By Alan W. Dowd
Sunetra Gupta, Gordon Gee and Jack Lewis come from different walks of life, different parts of the world, even different moments in history. But they share a keen understanding of how a free society should deal with—and live with—danger. We could learn a lot from them.
Sunetra Gupta is a professor of infectious-disease epidemiology at Oxford University. The Indian-born scientist has argued for months “the sledgehammer approach” to COVID19 doesn’t work. “People are treating it like an external disaster, like a hurricane or a tsunami, as if you can batten down the hatches and it will be gone eventually. That is simply not correct. The epidemic is an ecological relationship that we have to manage between ourselves and the virus,” she explains, adding that we must find “a way of living with this virus.”
Gordon Gee is the president of West Virginia University. With degrees in history, law and education, it’s fair to assume he’s no virologist or epidemiologist. But he is, in addition to serving as WVU’s CEO, a huge sports fan—especially football. Months ago, while public-health experts were shutting down our free society, Gee said something simple yet profound—something Gupta would have no trouble endorsing: “We need to learn to dance with the pandemic rather than being fearful of it.”
Finally, we come to Jack Lewis, who is better known by the initials of his first and middle names: C.S. In 1948, Lewis offered advice on living in an age suffocated by the threat of nuclear war. He reminded his countrymen that they had lived through “an age of air raids,” that their ancestors lived amidst a “plague [that] visited London almost every year,” that humanity had found a way to live under constant threat of disease, paralysis, accidents, brokenness. “Do not let us begin by exaggerating the novelty of our situation. Believe me, dear sir or madam, you and all whom you love were already sentenced to death before the atomic bomb was invented…Let that bomb, when it comes, find us doing sensible and human things—praying, working, teaching, reading, listening to music, bathing the children, playing tennis, chatting to our friends over a pint and a game of darts—not huddled together like frightened sheep.”
Again, it seems Gupta would have no trouble endorsing Lewis’s prescription for living in an age characterized by mortal danger.
Yet rather than learning to live with and “dance with” the virus, many Americans—owing largely to decisions made by policymakers—seem to be in a kind of suspended animation as they wait for a COVID19 vaccine.
The good news is that a vaccine could soon be ready for mass-production. As the Economist reports, a vaccine developed by Oxford University shows promise. Trialed in Britain and Brazil, the Oxford vaccine “stimulated a strong immune response and appears to be well tolerated and safe.” Positive results have also been reported for vaccines developed by Moderna, Pfizer and Johnson & Johnson. Synairgen has developed a promising antiviral treatment. The drug has “significantly reduced” the number of COVID19 patients needing intensive care and cut the need for ventilation by 79 percent.
The operative word in the above paragraph is “soon.” As the Economist details, once a COVID19 vaccine is ready, a public-private consortium is prepared to deliver hundreds of millions of doses nationwide by January. That, of course, presupposes fast-tracked approval by relevant government agencies. Even then, people have to be willing to take the vaccine. Only 45.3 percent of American adults get the seasonal flu vaccine, and no vaccine is 100-percent effective. Moreover, concerns are now being raised about “long-term impacts” of COVID19—something, by definition, we won’t understand for a long time.
All of this underscores why we need to learn to live or “dance” with this virus—just as we have done with other dangers and diseases.
Ways of Life
Early on, COVID19’s infection-mortality was thought to be 3.4 percent or higher. That understandably terrified policymakers. However, as we learned more about the virus, the actual infection-mortality rate rapidly emerged in the data: The virus kills not 3 or 4 percent of those infected, but somewhere between 0.1 percent and 0.4 percent, as the Hoover Institution’s Scott Atlas explained in congressional testimony. “Multiple studies from Europe, Japan and the U.S. all suggest that the overall fatality rate is…10 to 40 times lower than estimates that motivated extreme isolation.”
The seasonal flu, by way of comparison, kills about 0.1 percent of those infected. So, those of us who have argued for months that government reaction to COVID19 is at best ahistorical and at worst draconian must concede that COVID19 could be more deadly than the seasonal flu. At the same time, those who have supported the well-intentioned responses ordered by federal, state and local governments must concede that COVID19 is definitively not another Spanish Flu or Bubonic Plague. It’s not even another H2N2 pandemic (which killed 0.67 percent of those infected in 1957-58). As such, COVID19 doesn’t justify the measures put in place since March. Rather, it requires prudent precautions.
