Joseph George Caldwell, PhD (Statistics)
24 July 2020
Minor edits 31 July 2020
Copyright © 2020 Joseph George Caldwell. All rights reserved. Posted at Internet website http://foundationwebsite.org/IsTheCOVID19PandemicAHoax.htm . May be copied or reposted for noncommercial use, with attribution to author and website.
Contents
Is the COVID-19 Pandemic a Hoax?. 1
3. On Forecasting and Control 9
4. World Government Responses to the COVID-19 Pandemic. 11
5. Effects of the US Government’s Response to the COVID-19 Pandemic 13
6. Analysis and Assessment of the US Government’s Response to the COVID-19 Pandemic. 16
8. The American People’s Response to the Hoax. 24
9. Some Final Observations. 25
Do Pandemic Control Measures Save Lives? Are Face Masks a Hoax? Is Social Distancing a Hoax?. 25
On Testing and Contact Tracing. 27
On Preparation for the Next Pandemic. 34
A Little More on Motive…... 38
It is widely reported that US President Donald Trump called the COVID-19 pandemic a hoax. That is not quite true. Here follows a review and assessment of what he actually said, from Snopes.com:
Did President Trump Refer to the Coronavirus as a ‘Hoax’? Trump's commentary on the new coronavirus came before the virus began killing patients in the U.S., by Bethania Palma, Snopes, March 2, 2020.
Claim: U.S. President Donald Trump referred to the new coronavirus as a "hoax."
Rating: Mixture. This rating indicates that a claim has significant elements of both truth and falsity to it such that it could not fairly be described by any other rating.
What's True: During a Feb. 28, 2020, campaign rally in South Carolina, President Donald Trump likened the Democrats' criticism of his administration's response to the new coronavirus outbreak to their efforts to impeach him, saying "this is their new hoax." During the speech he also seemed to downplay the severity of the outbreak, comparing it to the common flu.
What's False: Despite creating some confusion with his remarks, Trump did not call the coronavirus itself a hoax.
President Trump is indeed sensitive to criticism of his administration’s response to the COVID-19 pandemic, and he is often critical of the views and opinions of others if they differ from his or reflect negatively on his policies or actions. Here follows an extract from a recent Yahoo News report on this topic:
Trump identifies another hoax: The coronavirus, by Christopher Wilson, Yahoo News, July 13, 2020.
President Trump has called many things hoaxes over the years — the investigation into his 2016 campaign’s dealings with Russia, his impeachment, global warming — but on Monday he called into question the existence of an epidemic that has killed more than 135,000 Americans.
During a flurry of activity on his Twitter account, Trump retweeted a message from game show host Chuck Woolery that claimed “everyone is lying” about the coronavirus as part of a plot to sabotage the economy and hurt Trump’s reelection campaign.
“The most outrageous lies are the ones about Covid 19,” wrote Woolery in the message promoted by Trump. “Everyone is lying. The CDC, Media, Democrats, our Doctors, not all but most, that we are told to trust. I think it’s all about the election and keeping the economy from coming back, which is about the election. I’m sick of it.”
Asked about the retweet at a briefing later Monday, White House press secretary Kayleigh McEnany said that the “notion of the tweet was to point out the fact that when we use science, we have to use it in a way that is not political.”
A key problem keeping the economy from coming back is the 135,000 Americans dead from the coronavirus, per tracking by Johns Hopkins University, which reported 61,352 new cases and 685 deaths on Saturday [June 11, 2020]. Woolery didn’t say whether he thought the death toll was faked. Florida set a record for most single-day cases of any state so far with more than 15,000 reported Saturday, the same day Walt Disney World reopened in Orlando. Arizona, California, Florida, Mississippi and Texas have all set record highs for daily deaths over the last week.
Trump sometimes uses “hoax” as an all-purpose denigration of opinions — or facts — he doesn’t like. In February he called criticism of his administration’s response to the coronavirus the Democrats’ “new hoax,” but he didn’t quite deny the existence of the epidemic, as Woolery appeared to do in his tweet.
There is no obvious precedent for a president repeating criticism that a key agency in his own administration — the Centers for Disease Control and Prevention — is lying, except for Trump himself, and the many times he has accused the FBI and the intelligence services of intentionally undermining him.
The President has been careful not to explicitly and directly refer to the pandemic itself as a hoax – he is generally careful to criticize alternative views and opinions, not facts. So, the simple answer to the question in the title of this article, Is the COVID-19 Pandemic a Hoax? is “No.” What President Trump is calling a hoax is not the pandemic itself, but any views that may be construed as criticism of his administration’s response to the COVID-19 pandemic. He is obviously irked by dire or gloomy forecasts about the consequences of the administration’s response, and rejects attribution of negative events to that response. The issue that arises is that much of the criticism is opinions expressed by scientists and health-care professionals. Are these views and opinions a hoax?
Well, the issue of whether the alternative views and opinions are a hoax may be of some interest, but a much more interesting question is whether the views and opinions of the Trump Administration are a hoax. This article reviews the Trump Administration’s response to the COVID-19 pandemic, and provides an answer to this question. More specifically, it provides an answer to the question: Is the US government’s response to the COVID-19 pandemic a hoax?
The COVID-19 pandemic began in December of 2019 at Wuhan, China. The World Health Organization investigated an outbreak of a number of pneumonia cases and identified the cause as a new strain of coronavirus. The new virus was initially named novel coronavirus 2019-nCoV and then SARS-CoV-2 (for severe acute respiratory syndrome coronavirus 2), and the disease it causes was named COVID-19 (for coronavirus disease of 2019). As of July 11, 2020 there have been at least 12,507,849 confirmed cases worldwide and at least 560,460 confirmed deaths worldwide (source: COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU), https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 ). The current world population is 7.8 billion, so that the 560,460 deaths equates to about 72 deaths per million people. To place this magnitude in context, deaths from influenza are usually in the range of 300,000 to 650,000 per year, or about 38 to 83 per million. (Note: Many of the statistics cited in this article are for July 11, 2020. Since new cases continue to occur each day, these statistics are quickly out of date.)
The virus is spread between people primarily during close contact, most often via small droplets produced by coughing, sneezing, and talking, or to a lesser extent by touching a contaminated surface and then touching one’s face. The time from exposure to onset of symptoms is from two to fourteen days, often about four or five days. Common symptoms include fever, cough, fatigue, shortness of breath, and loss of sense of smell or taste. Complications may include pneumonia and acute respiratory distress syndrome.
Very early in the development of the COVID-19 pandemic, it was assessed that this new coronavirus was more contagious than influenza but less contagious than measles. Initially, it was estimated that, in the absence of infection control measures such as social distancing and quarantine, 70 to 80 percent of the population could become infected. Later estimates were that 20 percent to 60 percent of people will ultimately become infected (estimates presented on 4 March 2020 by epidemiologist Marc Lipsitch at the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health).
There is no specific antiviral treatment for COVID-19 at present. The infection runs its course. Treatment is supportive (i.e., treatment of symptoms). Patients having difficulty breathing are given oxygen. Ventilators are used for people for whom simple oxygen-delivery measures (nasal cannula, nonrebreather masks) have not proved sufficient. Ventilators save a few lives, but they also cause some deaths. This treatment has little impact on survival or on survival rates, although it can prolong the disease and massively increase the cost of treatment. The longer a patient is on a ventilator, the higher the likelihood of death. The mortality rate for people sick enough to be put on ventilators (i.e., with severe respiratory stress) is high. In commenting on the ineffectiveness of ventilators to treat patients with severe breathing difficulties, one nurse remarked on national television that “We put patients on ventilators to die.”
