Reno and Hitchens Question the Shutdown

Rusty Reno questions the shutdown of the country in First Things.

Peter Hitchens does the same for the Daily Mail.

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Well, I’ve been waiting for this discussion here. I’m going to say at the outset (before I read these pieces) that I’ve gone back and forth several times in my own opinion on the matter, and I’ve read quite a bit on both sides.

My current opinion is that we simply don’t have enough data to know which is ultimately going to be the worse course of action.

Bigger picture, though, I don’t see Christians, much less the world, responding by humbling ourselves and asking God’s pardon and mercy. Instead I see a lot of trust in human wisdom and power to “beat this.” If “this” is judgment from God, and I believe it is, then we will be found fighting with God.

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Cards on the table: I’ve posted both pieces because I agree with them. I’ve taken the irrational panic position from the start. I don’t pass judgment on churches that have chosen to close, but, as Mr. Reno notes, even during the Spanish flu epidemic of 1918, churches did not close. We’ve never, as far as I know, taken such drastic measures during times of much greater danger, with far more evidence that what was happening was catastrophic. Indeed, our society has been so blessed that the Spanish flu of a century ago was the last big public health crisis we have experienced as a whole nation. No one alive even remembers such times.

I agree of course that, whether this be a genuine public health crisis or a crisis borne of our own irrational fears, what is happening is the judgment of God. There’s no question of that. I suppose, in even saying this much, I’ll be branded a dangerous and stupid rabble rouser by all the famous gatekeepers of the Reformed world. The Reformed world is dedicated to the proposition that God’s Providence never affects anything in our lives for the worse or for our punishment, either individually or corporately.

We should read our Bibles and take time to pray for mercy. To that end, when it becomes available, I recommend listening to the sermon Pastor Joseph Spurgeon preached yesterday, on calamity, repentance and the book of Joel.

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Looking at the UK response (where I live), what I think happened here is that the British Government was spooked at what they saw happening in Italy.

We’ve all wondered how the church could continue functioning under persecution. Perhaps we’re about to find out. The church I belong to had a live-streamed service (some songs, a good spoken word, prayers) and we had about 350 individuals/families join in. Overall, it shouldn’t have worked, but it did. The small group I am part of it going to test a video-conferencing system called Zoom.

The following may also be of relevance:

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It took almost 300 days for Swine flu to hit its peak of 2000 deaths per day. It looks like we hit that today (March 23) after just 84 days, just like this video projected back on the 19th:

With the contagiousness being obviously high, and even the skeptics acknowledging a potential mortality rate of 1%, I believe it is reasonable to adopt temporary extreme measures until we get more accurate data.

What I don’t want to see is months of this, and then off and then back on. I think we can ramp testing way up and then take more appropriate actions even if it is as severe as some are claiming.

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Some churches did close during the 1918 Pandemic:

Frankly, I’m thankful that our society is willing to endure so much economic loss to preserve life, particularly the life of the elderly and sickly.

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I’ve come to the same opinion. Is it worth possible economic ruin to slow a virus that most people will come into contact with anyway? Only time and more data can tell.

And, to be fair, churches did not have the technological capabilities that we have now in 1918. Closing in 1918 meant losing all contact with the sheep. That is simply not the case today. It is Apples and Bananas if not Apples and Oranges.

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I suspect you also had a lot more people going to church a lot less regularly due to health issues and risks as individuals. Another big difference is that medicine wasn’t nearly as far advanced. Today we can save many more people who get the flu—if we have the capacity. We can also likely create a vaccine given enough time. And on and on. At that time the only real options once it had spread widely were to quarantine yourself for a couple of years and hope somebody brought you food, or trust to God and get back to work. I’m not convinced those are the only options before us today.

As to cancelling church, different churches have different risk profiles and make different decisions about those risks at various times. Some churches in the north meet even if there is a lot of snow on the roads. People up there know how to drive in the snow, and things keep going. If Dallas gets a big snowstorm, almost every church closes. Are people in the north filled with faith and people in the south faithless? No. They are in different places with a different calculus.

