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22.7.20

On virus, Edwards still ignoring data, science

Passing through another policy inflection point, evidence continues to mount that Democrat Gov. John Bel Edwards and his Administration haven’t responded competently to the Wuhan coronavirus pandemic in Louisiana.

When in the world of the hard or soft sciences a researcher discovers a significant outlier, it often behooves further investigation to understand the phenomenon under study. Considering Louisiana by the reported numbers, its pandemic response truly stands out – and not in a good way.

The state, with a handful of others, the virus hit hard early. In these instances, all had events and commercial patterns that brought a lot of visitors to them and provided opportunities for them to congregate; in Louisiana’s case, Carnival. Since then, almost all have ratcheted down the early spikes in cases and hospitalizations.

States hit later now suffer the same wave. Although much media attention has focused on states like Texas and Florida with an alleged huge surge on both indicators, in reality their large populations and later adoption of testing only make it seem this way, the data show. In reality, only a couple of states not early sufferers have come to the forefront: Arizona and Georgia. In the top five for cases per capita at present still reside New Jersey, New York … and Louisiana.

But of these five, New Jersey and New York have suppressed successfully the early big hit, while Arizona and Georgia came late to the party and now grapple with what those pair encountered three months ago. Only Louisiana has seen an early spike, a trend downwards, then another spike.

In fact, only a few others states – Kansas, Ohio, and Washington – show a similar pattern, although of these only Washington had its initial spike earlier like Louisiana, with the other two spiking a month or so later. But, unlike Louisiana, they don’t exhibit high per capita numbers of cases or hospitalizations (Kansas and Hawai’i don’t report those numbers).

These data point to Louisiana’s truly unique status. In per capita terms of overall incidence, current hospitalization, and cumulative mortality – the leading, middling, and lagging indicators of the pandemic – the state ranks, respectively, third, sixth, and seventh. No other state (including the District of Columbia in all of these analyses) ranks in the top ten in all three. To sum, it is the only state to experience a bimodal peaking in daily cases and hospitalizations (which only a few have) and is being hit so hard for so long.

(Keep in mind that number of positive cases is related to testing, and Louisiana has one of the most aggressive testing regimes, ranking as a proportion of population third at nearly a quarter. All data used here are through Jul. 20.)

Now that we have determined that Louisiana has suffered the most and the longest from the pandemic, we need to understand why. A number of reasons can contribute – cultural norms, general population health, commercial activities – but astride and controlling for all of these is policy. Ultimately, the negative aspects of these relative to fighting off the virus – an enhanced sense of independence, a disproportionate number of more vulnerable people, an economy more dependent on outside visitors and congregate activities – can be mitigated through policy choices.

On this, Edwards failed and failed early. Failing to grasp that Carnival would act as an accelerant, he made no effort to ramp up testing capacity and set up contract tracing infrastructure that could have nipped early transmission in the bud. Then in adopting a one-size-fits-all response, he ended up shuttering large portions of the economy too late in some places and too early in the others, needlessly enhancing and dragging out the crisis.

Since then, his decision-making on when to unleash various shackles seems to have more basis in politics and less in science. And it has become increasingly clear that a tunnel vision has surrounded him and his key advisers on this issue that increasingly ignores the rapidly-expanding knowledge base around the virus.

In essence, over time Edwards has changed his justification for his policy pronouncements on the issue from overwhelming the health care system to having too many infections, as he articulated with his announcement yesterday that he will issue another proclamation extending for two weeks existing commercial restrictions (tighter than two weeks ago) and a face-covering mandate that might well be unconstitutional.

This approach, which one could derive from the data above, assumes that a “second wave” of infections has come, fueled by a public largely still unprotected by some form of immunity, meaning a large gap looms before acquisition of herd immunity. To refresh about the basic concepts, herd immunity is achieved when a sufficient portion of the population has the ability to fight off the virus before it sickens them and makes them contagious. The immune system either has this from having successfully fought off an infection from the virus or came about it some other way. With enough people having it, the virus has too few opportunities to spread.

Yet the Edwards Administration seems blissfully unaware of the latest science about the virus, which contradicts the implicit view behind its response of a large swath of unaffected or unprotected public short of herd immunity. That research tells us that far more people likely have had the virus than the official positive test record shows, and that herd immunity is much farther along than that record shows not only because of the untallied acquirers but also that a significant portion of the public already had their immune systems primed against the virus.

In fact, the latest research pins the herd immunity threshold for this particular virus, based upon data gathered over the past three months, at around 17 percent. Yet recently a Department of Health official repeated the canard that it had to reach at least 80 percent.

Immunity acquisition can be confirmed for the state by using the official Centers for Disease Control’s calculated infection fatality rate for the virus, of 0.26 percent (not that different from the seasonal flu), and Louisiana deaths, dividing the former into the latter. As of yesterday with 3,498 deaths, that would imply 29 percent of Louisiana’s population has gotten the virus, past the point of herd immunity.

Keep in mind as well that in the last flu cycle around 1,500 Louisianans died from that. Even if 1,000 more end up dying in the state during the present pandemic – and once herd immunity is approached, history shows deaths drop off considerably as they have in Louisiana over the past month (to about 14 per day, less than half the daily rate from three to two months ago) – to make the final total 4,500, contrast that with the annual response to the flu. That is, the state doesn’t do anything over 1,500 people dying, yet a toll three times that triggers a massive economic retrenchment and unprecedented restrictions on basic individual liberties,

The point is, months ago the Edwards Administration launched a heavy-handed approach in part justified because of the need to husband medical resources and protect vulnerable members of the population, but continues to do so past any real need to do so. Hospitalizations tick upwards, but aren’t near the peak of months ago and in part are driven by the backlog of elective procedures now being performed (which inflates virus numbers, because some of these elective admittances come in with it). What was justified three months ago now has become disproportionately restrictive of people’s liberty, given the diminishing havoc the virus could produce.

While this doesn’t mean racing immediately to phase 4 because of vulnerable people still out there, it does call into question the reversal by Edwards earlier this month and yesterday’s announcement that the state will continue in that mode for another two weeks. Practically speaking, Edwards policy is lengthening into a marathon what should be a sprint, making the public no safer while trampling needlessly on their liberties.

That the data he uses to justify this may be suspect makes his choices all the more disastrous. Numerous parishes continue to dispute credibly the higher numbers reported, and it’s bad enough that testing delivers a net 10 percent over-reporting of positives (30 percent false positive, 20 percent false negatives, or a stupendous 50 percent error rate).

Using inflated numbers to concoct bad strategy only heaps more incompetence onto an existing incompetent handling of the situation. Policy matters, and in the final analysis Louisiana is the state worst off because of Edwards policy choices. Edwards and his administration need to pay better attention to the data and its quality and what science says about the virus, instead of sanctioning an overbearing government response in the belief that government must indemnify everybody from death by coronavirus – and the expansion of government size and power needed to accomplish that.

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