Death By Lockdown

America is suffering under an event unprecedented in human history: an impoverishing depression caused, not by economic forces or defeat by an enemy, but by the intentional actions of a nation's own government.

We hardly need to detail all the human suffering caused by economic losses during this coronavirus shutdown - they're well known to each and every person capable of reading this article.  And why are most of us quietly tolerating this insanity?  Because, we are told, otherwise countless Americans will die.

Elsewhere, we've explored the fallacious reasoning and just-plain-wrong data that have led us to this destructive madness.  Still, there's no doubt that there are real people dying of coronavirus who otherwise would still be alive today.  Surely some action is merited to try to preserve human life?

Of course, in principle - but we're convinced that the limitations in our health care system which are caused by lockdown are killing more people than the virus.  In other words, for every person saved by shutting everything down, more than one other person is dying who otherwise would not have.

At the most obvious level, it's long been documented that economic calamity brings higher rates of domestic violence, drug abuse, and suicide.  As the Huffington Post put it:

Which causes more deaths in the United States: heart attacks or failure to graduate high school?  Strokes or racial segregation?  Lung cancer or poverty?  The surprising answer is that poverty and its attendant deprivations are deadlier than disease.

They cite a study by the American Journal of Public Health which states that poverty killed 133,000 people in 2000.

As you'd expect, the HuffPo article indulges in a bit of an exaggeration - a bad flu year kills more than 133,000 people in a year - but the connection between economic activity and public health is unarguable.  Countries like India with relatively low economic activity per person simply cannot afford well-known technologies like modern plumbing and sewer systems, to say nothing of the sorts of health care which Americans take for granted.

In the US, additional deaths caused by poverty and close confinement brought about by our reaction to the virus are difficult to measure, but since everyone agrees that the lockdown has caused people to die who would have lived without the lockdown, these deaths should be considered.

It's politically incorrect to point this out, but when the virus first popped onto the national radar, experts said that it was so contagious that without a vaccine, the only viable solution was "herd immunity."  Once enough people recover from the virus, it won't find enough victims to keep going.

The rationale for the lockdown was that, as in Italy, the virus spreads so fast that the hospital system would be overwhelmed.  Nobody pointed out that "flattening the peak" didn't keep anyone from getting the virus, it only slowed the spread.  Now that hospitals even in New York, our national virus hotspot due to crowding and mass transit, have been able to handle the virus flood, we have to start letting the country get back to work.

Yes, bat soup flu cases will increase, but most victims will recover.  We'll have fewer shutdown-caused deaths, and everyone will be exposed over time anyway no matter what we do.

Low Unemployment

Until the moment of the shutdown, the American economy had grown so that we had the lowest unemployment level of modern times.  Increased economic activity generated wealth which can be tapped to provide effective medical care to our large population.  This employment boom was driven by Mr. Trump's deregulation efforts, combined with a perfect storm of longstanding marvelous technological innovations which have begun to show large-scale results in the past decade.

The iPhone reached the market on June 29, 2007.  Over the next decade, Mr. Jobs' innovation has put powerful computers in the hands of Chinese street beggars and other low-income people all over the world.  Although the phrase "Cloud Computing" was used as early as 1996, the first commercial cloud became available only when Amazon announced its Elastic Compute Cloud in 2006.  Mr. Bezos' innovation has made vastly more data storage and computing power available to anyone at much lower cost than in the past.

The first 3D printer patent application was filed in 1980.  Although there were many industrial users who found 3-D printing useful for making quick prototypes, it didn't take off significantly until around 2010.  By 2019, it was possible to "bioprint" cells into living structures.  This technique has been used to create replacement human organs such as a bladder which has functioned for 14 years.  It's become cheap aneough and capable enough that one engineer was able to print enough scaled-up 3-D Lego Technic parts to build a ridable go-kart.

Genomics could be said to have started with DNA was discovered in 1869, but the double helix structure wasn't published until 1953 and the first human genome wasn't sequenced until 2003.  Though there was much speculation about the medical benefits that would result, not many cures resulted because our genome is so complicated that it wasn't clear how changing it would cure diseases instead of producing monsters.