The infection rate and death rate of COVID-19 in a population depend on a number of factors, including demography (population age distribution, spatial distribution, density, and urbanicity), health status, mobility and government actions. Older people are more likely than younger people to contract the disease and die from it. Persons with pre-existing health conditions, such as diabetes and obesity, are more vulnerable. Highly mobile societies, such as open, economically developed societies, see more rapid spread of infection. Nations whose governments conduct rigorous monitoring and follow-up actions, such as testing, contact tracing, banning of large groups of people, travel restrictions, social distancing, face masks, gloves, hand washing, sanitization, improved ventilation and filtration of indoor air, isolation and quarantine, see lower infection rates. (The infection rate (incident rate, incidence) is the number of new instances of infection, or cases, within a population during a specific time period (such as a day, month, or year, or since the occurrence of the initial cases of the disease outbreak that has led to the current pandemic). The prevalence is the proportion of a population having a disease (or other condition) at a specific time. The death rate (mortality rate) is the proportion of a population who die from the disease in a specific period of time.)
Some examples of the death rates for different countries follow.
In highly urban, mobile, open societies, such as many nations in Europe, the death rate for COVID-19 is about 600 persons per million people (population, not cases). The European countries having the highest death rates (as of July 11, 2020) are San Marino (1,238); Belgium (844); United Kingdom (658); Spain (607); Italy (578); Sweden (547) and France (460). For these countries, the pandemic has stabilized – the infection rate has peaked and the rates of new infections and deaths are stable and low compared to the peak.
A reason why the death rate for Belgium is somewhat higher than the rate for the other listed countries is that Belgium includes deaths from suspected cases of COVID-19 regardless of whether the person was tested (such as deaths in nursing homes), whereas most countries count only deaths for tested cases in hospitals.
The death rate for San Marino is 1,238 per million population. The population of San Marino is 33, 934 and the number of deaths is 42. Quoting a death rate per million population for a country having less than a million population may seem strange, but it is done.
Sweden decided on less strict control measures than many nations, choosing to keep schools, cafes, bars, restaurants and most businesses open. It realized about the same death rate (547 per million population) as many European nations, but a higher death rate than its Nordic neighbors (Norway (46 per million); Finland (59 per million); Denmark (105 per million)).
For most countries, the death rate from COVID-19 is substantially less than for the preceding countries. The median death rate (i.e., the death rate such that half of the countries have a greater death rate and half have a lower death rate) is 15 per million.
For China, which implemented an aggressive response to the outbreak, the death rate for COVID-19 is three per million people.
The US states having the highest death rates per million population are (as of June 16, 2020) New Jersey (1,772); New York (1,672); Connecticut (1,231); Massachusetts (1,216); and Rhode Island (933). The median death rate for US states plus the District of Columbia is 208 per million.
If the virus spreads rapidly through a country, the infection rate typically rises rapidly for one or two months, peaks, and then declines somewhat more slowly than it rose. (The infection rate is typically displayed as a time-series graph (bar-graph or curve), showing the daily infection rate over time.) As of the present time (July 2020), all of the world’s countries have had some COVID-19 cases, but a number of countries have had no known COVID-19 deaths. If a country attempts to slow the spread of the virus, it may wipe it out, such as China did. If it does not wipe it out, it may lower the peak (high point) of the infection-rate curve (or “flatten the curve”). A motivation for lowering the peak of the infection-rate curve is to decrease the caseload on the health-care system, so that its capacity to provide a desired level of care is not exceeded. Another motivation is that an effective treatment or vaccine might be discovered before the pandemic reaches its natural end. Disadvantages of lowering the peak are that the actions taken to do so (such as closing schools, businesses, and social events) may cause substantial social and economic cost. Furthermore, flattening the incidence curve may substantially prolong the pandemic, resulting in substantial additional social and economic cost (such as the failure of businesses that are unable to remain closed for long).
Since the pandemic began, there has been a lot of speculation about future caseloads, death rates, and economic indicators (e.g., unemployment rates, gross domestic product). Here follow a few comments about procedures used to make forecasts of these quantities.
An example of a simple forecasting model. As was stated, the death rate depends on a number of factors, including demography (age and spatial distributions, density, urbanicity), mobility, and government control policies (such as travel restrictions, social distancing and quarantine). For the large, urban, open-society, economically developed countries of Europe, the death rate from COVID-19 has peaked and new deaths are occurring at low rates – the situation has stabilized. For many of these countries, the death rate (cumulative over the time of the pandemic) is in the neighborhood of 600 per million. These countries implemented a range of control measures. In these countries, despite control measures, deaths continue, and so this level will increase. The disease is still spreading rapidly in the United States. Since the US is somewhat similar to these countries with respect to the factors that affect the death rate (including variation in control measures over the states), it is reasonable to conjecture that the death rate for the US might eventually tend to the level experienced by these countries, which is currently about 600 per million population. As of July 11, 2020, the total number of deaths in the US from COVID-19 is 136,671, the current population is 331.1 million, and so the death rate is 136,671/331.1 = 413 per million population. If the death rate increases to 600 per million, then the total number of deaths anticipated from the COVID-19 pandemic (barring development of an effective treatment or vaccine) would be 600 x 331.1 = 198,660, or about 200,000 people. The number 600 is a nominal figure, used for this example. Since the pandemic continues, this number will increase over time.
The preceding is an example of a very simple forecasting model. It forecasts the eventual death rate for the US as the level experienced by countries that are somewhat similar with respect to factors that affect the death rate, for which the infection rate and death rate have peaked, and for which the incidence of new cases is now low. To the degree that the US differs from the large economically developed countries of Europe with respect to factors affecting the COVID-19 death rate, the eventual US death rate will differ from the 200,000 of this example.
The preceding forecast is an example of an “unconditional” forecast, i.e., it is not conditioned on, or based on, assumptions about factors that could affect outcomes, such as government control measures. Of greater interest in the present situation are “conditional” forecasts, that estimate quantities of interest (such as caseloads, death rates, unemployment rates, welfare budgets, economic activity, health-care industry revenues, inflation rates, and tax revenues) subject to assumptions about control variables. Many forecasting models are statistical models, based on analysis of statistical relationships observed in past data. They work well as long as the statistical relationships observed in past data continue to hold. As long as the economy is stable, this approach can be useful. In a new situation, defined by shocks of a type and magnitude not seen in the past, that approach is not useful. For such situations, a more useful approach is to construct an optimization model. This approach makes use of statistical analysis to estimate some model parameters and determines forecasts based on the construction of optimal strategies based on goal-seeking behavior. An example of these two approaches is provided in the field of econometrics, through the use of statistical time-series-analysis models vs. computable general equilibrium (CGE) models for forecasting economic indicators and the response of those indicators to variables that affect them.
Optimization-model-based forecasts are relevant to the present situation. The health-care industry and the government are determining the government’s response to the pandemic in order to affect certain outcomes (such as caseloads and death rates). The primary stated goal of the government is to keep the COVID-19 caseload at a level that can be treated using standard treatment protocols. Now that the disease has exploded in the US, it may no longer be feasible to wipe it out, but, within limits, the infection rate can certainly be controlled. In effect, within limits, the infection rate can be whatever the government desires it to be. Given the government’s response policy, a reasonable forecast would be that the caseload will remain just under the capacity of the health-care system to handle it, in most localities. Experience has shown that if the caseload falls to a level far below the system capacity, then government will loosen restrictions to allow the caseload to increase back to the system capacity. A salient feature of this strategy is that it maximizes profits to the health-care industry.
The world’s governments have varied considerably in their response to the COVID-19 pandemic. China introduced strong measures to counter the spread of the virus, and was very successful in doing so. It has very few new cases and deaths, and has a current death rate of just three per million population. Most European nations imposed strict measures, such as closing down schools and businesses. Their efforts were not successful in halting the spread of the virus, and the death rates rose to about 600 per million population. As mentioned, Sweden decided on less strict measures, choosing to keep schools, cafes, bars, restaurants and most businesses open, and realized about the same death rate (547 per million population) as many European nations, but a higher death rate than its Nordic neighbors.
The United States’ initial approach to control of the virus included reducing air travel from highly infected countries, quarantining arriving passengers from infected areas, and contact tracing of infected persons. It allowed the various states to implement their own response policies. The states imposed a variety of regulations on social distancing and wearing of face masks in public, banned large gatherings of people (such as entertainment events), issued “stay-at-home” orders, and closed schools and many businesses, such as bars, restaurants, hair salons and gyms.