The first week we intended to meet and confirmed that the building we rent would be open for us. We are fewer than 100 people, and mostly young. The risk was not high, and there was no civil order prohibiting it. But then two things happened. I got sick, and I didn’t want to risk spreading CoVid to my church, no matter how remote the chance. And right after that we got a call saying they would not open the building for us.

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There are a lot of things wrapped up in this questioning the response. The “experts” have cried wolf on many “emergencies” in the past few decades. Not health experts per se, but scientists generally, with complex models of worldwide emergencies. This is why we don’t trust them about global warming, and it is part of why we don’t trust them with this pandemic. Still, the experts are worth reading, and the facts are worth evaluating to see whether their arguments hold water.

The only expert I’ve been able to find that is promoting the contrarian view is John Ioannidis. A recent paper he wrote on the topic is Covid-19: the harms of exaggerated information and non‐evidence‐based measures. He is apparently somebody who wants to see actual evidence and data—something I appreciate a lot. He is apparently known for backing this drum about bad science in the past.

However… let’s be clear. If we are basing our decisions on his guesses (as opposed to other experts’ guesses), how are his predictions doing?

If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.

Italy’s population is 60,550,092. If 1% got infected and .3% of those died, we’d see a total of 1,817 deaths in Italy. Italy has already seen 6,820 deaths, and peaked (hopefully) a few days ago at 793. Even if you discount some of those as testing positive at death but not actually caused by Covid, he’s obviously wrong in his guesses for Italy.

Is there any reason to expect things to be different in the US? New York State’s population is 19,440,469. That works out to 583 dead according to his guesstimate. We’re at 184 so far there. I’m not holding my breath.

But, to be a bit more generous, I guess those numbers weren’t so much his guesses as possible estimates based on the data. Now that we have more data, I think it’s safe to say those are not reasonable potential estimates anymore. But we could still be over-reacting. Even if he is off by a factor of 10, I’d say we’re overreacting if we keep this up for much longer.

Yet… I’m not placing much stock in Dr. Ioannidis at this point.

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This whole ballgame pretty much comes down to whether or not the health care system stays intact or falls to pieces. If it stays together, my guess is that this thing comes out within an order of magnitude of a flu season. If not, then we’ll be stacking the living and the dead in hallways and mass graves like Italy and Iran.

Then we get to figure out how to jump-start a health care system from near-zero.

Trump is correct that the cure can become worse than the disease. And the economy and the health care system are tied together in ways that are hard to tease out.

I don’t envy the people having to make the difficult decisions at this point. If I were in charge, I’d be focusing on getting manufacture of personal protective equipment spun up and protecting doctors/nurses/other health staff more generally.

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Another thing to remember here is that the deaths so far have been concentrated in a few states. Yet the whole country has been asked to respond identically, Nebraska the same as New York City. The elderly are at the highest risk but schools are shut down for weeks.

Airports and supermarkets, where groups of more than 250 people are gathered regularly, can stay open but churches have to close? This doesnt make a lick of sense.

The response is not proportional. It is not targeted. There’s every indication that this is not being thought through.

I’m in Arizona and on the phone all day with coworkers in California all day long. I assure you that the whole country is not responding “identically.” Californians are being ticketed for being out of their houses. Arizonans are being encouraged to stay inside. Arizona hasn’t even closed all its restaurants and bars yet, or hadn’t as of last night.

And this thing basically breaks out to contraction -> symptoms -> severe symptoms -> deaths. By looking at deaths, you are getting a picture of what the very first phase of the cycle looked like 20-30 days ago. You can’t manage your contraction responses today by looking at deaths today, and anything you do on the contraction side isn’t going to show up in your death number for another 20-30 days.

I don’t feel the need to defend everything that is being done in every state, but it seems absurd to me that we would do in Ohio what New York did when they were at this stage. It didn’t work. Now they are trying something more strict, and so are we, hoping that it will actually be effective and keep us from getting to where they are.

Nor are supermarkets remotely like church. You aren’t “gathering” there. You aren’t talking to each other there. You aren’t bringing your kids there and having them use a common bathroom there. You aren’t sitting close to each other there for over an hour.

