Did the President Shut Down Too Soon?

‘What if’ questions are kind of pointless, outside of fiction (‘What if the South had won the Civil War?’). But the Democrats love them if they can cast aspersions on their favorite boogeyman, Donald Trump. For two months now they have been loudly deriding the President for taking too long to react to the arrival of the Wuhan Bat Bug on our shores.

The Boston Globe editors declared on March 30th that Mr. Trump “has blood on his hands” for not acting sooner. Kenneth Peres at Common Dreams indulges in rampant ‘what-if’ism on May 12th:

 

An April 2020 analysis by epidemiologists Britta Jewell and Nicholas Jewell . . . provided the following estimates for the range of preventable deaths.

“…an estimated 90 percent of the cumulative deaths in the United States from COVID-19, at least from the first wave of the epidemic, might have been prevented by putting social distancing policies into effect two weeks earlier, on March 2, when there were only 11 deaths in the entire country. The effect would have been substantial had the policies been imposed even one week earlier, on March 9, resulting in approximately a 60 percent reduction in deaths.”

Rhinolophus_rouxii_sm

Rufous Horseshoe Bat (Rhinolophus rouxii), thought to be the source of the SARS-COV-2 virus.  (Aditya Joshi / CC BY-SA)

This claim of a 90% reduction is evidently based on estimates derived from epidemiological models, speculating on the possible effects of ‘social distancing’ on a then-hypothetical epidemic caused by the new SARS-COV-2 coronavirus. The models themselves, which made wild predictions of the pandemic danger of the virus, were the basis of the President’s Task Force recommendations, leading him to endorse a drastic shutdown of the US economy by mid-March. The most extreme of these, the work of the British epidemiologist Neil Ferguson, projected a possible 2.2 million deaths in the United States.

Even today President Trump is touting the 2.2 million figure to defend his policies since January. Had he not, he says, acted quickly in halting travel from China, and then from Europe, and had he not implemented the Task Force recommendations in March, we would be seeing vastly higher numbers of dead than we have. Given the vitriole of his critics, it is understandable that Mr. Trump would cling to the high model numbers, even if they have been long since discounted. “Look how much worse it could have been,” he can say.

But in point of fact, the models were based on scant evidence from China on both the contagiousness and the lethality of the Wuhan Bat Bug. Both were assumed to be as much as ten times worse than the influenzas that regularly afflict us, maybe as dangerous as the terrible Spanish Flu of 1918-19. Change the assumptions, and the model predictions change as well.

I suspect that the models also assumed that, like the Spanish Flu, the WBB virus would also infect and kill people of all ages. But as early as March 18th, it was already becoming clear that this was not the case. The Center for Disease Control (CDC) published this analysis:

Early data from China suggest that a majority of coronavirus disease 2019 (COVID-19) deaths have occurred among adults aged ≥60 years and among persons with serious underlying health conditions. . .

This first preliminary description of outcomes among patients with COVID-19 in the United States indicates that fatality was highest in persons aged ≥85, ranging from 10% to 27%, followed by 3% to 11% among persons aged 65–84 years, 1% to 3% among persons aged 55-64 years, <1% among persons aged 20–54 years, and no fatalities among persons aged ≤19 years.

These early age distributions are holding firm. Scott Johnson at the PowerLine Blog has been tracking the breakdown in Minnesota for about two months; as of May 26th, 81.5% of all MN deaths attributed to COVID-19 (the official name of the disease caused by the Wuhan Bat Bug) were in long-term care facilities. In Massachusetts, a particularly hard-hit state, the average age of deaths “in confirmed COVID-19 cases” was 82 years. Deceased with ‘underlying conditions’ were 98.3%. These numbers vary by state, but as of May 6th the CDC calculated the nationwide average age of deaths attributed to COVID-19 at 75.5.

