Perhaps the reason why Louisiana has had the country’s worst economy and most troubling health indicators throughout the Wuhan coronavirus pandemic is because of the wretched scientific advice Democrat Gov. John Bel Edwards receives from bureaucrats, whether he has any interest in following scientific knowledge rather than political agendas.
That became clear last week in testimony from a pair of Department of Health officials to a House of Representatives panel. This came during debate over measures that would force legislative input into renewal of gubernatorial public health emergency declarations, over which currently he has sole authority. The Republican legislative majority generally has complained that the scope and intensity of restrictions continue past any reasonable utility; Edwards has said he plans to keep these on with little modification “until a vaccine is widely available.”
Often, Edwards has hidden behind the skirts of the federal government saying his strictures follow these guidelines, except that he has taken great liberties with choosing how to apply those standards that leads to tremendous inconsistency in application that appears more grounded in politics than science. Further, his administration asserts that his orders are less restrictive than in many other states with lower rates of virus infections.
However, that’s a red herring. It’s the current rate, not accumulated, of which Louisiana has the highest in the country, that’s relevant. Further, while some states have roughly same the cluster of restrictions (AZ, IL, KS, ME, MD, MN, NV, NC, OH, OR, SC, VT, VA, WA) few states (CA, CO, CT, DE, HI, MA, MI, NJ, NM, NY, PA, RI) have more restrictions.
So, note how that “less restrictive than many with lower rates” statement distorts and misleads. By definition, every state has a lower rate, but of the 49, just a dozen have a higher level of restrictiveness – and in all but one case also laid down by a Democrat governor with the same ideological imperatives as Edwards of trying to maximize command and control over the population and stifling economic activity to try to besmirch the economic record of GOP Pres. Donald Trump and more generally Republicans to influence voters in this fall’s elections (in Edwards’ case, additionally trying to position himself for a future campaign once his term ends), using the virus crisis as a means to these ends. Just because his ideological soulmates go jump off a bridge doesn’t mean Edwards has to follow; bad policy elsewhere in a similar environment doesn’t justify its imposition here.
And, increasingly science and policy points to more draconian measures as bad policy, and understanding this starts with knowing the realities of this particular pandemic. First, beginning with the general, like all pandemics it will produce a particular volume of cases and deaths, graphically illustrated a by a plot of these over time creating the “curve.” The initial input creates the accumulation of a particular volume under the curve.
Louisiana got off to a bad start, chiefly because of poor decisions by Edwards and local executives, as the state had a ready-made super-spreader event occur at the worst time to kick off virus transmission: Carnival. While at its beginning foreseeing Carnival as that vehicle would have taken extraordinary prognostication powers, by its end the writing should have been on the wall given evidence from around the world. This created a delay of over two weeks that might not have nipped the virus in the bud, but at least would have given Louisiana a much lower start value.
We can think of the curve as an oddly shaped balloon with one side completely linearly flat. That volume largely gets set in stone from the initial start value because a pandemic, by definition, occurs when some disease goes through the population, and thus is stopped (to the point it is no longer a pandemic, but flares inconveniently among individuals from time to time) only when enough of the population becomes immune or is killed by it so that wherever it is it can’t find enough non-immune hosts to colonize to stay widespread.
Immunity comes from one of three places: inherent to the host, because of past encounters with the virus or something close to it; acquired from encountering presently the virus and surviving; or artificially induced, through a vaccine. Inherent immunity affects the start value of the balloon; the more of it, the less volume. Acquired immunity resides entirely within the balloon’s volume. Induced immunity can act as a relief valve to decrease the volume, but the temporally later that comes, the less decrease in volume can occur unless human behavior is such that people act in ways that delay significantly transmission until discovery of a very effective vaccine.
Importantly, other than induced immunity, you cannot change the volume of the balloon. Absent induced immunity, you can try to manipulate the circumference of the balloon so that it is more peaked and/or more often had peaks, but the volume remains the same. More starkly, you could have a steep increase from the start, which then burns itself out into a rapid decline, or a gradual rise and descent over a longer period, or small peaks and valleys throughout that also lengthens to shape, but they’ll all be the same volume – particularly meaning numbers of cases.
But not necessarily with numbers of deaths. In absence of a vaccine, if a uniform distribution of deaths by a risk category such as age exists, they would be the same. The only way public policy could prevent this would be to lock away tightly the population generally until a vaccine came about. Yet if certain risk categories bore the preponderance of suffering and deaths from cases, policy could isolate only those individuals at higher risk while letting the almost entirely-unaffected portion act without restriction, other than when interacting with the vulnerable population.
Better, this can change the shape of the balloon to end the pandemic earlier. If the virus burns through a population almost entirely unaffected in a shorter period, the shorter period of time the vulnerable faces risk of transmission. But by stretching the balloon through preventing those able to weather with little difficulty the virus from catching it, the virus remains generally transmissible for a longer period of time, increasing the opportunities for the vulnerable to pick it up simply because it’s irresponsibly allowed to circulate longer.
This describes the current pandemic, by age. People under 20 rarely even show symptoms; people under 70 seldom die from it. And even if you’re 70 or over, if you get it you have 22 chances out of 23 that you’ll survive it; centenarians out there have survived both the 1918-19 influenza pandemic and he current one. The fact is, almost nobody under 70 without a severe health impairment dies from this.
