I know that way too many news cycles have come and gone for me still to be fuming about the performance Senator Rand Paul turned in at the May 12 hearing of the Senate Committee on Health, Education, Labor and Pensions; the one with the diss of Anthony Fauci -- “I don’t think you’re the end-all” -- that went, forgive me, viral.
It’s not that soundbite that’s sticking in my craw. It’s the rest of Paul’s five minutes, during which he threw a stronger one-two punch of arrogance and ignorance than some politicians achieve in a lifetime. More important, he both encapsulated and advanced a lethal misreading of all things COVID-19 that persists among way too many Americans with power over the course of this crisis, from the hydroxychloroquine-popper-in-chief to his civilian corps of faux-freedom rangers, willing to threaten anyone who stands between them and their imaginary constitutional right to in-restaurant dining.
In just 300 seconds, Paul spouted several factual inaccuracies about the COVID-19 situation in Sweden, in his home state of Kentucky and in rural America generally. He repeatedly discussed the pandemic in the past tense, as if the point of the hearing were to grade the government’s response to a bygone crisis rather than to help formulate its next moves amid an ongoing one. He treated statistical models as fixed bets to be placed, won or lost, rather than complex, dynamic projections that change depending on such variables as what policies come into play. He equated the adoption of a national strategy to fight coronavirus, for which many Americans have been clamoring, with the imposition of identical marching orders for all localities at all times, which no one has ever suggested. And he exhorted Fauci to have “humility” in the face of uncertainty while revealing that he himself has no idea what New England is.
Such ill-informed churlishness was by no means the norm among Republicans in attendance. Committee chair Lamar Alexander set a tone of collegial earnestness, reiterating his mantra that “all roads back to work and back to school run through testing.” Tim Scott spoke with such respect for the gravity of the pandemic, reverence for its dead, and regard for the ongoing safety of the front-line workers facing it that when he described South Carolina’s reopening strategy, Fauci said that he would like to clone it. Mitt Romney was a model of clarity and concision: blasting the Trump administration for its slow rollout of testing, lauding it for its swift moves toward vaccine development, and dropping his square jaw at the lack of decent real-time data out of the CDC while embracing the Congressional responsibility to ensure the remedy of that. So Paul definitely stood out.
It wasn’t just for his crabbiness and his quackery, either. It was for his air of authority. Because it was delivered with such confidence – and by a U.S. senator who is also a medical doctor -- his feckless rambling was easy to mistake for straight talk.
That is why it remains important to debunk, point by misbegotten point:
“We need to observe with an open mind what went on in Sweden, where the kids kept going to school. The mortality per capita in Sweden is actually less than France, less than Italy, less than Spain, less than Belgium, less than the Netherlands, about the same as Switzerland…”
Of course, one of the few amusing side effects of coronavirus is that it has caused some American right-wingers to fall suddenly in love with socialist Sweden for its having eschewed the degree of shutdown that has been embraced elsewhere. And who knows? It may turn out that, in the fullness of time, Sweden will have achieved such herd immunity that it withstands any “second wave” better than others, in which case it will indeed end up looking brilliant. As of now, though, Paul’s declarations about its death rate are just ludicrous. (Granted, since I am writing a full eleven days after the hearing, the numbers have placed Paul further in the wrong than he was in the moment. But that hardly helps his case.)
First, Sweden has had 396 deaths per million population. That’s notably more than the Netherlands (339) and about 45 percent more than Switzerland (220).
Belgium indeed has a very high rate (797), but that is because Belgium has adopted a much broader definition than other countries of what constitutes a coronavirus death.
Sweden does have a lower per capita death rate than Italy (541), Spain (613) and France (434), none of which is anybody’s idea of a success story. Then again, the first coronavirus deaths in France and Spain were reported in mid-February, and the first in Italy on February 22. The first coronavirus death in Sweden was announced in mid-March. So, adjusting for the time lag, Sweden is right up there (although not as far up there as the United Kingdom, which Paul did not mention but which started out with the same bring-on-the-herd-immunity approach before turning tail on it not long before its happily hand-shaking prime minister landed in the ICU.)