Policymakers have been many things since March, but prudent is not one of them.
Policymakers were initially concerned about high infection-mortality rates, which we soon learned were wildly over-projected; then about skyrocketing hospitalizations, which spawned scores of largely unused backup facilities; then about infections, which proved to be a serious risk to the elderly and those with preexisting conditions (discussed below); then about positive tests, which are actually part of the solution (discussed below). Somewhere along the line, these terms—“infection-mortality rate,” “hospitalizations,” “infections” and “positive tests”—were conflated. Thus, the goalposts were dramatically shifted from slowing the spread of infection in order to give hospitals time to build up capacity, to stopping the spread of infection altogether. A 15-day sprint turned into a sixth-month forced march, with no clear end in sight (how many times have we been told “the next two weeks are critical”?). And the “home of the brave” became a nation afraid of just about everything: handshakes, hugs and high-fives; our grandchildren, neighbors and coworkers; where we worship, work and work out.
As they learned more about the virus, policymakers should have adjusted their policies. But very few did. The result is a smothering “new normal” that is not conducive to individual liberty, individual responsibility, our constitution, our way of life, even our humanity. As Gupta laments, “We are closing ourselves off not just to the disease, but to other aspects of being human.” She reminds us how we constantly “make quite difficult decisions about tradeoffs that exist between ways of life.”
Make no mistake: the lockdown way of life is an enemy of life and living.
Millions of surgeries have been postponed. Researchers project 10,000 “excess” cancer deaths as a result of delayed screening caused by COVID19 lockdowns. A team of research professors notes that half of cancer patients have missed chemotherapy treatments; transplants are down almost 85 percent; emergency stroke evaluations are down 40 percent; more than half of childhood vaccinations have not been performed.
A Brookings study concludes, “The COVID19 episode will likely lead to a large, lasting baby bust…a drop of perhaps 300,000 to 500,000 births in the U.S” next year. This is not a function of deaths among women of childbearing age—just 1 percent of U.S. COVID19 deaths are among people younger than 35, and far more than half of them are men—but rather uncertainty.
A staggering 40 million Americans were unemployed due to the lockdown; more than 72,800 U.S. businesses have been permanently shuttered.
The isolation, job loss and depression triggered by the lockdown way of life will lead to 75,000 deaths from drug abuse, alcoholism and suicide. Domestic violence and childhood malnutrition have surged during the lockdown. A new study concludes that 212,500 cases of child abuse have gone unreported due to the lockdown—a consequence of kids not being in school, where abuse is often first detected. Indeed, we may never be able to quantify the costs of a year without classroom instruction, which is why the American Academy of Pediatrics has urged a reopening of schools. Yet certain governors, school boards and teachers unions apparently know more than pediatricians about the wellbeing of children.
Again, the data are important here. Nursing homes account for 45 percent of all COVID19 deaths; in some states, these facilities account for 81 percent of COVID19 deaths. Americans 85 and older represent 32.8 percent of COVID19 deaths; Americans 75-84 represent 26.4 percent of COVID19 deaths; Americans 65-74 21 percent; Americans 55-64 12.2 percent; Americans 45-54 5 percent; Americans 25-44 2.6 percent; Americans 15-24 just 0.1 percent; Americans younger than 14 account for statistically 0 percent of COVID19 deaths.
Indeed, by April, it was clear that COVID19 ruthlessly targets the elderly and other high-risk groups. This isn’t to suggest that we shouldn’t care because those groups are closer to death’s door. To the contrary, we should care more about protecting high-risk groups—or better said, given what some policymakers ordered, we should have cared more about protecting them.
So how did this happen? Edward Stringham, president of the American Institute for Economic Research and professor of economics at Trinity College, details how computer modelers in 2006 resuscitated “a premodern idea of quarantines, closures and measured lockdowns” as a way to address pandemic disease. As Stringham’s AIER colleague Jeffrey Tucker discovered, the idea to ignore a century-plus of science related to pandemic response and instead repeat what failed in the Middle Ages can be partly attributed to a most surprising source: “a high school research project pursued by the daughter of a scientist at the Sandia National Laboratories.”