That vulnerable populations may be easily identified with the vast majority of the population at best mildly inconvenienced temporarily – and from a fifth to two-fifths never show any symptoms at all – is one distinguishing characteristic of this pandemic. Another is related to the relatively high degree of asymptomatic presentation, in that a significant portion of the population may already carry inherent immunity to the virus, as a function of encounters with past related ones. A recent Swedish study estimated roughly 30 percent of the population had derived such immunity, not having encountered this virus.
This leads to a final trait of this virus: the point at which a sufficient proportion of the population has immunity to it from inherent or acquired immunity so that it can’t jump to enough uninfected hosts to stay a pandemic, “herd immunity,” appears much lower than the historical norm in the 60-80 percent range. Recent studies have honed into a figure of around 43 percent infected/immune to acquire this.
Which mean Sweden is almost there, if not already. It adopted the above strategy of minimal restrictions – indoor gatherings limited to 50, no in-person schooling for post-high school and above last spring, and isolation measures for the elderly (which, it admitted, it didn’t execute well compounded by previously mild flu seasons that left alive a higher proportional of the vulnerable to succumb) – but didn’t close the economy in any way and didn’t impose a national face covering mandate.
As a result, its number of cases rocketed upwards quickly, but after a couple of months fell steadily to a fairly narrow, low range. In the past two weeks it has reported only 18 deaths in a country of nearly 11 million people, none for the past week, leaving its total at just under 5,900. Unlike the rest of Europe, it hasn’t experienced a “second wave” of infections and deaths coming after they relaxed their initial, more stringent, regulations.
Which also happened in Louisiana, a state with just over 40 percent of Sweden’s population (and in many other U.S. states as well), which has racked up almost 5,400 pandemic deaths. On Oct. 2 alone, 26 people died and almost twice as many new cases popped up as in Sweden – which currently tests at about half the rate of Louisiana.
And did things entirely differently from Sweden, closing schools in the spring, with Edwards imposing a mask mandate nearly three months ago, keeping many businesses closed for weeks, even months (and some still are) and continuing with capacity restrictions. In effect, these disastrous policies have flattened and lengthened the balloon, putting more vulnerable people at risk for a longer period – and Edwards shows no sign of letting up despite the higher per capita death rate associated with this approach.
Certainly, the LDH officials he appears to rely upon for advice, in their public statements, don’t give him any reason to reconsider. Get a load of the testimony given by Joe Kanter, assistant state health officer, who said trying to reach herd immunity would cause thousands more deaths and overwhelm health care facilities. “It would be disastrous,” Kanter said, who clearly knows nothing about how Sweden managed its affairs (without its health care system ever coming close to reaching capacity) and seems oblivious to the fact that the lockdown approach he supports has killed many more per capita – and this doesn’t even count the hundreds more “excess deaths” experienced in the state largely from increased mortality from mental health issues spurred and medical treatments delayed by the lockdown (by contrast, weeks ago Sweden’s count went to zero.)
Then there’s state health officer Jimmy Guidry, like Kanter a medical doctor, who repeated the canard of herd immunity needing 60-70 percent infection to kick in. He also backed the current lockdown measures on a presumed coming spike in the next few weeks. “[W]e're going to see as much if not more than what we saw in the spring,” he opined, because he took a look back at the H1N1 influenza epidemic of 1918 and concluded, “When you look at 1918, I hate to go back to that but that's what people did, they got comfortable and said not a big deal. They had another spike which was almost double what the original spike because they stopped doing things that protected people."
But according to medical historians, that’s not what happened. Instead, rapid mobilization then demobilization only months later of troops for fighting World War I mainly drove the patterns of outbreak. Plus, this virus has significant biological differences that has led experts to predict “[a]s states loosen nonpharmaceutical interventions, the U.S. will likely experience a long plateau of continued new infections at a steady rate, punctuated by periodic local flares.”
This is particularly true because the 1918-19 flu – a pandemic which lasted only 11 months, while this one already approaches its eighth month – affected populations more broadly. In fact, the 20-40 age group suffered as much as the 65 on up cohort, making much harder to acquire herd immunity without hospitalizations and death unless locking down the country in draconian fashion. By contrast, for this virus it’s far easier for government to mandate measures mostly non-intrusive for most of the population to protect the much smaller vulnerable cohort.
And this
is the pattern at this time in Louisiana. The problem is, because of the
longer period of more restrictions than necessary, the pattern will continue
longer than it should have.
It’s, quite simply, past overdue for a change in policy. Maintain rigid sanitation and visitation standards in nursing homes. Restrict large indoor gatherings, like at theaters or sporting events (or very large classrooms), and outdoor gatherings at locations where people otherwise might be jammed next to each other at reduced capacity like 50-75 percent. Have preparers and servers of food and drink wear face coverings with their establishments adhering to rigid sanitation standards. Advise vulnerable people to restrict their movements and wear masks. And that’s it. Something even less restrictive than this worked in Sweden, and it’ll work here.
Except you have an Edwards Administration ready, willing, and able to pass on bad information. Yet before passing off these bureaucrats as ignoramuses and giving bad advice to Edwards, consider an even more pessimistic scenario. It could be that they full well know the information explained in the paragraphs above, but that Edwards has ordered them to back up his actions in their public statements. Given how his response almost from the start put politics behind the wheel and relegated science to the back seat, that’s not improbable.
Regardless of the rationale for it, Edwards’ policy has caused needless suffering, and he appears all too willing to continue to inflict it for the years it might take to come up with an effective vaccine. It is madness. It needs to stop.
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