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Thursday, May 28, 2020

We Have Been Misled By Our Politicians, Medical Prognosticators And The Media

Will the politicians admit their lockdown mistake?

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This article was originally published for the American Institute for Economic Research.
See if you can make sense of the following transcript of an interview with Donald Trump on the lockdown, as conducted by Sharyl Attkisson.
President Trump: So I was hearing millions of people, and it would have been millions of people if we didn’t shut down. Now, would I shut it down again? No, because we understand it now much better. We didn’t know anything about it, it was new, it was fresh.
Sharyl: You mean you would not have, in retrospect, shut down the –
President Trump: I would have done exactly. We’ve done the exact moves that I would have done. And I did it early. Tony Fauci, Dr. Birx, they all said what I did was incredible. In retrospect, Tony, as you know, never thought he was going to be as severe as it was. And we’re talking about months later, a long time after I did the ban. I did a ban and nobody thought I should do it. I mean, literally I don’t think anybody thought I should do it. I made that decision by myself and it turned out to be a great decision. Hundreds of thousands of lives are saved.
Which is it? I get that all politicians are impervious to admitting error much less expressing contrition. It’s not just Trump. I’ve heard some version of this story from experts at all levels who both pushed the lockdown but now say it was a mistake – but a mistake that somehow had to be made because: “What else can you do?”
One thing you could do: in the absence of information, one could default to preserving human dignity, freedom, and the rule of law, and then get to work gathering information. Instead this one went the other way: shut down the whole of society simply because of uncertainties.
Are freedom and foundational principles luxuries in which we indulge and permit only under the right conditions? Do our rights exist only by permission of the state such that they can be blotted out under any pretense?
Now, you might say that a new virus in absence of testing is a rare exception. The trouble is that this is incorrect. A century of history in the U.S. is replete with new viruses, and tests have not always been available much less universal. Plus, the real record here demonstrates that a coterie of high-end experts had been waiting 14 years to deploy their experiment in a new paradigm for dealing with disease. In every other pandemic, the politicians stayed out and government left the economy alone. We trusted individuals and medical experts to deal with the problem, and it worked. Only this time did we flip the other way, and it will likely be years before it is universally admitted to be a catastrophic error.
There is also a psychological element here, fueled by media pressure. Early on, a friend of mine compared the panicked lockdowners to new residents of coastal towns during hurricane season. The media always and everywhere declares every hurricane to be the mother of all storms. They scream and yell for everyone to run and hide, go somewhere, anywhere, but there. Then the storm changes direction, which provides another excuse for a news update, telling more people to freak out and run for their lives.
No one knows for sure what the storm will be like or where it will land. It usually takes a couple of years for new residents to realize this, discount what the media is yelling, be cautious but remember that risk assessment is difficult. Mostly, there is most likely no good reason to spend days boarding up your house and then heading for the hills (given that the hurricane could hit the hills too). In other words, it takes a bit of time to become rational about these things but eventually everyone in coastal towns does.
What about those who spend weeks boarding up the house, thousands of dollars on food and freezers, and then days driving around with family in tow running from something that never materializes into anything but a bit of wind and rain? Now, the right answer is that all of this was a mistake. Clearly. But that is not usually the answer you get.
Instead, the panicked person will usually say: I did what I had to do given the information I had, and so, yes, if I had it to do over again, I would do exactly the same thing. This is of course completely irrational since there was no severe weather, and this is a known fact. Still, the pull of the sunk-cost fallacy to provide ex post rationales for irrational behavior is a powerful thing.
This problem now afflicts thousands of politicians in America. Much of the preposterous rituals we are going through – these distancing restrictions, mask mandates, occupancy limits, and so on – are nothing but imposed protocols to give the impression that it is a very dangerous and virus-infected world out there, so the lockdown was correct even if the virus turned out to be almost nothing at all for 99% of the public.
It would be similar to a mayor who irrationally ordered evacuation for a half-inch of rain to later order returning residents to wear rubber boots and eye goggles for a month. It’s a way of spreading and sharing fear to deflect from the egregious errors of the mayor himself. It’s ex post justification for coercing people pointlessly but trying to avoid blame (“We didn’t know anything about the storm, so we did the right thing.”).