In other words, Paul is basically holding up a country which is jockeying for world number one in the most deaths per capita, and scolding those who fail to see that as a model.
“Basically, I don’t think there’s anybody arguing that what happened in Sweden was an unacceptable result.”
In order to equal Sweden’s death rate, the U.S. would have to have lost 99 more people per million by now. That is, about 32,500 more Americans would have to be dead – from something that did not exist in this country until a few months ago. Is “acceptable” really the word everybody would have for that?
Bizarre, too, is the rear-view mirror installed in that sentence: “…what happened; was; result,” as if the pandemic was all over but the congressional hearing, when there was and is every reason to believe that this virus is still lacing up its boots.
“We’re opening up a lot of economies around the U.S. I hope that people who are predicting doom and gloom and saying ‘oh we can’t do this, there’s going to be a surge,’ will admit that they were wrong if there isn’t a surge.”
As Paul spoke those words, the U.S. death toll was just cresting 80,000. Less than two weeks later, it is 98,705 and counting, begging the question of how many more corpses it will take for the senator to raise an eyebrow.
Then again, this comment isn’t so much about calculation. It’s about comeuppance. For Paul, this public-health emergency amounts to a fight between Americans who think that dire expert warnings should be heeded and Americans who think that they should be ignored, and once it’s clear how many have ended up dead, it will also be clear which side deserves to be humiliated.
The reality, of course, is going to be a lot messier. Though the very opposite of an expert myself, I’ll bet anything that when all is said and done, all these re-openings will turn out to have wreaked more havoc than expected in some places, less in others, and it won’t be entirely clear why. Also, between this moment and the saving stroke of vaccination, there will be an increase in treatments, such as plasma transfers or therapeutic drugs, that will render this contagion less deathly. On the other hand, given the number of people who will survive with permanent damage of some sort, it will reveal itself to be devastating in ways that the daily death counts are not communicating. For now, though, one has to do one’s best with the situation as it is.
By that standard, I will never regret taking the advice of specialists who spend their lives studying epidemics over that of politicians who routinely denigrate the idea of studying anything at all. And, no matter how lucky they may get this time, I will always consider it a bad idea for leaders to have greeted this epochal crisis with a great big cry of “everybody dive in head first and hope there’s water in the pool!”
“In rural states, we never really sort of reached any sort pandemic levels in Kentucky and other states We have less deaths in Kentucky than we have in an average flu season.”
Again, what’s with the past tense? Whatever else might be mysterious about this pandemic, it’s definitely still going on.
As for the old flu canard: In the worst flu season in memory – 2017-2018 – flu killed 333 of the senator’s constituents. So far, COVID-19 has killed 391 – more than half in the past month alone. And that was amid the very significant, often-attacked social-distancing orders of Gov. Andy Beshear.
As for the rest of rural America: On April 22, the death toll in Iowa was 90. As of May 22, it’s 433.
In Texas, over the same time span, the death toll went from 517 to 1512.
In Nebraska, it has risen from 38 to 147.
And that’s no surprise: “While non-metro areas currently have fewer coronavirus cases per capita,” stated a Kaiser Family Foundation report issued on April 30, “both cases and deaths are growing at a faster rate compared to metro counties.” Subsequent numbers have done nothing but bear that out.
Numbers aside, there is an obvious logical flaw to treating urban and rural America as such totally separate concepts: they often converge. Rural states have their cities. And even the least populated areas within those states do not consist of nothing but wide open spaces. Any store, restaurant, beauty salon, church, or, God knows, prison or meat-packing plant can function as a perfectly Gothamite contagion site.
“Outside of New England, we’ve had a relatively benign course for this virus nationwide.”