Since the CRISPR gene editing technique was discovered in 2017, it became much simpler to adjust the DNA of any living cell to make changes, but it was still difficult to figure out just what changes to make.

The existence of billions of smart phones makes it possible to collect unprecedented amounts of data from all over the world; cloud computing gives us economical places to store and analyze all that data.  DNA collection services such as 23andMe allow people to upload their DNA and services like ancestry.com let people explore their family trees.  These databases have been used to match DNA samples from crime scenes and find perpetrators, but they are also used to tease out which genetic characteristics produce blue eyes and blond hair.

These technologies benefited immensely from Mr.Trump's efforts at peeling back costly federal regulations and from his tax cut.  Once the Trump Administration reduced regulatory uncertainty, the traditional American attitude of being willing to take great financial risks given the prospect of immense financial rewards led many entrepreneurs to start businesses based on these fundamental technologies.

This drove unemployment way, way down and made it difficult for any Democrat to mount a serious challenge to President Trump... until, by sheer happenstance, the Wuhan Flu forced our bureaucracy to throw half the country out of work.  Funny about that....

Upsetting the Apple Cart

The unprecedented virus-induced shutdown has upended longstanding risk / reward calculations.  Most business contracts have clauses which limit liability in case of uncontrollable and unanticipated events.  We have several centuries writing such "force majeure" clauses which cover war, riot, and plagues, on the premise that no business can possibly be expected to prevent, plan for or cope with events of that magnitude.

However, wars, riots, and plagues do happen, and insurers have them accounted for in their actuarial tables.  In contrast, no one anticipated the government forcibly shutting down the economy because of a supposed plague - that has literally never happened before - so it is not clear how these clauses will play out.

Suppose a school district opens, a nearby district doesn't, and a child gets the virus at school and dies.  With the normal flu, that would be sad.  With this virus, can the parents sue because their school district wasn't as paranoid as the other?  Nobody knows, but there are hordes of lawyers gearing up to help you find out.

The impending lawfare is an obvious and highly visible consequence that is already raising voices of concern and even legislative action, but there is less obvious fallout as well.   For instance, if people fear that the government can randomly shut down the economy on the basis of such flawed models as we've seen recently, they will naturally want to retain more cash on hand against such emergencies.  Indeed it would be foolhardy not to, when officialdom is already publicly calling for years of rolling shutdowns.   That will retard the economy by an immeasurably but doubtless vast amount.

Even in good times, most small businesses fail, and those that succeed generally operate on very narrow profit margins.  Will a potential entrepreneur start a business, knowing that decades of hard work could be wiped out in a few weeks by another shutdown based on flimsy mathematical models which turned out to be as wildly exaggerated as the climate models?

Once governments are able to grab such wide-ranging power, they seldom give it back, and will be tempted to use it again.  The Economist calls this "A pandemic of power grabs."  Such unprecedented government behavior might well destroy the American tradition of risking time, talent, and treasure to start a business to grow the economy.

So, while it would be almost impossible to calculate specific numbers, it's obvious that the global response to the coronavirus has already doomed countless hundreds of thousands to death-by-poverty, just as the mainstream media and left have long complained, by creating a forced depression.  If the HuffPo is even close in its guesstimate of poverty-caused deaths, that alone has killed more American people than the bat-soup flu.

But we don't have to content ourselves with mere guesswork, though making bad guesses seems to be the only required qualification to become Emperor of the Economy.  Let's look at some very specific, measurable ways in which our pandemic response boosted the death rate it was supposed to lower.

Questioning the Lockdown

The presence of the virus has obviously increased death rates.  The difficulty is deciding how the virus increases death rates so that we can minimize its effects.  Before we can explore that, we must define some terms.

If you catch the virus and the resulting infection kills you, you have died of the virus.

If you catch the virus and get run over by a truck on the way to the hospital, you have died with the virus.  You had it, but something else killed you.

Suppose you suffer severe appendicitis pains, you fear the virus and don't go to the hospital.  You hang tough until it ruptures and the pain becomes intolerable.  You go to the ER but the infection has gone so far they can't save you.  You die because of the virus (indirectly), but neither with it nor of it.

