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Good reporting on the pressures on public health officials and the politicization of science since last spring. Undoubtedly Trump and his supporters bear much responsibility. However, looking ahead its even more important to understand the failure of Democratic leaders. 1/ https://twitter.com/nytimes/status/1350936312849838084
Democrat-led states have managed covid transmission much more effectively overall than Republican-led states since the spring. But that's a low bar. Even the best performing Democrat-led states are only middling by international standards. Many more lives can be saved. 2/
The US is not the only western state to severely botch the fall covid surge. Other leaders delayed action that was advised by their health officials and experts, and have now tightened restrictions. Not to excuse Trump, but to note a pattern among some western governments. 3/
For example, in August, France's health department warned of exponential rise in infections.
"Macron said the government favors regional measures..and will do everything it can to prevent a new nationwide lockdown by 'learning to live with the virus.'"
4/ https://apnews.com/article/virus-outbreak-health-lifestyle-travel-europe-226bd083269e91bcbda0122d73c361b9
"Macron said the government favors regional measures..and will do everything it can to prevent a new nationwide lockdown by 'learning to live with the virus.'"
4/ https://apnews.com/article/virus-outbreak-health-lifestyle-travel-europe-226bd083269e91bcbda0122d73c361b9
The NYT article presents Washington State as a success case. They highlight that if the US had the same death rate as WA, 220,000 fewer people would have died.
But 180,000 is still a large toll. After major errors this fall, Germany's death rate is about the same as WA State. 5/
But 180,000 is still a large toll. After major errors this fall, Germany's death rate is about the same as WA State. 5/
Many deaths in WA were the result of policy choices to reopen businesses over the summer with insufficient workplace regulations. The state especially failed to protect agricultural workers. The result was highly disproportionate exposure and death. 6/
https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/data-tables/COVID-19MorbidityMortalityRaceEthnicityLanguageWAState.pdf
https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/data-tables/COVID-19MorbidityMortalityRaceEthnicityLanguageWAState.pdf
The Seattle/King County Dept of Health reported in November where they believe people were being exposed to covid. The most likely exposure source outside the household was non-healthcare workplaces, and that is more pronounced for people of color. 7/ https://kingcounty.gov/depts/health/covid-19/data/~/media/depts/health/communicable-diseases/documents/C19/report-outbreaks-exposure-settings-covid-19.ashx
To be clear, Washington is one of the best performing large US states. Inslee is credited with doing a great job, but the death rate is higher than Canada. For WA Hispanics, the age-adjusted death rate is higher than the US death rate. Other Democrat-led states did much worse. 8/
The NYT article blamed the current surge in California on personal behavior. A large share of the deaths in the state occurred before December. If the US had CA's death rate, there would still be 280,000 deaths. 9/
Similar to Washington State, California failed to adequately protect agricultural workers. Large outbreaks predictably emerged in major agricultural centers where many workers live in crowded housing and use shared transportation. 10/ https://www.wsj.com/articles/as-california-struggles-with-covid-19-farmworkers-are-among-most-affected-11597665116
Los Angeles saw significant outbreaks over the summer as well, particularly connected to workplaces. Like Washington, people of color were hit especially hard. Cal/OSHA was overwhelmed and taking months to complete investigations. 11/
https://khn.org/news/la-county-workplace-enforcement-covid-rules-save-black-latino-lives/
https://khn.org/news/la-county-workplace-enforcement-covid-rules-save-black-latino-lives/
After making progress in the fall, Los Angeles experienced a massive outbreak. Again, officials believe that people are getting sick on the job and bringing the virus back into their household. The figures show dramatic differences in who is dying. 12/
https://www.latimes.com/california/story/2021-01-14/latino-black-and-poor-residents-suffer-dramatically-worsening-covid-death-rates
https://www.latimes.com/california/story/2021-01-14/latino-black-and-poor-residents-suffer-dramatically-worsening-covid-death-rates
LA County is currently investigating 538 workplace outbreaks. 13/
https://www.latimes.com/california/story/2021-01-13/home-depot-whole-foods-hit-hard-la-covid-19-outbreaks
https://www.latimes.com/california/story/2021-01-13/home-depot-whole-foods-hit-hard-la-covid-19-outbreaks
California has a Democratic governor and legislature, fifth largest economy in world, anticipated $26 billion surplus, its own occupational safety agency (Cal/OSHA), and a mask mandate. Since Dec. 3rd, many businesses are closed, but many remain open. 14/
https://covid19.ca.gov/stay-home-except-for-essential-needs/#regional-stay-home-order
https://covid19.ca.gov/stay-home-except-for-essential-needs/#regional-stay-home-order
Everyone knows that the UK has a horrific death rate at 1.6 per 100,000 per day and is now under lockdown. People may not know that Pennsylvania's death rate is at 1.7 per 100,000 and on Jan. 3rd the state's Democratic governor reopened indoor dining. 15/
