Friday, May 22, 2020

The Progressive Case For Reopening America (And Never Shutting Down Again)

Recently there was an article titled "The Left-Wing Case Against Lockdowns" that explains in detail why genuine leftists and progressives should oppose extending these coronavirus lockdown policies.  It basically echoes what we at the TSAP has been saying for weeks now, namely that these policies have not aged very well and are doing more harm than good in the long run. And the empirical evidence actually bears this out:  non-lockdown countries are generally outperforming lockdown countries on average, and within the USA, non-lockdown states have also been outperforming lockdown states in terms of coronavirus case and death rates per capita.

The supposed effectiveness of lockdowns (compared to far less extreme restrictions) in terms of slowing or stopping the spread of coronavirus has been called into serious question lately by more recent studies.
Such studies have found there is at best no correlation, and perhaps a perverse effect between the two defining features of hard lockdowns (stay-home orders and closures of all non-essential businesses) and COVID-19 cases and deaths per capita after other factors such as less-extreme policies are accounted for.  The benefits are thus nothing more than a statistical mirage that does not stand up to scrutiny--much like the supposed benefits of the 21 drinking age vis-a-vis DUI deaths in the long run.

Meanwhile, the collateral damage (economic depression, inequality, poverty, alcohol and other drug abuse, domestic violence, child abuse, loneliness, poor mental health, delayed medical treatment, etc.), which also kills people too by the way, continues to mount with each passing week of lockdown, making an utter mockery of practically all progressive and even basic humanitarian priorities.  And that's to say nothing of the civil rights and liberties, as well as community cohesion, that progressives generally support.  It seems that the "cure" is quickly becoming far worse than the disease as time goes on.

(And that's just for the affluent countries.  For poorer countries, the collateral damage will most likely be at least an order of magnitude worse and deadlier.)

As for the disease itself, here is what we already know:  The horse has already bolted long ago, the train has left the station, the genie is out of the bottle, and herd immunity is ultimately inevitable at some point (if we're not already there in some places).   That is the only way the pandemic will finally end for good, since any effective vaccine or miracle cure will most likely come far too late.  Fortunately though, the true infection fatality rate is revealed to be far lower than was originally believed, and most likely somewhere between seasonal flu and pandemic flu (though still nothing to, um, sneeze at of course).

Thus, whatever the original merits of these sweeping, medieval-style quarantines (unprecedented on such a large scale and for such an extended period of time), there is really nothing "woke" or progressive about extending them any further than yesterday.  It is no longer "merely" about lives versus livelihoods anymore, but increasingly about lives versus lives.

So what would a progressive reopening plan look like?  At the TSAP, we believe that the following schedule should be the case:

Phase 1:  End of stay-home orders and "bubbles", and gatherings of up to 10 people permitted.  Construction, manufacturing, and select retail reopened with restrictions, with priority given to small businesses. Masks required in all public places where six feet of distance cannot be maintained.  Parks and beaches reopened with restrictions.

Phase 2:  Gatherings of up to 20 people permitted.  All retail stores reopened with social distancing and 50% occupancy restrictions.  Restaurants, but not bars, reopened with 25% occupancy restrictions.  Masks required for all employees and customers of reopened businesses whenever practical.  Select places of amusement reopened with restrictions.

(Somewhere around this point, reduce the six-foot rule to three feet, in line with the World Health Organization's recommendation of one meter distance.)

Phase 3:  Gatherings of up to 50 people permitted.  All retail stores reopened with social distancing and some occupancy restrictions.  Salons, barber shops, and other "hands-on" businesses along with gyms and fitness centers reopened with strict hygiene standards and occupancy restrictions.  Restaurants reopened with 50% occupancy restrictions, select bars reopened with 50% occupancy restrictions and table service only.  Nightclubs and casinos remain closed.  Places of amusement reopened with restrictions.  All schools and educational facilities reopened, and all daycares and camps reopened as well regardless.  Some professional sports leagues at least partially resume, without the fans of course.

Phase Out:  Gatherings of up to 100, then 500 people permitted.  Everything including nightclubs and casinos reopened, albeit with some occupancy restrictions.  Bar service now permitted.  Mask wearing is now voluntary, except on public transit and for employees of higher-risk businesses, where it will remain mandatory at least at first.   Six-foot rule is now just a common-sense and non-absolute guideline rather than a hard and fast rule.   Hand and respiratory hygiene still taken as seriously as ever.  All schools and educational facilities reopened, period.  Professional sports leagues fully resume, without fans until at least Labor Day, then fans very gradually reintroduced to stadiums/arenas.

