My father, Dr. Jay P. Gurian, a retired American Studies professor and Cultural officer for the State Department, just turned 91.  Locked into an assisted living facility under the shadow of Covid, suffering from Chronic Obstructive Pulmonary Disorder (COPD) and two other lung conditions, he is one of the people most vulnerable to Covid related illness and death.

As our country shut its economy down early in March, he said, “What in the heck are we doing?  We are going to go into a Depression in order to save some people like me? This does not make sense.”  This from a man who lived through the Great Depression as a child in New York City, then lived through WW II, then served in the Korean War, then fought the culture wars during the Vietnam era, then served in the Middle East during Desert Storm, and still teaches classes on world issues at a Senior Center.   He has been an active participant in life locally and globally.  He does not want to die.  But he is a social scientist who based his personal and professional life in understanding crises from a science-based perspective.   Even seeing what was happening in his native New York, still he worries that we are missing some very important things in our Covid response, things that we must consider immediately.

His son, 62 years old, also a social scientist with vulnerabilities to Covid due to asthma and auto-immune issues, I feel the sympathy he and all of us feel for fallen Americans, and I share his worry for our country.  As we watched–separately, from our own shelter-in-place domiciles–the spread of Covid, we talk by phone and Skype daily with one another, with relatives in New York, with friends around the country, and we also talk about the scales of crisis, like the scales of fate, with which everyone today is confronted.

Along with with empathy and our own anxieties, we share a deep concern that our nation is excluding information and research from multiple disciplines, thus avoiding the long view of this Covid crisis.  In the long view, we believe, lock downs and social distancing risk far more suffering to our country for far more people than lives saved from lock down.   Because my primary research area is child development, I will speak in this blog on behalf of our children to help our communities lobby for no future shut downs of our economy because of Covid.  Should this virus mutate into something more lethal than it is, my view and my father’s will likely change, but at this point, with Covid-19, the core questions we ask are primarily about our children’s futures.

With 20% unemployment (and growing) in our society, what happens to our children?

With schools closed, how do parents and children cope, and how do children avoid significant trauma as well as inadequate education?

With governors extending social distancing and other measures in some states like California, and with many schools and districts contemplating not reopening in the fall because of fear of liability, what happens to the child?

With national public health leadership suggesting we should expect to lock down again when the next surge comes in summer, fall or winter, and child and adult mental health suffering significantly during shutdown in ways we’ve barely begun to count, what about the child?

With services cut drastically across the board for lack of tax revenue especially in inner cities, among black and Latino populations, among the impoverished, and in rural areas, what happens to our children?

In answering these questions and making my argument to avoid future lock downs, I will challenge some of the assumptions you have heard in the public conversation up to date.  These assumptions are:

1.  Covid is a deadlier disease than many other causes of death in America, thus it warrants shutting down our country to fight it.
2.  Americans as a whole should be terrified by or at least significantly afraid of Covid because it is likely we ourselves or someone we love will die of the disease.
3.  Hospitals in all or most regions of the country were and/or are overrun with Covid cases or will be dangerously overrun.
4.  Children and families can get by well enough for a few months, a year, or more without brick-and-mortar schooling, social and mental health services, and full employment.
5.  The federal government can produce enough money over the next six to twelve months to help us survive a Depression while we wait for a treatment/cure/vaccine.
6.  Social distancing, quarantine, and lock downs work and have worked significantly to stop death and to protect hospitals and health care workers.
7. What we are told in the media is “the science” is the best and bulk of the science available to us as we face this difficult disease.

