Tales of lockdowns and Dr Fauci

With the US reporting > 60K new confirmed cases per day, many countries are also having small upticks, like hundreds of cases in Australia, Japan, Serbia, etc, begging the question of whether lockdowns will resume.  Which is unlikely to happen on a large scale as previously.   

Lockdown is being used as a one-size-fits-all phrase, but its application has been wildly diverse.  Lockdowns in Wuhan, rest of China, Italy, and NY are vastly different.  During some period of the Wuhan lockdown, most people could not get out of their homes, and anyone with a symptom was sent to a hospital.  For China outside of the Hubei province, many people must stay inside their local communities.  Shopping was done online and delivered to the doorsteps.  Italy and NY were much looser, as people could go out for shopping, exercising, and more work, and many with symptoms allowed to quarantine at home.  Wuhan lockdown lasted for 2.5 months, most Chinese provinces <1.5 months, and other countries and states 1-3 months.   

         

Furthermore, some places didn’t order a lockdown at all.  They nevertheless also felt the effect of a de facto lockdown: people stayed at home more even though they were not required to do so, simply because of the fear.  In other words, places without an official lockdown can’t avoid the lockdown consequences, positive or negative, either.  Sweden hopes by not locking down, the economy would be saved.  Instead, its economy contracted as much as its locked down neighbors, not entirely due to the disruption of international trades.  Hence a result not expected in Feb-Mar 2020.  When analyzing whether a lockdown is worthy or not, people must realize a lockdown in place A is not the same as in place B, while a non-lockdown in place C is not completely lockdown-free either.  In essence, lockdown vs non-lockdown is a false dichotomy.  Only what kind of lockdown effects one gets is the right question.  Wuhan lockdown worked doesn't mean a lesser lockdown wouldn't have been effective.  Reversely, if you have a garden-variety lockdown, don't assume a Wuhan-like result. 

Opening or reopening with COVID-19 hanging over the head has a meager return.  Many people will curtail activities no matter what.  Many other people will go out, of course, upon reopening, then get infected, prompting calls for a shutdown.  The only viable option really is to suppress cases to a very low number before doing anything else.  The slogan flattening the curve is actually meaningless unless the curve is not flat but down significantly.  Short of that, pray for a good vaccine soon.  This is the ultimate lesson for the past 4 months.  

That lockdown, strict or relaxed, saves lives is undisputed, at least in the short term.  But does lockdown only delay the loss of lives?  Because lockdown can’t go on forever, and once it is over, COVID-19 will come back.  Thankfully, this nightmarish outcome is unlikely as long as societies are still functional.  Many countries had survived lockdowns and stemmed the pandemic by May 2020.  While they continue to battle outbreaks in June and July, the situations are much better than the first time around.  Instead of thousands of new cases per day in Mar-April, at most hundreds by July.  Therefore, a key lesson learned is that if one can get the cases down to a low level, 10% of the highest or even lower, COVID-19 will be manageable.  COVID-19 is not that deadly, 99% of the infected will live.  If lockdown ever returns, likely a limited, targeted, and less restrictive version will suffice.  Of course the flip side is that if the first round of lockdown didn’t achieve that, then it would be too short, like in the US.

The US has a big flareup since mid June for many reasons.  First, the top, was focused more on blaming China and WHO than being productive.  Second, the local, governors had different policies, ignoring the fact that state lines are imaginary.  Third, the people, some are just not responsible: bars, partying, no masks.  As a result, the US locked down briefly, reopened quickly, the daily cases dropped to only 20K from a high of 40K, then is racing back up over 60K.  Unlike the EU, and countless other countries.  How to deal with this today?  Dr Fauci implies returning to some sort of lockdown.  Others suggest mandating bar closure and masks.  Perhaps a non-lockdown lockdown, or becoming another Sweden.

