What we learned this week

By Kevin Roche

From a science or epidemiological perspective the primary learning this week, gleaned from a variety of studies, most of which have been summarized in other posts, is that, as suspected, the true number of people who are or have been infected by coronavirus is multiples of the cases reported by actual testing.  This means that rates of serious illness and death actually are very, very low.  We should be reassuring the population instead of continuing to scare them.  And it is just further support for an immediate switch in strategy from severe lockdowns to more targeted measures.

And here is some further evidence which supports that perspective.  Widespread testing on the aircraft carrier Roosevelt, which has been hit by coronavirus among its crew of 4800, revealed that the great majority of the 650 or so sailors who tested positive are asymptomatic.  (Carrier Story) There are seven reported serious illnesses to date.  About 4500 of the sailors have been tested.  This is obviously a much younger, more male population than the cruise ships, but we are seeing the same phenomenon, in which a large percent of the population simply does not get infected, although they were almost certainly exposed.  And a similar story is found on a French aircraft carrier, where out of over 1000 positive test results, only 20 serious cases have occurred. (French story)

The economic damage just mounts higher and higher, to unbelievable numbers.  Jobs lost, economic output lost, loss of revenues to governments, serious damage to important industries like health care.  I am really tired of pointing out the obvious, we are committing economic suicide.  There is nothing more to say about it.

On the social front, pressure is beginning to build for a change in approach and politicians, of course, are responding.  But the moves they are contemplating are far too limited to ensure any meaningful return of jobs.  Consumer spending is 70% of the US economy.  It drives everything.  We have taken tens of millions of jobs away, we have scared the crap out of people in terms of going out, and we have given them an unheard of economic shock.  Until we rid people of the anxiety, and encourage them to return to normal activities, they aren’t going to go to restaurants and bars, they aren’t going to fly to places and stay in hotels, they aren’t going to go out and shop and they aren’t going to go to movies, sporting events and other entertainment.  Those are huge sectors of the economy and are responsible for a disproportionate number of jobs.  As I am going to detail more precisely in a future post, we need to rethink the whole social distancing strategy.

I continue to be grateful that a few states and countries have chosen a different path as that will give us clearer evidence on the value of different strategies.  Here is an update on Sweden, which so far is sticking to its guns and using moderate mitigation of spread measures.  (Reason Article)  They disavow any intent to pursue a herd immunity strategy, and there hasn’t been widespread population testing for either infection or antibodies, but if the situation there in terms of the ratio of undetected cases to detected ones is anything like the rest of the world, they are well on the way to achieving that population immunity.  It may be confirmation bias on my part, but I still think their strategy will prove to be the best one in the long run–attempt to protect vulnerable groups, try to prevent a real surge of cases, but let the virus proceed through the population.  In the meantime, the economic harm in that country is much lower than elsewhere.  While their death rates may look high, the article points out that, unlike most countries, they are treating every patient who died with a virus infection as a COVID death, even if the actual cause of death was something else. And perhaps most importantly, the citizens of Sweden can feel like they live a somewhat normal life.  Would that such wisdom existed here.

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