On the other side of studying these assumptions with you, I hope to convince you:

1. What we have done over the last few months was likely inevitable given the models presented to our CDC scientists at the beginning of the crisis.
2. Those models worked in a few areas but were not the best models to follow for most of our country, and going forward, we need to continue to expand our science beyond what we see on TV to include all new data available.
3. A new expansion of holistic science in the public discourse will set a foundation for ending lock downs of homes, schools, businesses, and communities in all areas except, when necessary, hot spots.
4. People who are sick, the frail elderly, and others who believe themselves vulnerable have the right and freedom to self-quarantine as they wish, and nursing homes will likely need to stay shut down for some time.
5. New data, however, creates a template for allowing our nation to avoid nationwide general shutdowns except in hot spots when the inevitable new surge of Covid comes in the summer, fall or beyond.
6. If we continue significant acute social distancing (except in hotspots) much longer, we will have entered an era in which our American treatment for Covid is worse than the disease.
7. In order to expand our thinking beyond the fear on TV and in social media, we will need to encounter and answer the question, “Is saving a life or a group of lives worth economic Depression?”

This is a lot to tackle in a blog, and I apologize for the length of this one, but I hope you’ll agree by the end of it that the science, data, and suggestions in it are worth discussion.

 

The Science Behind the Lock Downs

 

Some people in our culture have downplayed the significance of Covid as an illness.  I am not one of them.  Covid is a serious illness, in multiple ways, and worse than the seasonal flu because its patients who go to the hospital have average hospital stays longer than for the flu, and more Covid patients end up on ventilators per capita than do from the flu.  Because of lack of widespread testing, we do not know exactly how many people have the virus nation- or world- wide, but the number will end up in the many millions nationally and tens of millions worldwide, if not more.   Tens of thousands of people, especially 75 and older with pre-existing conditions, will die because of it, or because it suppresses their immune systems just enough for them to die of their pre-existing condition.  Simultaneously, some younger people will die from the virus, though that number is and will be very low under Covid’s present mutation.

No matter what, all death is very difficult for the dying, their families, and their friends.  Science is supposed to be utterly objective but all scientists are people, too, and no scientist does not feel empathy for people suffering in our civilization from this pandemic.

At the same time, the science of Covid is evolving daily, and we now have enough information to take a holistic, empathic view of various relevant factors.  Retired nurse, Susan Stoddard, 49, illustrated both empathy and holistic analysis on April 25, 2020 when while fighting breast cancer during chemo, she wrote this letter to the editor in her local newspaper (I have condensed this for space, all emphasis points are Susan’s):

“I was an LPN working in long-term care for almost 20 years.  I’ve worked through epidemics.  Initially, the president and our governor did what they felt was best following the science, but all models have a margin of error.  I am genuinely concerned about my fellow Americans as I watch them self-quarantine for my benefit.   The numbers of people dying from Covid actually suggest it’s high risk individuals who should be self-quarantining, but our governor is now talking about extending stay-at-home orders beyond May 4.  I DO NOT AGREE.  People who are healthy can work, use common sense, and should not have to stay home and lose their livelihoods.  I am one of those people who could very easily DIE from this virus, but this has gone on long enough.  This may sound cold and uncaring but it’s not!  Death happens.  It’s time to give people back their lives.”

For Susan to suggest our nation get back to work and back to their normal lives, she must be interpreting the science differently than governors or others are; and, she is.  Like me, she sees the social and mainstream media terrifying our nation and calls us to to look much more carefully at our Covid response from a comprehensive scientific perspective than we have.  One place to start doing this is this video clip from hospital practitioners in California.

https://youtu.be/xfLVxx_lBLU

These doctors’ interpretation of the science was flawed but data-driven and echoed what various scientists around the world are now discovering.  The video was taken down in the week I write this blog (April 30 – May 2), but I hope it will show back up for you when you read this.  In case it doesn’t, here are the points the two ER doctors made using data and statistical models.

1. COVID-19 is quite wide-spread, thus its actual death rate per million Americans is similar to or just slightly higher than the seasonal flu.
2. In certain hot spots like Manhattan, its death rate is another step higher and there is the probability of hospitals being overwhelmed in these hotspots for certain periods of time.
3. Most of the country, however, has had and will continue to have very low death rates from Covid whether locked down or not, and hospitals in most places will not be overrun.

