This is the text of an ad that was going to run in print in the Star Tribune. A digital ad will run instead on the paper’s website on Tuesday, directing people to this post. I would strongly encourage you to read all the coronavirus posts, I hope you will find them a source of useful information and thought-provoking ideas. And most of all, I encourage you to think about how we should deal with this crisis in a manner that considers the entire population. Please let public officials and others know your own perspective. And please, do whatever you can to donate to non-profit organizations or otherwise help the hundreds of thousands of Minnesotans who have lost their jobs. They are suffering.
I have also updated the content based on the release of significant information regarding the model the Governor relied upon in ordering the widespread shutdown of business and social activity. You can read in other posts some commentary on the model, which I think is reasonably constructed, but suffers the usual flaws of early models with inadequate data to make good assumptions. You can get a lot of materials on the models here and you should read those materials, especially the powerpoint. (Mn. Model Materials)
When you read those materials, you will conclude as I have, that the results of the latest model run do not support at all the continuation of the shutdown order in its current form. The outcomes are the same if we only focus on protecting the at-risk groups and maintain basic mitigation measures for the rest of the population as if we keep the current extreme shutdown. So we should immediately end that shutdown and move to a more targeted strategy, as Sweden has used all along.
That means the vast majority of the working age population could return to work, businesses and schools could reopen and people could return to normal social activities. There is no reason not to implement this approach immediately. And it was also revealed that no analysis was done in regard to the economic and non-economic harms that would flow from various mitigation of spread strategies. This is simply astounding, the Governor shut down economic and social life without any consideration of the damage that would be done by such an action.
The Governor seems like a decent person and I am sure he is doing his best to provide calm leadership. But his judgment and decision-making in ordering the economic lockdown instead of a more targeted, balance set of mitigation of infection spread measures has been dreadful. He has relied on erroneous models and now is ignoring the results of those models. He has completely failed to take the harms to all Minnesotans into account.
It should be apparent to everyone who reads the paper or has other sources of news that actual infection rates and death rates in Minnesota have been and will be far lower, even with modest mitigation measures, than the worst case projections being used by the Governor and others to justify more extreme lockdowns. Modeling is a complicated topic and people tend to focus on large and sensational numbers. The Governor justified his original shutdown order by saying otherwise 74,000 Minnesotans would die. This number was based on absurdly large infection and death rates that are not supported by any evidence and have since been greatly reduced. And, according to the model the Governor used to justify the order, 50,000 Minnesotans were still projected to die. How different would Minnesotans’ reaction have been if the headlines had read “In Spite of Extreme Lockdown, 50,000 Minnesotans Will Die”. And now the models say that regardless of the mitigation of spread strategy we use, around 20,000 Minnesotans will die. The projections from the original model were wildly wrong and these latest projections are also far too high, but they show the same number of deaths whether we continue the extreme lockdown or use a more targeted one.
The deaths that supposedly are delayed are largely due to not overwhelming health resources, but there is also no evidence to support the idea that this would occur, especially at the greatly reduced number of infections and hospitalizations that the state’s model now forecasts. Why were such wildly inflated numbers used? One explanation is that the higher the numbers you project, the better you look when the actual numbers come in much lower. And this is exactly what we see, with the Governor claiming that his order is “working”, when in fact, the number of cases and deaths used to justify shutting down business in the state were never going to occur.
The fact is that the vast majority of Minnesotans have a low risk of becoming infected and a very low risk of dying. The current rate of positive test results is only 4.3%, there are less than 200 current hospitalizations and under 100 deaths. The risk of infection, serious illness, and death, are very skewed to the elderly (the average age of those who have died in Minnesota is over 85), those with respiratory disease, and those with immune system issues, which is unfortunate for these populations and they should be protected. Isn’t it possible to protect these groups to a large extent without destroying the lives of the general population? If the working age population has a very low risk, why shouldn’t they be able to go on with their jobs and lives as normal.
It is critical that people understand that under the Governor’s rationale, the extreme shutdown does not have the effect of saving lives, it is merely delaying infections and deaths. So the Governor’s order may be “working”, but it is only working to delay the inevitable, under the state’s model. The virus is not going away. Sooner or later some number of infections and deaths will occur. So one of two things is true; either the model used by the Governor to justify the extreme shutdown is right, and we will still see a very large number of deaths eventually and the shutdown is largely futile; or the model is completely in error and we were never going to see the number of deaths projected by that model, which would call into the question the rationale for the lockdown.
