My mother died this week.

Mom was a victim of Alzheimer’s dementia. Up until six months ago, despite her memory loss, she was pretty happy. She was in one of the best care facilities in Nevada, catering specifically to Alzheimer’s patients. She loved her caregivers there, and she forged strong bonds with them.

My son and I took her on adventures. We took her to her favorite restaurants. Her favorite was Italian. She loved chocolate and she loved ice cream. We took her to Sigfried and Roy’s zoo that features lions and tigers, as well as dolphins. We took her to Redrock Canyon and to see the flamingos at the Flamingo Hotel & Casino. We wheeled her around the park on nice days, bought her ice cream, and brought her to my house on holidays and birthdays. The last years of her life weren’t perfect, but we made them as fulfilling as possible. 

Then COVID-19 came and made all of the above impossible.

When two weeks became six weeks and six weeks became months upon months, we knew it was only a matter of time. She was allowed to visit us only through Skype calls, which were confusing for her, or through the window, which seemed likely to make her more confused and agitated, as she began trying to escape. 

She tried to get her favorite caregiver to escape with her, so we knew if she saw us through the window, she would be beside herself. And we heard stories from other people, including close relatives of my great uncle (who died a month after COVID-19 lockdowns began), of patients crying and trying to push through the glass. We didn’t want her to go through that.

COVID-19 has taken many elderly lives, and while we all wish to protect them from that deadly virus, killing them via failure to thrive is not the answer. Our current policies will kill many more elderly Americans like my mother. 

There have been many cases of the disease spreading in nursing homes, particularly in New York where the governor signed an order in March to put COVID-19-positive elderly back in their facilities rather than keeping them at the hospital until the disease passed. That order killed thousands of elderly people in care facilities. Why Andrew Cuomo took that heartless step while making sure his own mother was safe is an astonishing mystery. Doing a “Cuomo” should really mean something going forward.

But there has to be a better way to care for these people than to lock them up with no hope of ever seeing them again. They are dying without their families around to love them. Their caregivers are depressed and anxious over what they see happening to their patients. They are watching people just give up and die. Their care, however good it might be, in no way compares to the love of one’s family and friends.

Yes, we need to protect our beloved elderly as much as possible. But we are probably fooling ourselves in thinking we can protect them forever from a respiratory illness like COVID-19.

 The disease still sneaks into facilities through staff members and deliveries, but as long as the infected person is taken to the hospital and not returned until there is no trace of the virus, good facilities have been able to deal with this challenge competently and keep other patients safe.

So long as this plague is handled in a professional manner rather than the “Cuomo way,” there should be no reason the elderly cannot be visited by their families with masks and maybe gowns on. There is no good reason to make them die alone in this way. COVID-19 has been devastating to the elderly who catch it, but our response to the disease has also been devastating to them. Our utopian and hubristic belief that we can perfectly protect them is having disastrous consequences.

I’m sure you remember watching hours of pandemic press conferences featuring Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases and Dr. Deborah Birx (who CNN called a “legend in global health”). When the two doctors spoke, President Trump listened.

Armed with graphs, data, and knowledge, these two professionals got the floor for long periods of time during the pressers. The nation watched intently as they spelled out what they believed was before us. They implored the citizens of the United States to “flatten the curve” so that hospitals would not be overrun with critical COVID-19 patients. The country unified around that mission, and then we flattened the curve.

The curve has been flattened for some time now. Hospitals never had to choose life or death between an elderly patient and a younger patient. We ended up manufacturing more ventilators than we needed. Free COVID-19 tests have been available for months across the country. We have been experiencing a shortage of personal protective equipment because we’ve been relying so heavily on China to provide that PPE, but now we understand why it’s so important to keep critical manufacturing within the United States.

I’m sure you will also remember the food and goods shortages at all the grocery stores when the pandemic began. There was a definite shortage of toilet paper—gold in an apocalypse. But even in pre-pandemic years, when a snowstorm came, people in Southern states would routinely buy up all the milk and bread over a half inch of snow. 

People panicking when uncertainty strikes is a given. Luckily our president was busy deftly responding to the deadly pandemic while carefully listening to the experts and keeping a positive outlook regarding the future, choosing not to panic us further but instead to give us all the facts while taking care of business.

On March 19, the Washington Post reported that 2.2 million people in the United States could die if we didn’t flatten the curve and mitigate our chances of spreading COVID-19 unhampered. In fact, the same article noted that if we did the mitigation, we would still see 1.1 million people perish. Six months later, and the death toll is 190,714—as of this writing, only a fraction of what experts were expecting. 

In the beginning, China lied to us about the virus transmission and their patsies in the World Health Organization parroted those lies to the world on January 14, tweeting “no clear evidence of human-to-human transmission.” According to a timeline published in the New York Post, the first COVID-19 positive patient in the United States was identified on January 21. The first known case that was contracted in the United States was on January 30. 