It is crucial to remember that based on flawed early models, nearly all hospitals in most states and cities were shut down, with some doctors, nurses, and other staff furloughed, which had the cascade effect not only of destroying economies for some of these hospitals and their medical staff, but reducing services to people ill without Covid who needed hospital and surgical care.

Another video from an epidemiologist, Dr. John Giesecke, in Sweden/European Union provides more scientific analysis along this line.

https://www.youtube.com/watch?v=bfN2JWifLCY

In the California video, a reporter challenged the two doctors, “Who are you to disagree with Dr. Fauci?  Fauci is world renowned.”  The doctors did not have a good answer, but Dr. Giesecke does.  He is just as world renowned as Dr. Fauci, and he sees much more of a herd immunity necessity than Dr. Fauci.   Drs. Fauci and Dr Berks have worked tirelessly on America’s behalf, and they should be appreciated by all of us, just as our hospital and health care workers are heroes in this era.  They are not, however, the only resources available to us for studying Covid from a holistic viewpoint.

 

Covid Death Rates in Perspective

 

Where does Covid fit statistically in American death rates?  What are the chances that you, an elder you love, or your child will die from Covid?  Are those chances higher than death rates for other diseases–diseases we suffer from every day but against which we do not put our country into economic recession/depression?

In 2017, there were 647,457 deaths in the U.S. from heart disease (2017 is the last year for which numbers are available); there were more than 600,000 cancer deaths, as well.  There were 67,000 deaths in 2018 from drug overdoses, including opioids.  There were a total of 708,000 deaths in the U.S. every three months in 2018.  Last year, 2019, we had more than 40,000 deaths by suicide.  Overall, each year, America suffers a total of 2.9 million deaths from all causes.  You can find these figures and study them yourself on the CDC website and on various websites for relevant non-profits such as the American Cancer Society.

Most models now put actual Covid 2020 deaths around 100,000.  Some people are now being counted as Covid deaths when they died of another cause; similarly, some people are not being counted as Covid deaths when they should be, so the numbers will shift, but whatever the exact number ends up, 100,000 real Covid deaths looks relatively certain.   Putting this number in the context of our country and its 325 million people, Covid deaths account for a death rate far below the death rates for many other killers, hovering at around the .03 percent range, which is very low; without the deaths in hot spots and nursing homes, the death rate would go down to a statistical range of around .001.

Because viruses like Covid tend to flare in hot spots of high population density with close-quarter subways and elevators and similar technologies, the numbers of transmission, illness, and death are generally higher in those hot spots than the rest of the world.  In America, for instance, most deaths have occurred in hot spots like Manhattan, and there has been a concentration of deaths in nursing homes.  But when we divide America into states that are themselves each about the size of some European countries, we find the death rate in some states to be in the range of .0001 percent.

Statistics cannot erase the pain of a loved one dying from heart disease, cancer, gunshot wound, flu, military service, addiction, other cause, or Covid, but, too, between 30 and 40 million Americans are out of work as of this writing (May 2, 2020) because of lock downs in areas of the country that did not need lock downs–they never carried the hot spot viral risk of flare up in the first place.  This means millions of families are in significant distress, adding up to hundreds of millions of Americans suffering loss and increasing desperation, especially among the poor, people of color, and children of the newly unemployed.

Two months ago, we did not know what we now know.  Leaders in public health, especially Drs. Fauci and Berks, argued that everything and everywhere had to be locked down.  We can argue about whether they were right or wrong, and all argument on this would be hindsight.  Better would be to look at what we know now about the efficacy of lock downs.

 

Do Lockdowns/Shutdowns Work?

