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Coronavirus (28): Sweden is Not New York

Jon Miltimore's essay "Why Sweden Succeeded in 'Flattening the Curve' and New York Failed" is, sadly, an exercise in comparing apples and oranges.

From the article:

If flattening the curve was the primary goal of policymakers, Sweden was largely a success. New York, on the other hand, was not, despite widespread closures and strict enforcement of social distancing policies. The reason New York failed and Sweden succeeded probably has relatively little to do with the fact that bars and restaurants were open in Sweden. Or that New York's schools were closed while Sweden's were open. As Weiss explains, the difference probably isn't related to lockdowns at all. It probably has much more to do with the fact that New York failed to protect the most at-risk populations: the elderly and infirm.

The article goes on to discuss the debate between the implications of different public policy responses to the virus. But I could not let this analysis go unanswered---without any justification one way or the other with regard to the pubic policy decisions that were made. I stated here:

There is absolutely no comparison between the Swedish and NY cases, regardless of the public policies adopted by either government. First, in NY, the share of COVID-related deaths in long-term care facilities was 20% of the total number of deaths (about 6,500 of the total of 32,000+ deaths in the state of NY). That means that the vast majority of deaths did not occur in nursing homes. Moreover, though damage was done early on, by putting recovering COVID patients back into nursing homes, that policy was influenced by the huge surge in cases at a time when not even the Comfort or the Javits Center were open to COVID patients (a policy that changed at the beginning of April). Conditions were evolving swiftly. Moreover, unlike other states that are experiencing a surge now, therapies based on steroids, plasma, Remdesivir, etc. were not in widespread usage. It's largely on the pile of bodies in NY that current medical advances have been made, sad to say.
Second, studies have shown that, at least in NYC, the highest transmission belt for the virus was its vast subway system, serving 5-6 million people per day prior to the city's curtailment of "business as usual" in mid-March and most of the communities that were disproportionately affected by the impact of the virus were minority communities, many of whose members continued to work and crowd the subways and buses, becoming infected and bringing that infection back to their families and neighborhoods. There is no similar density in Sweden (the Stockholm Metro typically serves one fifth the number of people compared to the subways in NYC).

Of course, I got push-back from one commentator who claimed, without offering any evidence, that in New York "COVID-19 has killed at least 11,000 to 12,000 nursing-home and assisted-living residents in New York, nearly double what the state admits to. And as the deaths mount, so have the lies and cover-ups. States like New York exclude from their nursing home death tallies those who die in a hospital. Outside of New York, more than half of all deaths from COVID-19 are of residents in long-term care facilities., even if they were originally infected in an assisted living facility." To which I replied: "Even if I accepted your statistic---which I don't---it does not explain the other 20,000 deaths that occurred in this state. Or are those lies too?" To which the commentator replied: "Covid kills nursing home patients for the rest it's the flu. that's the data. 77% of deaths in the US are over 65. 42% are nursing home deaths. NY at 20% lols. you're smoking some serious BS. for folks under 50 the mortality rate is statistically zero. NY state just published a statement saying their policies of sending infected patients back to nursing homes did not increase deaths. you believe that LIE too. get real. 20% OF DEATHS IN NYC ARE NURSING HOME DEATHS. TRY AGAIN. LOLS."

As I stated in my essay, "Lockdowns, Libertarians, and Liberation", too many people have been looking at this issue through ideological lenses that blind. So my response to the commentator was: "Conversation over. Have fun!"

Amazingly, the commentator subsequently deleted all their comments. This is the level of utter and complete stupidity that we witness from day to day; people who either downplay the virus, or continue to dispute the statistics, just puking up any numbers that come off the top of their heads, offering no evidence.

