What Is the Alternative to Lockdowns? A Symposium

Edward Stringham. My main academic contribution has been to emphasize the centrality of private governance in the building of social order. Private governance requires freedom, so that people and institutions can experiment with solutions to any and all social, cultural, and economic problems. There is not one answer but many competitive answers. As part of private governance there is learning. We find successes and emulate them. We observe failures and avoid them. Through this process, society gets better at dealing with the exigencies of existence and the need for progress. All of this pertains to the management and mitigation of disease. There is no one answer but many. Without the freedom to discover, we will be worse off. Private governance does not dictate models but lets them evolve by permitting individuals and institutions to use intelligence to find the right paths. Central planning does not work for public health any more than it does for the production and distribution of any good or service. 

Phillip Magness. Even before the Great Barrington Declaration came out, I was arguing for what amounts to a “focused protection” strategy centered upon our most glaring vulnerability during the pandemic, the nursing home situation. Not only have we failed our nursing homes, but most policy decisions in this area have been nothing short of disastrous. We have known about long-term care vulnerability since at least February when the earliest US outbreaks hit nursing home facilities in Washington State. These early data points were neglected in the policy response. The Neil Ferguson/Imperial College study that induced the US and UK to go into lockdown even specifically omitted nursing homes from the model it used to make these recommendations: “Lack of data prevent us from reliably modelling transmission in the important contexts of residential institutions (for example, care homes, prisons) and health care settings.”

Neglect of the nursing home situation turned to outright incompetence in March and April, when several states in the Northeast blundered their way through the first wave by adopting regulations that forced nursing homes to readmit Covid-19 patients. The regulations were likely intended to alleviate the strain on the hospital system by freeing up beds and moving their occupants into these facilities. But the hospital collapses never came, and instead they simply introduced Covid to run rampant through one of our most vulnerable populations. Catastrophic nursing home death tolls have become the predictable and avoidable result in many states.

Per the latest statistics, nursing homes alone make up at least 37% of all Covid-19 deaths in the United States – and the true number is actually much higher, because one of the worst states for nursing home patient readmissions – New York – intentionally hides its true nursing home death toll by excluding long-term care residents who died offsite in emergency rooms and hospitals from its counts. After almost a year of the pandemic, the evidence is clear: lockdowns do not effectively shield nursing homes. 

So what could we do to address the acute vulnerabilities of our long-term care facilities? One proposal that I’ve personally advocated since last April builds on an idea from a handful of privately operated nursing homes in the US. The operators of these facilities noticed early on that nursing home outbreaks came from residents and staff who carried the virus in from the outside world. They therefore adopted measures to house and accommodate staff onsite until the danger passed. One nursing home operator in Connecticut brought in RVs to house his staff onsite.

Others converted unused rooms at the facilities into staff residences. In the handful of places it was deployed the nursing home “bubble” strategy worked. Unfortunately, the lockdown emphasis of the Covid response and the accompanying neglect of nursing homes means we missed a genuine opportunity to try this strategy more widely. Indeed, when the second wave hit in the fall some nursing home facilities even began repeating their mistaken and deadly readmission practices from the spring. What might the alternative look like under a “focused protection” strategy? For one, we could subsidize nursing homes to bring in temporary housing (onsite RVs and trailers) for staff. Since asking staff to commit to living in a bubble for several months would take a toll on the nursing home workforce, we could also subsidize those who volunteer for this job with substantial salary premiums. Even though these seem like expensive options in their own right, the cost is miniscule when compared to the economic destruction of a year under lockdown and the public spending extravaganza of recurring trillion-dollar stimulus packages and payouts.

Jeffrey Tucker. I’ve seen many people asking what the alternative to lockdown is. The question presumes that lockdowns are normal. They are not. They are without precedent. Modernity has a long history of infectious disease and experience in dealing with new viruses for which there was no vaccine. We still managed to prioritize human rights and freedom. We used to understand the alternative to a medieval approach. Let individuals and medical professionals handle disease, not politicians. This idea was central to public health. It was the approach in 2009, 2006, 2002-2003, 1968-69, 1957-58, 1948-52, 1929, and so on, ever since public health discovered the scientific basis of immunology as it pertains to pathogens. Preserving the normal functioning society must be the priority in order to maximize the health of the community, and not by focusing on just one pathogen but all aspects of public health. I’m drawn to Sunetra Gupta’s understanding here. We have long lived with an evolved and implicit social contract: we agree to respect each other’s rights even in the presence of pathogens. That understanding needs urgently to be rediscovered. Now we find ourselves in a very difficult position of having to recover lost knowledge of 20th century public health wisdom. 

Robert Wright: As I suggested on 4 April, the alternative to government-imposed lockdowns are self-imposed “lockdowns” where each individual, household unit, and business decides what is best for it given its circumstances. Everyone knows about Covid-19 and what steps they need to take to “stay safe.” That might mean life as usual for a 20-something who already had the thing and might mean almost complete isolation for an 85-year-old with diabetes, with endless variations in between. Businesses know, or will soon discover, what they need to do to maximize revenue, which might mean business as usual on M-W-F and severe social distancing restrictions on T and S. Instead of just doling out cash to everyone, governments might pay delivery fees for everyone self-quarantining due to risk of active infection and subsidize sick days for employees who display symptoms. Policymakers cannot even control economies much less the natural world and should never have tried to “fight” a virus as if it was an enemy combatant but governments can intervene intelligently with targeted responses.

