The burden of proof



Lockdowns are back in full force as we enter the 11th month of “15 days to stop the spread.” New York City has closed schools and even outdoor dining. Pennsylvanians are required to wear masks in their homes. Californians are to wear masks between bites of food (except Governor Newsom, of course) and ordered to stay at home in the bay area. Schools in many states have committed to only offering remote learning for the foreseeable future, with over 40 million kids continuing to lose a year-plus of education.

Amidst the rising “cases,” are the lockdowns a proportionate response? Recall that governors locked down because the March 2020 Imperial College model predicted we’d be in a worst-case ten-fold shortfall of ICU capacity at our peak and a best-case three-fold shortfall. That never happened; we never got remotely close. Still, we’re locked down and really never fully reopened anywhere.

The WHO estimated in September that there may be 750 million people worldwide that have been infected with SARS-CoV-2. That run rate in America means that over 150 million Americans have been infected. No one that follows this closely would doubt at least 100 million have been infected. As “cases” rise and daily testing is between one and two million tests a day, it’s almost surprising that we’re not reporting over 300,000 cases a day.

Meanwhile, COVID-19 hospitalizations in America were at an all-time high in early January at ~132,000. How alarming is that? There’s no doubt COVID-19 activity is rising, but enough to justify more crushing lockdowns? With so many people infected, data from North Dakota, Iowa, and Miami suggest a good third of all COVID-19 hospitalizations are not from COVID-19 but rather patients with an unrelated illness that are carrying the virus. That applies to COVID-19 fatalities, too.

Consider South Dakota, which is, along with Florida, one of the two most open states. Governor Kristi Noem has been criticized by lockdown advocates for their rising cases and hospitalizations. However, the default for all states is to be open; we seem to have forgotten that. Locked-down states need to demonstrate far superior COVID-19 results in hospitalizations and fatalities to justify lockdowns. They aren’t.

South Dakota has 5.6% of their hospital beds occupied with patients with SARS-CoV-2 (meaning that they tested positive for the virus or have the disease COVID-19), down from a peak of 14% in November, when COVID-19 finally reached them. The United States as a whole is at 13.3%. However, look at the COVID-19 hospitalization percent in states neighboring South Dakota: Nebraska – 11.1%; North Dakota – 2.5%, down from a peak of 12% (North Dakota only counts those hospitalized for COVID-19 disease, not just testing positive, something all states need to do); Idaho – 15%; Montana – 9%; Iowa – 6%. Shouldn’t the locked-down states demonstrate fewer hospitalizations than South Dakota if their lockdowns were effective? They aren’t. Critics point to the surge in hospitalizations in South Dakota in November, as well as COVID-19 deaths. What they don’t contextualize is that every state around South Dakota peaked in the very same weeks. You can overlay one state’s curve over another, and they were nearly identical.

The total number of occupied hospital beds is basically flat compared to a year ago. South Dakota is below average in total occupied hospital beds for any cause. In November, tightly-locked Minnesota and Michigan were both up almost 10%, Pennsylvania was up a whopping 26%, and Wisconsin up almost 30%. If lockdowns work, shouldn’t they be doing better on average than the open states? South Dakota rose to a top-ten state in COVID-19 deaths per capita by year end, but it’s still in the mix with a dozen states that have been issuing harsh lockdowns for nine months and counting.

Florida completely opened up on September 25, removing individual mask mandates and most capacity restrictions; the Education Commissioner has consistently required schools to offer in-person options. If lockdowns work, the states surrounding Florida should have far better metrics for hospitalizations and deaths than the Sunshine State. They do not. Florida is rising in hospitalizations (still below their summer high), but so is every state within a thousand miles. Georgia, Alabama, Mississippi, both Carolinas… on and on. We can overlay each state’s curves, and they look almost identical to Florida. While it’s not reasonable to compare Florida to New Jersey and New York, it’s expected to compare them to the many states in the southeast.

CDC reports indicate that we have about 350,000 excess deaths in America for 2020. Most of those may be attributed to COVID-19, but a solid hundred thousand-plus are attributed to lockdowns: deaths of despair, Alzheimer’s abandonment deaths, deaths of those age 26-44 not from COVID-19, not to mention that it is estimated that 46% of the six most common cancers didn’t get diagnosed, half the 650,000 cancer patients missed treatments, and half of child immunizations were missed. We can discuss the 40+ million kids losing a year of education this year another time, all while people age 0-25 are actually 2% below average in total deaths this year. School-aged people are below average this year in total deaths.

The United States is +12% in all-cause deaths for 2020. Open South Dakota should be far surpassing locked down states this year in all-cause deaths. South Dakota is +13% in excess deaths this year. States doing worse than South Dakota that are locked down include New Jersey (+29%), Arizona (+22%), Illinois (+17%), Michigan (+14%), New Mexico (+9%), Colorado (+14%), Texas (+17%), and several others. When this is over, measuring all-cause mortality impacts will be the most reliable metric to determine the impact of COVID-19 and the lockdowns. If you consider COVID-19 deaths per million, locked-down states should have far fewer total lives lost than those that are open, and they do not. In many cases they are doing worse.

States that are locking down are not outperforming those that are open, and they should be by huge margins to justify lockdowns. The burden of proof is on the lockdown states to prove they are effective at suppressing COVID-19 infections, hospitalizations, COVID-19 fatalities, and all-cause fatalities compared to those that are open. They simply are not.

Michael Betrus is the author of COVID-19: Lockdowns on Trial, @betrus_michael



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