https://www.pa.gov/guides/responding-to-covid-19/
https://www.pa.gov/guides/responding-to-covid-19/
The Democratic governor of Rhode Island allowed high deaths for months before finally implementing a 3-week "pause" at the end of Nov. Indoor dining remained open. If the national death rate were the same as Rhode Island, then the current death toll would be nearly 650,000. 16/
President-elect Biden has named the governor of Rhode Island to be his commerce secretary. 17/
The NYT article emphasizes the importance of a "unified national strategy" directed at the federal level and led by science. That is in contrast to an approach where experts are ignored or sidelined. 18/
“We will manage the hell out of this operation,” Mr. Biden said on Friday. “Our administration will lead with science and scientists.” 19/
The core failure of the the US covid response, according to the article, was reopening too quickly over the objections of advisers. 20/
But even as Biden has insisted he'll listen to the science, like Macron in France or governors in the US, he has also defined what he wants (to reopen) and what he will not do (shut down the economy). The question is whether "science" is expected to fit those constraints. 21/
From Biden's recently released covid plan:
"A critical plank of President-elect Biden’s COVID-19 plan is to safely reopen schools as soon as possible- so kids and educators can get back in class and parents can go back to work." 22/
https://buildbackbetter.gov/wp-content/uploads/2021/01/COVID_Relief-Package-Fact-Sheet.pdf
"A critical plank of President-elect Biden’s COVID-19 plan is to safely reopen schools as soon as possible- so kids and educators can get back in class and parents can go back to work." 22/
https://buildbackbetter.gov/wp-content/uploads/2021/01/COVID_Relief-Package-Fact-Sheet.pdf
In early November, Michael Osterholm was named to Biden's Transition COVID-19 Advisory Board. Osterholm has previously called for a lockdown. On November 12th, he gave an interview and repeated his recommendation for a 4-6 week lockdown. 23/
At 6:00 https://finance.yahoo.com/news/biden-coronavirus-task-force-doctor-says-4-to-6-week-lockdown-could-control-the-pandemic-141642095.html
At 6:00 https://finance.yahoo.com/news/biden-coronavirus-task-force-doctor-says-4-to-6-week-lockdown-could-control-the-pandemic-141642095.html
A Biden spokesperson quickly rejected the idea and instead emphasized testing and masks. Similarly, Anthony Fauci said that a lockdown was not necessary. 24/
https://abcnews.go.com/Politics/biden-covid-19-advisory-board-member-suggests-week/story?id=74173793
https://abcnews.go.com/Politics/biden-covid-19-advisory-board-member-suggests-week/story?id=74173793
Vivek Murthy, the co-chair of Biden's coronavirus taskforce, was also quick to reject lockdowns as unnecessary. "We have got to approach this with the position of a scalpel rather than the blunt force of an ax." 25/
https://www.politico.com/news/2020/11/15/lockdown-biden-coronavirus-taskforce-436594
https://www.politico.com/news/2020/11/15/lockdown-biden-coronavirus-taskforce-436594
Another taskforce member, Celine Gounder, expressed opposition to lockdowns in favor of targeted approaches. "I think of this as a dimmer switch, not an on-and-off light switch.”
This was echoed by frequently quoted public health expert Ashish Jha. 26/
https://www.cnbc.com/2020/11/13/biden-advisor-dr-gounder-says-covid-advisory-panel-doesnt-support-full-us-lockdown.html
This was echoed by frequently quoted public health expert Ashish Jha. 26/
https://www.cnbc.com/2020/11/13/biden-advisor-dr-gounder-says-covid-advisory-panel-doesnt-support-full-us-lockdown.html
On November 19th: "I’m not going to shut down the economy, period. I’m going to shut down the virus," Biden said. "I’ll say it again. No national shutdown." 27/ https://thehill.com/homenews/campaign/526787-biden-vows-he-will-not-implement-a-nationwide-shutdown
"I'm not going to shut down the economy, I'm going to shut down the virus,' Biden said, according to Bloomberg News political reporter Emma Kinery. "There will be no national shutdown.... There's no circumstance I can see that would require a total national shutdown." 28/
On November 19th, the covid death toll had not yet hit 250,000. There have been 150,000 deaths in the less than two months since Biden rejected the idea of a lockdown and his covid advisers all confidently agreed that lockdowns were not necessary. 29/
Fauci Jan. 7: "You know, at this point a total country lockdown, I don't think there's any enthusiasm for that. There's such a fatigue, a COVID-19 fatigue, that just people would have a real tough time with that...you may look at selective lockdowns.." 30/ https://twitter.com/NPR/status/1347294467045302272
The suggestion here is not that the advisers are wrong (though polling indicates the public supports restrictions). Science cannot tell us whether to prioritize continued economic activity versus human lives. Science can help us achieve the objectives we set for ourselves. 31/
If the goal is to save lives, then we might consider following the same science as the UK, Germany, and Canada are right now. If reopening is the priority, then there is science to help encourage people to go along with that. But there will be an enormous cost in lives. 32/
More information has come to light since November. Many more have died. There is the question of potentially more contagious variants. The vaccine rollout is not going according to plan. Hopefully President-elect Biden will ask his scientists how many lives are at stake. N/