Donald Boudreaux. Given that Covid reserves most of its horrors overwhelmingly for an easily identified group – the very old and ill – the best course is, and would have been from the start, what the co-authors of the Great Barrington Declaration call “Focused Protection.” This thoughtful approach explicitly recognizes Covid’s contagiousness while implicitly recognizing also Ronald Coase’s insight that externalities are always bilateral. Human interaction creates not only some risks for fellow human beings but also many benefits. When you dine at restaurants you help waiters and cooks earn their livings. You might even, simply by being a smiling face, enliven the restaurants’ atmosphere for other diners. When you go to work you help your co-workers earn their livings as you increase the supply of goods or services available to consumers. When you venture out, unmasked, for walks in the park you often run into friends and neighbors – and sometimes even strangers – who benefit from stopping to chat with you. By going downtown to dine or shop or hear live music you contribute to the city’s vibrancy – itself of great value to countless strangers. If you’re going to analyze Covid and the response through the lens of externality theory, the positive externalities – in addition to other positive consequences – of human interaction (and of human freedom) cannot be ignored.

Jenin Younes. The question implies that lockdowns are the default response to the emergence of a new virus, when in fact large-scale, long-term quarantines of healthy populations have never been implemented before, let alone on a global scale. Ten months in, anyone who has done his or her homework knows that this unprecedented experiment is a catastrophe of epic proportions. Millions of lives and livelihoods around the world have been destroyed; poverty and mental health problems are skyrocketing; children have been deprived of crucial years of education and social development.  Perhaps worst of all, jurisdictions that enacted lockdowns fared no better in minimizing coronavirus deaths than those that did not, so the evidence is in that all of this was for nothing. It is pure hubris to believe that we can rearrange societies around the existence of a single pathogen without devastating consequences. So what is the alternative? Well, I would say a return to common sense and recognition of human rights. People should be given accurate information about the risk they face from medical professionals who are not feeding into media-driven hysteria, allowing them to make decisions about how they want to live accordingly. Treat the sick as best we can and fund research of treatments and vaccines, just as we have always done and continue to do for all other diseases.

Ethan Yang. The biggest mistake that was made during this pandemic was subscribing to a romanticized version of reality that destroyed our ability to promote the general welfare of society. Fighting Covid-19 became a moral issue rather than a policy issue. Perhaps it was because it came during a time of political tension and Covid-19 was the ammunition needed to spark the war. A war against Trump, a war against globalism, a war against enlightenment values such as individual liberty. If you just listen to all the narratives about how selfish Americans won’t wear their masks, it’s clear many issues have been leveraged as a tool to lead an attack on traditional American values rather than actually fighting the virus. The idea that Americans are inherently selfish and don’t wear masks is a false narrative at least according to YouGov data. From February to June 2020, it was reported that a higher percentage of Americans wore masks than their counterparts in Canada, Britain, Mexico, Sweden, Denmark, Norway, and kept pace to an extent with France, Italy, and Spain. Furthermore, there is a constant narrative that America didn’t lock down hard enough as if nobody noticed that two weeks to flatten the curve turned into ten months and counting. The fact of the matter is that the United States ranked quite high in lockdown severity according to the Oxford Government Response Tracker and with the strictest countries also having the most deaths per capita. Then when good-intentioned people such as Oxford’s Dr. Sunetra Gupta attempted to come forward with new ideas, rather than “listening to the experts” such dissenters were savagely attacked. There is plenty of evidence that pandemics can be better managed without lockdowns but I don’t think that was really the problem. The real problem was that we never wanted a conversation to begin with. 

Peter C. Earle. Early on I was stricken by the South Korean approach, where the engine of prosperity wasn’t subverted in the face of a then-unclear menace. It wasn’t just that Seoul responded so quickly and with such a meticulously-crafted, commerce-centric response. The United States, England, Germany, France, and many other countries with much larger economies and more extensive trading relationships, and thus one would think more to lose, took nearly the opposite approach: lockdowns, stay-at-home orders, and other euphemistic terms for forcibly imposing an economic depression.

We will be learning about the secondary and tertiary effects of lockdowns for decades, but a question that comes up repeatedly is: “So it’s turning out that lockdowns were an unnecessarily heavy-handed policy response, but aren’t there some diseases – something akin to the bubonic plague, say – that would necessitate that kind of government response?” My answer is: no, not even a science fiction scenario such as depicted in zombie movies justify tyranny on the scale of lockdowns. In the same way that a military invasion wouldn’t require conscription because most people would take up arms themselves, a particularly lethal outbreak would assuredly see individuals quickly adopting radical, local, ingenious, and individually-tailored measures without decrees. The human race has come to terms with thousands of viruses, bacteria, maladies and creatures over thousands of years. There is absolutely no reason to believe we will not continue to, or that we cannot without destroying civilization itself.

Micha Gartz. Recognize that Covid is now ‘endemic’ and move on. ‘Endemic’ diseases are regularly found among particular populations or in a certain geographic area, and maintained a baseline level without external inputs. Polio was endemic. Malaria is endemic across parts of Africa, Asia and Latin America. Chickenpox is endemic worldwide. Despite numerous and extensive restrictions – including travel restrictions preventing the introduction of new cases; mask requirements, capacity limits and bans on large gatherings to prevent transmission – Covid has maintained a constant presence in many countries. By definition, it is endemic. Reducing PCR threshold cycles to normal, reasonable levels of under 30 cycles would go a long way in excluding false positive results which pick up on genetic fragments of dead virus. This would lower case numbers (and numbers of deaths with Covid being misrepresented as from Covid) headlined in the media, and disable the frantic fear pervading the public. As endemic diseases become increasingly tolerated, responsibility shifts from the authorities to individuals who are better able to determine their own risk and seek access to medical care.

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