Saturday, September 12, 2020

How lockdowns could work

Imagine a group of people who want to play tag. They know they risk tripping or being bumped into by someone else. Once they're tagged, they sit out for awhile and join the game later. The game requires physical exertion and risk of injury, therefore the sick and feeble will stay home to protect themselves from the game's perils.

Now imagine games of tag have to be played indoors. You can run into someone else's house, run around, but then you have to move to another house. Playing tag in the street is now outlawed, because it's just too dangerous to play tag that way. 

The game will take much longer. It might go on for months or years. But this new restriction aimed at protecting people now puts the sick and feeble in the same path as those playing the game. The vulnerable population hasn't been protected.

This is why lockdowns don't work. They put everyone inside. When healthy people get "tagged" they recover; their immune system protects them from getting hurt and hurting others. But if they're forced to play indoors, the game drags on so long that the vulnerable have to expose themselves to the game one way or another.

Martin Kulldorff, epidemiologist from Harvard Medical School, supports an age-based approach to COVID-19. Since the young and healthy are orders of magnitude safer from the virus, it makes sense to develop herd immunity in this population.

Anti-lockdown advocates discredit themselves by saying "look at the numbers, there's nothing you can do to stop this." It's true, many of the patterns look very similar to past flu seasons. Perhaps in the modern world, our lives are so intertwined that it's impossible to slow the spread of a virus. On the other hand, you can imagine someone living on a self-sustained plot of land miles from anyone else where the virus can't reach. This scenario is exceedingly rare in the modern day, and maybe that's why the lockdowns have been so unsuccessful.

If there were a chance lockdowns help, it'd be to make them as short as possible. The only way to do that is through herd immunity. Let the vulnerable lock themselves away for a month. Let life go on as normal so the human immune systems can do the work of ending the pandemic. 

This is not what happened. New York and Sweden were hit hard and 40-60% of deaths came from their inability to protect nursing homes. This population is small and isolated and could have been protected. They weren't. So the mortality numbers are higher than they should have been. And due to the lockdowns, deaths caused by untreated illnesses, suicide, and abuse have increased as well. The exact wrong lesson was learned. To limit the movement of healthy individuals to reduce deaths in the vulnerable only prolongs the exposure of the population we needed to protect.

It's shocking to see the devastating rule of unintended consequences find its way into a pandemic. It underscores, once again, outcomes are much better when individuals are allowed to choose their own risks. Government works with a set of uncertainties when assessing the data. Individuals do as well, but the range of choices that are allowed naturally reduces that uncertainty quickly whereas government mandates puts us in a world of pure theorizing. The range of possible choices and actions allowed are forbidden, and the opportunity to use scientific analysis is lost.

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