Soon after the pandemic began, it was realized that containment such as was feasible in China was not feasible in the US. The US government’s stated policy in addressing the pandemic was to “flatten the infection-rate curve.” Although the claim was occasionally made that the goal of flattening the curve was to save lives, that was not the original stated goal. The original stated goal was to keep the rate of infection sufficiently low that treatment facilities would be able to handle the caseload using standard treatment protocols.
The US government’s policy of attempting to flatten the infection-rate curve has had a noticeable effect. For most countries, the infection-rate curve is unimodal – it rises to a single peak, and then declines. In the US, the infection rate curve rose, and then, as controls were implemented it declined. As soon as the curve declined to some extent, states proceeded to loosen controls, and the infection rate began to rise again, to a second peak.
Some people expressed consternation at this. They evidently believed that after the initial peak, the decline would continue. But that was never the understanding of the policymakers who adopted the policy of flattening the curve – it was to slow the rate of spread of infections. It was not represented that the purpose of the control measures was to reduce the eventual number of infections or deaths, just to delay them. (The number of infections and deaths might be reduced by slowing the infection rate if effective vaccines or treatments are developed before the disease runs its course, but, given the long time required to develop those, that was not the primary or immediate goal – the goal was to reduce the peak caseload.)
Controls do have an effect on the rate of spread of COVID-19. When they are imposed, the infection rate decreases. When they are relaxed, the infection rate increases. The US approach is to attempt to adjust control measures to keep the COVID-19 caseload within the capacity of the health-care system to treat it using standard treatment protocols. Given its stated purpose, the US government’s response has been, to date, successful. The spread of the virus was slowed, the initial infection-rate peak was sufficiently low that health-care facilities could handle the caseload, albeit with some difficulty in some places (such as New York City). It remains to be seen whether the second infection-rate peak will overwhelm health-care facilities. It could be that some states or localities loosened restrictions too much or too soon, and the second peak will overwhelm facilities in some areas. Given that the US death rate (at present 413 per million population) is nearing the level typical for a large economically developed country (about 600 per million), this is not considered (by the author) to be likely overall, but it could occur in some places. If the caseload begins to stress capacity, governments will tighten controls to bring it back into line with treatment capacity constraints.
A key thing to keep in mind is that it is not the primary goal of US government’s approach to attempt to limit or reduce the total number of cases or deaths (as was done in China), but to keep the caseload at each point in time within the limits that can be accommodated by local health-care systems using standard treatment protocols. The primary focus is not about the total eventual number of cases or deaths, but about the caseload at each point in time in localities (states, counties, cities). Given this approach, it could well be that the US death rate may eventually exceed that experienced in other large, economically developed countries.
Imposition of the control measures has had a devastating effect on global and national economies, leading to the worst economic recession since the Great Depression of the 1930s. In the United States, the unemployment rate has soared from just under four percent in January to over ten percent in June (from US Bureau of Labor Statistic: Jan 3.6, Feb 3.5, Mar 4.4, Apr 14.7, May 13.3, Jun 11.1), and economic output (measured by Gross Domestic Product, or GDP) decreased by an annualized rate of 4.8 percent for the first quarter of 2020 (source: US Bureau of Economic Analysis). It is expected that GDP will continue to shrink for each additional month that stringent controls are held in place, as businesses affected by the controls continue to lose money.
The response to the COVID-19 pandemic in the US is happening in two distinct phases, or “rounds,” or “waves.” The first phase of the response manifested in March, when a majority of US states imposed a variety of control measures, including stringent “lockdowns” in a number of states and cities. Those response measures were effective, and hospital caseloads fell. As they did, the control measures were eased, and most of the lockdowns were ended by June. Then, cases began to increase again, and recently (July 2020), control measures are being strengthened.
The economic harm caused by the first wave of controls was high. Despite the provision of almost $770 billion in aid from the CARES Act, economists project that more than 100,000 small businesses have shut permanently since the pandemic escalated in March, according to a study by researchers at the University of Illinois, Harvard Business School, Harvard University and the University of Chicago. Their latest data suggest that at least 2 percent of small businesses are gone, according to a survey conducted May 9 to 11. The toll has been even higher in the restaurant industry, where 3 percent of restaurant operators have gone out of business, according to the National Restaurant Association.
Now that caseloads have increased to the point where hospital facilities in some areas are being stressed, states and local governments are beginning to impose a second round of stringent restrictions. Many of the small businesses that survived the first round will not survive a second hit, a “double whammy.”
The economic cost of the controls has been very high, and is continuing. In view of the high cost, it is appropriate to assess whether the benefits of the controls are worth the economic cost.
Most individuals who come down with the virus recover at home. An estimated 15% of infected people are hospitalized, according to the Kaiser Family Foundation (KFF). The cost of treating COVID-19 in a hospital is expensive – several thousand dollars per day. For serious cases, treatment may continue for many days. Recent data indicate that patients who go to intensive care stay there for an average of 20 days. The average cost to treat a hospitalized patient with the virus is $30,000, according to a study released in April by America’s Health Insurance Plans.
The effectiveness of this treatment in reducing mortality is believed to be low – mortality rates appear to be about the same with or without treatment. In fact, use of a ventilator to treat COVID-19 patients may damage the lungs, lead to infection, and increase the likelihood of death. Given that the cost of treatment is so high, and the effectiveness of treatment is low, it is reasonable to ask whether a rational, informed person would pay so much for treatment that is ineffective and, in fact, dangerous. Well, if aware of the ineffectiveness and danger of treatment, most rational people would likely not. But people are not paying for treatment. Under the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, a Provider Relief Fund has been set up under which the US Department of Health and Human Services is distributing $175 billion to hospitals and health-care providers. Under this program, the government will cover the costs for the uninsured as long as the hospital accepting the government’s reimbursement rate does not bill the uninsured patient for any remaining balance (i.e., “balance billing”).
The preceding paragraphs address only hospitalization costs. In fact, the CARES Act provides financial relief well beyond those costs. The full amount of spending authorized by the CARES Act, passed in March, is two trillion dollars. In addition to the allocation to hospitals and health-care providers, this includes $300 billion in direct payments to individuals, $260 billion in increased unemployment benefits, $350 billion (later increased to $669 billion) in forgivable loans to small businesses, $500 billion for large corporations, and $339.8 billion to state and local governments.
The CARES Act is the largest economic relief act in history. It was passed to help mitigate the economic damage done by the government’s response to the COVID-19 pandemic. From the viewpoint of economic relief, it does not matter whether the treatment paid for by the relief funds is effective. What matters, from the viewpoint of the CARES Act, is minimizing the economic damage of business shutdowns, by getting money back into consumers’ pockets and keeping businesses alive. The fact that the government is paying $175 billion for supportive care that is of little effectiveness is not the primary issue here.
The government’s response to the COVID-19 pandemic caused tremendous economic harm, overall. It has been very beneficial to the health-care industry, paying for massive amounts of COVID-related goods and services, such as ventilators, personal protective equipment, testing, and health-care-provider services. It has been very harmful for some sectors, such as restaurants, entertainment, travel and tourism. Was the economic pain caused by the government’s response justified? It appears that it was not.
Most people who contract COVID-19 recover quickly. The overall (national) US mortality rate presently (July 11, 2020) stands at 413 per million population and, as discussed earlier, may rise, for example, to 600 per million, or perhaps a higher level. It is definitely higher in many localities, such as about 1,800 in many densely populated states of the northeast. The rate of 1,800 per million is .18 of one percent. It is a very small percentage of the population. The US population grows by about one percent a year. Compared to that growth rate, the loss of .18 of one percent is hardly noticeable. While the loss of a single person to a family is a devastating tragedy, the loss of that percentage of population to a nation or an economy is not significant. For most businesses, the loss of .18 of one percent of its employees, or .18 of its customers, would be as readily accommodated as other business events, such as the loss of some employees to other illnesses or accidents, to pregnancy, to retirement, or to being hired away by competitors.