As far as proportional and targeted goes, on February 22 Italy had 79 infections and 2 deaths. They could still trace every one of those infections back to a single case, though they didn’t know how that man got it. 54 of the infections were in Lombardy. They took targeted action:

A dozen towns in northern Italy effectively went into lockdown on Saturday after deaths of two people infected with the coronavirus from China, and a growing cluster of cases with no direct links to the origin of the outbreak abroad.

The secondary contagions prompted authorities in some Lombardy and Veneto towns to close schools, businesses and restaurants, and to cancel sporting events and religious services. The mayor of Milan, Italy’s business capital and the regional capital of Lombardy, shuttered public offices.

Hundreds of residents and workers who had come into contact with people who tested positive were put into isolation pending results of their tests. Civil protection crews set up a tent camp outside a closed hospital in Veneto to screen medical staff.

In the town of Codogno, where the first patient identified in the northern cluster was in a critical condition, closed supermarkets, restaurants and shops made the main street practically a ghost town. The few people outside wore face masks, which were coveted items after selling out at pharmacies.

Ten towns in Lombardy received orders to suspend nonessential activities and services.

National and regional officials approved an ordinance that put 10 Lombardy towns in effective lockdown around Lodi, southeast of Milan, after the region reported a quadrupling of cases on Friday. But individual cities outside the area covered by the ordinance, such as Cremona, issued their own restrictions after confirming there were local cases.

They also started “imposing fines on anyone caught entering or leaving outbreak areas.”

There are two ways of interpreting this that I can think of. One option is to throw up your hands and say nothing works, so we shouldn’t bother trying. The other is that trying to target it that closely was ineffective, so it needs to be broader.

Edited to add: I’m sympathetic to both of those interpretations, and have swung between them multiple times. I’m leaning back towards “nothing works anyway” today. I’m also open to other interpretations.

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Ben I tend to agree with you.

I think historians and social psychologists will get a lot of dissertation mileage out of this event and the new fault lines of reasoning it is exposing in our culture.

From a data perspective though, global death rate (so far) is not a good metric because foreign medical systems are not stable quantities. Italy’s insistence upon socialized health care keeps them overwhelmed on a good day. They experience chronic shortages of people and equipment on good days. This is important context, and if there’s one thing I see a shortage of today, it’s context.

When a ventilator and minimal other intervention allows most people to bridge the gap and recover, that is not the plague and it is not something that the gears of the global economy should be stopped over.

At risk of sounding like I’m tossing out a grenade, I’ll say this next part anyway. Several people, who I would not call “politically committed” or “Trumpers” have adopted a narrative that the panic is largely media-fueled to hurt President Trump’s chances for re-election by damaging the economy.

I plead indifference on this. I don’t doubt that there are people in the media and the Democratic party who literally would rather see people die and the economy tank out of hatred for Trump. I don’t know if I would use that characterizations as a broad brush across both institutions, though. I would agree however that some “usual suspects” in the mass media lit the panic fuse, though.

I was talking with my Mother this morning - her and Dad are taking precautions, but agree that this whole reaction is in a sense, “peak affluence.” For many, many years the US has become ever more affluent. Death has become more and more something that happens to “other people” behind closed doors, safely shut away in nursing homes, hospitals or in some cases hospice care. Funerals may be a community event, but dying itself is not. So whether the public hysteria is manufactured or not, I am convinced a great deal of the panic is happening because people are suddenly being reminded of their mortality.

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Agreed. But how about the New York death rate? They’ve done a lot of testing—over 91,000 tests—equivalent to about 0.5% of their population. (Not a representative sample, but still a lot.) They are not Italy, but they are mostly a big city, so that is a difference in context for many of us. So what do we see?

28% of the tests are positive, meaning 0.13% of the population has tested positive and currently 0.9% of those people have died. That percentage has been fluctuating between 0.6% and 1.1%. It’s also worth pointing out that we are not looking at a situation where only the serious cases are being tested. You wouldn’t see 72% negative results if that was the case. Nor would you only see 12% of those who test positive being hospitalized.