The scientist’s name is Robert Glass, a complex-systems engineer. His daughter, at the age of 14, “had done a class project in which she built a model of social networks at her Albuquerque high school, and when Dr. Glass looked at it, he was intrigued,” as the New York Times reports. “Students are so closely tied together—in social networks and on school buses and in classrooms—that they were a near-perfect vehicle for a contagious disease to spread. Dr. Glass piggybacked on his daughter’s work to explore with her what effect breaking up these networks would have on knocking down the disease. The outcome of their research was startling. By closing the schools in a hypothetical town of 10,000 people, only 500 people got sick. If they remained open, half of the population would be infected.” (Tucker unearthed the origins of the COVID19 lockdown in the archives of the New York Times and Albuquerque Journal.)
What Glass and his daughter—and too many policymakers to count—didn’t grasp is that infection is not the enemy. In fact, infection is the key to living with—or “dancing with”—a virus. We do this by acquiring “herd immunity”—the point at which a sufficient number of people in a given population are infected by a virus and develop resistance to it. Herd immunity is achieved either through vaccination—the purposeful introduction of a virus into our bodies—or through natural spread of a virus.
As Gupta explains, “The only way we can reduce the risk to the vulnerable people in the population is for those of us who are able to acquire herd immunity to do that…The reason we don’t see more deaths from flu every year is because, through herd immunity, the levels of infection are kept to as low a level as we can get.”
Adds Atlas, who recently joined the president’s COVID19 response team: “We are now dealing with infections in people who have essentially no problem with the infection…That’s not a bad thing…That’s how we prevent the connectivity of spread to people that have high-risk profiles…That’s what herd immunity is.”
In short, the high-risk should be protected and encouraged to stay at home. People with stronger immune systems, on the other hand, should not—and never should have been ordered to upend their lives or sacrifice their liberties because of COVID19. This doesn’t mean the healthy should try to get sick. Most of us avoid doing things that cause illness. Thus, during the 1957 H2N2 pandemic, 1968 H3N2 pandemic, 2009 H1N1 pandemic, 2017 flu season, and hopefully all the time, we wash our hands, avoid eating or drinking after sick people, take vitamins, and practice good hygiene. But we don’t quarantine the healthy or cocoon ourselves. Our immune systems need to be exposed to bacteria and viruses in order to function properly.
Likewise, a free society needs to be allowed to function in order to survive. When it is not, the consequences are dire, as we have seen the past six months.
The awful consequences detailed above may have been unintended, but they were not unexpected. As Stringham writes, the late Donald A. Henderson, who led the global effort to eradicate smallpox, “swung into action and composed a masterful response to the new fashion for quarantines and lockdowns” pitched by Glass and his teenage daughter. Henderson’s warnings, written in 2006, read like the writings of a prophet:
- “Experience has shown that communities faced with epidemics or other adverse events respond best and with the least anxiety when the normal social functioning of the community is least disrupted. Strong political and public-health leadership to provide reassurance and to ensure that needed medical care services are provided are critical elements. If either is seen to be less than optimal, a manageable epidemic could move toward catastrophe.”
- “The negative consequences of large-scale quarantine are so extreme…that this mitigation measure should be eliminated from serious consideration.”
- “A policy calling for communitywide cancellation of public events…would have seriously disruptive consequences for a community if extended through the eight-week period of an epidemic in a municipal area, let alone if it were to be extended through the nation’s experience with a pandemic (perhaps eight months).”
- Closure of “malls, fast-food restaurants, churches, recreation centers…throughout the pandemic would almost certainly have serious adverse social and economic effects.”
- Most intriguing of all, Henderson urged public officials to “request that all who are ill remain isolated at home or in the hospital but…encourage others to continue to come to work so that essential services can be sustained.”
As the New York Times later summed it up, Henderson’s recommendation was to “let the pandemic spread, treat people who get sick, and work quickly to develop a vaccine to prevent it from coming back.” Like a football fan, a writer and a fellow scientist, Henderson understood that free societies have to learn to dance with diseases and other dangers.