Why Are We Still Trying to ‘Flatten the Curve’?
Now that roughly half the states in the country are starting to reopen their economies, expect a rash of stories about how they opened “too soon” and that COVID-19 cases are climbing as a result.
A headline on Friday, for example, was about how Georgia reported more than 1,000 new cases of the virus “the same day its governor lifted the stay-at-home order.”
New York Gov. Andrew Cuomo warned Saturday about “blindly” lifting lockdowns and reopening the economy. “Use information to determine action – not emotions, not politics, not what people think or feel,” he said.
It’s Cuomo himself who is playing politics, acting on emotions, and ignoring information.
The fact is that the lockdowns weren’t about stopping the spread of the disease. Their justification was to “flatten the curve,” — that is, slow the spread so our health care system wasn’t overwhelmed. Cuomo should know that even in his home state there’s little evidence that the health care system was even close to being engulfed.
Remember, the impetus for the lockdowns was based on dire forecasts that COVID-19 would kill more than a million people – even with draconian measures in place – and that its death rate was on the order of 30 times greater than the flu. Now that we’re getting antibody test results – which are showing magnitudes more had been infected than showed symptoms – the death rate is more like 0.3%.
Yes, that’s worse than the flu and enough to cause temporary, local shortages of health care, but not anywhere near enough to cause a nationwide breakdown of the system.
In fact, NPR reported on April 7 that out of the 2,000 beds set up in temporary hospitals in New York, only about a hundred were used. April 7 was the very day that daily deaths in the state peaked.
Outside New York – which accounts for more than a third of all deaths nationwide – the cases have been comparatively few and far between.
As a matter of fact, there was a huge decline in hospital use nationwide just as the virus was peaking.
Inpatient admissions were down 30% from January, emergency room visits dropped 40%, observation services fell 47%, outpatient ancillary services declined 62%, and outpatient surgery volume plunged 71%, according to a report from Crowe LLP.
California: Elon Musk tweeted out a chart late last week showing the early predictions about hospital use in the state, and the actual data. “Hospitals in California have been half empty this whole time,” he said. The San Jose Mercury News reported that “In the absence of an anticipated coronavirus surge, Bay Area emergency room doctors and nurses say the ongoing pandemic has transformed hospitals into deserts.”
Minnesota: “Things are looking really good,” said Minnesota Department of Health Assistant Commissioner Marie Dotseth last week. “Every day that goes by we learn a little bit more and we’re feeling confident that we will see a surge but we are well prepared capacity-wise with what we’ve planned so far.”
Florida: “The goal of reducing the curve was to keep the infections underneath that hospital capacity. That’s the reason why we went on this, what we’ve done, and you can see not only did we not reach hospital capacity, we’re far under what hospital capacity is in the state of Florida,” Gov. Ron DeSantis said.
Tennessee: At the end of last week, Chattanooga hospitals had 232 vacant hospital beds, including 51 intensive care unit beds, and 357 ventilators not in use.
Connecticut: “Even on the worst day, the number of hospitalizations per county never came close to hospital capacity” NPR reported.
Philadelphia: Officials are moving to shut down a COVID-19 surge hospital that had been set up at Temple University’s Liacouras Center less than 10 days after it accepted its first patients.
Well, surely this good news is all because of the shutdowns, right? And doesn’t reopening “too soon” risk overwhelming the health care system down the road?
The fact is nobody knows whether the lockdowns made a difference. Johan Giesecke, who’s been described as one of the world’s most senior epidemiologists and is an adviser to the Swedish government, argued early on that the lockdowns weren’t evidence-based.
American Enterprise Institute adjunct fellow Lyman Stone notes that “the scientific and medical case for strict lockdowns is paper-thin.” He notes that “COVID infections were already declining before Spain went into lockdown.” The data show the same thing in France and in Lombardy, Italy.
A paper by Thomas Meunier of the Woods Hole Oceanographic Institution found that:
Extrapolating pre-lockdown growth rate trends, we provide estimates of the death toll in the absence of any lockdown policies, and show that these strategies might not have saved any life in western Europe. We also show that neighboring countries applying less restrictive social distancing measures (as opposed to police-enforced home containment) experience a very similar time evolution of the epidemic.
Even if the lockdowns were effective, keeping them in place for fear of an even worse outbreak ahead makes no sense. First, there’s the fact that millions have already been exposed to the virus and now have antibodies to it, which means a future outbreak isn’t likely to be worse than the current one. Plus, in addition to having plenty of hospital capacity, the country is now far better prepared to handle an increase if one does occur. We have more tests, more ventilators, a greater ability to trace the disease, and more experience in treating victims than we had at the start of the outbreak.
Edward A. Snyder, an economics and management professor at Yale, and L.S. Dugdale, director of the Center for Clinical Medical Ethics at Columbia University, summed it up well in a piece for The Hill.
“Although a flatter curve may reduce deaths in particularly overburdened health systems, the net number of lives lost may not substantially differ over the course of the disease. The extent of long-run adverse health consequences, however, will increase with the extent of damage to the economy from prolonged efforts to flatten the curve.”
In other words, the cure will end up being far worse than the disease.
Those are the facts, Gov. Cuomo.
With the nation’s health care system no longer at risk of being overburdened, strict lockdowns meant to flatten the curve no longer make sense, if they ever did. It’s time for the country to unlock the doors and let people resume their lives.
— Written by the I&I Editorial Board