Governor Northam, Don’t Destroy the Future

by James C. Sherlock

The President has just demonstrated strategic command of two ideas, combating the virus and preventing economic disaster, and is pursuing them in parallel.

His background as a successful leader of a large business gives him understanding of the complexity, interdependence and fragility of the economy. He knows that already some businesses will remain shuttered forever. More the longer we wait. Those businesses provide livelihoods not only to their owners, but also to their employees. Not all of them we see. While some are consumer-facing, others supply goods and services without which downstream production and retail can be brought to a halt and the food supply can suffer.

He described wide swaths of the country — the farm belt and many western states — far less impacted by the virus than the great international cities, media centers all, on the coasts.

The President wants the governors, including Virginia’s, to begin to open the economy in their states or parts of their states as soon medical data suggest it is relatively safe to do so. To wait for a declaration of absolute safety by scientists is to misunderstand the standards of scientists.

Fortunately, epidemiologists, while crucial and at his side, are not his only advisors. He spoke of not wanting the cure to be worse than the disease. He spoke of deep recession or perhaps depression as enemies that will kill Americans just as certainly and likely in greater numbers and over a longer period of time than the virus.

In the near term we will have treatments for the virus and then later a vaccine. The President, the Federal Reserve and Congress are working to treat the economy before it dies.

He knows he cannot order the loosening of the restrictions on business. He knows that in our federal system governors like Governor Ralph Northam have that power, not the president. The utility of federalism and state sovereignty, newly discovered or rediscovered by many Americans, will serve us well going forward. But he gave them cover, especially with his base, to move forward to restore the economy in their states or parts of their states when the time is right in those places.

In doing so he knows he will get criticism from those whose default position is disdain for his every action. He properly does not let it affect his decisions. Governor Northam must adopt the same philosophy. The Governor, a physician, has particular need to listen to advice from business and social-services experts about actions that strangle the economy.

Some of that criticism suggests he doesn’t care about the old and vulnerable. Some will levy the same charge against the Governor should he let, say, Southwest Virginia get back to normal before Northern Virginia.

I am writing this in my 75th year with a compromised respiratory system. All of my older friends and loved ones were born during or before WW II.

We know death, and we know that for us it is closer than it used to be. The combat veterans among us have had days and nights during which we did not think that a virus was the thing most likely to kill us. The least fortunate have buried one of their own children. Nearly all of us have buried our parents. We attend the funerals of our friends and loved ones more than happier celebrations.

We have reasonably well-tuned survival instincts or we would not be here. We will continue to take all of the precautions we can.

Most of all we love our families, most especially our children and theirs. We ask our leaders not to destroy their future in our name. None of us wants that to be our legacy.

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26 responses to “Governor Northam, Don’t Destroy the Future

  1. re: ” He knows that already some businesses will remain shuttered forever. More the longer we wait.”

    Yep, but the question is – if these businesses may never come back – were they destined to go away anyhow longer term?

    thoughts?

    • Some yes, most no. If I own a restaurant that does 90% in-store and 10% to-go under normal circumstances I have to move to all “to go” under the Coronavirus rules. I do my best to alert my customers that I am open for “to go” orders. It works to an extent. I’m now able to generate 30% of my typical business with “to go” only. But that cash flow is too low for me to pay my employees, continue cooking operations and buy product from my suppliers. What do I cut? If I go out of business it’s not that I was running a bad restaurant. I was running a sports bar. A place people came to watch sports with other people. Now? No sports to watch and even if there were sports … people can’t congregate in the manner that sports bars based their business models.

      Now imagine that my sports bar is in Wise County VA. Not only are there no COVID-19 cases in my county there are no COVID-19 cases in any bordering county.

  2. Agreed. Dem governors are just running the states in the ground.

  3. johnrandolphofroanoke

    Northam reminds me of James Buchannan. Both men tried to please everyone and in doing so they pleased no one and accelerated a national calamity.

  4. “His background as a successful leader of a large business gives him understanding” of bankruptcy.

  5. This is an excellent post. Our future still remains firmly in our hands as a nation.
    Frankly relatively few nations worldwide can say same the same. Hence we are blessed with many advantages and great powers of avoidance and action, stopping this virus in its tracks, and igniting our own recovery at the same time. Our options and our strengths grow day by day, should be act on them, contrary to this growing Wail of Wow Is Me among us.

