Pandemic and the ‘fog of war’

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Jim Ryan Jr. argues that it’s time to restart the economy and end Gov. Andrew Cuomo’s New York State on PAUSE executive order. In Ryan’s piece for the Beacon, he contends the policy response to COVID-19 has been an overreaction fueled by media sensationalism and politicians’ fear of being perceived as weak or indecisive. 

Kent Gardner

He also finds comfort in a few individuals suggesting that the case fatality rate may be no more than the seasonal flu, about 0.1 percent. Ryan also notes that 61,000 flu deaths in the 2017-18 flu season did not spur such a dramatic response (the Centers for Disease Control estimates the COVID-19 toll in the U.S. as 55,000 as of April 28).

Have we overreacted? Should New York’s lockdown end?

It’s not time yet to open all doors. Maybe Ryan is right—but we don’t yet know enough to take the chance. 

We know that the virus is quite contagious. Over the past couple of weeks New York has been randomly testing individuals without symptoms for the presence of antibodies to the virus. While these tests aren’t completely reliable, one in five of those tested in New York City appear to have been exposed to the virus. 

That individuals can contract the virus and not be symptomatic may suggest that the virus isn’t serious enough to worry about. Let’s explore the implications of this particular number being right, however, (acknowledging that every number in this calculation can be challenged). The official New York City death count from COVID-19 was 12,067 as of April 26. If about 20 percent had been infected, we’re looking at a case fatality rate of 0.7 percent, seven times that of the seasonal flu. Apply this simplistic math to the 6.7 million New York City residents who have not yet been exposed: Allowing the virus to run its course risks about 48,000 lives in New York City alone.

Let’s apply this math to Monroe County. If 10 percent of the county’s population becomes infected, about 500 would die.

The number and per-capita rate of confirmed cases in Monroe County (vs. the number of suspected infections based on the new antibody testing) is low relative to downstate counties. The state’s worst-hit county is Rockland with 3,511 confirmed cases per 100,000 population, nearly 20 times the rate here in Monroe County (180 per 100,000 population). 

The CDC guidelines for a loosening of restrictions rest on a trend of declining cases and other criteria. Although the downstate trend appears to have turned, there is no such evidence in Monroe County. There were only 15 new cases reported on April 26—but 87 only two days before, a record high. Looking at the entire Finger Lakes region, in fact, the number of new confirmed cases in the previous week is 49 percent higher than in the week before.

A phased reopen still makes sense. What we knew about the illness in mid-March justified the bold action taken by Cuomo and other leaders. Don’t lose track of the basic math of geometric growth. Consider the lesson plan posted for teachers of mathematics on Mathalicious.com. In Q4, students play with a simple simulation with only a few variables—how contagious is the disease, what happens after infection, etc. It’s a bit clunky—but it demonstrates a few of the basics, e.g. if every person infects three, all 7.7 billion people on the planet are infected in 17 weeks. If infections per person drops to two, it takes 21 weeks. If the disease actually kills one in five, well, do the math. 

That said, it is time to begin loosening the restrictions outside the worst-hit downstate counties. We all know so much more about this virus than we did, and both individuals and businesses have stepped up. We all have some kind of mask now, not good enough to provide care to a COVID-19 positive patient, but sufficient for our forays into the public square with “social distancing” in place. Retailers have made physical modifications to reduce the risk to cashiers, either plexiglass “sneeze guards” or barriers to maintain distance. Density restrictions have become commonplace.

The governor announced that elective surgery will resume on May 15 for certain regions based on public health indicators. Golf courses are reopening with restrictions. We now have time to refine the list of permitted and restricted activities to reflect the risk of transmission without the need to parse the meaning of “essential.” 

The economic cost of New York’s PAUSE has been enormous. This, too, has taken lives, although indirectly. When this happens again, as it likely will, we might be able to apply lessons learned from COVID-19 and “stop the spread” with more targeted restrictions. We still don’t know if the policy response will prove to have been too restrictive—or not restrictive enough. Our battle with COVID-19 continues in the “fog of war.”