Wow. That line really stopped me cold, and not just because New England consists of Maine, Vermont, New Hampshire, Massachusetts, Rhode Island and Connecticut, and thus excludes the two states that have been hardest hit, New York and New Jersey.
Granting Paul a pass, and assuming that he meant to say “the northeast,” it’s still a breathtakingly asinine remark. How about Louisiana? Michigan? Illinois? Indiana? Pennsylvania?
Two-thirds of new coronavirus deaths are now occurring outside the northeast. If that’s the senator’s idea of “benign,” I’d hate to see his “malignant.”
“The history of this when we look back is going to be wrong prediction after wrong prediction after wrong prediction, starting with Ferguson in England.”
This appears to be a reference to Neil Ferguson, a mathematical epidemiologist at Imperial College London whose models predicted, as of mid-March, that in the absence of government intervention, the United Kingdom might suffer more than half a million deaths from COVID-19, and the U.S. some 2.2 million.
Of course, there’s no guaranteeing that had government leaders done nothing, the numbers would have been as dire as Ferguson and company predicted. But government leaders didn’t do nothing. With rare exception (good going, Taiwan!), they acted late, they acted imperfectly, but they acted, and thus caused the happy failure of reality to bear out the darkest prophecies.
So yes, thankfully, the modelers have turned out to be “wrong.” But should they thus be chastised? That depends. Would Senator Paul use a drop in lung-cancer deaths to discredit doctors who successfully warned their patients off smoking? Or denigrate homeland-security officials for acting on information that prompted the thwarting of terrorist threats on the grounds that those threats were never carried out?
Maybe he would. But in my view, the notion that professionals who reasonably predicted catastrophe in the absence of action should be ridiculed for producing the data that prompted the action that mitigated catastrophe is a whole lot more bonkers than the worst statistical model imaginable.
“And I think the one size fits all, that we’re going to have a national strategy of nobody is going to school, is kind of ridiculous.”
Yes, that would be ridiculous, which is why absolutely no one has proposed any such thing.
Back when it occurred, in April, the stupid scuffle between Andrew Cuomo and Bill De Blasio over who had the authority to close the New York City public schools seemed completely pointless. It does, however, now come in handy as a reminder that Democratic leaders within Democratic states aren’t even in lockstep on the details of shutting down and opening up. The idea that anybody is advocating for some kind of uniform and total national lockdown unless and until a vaccine is found does not exist anywhere except in the straw-man-building division of the Republican party.
Perhaps the senator could read a little something on World War II, in which the Allied forces did certain things in certain ways in Europe, and other things in other ways in the Pacific. But it was considered ideal to have a common mission, and at least some sense of who was doing what to achieve it.
“As much as I respect you, Dr. Fauci, I don’t think you’re the end-all. I don’t think you’re the one person who gets to make a decision.”
Neither, thank God, is Paul. But if it ever came down to the mild-mannered doctor from Brooklyn or the ungentlemanly gentleman from Kentucky, I know which one I’d pick.
DO NOT CALM DOWN ABOUT CORONAvirus
Newsflash: Coronavirus is a really big deal.
With more than 80,000 Americans dead from COVID-19, you’d think that even President Trump would be painfully clear on this point. Then again, why should he be more rational than the bulk of his friends and fans?
From William Bennett to Laura Ingraham to Rush Limbaugh to Ben Shapiro and straight on down the list, so many right-wing talkers have demonstrated so much utter illogic in the face of global pandemic that it has become its own scary contagion. Like virus lingering on a half-washed hand, their echo chamber rings with the astounding contention that the infection currently ravaging the nation is nothing to get too hyped up about. No! It’s a wildly-overblown doom-and-gloom scenario spun up by public-health geeks and their liberal enablers. Bizarrely, the more scalding the evidence to the contrary that is poured on it, the more this misapprehension seems to replicate and spread.