 

On April 26’s Sunday morning talk shows, Dr. Berks advanced her view that “the science guided her and Dr. Fauci to argue our nation should”:

• agree with the position that quarantine, lock down, shutdown, and distancing of the whole country was necessary to significantly impede virus spread and death;
• therefore, practice significant social distancing across the nation for months or the next year;
• do so in order to avoid or later to manage multiple new surges of Covid which will emerge as soon as we come out of our first shutdowns;
• once the surges come, we should respond with full or partial shutdowns again, as often as needed until there is a vaccine; and
• we should follow this shutdown/lock down model because it works.

The CEO of a semiconductor company, T.J. Rodgers, during the week of April 20 – 27, employed his team and their technology to analyze the efficacy of shutdowns and lock downs.  Because some states in the U.S., and some countries like Sweden, did not lock down and/or participated in partial shutdowns, it was possible for Rodgers and his team to gather data.  In the Wall Street Journal (Do Lock downs Save Many Lives? In Most Places, the Data Says No, April 27, 2020), Rodgers wrote:

“We ran a simple one-variable correlation of deaths per million and days to shutdown, which ranged from minus-10 days to 35 days.  The correlation coefficient was 5.5%, so low that the engineers I employ would have summarized it as “no correlation.”  Data suggests New York City might have benefited from its shutdown, but in places with low Covid-19 death rates, such as my native Wisconsin, lock down doesn’t make sense.”

Rodgers and his team compared death rates in other countries with Sweden, as Dr. Gierneke has also done.   Rodgers writes, “How did the Swedes do (who shut down very little of their economy)?  They suffered 80 deaths per million 21 days after crossing the 1 per million threshold level.  With 10 million people, Sweden’s death rate without a shutdown and massive unemployment is lower than that of the seven hardest-hit U.S. states—Massachusetts, Rhode Island, Louisiana, Connecticut, Michigan, New Jersey, and New York—all of which, except Louisiana, shut down in three days or less.   Despite stories about high death rates, Sweden’s is in the middle of the pack in Europe, comparable to France; better than Italy, Spain, and the U.K (which all shut down their economies).  Older people in care homes accounted for half of Sweden’s death.”

Lock downs/shutdowns, this data indicates, don’t do much to keep death rates down in most places, and do not necessarily work for the vast majority of the world’s people; nor do we have proof that they do or have worked even for a minority, except that common sense shows us they partially worked in hotspots like New York City, where lock down assisted heroic health care workers to keep vulnerable individuals safe over a two to three-week period of surging disease and death.  The data also seems to show that lock downs and shutdowns are likely necessary in nursing homes, if the virus can be kept out of the facility.

Complicating matters here is that even our common sense belief in lock downs for hot spots might need adjusting.  Massachusetts, for instance, and Boston in particular, shut down their economies very early, in the first week of March, but their infection and death rates have not, two months later, come down; instead, they have plateaued.  Even this small gain is a good thing, we can say, and it is, but the fact remains, the lock down did not have the effect state officials thought it would by now.  Among the reasons are immigrant populations that live in large numbers in a small single family home and the fact that half of the state’s deaths have been people in long-term care facilities (Washington Post, May 1, “Massachusetts Did the Right Thing but Cases Surged,” by Griff Witte).

Even if we agree still argue that lock downs and social distancing must, logically, have some positive effects on slowing the virus, still, we are faced with the question:  given that they are not as effective as once thought, should we use them anymore, or are their economic consequences except in particular hot spots and nursing homes too dire?

Data is only as good as the numbers put into it, and surely we will find some way in which Rodgers’ data is imperfect, but with data now in from Sweden, Massachusetts, California, and much of the world, the point remains:  we shut down a whole country with “science” from a few scientists saying lock downs would stop deaths, and it appears the lock downs were likely effective for a minority of people but minimally or not effective for most of us.

That is another important piece of the scientific puzzle as we move forward to protect our nation’s children.

If lockdowns help somewhat in some places but do not help in most places, we need to learn from the spring Covid crisis and stop contemplating mass lock downs going forward.  If we lock down or shut down again, we will double down on cruelty to our nation and its children without significant or compensatory positive impact on death rates and hospital staff nationwide.