Kent Gardner is Rochester Beacon opinion editor. All Rochester Beacon coronavirus articles are collected here.

4 thoughts on “Pandemic and the ‘fog of war’

  1. Yearly flu statistics are not applicable when one considers that in the last six weeks we have recorded more deaths than the Vietnam War (58,000) . In mid March there were 100 deaths .
    There is also the possibility that the death toll is undercounted by thousands , especially in Nursing Homes and Veterans facilities were deaths spiked and were attributed to flu or pneumonia . There were no tests of the deceased tissue for Covid-19 , and we still do not have sufficient tests for doctors and nurses , let alone essential workers . Tracing has just started . In countries where leadership did not lie and show incompetence for two months , a move to open up has caused upticks in the spread of the virus , as Germany is seeing . Even Dr. Fauci said he expected 60,000 deaths by August 1st , but we will exceed that total by May 1st . We do not even know if someone who survived Covid-19 has immunity or can be re-infected . I guess we may listen to a leadership that lies every day and puts the life of the nation in the hands of ass kissers who have no experience , like a dog breeder and Jared Kushner . Pass the chlorine and Lysol cocktail glass . We need science to lead the way here.
    I think at least some of the push to reopen everything is a fear from Big Business and the upper classes is that an awakening is happening . An awakening that an economy where over 40% of workers make a median wage of less than $12 an hour (Non-partisan Brookings Institute) and are a pay check away from extreme hardship is not “The greatest Economy in History” . An awakening that many of the underpaid are the essential workers , and executives , bosses , and the one percent are not essential unless they pay high progressive taxes . An awakening that millions who have lost their jobs will lose their health care during a health care crisis when it’s most needed . An awakening that being the only country were health care is tied to a job , discouraging attempts at upward mobility , at twice the cost , with the big money going to health insurance executives and stockholders who treat and cure no one , is greed and not smart . There is the fear from the one percent and the politicians that they buy , that two generations of tax cuts for the wealthy is about to end if essential services like hospitals , education , first responders , infrastructure , and other essential public services are to be maintained . Just as Willie Sutton said about why he robbed banks , “That’s where the money is “. Yes , people want to go back to work , but now they know they deserve higher pay , that with rare exceptions they are not only essential , but their productivity produces most wealth , and they have a right to work , with a voice , without endangering themselves and their families . These are the people , with the advice of medical professionals and scientists who are independent , who will tell you when it’s time to return to work and what the new normal will be . The times , they are a changing .

  2. I don’t support rapid re-opening. I have a few concerns. First, how prepared will workers be to re-enter the workplace and perform the required tasks? Second, and I think this is a complete unknown, how many customers will return to their old spending habits? Keeping in mind that many of them have not been working and may not have much discretionary income to spend. Third, some businesses, especially manufacturing and some retail, are heavily dependent on foreign supply chains for parts and products. If those businesses can’t get inventory, they can’t sell anything. In a sense, companies exist as a highly interdependent global closed loop. Fourth, and again this is an unknown, how much have people shifted their buying habits from bricks and mortar to online purchases. Finally, what happens to a sole proprietor if they don’t believe in safety precautions and then become gravely ill from an infection passed on by an asymptomatic customer?
    Some personal service businesses will be swamped when they re-open, and others will possibly close their doors due to a change in the market. It would be much safer to open gradually and allow the market to adjust to the new realities.

  3. Thank you to both writers for giving us a thoughtful debate on the important question of re-opening our businesses. While I realize that our business, especially our small businesses, have a real need to re-start, I agree with Kent that we need to be cautious – very cautious. But, it is easy for me to say this. I’m retired and among those who have been defined as most at risk.

    Here’s my concern. The American Way is to charge ahead. I am deeply afraid that is exactly what we will do. While I can stay hidden away and protected by the walls of my house, when things begin to open up, I expect that I will be more vulnerable than I am now.

    Please be patient.

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