    The best article I have come across today is this in the Wall Street Journal found at:

    https://www.wsj.com/articles/is-the-coronavirus-as-deadly-as-they-say-

    The big story here is the sub-title “Current estimates about the Covid-19 fatality rate may be too high by orders of magnitude.”

    Here is the WSJ article:

    “If it’s true that the novel coronavirus would kill millions without shelter-in-place orders and quarantines, then the extraordinary measures being carried out in cities and states around the country are surely justified. But there’s little evidence to confirm that premise—and projections of the death toll could plausibly be orders of magnitude too high.

    Fear of Covid-19 is based on its high estimated case fatality rate—2% to 4% of people with confirmed Covid-19 have died, according to the World Health Organization and others. So if 100 million Americans ultimately get the disease, two million to four million could die. We believe that estimate is deeply flawed. The true fatality rate is the portion of those infected who die, not the deaths from identified positive cases.

    The latter rate is misleading because of selection bias in testing. The degree of bias is uncertain because available data are limited. But it could make the difference between an epidemic that kills 20,000 and one that kills two million. If the number of actual infections is much larger than the number of cases—orders of magnitude larger—then the true fatality rate is much lower as well. That’s not only plausible but likely based on what we know so far.

    Population samples from China, Italy, Iceland and the U.S. provide relevant evidence. On or around Jan. 31, countries sent planes to evacuate citizens from Wuhan, China. When those planes landed, the passengers were tested for Covid-19 and quarantined. After 14 days, the percentage who tested positive was 0.9%. If this was the prevalence in the greater Wuhan area on Jan. 31, then, with a population of about 20 million, greater Wuhan had 178,000 infections, about 30-fold more than the number of reported cases. The fatality rate, then, would be at least 10-fold lower than estimates based on reported cases.

    Next, the northeastern Italian town of Vò, near the provincial capital of Padua. On March 6, all 3,300 people of Vò were tested, and 90 were positive, a prevalence of 2.7%. Applying that prevalence to the whole province (population 955,000), which had 198 reported cases, suggests there were actually 26,000 infections at that time. That’s more than 130-fold the number of actual reported cases. Since Italy’s case fatality rate of 8% is estimated using the confirmed cases, the real fatality rate could in fact be closer to 0.06%.

    In Iceland, deCode Genetics is working with the government to perform widespread testing. In a sample of nearly 2,000 entirely asymptomatic people, researchers estimated disease prevalence of just over 1%. Iceland’s first case was reported on Feb. 28, weeks behind the U.S. It’s plausible that the proportion of the U.S. population that has been infected is double, triple or even 10 times as high as the estimates from Iceland. That also implies a dramatically lower fatality rate.

    The best (albeit very weak) evidence in the U.S. comes from the National Basketball Association. Between March 11 and 19, a substantial number of NBA players and teams received testing. By March 19, 10 out of 450 rostered players were positive. Since not everyone was tested, that represents a lower bound on the prevalence of 2.2%. The NBA isn’t a representative population, and contact among players might have facilitated transmission. But if we extend that lower-bound assumption to cities with NBA teams (population 45 million), we get at least 990,000 infections in the U.S. The number of cases reported on March 19 in the U.S. was 13,677, more than 72-fold lower. These numbers imply a fatality rate from Covid-19 orders of magnitude smaller than it appears.

    How can we reconcile these estimates with the epidemiological models? First, the test used to identify cases doesn’t catch people who were infected and recovered. Second, testing rates were woefully low for a long time and typically reserved for the severely ill. Together, these facts imply that the confirmed cases are likely orders of magnitude less than the true number of infections. Epidemiological modelers haven’t adequately adapted their estimates to account for these factors.

    The epidemic started in China sometime in November or December. The first confirmed U.S. cases included a person who traveled from Wuhan on Jan. 15, and it is likely that the virus entered before that: Tens of thousands of people traveled from Wuhan to the U.S. in December. Existing evidence suggests that the virus is highly transmissible and that the number of infections doubles roughly every three days. An epidemic seed on Jan. 1 implies that by March 9 about six million people in the U.S. would have been infected. As of March 23, according to the Centers for Disease Control and Prevention, there were 499 Covid-19 deaths in the U.S. If our surmise of six million cases is accurate, that’s a mortality rate of 0.01%, assuming a two week lag between infection and death. This is one-tenth of the flu mortality rate of 0.1%. Such a low death rate would be cause for optimism.

