Then and now

This review of the public health response to the Spanish Flu of 1918-19 in the US and Europe is interesting both for its similarities and differences to the current situation. Worth nothing is the highly varied and localized approach, and the absence of mass lockdowns, “shelter-in-place” orders and demands to shut down all commerce and social life indefinitely:

The public health authorities in both the United States and Europe took up fundamental measures to control epidemics that dated back to Medieval times of the Bubonic Plague. They aimed to reduce the transmission of the pathogen by preventing contact. They framed their public health orders in scientific ideas of their understanding of how the influenza microbe spread through the air by coughing and sneezing, and their conception of the pathogenesis of influenza. Since they concluded that the pathogen was transmitted through the air, efforts to control contagion were organized to prevent those infected from sharing the same air as the uninfected. Public gatherings and the coming together of people in close quarters was seen as a potential agency for the transmission of the disease. The public health authorities believed that good ventilation and fresh air were “the best of all general measures for prevention, and this implies the avoidance of crowded meetings,” (BMJ, 10/19/1918). This translated into the controversial and imperative measure of closing of many public institutions and banning of public gatherings during the time of an epidemic.

The rigidity of these regulations varied immensely with the power of the local health departments and severity of the influenza outbreak. In the United States, the Committee of the American Public Health Association ( APHA) issued measures in a report to limit large gatherings. The committee held that any type of gathering of people, with the mixing of bodies and sharing of breath in crowded rooms, was dangerous. Nonessential meetings were to be prohibited. They determined that saloons, dance halls, and cinemas should be closed and public funerals should be prohibited since they were unnecessary assemblies. Churches were allowed to remain open, but the committee believed that only the minimum services should be conducted and the intimacy reduced. Street cars were thought to be a special menace to society with poor ventilation, crowding and uncleanliness. The committee encouraged the staggering of opening and closing hours in stores and factories to prevent overcrowding and for people to walk to work when possible (JAMA, 12/21/1918). Some of the regulations in Britain were milder, such as limiting music hall performances to less than three consecutive hours and allowing a half-hour for ventilation between shows (BMJ, 11/30/1918). In Switzerland, theaters, cinemas, concerts and shooting matches were all suspended when the epidemic struck, which led to a state of panic (BMJ, 10/19/1918). This variation in response was most likely due to differences in authority of the public health agencies and societal acceptance of their measures as necessary. This necessitated a shared belief in the concept of contagion and some faith in the actions of science to allow them to overcome this plague.

The most frequently discussed and debated public health measure in the journals of the period was the closure of the schools. In Britain the prevalence of the epidemic led to the closure of the public elementary schools (BMJ, 11/30/1918). In France, students with any symptoms and their siblings were to be excluded from school. If three fourths of the students were absent then the whole class was to be dismissed for 15 days (JAMA, 12/7/1918). Some believed closing schools to be a useful measure to control infection but complained that it often occurred too late, after most students and teachers were sick (BMJ, 10/19/1918). In the United States, school closure was not as widely accepted. One article in JAMA said that, “the desirability of closing schools in a large city in the presence of an epidemic is a measure of doubtful value,” (10/5/1918). The APHA Committee debated its value too, questioning the effectiveness against the loss of educational standards. Generally, school closure was thought to be less effective in large urban metropolises than in rural centers where the school represented the point of dissemination of the infectious agent. The closing of schools and other public institutions as public health regulations to reduce the epidemic was not universally accepted. One editorial in the BMJ states that “every town-dweller who is susceptible must sooner or later contract influenza whatever the public health authorities may do; and that the more schools and public meetings are banned and the general life of the community dislocated the greater will be the unemployment and depression,” (12/21/1918).

Related – the jobs Armageddon has begun:

The state of play: Goldman Sachs predicts that more than 2 million Americans will file for unemployment claims by next week, pointing to “an unprecedented surge in layoffs this week.” […]

“We expect a total of approximately 3.5 million jobs will be lost,” BofA strategists said in a note to clients before the release of the Labor Department’s initial jobless claims report.

California is closed

Escape from L.A.America’s CPC-approved phased lockdown/economic self-immolation continues, with the most populous state in the Union ordering all its residents to huddle at home for an indefinite period of time:

Gov. Gavin Newsom on Thursday ordered California’s nearly 40 million residents to stay home, making it the first state to impose that strict mandate on all residents to counteract a looming surge of new infections.

