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The Cure Is Worse Than the Disease
In terms of serious problems being created by COVID-19, the financial and political ramifications of the panic (bankruptcies, lost income, instability in the financial system and the governments misguided attempts to shore it up) are going to be worse than the death toll.
Also, when a more dangerous pandemic comes along (and I believe what I’m told that someday it will) people will be much less likely to take the government’s and the media’s advice seriously. It’s the “boy who cried ‘wolf'” syndrome.
This panicked reaction is doing more harm than good now and sowing the seeds for a bigger disaster in the future.
Published in General
Peggy Noonan, who has to be one of the biggest idiots in the public square, is urging people to panic. Yes, you read that right.
http://peggynoonan.com/dont-panic-is-rotten-advice/
Meanwhile, one of the best of journalists, Sharyl Attkisson, does a great job of explaining the situation with a sensible approach.
https://justthenews.com/politics-policy/health/coronavirus-facts-vs-panic
I am in the “don’t panic” camp, and I suppose we just have to ride this out. Two quotes from Democrats come to mind: “The only thing we have to fear is fear itself.” and “Never let a good crisis go to waste.” It tells you a lot about what has happened to the Democratic Party over the last 70 year.
I couldn’t agree more. Not only are we setting ourselves up for a “boy who cried wolf” response, we’re setting ourselves up for the same response no matter how trivial the contagion is. Every year, we have a flu pandemic. However, give one strain a name, and the personalization of the bug lets the MSM ramp up the fear . . .
Would you prefer our future look like South Korea or Italy?
Because right now we are on track to follow Italy’s path?
Still in “the flu is worse, just wash your damn hands” camp?
You think maybe China, Italy, and now the US took such actions because they might know something about this we don’t?
Watch what they do not what they say.
@jessemcvay totally agree!
Morning Kozak,
South Korea has tested over 100K, the death rate is .7 of. 1%, compared to the annual flu at .1 of 1%. It is more deadly than the flu, but to my knowledge we have not had a person in US under 56 years old die. So closing schools, colleges, even sporting events on a national level is an over reaction. I am 72 with asthma, with a wife also 72 with a heart stent and we will still carry on as usual, my brother is a doc and has not advised us to do anything else. Italy’s media age is 45+, ours is 38, just using statistics the effects here would reflect the age skew of the population and we would have fewer deaths proportionally, not even considering the better quality of medicine we have here. There will be deadlier pandemics in the future and thinking about preparing for them would be worthwhile, but this respiratory virus has caused us to become hysterical and that does not lead to clear analysis. If this causes us to rethink the CDC and the FDA then that would be a plus, they have kept us from responding as quickly as we could have.
It’s very conceivable that the “cure” will end up being worse than the disease when it comes to Covid-19. But we need to accept that that’s part of how modern affluent societies function.
We are accustomed to a certain degree of security and a certain degree of certainty about our surroundings and our near-term future. When both of those pillars suddenly vanish, we naturally take very drastic measures to restore some degree of apparent control over our surroundings. I don’t think it’s controversial to say that a number of the reactions we took to 9/11 were more harmful than beneficial with hindsight. But at the time they were natural and justifiable (albeit sometimes debatable) measures.
I disagree for several reasons:
First, the dynamics of a pandemic pathogen are much different than the classical “boy crying wolf” scenario, which consists of a clear warning, a time period to prepare, and then a sudden attack that’s over in an instant. That would be more akin to hurricanes, where I think society does face something of a crying wolf effect.
But pandemics take a different course, since most of the preparations need to be taken before the warning ever comes, and because the “warning” (in this case, the first cases in Wuhan) typically provides a rough measure of how serious the threat is. Obviously the Chinese response didn’t give us as clear a picture as we would have liked, but it was still very clear by the time the virus became established on US shores that it was neither “the big one” nor less dangerous than the common flu when contracted by at-risk patients.
With that in mind, the current pandemic might actually make us better prepared for when “the big one” actually hits, by exposing the weaknesses in the system. Or it might not, but I don’t think there’s clear evidence that we are actively hurting our chances at a proper response to the next major medical crisis.
I, for one, would truly appreciate it if the powers-that-be would continue to lean forward against this threat by voluntarily extending the discontinuance of the insufferable product known as modern NBA Basketball for at least another decade. Pretty please…
I’m a high school teacher & my school is closed for at least 2 weeks. On Wednesday we begin online classes. Students & faculty too often come to school sick & infect others. A teaching friend of mine developed walking pneumonia after catching a cold from her students. She was in her 40s at the time. Classrooms are not large enough for everyone to sit 6 feet apart. For the overwhelming majority of my school, students who would contract CoVid-19 will recover; yet; we have students who have very serious, chronic health problems and faculty & staff who are over 60 or have underlying health problems. They are at risk of serious outcomes. Additionally, why would we want any student to become ill and miss school for 2 or more weeks?
On a practical teaching level, having a rotating percentage of students out sick for 2+ weeks will create havoc. How many students will miss lectures, demonstrations, experiments, and exams? How do you handle all of the makeup work & rewriting exams to reduce cheating? We’re not talking about 2 or 3 students who may miss 2 days. That’s routine for any teacher. What happens if multiple teachers fall ill? Will there be enough qualified substitute teachers who can teach Freshman English, Algebra, or AP Calc for several weeks?