What is most likely is that model at the time of the original issuance of the shutdown order and in the most recent runs, is substantially overestimating deaths. On the same use of mitigation measures, the projected number of deaths has fallen by over 50% and is still almost absurdly high. And we should accept that the harder we try to suppress spread, the longer the process of having a substantial part of the population develop antibodies takes. A vaccine, which is uncertain in its protective effects, is at least a year away by all experts’ opinions. Can we keep the economy and our society locked down for that long?
Our leaders are acting as though mitigation measures are all or nothing. Each mitigation measure is incremental, each can and should be weighed on its own, with its own benefits in terms of delaying infection spread and deaths, and its own costs in terms of economic and non-economic harms. If a package of mitigation measures that does not involve an extreme economic shutdown provides a significant portion of the benefit to be gained in delaying infections at a low economic cost; why are we engaging in the extreme lockdown? The most recent model runs evaluating different mitigation strategies find essentially no difference in death outcomes from any of the strategies. So why are we continuing with the most extreme version?
UNLIKE THE UNCERTAIN HARM FROM THE CORONAVIRUS, WE KNOW EXACTLY WHAT DAMAGE WE ARE DOING TO OUR ECONOMY
The economic harm, and the non-economic ones, from the extreme lockdown are enormous, unprecedented, unfathomable; there really are not words to adequately describe what is being done to tens of millions of Americans, primarily low and middle-income. 20 million jobs lost already, a projected 25% drop in economic output. Suicides; declines in health leading to greater illness and death; child and domestic abuse; drug abuse and alcoholism; mental illness; homelessness; food insecurity, the list goes on. We see this occurring in our state now. Over 350,000 Minnesotans have lost their jobs.
These consequences must be weighed in decisions about mitigation measures. They aren’t being weighed now. The people suffering them generally don’t make campaign contributions, they don’t have lobbyists, they don’t have an army of Twitter and Facebook followers to advance their agenda. They are relatively voiceless and I feel impelled to speak up for them. How can we have so little empathy for the plight of these people and be so callous about the effects on them?
WE NEED A DIFFERENT PLAN THAT PROTECTS VULNERABLE POPULATIONS BUT STOPS THE ENORMOUS ECONOMIC DAMAGE WE ARE DOING TO EVERYONE. HERE ARE SOME SUGGESTIONS.
1. Immediately begin a large-scale randomized testing study of the population for both antibodies and coronavirus infection. Nothing is more critical than gaining this information to guide public policy. This is not expensive and could be done very quickly; it is a simple study. The Governor should order it immediately and explain why he hasn’t done so to this point. People who have antibodies could immediately return to work and a normal life. The testing should prioritize health care workers, first responders and those serving the public, like grocery store workers. The results of this testing would also help us understand the level of immunity in the population and inform us on appropriate mitigation measures.
2. The Legislature should be and stay in session, conducting hearings and taking evidence on the likely effects of the coronavirus epidemic and the harms of the extreme economic lockdown and should make the decisions about what the appropriate mitigation measures should be. It is undemocratic and a poor decision-making process for one individual, the Governor, and a few public health experts to be unilaterally deciding the fate of all Minnesotans.
3. The lockdown should be lifted immediately. Businesses should be encouraged to re-open and put people back to work. Schools should be re-opened. People who believe they are at risk of serious illness or are fearful should be permitted to continue to isolate at home if they wish to. Basic hygiene should be adhered to, testing should continue, with contact tracing for positive results and quarantining for the infected. At-risk populations—the elderly, those with respiratory illnesses, those with compromised immune systems—should continue to be isolated and protected from transmission of the virus. This is a much more balanced approach than is currently being used. The latest run of the models indicate that there would be no more deaths from this strategy than from continuing the current one.
4. The Governor must immediately be more forthcoming on what his plan is. How long does he plan to maintain this extreme shutdown? On what evidence will he base a decision to either maintain, modify or end the lockdown? Does he believe he is actually preventing deaths or is he just delaying them? How much economic and associated harm to Minnesotans is too much harm?
We should all be realistic, adopting this plan may mean some level of additional infections, serious illness and deaths from the coronavirus in the near term, but according to the state, those were going to occur eventually. On the other hand we already know what we are doing to jobs and the economy of the state, and to the lives and health of the persons affected by the shutdown. Those harms deserve to be considered as well, and they were not considered in issuing and maintaining the shutdown.
YOU ARE NOT POWERLESS. RAISE YOUR VOICES!!
Write and call the White House, your Senators, your Representatives, the Governor, your state Legislators, newspapers and radio stations. Whatever your perspective, make it heard. Insist that the Legislature go into and stay in session and do its job. Insist that the harms being done to millions of Minnesotans be considered. Insist that we be given complete and accurate information on the epidemic and on the economic shutdown.
And if you are on Twitter, share your stories of the effect of the lockdown on you, at #thecureisworsethanthedisease