The order takes effect immediately and remains in place “until further notice.” Californians are not allowed to leave home except for essential purposes. They are allowed to purchase groceries, prescriptions and health care, as well as commute to jobs deemed essential.

The governor’s order comes with misdemeanor penalties for anyone who violates the restrictions, though he said he believes social pressure will keep people home rather than law enforcement.

“There’s a social contract here,” Newsom said. “People, I think, recognize the need to do more and meet his moment.”

Newsom said the order has to remain in effect indefinitely. He has repeatedly said the next eight weeks are crucial to bend the curve and stop the rapid contagion. He also said, however, that he does not expect the order to last “many, many months.”

Newsom invoked some worst-case-scenario estimates, of the type being hysterically pushed on social media, to explain why the Golden State needs to be turned into an open-air prison camp:

The measures are intended both to shield vulnerable residents and to maintain California’s health care systems’ capacity to handle an influx of new patients. Earlier in the day, Newsom laid out a grim scenario if California does not respond decisively: 56 percent of the state’s residents, or some 22 million people, could contract the virus in the next eight weeks.

Newsom’s office clarified that figure did not account for the sweeping mitigation efforts California has imposed, making it a kind of worst-case scenario. But it nevertheless communicated the dire stakes.

“It’s for their own health”:

A nationwide lockdown is most likely coming and you need to be preparing for this RIGHT NOW:

Whether you are reading this in your living room in Vancouver, office in London, or on a subway in New York City, you need to think hard, and fast, about two crucial questions: Where, and with whom, do you want to spend the next six to 12 weeks of your life, hunkered down for the epidemic duration? And what can you do to make that place as safe as possible for yourself and those around you?

Your time to answer those questions is very short—a few days, at most. Airports will close, trains will shut down, gasoline supplies may dwindle, and roadblocks may be set up. Nations are closing their borders, and as the numbers of sick rise, towns, suburbs, even entire counties will try to shut the virus out by blocking travel. Wherever you decide to settle down this week is likely to be the place in which you will be stuck for the duration of your epidemic.

Economic suicide: the cure for coronavirus

Florida is closedI admit, I’m having trouble wrapping my mind around the speed and scale of the changes that are being imposed on our society right now. A decision has apparently been made to power down huge swaths of the US economy, perhaps indefinitely, to fight the Wuhan Flu, the invisible enemy that has so far killed 155 people in the U.S. and a grand total of less than 10,000 people worldwide.

Disney World is closed. The Las Vegas Strip is closed. Atlantic City is closed. Macy’s is closed. Nordstrom is closed. Apple stores are closed. Half of all school children have been sent home. Nationwide.

For people living in New York, New Jersey, and Connecticut, it is no longer legally possible to eat at a restaurant, drink at a bar, work out at a gym, or assemble a crowd of more than 50 people. Andrew Cuomo, Phil Murphy and Ned Lamont have effected a radical (if “temporary”) transformation of social life that would be the envy of any totalitarian social engineer – and the alacrity with which the people of the tri-state region have accepted, even embraced, these changes is truly shocking.

Maybe I have it backwards – maybe it is the people in authority, the governors, mayors, health bureaucrats and CEOs, that have buckled to pressure from the social media hive-mind, which grows ever more powerful as the US state gets hollowed out. Perhaps it is blue check Twitter, and its sudden demands for ever-intensifying, draconian action, that truly occupies the driver’s seat of our national clown-car.

In any case, a vast chain reaction has now been set in motion that will be difficult or impossible to stop. Where it will lead, nobody knows. We are in uncharted territory and few people have even begun to think this through. A nationwide shutdown that lasts 15 days is perhaps survivable. One that continues for, say, five months probably is not. Having the entire country hunker down at home for a prolonged period of time will slaughter the economy and hurt millions of Americans, perhaps killing a large number of them through knock-on effects: stress, drink, drugs, suicide, vitamin D deficiency… At a certain point you begin to wonder whether the cure won’t be orders of magnitude worse than the disease.

The Fake Black Death

Costco toilet paperBased on the official reactions around the world, you’d think the death toll of the Wuhan Flu has surpassed one million people and the bodies are stacking up like cordwood in Western cities. But the virus has killed less than 8,000 people so far, three and a half months after being identified. Apparently not a single person under the age of 50 in Europe has died from it. As far as I can tell – based on publicly available information – this thing is orders of magnitude away from being a significant global threat.

