There’s nothing like a pandemic to catapult political and healthcare leaders to heroic heights. Overnight, they have become our saviors against the ongoing coronavirus (COVID-19) pandemic. With seemingly unlimited money and power, they now lead us in an effort that they liken to a war – apparently World War II. It’s our “Pearl Harbor Moment,” says surgeon general, Jerome Adams. Its casualties may exceed those of the armed forces in World War II, warns Senator Bernie Sanders. And, in this war, every American must do his part.
But what is our part, for how long must we do it, and why should we listen to the latest crop of public health experts?
Our part boils down to hiding at home, under a social and economic lockdown, until public health authorities tell us to come out. We must play that role because those very same authorities created a health care system that is incapable of fighting large-scale outbreaks of viruses – including viruses that they themselves predicted were coming. It has no nationwide testing and screening capability; it has no vaccines waiting in the wings; it has no prophylactic or therapeutic drugs that are “safe” to use. It is a system that forces mitigation by the general public to be the only available national strategy for dealing with the coronavirus pandemic.
Mitigation could work if it is implemented early enough. But Chinese public health authorities and the World Health Organization (WHO) made any chance of early containment impossible. Although the world’s first case of COVID-19 occurred on November, 17, 2019 in Wuhan, China, the Chinese government did not notify the WHO until December 31, 2019. It did not initiate its mitigation strategy until January 23, 2020, when Wuhan was finally quarantined, after 5 million residents had been allowed to leave the city, without being screened for the virus. What would have happened, had China implemented the strategy on January 1 instead of January 23? A University of Southampton study “found that if interventions in the country could have been conducted one week, two weeks, or three weeks earlier, cases could have been reduced by 66 percent, 86 percent and 95 percent respectively – significantly limiting the geographical spread of the disease.”
On January 14, as the Wuhan diaspora trickled into Europe, the US, and other parts of the world, WHO director-general Tedros Ghebreyesus announced that there was no evidence of human-to-human transmission. That is, he announced to the world’s public health authorities that there was no cause for alarm.
Except that the virus was extremely infectious, and, in the US, our previous crop of experts had left America’s healthcare system embarrassingly unprepared to confront it. This crop -- career politicians (including senators, representatives, and governors) and career scientists (employed by the NIH, CDC, FDA, and other government organizations) – had learned little, if anything, from their dealings with previous outbreaks (e.g., SARS, MERS, and the Swine Flu). The result: severe shortages of doctors, nurses, first responders, virus tests, face masks, personal protective equipment, hospital beds, ICU rooms, ventilators, and numerous other medical supplies to deal with this one. Thus, the first obstacle facing our new saviors was the prevention of our healthcare system from being overwhelmed by coronavirus patients. The second obstacle was the lack of applicable drugs. During the time that they were neglecting America’s pandemic readiness, the previous crop failed to develop prophylactic and therapeutic drugs that could be used to treat new viruses – such as SARS-CoV-2 (the virus that causes COVID-19).
The new experts don’t have vaccines; they don’t have drugs that have been approved by the FDA as effective SARS-CoV-2 cures or treatments; they don’t have the quantities of personnel, masks, ICU rooms, ventilators, etc. needed to care for COVID-19 victims. But they do have pandemic models -- highly sophisticated simulations that predict the spread of the virus as a function of the mitigation techniques implemented. After numerous model runs, the techniques found to most effectively combat COVID-19 are 1) the same ones that would be effective against any infectious disease and 2) pre-date highly sophisticated models.
For COVID-19, social distancing is key. Since half of those infected have no symptoms, the virus can be unwittingly spread. Our friends, neighbors, and co-workers could be stealthy carriers; they must be avoided to “flatten the curve” of its spread. With the models predicting unacceptable US death rates, state governors sprang into action, frantically employing personalized, and more draconian, versions of social distancing. What president Trump’s Coronavirus Task Force offered as guidelines, the governors imposed as commands, with fines to enforce them.
Initially they issued crowd-size bans and closed bars and restaurants. As to questions regarding the pandemic’s peak, demographic extent, severity, and duration, scientists had no answers. Speculation based on flimsy estimates ruled – that and the inordinate desire to demonstrate unlimited concern for public safety. Accordingly, governors leaped ahead to close schools, cancel public events, ban crowds, and shut down all non-essential business. As a result, American economic activity has been reduced to a bare minimum, with unemployment headed to 32% and 90% of Americans under “stay-at-home” orders – in strict compliance, until further notice.