In its response to COVID-19, it would appear that the US government severely and catastrophically overreacted. Had it done nothing at all, most business would have accommodated and adapted to the small effects on staffing and demand, and continued to operate essentially unaffected. The pandemic, which, if uncontrolled or controlled by modest measures, peaks in a few months, would by now be largely behind us. The initial peak in infections would have exceeded the capacity of hospitals in some places to provide the level of supportive treatment that they desired to do, but that treatment was (and remains) ineffective, so that doesn’t really matter with respect to medical outcome. It is reasonable to ask how the government’s response could have seemingly been so inept.
To understand what is going on here, it is useful to “follow the money.” Had the government adopted a laissez-faire response to COVID-19, then caseloads would have exceeded the capacity of hospitals in some localities to treat severe cases at a high level of care (ventilators, intensive-care units). America’s health-care industry would have had to treat the large number of cases at a lower level of care (e.g., home care, standard hospital beds, respirators) than it would have preferred. The serious issue that arises here is that the industry would have lost the opportunity to gain massive revenue from providing high-cost care. If the peak of the infection-rate curve could be lowered sufficiently, however, then all cases could be treated at a high level of care. This situation provided a massive financial incentive for the industry to promote a response of “flattening the curve.” By doing so, it stood to gain billions of dollars in additional income. The health-care industry was not about to let this windfall slip through its fingers – “let no good crisis go to waste.” The US medical establishment and insurance industry have been extremely successful in managing the US health system as a highly lucrative business for many decades, and in motivating the government to accommodate this operation. Consistent with the US government’s approach to treating health care as a profit-making industry, the US government’s response to COVID-19 was configured in such a way as to maximize profits for that industry. The US taxpayer would foot the bill.
This approach is similar to the one used in the financial collapse of 2007. It allowed banks and insurance companies to engage in very risky, correlated-risk investments that had a potential for catastrophic collapse. When the collapse happened, it used taxpayer money (about a trillion dollars) to bail out the banks and insurance companies, while millions of individuals (about ten million) lost their life savings and homes. The government privatized the profits and socialized the losses. (From Investopedia.com: Privatizing profits and socializing losses refers to the practice of treating company earnings as the rightful property of shareholders, while losses are treated as a responsibility that society must shoulder. In other words, the profits of corporations are strictly for the benefit of their shareholders. But when the companies fail, the fallout—the losses and recovery—are the responsibility of the general public. Popular examples of this include taxpayer-funded subsidies or bailouts.”)
In the government’s response to the financial collapse of 2007, most of the financial aid was given to large businesses, and little to individuals. Large banks and insurance companies were considered too important to the economy to let fail. The government received much criticism for that response. In the present crisis, the CARES Act provides for $300 billion in direct payments to individuals.
It may be difficult to understand why the medical community has been so alarmist about the prospect of not having sufficient resources to identify and treat COVID-19 (such as test kits and ventilators), when the available treatment is ineffective in saving lives. It may be difficult to understand the expressed alarm, when the death rate from COVID-19 is very low – well under one percent. When it is realized, however, that the health-care industry stands to gain many billions of dollars by manufacturing those resources and providing that care, even though it is not effective in saving lives, it begins to make sense.
If the medical establishment were not so alarmist about the COVID-19 pandemic, many people would not view the mortality rate of substantially less than one percent of population with great concern. They would not view it as a threat worth destroying the economy over.
A primary goal of the US health-care industry, which is profit-driven, is to maximize profits. Profits are increased by stretching the infection rate out over time, so that as many cases as possible may be treated with high-cost care. Profits are increased when patients are kept on ventilators for as long as possible – until they die. Profits are increased when the total caseload from the pandemic is increased. The driving motivation in government’s approach is not saving lives, because even the high-cost care is not effective in saving lives (so that stretching the cases out over time, assuring treatment of all cases at the highest standard of care, does not change the health outcome). As long as there is no effective treatment, “flattening the curve” does not save lives (unless it reduces the total number of cases).
In its response to the COVID-19 pandemic, the US government chose to do the bidding of the medical establishment, and structure the response in a way that generates massive revenue for the health-care industry. The benefit of this approach to the health-care industry would exceed 100 billion dollars. This amount is being paid for by US taxpayers through the CARES Act. The cost of providing the health-care industry with this windfall may be roughly measured by the total size of the COVID-19 relief package, i.e., two trillion dollars. In effect, the government chose to spend two trillion taxpayer dollars to provide a benefit on the order of one hundred billion dollars to the health-care industry. Was this reasonable? If you are a hospital owner or administrator, or a health-care professional, the answer is a resounding “YES!” If you are a US taxpayer who must foot the bill for this ineffective case, or a restaurant or entertainment worker who has lost a job, or a business, or a home, the answer is “NO!” The answer boils down to the issue of “who benefits, who pays.”
Because the COVID-19 pandemic has substantially decreased the demand for lucrative elective surgery, hospital income has taken a “hit.” The financial aid from the CARES Act is greatly welcome.
In designing its response to the COVID-119 pandemic, the US government did not utilize a “systems engineering” approach. (For an example of application of systems engineering to the design of a tax system, see my book, How to Stop the IRS and Solve the Deficit Problem: The Value-Added Tax: A New Tax System for the United States.) To a large extent, it followed the myopic and high-pressure urging of the health-care industry to provide the highest level of care, no matter what the cost and no matter that it is ineffective in saving lives. (It cannot be said that the industry’s goal in stretching cases out over time to assure the highest level of care was to save lives or shorten illness, since the best treatment available is ineffective.) The benefit to the health-care industry is over one hundred billion dollars. The cost to the rest of the country has been devastating: two trillion dollars added to the national debt, about twenty million people unemployed, and many people set to lose homes and businesses on a scale much grander than that of the Great Recession of 2007-2009. In the Great Recession, millions of people lost their life savings and homes, yet large businesses, banks and insurance companies were bailed out. This is happening all over again.
To his credit, President Trump tried to resist the pressure from the medical establishment to promote the interest of the health-care industry no matter the cost to the rest of the economy. His instinct was evidently to let the pandemic run its course, and enable social and economic activities to continue in a somewhat normal fashion, as has been done in some other countries. By continuing to attempt to lower the infection-rate curve, the country is prolonging the pandemic, incurring additional months of social and economic hardship, and courting economic disaster. As the economic harm being caused by lockdowns continues, Trump has become more vocal in asserting his position that business and school closings should not continue, and the country should get “back to business.”
The Introduction to this article posed the question: Is the US government’s response to the COVID-19 pandemic a hoax? Is it a hoax? Of course, the pandemic was and is real, just as the annual influenza pandemic is real. What was indeed a hoax was the alarmist urging of the US medical establishment to characterize the pandemic as warranting extreme containment measures, such as lockdowns, that were certain to cause, and did cause, massive economic harm, yet would have little effect on health outcome.
Worldwide, the death rate from COVID-19 stands at 72.1 per million population. The pandemic has peaked and stabilized in many countries (that is, the infection-rate has peaked, and new cases and deaths are occurring at a low, stable rate). The world population, presently at 7.8 billion, is increasing at an annual rate of about 1.1 percent, or about 83 million per year. The world COVID-19 death rate of 72.1 per million corresponds to a global count of .56 million people. Relative total population and to the annual increase in population, that is a small number. Even if the world death rate increased eventually to the level in open, urban societies (about 600-1,800 per million people), the global number of deaths would be about 5-15 million, still small compared to 83 million and 7.8 billion. Compared to global population and population growth, the COVID-19 pandemic mortality rate to date has been small, and, even if it increases several-fold, it would still be small. By itself, this level of mortality would have little effect on the global or US economies. It was government response to the pandemic, not the mortality from the pandemic, that caused so much economic harm.