And yet, Western governments are treating this like it’s an emergency unprecedented since WWII, demanding immediate, radical changes to the way we organize our lives. In the US, sweeping emergency powers are being invoked on the municipal, state and federal levels. Large gatherings are being banned. Churches are suspending services. Everyone is told to hunker down at home, to avoid human contact – that is the “responsible” thing to do. We are told that these are temporary measures to “flatten the curve,” to slow the spread of the infection and protect public health.

But how temporary? New York City schools have been shuttered until “at least” April 24 – that’s five weeks. San Francisco and surrounding counties have issued “shelter-in-place” orders covering 6.7 million people until April 7. The president, meanwhile, is saying that the pandemic could end in the US in July or August “if we do a really good job.” Something tells me that normal life is not going to be resumed in the next few weeks. And it seems obvious that if this national hunkering-down drags on for months rather than weeks, it will crater the US economy. Given this country’s sudden obsession with public health and safety, it’s interesting to speculate about how many people might die as a result of an economic depression.

There is a massive disconnect between the known facts about the virus and the political and economic reaction it has engendered. Perhaps, as one blogger suggests, the authorities know something about this virus that they’re not letting on. There are even darker possibilities. But it’s worth nothing that much of the impetus for these draconian changes in the US has been driven by social media, where it has suddenly become fashionable to post self-quarantine pics and berate others who have the effrontery to eat at restaurants. Many of those same people are going to be demanding Chinese-style totalitarian “lockdowns” and electronic surveillance in the interests of public health. A narrative is already being formed that China has conquered the coronavirus and that the rest of the world should follow its wise example.

Meanwhile, Wuhan – remember Wuhan? – is still under lockdown…

The lockdowns commence. Mass hysteria grips the US

America is going the way of Wuhan very rapidly. Consider:

Lamont issues executive order banning gatherings of more than 250

[Connecticut] Gov. Ned Lamont is using emergency powers to prohibit gatherings of more than 250 people to try to check the spread of coronavirus infection, excluding religious services. […]

The executive order prohibits gatherings of more than 250 people for social and recreational events. The prohibition remains in effect until midnight April 30, unless modified by a subsequent executive order.

The current order covers community, civic, leisure, or sporting events, parades, concerts, festivals, movie screenings, plays, performances, and conventions. It does not apply to any spiritual gathering or worship service. […]

The order also states that violation of the prohibition on large gatherings is a felony offense. The crime carries a maximum prison sentence of five years and a maximum fine of $5,000.

New York Gov. Cuomo bans gatherings of 500 or more amid coronavirus outbreak

New York Gov. Andrew Cuomo on Thursday announced a ban on gatherings of 500 or more people across the state “for the foreseeable future” as public officials try to contain the fast-moving coronavirus outbreak that’s spread across 44 U.S. states and infected at least 127,800 people across the world.

How quickly the freedom to socialize in large groups gets thrown out the window over a respiratory virus that has so far killed [checks notes] two people in New York State and zero people in Connecticut. Does this order cover political protests, i.e. freedom of assembly?

That was Thursday. On Saturday, Hoboken, New Jersey became the first city in America to implement a mass curfew:

Hours after announcing that gyms, health clubs, day cares and movie theaters would join the list of closures in Hoboken, Mayor Ravi S. Bhalla announced the forthcoming curfew and additional restrictions.

The citywide curfew that begins Monday will be in effect from 10 p.m. to 5 a.m. and requires all residents to remain in their homes, barring emergencies. People who are required to report to work are exempted, the statement released late Saturday said.

What public health purpose is served by banning people from going outside between the hours of 10pm and 5am? Especially when bars, move theaters, etc. have already been ordered closed and restaurants have been ordered to stop serving food on the premises? I don’t know, but I do know that people in a state of terror are easier to manipulate and control.

The newspaper of record has a front-page story today with the headline “The Coronavirus Swamps Local Health Departments, Already Crippled by Cuts.” Imagine my surprise to learn that the headline refers to something other than an uncontrollable wave of sick bodies:

CHICAGO — A widespread failure in the United States to invest in public health has left local and state health departments struggling to respond to the coronavirus outbreak and ill-prepared to face the swelling crisis ahead.

Many health departments are suffering from budget and staffing cuts that date to the Great Recession and have never been fully restored. Public health departments across the country manage a vast but often invisible portfolio of duties, including educating the public about smoking cessation; fighting opioid addictions; convincing the reluctant to vaccinate their babies; and inspecting restaurants and tattoo parlors.