Politics and anti-science underlie all these problems.  Dr Fauci has been sounding alarms from March to July, contradicting the rosy pictures painted by the WH.  In response, the WH has compiled a list of Fauci’s “wrong” comments in order to discredit him (https://www.yahoo.com/news/white-house-seeks-discredit-fauci-184700526.html).  Comments which are not necessarily “wrong”.  Like Fauci saying in Jan and mid Feb 2020 that COVID-19 was not a major threat in the US (4/4/2020 blog).  Evidence is clear now the US had only limited transmission until mid Feb.  The first patient in WA on Jan 19, 2020 didn’t lead to the late Feb outbreak in Seattle.  While there were early cases/deaths in CA, CA contained COVID-19 quite well until June 2020.  The major outbreak happened only in NY around Mar 1, after those in Western Europe in late Feb.  NY was bad not because COVID-19 arrived early, but because, being NY, it had a lot of superspreading events.  Thus, at the time Fauci made those statements or judgements, COVID-19 was manageable in the US.  Dr Fauci is no god: one always adjusts his views based on new data, and we are still learning about COVID-19 7 months later.  But the most importantly, had the WH followed Fauci’s subsequent advice, the US would have been much better.  Don’t blame the map for not getting you there when you enter the wrong GPS address.  

Then there is this mask debate.  It is important to note that even after the CDC OKed wearing masks in April, plenty of officials and people vowed not to, so blaming Fauci is sheer hypocritical.  The US might be the last country on Earth to resist masks.  Some of the prior justifications for not wearing masks are not unreasonable, even if one disagrees.  On the other hand, it does reflect poorly on certain people who should have known better.  The Surgeon General just explained why masks were not recommended earlier (https://www.cbsnews.com/news/coronavirus-surgeon-general-jerome-adams-wearing-masks-face-the-nation/), and one reason was not knowing asymptomatic transmission until April.  Astonishing if true.  This was a well-known fact by the end of Jan and published in numerous scientific papers and media reports.  CDC has said it since Feb.  One can argue the difference between the pre-symptomatic and true asymptomatic, but this matters little in real time because nobody knows what will happen to you 3 days later when you have no symptoms today.  Of course how much it contributes to spreading is uncertain, but it is nonzero for sure, and based on past experience and common sense, precaution is warranted.  A sense that the US simply doesn’t trust anybody.   

When the Wuhan lockdown, the mother of all lockdowns in the last 100 years, was initiated on Jan 23, 2020, it was hard to imagine anyone could miss the significance of it, whether he/she considered it worthy or not.  The only reference then was SARS in 2002-2003: SARS also spread to other countries, but China was the worst affected.  So how COVID-19 would turn out was never set unless China had a crystal ball.  From Jan to mid Feb 2020, it could be reasoned that by a severe lockdown China aimed to stop COVID-19 quicker than SARS, and the rest of the world would fare no worse than with SARS.   Dr Fauci might have thought so, too.  Although many more people got infected and died, China did stem COVID-19 (3 months) faster than SARS (> 6 months).  Only COVID-19 is no SARS.  And WCEV is worse than COVID-19.  

On a separate subject, an open letter was signed by 153 prominent names to denounce the “cancel culture” (https://harpers.org/a-letter-on-justice-and-open-debate/).  Surprising that Noam Chomsky was one of them.  This “cancel culture” is a made-up scam, and the letter and its undertone have been soundly refuted (e.g, https://theobjective.substack.com/p/a-more-specific-letter-on-justice, and https://www.yahoo.com/huffpost/cancel-culture-harpers-jk-rowling-scam-191428327.html).  A big knock on the letter is that “cancel culture” is nothing new or compared to how the media and platforms have long been dominated or filtered by an elite and biased minority.  The author of “Manufacturing Consent” should have known better.  Case in point, in the West and the US, China is a coded word.  Saying China is bad requires no credibility, while anything positive or even neutral in press is radioactive and demands an exceeding level of standards and courage, if ever allowed.  The speed of COVID-19 identification was unprecedented in the history of disease (https://www.the-scientist.com/news-opinion/opinion-dont-disparage-the-pace-of-covid-19-research-67653?utm_campaign=TS_DAILY%20NEWSLETTER_2020&utm_medium=email&_hsmi=90653921&_hsenc=p2ANqtz-9EEdsJ9vksnr3M56Oy6fDQRRr2BK9Yu4dwf_P-JtLxvrKH8AH_pjC1f-8gNyMdZRtKEQ5NXHKR12fdMEigPVCQb-S0Sg&utm_content=90653921&utm_source=hs_email).  Wuhan had an earth shattering lockdown.  Everybody in China wore a mask from day 1.  No matter, China was hiding sth.  Scapegoating, now including targeting Dr Fauci, feels better than self reflection.