On July 11, this newspaper published an editorial commending to readers a book written by Andy Slavitt regarding the response to the COVID-19 epidemic. Slavitt may seem an inapt choice for such a book or editorial, given his frequent inaccurate predictions and observations regarding the course of the epidemic and his indefatigable support of suppression measures that have been shown to be largely futile and to have caused more harm than benefit to the population as a whole.
An article in this paper in October noted Slavitt's support for a supposed virus-crushing — and soul-crushing — six-week complete shutdown of everything. He cited several nations that supposedly followed such a course with success, but almost every one of them, such as England, Italy, the Czech Republic, and currently Japan and Thailand, went on to have substantial waves of cases.
What is most striking in looking at epidemic curves from various areas is both their textbook shape and the visible lack of impact from differing suppression regimes. A recent study from the National Bureau of Economic Research examined the effect of stay-at-home orders on mortality across 43 countries and all U.S. states and found no beneficial effect, consistent with several prior pieces of research.
Recently, Slavitt has been spreading fear and misinformation about the delta variant, claiming it is twice as infectious and has worse outcomes, referring to it as COVID-19 on steroids. The Public Health England, where delta has been the dominant strain for a number of weeks, publishes a regular technical bulletin on all variants of concern. The most recent of those shows that delta has a lower hospitalization and death rate than did the prior predominant strain, alpha or B117, and that its transmissibility is roughly the same as alpha. Pretty weak steroids.
But what is more striking are the lessons he would have us learn, particularly those regarding Americans' character and soul. Slavitt refers to the ugly selfishness of many. I must differ both as to that characterization and regarding the primary lessons that should be taken from our response to the epidemic. Is it ugly selfishness that led many Americans to wish to keep their jobs? To not lose their businesses? To have their children continue with their educational and social progress? To be with elderly loved ones in their last days? To resent government orders that were promulgated in an undemocratic manner with little actual support in data or research? Slavitt apparently believes we should all just slavishly kowtow to these pronouncements as words delivered on high from the gods themselves.
In fact, there is every reason to disregard the government epidemic-suppression measures. Most people do not understand how unprecedented these measures were. Never before in a respiratory virus epidemic had restrictions such telling people to stay home, closing businesses or cutting off access to health care even been considered. These measures were justified on models universally found to be far off the mark. The large and growing body of research on the epidemic response almost universally finds that lockdowns made no difference in case spread, that closing schools made no difference, that social distancing and plastic barriers and constant cleaning have no value.
Just last week a Danish study found that Denmark's mass testing and trace program, which included banning people from certain activities and places unless they had been tested, not only did not lessen spread, it may have increased transmission. Unprecedented, too, were the methods of case and death attribution, which fed a campaign to frighten the public. And research demonstrates that governments around the world adopted a panicked herd mentality; the most significant factor for predicting enactment of a suppression measure was whether a neighboring country or state had done so.
These suppression measures exacted a frightful toll on the population that will be felt for literally a generation or more and that ultimately will exceed the toll from the epidemic itself. Millions lost jobs; tens of thousands lost businesses. Domestic abuse, psychological problems and drug and alcohol use and deaths all rose to new heights. Children were horrendously affected, losing educational attainment, which in turn will damage their lifetime economic status. Many children simply abandoned education. We have a mental health and suicide crisis among children. They missed needed vaccinations and other health care, as did adults, leading to excess mortality likely to be sustained for several years. As always, minorities and low-income persons were affected the most.
The primary lesson Americans should have learned from the epidemic response, and the one many have learned, is that you can't place wholehearted trust in either political leaders or experts. I became an adult during the Vietnam War so was ingrained with a strong impression of government's dishonesty and lack of transparency that has stayed with me, and those characteristics have consistently stayed with every government I have seen. Scientists and public health experts have often revealed themselves to be political creatures, guiding their "research" and advice with the benefit of one party or another in mind. The media largely abandoned its obligation to challenge authorities and to insist on full transparency and a clear justification for government actions.
And governments generally have ignored reasonable suggestions from those outside the circle of power. One simple example from Minnesota is that I and others since the beginning of the epidemic have begged the Department of Health to release death data on the basis of date of death, not date of report. This would give a more accurate picture of the course of the epidemic and would facilitate tracking outcomes by cohorts of cases. The department ignored this request until two weeks ago, when suddenly the change was made, using the same rationale that had been presented to it more than a year ago. I could cite countless other examples of this failure to respond to reasonable data and analysis requests and to mislead the public about what data actually shows. People are justified to be highly distrustful in this environment and should always find the facts and reason out the truth for themselves. Citizen analysts and researchers keep the government from misleading the public without challenge and generally were more accurate regarding the epidemic than were the prominent experts.
A well-known Minnesota musician once wrote "you don't need a weatherman to know which way the wind blows" and recommended in the same song "don't follow leaders." My lesson from the epidemic response is a reinforcement of the determination to think for myself. I strongly encourage everyone to do the same and to constantly pressure governments to be fully transparent and to enact policies that do the greatest good for the entire population.
Kevin Roche is a health care investor and consultant and writes the health care policy and research blog The Healthy Skeptic.