“The road to reality is paved with numbers.” Anon.
INTRODUCTION
Those who follow TAC know there is a spectrum of opinion about current measures to combat the spread of the covid-19 virus: ranging from “it’s not that much worse than regular flu” to “the sky is falling, we’re all going to die!.” Not so many of the latter and lots more of the former. I’ve been more or less in the middle, but some recent articles in the American Spectator (see here, here and here) and some data put out by the Pennsylvania Department of Health have pushed me to “it’s time to get off the couch and get out of the house,” if not for the entire USA, at least for flyover country.
There are certainly strong economic reasons to get back to normalcy. What are the reasons presented for a tight lockdown?
- Minimize deaths for the vulnerable—the elderly and those with pre-existing medical conditions
- Not overload hospital critical care facilities—intensive care beds, isolation rooms, ventilators,…
The first can be accomplished, as it was in South Korea, by selective, voluntary quarantining. With respect to the second, hospitals are not in risk of overload, if the statistics from the PA Department of Health shown below can be believed.
Before I discuss the numbers in the clip from the Bloomsburg Press-Enterprise, let me say a little bit about where I live. It’s flyover country, what James Carville called “the Alabama between Philadelphia and Pittsburgh.” So we’re not crowded. I’ve been going out once a week to pickup curbside delivery groceries from Walmart, and there’s not much traffic on the road. A couple of neighbors have dropped by to see if we needed anything, and our kids have called in to see how we are, but my wife and I, included in the vulnerable elderly and medically susceptible, have been isolated and not suffering from that.
WHAT THE NUMBERS SHOW
If you examine the table you’ll see that most of the cases have been in Luzerne County. This county includes two metropolitan areas, Wilkes-Barre and Hazleton. Most of the deaths have occurred in Hazleton.* What’s important to notice is that even in Luzerne county the hospital facilities are not being saturated.
Even in Philadelphia county, the hardest hit, it does not seem that the hospital facilities are overloaded, as the diagram below shows:
Note: darkest red are most cases (over 1000); lightest, least (under 20)
CAN VOLUNTARY MITIGATION WORK?
What I’m about to say is based more on anecdotal evidence than hard data. In China mitigation was enforced by the state; people needed to show on their smart phones permission to travel from Wuhan, and Big Brother knew where everyone was. In South Korea, albeit a democracy, a homogeneous population, used to hardship, obeyed government directives about quarantine. And the recovery / fatality ratio for South Korea is steady at 34, with about one-tenth the death rate per capita of the USA.
Will voluntary mitigation—self-quarantining of the aged and medically vulnerable, wearing masks, practicing social distancing—work in this country? Can we keep people from heavily infected metropolitan areas from going to the flyover country? I doubt it. We travel to a farm market about 10 miles away from our house. They give curbside delivery for good stuff (even toilet paper) and their prices are good. I was going there this afternoon (the 11th) and noticed a fair amount of traffic on the road. The store was as crowded as it used to be on a Saturday afternoon, and only about half the customers were wearing masks; the manager, who delivered my order to the back of our station wagon, wasn’t wearing a mask. When I visit Walmart to pick up our curbside delivery order there, the situation is much the same, although most of the delivery people are wearing masks.
ETHICAL CONSIDERATIONS IN MAKING MITIGATION VOLUNTARY
Here’s what is crucial to my argument. The Church has said that extraordinary measures to prevent dying should not be applied if they are unlikely to be effective and bring about hardship on the patient and family. (See here.) I assert that bringing the country to an irreversible depression to enforce practices that could done voluntarily is indeed an extraordinary remedy and should not be applied. It isn’t a case of overloading hospitals so that they can’t give their usual care.
My final thought. We are to be our brother’s keeper, but if our brother refuses to take the moral way, it is not our obligation to act for him, other than to prevent him from doing harm. Here’s one goal: that our country be free, healthy and prosperous (priorities in that order). If the Double Effect principle is applied, that means if we intend the larger goal and do not intend bad consequences, even if they might arise in meeting the larger goal, then we are acting in accord with Catholic principles.
