Friday, August 7, 2020

End U.S. COVID-19 Restrictions Now

It’s not in the public interest to sacrifice the young and the healthy to the old, the sick, and the fat. 

Updated September 14, 2020

COVID-19 has upended life globally. As of August 2020, it has directly killed over 800 thousand people  and indirectly killed thousands more due to their not being treated for other medical conditions. It has led to a global recession that may turn into a second Great Depression. Governments worldwide have taken unprecedented powers to enforce social distancing, lockdowns, and other public health measures, and to try to prop up economies.

There are heroes in this worldwide tragedy. Doctors, nurses, and other healthcare workers have stepped up at significant personal risk to treat the sick. They should be saluted, along with other essential workers like grocery store workers, police officers, and transit workers who have helped keep us fed, safe, and able to go to where we need to go.

But we must not overlook the collective failure of important institutions that could have prevented this catastrophe. This pandemic is both a scientific and political failure. Scientists knew from the SARS epidemic of 2002 – 2004, and the MERS epidemic beginning in 2012 that certain coronaviruses could be deadly, but didn’t do enough to prevent the COVID-19 pandemic. What could they have done? Universal (aka panviral) coronavirus vaccines or treatments. Isn’t that very difficult? Yes. It would have required the combination of a major research effort, including funding, along with a scientific breakthrough. In other words, a combination of political long-term, strategic planning along with scientific genius. Both are globally lacking in today’s world, and we are now paying the price.

Many countries have combined lockdowns with widespread contact tracing, testing, and social distancing to flatten the curve  The economic cost has been high, but countries that managed to reduce the case count are now reopening (although some of them are locking down again due to renewed COVID-19 spread). In the U.S., this has not been successful. Although it created a temporary flattening of the curve, buying time for health professionals to ramp up testing, PPE, and better treat the disease, we are now seeing a spike in many parts of the U.S. (although this spike is associated with much lower death rates than before). The combination of poor U.S. public health infrastructure, large number of people with chronic health conditions, fragmentary government responses, and history of individual freedom and rejection of government authority, made the global standard COVID-19 public health response a failure in the U.S.

While some commentators have attributed this failure to American decline, others have noted that the projected COVID-19 death count is not comparable to the horrific Spanish Flu of 1918 – 1919, but instead the Asian flu of 1957 – 1958, or Hong Kong flu of 1968 – 1969, in which there were no U.S. shutdowns, and minimal public health response and economic impact. We had better leaders back then who, guided by common sense, understood that shutting down the economy in response to a pandemic would have devastating effects.

At this point, it’s time to reopen the U.S. economy. Repeated widespread lockdowns to flatten the curve are not going to be politically acceptable anymore. The business closures that remain are only postponing the inevitable deaths, while destroying the economy. People are going to become sick and die of COVID-19 whether or not the economy reopens. We might as well reopen it now.

It’s summer as I write this. People are doing less risky outdoor activities. It makes sense to completely open up the economy now. Let’s build up herd immunity among liberated younger people. Continuing the way we’re going with partial closures and restrictions will result in a large number of susceptible people this coming flu season. Then hospitals will be overwhelmed with the combination of flu and COVID-19, and our leaders will demand more shutdowns. Small businesses can survive a single shutdown, but not repeated ones. Very soon, years of hard work and effort among thousands of business owners to build their brands will be flushed down the toilet.

By rescinding all state, county, and local COVID-19 business restrictions, many small and medium-sized businesses will be saved from destruction. Governments are not expropriating wealth, but instead are destroying it by continuing with these restrictions. This will save a large fraction of our middle class, many of whom are small business owners. It will save millions of jobs from elimination. Opening schools will save our children, the future of our country, whose education is at risk of being abandoned. Many school systems refuse to reopen despite the overwhelming evidence that remote schooling is ersatz, especially for disadvantaged kids, and children rarely become seriously ill with COVID-19.

I’ll now discuss some arguments and counterarguments for COVID-19 restrictions.

