Learning the Lessons of the Pandemic

In the last few days the World Health Organization has announced that it does not recommend lockdowns as the “primary means of control” of the coronavirus. Dr. David Nabarro, who is the WHO’s “special envoy” on the coronavirus epidemic and presumably knows something about the costs and benefits involved, went on to suggest that there was only a limited role for lockdowns in combatting the virus:

“The only time we believe a lockdown is justified is to buy you time to re-organize, regroup, rebalance your resources, protect your health workers who are exhausted, but by and large, we'd rather not do it," he told the media.

Other methods of controlling the virus are as good or better than lockdowns—there’s a long list of them on the WHO’s website—and they don’t have the catastrophic impact of lockdowns. As Nabarro explained with some feeling:

Look what's happened to smallholder farmers all over the world. … Look what's happening to poverty levels. It seems that we may well have a doubling of world poverty by next year. We may well have at least a doubling of child malnutrition.

On most occasions when we hear appeals like that, they come accompanied with a bill for the rest of us in the form of higher redistributive taxation. We sigh “well, it’s a good cause” and pay up, even if it means cutting down on some little luxuries (or, if we’re among the poor ourselves, giving up some portion of necessities too).

On this occasion, however, industries, social services, charities, and ordinary taxpayer-citizens, rich and poor alike, would all benefit economically if the lockdowns were to end. Dr. Nabarro might have said with equal force and relevance: “Look at what’s happening to steelworkers, coal-miners, secretaries, para-legals, physiotherapists, plumbers, carpenters, Anglican vicars, waiters, travel-agents, and strip-tease dancers.”

It might not have had the same emotional impact as his appeal to prevent child poverty, but it would be pointing to severe everyday economic damages experienced by the whole community. Almost everyone in the private sector is hit by lockdowns, and they will by paying the accumulated bill for their own enforced idleness for a very long time to come. And that should count for something.

Don't go away mad, just go away.

Of course, Nabarro was announcing a U-turn by the WHO. That’s usually felt to be a political disgrace and a cause for great embarrassment. Maybe sometimes it is exactly that. But it surely makes sense to change policy, however drastically, when the evidence suggests that the existing policy is producing negative or perverse results. And that seems to be the case with lockdowns.

Almost simultaneously with Dr. Nabarro’s statement, three distinguished medical experts-- Sunetra Gupta of the University of Oxford, Jay Bhattacharya of Stanford University, and Martin Kulldorff of Harvard University—wrote what amounted to a statement of skepticism about lockdowns which were, they said, inflicting irreparable damage on health.

That statement, known optimistically as the Great Barrington Declaration, became a petition that’s already been signed by 1200 health professionals. It is unsparing in its critique of the policies of many, even most, governments worldwide:

As infectious disease epidemiologists and public health scientists, we have grave concerns about the damaging physical and mental health impacts of the prevailing COVID-19 policies, and recommend an approach we call Focused Protection.

Coming from both the left and right, and around the world, we have devoted our careers to protecting people. Current lockdown policies are producing devastating effects on short and long-term public health. The results (to name a few) include lower childhood vaccination rates, worsening cardiovascular disease outcomes, fewer cancer screenings and deteriorating mental health – leading to greater excess mortality in years to come, with the working class and younger members of society carrying the heaviest burden. Keeping students out of school is a grave injustice.

Keeping these measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed.

The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk. We call this Focused Protection.

Even or especially if governments agree with the professors, however, they must be horrified  by the idea that lockdowns are a mistake, an overreaction, and a net disadvantage in cost-benefit terms. That conclusion is politically disastrous for them. They have spent much of the last year telling their voters that lockdowns were essential to prevent the spread of the virus and protect lives.

In the countries of the Anglosphere that usually pride themselves on their dedication to liberty, they have been exceptionally heavy-handed in their enforcement of lockdowns on the citizenry, imposing heavy fines on citizens for breaches of it and insisting on closing down cities with curfews and prohibitions of church services, drinking, and even singing. And they have made lockdowns a key item in a coronavirus “orthodoxy” that dismissed other policies—Dr. Gupta’s “focused protection” (focused that is on the elderly and especially vulnerable), or Sweden’s alternative policy mix that included a much more limited lockdown.