NOTE
*The two deaths in Columbia County were in a nursing home. There has been some discussion in news broadcasts and on the internet whether a language barrier has prevented hispanics in Hazleton (comprising 50% or more of the population) from realizing that quarantine and protective measures have to be taken, or whether there are pre-existing medical conditions that make this group more vulnerable
Agree!
Superb post Bob! As a practical matter, with warmer weather coming, I think we are already seeing the break down of shelter in place. Texas is going to announce a road map for its re-opening next week, and I think that will lead to a rush by other states to do so.
One of the fallout of this mess is going to be a growing divide between rural and urban Americans. Cuomo has made clear that New York state as a whole will suffer the same restrictions as long as there are any problems in New York city, regardless of whether the virus is spreading outside of the city. Many other state governors have taken similar positions with the relevant major cities for their states.
People on the rural side of the equation are going to get angry at having to follow restrictions which clearly serve no benefit for them. They will also realize that the elites in the urban environments do not perceive at all what is like outside of the big cities.
On the other hand if restrictions are not enforced uniformly across the state or if the rural citizens just complain too much, the city dwellers will think that the people in the country are being ungrateful for not joining in the suffering that the city dwellers have to deal with.
There’s been elements of this friction for a long time, but the crisis will bring it to the forefront.
RH, you have it. I wish there were a way for flyover country to secede from the rest of the country. That would solve a lot of problems.
(Almost Heaven, West Virginia, Blue Ridge mountains, Shenandoah river… )
Probably going to let States go one at a time / in groups
RH, I agree, you are on the mark here. I live in north Texas most of the year, and am eagerly awaiting Gov. Abbott’s announcement next week. However, since I retired from the law mines back in 2014 my wife and I have spent summer and early fall up in rural northwestern Illinois, where most of my family lives. At last count Carroll County, IL has had exactly one fatality, attributed in part to C-19, a lady in her mid-80’s in a nursing home with at least one serious pre-existing condition. There are only a handful of confirmed cases. Yet I fear that the governor there is likely to pull a Cuomo and insist the entire state must suffer along with Chicagoland until he decides to open things up. The county has prosperous farms but the towns have suffered greatly with the migration of factory jobs out of the country and have not tasted much of the recovery yet. This lockdown exercise is likely to set the county back significantly, not to mention messing with my summer vacation. 🙂
There is a way for flyover country to secede from the rest of the country: repeal the 17th Amendment. No secession necessary.
Getting the courts to stop mindlessly applying the 14th and State Senate’s could start representing geographical areas like counties or groups of counties, instead of people would help too.
I’m afraid Rudolph is right.
(Almost Heaven, West Virginia, Blue Ridge mountains, Shenandoah river… )
Agree. “I assert that bringing the country to an irreversible depression to enforce practices that could done voluntarily is indeed an extraordinary remedy and should not be applied.”
Let us get back to work ASAP with proper and reasonable precautions.
We have had other pandemics and this risk will likely continue, This could have been worse and we may one day face a pandemic at the scale of the 1918 influenza.
As a result of this pandemic we should consider how to reduce future pandemic threats to our nation. Reliance upon the foreign manufacture of critical medicines and medical supplies that is coupled with a “just in time resupply chain” could be a critical point of failure.
It will likely be difficulty to wrestle control of critical industry from international to domestic production. There are many who have profited from this arrangement and they will likely resist anything that may reduce profits from overseas production investments.
Bob’s observation regarding different levels of virus penetration of urban verse rural regions should be applied If we are able to return to domestic production. Production and storage of critical materials in the locations where the effects of a pandemic are more likely to be delayed, or essentially spared, this could be crucial to our nation’s ability to maintain production during and immediately after a pandemic.
I wonder if this event may sensitize us to every pandemic and if we will have a similar response every typical influenza season. Perhaps this would be beneficial if it provides an annual opportunity to develop and improve our pandemic response strategies; especially if each year we are able to reduce death rates from the annual influenza while protecting economic resilience.