    This does not make Covid-19 a nonissue. The daily reports from Italy and across the U.S. show real struggles and overwhelmed health systems. But a 20,000- or 40,000-death epidemic is a far less severe problem than one that kills two million. Given the enormous consequences of decisions around Covid-19 response, getting clear data to guide decisions now is critical. We don’t know the true infection rate in the U.S. Antibody testing of representative samples to measure disease prevalence (including the recovered) is crucial. Nearly every day a new lab gets approval for antibody testing, so population testing using this technology is now feasible.

    If we’re right about the limited scale of the epidemic, then measures focused on older populations and hospitals are sensible. Elective procedures will need to be rescheduled. Hospital resources will need to be reallocated to care for critically ill patients. Triage will need to improve. And policy makers will need to focus on reducing risks for older adults and people with underlying medical conditions.

    A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health. We should undertake immediate steps to evaluate the empirical basis of the current lockdowns.

    Dr. Bendavid and Dr. Bhattacharya are professors of medicine at Stanford. Neeraj Sood contributed to this article.” End Quote

    Huge amount of inflammatory claims are being tossed around today, including by health care professionals who should know far better, like for example the CEO of a urban hospital describing on TV the awful details of a single patient as if this patients death was the future of all Americans! What an irresponsible Clown this CEO is.

    I used to climb serious mountains, rock and ice, doing it at the sharp end the rope. Had I or my partners focused on all those who died and how they died, doing what we did over three decades, nobody, not one of us, would have gotten of the deck, much less lived rich full lives climbing on four continents, creating and experiencing many of the greatest highlights of our lives.

    Now is the time for us to make a difference in the world, not live on the world like helpless, wailing, complaining, finger pointing, snarky, nasty and useless parasites.

    • Reed, your WSJ article says, “a 20,000- or 40,000-death epidemic is a far less severe problem than one that kills two million. Given the enormous consequences of decisions around Covid-19 response, getting clear data to guide decisions now is critical.” Yes, yes and yes! Testing, testing, testing! And where are the G.D. tests?!

  6. The delusion and cowardice on display here lately is disheartening to say the least.

    The President remains clueless. His “feelings” about the situation are devoid of reality. As of this minute, flyover country states are reporting more than Virginia* (a lot more). This isn’t a coastal / media market disease. It’s nation-wide (and Wise will report its first cases soon enough). The number of cases continues to double every 3 days. Every medical expert and every statistician believes that we are a month or more away from peak infection.

    The economy has already taken the hit. The damage to it has been done. If we talk about retreating only two weeks into trying to manage the outbreak (when a week ago we accepted that this would be a long haul) what would all of this destruction be for? You really want people to go back to work weeks before we even know what the virus will do? The likely outcome is that economy will remain in shambles and we ruin “the best healthcare system in the world” at the same time. How is that long-term thinking ?

    Is American resolve just another founding myth?

    *until Virginia gets serious bout testing/reporting stop citing our numbers. They are illogical based on what our neighboring states and the rest of the country is reporting.

    • “The (economic) damage has already been done.” That is just wrong by orders of magnitude. Note my reference to political leaders consulting social scientists as well as economists and epidemiologists to get a balanced view. Social scientists have a role to play. The damage being done to human society and social relationships beyond the immediate family is significant and extremely important. We see acts of generosity, yet we all are experiencing the effects of acts of hoarding. We have lost touch with many people dear to us. Many are increasingly depressed. That is damage from social distancing that must be ameliorated as soon as possible.

    • You have a very optimistic view of what a long term economic depression would mean to the United States and the world. The economy has hardly taken the hit of such a depression. While uncommon in developed countries the economics of a “sudden stop” are well understood in the developing world. The consequences are not just economic. In many ways the Treaty of Versailles imposed a “sudden stop” on the German economy after World War I. How did that turn out?

      If you want to stay in your home for the next year and hope the government will take care of you – you should do just that. If you want to cajole others to stay in their homes for the next year hoping the government will take care of them – cajole away. We part ways when you suggest that the government should use its coercive power for a prolonged period of time to prevent people who understand the personal risks from freedom of action.

