PROJECT FORTRESS 10.12.20
BY ALAN W. DOWD
From the outset of the crisis spawned by COVID19 (and by government
reaction to it), Project Fortress essays have emphasized that there are
people of good will and good intentions on both sides of the COVID19 divide. But even people of goodwill sometimes engage in bad reasoning.Patriots
Before going any further, it’s necessary to sketch the terrain of America’s COVID19 divide.
On one side are what we might call “individual liberty patriots.”
These are Americans who so deeply identify America with freedom—and
being an American with freedom—that they bristle at limits on freedom.
They hold that America’s well-being—indeed its very essence—is a
function of freedom. They believe it’s their civic duty to live free and
take individual responsibility. They recall that America didn’t shut
down during the pandemics of 1957 or 1968, criticize government
responses in 2020 as drastic, and say life must go on in order to
preserve individual liberty.
On the other side are what we might call “public health patriots.”
These are Americans who love their country and countrymen so much that
they’re willing to limit freedom and scale back the American way of life
for the good of the whole. They hold that public health is at the very
core of America’s wellbeing. They believe it’s their civic duty to
prevent spread of the virus and promote social responsibility. They view
COVID19 as more dangerous than past pandemics, applaud government
responses as prudent, and say life must change in order to preserve
public health.
As we chart a path forward and build bridges across the divide, we
need to remember that public-health patriots have legitimate concerns
about safety, that individual-liberty patriots have legitimate concerns
about freedom, and that both groups love their country.
Models
Given that backdrop, let’s start with some arguments heard on the individual-liberty side of the divide.
Fear is the real virus.
Some of us individual-liberty
patriots seem to forget that fear is a healthy, necessary, God-given
response to the unknown and to things that could harm us. Whether we
encounter a hissing snake or a new virus, fear is a natural
self-defense, self-preservation response. Given that in March the
infection-mortality rate for COVID19 was thought to be 3.4 percent,
COVID19 was definitely something to be feared. Indeed, the initial
government responses to COVID19 were largely shaped by computer models
that predicted if we went on with life as usual the virus would kill 2.2 million Americans—and
as many as 1.2 million Americans even under “the most effective
mitigation strategy.” Those models understandably terrified
policymakers.
Yet the data—not computer models—soon revealed the actual
infection-mortality rate to be much lower. By the end of April, the data
indicated that the virus kills not 3.4 percent of those infected, but
somewhere between 0.1 percent and 0.4 percent. By July, CDC officials concluded that COVID19’s infection-mortality rate could be as low as 0.26 percent. The seasonal flu, by way of comparison, kills about 0.1 percent of those infected.
Put another way, with a lethality of perhaps double that of the flu,
there’s good reason to take extra precautions with COVID19. But by the
same token, policymakers should have adjusted their pandemic-response
policies when the data showed COVID19’s lethality to be much lower than
originally feared. Regrettably, most didn’t make those adjustments.
Even if I get COVID19, I’ll recover.
Maybe, maybe not. COVID19 ruthlessly targets people in certain high-risk groups and people of certain age groups, as President Trump’s bout with the
virus underscores. Again, the data are important here: Cancer and heart
patients, diabetics, people with kidney disease, sickle cell or COPD,
the immune-compromised, and the obese are in COVID19’s crosshairs. Americans 85 and older represent 32.8 percent of COVID19 deaths; Americans 75-84
represent 26.4 percent of COVID19 deaths; Americans 65-74 represent 21
percent. Add up all the people in those high-risk groups and age-groups,
and a large segment of Americans need to adjust their behavior for
their own good.
Masks are useless.
A properly fitted mask properly worn can be effective at preventing the spread of viruses via
coughing or sneezing. Whether all of us have access to the proper kinds
of masks, whether all of us are wearing them properly, and whether
mayors and governors have the authority to order that masks be worn is a debate for another essay. But one
thing seems beyond debate: If masks help people move toward some
semblance of normalcy—even if wearing them is more about perception than
effectiveness—then masks are performing a very useful function.
Limits
That serves as a bridge to the public-health side of the COVID19 divide, where we’ve heard some equally dubious arguments.
We can’t compare our response to COVID19 with our response to past pandemics.
A
colleague recently shared a quote from a government public-health
expert, who dismissed a question contrasting America’s response to the
1957 and 2020 pandemics by bluntly retorting: “We didn’t have the
ability back in the 1960s and 1950s to do what we can do today.”
