Evidence Based Politics to Beat COVID

Only evidence based politics can save our democracy. In this replay of the Cold War between communism and the American idea of freedom, China won. China won because despite early mistakes, they tackled the greatest challenge of the 21st Century with evidence based medicine not politics. Today’s article in the New York Times delves into the how deep our COVID crisis still is:

There are a thousands stories to illustrate how long our COVID ordeal has been. The New York Times chose to tell the story of an ICU nurse from Oklahoma City, Lizanne Jennings. In the Spring, Oklahoma braced for a New York size onslaught, it didn’t come. In the summer, she went off to Texas to help.

In March, Ms. Jennings remembered sitting after work one day with her husband, Dennis Davis, a machinist and former bodybuilder.

“I need you to pay attention,” Ms. Jennings, 53, recalled telling him. “Look at me: People we know, people we love — our family, our friends — people are going to get this virus. And people we know are going to die.”

She returned to Oklahoma this fall, with many of her friends, in the deep red Oklahoma still not believing the virus was real. Last Friday, her mother, Linda Jennings, who had been infected with the coronavirus, died.

“I’m weary and I’m miserable,” she recalled her mother, who was 78, saying as she lay in a hospital bed. “I can’t do this anymore.”

Then on Monday, Ms. Jennings sat beside her husband, eight and a half months after warning him of the dangers of this frightening new virus. He was lying on his stomach in a hospital bed, hooked up to a machine that helps with breathing. He had been admitted 11 days earlier, she said, with a Covid-19 diagnosis.

“I love you so much,” Ms. Jennings remembered saying as she held his hand in the last hours before he died. “I said, ‘You’re going to go, OK? I’m letting you go. You’re going to be at peace.’”

I was angered by the needless march of this disease, touched by Ms. Jennings story. I live in a small Wisconsin town and her description of the denial of the public health threat is as true here as there.

I make my living challenging medical professionals, especially those who work for insurance companies who try to evade evidence based medicine, to claim that carbon monoxide does not cause permanent brain damage. Epidemiology is core to proving a carbon monoxide case. Thus, when COVID struck, I followed the science closely, from the safety of my conclave in rural Wisconsin. I have not spent a night away from home, or eaten in a restaurant since March 11, 2020. But most people don’t have the ability to work at home like I do. Most are forced to give up strict social distancing to survive.

Here is the comment I wrote to today’s New York Times story:

The epidemiological curve of this virus has been crystal clear since April, despite the White House Task Force misdirection. In March, there was an article in Lancet from Wuhan that said the virus could only be controlled with 85% mask compliance. It waxes and wanes, depending how scared people get, but there was no chance to defeat it without comprehensive tracing, which was never really attempted.

It could have been worse, the number could be two to four million. It still could get to be a New York level in South Florida, although, when fear kicks in, the numbers drop.

It has been said countless times, but history must record it. Had the Trump administration acted in February, the death toll could have been low five figures. If Trump had modeled a mask, it would not have ever gotten to the 50,000 he promised in April would be good news.

This has been political genocide. All these deaths because of one man’s ego, one man’s calculation as to how to save a failed presidency.

This is his biggest crime. Yet, I am not even sure he was held accountable for it at the polls. He got more than 70 million votes. I think his mask stance may have helped him.

Somehow, to save our society, our great democracy, we must find a way to get real news, real facts to that other 48% who don’t read newspapers.

Thank you New York Times.

Only evidence based politics can save us. My first degree was in journalism and there was a time where the writing for the New York Times might have been the pinnacle achievement for me. The newspapers of our country may be the only thing that stands between us and a failed country. Unfortunately, a large segment of our country, far larger than I would have believed until Election Day, doesn’t get news as part of its daily information intake. In Journalism school at Northwestern University, objectivity was our creed. Only in newspapers does that continue to be the standard.

My comment references a March paper in Lancet that mandate that an 85% Mask compliance was necessary to defeat the virus.

What is Required to Prevent a Second Major Outbreak of the Novel Coronavirus COVID-19 Upon Lifting the Metropolitan-Wide Quarantine of Wuhan City, China: A Mathematical Modelling Study. https://papers.ssrn.com/sol3/cf_dev/AbsByAuth.cfm?per_id=3257337

Here is what that paper, published on March 3o said:

Early quarantine lifting on 21st March is viable only if Wuhan residents sustain a high facial mask usage of ≥85% and a pre-quarantine level public contact rate. Delaying city resumption to mid/late April would relax the requirement of facial mask usage to ≥75% at the same contact rate.

Instead, the White House COVID Taskforce was talking about reopening by Easter and no one was wearing a mask. Much of April, Trump was bragging about keeping the fatalities as low as 50,000 instead of 250,000. I was so angry at the time I started to keep my own daily tally.

My April Warning

Here is what I posted on April 30, 2020:

As trial lawyers, our natural instinct is to distrust everything that comes out of the administrations mouth, even the hostage medical experts, Fauci and Birx. Our instincts appear to be substantiated by high quality medical research. As someone who has been watching what has happened in the NYC metro area from the safety of my wooded environment in central Wisconsin, I do apologize for any lack of empathy my take on the future might imply. I do not get what you guys are going through; I only know that it is coming here too.