The US medical establishment characterized the COVID-19 pandemic as a very serious threat to the nation’s well-being, and recommended extreme containment measures that were sure to cause substantial damage to the economy. Their alarmist, “sky is falling,” fear-mongering, doomsday characterization was grossly out of proportion to the actual threat, even as perceived from the very beginning. They spoke as professionals, forcefully, convincingly and with a united front, however, and the US government heeded their advice. The stated rationale for the response was “flattening the curve” and spread the caseload over time – not to decrease the total number of cases. The implementation of their recommended response has substantially disrupted lives, damaged the US and global economies, and caused very serious economic harm to many US citizens.
Had the US response to COVID-19 been designed and implemented as in China, to reduce the number of infections to near zero, then that approach would have saved lives. But the US approach was to “lower the peak,” by delaying the infection rate so that hospital treatment facilities would not be stressed and all cases could be treated with the highest level of care. As long as treatment is ineffective, if cases are simply delayed, lives are not saved (unless the total number of cases is reduced, e.g., by the development of effective treatments or vaccines). Under these conditions, pandemic control measures do not have an effect on the eventual total number of deaths. They do not save lives. In this case, the social and economic costs of imposing those measures are of no value, and the measures are a scam. In the US, where the disease was not wiped out, the control measures do not save lives, and they are a scam, a hoax. In China, where the disease was wiped out, lives were saved and the control measures were not a scam.
The arguments presented in this article hinge basically on two key premises: (1) the susceptibility of people to the COVID-19 virus is relatively high (on the order of 50 percent); and (2) there are no effective treatments or vaccines for the disease. Under these assumptions, the pandemic control approach of flattening the infection-rate curve so that all cases may be treated at the highest appropriate level of care – unless it wipes the disease out – simply delays the incidence of cases. Since treatments are not effective, the level of care received by a patient has little effect on health outcome, and the total number of deaths is about the same with or without the control measures. In summary, if control measures are not effective in wiping out the disease, the approach of flattening the curve has no long-term effect on deaths. Its implementation may lower incidence rates and hence death rates for a while, but unless the disease is wiped out, the disease continues to spread to the susceptible population and the total number of cases remains unaffected by the control measures. In other words, unless control measures are successful in wiping the disease out, if treatments are ineffective, the implementation of control measures in ineffective and does not save lives.
Note that the arguments presented here do not hinge on the number of cases or deaths, or on the relative size of the numbers of cases or deaths to population, or on forecasts of the numbers of cases or deaths. As mentioned, the actual level of cases depends on a number of factors, including demography, mobility, and government actions. The key point is that whatever the number of cases, as long as there are no effective treatments and vaccines and the disease is not wiped out, then the controls simply delay cases, and do not change the eventual number of cases or deaths.
The US approach to COVID-19 was not to save lives, but to control caseloads. This response caused massive economic and social harm, was not justified relative to health outcome, and was entirely disproportionate to the threat. The response was structured to generate massive benefit to the US health-care industry at massive cost to the rest of the economy; it was not effective in saving lives. It was extremely beneficial to the health-care industry, extremely costly to taxpayers, and extremely harmful to individuals and small businesses. It was unjustified, unnecessary, inappropriate, unconscionable, and outrageous. Or, it should be outrageous. The rather amazing thing is that no one seems to be outraged.
So, is the characterization of the COVID-19 pandemic as represented by the US medical establishment a hoax? You bet it is! Is the government’s response to the pandemic, which has precipitated the largest economic recession since the Great Depression, a hoax? You bet! It is a hoax, a malicious deception. It is a cruel scam that has the effect of transferring billions of dollars to the health-care sector, and imposing costs of trillions of dollars on others to do so. It is a massive “get-rich-quick” scheme that provides the health-care system with windfall profits while causing extreme harm to the rest of society. “Flattening the curve” and “lowering the peak” are now euphemisms for “bilk the public.”
Indeed, the response to the COVID-19 pandemic is a hoax, a cruel scam orchestrated by the medical establishment and implemented by the US government. In many respects, it is a replay of the financial collapse and Great Recession of 2007-2009. The villains of the plot – banks and insurance companies in 2007 – have been replaced by health-care providers. In both cases, the perpetrators of the venal schemes got off scot-free, the US government served as henchman to the perpetrators, and the victims are the US citizenry.
Some might question the motive of government and the health-care industry, and assert that the government was simply inept in its response. That viewpoint is disingenuous. America’s health-care system is fundamentally a for-profit enterprise, and the government’s policy is to privatize profits and socialize losses of businesses. The US government’s response to the COVID-19 pandemic was entirely consistent with its policy. It applied this policy in its response to the 2007 financial collapse, and it is applying it in its response to the present pandemic. Its motives are crystal clear and beyond doubt.
In designing and implementing the systems, policies and procedures that led to the financial collapses of 2007 and 2020, government and business worked hand in hand. Such a system – a government-business partnership – is a key element of fascism. An interesting feature of this arrangement in the US is that fascism is usually associated with a dictatorship, not a democratic republic. About 2,500 years ago, Plato warned of a principal danger of democracy, that the people would elect poor leaders who would promise anything. The really interesting aspect of the current situation is that the American people were not forced to turn their health-care system into a massive for-profit enterprise run by the government and big business, but, over time, they willingly let it happen. The COVID-19 response is simply the latest twist in the evolution of this system, which is a key component of the plutocracy that the country has become.
The American people appear to have an infinite capacity for getting ripped off by big business, banks, insurance companies, and, in particular, the health-care industry. When will they learn? When will they ever learn? “For to him who has will more be given, and he will have abundance; but from him who has not, even what he has will be taken away." — Matthew 13:11–12, RSV. Nous sommes toujours esclaves, seulement nos maîtres changent.
The government’s first round of controls failed spectacularly, yet it seems that the same approach is being considered again. Albert Einstein is quoted as saying, “Insanity is doing the same thing over and over again and expecting different results.” The government’s seemingly helter-skelter, on-again, off-again control strategy, has imposed and is continuing to impose, month after month, tremendous economic and social harm. It is like a death by a thousand cuts.
For more discussion of the US health-care system, see my article, A New Health-Care System for America: Free Basic Health Care.
The preceding discussion has focused on the massive economic harm caused by the US government’s response to the COVID-19 pandemic, and to the massive benefit transferred to the health-care sector at tremendous cost to the rest of the economy. Here follow some observations on other aspects of the US government’s response to the COVID-19 pandemic.
Since the start of the COVID-19 pandemic, governments have imposed a variety of measures to slow the spread of the virus, including travel restrictions, quarantines, limitations on the size of social gatherings, curfews, stay-at-home orders, business closings, school closings, social distancing and face masks. In China, these measures were imposed very aggressively, and the rate of spread was reduced to zero (except for some cased arriving from other countries). In China, the imposition of control measures indeed saved many lives. In other countries, such as the US, these measures have been implemented less aggressively. The result of this less-aggressive implementation is that the infection rate is lowered, but the epidemic continues.
In the US, the stated goal of the adopted control measures was to reduce the rate of spread of the virus so that all cases could be given a high level of care. This policy was referred to as “lowering the peak of the infection-rate curve,” or “flattening the infection-rate curve,” or simply “flattening the curve.” When the control measures were initiated, it was not represented that flattening the curve would result in fewer deaths (“save lives”). There were two reasons for this. First, it was believed that about half of the general population was susceptible to the disease (various susceptibility rates were surmised, such as 80 percent, or 20-60 percent). Second, there was no effective treatment or vaccine for the disease. Unless the disease was wiped out (as in China) in a population, or unless effective treatments or vaccines were developed, the control measures simply slowed the infection rate, but the eventual number of cases, and hence the eventual number of deaths, would be about the same, whether or not the control measures were imposed. Delaying cases so that all can be treated at a high level of care does not save any lives, because there is no effective treatment.
To repeat: Unless the measures wipe the disease out, or unless effective treatments or vaccines are developed before the pandemic subsides, the imposition of control measures to lower the infection-rate curve is ineffective in saving lives.