      It may be too early to back off the restrictions today. It may be too early tomorrow. But the idea of a lockdown through Labor Day is absurd. For one thing people won’t comply. Young people will simply leave their homes and go about their business as usual. What will the police and/or military do? Lock them up by the thousands in prison camps? I doubt it. In fact, I’d bet that the police and military are much more likely to point their muzzles toward the politicians and elite who try to imprison an entire country for month after month than the people exercising their constitutional rights.

      • “For one thing people won’t comply. Young people will simply leave their homes and go about their business as usual. What will the police and/or military do? Lock them up by the thousands in prison camps?”

        How right you are. Actually, the usual suspects are beating the drums already to let young, non-violent offenders out of jails and prisons.

        Washington Post: “‘Disaster waiting to happen’: Thousands of inmates released as jails and prisons face coronavirus threat”

        And then there’s this press release from RISE for Youth: “Incarcerated populations have been identified as ‘at highest risk for infection’ during the COVID-19 Pandemic. RISE for Youth continues to advocate for the transformation of the juvenile justice system and we are concerned for the health, safety, and rights of residents of the Bon-Air Juvenile Correctional Center, and all young people in detention centers across Virginia. … Immediately halt as many new admissions to juvenile detention and correctional facilities as possible.”

        Once young people figure they won’t be incarcerated, many will start disobeying the rules.

      • DJ writes – “You have a very optimistic view of what a long term economic depression would mean to the United States and the world. The economy has hardly taken the hit of such a depression. …If you want to stay in your home for the next year and hope the government will take care of you – you should do just that. If you want to cajole others to stay in their homes for the next year hoping the government will take care of them – cajole away. We part ways when you suggest that the government should use its coercive power for a prolonged period of time to prevent people who understand the personal risks from freedom of action.”
        You can’t possibly have read and absorbed the meaning of my words and characterize them this way. I am asking the Governor to relax economic restrictions on the general population sooner rather than later. I am saying that we in the “vulnerable population” have experience in taking care of ourselves and will follow the hygiene and social distancing guidelines. Those of us in my age group that won’t follow those guidelines accept responsibility for the results. Everyone dies of something. But we don’t want to be remembered as selfish.
        I am mystified how you came to your interpretation of my remarks.

  7. Voluntary infections and recoveries may be the only quick way out. Healthy (generally young) people would be asked to voluntarily be infected. Once infected they would be quarantined and provided with the appropriate level of medical treatment justified by the severity of their case. All participants would receive free health care and a government funded life insurance policy. Once recovered the newly immune would be effectively placed into the state national guard – subject to call up by the government. In return all participants would be paid and offered GI bill type education financing.

    All people certified as immune (whether from this program or by “accidental” contracting of the disease) will be issued identification cards certifying their immunity and the length of time that immunity is expected to last. Businesses employing immune people will be allowed to reopen so long as their reopening does not jeopardize the general public.

    It’s time to stop wallowing in the mire and start acting.

  8. I just re-watched Northam’s Coronavirus press conference from yesterday. Not a word about testing. Not a question about testing from the assembled journalists. When I watch Cuomo testing is an absolute centerpiece of his presentation. He claims that New York is the most tested population in the world. He strongly believes that testing is crucial to containing the virus.

    How do two governors with states only a couple of hundred miles apart have such different views on the importance of testing?

  9. I am with Cuomo on that one. How can Northam ignore this issue? For that matter, how can the President remain so uninformed and seemingly unconcerned about the failures in the testing pipeline and obvious lack of test kits even in hospitals? How can we understand the scope, the mortality, the effect on health resources, without testing? How can we know when things are returning enough to normal to resume normal work hours and conditions, without testing? If I never caught the virus and remain exposed, when is it safe to be around my co-workers?The WSJ article quoted by RF above dwells on the importance of testing to a returning work force — where are the tests? How can we identify and isolate, in the manner of South Korea that we seem to want so much to emulate, without widespread free rapid testing of everyone who feels the need or displays a fever? Where are the tests?

  10. re: ” Cuomo spoke about those who had recovered being great candidates as Coronavirus volunteers in hospitals, etc during the last of his news conferences I watched. Given that, I assumed they would no longer be carriers. Otherwise, why would they make good volunteers?”

    Maybe. Not sure that Cuomo is an “expert” – he’s just good at consulting with experts and this question might be more nuanced than first blush.

    re: where are the tests?

    Yes… for some reason South Korea and Germany look like they have had great success and it was not luck -it was test, test and test.

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