In this epidemic, what we don’t know is killing us

By Phil Lawler ( bio - articles - email ) | Apr 20, 2020

Sometime in January, before most of us had heard anything more than vague rumors about CO19, I developed a nagging cough. It was never more than a minor nuisance—the sort of cough that comes with an ordinary cold—except that it stayed with me longer. Finally the cough went away, but I developed a low-grade fever, and felt exhausted. After two days spent mostly asleep, I felt fine again. Was that just a bout with an ordinary winter flu, or did I actually have an early encounter with CO19?

We don’t know.

And that’s an important question, isn’t it? Because if I’ve already been exposed to the virus, then maybe I’m safe. Or am I? Does one battle with the virus confer immunity?

We don’t know.

That’s the answer to nearly all of the most important questions about this epidemic: We don’t know.

• We don’t know how many Americans have already been exposed to the virus. Estimates range from under 1% of the population to over 20%.
• We don’t know how many of the people who are exposed will be hospitalized or will die. The latest statistics suggest that early estimates of the mortality rate may have been 50 times too high. (To be fair, these statistics are disputed—as are pretty much every set of statistics connected with this mysterious disease.)
• We don’t know how contagious the virus is. Some models assume that each person who is CO19-positive will infect four others; other models say that’s four times too high.

No wonder, then, that since this epidemic hit the headlines, and experts began making apocalyptic predictions based on their models, none of the predictions have been on target. Think of those models as complicated mathematical equations, in which nobody knows the variables.

We don’t know.

Yet on the basis of our pitifully inadequate knowledge of this disease, we have embarked on the most radical set of public policies—apart from all-out war—in the history of the human race!

Think about it. We have shut down a large portion of our economy, voluntarily creating unemployment on an unprecedented scale. We have required people to live in a situation that is unnatural if not unhuman: staying at home, not meeting with family and friends, keeping energetic little children indoors, holding the elderly in isolation in nursing homes, forbidding political gatherings, limiting public prayer. The US government, already drowning in debt, has given away several trillion dollars that it does not have, and now plans to give away trillions more, in a desperate bid to prop up the economy artificially. Churches are closed, schools are closed, the Bill of Rights has become an afterthought, neighbors are spying on neighbors.

And we did all this—we took these drastic actions—on the basis of what we know about CO19. But…

We don’t know.

Some of these actions may have been justified, in light of what (very little) we knew a few weeks ago. The virus looked so contagious, and so deadly, that it made sense to try to “flatten the curve.” If we could slow the spread of the disease, and protect the resources of the health-care system, we could save some lives. A month of “social distancing” seems to have had a beneficial effect (although, sure enough, that too is in dispute). But there has never been a viable plan to eliminate CO19, short of the development of a vaccine that might still be years away. Sooner or later these draconian policies must be lifted. And then what will happen?

We don’t know.

In this unusually informative interview, Dr. Jay Bhattacharya of Stanford, who has conducted some much-needed research on the spread of the disease, declines to criticize those who have shut down America’s (and the world’s) economic and social systems in a pyrrhic campaign against CO19. It serves no useful purpose, he reasons, to blame policy-makers for the decisions they reached on the basis of inadequate information. What is urgently necessary now is to find better information. How infectious is CO19? How deadly? How many people already been infected? We need to know.

We also need to know the costs associated with the current emergency regulations. Today anyone who proposes easing the shutdown is likely to be condemned as a merciless killer, ready to sacrifice human lives for the sake of the economy. That argument is obviously uncharitable; it is also unintelligent.

The costs of the shutdown are not merely economic. Nor is it simply a question of comfort. The shutdown itself is costing human lives. Calls to drug-abuse hotlines and suicide-prevention services have skyrocketed. Elderly people locked down in care facilities, unable to see their loved one, are suffering a dangerous loss of morale. Heart patients, told to stay indoors, aren’t getting the exercise they need. With hospitals postponing all “non-essential” services, cancer screenings aren’t being done, and in some cases won’t be done until it’s too late. How many people will die of these and other unintended consequences of the shutdown?

We don’t know.

The curve seems to be flattening (although sure enough, that’s in dispute) and policy-makers are beginning to plan for some lifting of the restrictions that were hastily imposed. Those plans should be based on facts, not speculation. We don’t need more models. We don’t need more rhetoric. We certainly don’t need accusations. We need answers.