It’s a cryptic quote, to be sure. Is he talking about the use of
modeling and data? The monitoring and control of movement? The
feasibility of quarantining the healthy due to technologies that allow
for some (but not all) Americans to engage in remote learning and remote working? Regardless of what he
means by “ability,” the response reflects a troubling view of power.
If
he’s referencing the use of modeling, the computer models that
terrified policymakers and led to the lockdowns and triggered a cascade
of destructive consequences proved wildly inaccurate—so inaccurate and
so destructive that many observers are raising hard questions about such
modeling.
Related, if he’s referencing the analytics capabilities offered by today’s technologies, he’s not alone: A CDC report concludes that government agencies today have
“situational-awareness tools to help monitor influenza activity.”
Likewise, the World Economic Forum trumpets “aggregated mobility information from telecom data” that
allows “insight into preventive actions, population mobility, the spread
of the disease, and the resilience of people and systems to cope with
the virus.”
True, this sort of real-time data-collection, data-mapping,
data-tracking and data-sorting didn’t exist during the pandemics of 1957
and 1968. However, in a free society like ours, technologies that allow
the sifting, sorting and manipulation of data should be used to promote
human flourishing—never to smother it. Just because government agencies
have the ability to do something, doesn’t mean they should do it.
Finally, if he’s suggesting that governments didn’t have the ability
to monitor, control and confine people during those earlier pandemics,
that’s flatly wrong. In fact, dating to the time of Pharaoh and Moses,
governments have long had the ability to confine people, prevent
commercial and religious activity, and limit individual liberty for the greater good.
That’s the very reason America’s Founders wrote a constitution that
expressly limits the power of government. President Eisenhower and
President Johnson (who was stricken during the 1968-69 pandemic) had the wisdom and perspective to respect
those limits during past pandemics, and governors and mayors followed
their lead. We would do well to learn from their example.
All we need to do is follow the science and listen to the experts.
That
makes for a good soundbite, but it’s not that simple. Scientists
disagree on lots of things, including how to respond to COVID19.
For
example, before COVID19, infectious-disease experts recommended that
policymakers respond to pandemics by: ensuring that “the normal social
functioning of the community is least disrupted,” recognizing that “the
negative consequences of large-scale quarantine are so extreme…that this
mitigation measure should be eliminated from serious consideration,”
urging that “all who are ill remain isolated at home or in the
hospital,” and encouraging “others to continue to come to work so that
essential services can be sustained.”
Those are the words of the late Donald Henderson, a giant in epidemiology and disease mitigation. Shaped by Henderson’s work, 800 virologists and epidemiologists signed an open letter in March that warned policymakers against lockdowns and cited many of the unintended consequences Henderson had forecast in 2006. (Project Fortress detailed those consequences here.) Infectious-disease experts in countries as diverse as Taiwan, South Korea and Sweden largely followed the time-tested methods laid out by Henderson and those 800 scientists. The comparatively low number of deaths per million in those nations, as well as the lack of disruption to their
economic-commercial-cultural wellbeing, underscore how effective those
methods are. Regrettably, the infectious-disease experts who advised the
president and most governors recommended a very different response,
which yielded very different results.
Moreover, how do we follow the science when a scientist disagrees with himself? In January, Anthony Fauci said of COVID19, “This is not a major threat for the people of the United
States, and this is not something that the citizens of the United States
right now should be worried about.” In February, he concluded in a medical journal, “The overall clinical consequences of COVID19 may
ultimately be more akin to those of a severe seasonal influenza (which
has a case fatality rate of approximately 0.1 percent) or a pandemic
influenza (similar to those in 1957 and 1968).” But in March he
dramatically reversed course. He did a similar one-eighty on the issue
of mask-wearing, saying there was no need for masks in late winter, before urging “universal wearing of masks” in early summer.
Similarly, officials with the World Health Organization reported “no clear evidence of human-to-human transmission” of COVID19 in
January and said there was no need for masks in February. They, too,
then reversed course, declared a global health emergency due to the
highly-contagious COVID19 virus, and urged everyone to wear a mask.
It’s all well and good to defend these reversals and the rejection of
a century of science related to pandemic response by declaring, “When
the facts change, we must change our minds.” But given that the
underlying facts of prudent pandemic response didn’t change, given the chaos caused by the reversals, given the consequences of rejecting what worked during the pandemic of 1957-58 (which had an infection-mortality rate of 0.67 percent), Americans can be forgiven for questioning “the science” and doubting the experts.