Simulating COVID19 Restrictions is Eye-Opening

Harvard Medical School, Mass. General Hospital, Georgia Tech, and Boston Medical Center have collaborated to create on online, free-to-use COVID19 simulator, in which you can select policies at both national and state level to determine their impact on infections, mortality, hosptial utilization, and more.

I encourage you to try the model for yourself, but I took it for spin, and this is what I found regarding Arizona, in particular.

I modeled what would happen to expected deaths if we continued the current shelter-in-place order and essential business only rules for another 16 weeks, through the end of August. the result is that mortality could be limited to 544 deaths, which is pretty well in line with the current flattened trajectory of death rates in AZ.

Of course, it seems unlikely that the Ducey Administration would continue the current restrictions that long, given that he’s already committed to re-opening non-essential business. So what would happen if the current regime continues for another two weeks (which is about the span of the shelter-in-place order expiring May 11th), and then moves to a regime of minimal restrictions through the end of August?

First, you might ask, “exactly what does ‘minimal restrictions’ mean?” In the model ‘minimal restriction’ is clearly defined: “This strategy assumes that there is minimal social distancing in place to reduce the spread of COVID-19, with an assumed level of learned social awareness (handwashing, avoiding close contact when sick, etc.). We assume the R_E of this intervention will be 1.68, which is 30% lower than the basic reproduction number, R_0, of COVID-19.”

Essentially, the model’s “minimal restrictions” closely resembles the GOP’s current talking points about re-opening the economy and relying mainly on personal responsibility, good hygiene, and voluntary common sense practices to slow the spread of the virus.

So what happens?

A median estimate of almost 20,000 dead Arizonans. Of course, that is just the median, or most likely, number. The minimum number is just over 6,000, and the maximum is over 45,000.

The GOP is pushing nation-wide, despite a distinct lack of support among the citizens, to re-open the economy as soon as possible. Whose opinions are they reflecting, since it is clearly not that of the American people? You might guess business leaders, but you would be wrong, by and large. Mostly, even business leaders understand that we need a greatly expanded testing capacity before returning to business as usual.

So who is behind the big rush to get America back to business? Conservative lobbying groups.

“The outside effort from conservative groups [to re-open the economy] is expected to be led by Stephen Moore, a conservative at the Heritage Foundation who is close with White House economic officials; Jenny Beth Martin, co-founder of the Tea Party Patriots; Adam Brandon, president of FreedomWorks, a conservative advocacy organization; and Lisa Nelson, chief executive of the American Legislative Exchange Council, a conservative organization with ties to the Koch brothers…”

In other words, the lobbyists of the American oligarchy and white supremacists. A tiny, minority alliance of the ultra-wealthy and white supremacists – who see the virus as an opportunity to kill non-whites at a higher rate than whites – seem not to care much if Americans experience a viral massacre.

Here’s what happens nationally if these fringe elements get their way and America as a whole resumes business as usual after two more weeks of restrictions:

We get a pretty flat death rate through late June, and then the death rate explodes again through July and August, resulting in a median death toll of 2 million Americans, if we continue with minimal restrictions through August.

Just imagine how the right wing will crow about how they controlled the outbreak and defeated the virus through all of May and June as deaths rise only slowly through 70 or 80 thousand. They will say that the whole lockdown was unnecessary, and all the economic damage was for nothing, and it was all a Democratic plot to bring down Trump. They will ridicule those who continue to physically distance, and probably demonstrate against businesses and governments they deem overly cautious. Even as they revel in their ignorance, however, a exponential tidal wave of infections will be silently sweeping the nation, followed by a massive wave of death that will quickly overwhelm our healthcare system nationally.

Of course, such a result could not be tolerated. So, we will inevitably be forced back into a full lockdown toward the end of June, or early July. We will have bought two months of increased economic activity at the cost of tens of thousands of lives, and untold misery. We’ll be back in lockdown and have only piles of dead Americans to show for it.

So, what SHOULD we do? Stay with the current policies in most states, and force recalcitrant states to adopt the same, until we have the resources in place to test (PCR RNA tests for active virus, not antibody tests) every suspected case, and to proactively test and re-test especially vulnerable populations, to contact trace every infection, to effectively isolate every identified person, and to provide the supplies and training needed for business to operate safely in a new age of global pandemic, into the foreseeable future.

Re-opening the American economy is not going to be cheap, fast, or easy. It’s going to require careful planning, smart government, an effective and expanded public health infrastructure, and a more equitable and accessible healthcare system for everyone. Everything the GOP stands against.

We can’t just throw American lives at this problem and hope it goes away. You can’t ignore, bully, or gaslight a virus; you have to kill it. And that requires a determination, scientific discipline, and willingness to sacrifice for the greater good that the GOP has amply demonstrated that they simply lack.

The American people deserve better, and they will get it in a landslide election this fall, if we live through their misrule.