My dad, who’s a holocaust survivor, and 97 years old, curates a blog for his independent living community about current politics. Yesterday he sent me this note. This is my reply to him.
Sections in italics are direct quotes from Scot Atlas’ op-ed piece in the Hill. Given Atlas’ position, this has to be taken as something pretty close to the “official” policy of the Trump Administration and why it’s safe now to reopen the schools (this post will make a lot more sense if you read it first).
My response follows:
We know who is at risk. Only 0.2 percent of U.S. deaths have been people younger than 25, and 80 percent have been in people over 65; the average fatality age is 78. A JAMA Pediatrics study of North American pediatric hospitals flatly stated that “our data indicate that children are at far greater risk of critical illness from influenza than from COVID-19.”
- Death is not the only metric. There clearly are pediatric complications of COVID at an unknown incidence. See, for example this article: https://undark.org/2020/09/02/kids-covid-19-long-haulers/ . This is like suggesting to parents “Don’t worry about preventing your kids from catching Lime Disease. No one dies of Limes”.
- Kids are contagious to adults, and are frequently low- or non-symptomatic. Kids catching COVID at school are a perfect vector to bring COVID home and getting adults in the household sick.
- See also recent evidence that young adults can suffer high rates of serious side effects, e.g. myocarditis. https://www.washingtonpost.com/sports/2020/09/03/big-ten-coronavirus-myocarditis/
While we saw more cases in July and August, we are not seeing the explosion of deaths we saw early on. An analysis of CDC data shows that the case fatality rate has declined by approximately 85 percent from its peak.
- Again, a focus on death. See above.
- CFR is a truly stupid way to judge the effectiveness of the Administration’s response. It’s much better to keep people from getting sick in the first place. The administration focuses on it because it’s the only measure where the US doesn’t look awful.
- CFR is substantially understated in the US compared to other countries because, among other issues, our cases are newer and people haven’t had time to die yet. For example, last month the average case in Florida was 37 days old.
- “Peak” CFR is presumably referring to the “bad old days” of April and May when NJ and NY were experiencing so many deaths. Those states did a terrible job keeping COVID out of nursing homes. Lower CFR today is significantly because of a younger population in hospitals. Treatments are better, but not 85% better.
- Note also that many red states are skimping on testing (to reduce case counts), and not reporting probable deaths. For many states, particularly Florida and other Sun Belt states, the reality is currently worse than it seems. See my piece: Official Misinformation.
See this post I wrote 3 weeks ago which compares NJ’s much higher CFR to Florida’s. https://pandemic-sense.com/2020/08/17/is-fl-5x-better-than-nj/. The situation is actually worse than I estimated in that article because there’s recent evidence that Florida has been delaying death reporting by several weeks.
We are doing much better with treating hospitalized patients. Lengths-of-stay are one-third the rate in April; the fatality rate in hospitals is one-half of that in April. Fewer patients need ICUs if hospitalized, and fewer need ventilators when in ICUs.
- I suspect a lot of this ties to the fact that a much higher % of cases are now younger (including share of hospitalized patients)
- One of the reasons for fewer patients on ventilators is that they’re not nearly as helpful as originally assumed based on pre-COVID analogues. See: https://elemental.medium.com/a-supercomputer-analyzed-covid-19-and-an-interesting-new-theory-has-emerged-31cb8eba9d63
- Again the emphasis only on acute illness and death. Most “long haulers” never see a hospital. Again, should we ignore Lime Disease because fewer folks end up in the ICU? The administration’s policies are infecting millions of people. I suspect we’ll be paying the cost in disabilities and increased health care costs for decades. Similar to Opioid Addiction, Diabetes, and Obesity, add COVID to the list of devastating morbidities.
We are progressing at record speed with vaccine development. This is due to eliminating bureaucracy and working in partnership with America’s world-leading innovators in the private sector.
True-ish. However, to be useful in re-opening schools now, we’d need a vaccine now, not next year, which is the earliest it could be delivered in quantity, even if the “end of October” date is real. Frankly, the idea that you can reopen schools now, with limited testing, and high community infection rates is delusional. Especially when many students don’t even think COVID is real. It would be much better to wait for the vaccine to become available before reopening the schools for in-school instruction, especially without adequate testing. Otherwise you risk killing off your most experienced teachers and sickening a generation of parents.
Third, we are leveraging our resources to guide businesses and schools toward safely reopening with commonsense mitigation measures. We must safely reopen schools as quickly as possible, and keep them open. The harms to children from school closures are too great to accept any other outcome.
Same problem as just noted. In many states, positivity rates (when calculated properly) remain above 10%. Florida, for example, is claiming a Positivity rate of 5.83% for the week of 8/23, when the real rate (calculated according to CDC guidelines) was in fact 13.9%. Many of the states most anxious to reopen have positivity rates above 10%. See: https://pandemic-sense.com/2020/09/03/official-misinformation-2/
With this level of infections, I don’t believe any schools will be able to stay open long.
For in-school to work, you need, at minimum, vaccinated teachers and staff, mask mandates, and instant testing available as needed. None of that is required in the current CDC guidelines. Until those elements are available, I believe Atlas is playing politics with the lives of students, teachers, and school staff.