Economist Paul Krugman argues that Republicans have “sacralized selfishness,” encouraging people to act irresponsibly by going to bars and refusing to wear masks. Implicit in this argument is that it’s selfish for young people to party, hang out at bars, and engage in what otherwise would be a normal social life for a young adult. Taking its argument to its logical conclusion, it’s also selfish for young people to go to school, work, shop, socialize, travel, or do anything other than sit at home and watch Netflix, because there’s the chance that they will catch COVID-19 and pass it onto vulnerable people. That’s one way to look at things.

There’s another way to look at this. We know that people vulnerable to getting seriously ill and dying from COVID-19 include the elderly, those with chronic health conditions like hypertension and diabetes, and the obese. In other words, the old, the sick, and the fat. Isn’t it selfish for the old, the sick, and the fat to tell the young and the healthy that they cannot have a life? They cannot go to school, work, shop, socialize, or do anything that normal, healthy young people do? They cannot do this because there’s a chance they will catch the virus and pass it onto a vulnerable person? Many of the old, sick, and fat were once young and healthy. Back then, they had the opportunity to go to school, work, socialize, travel, and have fun. Isn’t it selfish of them to tell the youth of today that they cannot do what they themselves did when they were younger? That the youth of today must come of age in Great Depression 2, a Great Depression that was caused by a global overreaction to COVID-19, with no opportunities to have a fulfilling career and make money? That the youth of today must pay off massive government debt that we have accumulated trying to prolong the lives of the old, the sick, and the fat?

Another perspective, common in contemporary America, is the rights perspective. The old, the sick, and the fat have a right to life, that’s being taken away by the irresponsible young and healthy who party and pass on the virus to them. That’s one perspective, and the right to life is important.

But there’s another perspective: the right to liberty. The young and healthy have a right to liberty, which is being taken away in an unprecedented way with COVID-19 restrictions. For example, when in American history has there ever been a general stay-at-home order or lockdown, affecting most of the population? World War II? There were restrictions and shortages, and young men were subject to the draft, but people were free to move about and go on with their lives. The same was true for World War I and the Civil War (with the possible exception of being actively attacked or invaded). There were pandemics in the past that provoked a public health response, the most notable being the Spanish flu pandemic of 1918 – 1919. As I said above, COVID-19 is not comparable to the Spanish flu. The Spanish flu’s death rate was 2 to 6 times higher than COVID-19’s death rate. Also, unlike COVID-19, the Spanish flu was especially deadly for young adults. But despite being the most deadly flu pandemic in modern history, the public health response was muted compared to what we’ve done with COVID-19. In some cities, bars, restaurants, theaters, and schools were closed, and masks were required. Sound familiar? But there were no general lockdowns, no attempt at universal “social distancing” (a euphemism for enforced mass social isolation), and no restrictions on private social functions. The economy back then was mostly agricultural and industrial, and healthy people continued to work in the farms and factories.

If this extreme mass denial of liberty resulting from the global overreaction to COVID-19 didn’t come from democratic historical examples, where did it come from? China, where the virus also came from. Although China at first denied the severity of the virus, allowing it to escape to other countries, eventually they instituted a strict lockdown of Wuhan. Other countries, including the U.S., decided to imitate the Chinese response, conveniently forgetting that China is a totalitarian communist dictatorship. Why should democracies imitate the actions of a totalitarian communist dictatorship? Aren’t we supposed to value individual liberty? 

In my opinion, the best perspective to evaluate the COVID-19 response is on the basis of the “public interest.” I define this as the long-term interest of society as a whole. In the contemporary U.S., the public interest is not discussed very often. On the political left, identity politics rules. Every group is concerned with its own interests, and these interests conflict with each other. Examples include feminists, and advocates for blacks, gays, and the disabled. On the political right, the interests of the wealthy donors are paramount. Hence the Reagan, Bush Jr., and Trump tax cuts, which overwhelmingly benefited the rich.    

Looking at COVID-19 from a public interest perspective, is it in the public interest to sacrifice the young and the healthy to the old, the sick, and the fat? Let me ask the question in another way. Who is the future of our country? Is it the demented 85-year-old man in a nursing home, or a 7-year-old in elementary school? Should the 7-year-old elementary school student be denied an education because there’s a chance that, not that the student will get seriously ill from COVID-19, but that he might pass the virus to someone, who will pass it to someone else, and it will eventually reach the 85-year-old demented guy in the nursing home? The 85-year-old demented guy represents the past. He’s lived his life. It may have been a good life, maybe not. He has, at best, a few more demented years left. The 7-year-old represents the future. He may live another 80 years or more. His development could be irreparably harmed if he’s denied an education and normal social interaction with his peers.

