Andrew Cuomo, governor of New York, is moving up in the betting odds for getting the Democratic presidential nomination, even though he is not running. The reason is that binge-watching newshounds have noticed something about his comportment during this crisis. He seems just slightly struggling to know what’s true. Sometimes he is even honest.
Consider this. On Thursday March 26, Cuomo dared question the orthodoxy that has wrecked countless businesses and lives. He revealed what actual experts are saying quietly all over the world but had yet not been discussed openly in the endless public-relations spin broadcast all day and night.
He said the following:
“If you rethought that or had time to analyze that public health strategy, I don’t know that you would say quarantine everyone. I don’t even know that that was the best public health policy. Young people then quarantined with older people was probably not the best public health strategy because the younger people could have been exposing the older people to an infection. “
“What we did was we closed everything down. That was our public health strategy. Just close everything, all businesses, old workers, young people, old people, short people, tall people. Every school closed, everything.”
It’s true that anyone following the unfolding fiasco and the gradually emerging data behind it knows that Cuomo is right. The response has not been modern and scientific. It has been medieval and mystical. The theory behind the policy has been nothing but a panicked cry of run and hide before the noxious gas gets you. Lacking reliable data – which is the fault of the CDC and FDA – we replaced knowledge with power.
In the end, this fiasco is an epistemic crisis. As Ed Yong has written in a beautifully detailed article for The Atlantic, “The testing fiasco was the original sin of America’s pandemic failure, the single flaw that undermined every other countermeasure.” Even the wide acceptance of social distancing as a norm, however much it helps curb the spread, presumes this absence of knowledge. Stay away from everyone as much as possible: a slogan that reveals how little we know.
And yet lacking that knowledge, the politicians, cheered on by the media, acted in ways that have fundamentally wrecked life as we knew it, all in the course of a couple of weeks.
The massive knowledge gap was filled by a cascade of predictive models made possible by modern statistical packages readily available by subscription to any member of the clerisy. If this, and this, and this, and if this and this and this, then ENTER. Out pops what appears to be a precise presentation of our future under the following conditions, along with an overlay of embedded cause-and-effect assumptions about certain policies followed or not followed. Day after day we were bombarded with such predictions, and we paid close attention because we had little in the way of actual on-the-ground facts that have been available to us in previous disease panics.
It then became the perfect storm. Risk-averse politicians deciding to do something, anything, to avoid blame. Bureaucrats doing what they do best, which is telling people no, you cannot innovate, you cannot produce, you cannot distribute. Local tyrants stopping price gouging and therefore preventing the price system from working. A howling media famished for eyeballs, ears, and clicks. A public panicked about disease and death. An egregious dividing of people into essential and nonessential. Policy snares, tangles, missed opportunities all around.
The cacophony of information chaos has been palpable, unbearable.
All the while, a few knowledgeable experts have been trying their best to weigh in and get some slight attention for rationality. My heart, in particular, goes out to the esteemed Professor John Ioannidis who has been exposing fake science based on bad data his entire life and has been previously celebrated for doing so. He writes as often as he can, while still trying to be as precise and accurate as he can. Apparently such high-end people have a private email list in which they share observations and data, while doing their best to bring calm while civilization is falling apart.
At the moment, we are enacting extremely severe measures in an effort to do something. However, we have very little evidence-based data on how to guide our next steps. We really don’t know where we are, where we are heading, whether our measures are effective, or if we need to modify them. There is a possibility that many of our aggressive measures could be doing more harm than good, especially if they are to be maintained in the long term. There will be major consequences in terms of lives lost, major disruptions to the economy, to the society, and to our civilization.
At this juncture we need to act swiftly. At the same time, we need to act equally swiftly to collect unbiased data that will tell us how many people are infected, the chances that someone who is infected will have a serious outcome and die, how the epidemic is evolving in different settings and places around the world, and what difference we are making with the measures that we’re taking. This information can make a huge difference and there is a lot that can go wrong if we don’t have the right data.
This has been an acute situation. At the same time, collecting reliable data should not take time and should not halt our decision-making process. Getting information on representative samples of the population is very easy. It has been done in Iceland, where they have a cohort covering most of the national population looking at samples that have been provided. They see that they have an infection rate of 1.0 per cent, and up until now only two people have died. So, out of the 3,500 infected people in Iceland there have been two deaths, which corresponds to an infection fatality rate lower than the common flu. Of course, some people may be infected later, but nevertheless, these estimates would be very different compared with the original claims of case fatality rates of 3.4 per cent that were circulated.
At the same time, we have other pieces of evidence that the number of people who are infected is much larger compared with the number of cases we have documented. In most places, with few exceptions around the world, we are just testing people who have substantial symptoms who have come to seek health care or even to be hospitalized. These are just the tip of the iceberg. The Iceland experience and other data from Rome and Italy where entire city populations were tested shows that the vast majority of people are either completely asymptomatic or mildly symptomatic in ways that you would not be able to differentiate from the common cold or common flu. This information makes a huge difference while we are proceeding with aggressive measures of social distancing and lockdowns that may have tremendous repercussions, especially in the long term.
As the song says, stop making sense.
I write on Saturday morning March 28, and right now there are two contrary strains about to collide. On the one hand, you have scientists reducing their death-rate predictions further and further, lopping off zeros by the day. On the other hand, this is accompanied by appalling levels of despotism, even to the point of National Guard checkpoints at state borders and restrictions on what you can buy even at “essential” stores. This gigantic gap between emerging professional medical consensus and appalling policy ignorance is revealing as never before the practical impossibility of scientific public policy.
Then you have the cascade of unintentional and unexpected outcomes of the rush to coerce. It began with Trump’s disastrous block on flights from Europe that sent millions scrambling for tickets and led to an unspeakable crush of people standing shoulder-to-shoulder at our nations’ airports, contradicting the demand that people social distance just when the virus was revealing itself as highly contagious. The very opposite of intended results!
That’s just the beginning. I doubt seriously that the political class in this country, as low a regard I have it, set out to destroy all that we call civilized life, instantly generating millions of unemployed workers and bankrupt businesses all around, not to mention a pandemic of utter hopelessness on the part of vast swaths of the world’s population. Still, this is what they have managed to achieve. This is what their pretense of knowledge – as opposed to actual wisdom – has unleashed on the world, with incalculable human cost.
As for economics, are we talking recession? Depression? Those words indicate cyclical changes in business conditions. My friend Gene Epstein suggests another term for what we are going through. The Great Suppression. There will be months, years, and decades in which to more clearly observe the countless ways in which the supressors piled error upon error, blockage upon blockage, to add to the grotesquery.
What truly should inspire us all right now are the grocers, pharmacists, truck drivers, manufacturers, doctors and nurses, construction workers, service station attendants, webmasters, volunteers of all sorts, philanthropists, and specialists in a huge variety of essential professions who keep life functioning more or less. And let us not forget the “unessential” people (it’s an incorrect and vicious term) who have innovated ways around the Great Suppression to continue to serve others, keep the rent being paid, and food on their tables. They are the means of salvation out of this mess.
The market, hobbled and bludgeoned, still loves you.
As for the politicians, Andrew Cuomo has admitted some of the error. In a much-welcome change, he has even deregulated medical services. There’s just a hint of humility and humanity embedded in these statements and actions. We need more of that, vastly more, if only to contribute to calming things down long enough to gain some perspective, and, hopefully, some eventual realization that in the “land of the free and the home of the brave” a virus should be regarded as a disease to mitigate and cure, not an excuse to bludgeon life on earth as we know it.