Several weeks ago, I wrote a series of 4 articles trying to explain why good people in the scientific community looked at the same data and came to very different conclusions. We discussed “risk tolerance transference”, “herd dynamics”, and finally several forms of bias including outcome and hindsight bias. Within the past 2 days, two books have been released from publishers—One entitled The Premonition: A Pandemic Story by Michael Lewis that is a perfect example of hindsight bias. Using articles from THE LANCET and other medical journals and by interviewing “experts” the book tries to repeat a running narrative about the severity and devastation of the Covid-19 pandemic, and at the same time explain why these “experts” many who are quoted and interviewed in the book were so correct in their initial assessment of the threat and their designing of mitigation strategies. The book is historical fiction at best. I have always been a fan of Michael Lewis—THE BIG SHORT AND COACH but applying a retrospective analysis on the public health response in our country by the very people who designed that response is flawed. The book in my opinion is not worth reading because of this flaw.
The second book I read this weekend is Doom: The Politics of Catastrophe by Niall Ferguson. It does not subject itself to any of the biases found in the 1st book. The book does not try to support a failed narrative or failed science, but meticulously points out where bureaucracy and the “experts” failed. His support for the clinicians who took care of sick patients as opposed to his criticism of the Federal and most of the State’s public health response is well founded in my opinion.
I have tried to find a way to explain my positions regarding data analysis and mitigation strategy within the framework of the pandemics—Spanish flu in 1917 and the Asian (H2N2) flu in 1957. I have had millennials—many of them professional including my own children tell me “this pandemic is our own Pearl Harbor” or this is just like the Spanish flu or this is the “great challenge of our generation”. Many people today who have been defining themselves as “experts” in our State are in a similar position of those in leadership positions in our military and Congress. They have never been in a fight or a battle, so they have no perspective of what a real battle or pandemic is all about. I have always supported Dr. Hahn and her role in advising the Governor. She has done a good job of defining the threat, but it was never her job to assess risk. This was the job of “experts” who were in fact lobbyists and cronies of our Governor. Not one ICU nurse on his task force and who better to report the facts on the ground than someone who was in the fight?
In today’s Wall Street Journal, two economists, Charles Hooper and David Henderson, define the pandemic in actuarial terms—a way I was unable to explore myself—-nor do most of the experts have the tools for such an analysis: The most important point of the article is that early on—our State included. The benefits of protecting the old and at-risk groups far exceeded the costs. Secondly the costs of protecting the young and healthy far exceeded the benefit. There was never an excuse for closing schools. A one size fits all approach with only 35% ability to protect everyone cost lives and will continue to have a negative impact on our country for at least one generation. Using actuarial data and techniques it is estimated that for every year of lost school a person will lose over $100,000 of lifetime income.
The cost of “protecting” everybody especially universal lockdowns, but also universal masking, quarantining, and school closures, must be measured against the benefit of death and prolonged hospitalization and the chance of infecting others. They begin by using the Infection Fatality Rate (IFR)—the probability that a person once infected will die from the disease, and determining for the entire world that it is 0.23%, and for the USA it is 0.4%—we are overall less healthy and we also have better reporting mechanisms, but here is the kicker—they show that for those over 80yrs of age the rate is 2000 times higher than for an 18-year-old.
The primary risk for Covid-19 is of course death. By using life expectancy tables, IFR and chance of being infected, Scientists at Cal Berkley and Stanford estimated that mitigation techniques in the USA decreased the chance of being infected by 35%–at best. There was and has never been such a thing as “perfect protection” for a population, but consider the consequences between “best practices imperfect protection” between an 18-year-old with 61 years of lost life with an IFR of .004% and a protection rate of 35%, and an 80-year-old. Multiplying these numbers together tells us the statistically expected years of lost life for an 18-year-old would be 0.0009 years or 7 hours! Using the same formula and actuarial tables for an 80-year-old with a 2000 times higher chance of dying that person would lose 65 days of life. Counterintuitive yes, but in our country, we actually do a good job of taking care of the elderly and those with co-morbidities when they become sick. The benefits of protection to risk are 210 times higher for the elderly.
The cost of protection includes not only the cost of medical care, but the cost of unemployment—-PPP checks and increased unemployment benefits are a future cost because they are mostly paid for with debt, paid off by future taxes, Using the previous loss of income numbers for an 18-year-old is losing a $100,000 worth the price of 7 hours at the end of your life? The cost to benefit for an 80-year-old person is close to zero—if they are retired and we use only wages and not investments and this zero cost comes for an extra 65 days of life. And certainly most octogenarians would be happy for an extra 2 ½ months with loved ones and dear friends and if they chose to isolate themselves using type 3 mitigation strategies that time could be much longer.
Our clinicians—doctors and nurses and med techs were heroes. They defined the clinical problem and very quickly adjusted and changed. They communicated across the internet, and didn’t rely on bureaucratic directives and “best practices” promulgated from on high by professors at medical schools in academic journals like The Lancet. Politicians and their expert advisors should have focused their protection and mitigation strategies on the vulnerable 11%. Had they a better understanding of the enemy and the terms of engagement we would have saved more lives.
I could not have said it better than Messrs. Hooper and Henderson—but maybe I have and did? Sure glad I am not an “expert”, but they have nothing to worry about. They played along with the media political narrative and they will never be held accountable nor will our legal system hold people like governor Cuomo accountable—he, after all, followed the advice of “experts”. See what happens when public health experts start practicing medicine—or politicians do the same?
I am glad I am not an expert today having to explain myself.
“Alibies destroy character” even when promulgated by MSNBC/CBS/CNN/WaPo and The NYTs and Mr. Faucci. Always the politician bureaucrat he, never a physician. His job changed once he started seeking the spotlight.
MAGA “Fight Like Hell”