Now, apply this to elementary schools where young children are still being taught good hygiene.
I am wholly aware of the downstream economic impact of shutting down schools, people not going to restaurants, religious services, sporting events, etc. Already, restaurants in Los Angeles are laying off employees. I expect parents of our students to be laid off. The economic hit to our communities will be hard.
I pray that come May or June, we look back & say, “Corona Virus was a nothing burger.”
Closing schools, limiting public events may make nothing burgers.
Edited to add: Closing schools is not a panicked decision. It is a rational decision.
Agreed.
But to be clear, closing schools for two weeks with the ability to reassess the situation and amend reactions at that time is a completely reasonable and responsible reaction in most cases. Announcing today that school is cancelled for the rest of the year would be irrational…and an unnecessary panic. In my humble opinion, too many organizations appear to have panicked.
If you look at the Worldometer site, one of most the disturbing numbers is the death rate among cases with known outcomes, which is 7%. That is, of the cases which have been resolved one way or another, either recovery or death, 7% have died. I’m sure that number is skewed high for some reason, but it’s still a high enough number to justify these precautions.
What are the early warning signs you would use to distinguish a more dangerous pandemic from this one?
There’s at least one in WA as of yesterday 3/13, reported by Sharyl Atkisson here.
Original Snohomish country report here.
Here’s the problem: Time only has one direction. There are no alternative countries where you can do a controlled study. Add an election year to the equation and it all goes south rather quickly.
So you’re faced with two choices: under react or over react. There’s no provable middle ground, no Goldilocks in the corner with the ability to declare everything “juuuuust right!” especially when you have a situation where a large section of the political class has been pointing their fingers back at the electorate for four years and screaming at them, “You’re idiots! Now we’re all gonna die!”
Politically Trump is faced with an unpalatable choice: he can be accused of incompetence and/or callousness or he can be accused of acting like a wannabe dictator. Heads they win, tales he loses. His opponents know that and they are going to play that card to the hilt.
If Hillary were facing a re-election campaign right now her reaction would have also been to declare a national emergency but her version would have probably produced new wide-sweeping powers for the government. Powers that would remain long after the crisis passed.
No one wants to examine the real politics of this crisis, namely how the globalization advocates that has dominated politics in the post-Reagan/Thatcher Era set this up. Making America dependent on Communist China? Now you see the results. Yeah, we’re going to have shortages of ventilators and other vital medical supplies, but more importantly we can get cheap TVs at Walmart! And don’t get me started on the open border crowd. What’s a pandemic party if everybody in the whole world isn’t invited?
Young people dying.
Healthy people dying.
A case fatality rate obviously above ~%3 (i.e. without the current suspicion that many people were infected but asymoptomatic or mildly symptomatic).
Similar transmission dynamics in different regions and more homogeneous spread through neighboring regions (in this case, other regions of China).
Untraceable transmission.
A history of mutations making the virus more pathogenic and/or transmissible between case 1 and case 100,000.
And many others…
Sharl has been saying that the Swine Flu epidemic never happened. Way back in 2009, the govt. couldn’t test everybody for this specific flu strain, so they just assumed that ‘flu-like’ symptoms were H1N1 (Swine) Flu. People on the Right blame Obama for poorly handling it, but it is not clear how testing to verify H1N1 vs H1N7 makes any difference in health outcome. The severity and treatment are the same. That said, Biden should brag about being the point-man on Swine Flu.
Yet most people would rather some events be canceled than we have mass graves like they do in Iran:
I agree. Whatever this current situation turns out to be it has already exposed many weaknesses in the system. We spent billions post 9/11 in supposedly preparing to detect and respond to pandemics, prompted by fears of bioterrorism. Not sure what happened. We’ll see if we learn from this experience but we will certainly have the opportunity to do so if we take it.
Can you point me to a link where Atkinsson say the epidemic “never happened”? That is a pretty bold claim, particularly since it is utterly untenable (I worked in an influenza lab at the time and saw the raw sequences with my own eyes). But this sounds like something might be getting lost in translation.
Regarding the second point, it’s not that the government “assumed” that everyone with flu-like symptoms had swine flu. There’s a big difference in “counting someone as having swine flu” and “assuming someone has swine flu”. Most research or statistical analysis that does the former does so knowing full well that a large number of the cases included will be spurious. That limits the use of such data to specific analyses which are robust to this type of error and/or requires other statistical methods to correct for the spurious cases. But in both instances, all of the experts involved are well aware of the imprecision and are not simply “assuming” facts not in evidence.
Dangerous pandemics are very, very rare. Nature just doesn’t work like that. We have been studying Corona viruses since the first SARS outbreak. We learned two things: (1) the vaccine is worse than the disease (2) they go epidemic. This SARS-2 variety is different in that it spreads and spreads well. Ideally, our experts would have been on the watch for such a thing. Everyone knows now and it is still early in the fight. Would a few weeks extra notice have saved those folks in the Kirkland nursing home?