Furthermore, the numbers who die from WBB drop dramatically in a steep curve from age 65, to practically zero for youngsters. Studies of antibodies are also starting to show that many people are infected but show no symptoms, as many as 35%. WHO’s initial estimate of fatality rate of COVID-19 infected patients was 3.4%. For influenza that rate is only about 0.1 percent. Now the CDC is estimating the COVID-19 death rate at 0.4%. If you include the asymptomic cases, writes C. Douglas Golden in The Western Journal (May 25th), “do the math: It turns out that means the death rate is only 0.26 percent.” Clearly this is a not a disease that is going to ravage the entire population as the Spanish Flu did. Golden continues:

If there’s a disease that spreads rapidly and has a death rate of 2 or 3 percent, yes, locking down the populace is a reasonable reaction.

If we’re talking about something closer to 0.26 percent, putting the world into a new Great Depression seems a bit of an overreaction.

The likelihood is that as we learn more about this disease that ‘death rate’ is going to fall even lower, perhaps comparable to that of a severe flu year. Of course, the modelers can argue that if we practiced ‘social distancing’, and shut down gatherings of more than ten people, we’d lose even fewer to influenza as well. But this is entirely hypothetical, and the question is: at what cost? At very least, it makes the Democrats’ ‘what if’ criticism of President Trump rather moot: there’s no evidence that shutting down the economy a week or two earlier would have reduced the deaths from COVID-19 at all.

To the contrary, what if the President had told the Task Force, “Hold your fire. Let’s wait till the end of March or even mid-April and see what happens?”

As the data mounted, and as it became clear that the Wuhan Bat Bug was not nearly as virulent as the modelers assumed, and that it posed a serious hazard mostly to citizens over 70—especially those with chronic health impairment, and even more especially in nursing homes—would not plunging half the country into unemployment have looked completely unreasonable?

So did the President act too soon? Maybe, but arguably he had little choice. Mr. Trump has described himself as a ‘germophobe’, reluctant before going into politics to even shake hands. He was faced with the dire prospect of a deadly disease spreading out of control and killing millions in the United States. The ‘professionals’, as he describes them, were adamant that once someone caught the bug with no traceable source, we were facing ‘community spread’, which could not be contained, only ‘mitigated’ with social policy.

What was the alternative? To isolate and protect the nursing homes, and urge those in contact with the most vulnerable to take special precautions. With a bit of hindsight, we have to credit Governor Ron DeSantis of Florida. As usual, spring-break collegians descended upon the Florida beaches, and the Governor came in for much obloquy:

“The day that the media had their first big freakout about Florida was March 15th,” DeSantis recalls, “which was, there were people on Clearwater Beach, and it was this big deal. That same day is when we signed the executive order to, one, ban visitation in the nursing homes, and two, ban the reintroduction of a COVID-positive patient back into a nursing home.”

Gov. DeSantis concentrated on the elderly, of which Florida has many; much of the state stayed open, and ultimately Florida fared far better than others, who shut everything down. It might have been the best strategy for the nation, but the President clearly decided he had to stay on top of (what he was told) was the looming crisis. He found the nation woefully unprepared for a major epidemic, so he had to scramble, for tests, equipment, facilities—you name it. Now of course the Democrats fault him for waiting too long, and they trumpet the inevitable bureaucratic delays and snafus. But the result was, if anything, a nation that quickly became over-prepared, with field hospitals and rapidly-manufactured ventilaters, waiting for a disaster that has never quite happened.

The real disaster could be the hundreds of thousands of closed businesses and unemployed workers, but it’s also an opportunity, if Mr. Trump can act quickly enough to ameliorate the pain. White-collar employees who could work from home didn’t suffer much, nor did State and Federal employees. Those hit hardest are the owners and employees whose businesses were closed. They are in the millions, but many are also Trump supporters, and they will be overjoyed if the President can bring the economy back. Let’s just hope we don’t find ourselves engaging in another ‘what if’ scenario:

What if the President didn’t act fast enough to reopen?

/LEJ

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