These categories aren't nearly as clear-cut as data scientists and modelers would like.  Hillsdale College presented a free symposium "The Economic Ramifications of Economic Shutdown" which pointed out that Medicare and Medicaid have boosted reimbursement rates 15% for treatment of Covid patients.  In addition to the financial incentives, the New York Post tells us:

The federal government is classifying the deaths of patients infected with the coronavirus as COVID-19 deaths, regardless of any underlying health issues that could have contributed to the loss of someone's life. ...

"The intent is ... if someone dies with COVID-19, we are counting that," she [Dr. Deborah Birx, response coordinator for the White House coronavirus task force] added.

Other countries count deaths of patients with underlying conditions such as heart disease or kidney problems as caused by those conditions whether they've been exposed to the virus or not.  That makes their handling the virus look better than Mr. Trump's because they show fewer Covid deaths per capita.

This data problem will only get worse as testing increases because more people who die of other causes will be charged against the virus.  Why not, when you get a 15% bonus?

Questioning the Death Rate

The Post tells us that studies in California suggest that 40 times as many people carry the virus than have been counted as confirmed cases.  Instead of the 4.5% fatality rate which motivated the lockdown in the first place, the actual fatality rate is 0.11% - not much higher than our traditional flu.  The fatality rate may come down even more depending on how many more people test positive.  The major difference is that Covid spreads faster than the flu.

What if a symptomless California virus-positive is run over by a truck?  If they are tested during their autopsy and the virus is found, they'll still count as a Covid death per CDC guidance, along with millions more people who've had the virus without knowing it.

Suppose you go to the hospital before your appendix ruptures.  They can't help - they laid off their non-Covid workers because "Elective," that is, not total emergency, surgery has been banned to reserve hospital capacity for the Covid flood.  You die because of the virus... but if you pick up a trace of the virus from the ER floor where someone's cough settled, you'll count as dying of the virus, even though you didn't have it before you set foot in the (unhelpful) hospital.

An Illustration

This diagram from the Economist shows the impact of how we categorize deaths.  The black line at the bottom of the graph shows that this small Italian village averaged a bit under one half a death per day in January through April for the past few years.  The dark triangles show how many deaths were officially counted against the virus and the lighter triangles show overall deaths.

This diagram deserves considerable thought.

There were between zero and two deaths per day in January and February - not much different from the black trend line.  March deaths, though were far above what the medical system was expecting based on past history.  The main rationale for the global lockdown was to slow the spread to avoid overloading hospital systems as happened in Italy.

Consider the four days in March when there were 10 total deaths.  Each of those days had 3 or 4 deaths attributed to Covid, but the graph doesn't show the causes assigned to the other deaths.

It's reasonable to say that they were because of the virus - the low death rate on those days in earlier years suggests that many if not most of these people would have been saved if the hospital wasn't so overloaded.

Some people say that because of limited testing capability, many of the extra people who died weren't tested for the virus and probably died of it.  They assert that extra deaths should be counted against the virus too.

A scientific adviser to Italy's minister of health reported that only 12% of Italy's Covid deaths were really caused by the virus because so many of the deceased had as many as 5 underlying conditions.  The virus may have hastened their deaths, but they weren't going to live long anyway.  The virus compressed deaths into a shorter time interval and overloaded hospitals, but he asserts that these people died with the virus, not of it.

The $64 Question - Maybe $128 with Inflation

The modelers who recommended our shutdown claim that the lockdown slowed the spread of the disease, which was why deaths never came remotely close to their doomsday predictions.  We doubt this because of all the studies we cited that show that the virus had spread much further than anyone knew.  That means that it's fatality rate is far below the initial estimates.

The models would have made much more accurate estimates if they had used the lower fatality rate which is emerging as testing becomes more available.  Townhall tells us that New York's Gov. Cuomo has described new studies proving this:

The death rate in New York State isn't 7.4%, it is actually .75%. The recently ended influenza season numbers from the CDC indicate possibly 56,000,000 cases of flu, 740,000 hospitalizations, and 62,000 deaths. Under the current count from the Johns Hopkins Dashboard in this five month stretch CoVid19 has racked up 845,959 confirmed cases, 122,000 hospitalizations and 46,972 deaths.

