Photo: Francisco Àvia, Hospital Clínic Barcelona. (Sorry, didn't find US hospital pix with a Creative Commons license)

The United States could have had nearly 400,000 fewer deaths from COVID-19 if it had instituted and stuck with strict infection-control measures starting in May of last year, according to a paper presented this week at a Brookings Institution conference on the health and economic costs of the pandemic response. UCLA economics professor Andrew Atkeson did some computer modeling of the history of the virus and the effects of various scenarios — from doing nothing to taking universal precautions like masking, social distancing, and limiting social gatherings, plus an aggressive regimen of testing and contact tracing. We've cued up his presentation, which is really only 15 minutes long (do not panic at the seven-hour video length, which is the whole conference).


Had we done nothing at all, Atkeson concluded, the death toll could have reached 1.5 million in the US in the first six to nine months of the pandemic, so hooray for our having done something, at least. We would note that's pretty much what Donald Trump frequently demanded we praise him for.

Atkeson noted that in that model, the rapid, uncontrolled pandemic and all those deaths might have brought us to herd immunity, assuming the disease actually resulted in adequate resistance to the virus (which isn't actually certain). Hi, Dr. Scott Atlas!

Now that we have vaccines available, Atkeson estimates that the US death toll will eventually reach something like 670,000 (as of now, we're at over 540,000 deaths and counting.)

However, Atkeson also ran a simulation assuming that if

disease-control measures were imposed May 1, 2020 and not relaxed until vaccines are distributed, produces a death toll of only 292,000. [...] This simulation shows what could have been achieved by implementing more aggressive testing, tracing, and isolation while waiting for deployment of the vaccine.

"Isolation" there means quarantining people who test positive, and localized lockdowns in case of outbreaks, as in the South Korean response, or in Australia or New Zealand. He's not saying the better response would have meant keeping everyone in the US locked in the basement forever, shut up, Republicans.


Of course, that's not anything like what we actually did. Testing was almost never adequate to the need, with no national testing strategy under the Trump administration at all, and contact tracing has been both very spotty and resisted by freedumb-lovers who don't want the government prying into who they might have been spreading infections to. So the overall response to the virus, left to state governments, led to a lot of opportunities for the virus to spread:

Adding disease-control measures to the model slows the spread of the virus. However, behavior offsets their effect. As deaths and cases decline, authorities relax economically costly measures such as business lockdowns, and "pandemic fatigue" causes many people to become less cautious. That produces a more drawn-out pattern with waves of deaths, similar to what has actually occurred. Long-run deaths in this scenario, absent a vaccine or cure, total 1.27 million over two-and-a-half years.

Or if you prefer a metaphor, you could think of our pandemic response as being something like driving on cruise control (and on hills, at that): As people stayed mostly home and observed medical advice, infection rates went down, but as governors opened up businesses and people confidently headed out to bars and holiday gatherings, infections shot up again. That too would result in a lot of death until eventually some kind of herd immunity is reached — but over a far longer time. That's how we get to pretty much where we are — but thankfully, with the vaccines available to pump the brakes.

Atkeson recommended that to better prepare for future pandemics, authorities should

improve infectious disease surveillance worldwide, invest in new models to accelerate the development and distribution of vaccines and cures, and stand ready to quickly deploy measures that slow disease spread with the least cost to the economy.

"Public efforts at disease control can save a lot of lives over the long run by controlling disease while we wait for a vaccine or a cure," Atkeson tells The Brookings Institution. "We have a tremendous opportunity to learn from international experience with COVID on how to do that without tanking the economy."

Which is all well and good, but doesn't take into account the pro-disease perspective of people who think it's far more important to shout about liberty and tyranny right in your face without a mask.

[Reuters / Brookings Institution / Photo: Francisco Àvia, Hospital Clínic Barcelona, Creative Commons license 2.0]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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