The last virus to go pandemic was HIV. It was completely different than previously studied viruses in that it could “hide” for years before activating and allowing other diseases to kill. That is 44 years without a pandemic capable virus. Before that, there was the 1957 pandemic of H2N2 (asian flu) that killed 116,000 in the US (estimated). But that was just a variation on the H-N- season flu. Before that, you have to go back to 1918 when the first H-N- flu went global. These things happen once every 50 years and each time it takes a different form. It is hard to to detect a new thing early. We should focus on being able to react quickly.
I always assume the next pandemic will a form of pox. Small pox is the most virulent disease ever (R0=20+). It wiped out 95% of the people of Americas when it was introduced. Someday another pox will come along and we should be ready to invent, test, scale, and distribute a vaccine. It might be 2 years or might 2000.
Korea quickly moved to identify and isolate cases and do aggressive contact tracing to limit the spread of the disease. As a result they kept their medical system from being overwhelmed. Thats a major reason the death rate was low. Ditto Singapore and Hong Kong.
Italy did none of that, and allowed the disease to spread, so now the medical system is overwhelmed. They are having to resort to making Triage decisions about who gets ICU care. The death rate if therefore much higher.
Ditto Iran.
We are on the exact same trajectory as Italy.
About 20 % percent of those who are symptomatic require hospitalization and half of those end up with extensive ICU stays.
The goal is to try and limit the spread of this wildly infectious disease and slow the growth of cases to keep the system from getting swamped.
This will benefit you and your wife . If we follow the course of Korea…
Or we can follow Italy.
Part of this is an apples to pears comparison.
Only a small number of agents and specific means of deployment would theoretically used for a bioterrorism attack, and both of those differ greatly from the types of pathogens and means of spread of a natural viral or bacterial pandemic. Therefore, even the best-designed system to protect us from a bioterrorism attack would only provide us inadequate protection from many types of novel emerging pathogens.
Plus, there’s also the quip about every boxer having a great plan until they get punched in the face. Even the best-designed and equipped crisis response system (or army or football team) often gets pummeled in its first real-life conflict and needs to be ironed out afterwards. Seeing as how this pandemic likely won’t lead to widespread excess death, learning from our mistakes and improving the system may be one of the toughest long-term challenges going forward.
Whatever the inherent characteristics of the virus, that miniscule death rate in SK was not achieved without a massive public health effort (and a bit of good luck).
Below is a list of the public health measures they carried out. SK has a popn of 50M.
Measures after infections exploded on the third week of Feb (from fewer than 60 on Feb 19 to 3150 by Feb 29), because of a chain of infections related to crowded services by a Christian sect, the Shincheonji:
The good luck:
Young people may not fall gravely ill and be less vulnerable, but they can clearly spread the virus to those who are vulnerable.
Addendum: It was precisely the South Korean government’s aggressive public health effort that enabled them to keep their cities open, including Daegu, the worst-hit by the virus and thus avoid the lockdowns China and Italy have had to impose.
In contrast to the FDA’s insistence on its prerogative to issue emergency authorizations for private lab tests (e.g., coronavirus testing kits) at the end of Jan–after Sec Azar’s declaration of a public health emergency, after S Korea’s 2015 MERS outbreak, they introduced a system to grant rapid approval of virus testing kits.
sources of info for this and comment above:
https://asiatimes.com/2020/03/why-are-koreas-covid-19-death-rates-so-low/
https://www.scmp.com/week-asia/health-environment/article/3065187/coronavirus-south-koreas-aggressive-testing-gives
I really appreciate your comments on this.
While there are certainly differences what I had also anticipated was planning, materials, and capabilities to respond – protective gear, plans for quick development and implementation of testing, screening protocols at entry points, capacity to rapidly expand treatment capabilities etc. We’ve had 17 years since the response legislation was passed to develop and test the system. I’ve also been involved in emergency planning and crisis response and you’re correct – some things always go wrong. What I’m surprised about is how many basic things here have gone wrong. Traditionally Americans have been good at improvisation and that will help here though speed is of the essence.
Is untraceable transmission the same thing as “community spread” or “community transmission”?
Edited comment: yes, this is roughly the same thing. I made up the term “untraceable transmission” as something of an extension of community transmission: community transmission generally means that a critical mass of infections has been reached within a given community that it is not always possible to track exactly who gave whom an infection.
By “untraceable transmission”, I meant both the example of community transmission, but also “orphan” cases of a disease (i.e. isolated from an infected community) for which transmission cannot be explained. This happened a few times at the beginning of the AIDS epidemic before all of the possible modes of transmission had been confidently identified.
[Ignore my previous comment here, I got confused for a second.]
Absolutely agree. My school will continue to assess the situation. To stay closed longer than necessary will bring harm to our families.
Agree. You might add that those little creatures (your students) are great disease carriers. As an octogenarian, I’m very conscious that many, many people carry diseases that have no symptoms for them but are life-threatening for those with weaker immune systems. Isolation is sometimes a good thing; necessary, even.
Wow! Thanks for the graphs, @Kozak, they make the contrasts in responses/results very clear.