In recent weeks, there has been a surge of articles stating that pandemic control measures save lives in the US. The assertions have been quite spectacular, claiming that thousands, even tens of thousands, of lives could have been saved if only stringent controls had been implemented earlier. There are graphs that suggest that if the peak of the infection-rate curve is lowered, then the entire curve is lowered (instead of just skewed to the right), resulting in a smaller total number of cases. While it would be true that thousands of lives would have been saved had the control measures wiped out the disease, and while it may be true that thousands of deaths may have been delayed by the imposition of these measures, there is no evidence to suggest that any lives would have been saved in the long run by control measures as implemented in the US.
Except in cases where the disease is wiped out, the claims that pandemic control measures save lives in the US are a hoax. The claims that social distancing saves lives in the US are a hoax. The claims that wearing face masks save lives in the US are a hoax. In China, where the government’s pandemic response wiped the disease out, such claims are not hoax.
The practice of pandemic control measures such as social distancing and using face masks save lives when they are used, as in China, to wipe out the disease. As implemented in the US, where they simply reduce the infection rate but do not wipe out the disease, these measures simply delay deaths, and they do not save lives. In the US, social distancing is a hoax. In the US, face masks are a hoax.
There is no evidence that pandemic control measures have saved lives in the US. If you are a person who lost his job or small business because of pandemic control measures such as social distancing, cancellation of large gatherings, stay-at-home orders, curfews, or business closures, then you have been the victim of a cruel hoax. If you are a young student who was shunted from classroom-based schooling to on-line schooling at home, you have been grievously and unnecessarily cheated out of several months of quality education.
The medical establishment has repeatedly called for massive COVID-19 testing, to support contact tracing and isolation of active cases. The US is now (July 2020) testing about half a million people a day. The US government requires insurers to cover the costs of COVID-19 testing. While many providers charge about $100 per test, some charge much more, such as $500-2000.
Early in the pandemic, when testing and contact tracing could assist containment of the disease, targeted testing, contact tracing and isolation made sense. When the disease began to spread rapidly and the goal of containment was no longer achievable, the value of testing diminished substantially. One reason for this is that there is a substantial (many-day) delay in obtaining the test results. Another reason is that many people are contagious before they test positive. A principal reason for this, however, is that there is no effective treatment for COVID-19. Since treatment is supportive (i.e., treats symptoms), the choice of treatment and the treatment outcome are little affected by the test results. Under these conditions, mass testing and contact tracing do not affect the eventual death rate, and are a scam, a hoax.
A strong incentive for testing by medical providers is that the US government reimburses quite differently for treatment of COVID-19 cases than for other similar cases. Here follows a statement by Sen. Scott Jensen on this topic (from Michelle Rogers, USA Today Network, April 24, 2020):
Sen. Scott Jensen, R-Minn., a physician in Minnesota, was interviewed by "The Ingraham Angle" host Laura Ingraham on April 8 on Fox News and claimed hospitals get paid more if Medicare patients are listed as having COVID-19 and get three times as much money if they need a ventilator.
The claim was published April 9 by The Spectator, a conservative publication. WorldNetDaily shared it April 10 and, according to Snopes, a related meme was shared on social media in mid-April.
Jensen took it to his own Facebook page April 15, saying, in part:
"How can anyone not believe that increasing the number of COVID-19 deaths may create an avenue for states to receive a larger portion of federal dollars. Already some states are complaining that they are not getting enough of the CARES Act dollars because they are having significantly more proportional COVID-19 deaths."
On April 19, he doubled down on his assertion via video on his Facebook page.
Jensen said, "Hospital administrators might well want to see COVID-19 attached to a discharge summary or a death certificate. Why? Because if it's a straightforward, garden-variety pneumonia that a person is admitted to the hospital for – if they're Medicare – typically, the diagnosis-related group lump sum payment would be $5,000. But if it's COVID-19 pneumonia, then it's $13,000, and if that COVID-19 pneumonia patient ends up on a ventilator, it goes up to $39,000."
Jensen clarified in the video that he doesn't think physicians are "gaming the system" so much as other "players," such as hospital administrators, who he said may pressure physicians to cite all diagnoses, including "probable" COVID-19, on discharge papers or death certificates to get the higher Medicare allocation allowed under the Coronavirus Aid, Relief and Economic Security Act. Past practice, Jensen said, did not include probabilities.
Given that the massive response to the COVID-19 pandemic is extremely damaging to the economy, that containment is no longer possible, and that no effective treatment is available, there is no medical justification for massive testing and contact tracing. They are just means for transferring more billions of dollars to the health-care system.
As mentioned, COVID-19 patients having difficulty breathing are given oxygen. Ventilators are used for people for whom simple oxygen-delivery measures (nasal cannula, nonrebreather masks) have not proved sufficient. As the number of cases began to increase to stress the ventilator availability, efforts were made to produce more ventilators. They are not inexpensive. Although some models are available for as low as $5,000, a hospital-grade ventilator costs in the range of $25,000 to $50,000. In April, the Trump Administration issued contracts for $2.9 billion for nearly 190,000 ventilators. That works out to a cost of about $15,000 per ventilator.
As mentioned, while ventilators may help COVID-19 patients by giving them time for their bodies to fight the infection and heal, they can also cause serious lung damage. As the COVID-19 pandemic progresses, the medical community is learning how to better treat COVID-19 cases. Here follows an extract from an article by Sharon Begley (April 21, 2020) discussing this.
By using ventilators more sparingly on Covid-19 patients, physicians could reduce the more-than-50% death rate for those put on the machines, according to an analysis published Tuesday in the American Journal of Tropical Medicine and Hygiene.
The authors argue that physicians need a new playbook for when to use ventilators for Covid-19 patients — a message consistent with new treatment guidelines issued Tuesday by the National Institutes of Health, which advocates a phased approach to breathing support that would defer the use of ventilators if possible.
As the pandemic has flooded hospitals with a disease that physicians had never before seen, health care workers have had to figure out treatment protocols on the fly. Starting this month, a few physicians have voiced concern that some hospitals have been too quick to put Covid-19 patients on mechanical ventilators, that elderly patients in particular may have been harmed more than helped, and that less invasive breathing support, including simple oxygen-delivering nose prongs, might be safer and more effective.
The new analysis, from an international team of physician-researchers, supports what had until now been mainly two hunches: that some of the Covid-19 patients put on ventilators didn’t need to be, and that unusual features of the disease can make mechanical ventilation harmful to the lungs.
“This is one of the first coherent, comprehensive, and reasonably clear discussions of the pathophysiology of Covid-19 in the lungs that I’ve seen,” said palliative care physician Muriel Gillick of Harvard Medical School, who was one of the first to ask if ventilators were harming some Covid-19 patients, especially elderly ones. “There is mounting evidence that lots of patients are tolerating fairly extreme” low levels of oxygen in the blood, suggesting that such hypoxemia should not be equated with the need for a ventilator.
If a Covid-19 patient is clearly struggling to breathe, then invasive ventilation makes sense, wrote Marcus Schultz of Amsterdam University Medical Centers and his colleagues.
But using low levels of blood oxygen (hypoxemia) as a sign that a patient needs mechanical ventilation can lead physicians astray, they argue, because low blood oxygen in a Covid-19 patient is not like low blood oxygen in other patients with, for instance, other forms of pneumonia or sepsis.
The latter typically gasp for breath and can barely speak, but many Covid-19 patients with oxygen levels in the 80s (the high 90s are normal) and even lower are able to speak full sentences without getting winded and in general show no other signs of respiratory distress, as their hypoxemia would predict.
“In our personal experience, hypoxemia … is often remarkably well tolerated by Covid-19 patients,” the researchers wrote, in particular by those under 60. “The trigger for intubation should, within certain limits, probably not be based on hypoxemia but more on respiratory distress and fatigue.”
Absent clear distress, they say, blood oxygen levels of coronavirus patients don’t need to be raised above 88%, a much lower goal than in other causes of pneumonia.
Without effective drugs, surviving severe Covid-19 depends on supportive care, including breathing support where necessary. But recommendations for that care are largely based on guidelines for other viral pneumonias and sepsis. That explains the second reason ventilators aren’t helping more patients: Covid-19 affects the lungs differently than other causes of severe pneumonia or acute respiratory distress syndrome, the researchers point out, confirming what physicians around the world are starting to realize.