Each of the first three phases will last two weeks (or one week each for both Phases 1 and 2, if the onset of Phase 1 happens to be delayed until June 15 or later), while Phase Out is indeterminate but will likely last for 90 days or more.  Ideally, Phase 1 would not have begun until a state is at least two weeks post-peak, but after June 1st states may not have the luxury of waiting any longer to begin reopening (if they wish to avoid irreversible economic damage and a long-term depression).  If during any phase there is any resurgence in disease there should be a further pause between moving to the next phase, but otherwise full steam ahead with no backtracking after June 1st.

(Any reimposition of tighter restrictions after June 1st should be limited to the local level only, not statewide or nationally.)

Indoor gatherings, which are riskier than outdoor gatherings, should probably have a tighter limit.  For example, thet could have a cap of 10 people indoors vs. 50 people outdoors for Phase 3, or 50 people indoors vs. 500 people outdoors in Phase Out.

At all phases, mask and sanitizer kiosks should be available everywhere, and/or there should be a Taiwan-style free mask rationing app available for everyone.  And Taiwan-style temperature checks to enter most places should prevail through the first three phases and much of Phase Out as well.  (Hey, they must be doing something right over there, and with no lockdown or shutdown either.)

And while we clearly need to scale up testing and contact tracing, quite frankly the time to do that was weeks if not months ago, and we can no longer afford the luxury of time at this point.  We will simply need to make do with what capacity we have right now and in the immediate future, even if we have to do it the Japanese way of focusing mainly on the larger clusters instead of every single case out there, which is far less resource- and labor-intensive.

As for vulnerable populations (elderly, immunocompromised, and/or those with underlying health conditions), the lockdowns have utterly failed to protect them, so extending the lockdowns will not benefit them at all.  Rather, they should be encouraged (but not forced) to stay home as much as possible and avoid crowds during Phase 1 and 2 (and possibly 3), and nursing homes should continue to ban visitors or allow only one designated visitor per family during at least the first three phases of reopening.  And for the love of all that is good, immediately stop discharging still-contagious hospital patients into nursing homes!  Shame on any policymakers (New York, I'm looking mainly at you) who thought that was somehow a good idea!

The TSAP also supports a far more robust stimulus that includes Universal Basic Income and Medicare For All, and the rest of Rodger Malcolm Mitchell's Ten Steps to Prosperity.  We also support expanded unemployment benefits, expanded Social Security, and a Green New Deal.  And of course the HEROES Act.  It is not too late to prevent the greatest depression the world has ever seen--but only if we both reopen reasonably soon and implement such programs sooner.  It is NOT an either-or.

Also, it should really go without saying of course, but we at the TSAP do NOT support any sort of reckless behavior, rioting, violence, or death threats against Governor Gretchen Whitmer of Michigan or any other governor or government official regardless of how much we dislike their policies.  We hereby denounce and condemn such behavior, period.  Peaceful protests which follow proper health and safety precautions, fine, but anything else has no place in our movement or any other movement worth its salt.

UPDATE:  The TSAP does NOT support Trump's Fourth of July military parade or any other parade, campaign rally, or mass gathering of similar size at this time, as it is really far too soon and thus very, very ill-advised.  We believe that even the best-performing states and localities who appear to be almost out of the proverbial woods in terms of the pandemic should still do their darnedest to avoid gatherings of more than 50 people before July 4, and more than 500 people after that until at least Labor Day at the earliest.  The deadly lessons of the 1918 flu pandemic loom large.  But if we must have a second wave, which Dr. Fauci himself claims is somehow (but hopefully not) inevitable, frankly better it should happen in the summer when the virus is less virulent than in the fall or winter, and as a bonus, those Trump supporters who will be earning Darwin Awards will thus "thin the herd before" they can vote in November.  Unfortunately, these fools also put others at risk as well--they should at least be wearing masks to protect others even if they don't care one iota about themselves.  (At least it won't fall on the conscience of progressives this time.)

