deconstructing rand

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.