The New England Journal of Medicine has endorsed Joe Biden (without mentioning him by name) in “Dying in a Leadership Vacuum”. Once we get over the shock that a group of physicians support the political party that made it illegal for Americans to refrain from purchasing insurance policies that make payments to physicians, what are these doctors/editors actually saying?
the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China. The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000.
We know that we could have done better. China, faced with the first outbreak, chose strict quarantine and isolation after an initial delay.
This is consistent with what the Swedish MD/PhDs said, i.e., that lockdowns could work in a police state. But how was Donald Trump supposed to arrogate police state powers to himself? Supposedly, only state governors had the ability to terminate Americans’ First Amendment rights to assemble, terminate children’s rights to go to school, etc.
(Why cite Vietnam? Laos and Cambodia have had zero deaths! See “Vietnam miracle escape from Covid may be down to ‘natural immunity'” (Telegraph) for a report on Oxford professors poking into this question)
The unkindest cut of all:
Yet our leaders have largely chosen to ignore and even denigrate experts.
(But Trump can just say that he wants to follow the 15,000ish doctors and MD/PhDs who say that shutdown is the wrong policy. Sunetra Gupta, Oxford professor, doesn’t qualify as an “expert”? Martin Kulldorff, professor of medicine at Harvard, is not an “expert”?)
To minimize COVID-19 deaths, therefore, what we really need is a police state that can take dramatic muscular action unfettered by a written constitution. This reminds me of Looking at Covid-19 death rate is like the old saying “An economist is someone who knows the price of everything and the value of nothing”?
Is asking an epidemiologist whether to keep schools and playgrounds open like asking your accountant whether you should buy a dog? Yes, the expert can give you a bit of insight (“my other clients with dogs spend $4,000 per year on vet, food, and grooming”), but not a life-optimizing answer.
In this, the NEJM simply ignores its own content, e.g., “The Untold Toll — The Pandemic’s Effects on Patients without Covid-19” Shutting down every other part of society in order to focus on COVID-19 necessarily results in a lot of deaths. “The COVID-19 shutdown will cost Americans millions of years of life” (The Hill) takes a stab at calculating the cost.
Maybe this is a good window into what would have happened if technocrats had been allowed to run the White House!
(Separately, if you work at a hospital or medical school, one fun thing to do is listen for when a physician criticizes Donald Trump for trying to stem the tide of undocumented low-skill migrants. Most of these folks eventually end up on Medicaid and/or have children who are on Medicaid, thus becoming revenue sources for physicians. Then ask “Should a Swiss, German, French, English, or Taiwanese doctor who is fluent in English be able to come over here and practice?”)