I’ll leave it to epidemiologists and their demonizers to fight over whether X restriction-loosening will lead to Y public-health disaster, and further leave it up to cable-news luminaries to weigh in on whether that’d be better or worse than risking Z cases of financial ruin.
My only point here is one that I can’t believe still needs to be made. Purely based on what actually has happened, and is happening, in plain view, COVID-19 is a national catastrophe. Thankfully, polls suggest that most Americans understand this. But whether snarking at Anthony Fauci, swinging a noose at Gretchen Whitmer, or purring condescension about lefty hysteria across the airwaves, a significant and influential minority does not grasp it at all. It is far past time for their foolishness to be injected with Clorox, flooded with ultraviolet rays, and blasted straight out of the body politic.
With apologies to those conservatives who have met this moment with the seriousness it demands – I’m lookin’ at you, Mike DeWine -- let’s take a few of the standard minimizations one by one:
It’s just another flu.
Senator Rand Paul is the latest to float this falsehood. “We have less deaths in Kentucky than we have in an average flu season,” he said, by way of needling Fauci at Tuesday’s hearing before the Senate Committee on Health, Education, Labor and Pensions.
This despite wrenchingly irrefutable evidence that COVID-19 has already made the average American flu season look like a day at the beach, circa 2019.
Even accepting the most dire figures on the most dire flu season in recent memory – that some 80,000 Americans died of flu and its complications in 2017-18 -- COVID-19 has already killed more than that number in less than a third of the time. And if a recent Scientific American post by Jeremy Samuel Faust is to be credited, typically-cited CDC flu figures should be binned like yesterday’s PPE. Faust points out that such estimates are a model, rather than a tally. Counting real-time death by real-time death, the way that coronavirus fatalities are being tabulated, a terrible flu year claims something under 16,000 people. That’s less than two weeks in the life and deaths of COVID-19.
By the way, in that unusually-brutal flu season of 2017-2018, 333 Kentuckians died. Figuring the flu season to last from October through April, that works out to about 11 or 12 deaths per week. Since March 16, when its first death was announced in Senator Paul’s home state, COVID-19 has killed 321, which works out to about forty deaths per week. That seems like a lot more.
Think of all the traffic accidents we have every single year, and we don’t shut down the country for that.
As I type this, coronavirus has killed 44,625 more Americans than are estimated to have died in traffic accidents in the whole of 2019 (38,800). That’s more than a 2:1 COVID-to-car-death ratio. At its current daily death rate (1630), COVID-19 annualizes to 594,950 deaths per year, or a little over 15 times the rate of 2019 traffic deaths.
Of course, optimists will point out that the current daily death rate may do nothing but fall. And who doesn’t hope that they are right? But even if they are – even if, a year from now, every go-ahead-and-get-a-manicure governor is laughing in the face of everyone who voiced a doubt – it will still be true that comparing deaths from COVID-19 to those from traffic accidents has long since been rendered ridiculous.
Sure, it’s bad for old and/or sick people but they were about to die anyway.
The moral odiousness of this argument is the subject for a whole other head-banging.
For those who remember the painful birth of Obamacare, though, the political irony is to choke on. Back in 2009, anyone who dared to hint at the very high proportion of health-care resources that are expended to prolong clearly-soon-to-end lives was basically accused of murder. Now, as many of the same folks would have it, if you’re over 65 and/or diabetic, off you go!
In fairness, not everyone who decries the COVID-19 “overreaction” does so out of a cruel indifference to Grandma. Some insist that they are doing so, all the more to protect her. “The coronavirus danger is narrowly targeted at a very specific portion of the population: the elderly infirm. These individuals need to be intensely protected,” Manhattan Institute fellow Heather Mac Donald recently argued in a New York Post column that mostly blasted how “overfearful of coravirus we’ve become.”
That sounds great: Go all-out to safeguard the handful who could get really sick or die, and let everybody else get on with earning a living. It’s a win-win.