A few of the facts that I have been focusing on.
The Curve: The curve is not flattening nationally. Despite a major drop in NYC area deaths, there were 2,612 reported deaths yesterday. With the exception of two days when NYC reported a bunch of deaths that were outside of hospitals, this is one of our worst days yet.
The curve so to speak, is a matter of the density of the populated places it gets inside of the fastest (not necessarily the hardest.) It is easy to say if you live in west Texas or central Wisconsin that this is a big city problem and as long as you can avoid density, it may avoid you. But even in small town American, we have dense places like meat processing plants, prison, and yes schools. And yes, we have nursing homes too. We have a nursing home in Berlin, Wisconsin and a pretty good small hospital. Once COVID gets inside that nursing home, it will overwhelm that hospital in days. But why would we worry. We aren’t a big city, how would it get its start here? Two cases in our County so far, wait now it is two. Yet Brown County, Wisconsin is small town America, too, except they have meat processing plants, which is why they call them the Green Bay Packers. Now a 1,000 cases from the meat processing plants.

Mortality. Fauci moved the goal posts again this week, before the last two days of 2,000 plus deaths to 80,000. For the first time I heard him say that the issue might not be a second wave in the fall, but that the virus will have never left. On Tuesday:  “In my mind, it’s inevitable that we will have a return of the virus, or maybe even that it never went away.” Keep in mind that Sunday’s reported deaths were 1,378 and Saturdays 1,126. Below is a chart which shows the daily deaths reported by Johns Hopkins.

Evidence based politics must look at hard science rather than political considerations in managing epidemics, climate, hunger.

The modeling out of the University of Washington where these numbers the Trump folks are relying on come from has almost nothing to do with medical science but would more accurately be categorized as “analytics,” ala the sports analogy. https://jamanetwork.com/journals/jama/fullarticle/2764824?
What is the true case fatality rate (“CFR”)? All of the projections have been based on the Wuhan data. Yet, the CFR in Europe is far higher. While the deaths per positive case number ratio is clearly too high to predict a CFR, by how much is it really too high? (On one hand not everyone who had the disease died, on the other hand not everyone who died has been counted.) When an epidemic is as mature as it is in Italy and Spain, it may a meaningful relationship. Currently Spain has 24,543 deaths out of 239,000 infections. Italy has 27,682 out of 203,000 cases. France and the UK are even worse. In contrast, China, where all the projections are coming from had 4,637 out of 84,000 cases (if you trust the Chinese reporting.) I have been looking and I haven’t seen anything that has revised the CFR against the European mortality figures.
Treatment. While progress for treatment and a vaccine are the only hopes, these two articles from Lancet should provide some perspective.
Morbidity – Brain Damage. Another thing that is missing is in this reopen the economy is calculus of the disability that may occur in those who survive this. Brain damage is a real possibility. Hypoxia of this level can kill brain cells, but perhaps more dangerous is the inflammatory/immunological response, like you might get in a carbon monoxide poisoning or other hypoxic event. It may be years before we figure that out and young people don’t appear to be immune from catastrophic events like strokes.
The Facts and the Science Matter. What is my point? The facts matter as we look towards the next few months. Stay home, maintain every possible social distancing measure you can. It may be a long time before we can safely impanel a jury.
I wasn’t prescient. I was wrong about some things. The death rate, the CFR, has been less than I anticipated. The slower but methodical pace of the spread to all 50 states has not yet created the need to triage cases where some who couldn’t get treatment might have lived. We have gotten better at treating the sickest, which might change if our hospitals get overwhelmed. But I wasn’t wrong about the threat, and I wasn’t wrong about the cost. Next year the studies on brain damage will start to surface.
The April 2020 White House projections were flawed because they relied on confirmation bias, not epidemiology.  From the JAMA article referenced above:
For instance, the predictions assumed similar effects from social distancing as were observed elsewhere in the world (particularly in Hubei, China), which is likely optimistic.
Those words were published on April 16, 2020. Armed protestors invaded the Michigan State Capitol, demanding an end COVID precautions on May 1, 2020. https://www.bbc.com/news/world-us-canada-52496514  Trump tweeted his approval.
Trump never modeled a mask. Until the COVID scare was staring my neighbors in the face, they didn’t either. Yes, there will be a vaccine. Jury trials will some day resume. We may not get to 1,000,000 deaths in the U.S. before that. But the difference between the deaths here and in China has a been a political genocide, all for one man’s ego.
If we don’t insist on evidence based politics–use our collective creative capacity to penetrate the sphere of Trumpism with facts–it won’t just be a COVID genocide, the cost will be the United States of America. The only way to Make America Great Again, is to insist on facts and evidence in our marketplace of ideas.

Attorney Gordon Johnson, BS-Journalism, Northwestern University-1975.

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