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John Livingston

We Could Have Done Better

In my last article entitled Comorbidities and Unintended Consequences, I reviewed several anecdotal case studies and how type two Covid mitigation techniques may not have been the most efficacious in combating Covid19. I have argued early on that traditional type 3 mitigation—isolating the elderly and those with comorbid conditions could have produced better morbidity and mortality outcomes than wide based public health shutdowns and isolating well people from each other. From the beginning of the pandemic until today communal command and control top-down policies with the emphasis on the number of cases within a population instead of the number of people with the disease who needed hospitalization and those that died, led to bad decisions. Public policy became more important than patient care. Population testing “en mass” became more important than targeted testing of at-risk patients in high-risk institutions. Government bureaucrats and “expert” hospital administrators supported by a lazy uncurious press with a political agenda—Alex Berenson being the exception, created a psychological milieu ripe for a populace who were scared into conformity.

Those who dared to question the public health experts, medical and scientific experts, or those heads of government agencies that directed the Covid response in the States and Public Health Districts were often ostracized, personally, professionally, and politically. People like Dr’s Jay Bhattacharya and Scott Atlas from Stanford, Marty Makaray from John’s Hopkins, the signers of the Greater Barrington Declaration, and Georgetown Medical School and Mayo Clinic trained Ryan Cole in Idaho have been correct in their scientific assessments and recommendations far more often than their critiques. (Dr.) Jim Jones ESQ —where did he get his medical degree?, or David Pate (ESQ. DR.) and their syncopate accomplices in the media have been ruminators of doom for two years. Jones and Pate should both apologize to Dr. Cole publicly for their misguided hateful rejections of his scientific judgements and opinions. He has been right far more often than they. The great Robert Zollinger always told his surgical house staff—”the experts, as time goes by, will be proven wrong more than 50% of the time”.

This month from two highly respected sources—the largest metanalysis of data (I personally believe metanalysis is like making soup with lots of ingredients) from the Rand Corporation Herby et.al, concluded “lockdowns increased all case mortality to a significant level”, and most importantly Working Paper 29928 entitled A FINAL REPORT CARD ON STATES RESPONSE TO COVID-19, by Phil Kerpen, Steven Moore and Casey Mulligan from the National Bureau of Economic Research published last week supported the claim by The Rand Corporation. I will use these two resources to make my argument. I would also refer the reader to the graph of co-morbid conditions by age group at the end of my last article and to the graphs at the bottom of this article showing the relationship to trauma deaths, comorbidities, and age. The graphs are precisely the same for Covid-19 if you replace liver failure with renal insufficiency.

Because of our Federalist system of government State and local responses varied somewhat across the country. Certain demographic conditions also had an impact on mitigation—no matter the type. Urban populations with high density living conditions were a strong negative. An island State like Hawaii, or an isolated State like Alaska or Maine also were able to use mitigation techniques unique to their situations. But we can also compare similar States that used different strategies and I believe unequivocally that type three strategies have proven to be most effective by a long shot. The factors that we should have always been concerned with were education, economic, and health outcomes. Not how many people tested positive and were asymptomatic.

The correlation between health outcomes (morbidity and mortality) and shutting down the economy was zero. What that means is that States that withdrew the most did not significantly improve health outcomes. In fact, in New York and New Jersey outcomes and shutting down were negatively correlated due mostly to the way the transfer of patients from hospitals to nursing homes happened. Where populations could be isolated in island nations and states (Hawaii and New Zealand) the initial surge was slowed with shutdowns but the second and third variant peaks were increased. Natural immunity that occurred across the world with the Omicron variant was delayed. Maine that opened schools three times faster than Hawaii had a health score just as good—at the top of the states. Age adjusted Covid-19 deaths were higher in Idaho than in Florida (287.1/100,000—265/100,000.

Over ninety percent of Catholic Schools remained open except for the first two weeks of the first surge. In private schools across the country that remained open their health scores were the same as the schools that closed. Students had more of a chance of catching the virus at home from adults than they did at school. In Idaho only two children under the age of 18 died of Covid-19, less than the average death rate for seasonal flue.

Another figure that is butchered in the scientific and lay press is All Cause vs All Case Fatality rate. CDC measures the last number every year and two years before Covid about 2.8 million people died, and the first year into Covid 3.2 million people died—of all causes. The difference is much less than the total Covid deaths reported, and we are now coming to know—like the lady reported on in my previous article with delayed diagnosis of her metastatic colon cancer, that other causes of death have increased during the pandemic including cancer, and cardiovascular deaths, and just as importantly the suicide rate went up to over 100,000, year an increase of 15%. And we still don’t know in Idaho or any place else how many people died from or with Covid-19.

Health outcomes, economics (shutdowns of businesses), and education all had to be looked at in their totality. Some States did very well—Idaho scored 10th overall mostly because of the demographics of our large open State and the health of our people (comorbid conditions), but when compared to a state like Florida or Texas, or South Dakota, Vermont, or Montana, we didn’t do as well as we should have. This all comes down to the mitigation strategy prescribed by “experts” who were anything but experts. Dr. Hahn was great and did her job well. The others on the Governor’s advisory Board including Dr. Pate (ESQ) who along with Dr. Jones (ESQ) has been so critical of others with alternative theories, proceeded with tunnel vision. Lacking knowledge, they could provide little wisdom when giving advice to the Governor. He would have been better served if he had received advice from people with an open mind, and who understood foremost and always their job was to provide scientific advice, not to define individual or familial risk. Compare what Governors DeSantis and Abbott accomplished in Florida and Texas—both States with more challenging demographics and an older population. A nurse on the advisory Board would have also helped, who was down for the fight in the trenches and not looking at the situation from the perspective of a lobbyist or special interest group.

We could have done better in Idaho. We should have done better in Idaho.

In Idaho, the “experts” failed us.

The symbiotic corporate collusion between government agencies and private or non-profit hospital systems failed us—not the doctors or nurses that work at those facilities—most feel the same way. The medical and nursing staffs at those facilities is deserving of far better leadership than they had during the pandemic. One group had a voice in setting public Covid Policy, the other two (working doctors and nurses) didn’t. Crises Standards of Care (CSC) and the emergency protocols that followed violated patients’ rights, secured in most states limitations of liability for substandard care of policy makers and institutions, and resulted in conditions that did not produce the best of overall outcomes.

Before anyone does a victory lap in Idaho, they should at least admit that they could have done better—MUCH BETTER.

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