For one thing, the thick mucus-like coating on the lungs developed by many Covid-19 patients impedes the lungs from taking up the delivered oxygen.
For another, unlike in other pneumonias the areas of lung damage in Covid-19 can sit right next to healthy tissue, which is elastic. Forcing oxygen-enriched air (in some cases, 100% oxygen) into elastic tissue at high pressure and in large volumes can cause leaks, pulmonary edema (swelling), and inflammation, among other damage, contributing to “ventilator-induced injury and increased mortality” in Covid-19, the researchers wrote.
“Invasive ventilation can be lifesaving, but can also damage the lung,” Schultz told STAT.
It’s important to highlight “aspects of Covid-19 that differ from other diseases that require respiratory support,” said Phil Rosenthal of the University of California, San Francisco, editor of the journal. Patients with Covid-19 pneumonia are often less breathless “compared to other patients with similar [blood oxygen] levels,” he said, adding that this difference “may allow physicians to avoid intubation/ventilator support in some patients.”
There is a growing recognition that some Covid-19 patients, even those with severe disease as shown by the extent of lung infection, can be safely treated with simple nose prongs or face masks that deliver oxygen. The latter include CPAP (continuous positive airway pressure) masks used for sleep apnea, or BiPAP (bi-phasic positive airway pressure) masks used for congestive heart failure and other serious conditions. CPAP can also be delivered via hoods or helmets, reducing the risk that patients will expel large quantities of virus into the air and endanger health care workers.
As noted, the number of deaths resulting from the COVID-19 pandemic is likely to be small compared to the annual global population growth rate of about 83 million people per year.
Also as noted, half of all COVID-19 deaths occur in the population of people over 65 years of age. Since these people are not of reproductive age, their early demise from COVID-19 has no effect on the long-term global population growth.
The effect of the COVID-19 pandemic on the future size and age composition of the human population is estimated to be small.
Human beings are social creatures. They enjoy social interactions, such as eating out in restaurants, going to school, going to work, meeting with friends, dinner parties, drinking in bars, volunteering, and attending cultural events such as plays, concerts and sporting events. In some countries, such as Sweden, stringent containment regulations were not imposed, and most of these activities continued. In the US, many of them were curtailed or banned. Many firms are now attempting to promote “work from home,” if that is feasible. Many schools closed in-person classes and switched to on-line instruction.
While these restrictions can be accommodated by people for a while, the US COVID-19 pandemic response of stretching the disease over an extended period of time is imposing not just a severe economic toll, but a social one as well. The loss of employment, imposed idleness, loss of self-worth, and isolation associated with the response has generated economic and social hardship that may be contributing to increasing political demonstrations, breakdown in law and order, and mob violence. Cancellation of classroom teaching has imposed substantial hardship on many parents, and has substantially diminished the quality of education for many school children. On-line instruction may work in some settings, depending on the age and personality of the student, but it appears that it is a disastrous general approach to education for many children. For imparting socialization and normalization skills, it is worse than useless.
Young people are being constantly reminded that even though they may experience mild symptoms from COVID-19, they may pass the disease on to their parents and older relatives. Imposition of this guilt is unnecessary, and would not occur if all containment measures were dropped.
The US health-care industry has made out like a bandit from the US government’s response to the COVID-19 pandemic, which it aggressively promoted. That response worked very well for them, but very poorly for some sectors of the economy, and disastrously for many individuals and small businesses. As the world becomes more densely populated and interconnected, viral diseases such as COVID-19 are breaking out at a more frequent rate. It is just a matter of time until the next outbreak, and the next global pandemic. This situation begs the question, What lessons have been learned from the current experience?
Well, it doesn’t look good. The COVID-19 pandemic is essentially a replay of the financial collapse of 2007, with different protagonists (medical establishment vs. banks and insurance companies), the same henchman (the US government), and the same victims (the US taxpayer, individuals and small businesses). Both times, most politicians jumped on the perpetrator’s bandwagon, taking advantage of the crisis to pass legislation to greatly enrich large companies at the expense of the taxpayer, individuals and small businesses.
The US government willfully assists US businesses in the implementation of schemes that generate billions of dollars for the wealthy, at great cost to the taxpayer, individuals and small businesses. The US government has done this before, and there is no reason to believe that it will not do it again. While this view may appear to be cynical, it is realistic, based on experience. The government has transformed the US health-care system into a very expensive, profit-based system. In the financial crisis of 2007 and the present one, it has followed the policy of privatizing the profits and socializing the costs. This approach is its standard operating procedure. Comme on dit, plus ça change, plus c'est la même chose.
To date, it seems that no US leader in the US except President Trump has the instinct, insight, or temerity to recognize the COVID-19 pandemic scam for what it is – a massive, unnecessary, unjustified transfer of wealth to the health-care system, at extreme cost to other sectors. In view of this, it would appear that the next pandemic will be handled just like the present one. Sad.
It could be, over time, that people come to realize how unnecessary their pain and suffering was. Perhaps they will examine closely the experiences of Sweden and many other countries who did not implement a strong containment response, and suffered much less pain and suffering over a much shorter period of time. One would hope so.
Early in the present pandemic, there was much confusion concerning what control measures should be implemented, and what authority should be given to state and local governments to do so. It is possible that the present experience could lead to “standard operating procedures” in addressing the next pandemic, so that the government does not appear to be so inept. To a considerable extent, the US response to the pandemic has been a political football, with the various states and municipalities imposing restrictions in an unscientific and uncoordinated manner. The pandemic is a complex stochastic system. The methods used to analyze it and to develop policies and procedures to manage it should make use of the technical tools that are available to control such a system, including the tools of statistics (probability sampling, stochastic processes, decision theory) and operations research / systems engineering (systems analysis, optimization, mathematical programming, control theory, simulation and modeling).
The government is spending many billions of dollars to develop effective treatments and vaccines for COVID-19. In the case of COVID-19, in view of its low mortality rate, that the benefit of these measures will be small relative to the costs, and less efficient than simply letting the pandemic run its course. This situation underscores the value of conducting cost-benefit analyses of alternative responses, before selecting one for implementation.
Perhaps the most concerning aspect of the COVID-19 pandemic is the fact that the death rate is quite low, yet the response caused massive harm to the global economy. What will happen if a disease occurs that has a much higher death rate? It appears that we are woefully unprepared for that possibility.
It would be useful to conduct a comparative analysis of the COVID-19 responses in different countries, to better understand the costs and benefits of alternative control responses. In conducting such a study, it would be of interest to address the following issues.
1. The nature of the response to the pandemic by international, national, and state organizations and governments.
2. The fragility of the global economy to a mild pandemic.
3. The fragility of the US economy to a mild pandemic.
4. The robustness of many national economies to a mild pandemic.
5. The initial high level of fear of US citizens to death from COVID-19 (as compared to familiar causes of death such as annual influenza, traffic accidents, and guns).
6. The quick willingness of the US population to accept risk of infection, after a month of lost wages because of closure of non-essential businesses (such as schools, gyms, cafes, bars, restaurants and sporting events).
7. The effectiveness of quarantine, travel restrictions and social distancing in slowing the spread of the disease, and on long-term infection, sickness and mortality rates.
8. The economic impact of the preceding measures.
9. The nature and outcome of the US response (many business closings, a high level of social distancing, face masks required in some places, handshake and hugging greetings discouraged) to the pandemic, compared to other countries, such as Sweden (few business closings (no mass gatherings of over 50 people), some social distancing, face masks not required in public) and China (strict control measures).
10. The degree of influence and control of the privatized US health-care system in controlling the response to the pandemic.
11. The extremely lucrative effect of the pandemic on the owners and operators of the US health-care system (providers, insurers, equipment and supplies manufacturers).
