Florida and Texas flattened the curve. California did not.
- After the initial shutdowns in March, ventilators, PPE, and testing shortages were mostly solved by early May.
- Florida, Texas, and other states that followed the original plan to flatten the curve for hospitalizations have re-opened their economies while maintaining hospital capacity.
- California opted for a novel virus suppression strategy that has destroyed its small businesses with a profoundly negative impact on minorities. California is now about to run out of hospital capacity.
States like Florida and Texas re-opened per the original virus mitigation plan and were pilloried by the press and health officials. States like California and New York that went with the suppression strategy were lauded for “following the science.” When we moved from California to Florida in September, my friends told me we were insane. I told them that, looking at the math, they were insane for staying. It is now clear that “following the science” without the integration of economic or social science has had devastating effects.
Florida, Texas, and California are directly comparable: large states with a mix of cities and rural areas, “sunbelt” weather (especially in the Southern California epicenter), and all three shut down before the coronavirus began to spread.
Florida and Texas split two surges evenly
When states like Florida and Texas re-opened in May and June, there was, of course, a surge in the virus. People gradually began to re-engage with society, and vulnerable people were much less likely to socialize. Hospitals were stressed, smaller hospitals ran out of capacity, and some patients had to be transferred to other areas in order to get treatment. However, no patient needing intensive care was unable to get the care they needed. Cases soon subsided, following a textbook Gompertz curve, and the hospitalization curve was flattened.
When the inevitable second wave came in the fall, Florida and Texas’s curves followed the same trajectory as the first wave. Vulnerable people were exercising more caution, and businesses were open but less busy than usual. An estimated 20-30% of residents had already been exposed to the coronavirus and built up immunity, In addition, some scientists theorized that there are already some people with pre-existing immunity from other coronaviruses. Of course, this is not full herd immunity, but enough immunity to dampen the second wave to a level that hospitals would not be overwhelmed. Even Thanksgiving did not spike the trajectory of the curve in Florida and Texas.
Hospitals are again becoming stressed, but there are now better therapeutics and knowledge, and hospital stays are shortening compared to the first wave. Despite claims that Florida is manipulating its data, Florida tracks exactly like Texas and its neighbor Georgia. New York has a similar curve as Florida and Texas in its second wave, not because of mitigation measures, but because New York had a similar number of cases in its first wave that built up immunity. Now of course these curves can continue to spike up, but not as sharply or as high as California's second wave curve.
California did not “flatten the curve” and will run out of hospital capacity
When California experienced its first wave of cases last summer, it very quickly shut down again even though hospitals were virtually empty. Counties in the San Francisco Bay Area went beyond the state guidance by shutting down earlier and longer. These actions pushed all of the cases that would have happened in the first wave directly into the second wave. And due to exponential math, moving more cases into the second wave dramatically increases the spike in cases.
The media has had a penchant for fearmongering about hospital capacity. During Season 1 of “the hospitals will run out of capacity” in March in New York, massive surge facilities were built out by the Army Corps of Engineers, and Navy hospital ships were deployed. But then they weren’t needed. During Season 2 of “the hospitals will run out of capacity” in the Sunbelt over the summer, rural and small hospitals were highlighted, especially in Texas. Even when cases were already steeply dropping, meaning that hospitalizations would soon drop, we were deluged with articles about hospitals running out of capacity. During Season 3 of “the hospitals will run out of capacity” in the fall, a surge in the upper Midwest stressed rural hospitals in states like South Dakota, even while “Covidiots” still celebrated Thanksgiving across the country.
Through all of the ups and downs of the first three seasons, the hospitals’ heroic doctors and nurses made it through! Elective surgeries were canceled! Every patient that needed an intensive care bed got one! America!
We are now kicking off Season 4 of “the hospitals will run out of capacity” in California. This time the hospitals will actually run out of capacity. Cases are stratospheric and climbing, so more hospitalizations and deaths will soon follow. Unfortunately, very few people in California believe the hospitals will fail. The media and public health fearmongering about hospitalizations are now the boy who cried wolf.
California does not have as much ICU capacity as Florida and Texas. California also did not build up extensive surge facilities over the past nine months. Inexplicably, even amid a massive spike in cases, California has not stopped elective surgeries that can fill up ICU beds. Officials seem to think they can stop this wave by doing another shutdown.
Public health guidance has to account for “will people actually do it”?
We can immediately save the 40,000 Americans that die every year from car accidents. Scientists say that if we set the speed limit to 5 mph on every street and highway, we can reduce those fatalities to zero. The experts have spoken! Science! Easy-peasy, right?
Public health guidance has to account for whether the target population will actually do it. Dr. Anthony Fauci is now lamenting that Americans are too independent. Yet it is very well-known, especially to social scientists, that Americans are one of Earth’s most independent peoples. The U.S. cannot employ strict multi-month lockdowns deployed by Confucius-based societies like China and Singapore. Or the military- and police-enforced lockdowns deployed in Australia and Europe every time there is a new outbreak, even if they produce no results as is the case in Europe. It is simply (and now obviously) not a strategy that will work in the U.S. for ten months. The people won’t comply, and the police and military will refuse to deploy.