No lockdowns, please, we're Swedish.

Nor are governments alone in the dock. Scientists too have to share in the blame. Did the Imperial College and SAGE scientists in the UK, for instance, make a mistake when they recommended abandoning HMG’s original strategy ( tested and approved by the WHO only the previous year) and moving to a lockdown one? Not at the time, perhaps, when UK policy was dominated by a need to avoid the National Health Service being overwhelmed by the avalanche of cases that had overwhelmed Italy’s health services.

That decision was in line with Dr. Nabarro’s argument that a lockdown was “justified to buy you time to re-organize, regroup, rebalance your resources, protect your health workers who are exhausted, etc. Long after that threat passed, however, the scientists continued to press the politicians to tighten the lockdowns ever more firmly. And the politicians are afraid to disagree with the scientists.

Britain’s current policy is now a kind of paralysis: almost everyone, including ministers, realizes the lockdown was a mistake and is increasingly a catastrophe for the country’s economic future but the government has been so successful in inculcating a fear of the virus that far outstrips the real risks to the entire population that it carries that the public now supports tightening the lockdown rather than lifting it.

Covid headache, check.

For that outcome—which is worse in Australia and the U.S. than in Britain—the media must accept a heavy share of the blame. Their coverage has often been more driven by political considerations than by medical ones. Mainstream reports of the pandemic in the U.S. has been more concerned to damage Donald Trump than to provide a cool and fair-minded examination of how best to treat the virus—“Orange Man Bad” being its main diagnosis of any of the cures proposed.

And social coverage is worse. At the time of writing, Twitter had ruled against coverage of the Great Barrington Declaration on the grounds that it was misleading (i.e., Twitter disliked its political implications.)

The lessons of the Covid-19 pandemic will be relevant long after the virus has reached herd immunity and become one of the many illnesses dormant in the population that springs into life every Fall. They tell us that whether the threat is a global pandemic or a rise in global temperature, we must preserve a free and skeptical public debate. That means asking the experts to give us their opinions but also to tell us where they differ and why.

Some of the most prescient criticisms of the lockdown policy came from other experts like Dr. Gupta and some from intelligent non-experts like (Lord) Jonathan Sumption, a distinguished lawyer, who saw in official  policy the logical likelihood that a lockdown could do little more than redistribute Covid-19 infections and deaths over time—but at huge loss in our economic prospects and our political liberties too.

In short, the biggest global threat today is the ever-present danger of an establishment consensus that won’t allow other views to be expressed and debated. And that threat hasn’t faded even if the lockdown does.

Covid Hysteria: Worse Than a Crime, a Blunder

With parts of America and Europe still in lockdown, was the massive overreaction to the Wuhan Flu, aka Nursing Home Disease a crime or a blunder? As a French official during the time of Napoleon said of the execution of Louis Antoine du Bourbon, "C'est pire qu'un crime, c'est une faute." Which is to say, were the loss of civil liberties and the massive economic destruction of the unconstitutional lockdowns simply malicious and punitive, or is the damage irrecoverable, with all the attendant political consequences whose effects will be felt at the ballot box this November?

Some folks at the Foundation for Economic Education are beginning to smell a rat:

The 'experts' may have subjected us to a blunder greater than any since the Iraq War.

The Iraq War WMD debacle is arguably the greatest expert “fail” in generations. The holy triumvirate—lawmakers, bureaucrats, and media—all failed to sniff out the truth. If any of them had, a war that cost trillions of dollars and claimed the lives of 100,000-200,000 people likely could have been avoided.

It would be difficult to surpass the Iraq blunder, but emerging evidence on COVID-19 suggests the experts—again: lawmakers, bureaucrats, and media—may have subjected us to a blunder of equally disastrous proportions.

The evidence? How's this for a dispatch from the Dept. of Now They Tell Us?

Antibody Tests Point To Lower Death Rate For The Coronavirus Than First Thought

Mounting evidence suggests the coronavirus is more common and less deadly than it first appeared. The evidence comes from tests that detect antibodies to the coronavirus in a person's blood rather than the virus itself. The tests are finding large numbers of people in the U.S. who were infected but never became seriously ill. And when these mild infections are included in coronavirus statistics, the virus appears less dangerous.