I should state that I previously addressed this nursing home disaster in several posts and comments, including this comment way back on 25 May 2020:

Well, if you listen to the folks at Fox News, Cuomo, Murphy, etc. purposely sent patients, who previously lived in nursing homes and were subsequently hospitalized for and designated as having recovered from COVID-19, back into the nursing homes from which they came. The Fox Folks claim that this was some diabolical plot to kill off the elderly population and/or to inflate the death tallies in NY and NJ, since many of those who were designated as "recovered" were still capable of infecting others. But yes, aside from the Fox Folks, there are legitimate questions about the wisdom of the policy of sending these patients back to the nursing homes---though it is not at all clear that the infection rate within nursing homes was strictly a result of this policy. Indeed, it is entirely possible that the spike in nursing homes was as much the result of nursing home residents coming into contact with asymptomatic infected staff.
The initial policy was adopted because the hospitals in NY were being overrun and taxed to a catastrophic degree, and when the USS Comfort arrived, and the Javits Convention Center (along with four other centers in the outer boroughs) were set up, they were opened to take in patients who were not sick from Coronavirus; they were to be places where folks facing traumatic medical problems unrelated to the virus could be cared for under “virus-free” conditions. The private and public hospital network were to shoulder the burden of the growing population of sick and dying patients from the virus, while these other places (the Comfort, Javits, etc.) would provide medical care for those not infected with the virus, but in need of urgent medical care (so-called "elective" surgeries were all postponed, but, obviously, there are many other medical problems that people face, for which they require treatment, in medical facilities that are not death traps for those with underlying pre-existing conditions).
Though the official reversal came at the beginning of May, the policy actually started to change at the beginning of April. It was at that time that the Comfort and the Javits Center were finally opened up to care for the overflow of COVID-19 patients. But, yes, the damage was done. And I suspect that's what Cuomo's mea culpa is about. He's certainly not in agreement with the Fox Folks that his policy was designed to kill people; but it was a policy that was shaped by the exponential growths in hospitalizations and intubations that were happening in late March and early April, until the state hit a plateau of 800-1000 deaths per day. Once it became clear that the healthcare network, as taxed as it was, would not collapse, and that these other facilities could take in COVID-19 patients, the practice of sending recovering nursing home patients back into nursing homes started to change. And extra precautions were put into place at the beginning of May. ... Clearly, mistakes have been made at every level of government; but it's a huge leap to characterize something that was a tragic mistake to viewing it as a criminal act. I live in NY; I've lost neighbors, a cousin, friends, and even cherished local proprietors, to this horrific disease. There's a lot of blame to go around; those most at fault, however, were the folks who denied that there was even a virus at work, that the whole thing was a hoax, and that one could just wash it away with a little detergent or by mainlining bleach.

While this is not the final word on this pandemic, I'd like to say to readers that this is going to be my last word for quite a while about this subject. I have devoted, now, twenty-eight installments to this issue, and if folks don't know where I'm coming from... that's their problem, not mine.


Postscript (17 July 2020): It should be noted that Sweden, whatever its intended policy aims, did not achieve herd immunity (see Scott Sumner's essay) and that the other Scandinavian countries, such as Finland, Denmark, and Norway have closed their doors to Swedish travelers this summer. By contrast, the hardest hit state of New York (in terms of the number of cases and the total number of deaths) now has an infection rate of less than 1%, relatively low hospitalizations and very few daily deaths from COVID-19 (zero for several days, 15 today, after a height of over 800!). Once the pariah of the United States, NY is now asking most travelers to the state to quarantine for 14 days if they intend on traveling here.

Oh, and I've also noticed that Billy Binion over at Reason has just published an essay entitled "Andrew Cuomo's Coronavirus Response Has Been a Failure." At least Binion gets the numbers right; but I think the piece is flawed by adopting the same nursing home narrative outlined above. It drops the context of the ever-changing facts on the ground, which I've highlighted here. And his comparison of NY deaths to other states' tallies also drops the context of time frame: The treatment options today are not the same as they were in March, April, and May. So, I'm left Shaking My Head (not because I'm a defender of Cuomo, but because I still see ideological blinders dictating Monday-morning Quarterbacking concerning an admittedly flawed response to a virulent pandemic---flawed partially because hindsight is always 20/20).

On these issues, readers should check out various posts on Policy of Truth by Irfan Khawaja, to which I've contributed some comments along the way, especially here, here, here, and here (the last of which applies some Hayekian insights on local knowledge to the issues in question).

Postscript (30 July 2020): To all those who would like to be a part of massive COVID parties so that "we" can all get "herd immunity", please check out these two articles on vox.com, which should at least give you folks some pause---given the fact that there are still so many "unknowns" with regard to COVID-19:

1. "My patient caught Covid-19 twice. So long to herd immunity hopes? Emerging cases of Covid-19 reinfection suggest herd immunity could be wishful thinking" and

2. "The stark differences in countries’ coronavirus death rates, explained."