1109011/coronavirus-covid19-death-rates-us-by-state/
Steve
At Quillette, Toby Young makes a compelling case that lockdowns do not work, but instead are a response to high infection rates, which themselves provoke a public response of voluntary isolation.
If he’s right, it appears to me that the reason lockdowns don’t “work”, is that they always are partial, by our nature, and leak badly.
https://quillette.com/2021/02/05/the-case-against-lockdown-a-reply-to-christopher-snowdon/
I don’t want to get involved in this pissing contest but IMO methologically speaking you’d want to compare number of deaths per 100K population in the same timeframe. In other words if you want to weight the NY and NJ deaths down due to the learning curve in March and April you should do the same with, say, SC and Florida deaths. I’m skeptical there’s any way to structure the comparison fairly and objectively.
GS:
I think that lockdowns don’t work in the U. S. because they are invariably applied politically and capriciously.
No, you dont because it is clear that some areas started out with a much higher incidence of Covid. We know that on the East Coast Covid came from Europe and that most of it came through New York. So for a given incidence of Covid the NY/NJ area had a much higher death rate before July. After July their incidence of Covid has been much lower than those other states and their death rate has been even lower. Then you look at hospitalizations, probably a better measure. If you had the same rate of people in Georgia, just to pick one, dying in October as NY did in April per hospitalization, their death rate would far exceed that of NY or NJ.
So what you end up seeing is that the NY/NJ area both learned to decrease the incidence of Covid AND decrease the death rate. This was passed on to other states so that when other states had their rates of Covid increase their death rates did not increase at the same rates seen in NY and NJ in the Spring.
Bonus- I keep seeing it written on right wing and libertarian sites that vaccinations are going much better in red states so Looked at the numbers. Link goes to them. I dont see much pattern. Some of the best states are red states but 6 out of the 7 worst are also red states. Small states seem to have some advantage.
https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-covid-19-vaccines-administered.html
Some observations.
One thing I learned in this pandemic is not judge a government’s performance until the pandemic is over. Given data from Israel, its looks like there will be significant cases / deaths until > 50% of the population is vaccinated, which is at least this summer.
Second, grading New York’s performance on a curve because they got hit with COVID in March 2020 instead of July 2020 is misleading. Here is a counter example; Washington state had the countries first case, first death, first nursing home outbreak. It was in the leader among states for cases per capita / deaths per capita until Mid March 2020. Yet today it is among the lowest in both categories. How did New York end up with deaths per capita six times of Washington?
Third observation, the missed opportunities were the things other countries did but not considered in the US because they were outside the Overton window. Here are 3;
1. Domestic travel restrictions — employed to favorable effect in China, Australia, Canada (informally), Europe (informally). Trump blundered in not forcefully pursuing DeSantis suggestion to stop travel out of New York and making a national framework of red/green zones.
2. Mandatory quarantine — a key reason China, South Korea, HK, Singapore, New Zealand have been able to suppress outbreaks. I have been beating this drum forever, but a reminder, the Chinese found this was a more effective measure in Wuhan then the draconian lockdown imposed.
3. Travel restrictions — Trump imposed what were considered severe restrictions last year; but it could have been better if isolation orders were enforced instead of voluntary. Again, used to favorable effect in China, South Korea, HK, Singapore, New Zealand, and Australia. Through the Overton window maybe changing on this one with the UK adopting “hotel quarantine”.
I thought that all domestic passenger air traffic should have been shut down and the interstates should have been closed to all but truck traffic.
Heck, in NYC they couldn’t even bring themselves to shut down the subways.
” It was in the leader among states for cases per capita / deaths per capita until Mid March 2020. Yet today it is among the lowest in both categories. How did New York end up with deaths per capita six times of Washington?”
Washington doesn’t have nearly the population density of NYC and the surrounding metropolis. Washington also isn’t the financial capital of the world so it didnt have the level of traffic coming back from Europe seen by NYC. Washington was generally better resourced than many of the inner city NYC hospitals. While I dont know Washington like I know the NYC area, I doubt very much that they have the 200-300 year tradition of the more well to do New Yorkers who have homes outside the city in places like the Poconos that they could flee to and spread the disease.
“Second, grading New York’s performance on a curve ”
Lets not grade them on a curve but just set equal metrics. If people died at the same rate when hospitalized in NYC in April as they did in July then their death rate would have been below that of South Carolina and Florida. Secondarily, if those southern states had seen big surges early their death rates would have been much higher.
“Heck, in NYC they couldn’t even bring themselves to shut down the subways.”
How would people get around without it? Not enough cabs or buses.
Steve
They wouldn’t. That’s the point.