12. The absence of a stated rationale for dealing with the pandemic, by US and state governments.
13. The US and state governments’ apparent lack of preparation for dealing with the pandemic.
14. The US and state governments’ lack of contingency plans for dealing with the pandemic.
15. The evident absence of a prepared strategy for dealing with the pandemic.
16. The evident lack of use of modern scientific methodology for synthesizing and analyzing alternative responses to the pandemic and for selecting a preferred response, including systems engineering, economic analysis (including cost-benefit analysis), statistics, decision science, and operations research (including optimization, mathematical programming, control theory, and simulation, modeling and analysis).
17. The evident lack of business continuity plans (disaster management plans) for dealing with the pandemic.
18. The lack of coordination between the federal and state governments in handling the pandemic.
19. The confusion about authority and responsibility between the federal and state governments in addressing the pandemic.
20. The extent of hoarding and price-gouging of medical supplies.
The extreme financial harm caused by a virus that incapacitated a very small number of people has surely caught the eye of those engaged in biological warfare. Considerations of biological warfare are addressed in an upcoming article (On Biological War, in preparation).
The present article actually began as a chapter in that article. I drafted that chapter in April. In early July, I realized that the article On Biological War was going to take somewhat longer to finish than I had originally intended, and so I decided to expand the chapter on COVID-19 and publish it as a separate article.
A colleague of mine reviewed this article and commented that while he accepted the argument that if no effective treatments and vaccines are available then, if control measures simply delay cases but do not wipe out the disease, they are ineffective in the long run, he did not accept that the control measures were a scam. Here follows some discussion of my characterization of the US government’s pandemic response as a scam and hoax.
The definition of “scam” is a fraudulent or deceptive operation. The definition of “hoax” is a humorous or malicious deception. An error is not a hoax. To be a scam or hoax, there must be deception. The fact that the measures have been extremely costly yet have not saved lives, does not make them a scam or hoax. Neither does the fact that they benefit the health-care sector at great cost to the rest of the economy.
In this article, I have called the US pandemic a scam and a hoax. Given the definition of these words, this assertion implies that there is deception involved. America’s health-care system is a profit-making system. The US government’s policy with respect to the failures of large firms is to privatize the benefits and socialize the losses. These are facts. They are known facts. They may constitute the basis for a strong incentive for the health-care industry to promote a worthless program of pandemic response measures, but, unless there is deception involved, these characteristics do not make it a scam or hoax.
On television, on a regular basis, the claim is heard that pandemic response measures such as social distancing and wearing of face masks save lives. Such claims may be true or false, depending on context. For a time, the imposition of these control measures does indeed save lives. As I have asserted, however, unless the disease is wiped out, if no effective treatments or vaccines are available, then these measures simply slow the infection rate but do not change the eventual total number of deaths. In this case, in the long term the measures are ineffective and do not save lives. Such claims, then, are conditionally true (or conditionally false), but whether they are deceptive depends on the context and on the intent of the speaker. The unequivocal, unconditional statement that the control measures save lives is not true. Whether it is a lie or a hoax depends on whether there is intent to deceive.
Proof of intent may be difficult. I have asserted in this article that the US government’s pandemic control program is a scam and a hoax. That is my opinion, based on my knowledge and perceptions. My colleague has a different opinion. The verity of this assertion depends on the government’s intent – its plan, purpose or goal.
For an individual, intention is defined as a mental state that represents a commitment to carrying out an action or actions in the future. Intention involves mental activities such as planning and forethought, relative to accomplishing some goal.
More generally, intent or intention refers an agent's specific purpose in performing an action or series of actions. As difficult as it may be to ascertain the intent of a single individual relative to a specific goal, ascertaining the intent of a government, comprised of many people and agencies having varied (and conflicting) interests, motivations and agendas, some cloaked in secrecy, is even more difficult. The issue of proving the intent of the government may be, in fact, an ill-posed question. The “US government” is not a single entity, but is comprised of many entities, including the federal government, the state governments, and local governments. Indeed, since a government is comprised of so many individuals and entities, each possessing many purposes, how should “intent” be defined? How is the “intent” of a law, regulation or program defined or measured? By a statement of intent? By a written plan? The declared intent of a law may differ from the true intent. For example, a law to deregulate banking may be represented as a move to increase freedom, when in fact it is motivated by a desire on the part of the banking industry to make more money. Assessing the intent of an action or set of actions is problematic.
For the purposes of this article, and for deciding whether the US government’s pandemic response program is a scam and a hoax, I needed an operational definition of “intent.” Relative to the COVID-19 pandemic, I view the US government’s intent as its declaration to lower the incidence curve to the level such that the caseload could be treated at a standard level of care. One may question why this goal was adopted by the government and whether it was the government’s true goal, and seek to identify a more fundamental purpose. While science has powerful tools to assist estimation of the effects of causes, it does not have good tools for identifying or assessing the causes of effects. My assessment that the US government’s pandemic response is a scam and hoax is conditioned on, or relative to, my view that the government’s intent was, as the government asserted, to lower the incidence curve to a manageable level.
In assessing whether the US government’s pandemic response was a scam and a hoax, I considered, among other things, the following.
1. The purpose of the US government’s pandemic control measures. The initial outbreak of COVID-19 occurred in China. The Chinese government acted quickly and decisively to wipe the disease out. Why did the US government not do the same? The initial stated purpose of the US government for imposing pandemic control measures was to lower the incidence curve, not to wipe the disease out. It would appear that the US government did not wipe the disease out because that was not its goal. It had the resources and know-how to do so, but not the will. The US health-care system is fundamentally a for-profit system. Its primary intent, or purpose, or goal, is to make a profit. Relative to supporting large organizations, the policy of the US government is to privatize benefits and socialize costs. The US government’s pandemic control measures are consistent with this policy. Relative to these general goals and policies, there is no scam or hoax.
2. Under the US Constitution, the primary goals of the US government are to establish justice, insure domestic tranquility, provide for the common defense, and promote the general welfare. Relative to these goals, the pandemic control program of the US government falls short. It did not defend the population from COVID-19, although it could have. By providing large economic benefits to the health sector at great cost to the other sectors of the economy, it did not establish justice. In not wiping out the disease, the US government caused tremendous harm to the economy, and wiped out the livelihoods of millions of people. It did not provide for the general welfare. It is relative to the failure of the US government to perform its duty to provide for the general welfare, opting instead to enrich the medical establishment at great cost to the citizenry, that I view its pandemic response to be a scam and a hoax. All programs and policies must be consistent with its duties and responsibilities as laid out in the Constitution. In proposing its pandemic response program, it may be taken for granted that the US government represents that the program is consistent with its Constitutional duties. It was not. That is the scan and the hoax. The US government did not fail to wipe out the COVID-19 disease because it was ignorant, or inept, or incapable. It failed to wipe it out because that was not its goal. Its goal was to lower the incidence curve. It sold that goal to the US public, and it accomplished that goal. That goal was not, however, consistent with promoting the general welfare of the US population. That is the scam and the hoax.
Because of the difficulty in defining and measuring intent, the position of whether the US government’s COVID-19 response program is a scam or hoax is arguable. Here follows a comment from my colleague in the matter: “I think that the US government failed to wipe out the COVID-19 disease both because it was ignorant, or inept, or incapable and because that was not its goal. But as you point out it is difficult to assign intention. Did it have the intention of flattening the curve so as to have time to develop a vaccine? If so, was it not consistent with promoting the general welfare of the US population?” The tine required to develop, manufacture, and distribute a vaccine is many months, usually on the order of a year. In view of the tremendous economic harm that would have been caused by locking down the economy for that long a period of time, it is unreasonable to imagine that that was its intent.
FndID(60)
FndTitle(Is the COVID-19 Pandemic a Hoax?)
FndDescription(This article reviews the Trump Administration’s response to the COVID-19 pandemic, and provides an answer to this question. More specifically, it provides an answer to the question: Is the US government’s response to the COVID-19 pandemic a hoax?)
FndKeywords(COVID; COVID-19; pandemic; US response to COVID pandemic; coronavirus; social distancing; masks; lockdowns; response to pandemic)