Indeed, in theory, if adopted nationally, forcefully, and very early on, some version of that approach might have made some sense. In practice, it’s not a tack that any American government could easily take, and the very antithesis of one that the current American government would remotely contemplate.
In order for a masterful, pre-emptive surgical strike to have had a snowball’s chance in hell of saving the economy from coronavirus, there would have had to have been a supremely masterful surgeon in charge, scalpel expertly aimed. To this day, our actual guy won’t even put a mask on.
Think back to late January, or early February. There are no known coronavirus cases, let alone deaths, anywhere in the U.S. In the midst of what Americans are experiencing as a complete non-event, President Trump gets an earful from global-intelligence and health experts, some of them “deep state” lifers like Fauci. Ignoring the objections of corporate titans and the Tea Party, he mandates the isolation of private as well as state-run nursing homes and everyone who passes through them. He exhorts Congress to fast-track emergency legislation requiring businesses to allow immunosuppressed employees to work from home; compensate those obliged to stay away from affected jobs; hyper-regulate the sanitation, social distancing, and virus-monitoring in essential businesses, on the grounds that they can’t shut down no matter what, and therefore safeguards need to be put in place for their workers. He calls all his favorite pastors to the White House and tells them that their church services are to be closed to everyone who either is -- or lives with anyone who is -- sick or over the age of sixty-five.
Maybe, just maybe, if the Trump administration had taken that and a host of other uncharacteristically wise and difficult actions, many lives and much of the economy would have been spared. But can anyone imagine him doing that? Or anyone in his posse urging him to do that?
Then again, even if Team Trump were capable of such action, “super-protect the super-vulnerable, hands off everybody else” is not the finger-snap solution it sounds like.
The whole formulation lowballs not only the proportion of non-ancient people who have seriously suffered or died from COVID-19, but also the degree to which the old and “sick” typically exist among everyone else, and therefore cannot so easily be cordoned off from the nation’s breadwinners. In many cases, such people are the nation’s breadwinners.
No question, the virus hits the oldest by far the hardest. But it’s simply not true that everybody else gets some kind of pass.
According to Michigan’s official numbers, for instance, one-quarter of its cases have been under age forty. Sixty per cent have been under age sixty.
Granted, “under sixty” does not exactly mean “young.” But given that the average age of retirement in this country is 62 – and the youngest our next president can possibly be on inauguration day is 74 -- it hardly equates to “elderly infirm,” either.
Meanwhile, the vast majority of older Americans -- about 95 per cent of those over 65, according to census data -- do not live in nursing homes. That goes for a sizable chunk of super-seniors, as well: In 2012, for example, Forbes noted that more than half of Americans aged ninety-five and above were still living in their own homes. And it’s not as if everybody who gives up the house goes straight to Shady Pines. In 2016, according to a Pew Research Center study, nearly one quarter of women over age 85 were living with their grown children – and thus, in many cases, grandchildren.
Then don’t forget the grandparents who babysit, some to the point of furnishing day care. That’s apart from the more drastic circumstances -- overseas deployments, opiods, incarceration – that call upon grandparents to rear their children’s children, full stop. No doubt, some of those grandparents are fortysomething triathletes. Some most certainly are not.
As for those with “underlying conditions,” they’re not so easy to bubble wrap, either. More than forty per cent of Americans qualify as obese. Some 23.5 million have an autoimmune disorder. At least 16 million live with chronic obstructive pulmonary disease. In any given year, more than a million are diagnosed with cancer.
This isn’t to suggest that most of America is fated to drop dead at the first hint of coronavirus. But it’s still an awful lot of elevated-risk people, functioning day in and day out at the center of American economic life – or, at the very least, living with people who function there. It’s not as if all concerned could be benched without affecting the game.
