30.5.21

Edwards virus policy caused net loss of life

Finally, Louisiana Democrat Gov. John Bel Edwards (mostly) set the state’s people free. The Wuhan coronavirus pandemic public health emergency continues, but with the only restrictions left being face coverings required in public transportation, health care, and corrections settings – which should have been the regime all along except for the initial stages of the pandemic.

But because it wasn’t – because Edwards’ restrictions went far beyond that for an extended period time, human dignity suffered a major affront in that overly-restrictive rules needlessly attenuated people’s liberties. Worse, data show his heavy-handed approach probably cost more lives than saved them.

This is demonstrable both theoretically and empirically. For the first part of 2020 – the national and international pandemics were declared in mid-March – scientists and policy-makers knew little about the virus and the epidemiology associated with it. Scary scenarios predicated on a much broader conceptualization of transmission possibility, rushing in to fill the vacuum of knowledge, perhaps justified stringent measures.

Yet by the start of the year’s second half, a solid knowledge base existed concerning the virus. Many things became known: outdoor transmission is close to impossible; indoor transmission is difficult unless people are physically closed in for an extended period; transmission from surfaces only can happen immediately after virus implantation; virus lethality varies considerably according to age and comorbidity, to the point almost no healthy individuals below age 70 die from it; and the relative lethality is hardly different from influenza. Moreover, implementation of face covering mandates only marginally reduces transmission.

Armed with this knowledge, the overtime overkill that Edwards imposed, which featured extended periods of indoor commercial capacity restrictions if not complete closures for months on end and mandatory masking, was entirely inappropriate. And the data show this.

We can compare representative states in terms of their strictness as assessed over time. Louisiana doesn’t fall into the strictest of states as a whole over time, but was more restrictive than the majority. Less restrictive was Texas – which shed its lesser restrictions in early March, almost three months sooner than Edwards did --and essentially unrestrictive was South Dakota.

To assess degree of success, we can use the using the most certain of criteria, deaths caused – but not just those where the virus proved the prime instigator. As part of excess deaths since declaration of the pandemic we need also to review other causes besides the virus, since in all likelihood the overwhelming majorities of these came consequentially from the lockdown conditions, such as “deaths of despair” triggered by social isolation and deprivation of income generation or validation as a contributing member of society, or those resultant from discouragement in seeking medical interventions for unrelated diseases. Research already notes a positive association between state restrictiveness and number of excess deaths.

Using the latest compiled data, starting from Feb. 6, 2020, through Feb. 5, 2021 – a month before Texas went from few to no restrictions, Louisiana continued to maintain significant ones, and South Dakota stayed on its course of basically none – excess deaths remained congruent to that pattern. In Louisiana, these were 27.0 percent above the average from 2014-19 (excluding 2018 because of data questions), while in Texas the figure was 26.8 percent above and for South Dakota 13.6 percent above. Keep in mind as of this writing Louisiana and South Dakota had about the same death rate of 227 per 100,000, while Texas was at 178.

The very slight difference in excess death increase between Texas and Louisiana should have grown since, as Texas went from some to no restrictions. One report estimated complete reopening caused no additional deaths from the virus (and thus fewer excess deaths) compared to restrictions maintenance. However, that would stand to reason because of the South Dakota numbers at roughly half the rate.

Another way to view this looks at the proportion of excess deaths from the pandemic (the periods for each state vary slightly, as they begin with the first date a virus death occurred). In Louisiana, just over 70 percent of the excess were virus deaths, and in Texas just on 80 percent. But in South Dakota, backing out virus deaths actually produces a negative number: 12,129 deaths instead of the average 10,790, but 1,798 virus deaths means -459 excess deaths from other causes.

Practically speaking, this means in South Dakota the virus took people who would have died from other causes and its presence – in the absence of government restrictions – altered behavior enough to reduce the death count to below historical norms. For example, absence of restrictions didn’t discourage people from taking care of medical concerns, and they drove fewer miles, meaning fewer fatal vehicle accidents -- and weren't driven to despair by restrictions. That as the relative proportion of non-virus excess deaths as a whole diminishes, and the whole even reverses in absolute numbers, as government restrictiveness declines, demonstrates (from this very small sample) that human behavior restrained only to the lightest degree by government proved the optimal strategy to minimize the number of deaths.

Which Edwards didn’t mimic. In other words, Edwards could have placed fewer restrictions and achieved about the same level of safety, minus the social and economic suffering. Or, the only restrictions in place now could have been the only ones ever imposed, and the excess of the excess death rate would have been halved with almost none of that additional suffering.

Sadly, he didn’t, botching the state’s pandemic response that never understood that the infection curve’s volume doesn’t change until an exogenous agent such as a highly-effective vaccine – not available until eight months in – can siphon it, so all suppression does it lengthen the time the virus remained widespread thus leaving vulnerable people at risk for longer. A strategy of implementing only the current restrictions, tightly controlled access to and highly sanitarian practices at health care facilities, and public exhortation for the medically-vulnerable to stay out of situations of more than a very low order of transmission would have worked so much better.

Instead, Edwards’ command-and-control approach designed to give the appearance that government had to protect intensely the entire population, far beyond the actual risk involved or societal costs that ensued, left a legacy of preventable deaths. He, and we, will have to learn to live with that fact and its consequences.

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