 

Depression Destroys Lives in the Long Term at Higher Rates than a Virus Does

 

With 20% unemployment and thousands of failed business in a society, what happens to our children?  With schools closed, how do parents and children cope, get educated, connect, mentor, survive or thrive?  With some governors extending social distancing and other measures in states like California; with many schools and districts contemplating not reopening in the fall because of fear of liability; with national public health leadership suggesting we should expect to shut down again when the next surge comes in the winter; with services cut drastically across the board for lack of tax revenue especially in inner cities, among black and Latino populations, among the impoverished, and in rural areas, what happens to all these children?

Tens of thousands–likely hundreds of thousands–die and/or suffer from:

• Suicide
• Child abuse
• Poverty
• Crime
• Violence
• Sexual abuse
• Substance abuse
• Alcoholism
• Deaths of despair
• Educational failure
• Unemployment
• Anxiety
• Purposelessness.

There is no mental health issue including post-trauma response that will not rise.  As 30 – 40 million parents lose jobs, most will become depressed.   Economic depression always leads to wide scale human depression.  Specifically in the area of schooling, our children, especially the under-resourced, will not receive the education we need them to receive.   Not only will they have been locked out of school and, for many of them, locked out of learning because they do not have ready access to and context for significant online learning, they will be locked out of success paths our nation needs them to find for the sake of our national future.

Deepening the ongoing crisis, without immediate national return to patterns of consumption and normal life, there will be inadequate or empty budgets available for teachers and schools because state coffers will be depleted and federal stimulus dollars can only go so far.  The domino effect of teacher furloughs, lack of teacher training, and lack of educational resources will pass dangerously onto children.  Down the road at hospitals, furloughs of hospital personnel in rural areas will become permanent or will at least last for years.  Health care, education, and social service systems will be so denigrated as to become ghosts of what they are now.  Overall, we will end up with between 40 – 50% of American at or near the poverty line.

 

An Action Plan Going Forward

 

Based on the analysis I have just presented, I plead for us to quickly return our economy to something close to normal, with these ten strategies in mind, and in basic agreement that we will not shut down our economy again unless we see a virus mutation that raises death numbers much higher, per capita, than they are now.