JUNE UPDATE:  It looks like several states are seeing spikes in COVID-19 in recent weeks following reopening.  While some of it is due to increased testing, the very large spikes in Texas, Arizona, Florida, California, and some other states also show increases in hospitalization rates*, so at least some states are seeing real increases.  And those are generally the ones who reopened before even reaching their peaks, while California's early flattening of their curve seems to have merely delayed the bulk of their infection burden.  And interestingly, Georgia had not seen any real spikes until very recently, despite being the first state to reopen.  Meanwhile many states, most notably New York and New Jersey, have not seen any spikes at all despite increased testing and massive protest rallies in recent weeks.  Both were among the first states to have mandatory mask requirements, and were also the earliest and hardest-hit states.

(*Even the increase in hospitalization numbers may be less than meets the eye.)

Thus, it may not even be due to the timing and pace of reopening at all, but rather due to how many people are wearing masks, and simply that states that were hit harder earlier, the epidemic has largely run its course, while the states that started with milder outbreaks simply still have a ways to go yet.  And overcrowded bars and nightclubs seems to be the biggest culprits in the new hotspots lately.

It is notable that death rates are still dropping nationwide despite the apparent surge in daily cases to new record highs.  Even in the new hotspot states, deaths are generally low and flat or declining, and even Arizona's death rates are still following the same old slow-burn pattern they had before reopening despite being the fastest-growing state in terms of positive test results lately.  Most new cases are coming from younger people (under age 35), a possible reason for the apparent decoupling of infection rates from death rates, and suggesting herd immunity likely occurring sooner rather than later.  Or perhaps we have learned (often the hard way) better ways to treat the disease, thus saving more lives.  Or the virus itself could simply be getting tired and losing its "mojo" after circulating so much for so long.

Also, here is another good article for any anti-lockdown leftist or progressive.  And another.

Wednesday, May 13, 2020

Reborn On The Fourth Of July? (Updated Part Deux)

A little gallows humor:  What do Julius Caesar and America as we knew it have in common?  Both died on the Ides of March (March 15).  That date was, indeed, roughly when America began to shut down to one degree or another.  But will America be reborn on (or before) the Fourth of July?

There is much debate lately about how and when to ease lockdown/shutdown restrictions and re-open the country for business.  Unfortunately, neither side seems to do nuance very well if at all.  Opening up everything or nearly everything all at once overnight would of course be reckless and cavalier, risking a resurgence of the virus (and associated deaths) and eroding much of the progress that has been made thus far.  But continuing the status quo indefinitely (or even simply taking too long to ease restrictions) is also not very wise either since that will do irreversible economic damage and likely will still not conquer the virus entirely.  Thus, if we wait too long, there may not be anything left to re-open by then, at least for small businesses.  And that's to say nothing of the adverse consequences to civil rights and liberties, mental health, and community cohesion as well.

(And you know, slopes are much, much slipperier than they appear, as Orwell spins in his grave.)

The supposed effectiveness of lockdowns (compared to far less extreme restrictions) in terms of slowing or stopping the spread of coronavirus has been called into serious question lately by more recent studies comparing those locations that had lockdowns and those that did not, or differed in the timing.  The results strongly imply that the observed declines in COVID-19 deaths (and thus the number of infections three weeks prior) was actually driven by the more moderate social distancing measures that were in place earlier, not the lockdowns, based on the timing.  And if there somehow was any extra effectiveness of the most extreme measures such as lockdowns, it is most likely only a short-term effect that eventually reaches a point of diminishing returns after which the "cure" really DOES become worse than the disease.

In other words, lockdowns early enough (and long enough) in the curve to successfully suppress the disease are unnecessary since more moderate measures apparently work just as well when done that early, while belated lockdowns are apparently worse than useless in terms of total excess deaths.

Perhaps the much-maligned Swedish mitigation strategy of moderate social distancing (not to be confused with the mythical "do nothing" strategy) really isn't so crazy after all?  The train has clearly left the station long ago for a suppression strategy to work at this point, and herd immunity is ultimately inevitable at some point in most countries (including the USA), if we're not already there in some places.

And support for reopening is clearly NOT just for right-wingers and fringe folks, by the way.   An even stronger left-wing and progressive case can also be made for ending the lockdowns sooner than later as well.  Keep in mind that Sweden is largely run by progressives, and even their self-proclaimed "conservatives" are still largely to the left of most American Democratic Party politicians today.