Striking, too, is the amount of geographic overlap between the prevalence of underlying conditions in a given state and the reluctance of that state’s leadership to treat coronavirus as a major threat. Go through the top ten states for chronic heart disease, chronic lung disease, adult asthma, diabetes and obesity, and you will not find the stomping grounds of Andrew Cuomo or Gavin Newsom. You will find one rural Republican state after another.
This brings us to another favorite pandemic-shrinking point:
COVID-19 may be a hammer to the heart of some major cities, but it’s barely a prick to the pinky of the heartland.
That’s the gist of Bret Stephens’ New York Times column for April 24: “The Whole Country Shouldn’t Have To Play By New York Rules.”
“Even now,” Stephens wrote, “it is stunning to contemplate the extent to which the country’s Covid-19 crisis is a New York crisis.”
Well, yes and no. Given its 66,000-plus people per square mile and their propensity to be crammed into high rises and subway cars, it is to be hoped that nowhere else gets hit nearly as hard as New York City. But to call this a “New York crisis” is a shrug too far.
To start with the present: On May 12, according to Worldometer, there were 1,630 new deaths recorded in the U.S., of which 172 (10.5%) belonged to New York. Add in New Jersey and Connecticut, and the total rises to 403 (about 24%.) In other words, three quarters of the COVID-19 deaths In America are now deaths outside the New York metropolitan area.
Not too long ago, those figures would have been flipped – which points to the odd fact that the places currently being portrayed as pretty darn safe from the virus are the very places where it is starting to kill more people.
Now, going back to the beginning: if one completely lops all of the New York COVID-19 deaths off the national total, one is left with 56,250. Lop off New Jersey and Connecticut, too, and one is left with 43,668. That means that, even accounting for the worst days in the Big Apple, more than half of American deaths from COVID-19 have taken place outside the New York metropolitan area. And it means that – apart from that metropolitan area – COVID-19 has already killed 4,868 more Americans than died in motor vehicles in 2019, about twenty times more than perished in Hurricane Katrina, and slightly more than died from opioid overdoses in the drug-devastated year of 2017.
In Wisconsin, in Indiana, in Iowa – let alone Illinois and Michigan – COVID-19 has taken much less time to kill many more people than the flu or car accidents, and it’s easily on track to surpass opiod deaths where it hasn’t already.
In short, regardless of what happens from this day forward, there has already been an awful lot of non-New-York dying to be blasé about.
Again, I’m in no position to predict what any of this bodes for the future. But anyone can see how it has played out thus far.
In state after state, government energy or apathy has either improved or worsened the COVID-19 odds relative to population density.
Brian Kemp’s Georgia has both a population density and an urbanized-population rate of roughly a third less than that of Gavin Newsom’s California. So far, Georgia has suffered about twice as many deaths per million as California has.
Mississippi, whose governor, Tate Reeves, resisted a statewide stay-at-home order until April 1, ranks 32nd in population density, 14th in deaths per million.
Conversely, Maryland, under the proactive leadership of Larry Hogan, ranks fifth in population density, but tenth in deaths per million. Ohio, one of the first to lock down under Mike DeWine, ranks tenth in population density, but 17th in deaths per million.
Of course, downstate New York and New Jersey are populated up the wazoo, and despite being governed by a pair of pearl-clutching Democrats, Andrew Cuomo and Phil Murphy, they’ve got far more fatalities than anywhere else. Looking back over the past few months, there’s certainly a case to be made that had Cuomo and Murphy taken swifter, even more sweeping action, the gravediggers of their states would have had a lot less work to do. But could anyone argue that if they had simply cordoned off the nursing homes, urged – but not mandated! -- the cessation of social gatherings, the curtailment of non-essential travel and the wearing of facial coverings by those who enjoy that feeling of snugness on their skin, they wouldn’t have had much more?
As it happens, yes. Many are making just that argument, and the more bodies pile up, the more they double down.
These folks may forever scorn the idea of placing masks over their noses and mouths. But could they please remove the blinds from their eyes?