Some may argue that I am making a straw man argument. Many people who die of COVID-19 are not demented old guys in nursing homes. But 40% of U.S. COVID-19 deaths are linked to nursing homes (nursing home residents make up only about 0.5% of the U.S. population). Elderly people are in nursing homes for a reason. They’re not doing too well. The point is that by continuing these restrictions, we’re sacrificing our future to our past.

What about teachers in schools? Let’s take the case of a 65-year-old teacher with diabetes and hypertension. She is afraid of contracting COVID-19 from her students. I would be afraid if I were in her situation, also. But there’s a simple solution for her: she can quit. There are plenty of unemployed and underemployed young healthy college graduates who could replace her. You could hire someone with a bachelor’s degree and without teaching credentials, and have her earn credentials while she’s working.

Another argument is that the restrictions are only temporary, until we get an effective vaccine or treatment. In the meantime, why can’t the young and healthy stay at home and not infect the vulnerable? If “temporary” meant a month or two, I might agree with this. But the lockdowns and restrictions in the U.S. started in March, over 4 months from the time I’m writing this. I don’t see an end date. The longer the restrictions occur, the more businesses will fail, the more the economy will suffer, and the better chance the world economy will sink into Great Depression 2. While optimists can say that as soon as we have a vaccine everything will return to normal, we don’t know that. We don’t know if or when we’ll have an effective and safe vaccine. Many small businesses, and the jobs associated with them, will be permanently closed. The passion, energy, and years of hard work they put into these businesses will be lost forever. Some of these businesses go back generations. It’s unlikely that we can just flip a switch and get back to the way things were. It’s incredibly risky to start a Great Depression 2. Along with the expected consequences of widespread unemployment, homelessness, starvation, etc., the unexpected consequences can be catastrophic, as they were for the Great Depression in the 1930s. The Great Depression led to Hitler and the Nazis coming to power in Germany, and six years later Hitler started World War II by invading Poland. 70 to 85 million people died in that war.

Rushing a vaccine to return as quickly as possible to normal life is also a bad idea. An unsafe and ineffective COVID-19 vaccine would not only hurt the people who received the vaccine and got sick and/or died, but would also make people wary of taking other vaccines. Even before the COVID-19 pandemic, there have been a lot of people refusing to take safe and effective vaccines like measles. A COVID-19 vaccine fiasco would accelerate this anti-vaccination trend, resulting in preventable outbreaks of measles and other diseases.

The solution in the U.S. (and many other countries) is to no longer utilize public health interventions for COVID-19. These interventions, such as testing, contract tracing, and isolation/quarantining, made sense early in the pandemic, as an attempt to contain the virus. Not only would containment have saved thousands of lives, but it would have had minimal impact on the economy and daily life. After containment failed, it no longer was logical to continue these interventions. The cost in terms of jobs, economic collapse, mass restrictions on individual liberty, and disruption to daily life have become too high. “Flattening the curve” sounded good in theory, but has proved to be a total failure, at least in the U.S. People with serious symptoms requiring medical attention should be tested and treated; everyone else with mild or no symptoms should be left free to go on with their lives. All state, county, and local restrictions should end (with the exception of protecting nursing homes and other elderly long-term care institutions). Schools should be open for full-time in-person instruction under normal pre-pandemic conditions. People with mild or no symptoms should go about their life without being subject to testing, enforced mass social isolation, masking, quarantining, or any other public health intervention. If businesses want to implement health measures such as masks/distancing/cleaning, they should be allowed to but not required by law. Vulnerable people living outside of institutions will need to take appropriate precautions while there is community spread (e.g. while usually it’s healthy for obese people to work out at the gym, not now). It’s possible that natural herd immunity will occur before an effective and safe vaccine is developed, which will make the vaccine superfluous. Whether the herd immunity is achieved naturally or through a vaccine, life must go on.

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