You can read people recently who note that in China, even in Wuhan, people walk the streets comfortably and easily now, the thought being that they have handled all this better than we have. They had a hard lockdown early and the disease went away. One has to pretend that the data coming out of China is accurate, but let's do. In all likelihood it has at least partial accuracy, simply because even China has been unable to contain information about anything as much as it would like.
We have some more pretending too do, but let's have a go at it. If Donald Trump had not only discontinued flights from China, then Europe, then basically everywhere last February, but closed the NYC metro area, do we think that would have worked? I mean closed in the same sense the Chinese use, of welding the gates to apartment complexes shut because there were some known infected people and they wanted the spread to stop. Like, "No one leaves Manhattan. The bridges and trains are all closed. Hope you guys make it. Have a nice day." And then the next day saying "The other boroughs are now closed as well," and then "Okay, New Haven to maybe East Brunswick. No planes, no trains, no buses. No private cars, no bicycles, no matter how much military presence it takes."
I want to stress this because I do get a sense that people who believe Trump and various governors and mayors should have locked us down even harder to contain Covid and save lives think that this means just a little harder. Just a few tweaks, dude. Because of the fatigue of people isolating and distancing, whether by choice or by command, it is tempting to look back and say "If only...if only. Sure, we could have done that. A few weeks of serious shutdown and we'd all be fine now." There is a failure of imagination what it would really have been like. It would not only be shutting down a number of borders from scratch, it would be in an area with 20,000,000 people. Good luck with that. You only manage that by shooting people.
So I don't think we would even be able to do that, not remotely. What you can do in China is not like what you can do here. You could maybe do it in a place like Norway, with only one large city and a limited number of exits - and a population that would be much more cooperative than Americans would. Also, even at maximum movement in China they don't have remotely near the interaction between regions that we do here. Unless it was eradicated to ridiculously low levels, as soon as the restrictions went off people would be free to move about the country and it would start all over again.
Let's pretend levels deeper, even though we are currently at "I think this would not even be possible" stages. Suppose we did do that, and only had to shoot a few people. Then suppose that it actually worked, and we were all singing drunkenly into each other's faces now without fear. We cut our Covid deaths by 70%, well lower than any comparable country. (There are no comparable countries, and insofar as they are comparable they have about the same death rate, but work with me here.) Would we say it was all worth it? 350,000 avoided deaths, with vaccines now coming online would be a significant burden for any other plan to overcome to prove its worth. Wouldn't it? If we could do it and it did work, why wouldn't we? It's only a couple of weeks.
I am trying to make this sound like a difficult choice, but I don't see it that way myself. We should not do this, not even for 350,000 lives. It would change the balance of government power over citizens so profoundly, even in that brief period of time, to change the country forever. I admit that I am balancing an abstract and something that is ultimately just an opinion about the way life should be lived against real death. I still say it.
Release the hounds.
Mostly I agree, except for one small point:
“ Also, even at maximum movement in China they don't have remotely near the interaction between regions that we do here.”
The Chinese New Year is usually considered to be the largest migration on the planet. This year travel was way down, perhaps to 1.15 billion trips across country. The USA had around 84 million for Christmas.
I'm not sure I agree--in principle. In practice we were looking at a relatively mild plague and we knew it a year ago. 350,000 deaths would have been purely speculative, and if the measures worked, after the fact nobody would have believed the claimed deaths that didn't happen--they would only see the losses due to the drastic measures.
Crank it up a notch or two, and pick a plague with a higher and faster death rate. Then 350,000 deaths isn't a year-long toll but a couple of months or less. Now enforced quarantine isn't optional, but mandatory -- and probably wildly popular except among those who got stuck. No question: because private cars are ubiquitous and roads out of cities numerous, enforcement would be very hard, and lethal.
I don’t think that works in America. “Your job is to set up machine guns covering the roads and bridges and prevent all unauthorized nocturnal traffic” didn’t even work in Iraq with air support.
I seem to recall that the American Revolution was fought during a Smallpox epidemic, in fact.
It's a logistics issue.
The figure I hear quoted most often is that there's about 3 days worth of food in stores in a typical city. Let's make that ten days, assuming people have some stocks at home and you can repurpose commercial stocks and what's stored in food service establishments. How long does it take to distribute, and how do you make sure each household gets enough? How do you perform the resupply operation if you're locking down more than three or four days, because that process isn't going to happen overnight? (Toilet paper writ large.)
Now think of all the people that means have to be moving around. Truckers and other transportation workers, obviously. Warehouse people, too. Somebody to man the distribution points (aka stores). But you also need all the infrastructure to keep those trucks moving. Fuel. Repairs, which means spare parts, which means more people and more trucks. And the infrastructure to keep the repair and refueling facilities, warehouses, and food distribution points active. Power plants and the electric grid. NG and other fuels delivered by pipeline. Water. Waste treatment (Think of the recent Texas freeze.)
How much food is stockpiled in warehouses, and when do you have to restart the deep supply chain of farms and slaughterhouses and packing facilities? You've also got food that's growing. If you let those crops rot because you've restricted farm and food processing workers you're looking at shortages coming in the future. You're going to exhaust fuel and other supplies as well, so you're eventually going to need to restart refineries and other factories, too.
Now do all the people in congregate facilities who can't care for themselves. Hospitals, LTC facilities, prisons. All their staff, even at a minimal service level. Add in the folks who need regular care but are homebound.
Now add public safety, sanitation, and all the folks needed to support them. As well as the folks you're using to enforce this lockdown.
So there's some obvious things you can stop like sporting events, concerts, and other mass entertainments but those are going to bring their own set of issues like what do you for the people who depend on those for income, as well as all the people you've put out of work in other industries (until you need them again, because you will at some point).
In the end, the choice isn't between surviving or dying from the plague. It's between dying from the plague or staving to death while shivering in the dark.
Grim, it sounds like China could solve a lot of pandemic problem every time by just shutting down that one thing when they need it. Easier said than done, I'm sure.
Yes, it doesn't even seem possible to shut down, even with draconian measures. They would probably have had riots if they tried to shut down public transportation, but that was likely necessary, and the one single thing that would have helped the entire country the most.
@Christopher B you make a cogent point I think, one that has just been tested on a practical basis in Texas. With the ice storm, store shelves were emptied quite quickly due to a combination of early panic buying followed by a break in the supply chain due to road conditions. Here we are two weeks later, and some items are still not stocking adequately.
So this was a mandatory shutdown due to extenuating weather circumstances that left no other choice. But it proved how 'just in time'-reliant our supply chains are, and how little margin for contingencies there is in the operating model. What would happen if all this ground to a halt by government order?
Most people don't keep a pantry stocked. After 2-3 days there would be hungry people whose only obstacle is a government order - not an quasi-insurmountable weather condition requiring shelter-in-place. Mayhem would swiftly and surely follow in the urban areas especially.
We can put at least a few brackets around how far we ought to have been willing to go to prevent a big fraction of those 500K+ deaths. We know we could have prevented many of them by simply killing everyone instantly who tested positive or showed symptoms suggesting COVID infection. Knowing that was an unacceptable choice should make it easier to understand that we also weren't going to weld any doors shut and let people starve their way through a quarantine. Or at least, that if we had done so, we'd have inflicted something on ourselves that was worse than 500K+ people dying considerably sooner than they would have done in the natural course of things without COVID.
Good point. We actually did have a very efficient, but morally unacceptable solution.
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