"The current best estimates for the infection fatality risk are between 0.5% and 1%," says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. That's in contrast with death rates of 5% or more based on calculations that included only people who got sick enough to be diagnosed with tests that detect the presence of virus in a person's body.

And the revised estimates support an early prediction by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a leading member of the White House coronavirus task force. In an editorial published in late March in The New England Journal of Medicine, Fauci and colleagues wrote that the case fatality rate for COVID-19 "may be considerably less than 1%."

Mon Dieu!

Wait -- what?

The new evidence is coming from places such as Indiana, which completed the first phase of a massive testing effort early in May. Indiana's program began soon after coronavirus cases began appearing in the state. The governor's office contacted Nir Menachemi, who chairs the health policy and management department at Indiana University's Richard M. Fairbanks School of Public Health.

The governor wanted basic information, such as how many people had been infected, and how many would die. At the time, "it was really difficult to know for sure," Menachemi says. "And frankly, not just in our state, but in any state." That was because health officials only knew about people who had been sick enough to get tested for the virus. And that number can be misleading, Menachemi says.

In other words, based on the faulty premise that infection=death -- aided and abetted as usual by a hysterical media that always runs with the worst-case scenario first -- the major economies of the West put a loaded gun to their heads and pulled the trigger.

For Menachemi and his team, it was like finally getting a glimpse of the entire coronavirus iceberg, instead of just the part above the water. And the data allowed them to calculate something called the infection fatality rate — the odds that an infected person will die. Previously, scientists had relied on what's known as the case fatality rate, which calculates the odds that someone who develops symptoms will die.

Indiana's infection fatality rate turned out to be about 0.58%, or roughly one death for every 172 people who got infected. And the results in Indiana are similar to those suggested by antibody studies in several other areas. In New York, for example, an antibody study indicated the state has an infection fatality rate around 0.5%.

Studies suggest a healthy young person's chance of dying from an infection is less than 1 in 1,000. But for someone in poor health in their 90s, it can be greater than 1 in 10.

To translate that into plain English: the very elderly are more likely to die of something than healthy young people. But will this stop people like Fauci from continuing to insist that the destruction of civilization the price we pay for allowing him and other doctors to continue to exercise an undue influence over the public policies of the U.S., Britain, and elsewhere? Of course not:

Anthony Fauci, the top infectious disease expert in the U.S., said Sunday that the ban on British travelers entering the U.S. is likely to last months. Fauci, a member of the White House coronavirus task force, told The Telegraph that the U.K. travel ban is expected to be lifted in “more likely months than weeks.” The infectious disease expert said the travel restrictions could last until a vaccine is ready, adding that it’s possible they are lifted sooner.

The other travel bans from the European Union, China and Brazil are also expected to last for “months” based on “what’s going with the infection rate,” Fauci said. The expert predicts the virus could “go on for a couple of cycles, coming back and forth... I would hope to get to some degree of real normality within a year or so, but I don’t think it’s this winter or fall.”

“This will end,” Fauci said, according to the newspaper. “As stressful and devastating as it is, it will end.”

Good to know. Now please go away, take Scarf Lady with you, and let the rest of us enjoy life.

Why Can't We Go to the Hairdresser?

The cynic in me thinks the press will urge a nationwide lockdown unless and until a Democrat sits in the White House at which time they will take a harder look at the diminishing Covid-19 fatalities and the increasing cost of the lockdowns. In the meantime frustrated, increasingly broke Americans are asking what happened to such rights as free speech, assembly,  worship, freedom from unreasonable searches and seizures, right to bear arms, right to due process in criminal cases and privacy.

Fundamentally, why can’t we go to the hairdresser or the gym, make routine visits to the doctor, the dentist, get elective surgeries, visit our families and friends, shop without looking like masked bandits?  The answer is not that complicated. Unless the state governments, which have imposed these often-draconian measures, can justify them in court, you can. But you have to get them judicially enforced by civil suit or in defending a criminal action against you. Your rights are not self-enforcing.

