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I’ve posted about covid19 a lot over the last few months, but never commented on if we should shut down the country or when we should re-open, because I didn’t have enough data for a high conviction view. Now I think it’s clear we need to quarantine vulnerable and mostly re-open-
2/ there’s still much we don’t know. I’m scared by the possibility that even asymptomatic cases may produce serious long-term health issues. But there simply doesn’t seem to be a viable alternative to mostly re-opening. “Track and trace” seems like TSA security theatre.
3/ even countries with the most effective track and trace programs like Singapore seem to have failed to contain the virus. https://slate.com/news-and-politics/2020/04/singapore-coronavirus-outbreak-migrant-workers.amp?__twitter_impression=true
4/ the best case would be to successfully contain it. If we can’t though, trying to with “shelter in place” is the *worst* choice. We’ll still end up with most people getting infected but we’ll also cause much greater economic (and indirect health) harm.
5/ with that said, “flattening the curve” remains prudent. We still very much want to avoid our health systems getting overwhelmed. Current evidence suggests this doesn’t require the level of quarantining we’re currently doing in most areas of the US.
6/ to be clear - re-opening the US *will* result in faster covid19 deaths, and maybe more total covid19 deaths. But we have no reason to believe it will change the total dramatically since containment seems clearly impossible. And quarantining causes a great many indirect deaths
7/ it’s also worth noting that aside from simple mortality, “track and trace” creates many social and political problems ranging from loss of civil liberties to furthering disparate health and economic outcomes among privileged and less privileged communities.
8/ these costs might be tolerable if we had reason to believe it would in total, meaningfully save lives. I think current evidence suggests the opposite.
9/ I write all this based on the data currently available, and in light of the public policies currently being discussed as viable. If I get new data, my opinion may change. At least now I feel like I have enough data to *have* an opinion.
10/ to clarify one key element here: theory vs practice. Containment might be possible in theory. It’s not in the US with current infrastructure and leadership. We have doctors warning people not to drink bleach and lies from the top on testing availability. Dems not much better
11/ in NYC for example, we had both the governor and mayor encouraging people to go to sporting events long after the pandemic was clearly ripping through the state. I’m not saying we shouldn’t contain, I’m saying for practical reasons, we can’t in an efficient way.
12/ we had the FDA blocking covid19 testing over a bureaucratic snafu. We had the CDC and surgeon general telling people not to wear masks. Bernie Madoff isn’t suddenly going to be Warren Buffett tomorrow. Our bureaucracies and political leadership weren’t/aren’t competent.