But are these big numbers? Are they worth all the trouble?

Comparisons are both helpful and very difficult to do. The flu is a natural comparison because we are all used to it happening every year and understand what we do and don’t do as a society to combat it. We’ve heard it kills a lot of people, but how many? How does it compare to Covid-19?

It turns out that 2017-2018 was a particularly bad year for flu. 8634 deaths in New York state that season. There were way more cases than normal at peak and way more deaths. How much worse? Almost twice as many more than last flu season. Enough to make it the third leading cause of death instead of the 6th in NY, killing 25% as many people as cancer and 20% as many as heart disease, the two leading killers. It beat out accidents by for 3rd place by 12%.

At its peak week, “flu” (and pneumonia) was killing 41 people per day and there were 18,258 positive flu tests one week. Yesterday there were 87 deaths from Covid and 28,255 positive tests in the last 7 days. If the number of deaths today is 33 or above, NY will surpass the peak week of a bad flu year in average deaths per day.

Will the Covid season be much shorter than flu? We don’t know. Will there even be a “season”? We don’t know. What we do know is that even with all of these efforts we’ve taken to limit its spread, (edit: this week) it’s about to pass (edit: a peak flu week) on a bad year. And we don’t know where the peak is, yet, or what it would look like without whatever flattening of the curve we’ve managed to accomplish. With the current death rate of 0.9% in NY, and assuming nothing changed in the death rate if we just let this thing go (not a safe assumption), and assuming only 1% of the population got it (also not a safe assumption), we’d only have 1751 deaths in NY. Definitely not worth it.

So let me ask you all a few questions.

  1. What percent of people do you think will get it if we relax the rules? (Currently sitting at 0.13% that we know of.)
  2. What do you think the death rate will end up being with adequate medical care? (Currently 0.9%)
  3. What percent of people who test positive do you think will end up needing to be hospitalized? (Currently 12%)
  4. How quickly do you think it will happen (meaning, how concerned are you that people who would have been hospitalized will have to go without hospital care, or need ICU but not be able to get it?)

Until I saw that 72% of tests in NY were negative, you might have convinced me that vastly more people already had it than we know about, and therefore the death rate is extremely overblown. If we weren’t continuing to see spread even with these extreme measures, you might have convinced me that it wasn’t nearly as contagious as we fear. If it wasn’t for the fact that NY’s hospitalization rate is actually outpacing initial estimates, I might have been convinced that the rate of serious cases is not nearly as high as we fear. But I’m not finding anything to allay my concerns in NY.

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As our illustrious President might say, “complicated business folks”

One of my portfolios at work includes a computational data science line of effort. I am not a data scientist I just manage a few. So take what I say with a grain of salt.

But, I notice that even with phenomena we believe we understand extremely well, and have what could be called “robust” data on, the conclusions drawn from that data are often wrong or skewed by the fact that

  • human action/motivation is more complex than any schema
  • even if the schema is good the methodology for drawing conclusions is imperfect; often dramatically
  • the faith placed in such models and analyses is frequently irrational because people desperately want an answer and to make sense of the unknown

So if you build a math model that gets it right 60% of the time you’re doing pretty terrible. If you build a social model that gets it right 60% of the time you’re doing pretty darn amazing. Similar to social models are climate models, and yep infectious disease models.

And the output validity of those models is related to sample size of the study. The bigger the sample, the stronger the hypothesis.

Bringing it way back home to the original topic then, I still find it unsound to draw conclusions based on percentages when the sample size in absolute terms is still a rounding error, of a rounding error, of a rounding error. I didn’t mow my 3 acre yard yesterday. But I went and mowed it today. My grass-mowing increased by 100% in 24 hours. My acreage mowed stats went from 0 to 3, representing a 300% increase in acreage mowed. This is the sort of approach the media is using to fuel panic. The numbers they are breathlessly reporting raise more questions than they answer. Who are the dead? Who among them had pre-existing morbidity factors? What is the age distribution? Who has died because of the lack of some technology like a ventilator, and who has died in spite of it? And on, and on.