Now, these bare-bones staffs of medical and administrative workers are trying to answer a sudden rush of demands — taking phone calls from frightened residents, quarantining people who may be infected, and tracing the known contacts and whereabouts of the ill — that accompany a public health crisis few have seen before. […]

With the virus now consuming all attention, key functions have been put on hold. Some health departments are now making reductions in home health care and education on unwanted teenage pregnancy and other core issues. In Wayne County, Ohio, the health department called off upcoming seminars to vaccinate people in Amish communities, where parents are often reluctant to immunize their children.

I’m not pointing out the glaring discrepancy between headline and news content in order to minimize the problem that our hospitals are probably ill-equipped, maybe severely so, for a major outbreak – an issue I’ve addressed here.

I would, however, like to call attention to the way the media is fanning the flames of mass hysteria over a novel virus that is still not well understand and has still, despite the chain reaction of extreme global dislocations it has triggered, killed fewer than 6,500 people worldwide since its first documented case in either November or December 2019. And yes, I understand exponential growth, but the data is so vague at this point that it’s safe to assume that any “projection” (of death tolls, etc.) is total conjecture. Complacency is not the answer, but neither is fear.

Italy on full lockdown

It has been less than seven weeks since Wuhan and nearby cities began to impose travel bans – and only three weeks since Hubei province itself (population: ~58 million) was placed on full lockdown by the authorities.

Now the Western, democratic world is witnessing its first lockdown on a similar scale, with Italy (population: 60 million) extending quarantine measures across the whole country.

At this rate, how long before Governor Cuomo blocks the roads and trains out of New York City?

Bonus: notes from a very interesting podcast chat with Scott Adams and Naval Ravikant.

The effectiveness of a mass quarantine

Hypothesis: The effectiveness of a mass quarantine is greatly reduced when the target population is given several hours’ advance notice of it.

Item (Wuhan):

A sudden overnight quarantine, with a 7-hour grace period for people to leave, has predictably led to this. Can an epidemic both be severe enough to justify a lockdown of 10m people and sufficiently under-control to allow this?

Item (Northern Italy):

There was chaos and confusion in the hours before Conte signed the decree, as word leaked to the news media about the planned quarantine. Students at the University of Padua in northern Italy who had been out at bars on a Saturday night saw the rumors on their cellphones and rushed back to their apartments to grab their belongings and head to the train station.

Hundreds of passengers, some wearing face masks and rubber gloves, crammed onto the last local train leaving Padua at 11:30 p.m. Anxious students wrapped scarves around their heads, shared sanitizing gel, and sat on their suitcases in the aisles. No conductor came by to check tickets.

More supply chain disruption

Chris Martenson of Peak Prosperity talks about how the Indian government has banned the export of 26 active pharmaceutical ingredients (APIs) due to coronavirus (Reuters report here):

And more:

And here’s an excellent interview with Cornell professor David Collum on coronavirus, what we don’t know, and erring to the side of caution: https://quoththeraven.podbean.com/e/quoth-the-raven-175-cornell-professor-dave-collum-on-the-coronavirus/

Italy quarantines a quarter of its population

Escape from Milan (source)

Wuhan-style mass quarantines come to the West:

Italy announced a sweeping quarantine early Sunday, restricting the movements of about a quarter of its population in a bid to limit contagions and end the virus’ advance at the epicenter of Europe’s outbreak.

Shortly after midnight, Prime Minister Giuseppe Conte signed a decree affecting about 16 million people in the country’s prosperous north, including the Lombardy region and at least 14 provinces in neighboring regions. The extraordinary measures will be in place until April 3.

“For Lombardy and for the other northern provinces that I have listed there will be a ban for everybody to move in and out of these territories and also within the same territory,” Conte said. “Exceptions will be allowed only for proven professional needs, exceptional cases and health issues.” […]

In its daily update, Italy’s civil protection agency said the number of people with the coronavirus rose by 1,247 in the last 24 hours, taking the total to 5,883. Another 36 people also died as a result of the virus, taking the total to 233.

There was chaos and confusion hours before Conte signed the decree, as word leaked that the government was planning the quarantine.

Packed bars and restaurants emptied quickly as people rushed to the train station in Padua’s Veneto region. Travelers with suitcases, wearing face masks, gloves and carrying bottles of sanitizing gel shoved their way on to trains.

All this over 233 deaths? Yes, yes, I understand the concept of exponential growth; still, this seems extreme.

Next up: Seattle?

The West Coast?

New York?

The Northeast? (Oh wait: “Amtrak to suspend nonstop Acela trains between DC, NY amid coronavirus concerns”)