Thus will we continue this opening-up kabuki dance for a few more months simply so that the politicians and panicked among us can save face and avoid admitting error.
And yet, daily the evidence pours in of the calamity. The latest calculations of loss reveal wreckage far beyond that of deaths from COVID-19. Authors Scott W. Atlas (Hoover Institution), John R. Birge (University of Chicago), Ralph L Keeney (Duke University and University of Southern California) and Alexander Lipton (Hebrew University) write:
The past century has witnessed three pandemics with at least 100,000 U.S. fatalities: The “Spanish Flu,” 1918-1919, with between 20 million and 50 million fatalities worldwide, including 675,000 in the U.S.; the “Asian Flu,” 1957-1958, with about 1.1 million deaths worldwide, 116,000 of those in the U.S.; and the “Hong Kong Flu,” 1968-1972, with about 1 million people worldwide, including 100,000 in the U.S. So far, the current pandemic has produced almost 100,000 U.S. deaths, but the reaction of a near-complete economic shutdown is unprecedented.
The lost economic output in the U.S. alone is estimated to be 5 percent of GDP, or $1.1 trillion for every month of the economic shutdown. This lost income results in lost lives as the stresses of unemployment and providing basic needs increase the incidence of suicide, alcohol or drug abuse, and stress-induced illnesses. These effects are particularly severe on the lower-income populace, as they are more likely to lose their jobs, and mortality rates are much higher for lower-income individuals.
Statistically, every $10 million to $24 million lost in U.S. incomes results in one additional death. One portion of this effect is through unemployment, which leads to an average increase in mortality of at least 60 percent. That translates into 7,200 lives lost per month among the 36 million newly unemployed Americans, over 40 percent of whom are not expected to regain their jobs. In addition, many small business owners are near financial collapse, creating lost wealth that results in mortality increases of 50 percent. With an average estimate of one additional lost life per $17 million income loss, that would translate to 65,000 lives lost in the U.S. for each month because of the economic shutdown.
In addition to lives lost because of lost income, lives also are lost due to delayed or foregone health care imposed by the shutdown and the fear it creates among patients. From personal communications with neurosurgery colleagues, about half of their patients have not appeared for treatment of disease which, left untreated, risks brain hemorrhage, paralysis or death.
Here are the examples of missed health care on which we base our calculations: Emergency stroke evaluations are down 40 percent. Of the 650,000 cancer patients receiving chemotherapy in the United States, an estimated half are missing their treatments. Of the 150,000 new cancer cases typically discovered each month in the U.S., most – as elsewhere in the world – are not being diagnosed, and two-thirds to three-fourths of routine cancer screenings are not happening because of shutdown policies and fear among the population. Nearly 85 percent fewer living-donor transplants are occurring now, compared to the same period last year. In addition, more than half of childhood vaccinations are not being performed, setting up the potential of a massive future health disaster.
The implications of treatment delays for situations other than COVID-19 result in 8,000 U.S. deaths per month of the shutdown, or about 120,000 years of remaining life. Missed strokes contribute an additional loss of 100,000 years of life for each month; late cancer diagnoses lose 250,000 years of remaining life for each month; missing living-donor transplants, another 5,000 years of life per month – and, if even 10 percent of vaccinations are not done, the result is an additional 24,000 years of life lost each month.
These unintended consequences of missed health care amount to more than 500,000 lost years of life per month, not including all the other known skipped care.
If we only consider unemployment-related fatalities from the economic shutdown, that would total at least an additional 7,200 lives per month. Assuming these deaths occur proportionally across the ages of current U.S. mortality data, and equally among men and women, this amounts to more than 200,000 lost years of life for each month of the economic shutdown.
In comparison, COVID-19 fatalities have fallen disproportionately on the elderly, particularly in nursing homes, and those with co-morbidities. Based on the expected remaining lifetimes of these COVID-19 patients, and given that 40 percent of deaths are in nursing homes, the disease has been responsible for 800,000 lost years of life so far. Considering only the losses of life from missed health care and unemployment due solely to the lockdown policy, we conservatively estimate that the national lockdown is responsible for at least 700,000 lost years of life every month, or about 1.5 million so far – already far surpassing the COVID-19 total.
In conclusion, was this a mistake? Yes. It’s time to admit it. There ought to be acts of contrition from the political class and the modelers who advised them, in which they loudly and earnestly declare that they are heartily sorry for their sins, mea culpa, mea maxima culpa.

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