Note that I’m not pooh-poohing a response, or New York’s acute need of particular technology to assist patients in getting over the sickness. I’m not pooh-poohing anything. I am saying that there is very little meaningful context available in the public discussion, so it leads to what my wife calls just pushing the food back and forth on the plate. Therefore we pray and make peace with the fact that we need to get back to work and life despite the gnawing presence of the unknown and inexplicable.

Let me also add that I’ve seen different responses among my church in terms of prayer. People are praying. Though, as I talk with them, they seem to have some confusion as to what they are praying about. Many seem to have some cognitive dissonance over the idea that they’re being asked to pray for the removal or reduction of some pestilence, but the pestilence at least currently (thankfully), barely even registers as a pestilence by any historic measure. It is eclipsed by any number of other causes of death. Instead it seems most people are just praying for the time of confusion to be over and things to get back to normal, which is a reasonable prayer for the person standing in the unemployment line, wondering how the electric, gas and mortgage is going to get paid.

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Whatever the best course of action might be given the current situation, this pandemic reveals that our country as a whole and a huge majority of individuals have utterly rejected all biblical moral sense when it comes to money and debt. We are one of the wealthiest nations in the history of the world, yet nearly 80% of us live paycheck-to-paycheck. Like the Preacher of Ecclesiastes 2:1-10, we have not denied ourself any pleasure of eye or heart, but unlike him we have not learned that it is all vanity and striving after wind.

I can give a brief personal testimony: I am working my way through college as an adult student with a wife and a baby on the way. Because of God’s blessings upon me, and because of good stewardship (my wife’s wisdom more than mine), I can study from home and voluntarily take some time off work and it doesn’t hurt us at all. I have been incredibly busy the past year, and these past couple weeks have been like a second honeymoon for us (except the part where I still have to study several hours a day). We are thankful to God for the extra time together. The country would be in better shape if more people lived on less than they make, and learned to save for times of need. In short, we know that sickness is part of the fallen order, over which we have very little control. However, the fact that individual, national, and international economic disaster is such a large portion of the concern betrays our long history of moral rebellion against biblical finances.

As an aside, I saw Dan Patrick saying that grandparents should be willing to risk their lives for the sake of the economy. He seemed like a nice man with good intentions, but his message was appalling. I enjoy comforts of life as much as anyone, but I would rather the economy collapse to third world standards forever (and I lived for many years in the third world) than to knowingly sacrifice human life to keep an arbitrary standard of living far beyond the food and clothing with which our Lord commanded us to be content.

That’s my two cents.

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That is an extraordinary thing to say. Since you’ve lived in 3rd world countries, you have seen the appalling poverty and needless suffering. I’ve not lived it, but have witnessed it in Haiti. You’d want children running around naked and malnourished? Dying of preventable disease and hunger? Families eking out a living by rummaging through garbage?

I wish there were some way to compel gratitude to God and its fruit, generosity, in affluent societies. But it didn’t work out for the Israelites who forgot the God who gave them the ability to create wealth. And this is the testimony of cultures down through history.

But I’d have to say 3rd world poverty, while it may be a harsh chastisement, it is not something to wish for or embrace.

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Here is some context:
If you were to make a list of things important to the Chinese Communist Party, “The Chinese economy” is a top-five item, for sure, and maybe #2. The Chinese Communist Party opted to more-or-less shut down the economy to stop WuFlu. This is the same CCP that holds the all-time world record for people killed to maintain power. They haven’t even said sorry for that. They shut down their economy. Ok, maybe that’s just a third world health care system trying to deal with WuFlu.

Now to Northern Italy. Northern Italy looks an awful lot like China did a couple of months ago: country shut down, hospitals overflowing. Talk of “socialism” is whistling past the graveyard. Northern Italy has entirely first world standards of care.

Data is great, and the people running this thing need more of it, especially as we try to open this thing back up again. If I were in charge, it would be pretty close to my #1 priority. But good data takes time, and time is the one thing that we don’t have to lose.

If we can slow the rate of spread, we can buy ourselves time.

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