Yesterday, for example, a circuit court judge in Clay County, Ill., found that Governor J.B. Pritzker's extension of a previous stay-at-home order was illegal, handing at least a temporary, narrow victory to Republican state representative Darrin Bailey with a restraining order -- which, however, only applies to Bailey himself. Pritzker vowed a swift appeal in a higher state court.

There are other means, of course.  If you want your fundamental constitutional rights back sooner you can move to those states run by Republican governors who did not mandate a lockdown, or  you can work to make your state legislatures to rein in your governor’s dictates. Short of that there is only judicial redress.Some states have never issued mandatory stay at home orders: Arkansas, Iowa, Nebraska, North Dakota, Oklahoma, South Dakota, Utah and Wyoming. Meanwhile, Georgia, Oklahoma, Alaska, and South Carolina have allowed some business openings and plan to relax more rules this  week; Maryland’s governor Hogan announced he anticipates a gradual reopening beginning in May.

Colorado’s Democratic governor Jared Polis says he will allow hair salons, barbershops, and tattoo parlors to reopen on Friday and has permitted curbside pickups at retail stores. Florida’s GOP governor DeSantis has opened some beaches and some have reopened in California, but not in Los Angeles. In some states-- to add to the confusing disparities -- city mayors have issued their own rules about what is permissible.

The most draconian rules of all were those issued by Michigan governor Gretchen Whitmer (D) which, inter alia, banned state residents travel to in-state vacation homes, prohibited the selling of seeds and gardening tools, home improvement materials, baby care seats and the use of motorized boats. Last week the Michigan state senate passed two bills to curb her emergency powers. She’s threatened to veto any such attempts and it’s unclear whether this legislative effort will be successful unless Democratic voters in the state are angry enough to support the move to clip her wings.

Who Can Exercise Power in a National Emergency?

The Emergency Powers of the President and Executive Branch are extensive. The Brennan center has prepared a 42-page compendium of their powers and legal basis. In addition to these, under the Tenth Amendment, state governors have substantial powers to issue mandates once an emergency is declared. The extent of the powers of a governor is determined by the constitutions of the various states and any applicable state law. But under the Fourteenth Amendment, per substantial case law for almost 100 years, most of the rights guaranteed under the Bill of Rights are applicable to the states (the "incorporation doctrine"). The question is whether the rights you have in normal times apply in an emergency.

Short of cases dealing with known methods of preventing a disease (smallpox vaccinations) or short-term emergencies such as hurricanes, we have few legal cases dealing with Covid-19 restrictions. Covid-19, after all is new, and we do not have conclusive studies of its transmissibility, treatment, or prevention. Instead we have conflicting reports about what works. Unlike with smallpox or polio we have no vaccine yet and, if one is to ever be developed it will take a long time to fashion and test it before we could compel people to vaccinate.

Further, we have no idea if reinfection is possible or likely after recovery. Nor have we any notion how many of us are or were infected, or are immune. Infection, hospitalization and morbidity rates are subject to manipulation and seem to have been jiggered but credible accounts indicate that the elderly and those with comorbidities have poor survival chances should they catch it, while the rest of us are almost certain (percentage wise) to survive it. We do know the cost to the nation and the world, not to speak of private sector workers and businesses is substantial and mounting.

Which Tests Should Courts Use in Cases Challenging Governor’s  Emergency Orders?

There have been few cases testing the power of the Governors to interfere with normal civil liberties. The best legal arguments on balancing the rights of citizens in emergency litigation can be found here by Lindsey Wiley and Steve Vladeck: COVID-19 Reinforces the Argument for “Regular” Judicial Review—Not Suspension of Civil Liberties—In Times of Crisis.

The authors review two of the first cases where the power to restrict civil liberties in the Covid-19 emergency was tested  and a minimal level of scrutiny was applied. That is if there was some factual basis and the restrictions were made in good faith, the courts let them stand.

In one of the first challenges to a coronavirus emergency order, New Hampshire defended Governor Christopher Sununu’s emergency order banning gatherings by arguing that “[a] court should only interfere” with “[a]n executive’s decision to exercise emergency powers in the face of a rapidly evolving public health crisis. . . . when the executive’s actions were not taken in good faith or if there is no factual basis for the executive to believe that a restriction he imposed was necessary.” Relying on Smith v. Avino (a widely cited Eleventh Circuit decision arising out of Hurricane Andrew), the state’s argument, in essence, is that the heightened judicial scrutiny that such invasions of civil liberties would usually provoke should be “suspended” for the duration of the emergency. The trial court agreed—upholding the group gathering ban because it met the very low bar of “good faith/some factual basis.”