1. Testing is crucial over the next year and beyond.  Testing will show what new research models from Stanford (Stat News, John Ionnidis, April 2020) showed last month—tens of millions of Americans have, have had, or will have Covid, and their percentage of death is statistically low.  Without adequate testing, though, the incomplete death numbers and death rates published on television every day will continue to inordinately frighten the public, and we will not understand the advantages, in most areas, of herd immunity.
2. As we open the economy, we must fight our fear by using comprehensive science that shows us exactly where hot spots are, and what shutdowns are actually needed in what localized areas such as nursing homes.  Using common sense, let’s consider buying middle seats in airplanes once they go on sale and, in most parts of our country, frequenting restaurants, ball games, conventions, places of worship, and all the other social institutions we love so that we can become full consumers and gatherers again, and thus rescue our economy for our children.
3. Provide waivers to all schools, educational institutions, places of worship, and similar organizations so they cannot be sued if the virus transmits through their personnel or brick-and-mortar location, while also providing everyone in that location with good guidelines for effective hygiene.  People are smart and will use common sense if we provide them with health information that they need to minimize the spread of the virus in close quarters.  These common sense measures will become a part of our basic survival instinct.
4. Keep sick people quarantined, which is something most sick people should always do in all cases, and keep the vulnerable and elderly who are in nursing homes quarantined until it is safe for them to re-emerge into public life; meanwhile, encourage them to consume online to help get the economy re-started.  Each human being has the right to self-quarantine if they wish–if you want to work from home and can, work from home–that freedom is essential.  Meanwhile, the elderly not in retirement facilities will likely need to self-quarantine in their domiciles during surges.
5. Provide social programs for the poor, rural populations, and inner city populations that will help them through the fallout from the lock downs; reinvigorate charity giving, philanthropic and grant funding as the stock market, hopefully, rises back up and investment dollars again flow, so that we avoid the very dangerous situation of an expanded poverty line without essential services.
6. Do not lockdown again, even when the next Covid 19 surge happens, except in hot spots and elder facilities as necessary. Especially crucial in all this is the full opening of schools without threat of future shutdowns so that we can protect our children from what is now becoming a new crisis, overuse of screen time during lock down, with concomitant negative brain effects.
7. Fund and develop national and international preparedness for present and future viruses that include national shutdowns only as a last, not first or primary, resort. We will have many more viruses over the next decades because climate change is warming the planet such that more viruses will emerge.  Let’s learn from Covid 19 and put into place best practices that quarantine the vulnerable and sick while the rest of us keep our economy moving and our children flourishing.
8. Re-define the mission of the military to include field hospital construction in hot spot areas now and in the future.  Because a new Covid or other viral surge will happen more than once, the military should be re-purposed with an added mission: to provide extra beds and field hospitals immediately so that hospitals in hot spot areas do not have to furlough doctors and nurses and destroy their own business to wait for surges.
9. Keep politics and narrow science out of virus response.  Largely due to the way our media reports crises (also due to this election year in which politicization was likely inevitable), we have torn our country apart politically on the backs of crisis response.  As the President, governors, and Congress wrangle against one another, all of us lose.  Most of us will need to turn off social media, TV, and print media that pushes terror and fear.  And we will need to stop taking the bait when one side of the aisle or the other uses crisis as a political weapon.
10. Put children first, always. This means making no decisions culture-wide or locally that will significantly harm our nation’s children.  In the area of shutdown and economic recession/depression, we need to re-frame our future political discussions to account for the welfare of children as our first principle.

Hopefully our children’s health and welfare will inspire us to respond differently to fear.  When a well-meaning leader says, “If we even save one life, we are doing the right thing,” we will listen carefully to the science behind the statement and then ask in response, “But how many children’s lives will be lost or destroyed?”

This is a bitter weighing of scales, but one we must have the courage to undertake.

 

The Denial of Death

 

A final point I will make is a philosophical one that calls out to us, I believe, from deep within the human soul.

The psychologist Ernest Becker wrote in Denial of Death (1973) that all cultures and civilizations must come to grips with death in their own way.  America, he noted, is more afraid of death and more in denial of death’s grace and necessity than many other countries and zeitgeists.

As I recently discussed Becker’s book with my father (who, during my teen years, gave me that book to read and discuss), we talked about the psychology of our shutdown response.  “A civilization that protects its children is one that has accepted the reality of death,” my father said to me in our daily call yesterday, “but when we deny the inevitability of death, we become terrified even of sickness, and we make irrational, fear-based decisions that we later regret.”

At 91, Dad has seen a lot of death.  He understands it and is ready for his own. When he saw the Imperial paper that triggered the shut downs (2,000,000 American deaths from Covid were modeled in that paper), he saw what we all saw, a terrible carnage that required lockdown to avoid.  Within a week or so, though, that paper was altered and in some ways debunked.  It was at that point in mid March Dad said, “What the heck are we doing?”

Not in fear but with resilience, ingenuity, and an urgency for immediate rebirth will we revive our economy, our schools, our families, and our communities.  To be reborn from this crisis stronger than we went into it, we will need to admit  some of the mistakes we’ve made in terms of lack of testing and unnecessary national lockdowns and admit, too, that we as a nation may be so terrified of one death as to destroy tens of millions of livelihoods to avoid it.

Please write me at info@gurianinstitute.com with your stories, thoughts, and even with your disagreements or arguments against my viewpoint.  A healthy scientific debate is crucial to the welfare of our country’s children, and indeed, to the healthy future of our world.

–Michael Gurian, May 2, 2020