Our CDC is telling doctors to put down covid as the cause of death when in doubt, and hospitals get 15% more money for covid deaths than for others, so there are fewer actual covid deaths than we're being told.  Similarly, the Italian health minister argued that Italian doctors did as our CDC urges and that the number for direct covid deaths is unrealistically large.

In that case, the other excess deaths are because of the virus and not of the virus.  The most reasonable explanation is lack of medical treatment due to hospital crowding caused by the virus packing an entire season's worth of flu deaths into a month, and because so many American hospitals laid off so many people when non-covid treatment was stopped.

To be fair, some of the rationale behind banning "elective" surgery and other non-virus treatment was that hospitals are good places to catch the virus.  Having people stay away from the hospitals if at all possible was thought to be a good idea.

Whether that was true initially is debatable, but it's clear that it's time to end the hospital ban in most areas.  The New York Post reports:

...hospitals desperately need the "normal" business, too.

"Elective" surgery includes a lot of vital work for cancer patients and others, including procedures that keep providers solvent. Hospitals have been losing millions.

Last month the Centers for Disease Control and Prevention advised all states to order the postponement of elective procedures. But that has put off hip- and knee-replacements, vital preventative screenings such as mammograms and colonoscopies and even chemo for less-aggressive cancers. New York City alone saw more than 1,000 cancer surgeries delayed.

In short, resuming elective procedures in places where pandemic risks appear low is a no-brainer.  [emphasis added]

The Post also noted that 64% of New York State's covid deaths were over the age of 70 and 95% were over 50.  This is a strong argument for letting younger people go back to work as hospitals get back to work.

Reducing the enormous human cost of the lockdowns is every bit as important as minimizing the direct harm from COVID-19.

The Wall Street Journal was pretty blunt in outlining some of the costs of the hospital shutdown:

As Covid-19 overwhelms doctors and hospitals, patients with other conditions receive less care, leading to a rise in mortality.

Most weeks at my hospital near New York City we see about 40 acute or near-acute heart attacks. For the past few weeks, we've seen an average of five, a 90% drop. We're hardly alone. At Detroit Medical Center, the number of heart attacks being treated has dwindled from 15 to 20 a week to one or two. Hospitals in Atlanta and Boston have seen similar drops. The decline is also being observed abroad. In Milan, for example, the number of heart attack cases is down by 70%. In Madrid, the dip may be closer to 80%.  [emphasis added]

It's unlikely that the virus prevents heart attacks; it actually seems to make them worse.  The New York doctors are seeing fewer heart attacks, not because they aren't happening, but because the victims never make it to the doctor - they go directly to the morgue.  Sure enough, New York City reports a disturbing spike in deaths from cardiac arrests at home.

Our using appendicitis as an example of misallocating deaths to covid wasn't just an abstraction.  ERs are seeing fewer appendicitis cases than usual and other emergencies are going untreated.

Case volumes have plummeted for appendicitis, gallbladder infections and obstetric emergencies, to name just a few conditions that reliably appear in emergency rooms in non-pandemic times.  [emphasis added]

These are all life-threatening conditions for which well-known treatments have a high success rate.  There's no way to know how many untreated patients have died because of the virus, but it could be far more than died of it.

A study published in the Italian newspaper Corriere Della Sera recently looked at the spike in deaths in Nembro, a town in Lombardy severely affected by the coronavirus. The report suggests that deaths directly attributable to the coronavirus may account for only about a quarter of the rise.  [emphasis added]

This study confirms our interpretation of the Economist's graph.  In other words, about three times as many Italians died because of the virus as died of it.  The Journal also cites a study of the Ebola pandemic which concluded that more people died from lack of access to the overstrained health care system than died of Ebola itself.

Given that major portions of our hospitals have been idled to the point of going bankrupt and that it's likely that more people are dying because of the virus than die of it, it's plainly immoral to keep hospitals closed.

Given the age distribution of covid deaths in New York City, our hardest hit, most crowded area with its tightly-packed mass transit system, it's also time to let the under-50 set go back to work - just as we've said all along.