Somewhat more controversially, the Fifth Circuit took a similar approach just this Tuesday in upholding Texas’s application of a coronavirus emergency order postponing “non-essential” medical procedures to abortions. Describing the Supreme Court’s 1905 ruling in Jacobson v. Massachusettsas imposing “the controlling standards, established by the Supreme Court over a century ago, for adjudging the validity of emergency measures,” the majority set aside Planned Parenthood of Southeastern Pennsylvania v. Casey’s familiar (and far more recent) undue burden test in favor of a rule that “the scope of judicial authority to review rights-claims” during “a public health crisis” is limited to cases where “a statute purporting to have been enacted to protect the public health, the public morals, or the public safety, has no real or substantial relation to those objects, or is, beyond all question, a plain, palpable invasion of rights secured by the fundamental law.” Moreover, the court suggested that in a crisis, this minimal level of scrutiny applies equally to “one’s right to peaceably assemble, to publicly worship, to travel, and even to leave one’s home.”

Their conclusion?

As a country, we thus find ourselves in uncharted waters. But the debate over the proper judicial role in such novel and extraordinary circumstances is not a new one; rather, it dates to the earliest years of the Republic. As D.C. Circuit Chief Judge (and John Adams’ nephew) William Cranch wrote in 1807, “The constitution was made for times of commotion. . . . Dangerous precedents occur in dangerous times. It then becomes the duty of the judiciary calmly to poise the scales of justice, unmoved by the arm of power, undisturbed by the clamor of the multitude.” 213 years later, we aim to demonstrate how the coronavirus pandemic — and the governmental reactions thereto — undermine the suspension model, and, in the process, prove Cranch right.

While in my opinion the authors take too optimistically the time involved in developing and testing an appropriate vaccine, I agree with their view that what is called the “suspension power” -- that is, it takes minimal evidence to uphold the restrictions while the emergency exists -- is unsuitable.  This emergency is different, as it has no reasonably foreseeable outcome and  generally agreed upon termination. Therefore, the ordinary emergency order review is insufficient for Covid-19  orders. Think about it. A dictatorial government could in the same often mind-bogglingly arbitrary manner in which many have delineated between essential and non-essential businesses, decide the emergency will continue until everyone is tested or a vaccine is found, or there’s no longer anyone hospitalized with the virus, or we have definitive proof that recovered patients cannot reinfect.

Wiley and Vladek also argue, persuasively in my opinion, that the restrictions imposed should be subject to review of government restrictions of civil liberties in non-emergency situations. Are rules less restrictive of liberties options available? If there are, then the restrictions should fail.

So many of the restrictions, it seems to me, require defending in transparently open court proceedings. Does the requirement we wear masks really prevent the spread of the disease? Expert opinion is divided. Is it wise, in fact, to restrict movement of citizens or should we allow greater mingling to build herd immunity? Again expert opinion is divided. Is it better to prevent people from using parks and beaches, or is the sunlight, exercise and fresh air a better antidote to the spread of the virus or at least its virility? Our courts deal with such issues every day. Let’s have the governors defend their actions instead of blindly following along or listening to one set of “experts” and ignoring conflicting views.

So many of the restrictions seem ill considered and incomprehensible, if not totally indefensible. Let the state persuade a court that its perfectly reasonable to shut down my dentist’s and doctor’s enterprises even though both can and do sanitize all surfaces and can arrange it so patients will be notified by mobile phone of readiness to see them so that patients will not enter their offices and have to sit with others in the waiting room. Let the states defend arresting a surfer, far from anyone else, while permitting shopping in big box stores.  Let Michigan defend refusing to permit Detroit residents from going to their vacation homes in rural areas less densely populated, or permitting kayaking but not motorboating. Waiting to see any defense of actions like arresting a father for playing in a deserted park with his two children or worshippers praying in a church parking lot while sitting in their cars with the windows up.

Go ahead, make my day.