Government officials are being called out as hypocrites for violating their own health guidance. They are not hypocrites; they are simply human beings like millions of others that can’t follow impossible public health guidelines. However, when the leaders don’t follow their own guidance, they lose all credibility upon issuing new guidance. They are signaling that the guidance is like the speed limit: optional.
We have known for months that COVID transmission requires fifteen minutes of close contact. Suppose you could pick one thing to get every American to do. Which would it be: #1 wear a mask and keep social distance outside at the beach and walking down sidewalks, #2 wear a mask and keep social distance while walking down the grocery store aisle, or #3 wear a mask and social distance while visiting friends and family. We have a lot of virtue signaling with people doing 1 & 2, but then not doing #3. To mitigate transmission public health education should have focused on #3, rather than whether people are wearing masks while sitting on a beach.
People in California mocked armed anti-lockdown demonstrations in Michigan in May and then hosted indoor dinner parties just a few months later.
Californians are no longer listening to public health guidance
Officials no longer use the words “data and science” in their diktats. As court cases and anyone Googling basic science can find, it is because officials are no longer actually using any “data and science.”
Residents and even the mayor of San Francisco are pushing back on closed playgrounds because surface transmission is minimal. Restaurants are pushing back on closed outdoor dining because tracing shows minimal transmission, even for indoor dining. Every major school system in California is still closed even though they are open in other deep Blue states, and all data shows that there is minimal transmission risk in schools.
If you force a bunch of people to do erratic things that don’t actually drive results, eventually they give up on all of them. There is learned behavior from the first shutdown, and people in California know that a two to three-week shutdown will likely lead to months-long shutdowns. This time, rather than waiting, they are immediately visiting each other’s houses. The social media Karens that were proudly wearing masks in their avatars and hectoring everyone as “Covidiots” are now busy having their friends over for wine.
California has, at this point, lost the consent of the governed.
The racist and deleterious effects of California’s extended lockdown
The California lockdown has been systematically racist and benefited the tele-working rich hiding in their homes. The truancy rate among Hispanic and Black students is enormous, while teachers’ unions in California implore that teachers Zoom from home, unnecessarily participating in the work from home Zoom life of their college-educated peers. Small businesses with large proportions of minority ownership, like nail and hair salons, have been decimated.
Minorities make up a large proportion of essential workers and have died in much greater proportions than Whites. The essential workers in the back of a restaurant are making the food whether it's meant to go to the front of the restaurant or for delivery, and then they go home and infect their inter-generational households. In Los Angeles, Hispanics are dying at three times the rate of Whites. There are more drug overdoses than COVID deaths in San Francisco, deaths that also disproportionately affect minorities.
Officials were in competition with each other over virus rates and deaths and not tracking any other metrics, seemingly only capable of first-order thinking without considering second-order effects. In San Francisco, more than half of the storefronts are permanently closed, and 10% of households have left the city, with many ironically moving to Florida and Texas, which are both open and growing. California's unemployment rates increased by roughly 3% more than in Florida and Texas. The CDC estimates that a third of excess deaths are deaths of despair. People are walking around with the same dazed and depressed vibe as those living in an authoritarian state.
California’s pandemic response has followed the exact arc of its response to other crises. Consider the homeless crisis. Bring in experts. Listen to the experts. Roll out policies that burden the many and business owners in favor of the few. Even if the results are terrible, double down, because the intentions are honorable.
The pandemic is over in February - no matter what
After a couple of months of vaccinations, there will no longer be vulnerable people that can die from the coronavirus. The death rate and hospitalizations will drop to below that of the flu. Cases counts will also drop given WHO guidance on using a lower PCR cycle threshold to determine positivity, which Florida had already implemented.
Florida and Texas are still forging their own path rather than relying on the CDC expert guidance, with the obvious idea of distributing the vaccine first to the people who are dying the most. Consider: you have one group of people working in hospitals that are not in the most at-risk group, with PPE and protocols to stay safe. You have another group of people that is the most at-risk clustered in nursing homes with insufficient PPE and health protocols. Which group do you give it to first? Florida is going with the at-risk people. Ironically, medical professionals have already pushed back about taking the vaccine themselves, while the elderly are begging to get the vaccine immediately.
With vaccines deployed to vulnerable populations, people will not be “killing grandma” by going out, and there will be a full-scale revolt against any public health guidance. Scary articles that skew numbers will fail to convince young people that they will die from a virus with the death rate of the flu for those under age 65. Long-term effects apparently rectify within a few weeks. It’s time to see some real data that is not manipulative because young people are smart and are seeing through any dissembling. At this point, it’s likely that a third of a young person’s social network has already had the virus, and these friends can make it up the stairs months later without wheezing.
Follow the multi-disciplinary science
Hopefully, in the future, we can indeed “follow the science.” Actual science that is multi-disciplinary and uses empirical evidence to test hypotheses.