Thus, a careful and gradual but fairly speedy easing and re-opening is what is called for, in order to minimize the damage from both the pandemic itself as well as from the restrictions in place to suppress it.  The timing should vary by state and locality as well as exactly which types of restrictions to be eased and which types of businesses to re-open.  It would probably be best for all states to wait until at least two weeks post-peak (whichever is later) before making any major changes (though baby steps can and should be taken sooner).  Some states have already peaked in early to mid-April, others in latw April to early May, while others will not peak until well into May.  Hospitals would also have to not be overwhelmed as well (fortunately, very few are).  And testing would at least ideally be significantly ramped up along with contact tracing and individual quarantining--which should have been done weeks or even months ago--as well in order to move forward into the later stages of reopening.

(Though at this point, large-scale testing and contact tracing would probably best be put in the "wouldn't that be nice?" category rather than decisive.)

And of course we need a far more massive stimulus, and the Ten Steps to Prosperity that Rodger Malcolm Mitchell recommends.  Because even if we re-opened tomorrow, consumers will still be too cautious to come roaring back right away, and the damage is already done.  Especially a significant and permanent UBI, which would cure even the worst depression a lot sooner than not implementing a UBI.

Mitchell also recently wrote an article noting that reopening can be done a lot sooner, safer, and more cheaply simply by requiring everyone to wear masks in public (at least when practical to do so) and provide such masks for free to everyone via kiosks.  And with a little bit of nuance added to the mix, this seems to make the most sense of all for now.

Trump's latest guidelines for reopening are surprisingly reasonable now, likely because he finally consulted with experts rather than just going with his gut as usual.  But his administration is really lagging on providing coronavirus testing kits, which would clearly hinder any reopening strategy.  So they really need to speed that up.  It was, after all, due to the Trump administration's recklessness and negligence that this pandemic got so far out of control here in the first place, and it is estimated that up to 90% of the deaths could have been averted had they acted sooner and not screwed up so monumentally.

Thus the TSAP recommends that all states gradually lift lockdowns and partially reopen by Memorial Day (with many states doing so in early May) and fully lift all significant restrictions (except perhaps for restrictions on very large gatherings of, say, 500+ people) by the Fourth of July at the latest.  While some outlier states like Georgia rushed the reopening process (though interestingly, it still did not turn out to be the disaster that was predicted), most states are being cautious to a fault right now in terms of reopening, and you really can't blame them in the current climate of fear.

At the local (county and municipal) level, some hotspots may choose to still maintain tight restrictions or reimpose them in the event of a resurgence of the virus, but these restrictions should be exactly that--local.  In a similar vein, states may also impose modest, New Rochelle-style "containment zones" or "red zones" where local outbreaks or large clusters are observed.  As we move past the initial crude "sledgehammer" phase of suppression and into the more refined management phase, we need to be careful in how we calibrate such measures to avoid doing more harm than good in the long run.

As for school closures, that should really be decided locally for the most part.  While school closures are known to work very well in the short term in slowing the spread of infectious diseases in general, the longer-term effects are unknown, and children and teens seem to be at relatively low risk from this virus as well as not a particularly significant vector for spreading it to adults.  While some evidence strongly suggests that temporary school closures early in the epidemic curve have helped to flatten that curve (even if only indirectly to reduce the number of adults infecting each other), it remains unclear how long such benefits can last (likely not very long).  Some countries like Iceland, Denmark, and Taiwan have already reopened schools with no evidence of resurgence of the disease, and Sweden never closed them at all for children under 16.  Certainly they should at least plan on reopening in September at the very latest absent evidence of a large second wave of the disease.  And the usual summer school programs and even summer camps should be seriously considered as well.  At the very least, daycares (if not schools as well) should be opened yesterday, as it is really the only way to get the economy going since so many of American's workforce are parents of young children.

Regardless of the effectiveness (or lack thereof) of lockdowns, simply going straight from red to green overnight would be utterly foolish, since it's really still too soon to safely encourage a massive influx of tourists when the "all-clear" signal is given.  So we should thus go from red to orange, then yellow, then green, and we really only need a few weeks (not months) of orange and/or yellow in between.   And even green does not preclude very mild restrictions and common-sense precautions as well.

We have already flattened the curve.  Now let's keep it flat, without also flattening the economy as well.

UPDATE:  It should really go without saying, but we at the TSAP do NOT support any sort of reckless behavior, rioting, violence, or death threats against Governor Gretchen Whitmer of Michigan or any other governor or government official regardless of how much we dislike their policies.  We hereby denounce and condemn such behavior, period.  Peaceful protests which follow proper health and safety precautions, fine, but anything else has no place in our movement or any other movement worth its salt.