Friday, May 1, 2020

COVID-19: The Story So Far

From an overlong Facebook post.

The story so far:

For years, experts had been warning us to prepare for a pandemic respitory disease. We didn’t. Government in particular did not adequately do so, nor did the healthcare industry, since there was no economic incentive for them to do so because healthcare pricing in this country is controlled by the federal government, particularly in the hospital sector where the weight of such a pandemic would fall, which did not incentivize preparedness.

Then a pandemic hit and we squandered many chances to respond promptly (to the extent we could have being unprepared) because the present occupants of the White House and the state houses didn’t heed the early indicators. The former, in particular, attempted his typical routine of trying to create an alternate reality in which the virus went away on its own. The virus didn’t get the memo.

The inadequacy of the preparedness and initial response resulted in tens of thousands of avoidable deaths.

When governments finally started responding, the initial step was to initiate lockdowns of the population to slow the spread of the virus. We were told this was to ‘flatten the curve’: meaning to avoid a surge in people getting the virus all at once if it spread uncontrolled that would exceed the surge capacity of the hospital system. If that surge capacity gets overwhelmed at any point, we were told, more people than necessary will die. It will not reduce the overall number of people infected or needing hospitalization, though: it just spaces them out over time. The area under the curve remains the same (aside from the excess deaths due to overwhelming hospital capacity), it’s just flatter.

We were told this step — and the lives jeopardized and reduced in quality as a result of it — were necessary sacrifices. But this phase was only temporary as we built testing and treatment capacity. Testing capacity lets us more selectively isolate people with the virus and those who may have come in contact with them, allowing healthy people to resume their normal lives. And increasing treatment capacity lets us treat more people at once, reducing the need to flatten the curve.

Now, almost two months later, we’ve made some progress. As a country, we’ve gone from doing only a few thousand tests a day to over 200,000. It’s harder to get numbers about increased hospital capacity, though the number of people in ICUs has come down significantly from the peak a few weeks ago (over 15,000 to around 9,000 on a given day), suggesting the curve flattening is working but also that, in many but by no means all places, there is not, at present, a need for as much curve flattening because excess hospital capacity exists. And though 200,000 tests per day is impressive, it’s still an order of magnitude short of what the experts say we need.

And still 95%+ of the population remains under lockdown. Neither state nor federal government have articulated sufficiently detailed plans for getting the treatment or testing capacity we need to end them.

As a result, the de facto plan is to keep the entire population under indefinite house arrest (without any actual crime, trial or indeed any legal basis) as a form of preemptively rationing access to (allegedly) scarce healthcare resources. We are now told this will continue until the rate of infections or hospitalizations declines significantly, which was never something that curve flattening was supposed to achieve. And the de facto plan for dealing with the massive economic consequences of this is socialism: both rationing access to other necessary resources to deal with disruptions to the supply chain the economic devastation is causing, and engaging in massive, hastily assembled wealth redistribution plans, ignoring the fact that if production isn’t occurring than the wealth to be redistributed isn’t being created.

And, perhaps most shockingly, almost all ‘respectable people’ are willing to tolerate it. They are fine with the government pointing a gun at them and their neighbors and saying ‘Don’t leave your house. Don’t run your business. Don’t have your kids learn. Don’t pursue any value other than the ones inside your four walls. Unless you’re a healthcare or ‘essential’ worker, in which case you are expected to put yourself at risk for the Common Good. Do this indefinitely because we’re in charge and, really, this is all we can do. We can point guns, tell people what not to do and shuffle wealth other people created around. We can’t adequately increase testing capacity. We can’t even have an actual plan or strategy for increasing and managing the treatment capacity we have. We certainly can’t invent a vaccine. So stay inside, because we have calculated (correctly) that you, the voting public, will tolerate lives being destroyed, including your own, if it happens slowly enough, in private, and in the name of the common good; but not if it happens rapidly and all at once with people hooked up to ventilators.’

Apparently, they are absolutely right in that calculation. Most people apparently don’t care whether they live. Not in a meaningful sense. If they’re motivated at all, it’s to avoid death. But living is not avoiding death. They may succeed in that. But it isn’t living. When it comes to actual living, we’ve done more in the last two months to dig our own graves and climb into them than any other generation of Americans.

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