Many experts, however, believe we must do more. That is, they believe that Mr. Trump hasn't done enough. Presidential candidate Joe Biden has faulted Trump for holding back on using his full powers. Perhaps a president Biden would use his full powers to execute a “stay-in-home” policy, following England's success, where local police departments throughout the nation would be sufficiently enlarged to “respond to calls from people reporting their neighbours for "going out for a second run’.”
With mitigation as the only option, science has been relegated to counting (infections, deaths, hot spots, ventilators, …). And the numbers add up to patriotism. We must come together as a nation to fight the common enemy, but confined to our homes in fearful communities of idle virus vigilantes. During WWII, Americans joined the army or worked in weapons production factories. For the war against COVID-19, the new crop believes that Americans will feel heroic, huddling in their homes; that shunning and shaming neighbors will unite us.
Speaker of the House, Nancy Pelosi, would hold nothing back to reduce the death count, saying "As the president fiddles, people are dying, and we have to take every precaution." Further, in addition to accusing Mr. Trump of, well, reckless homicide, Mrs. Pelosi believes that he has not heeded the advice of scientists, and has promised a congressional investigation to find out why. "What did he know and when did he know it?", she barked. Both Biden and Pelosi worry that Trump will disparage science, and lift restrictions to restart the economy. They demand more restrictions. The more economically damaging the better. In their view, if it takes a crushing recession to save lives, then so it must be -- at least until the November election.
Trump, on the other hand, has plenty of reason to ignore the advice of “science experts.” Their hard work and valiant efforts do not preclude contradiction and incompetence. For example, in January, Dr. Fauci joined Ghebreyesus in dismissing SARS-CoV-2, saying that the outbreak in China would be “a very, very low risk to the United States.” Today he tells us that it is a very, very, high risk. Along with many other experts, Fauci, argued against the travel restrictions imposed by Trump in early-February. But, by mid-March, he told NBC news that “One of the things we did right was very early cut off travel from China to the United States.”
Mr. Fauci has been adamant about social distancing as the main line of defense against the pandemic. Yet he and other Trump team scientists have been dismissive of attacking the virus with drugs such as hydroxychloroquine, despite its successful use by thousands of doctors, to both treat their patients and to protect themselves. After months of mitigation-only, the coronavirus pandemic remains active, with more than 500,000 infections and 20,000 deaths, as of this writing. Could a mitigation - hydroxychloroquine strategy have produced worse results?
Even if you wanted to heed the advice of scientists, how do you decipher it? Fauci and other experts have recently indicated that they see light at the end of the tunnel. According the Washington Post, on April 1, Fauci said we could “relax social distancing” once there’s “no new cases, no deaths,” but the real turning point won’t come until there’s a vaccine”. So put yourself in the shoes of president Trump (or the average American), who must certainly be worried about how long the economy can endure the shut-down, when Mr. Fauci says “for a few months or until October 2021.”
There are a number of scientists who tell Trump that the pandemic actually will be over in a few months. It will die out with the hot weather, they say. Still others tell him that it will return in autumn, or winter. Which advice should he heed?
And what is Trump to make of the models, whose predictions define the mitigation measures that, scientists assert, will save us from COVID-19? In late March the models forecast a death toll of 245,000. At that time, a
survey of 20 public health experts independently estimated the number to be 245,500, thereby validating the models. The scientists advising Mr. Trump were no doubt thrilled to have their recommendations justified – the ones that devastated the economy, crashed the stock market, disrupted American society, and left tens of millions of Americans cowering in their homes.
But less than two weeks later, the death prediction was revised down to 60,000 – one thousand fewer than the death toll of the 2017-2018 flu season, from which the political and healthcare leaders of that period didn’t think was worth saving us.
Today, the new crop of saviors advise the president of the United States based on pandemic models that apparently are no more reliable than climate change models. As with the latter, the predictions of the pandemic models significantly conflict with reality. For example, estimates of the number of hospital beds needed have been four times greater than the actual number. The discrepancy was not the result of fastidious social distancing; social distancing was incorporated in the models. It is likely that the experts drastically over-estimated the virility of SARS-CoV-2, and, therefore, the necessity for an hysterical national shut-down.
Perhaps Mrs. Pelosi’s congressional investigation should ask what our scientists knew and when did they know it.
And, is the new crop of saviors any better than the old one?