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May 29, 2020
The Experts Were Wrong. Evidence Must Guide Us Now–– Issue #88

In the five months since the first known COVID-19 case was reported, policymakers have much more evidence to guide better and more informed decisions about opening the U.S. economy and keeping vulnerable people safe.

Galen Senior Fellow Doug Badger and Heritage Scholar Norbert Michel provide a valuable roadmap based upon their detailed review of what has worked and failed in an important new paper, “Policymakers Should Adapt COVID-19 Responses to the Evidence,” published by The Heritage Foundation.

First the evidence: 
  • The pandemic remains geographically concentrated
  • COVID-19 is primarily a threat to the elderly
  • Those with comorbidities face higher risks
  • Public officials are failing to protect those in nursing homes
  • The case fatality rate appears to be less than initially feared
  • U.S. hospital capacity has so far proven robust, and 
  • Widespread curbs on non-emergent care are ill-advised.
Instead, too many governors and local officials still are insisting that lockdowns continue, schools remain shut, and businesses crippled.  

In light of this evidence, Badger and Michel say policymakers should follow these recommendations: 
  • Replace widespread stay-at-home orders that treat all counties in a state the same with an approach that tailors policies to local circumstances 
  • Implement enhanced, more traditional public health interventions in communities where infection rates are high—voluntary isolation facilities for the sick, contact tracing, testing, and, in some cases, travel restrictions
  • Protect those who are at greatest risk—the elderly and those with underlying medical conditions
  • Protect those in nursing homes, and
  • End statewide bans on non-emergent care.  
    [To that end, nearly 1.7 million have read my Forbes piece from last Friday, “600 Physicians Say Lockdowns Are A ‘Mass Casualty Incident,” showing how desperately important it is for our health care system to open to non-COVID care.]
Lockdowns were not an unreasonable response when little was known about the virus, and when there were justifiable fears that hospitals might be overrun by a surge in patients, Badger and Michel explain.  But widespread lockdowns are unnecessary and damaging in most places and insufficient in hotspots, such as New York.

“We now know enough to develop policies that are targeted geographically, demographically (age), by place of residence (congregate settings for the elderly) and by infection intensity (pandemic hotspots),” Badger said.

“Governors who insist on staying with untargeted policies of questionable theoretical value should reconsider. Sweeping lockdowns are unquestionably ineffectual at protecting the vulnerable and harmful to those at minimal risk of severe morbidity or death,” he told us.

With more than 100,000 U.S. deaths (a shockingly high proportion in nursing homes), an economic depression, unprecedented levels of deficit and debt and reckless monetary policy, it is vital that policymakers retarget their responses to avoid exacerbating the catastrophe.
 

And for further evidence, Avik Roy and Gregg Garvin of the Foundation for Research on Equal Opportunity have taken a deep dive into available data on nursing home deaths to show our focus must change to protect the most vulnerable.

Avik writes for Forbes in “The Most Important Coronavirus Statistic: 42% Of U.S. Deaths Are From 0.6% Of The Population:”

“Let that sink in: 42% of all COVID-19 deaths are taking place in facilities that house 0.62% of the U.S. population.

“And 42% could be an undercount. States like New York exclude from their nursing home death tallies those who die in a hospital, even if they were originally infected in an assisted living facility. Outside of New York, more than half of all deaths from COVID-19 are of residents in long-term care facilities,” he writes.

And it’s worse elsewhere: 70% of COVID-19 deaths in Ohio have been among those residing in long-term care facilities, 81% in Minnesota, and 69% in Pennsylvania.
 

New York made a scandalously-bad decision in March to allow hospitals to send patients recovering from COVID-19 back to nursing homes and requiring nursing homes to accept them.

In “We All Failed”— The Real Reason Behind NY Governor Andrew Cuomo’s Surprising Confession,” Seth Cohen, writing for Forbes, captured a rare moment of candor from New York Gov. Andrew Cuomo speaking at a Memorial Day ceremony. Cuomo was asked when New York would fully reopen.

“Now, people can speculate. People can guess. I think next week, I think two weeks, I think a month,” the New York governor said. “I'm out of that business because we all failed at that business. Right? All the early national experts. Here's my projection model. Here's my projection model. They were all wrong. They were all wrong.”

Cuomo continued: “There are a lot of variables. I understand that. We didn't know what the social distancing would actually amount to. I get it, but we were all wrong. So, I'm sort of out of the guessing business, right?”

So instead of relying on clearly flawed models and guesses by “experts,” we must look at the actual evidence and change course immediately to save lives.
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