President Trump shut down the borders to China on January 31. Joe Biden’s response was to call the president a xenophobe. Meanwhile, Nancy Pelosi was in San Francisco’s Chinatown in late February telling people there was no reason to stay away.

That same month in New York City, Mayor Bill de Blasio allowed the Chinese New Year celebration to continue with thousands of people in the streets. The media’s main concern at the time was that the COVID-19 scare was somehow xenophobic. 

On March 25, New York State Governor Andrew Cuomo made the deadly decision to order nursing homes to take recovering COVID-19 patients back into their facilities rather than leaving them in hospitals until they tested negative or sending them to the USS Comfort. At least 4,300 patients were put back in their nursing homes resulting in thousands more deaths in New York state. New York state has had by far the most deaths of all the states and U.S. territories from COVID-1933,019 as of this writing.

While Cuomo, Biden, and Pelosi were all downplaying the virus and equating worry of viral spread with anti-Chinese bigotry, , President Trump and his administration were getting into high gear working on the systems and the task forces that would carry this country through the storm of 2020. 

On January 20, Fauci announced the National Institutes of Health were already working on a vaccine. On January 21, the CDC activated its Emergency Operations Center. The Coronavirus Task Force began meeting in the White House on January 29. You can read the impressive timeline of the administration’s efforts here.

The response from the United States government during this pandemic is unmatched throughout history. Thank God for President Trump and his hard-working administration keeping so many millions of people alive through this harrowing time.

In an appearance on MSNBC in March, Washington Post columnist and obsessed NeverTrumper Jennifer Rubin asserted (more in sorrow than in anger) that more Republicans than Democrats would die from the novel coronavirus because of the unscientific policies (no social distancing, no masks, etc.) of Republican governors and other local officials who were being led, in spirit and example, by that most unscientific of chief executives, Donald Trump.

Rubin’s claim, which she elaborated upon at length at the Post, was risible on its face given the COVID-19 vectors originated in China and Italy and entered the United States through Washington state, California, and New York City and because—especially in the case of New York—the urban density in those locations was highly conducive to contagion.

Nevertheless, Rubin, who seemed more than anything to be blinded by wishful thinking, clearly suggested that the number of deaths in different jurisdictions would serve as evidence of which political leaders were culpable and which ones were not. 

In spite of the difficulty in realistically assigning blame for the COVID-19 deaths in the United States, it is nevertheless a talking point in this election season that more than 185,000 Americans are dead and someone must be responsible.

COVID-19 in Blue and Red

We have had a full five months of pandemic hell since Rubin’s provocative pronouncements. So what does the data say?

I have performed a simple calculation to estimate the number of coronavirus deaths of those who voted for Trump and those who voted for Clinton in the 2016 election. (This is distinct from numbers of Republicans and Democrats, of course—but this data is readily available and the Trump/Clinton distinction is, I think, a sensible proxy for Republican/Democrat under the circumstances). 

Election data is tabulated by county here. Daily U.S. deaths due to COVID-19 are compiled in the Johns Hopkins University Center for Systems Science and Engineering database (henceforth called the JHU data) again by county. The calculation is simple and it is described in more detail in my webpage AIVoyager.com and, further, the Python code and datasets used are available for download from my github page. 

Briefly, I have taken the number of daily deaths as compiled in JHU data and I have multiplied each death in a given county by the fractions of Trump voters, Clinton voters, and voting age nonvoters in that county to obtain the number of Trump voter/Clinton voter/nonvoter deaths on that day in that county. The calculation thus assumes that no deaths occurred for citizens who are ineligible to vote, i.e. under the age of 18.

Figure 1(a) shows clearly that throughout the pandemic Clinton voter mortality exceeds Trump voter mortality, but both are exceeded by mortality among nonvoters. The final totals (as of August 29) are 58,200 Clinton voter deaths, 40,400 Trump voter deaths, and 81,300 nonvoter deaths. The dramatic rise in late April clearly shows the concentration of the disease in the urban northeast—especially New York City. The second wave of the disease is more closely distributed between the two groups with nonvoters continuing to show a larger percentage than both voter groups.

If we assume the vote proportion in a given county is indicative of the overall support for the candidates—even among citizens who did not cast a ballot—then we can calculate the number of deaths of Clinton supporters as compared to Trump supporters. This is shown in figure 1(b), where all the deaths in a given county are attributed to one or the other candidate’s supporters. The absolute numbers are thus higher for each group, but the ratios of the “D” to “R” numbers do not change from figure 1(a).

If there is no systematic bias for Clinton voters or Trump voters—in a given county—to contract the coronavirus, then the data in figure 1(a) gives a statistically sound depiction of the relative mortality numbers. 

As I alluded above, however, the fact that more deaths occur in blue counties than in red counties is only one piece of evidence that red county policies are better than blue county policies—and a fairly weak piece of evidence at that. 

In an attempt to get somewhat closer to partisan political leadership and its influence on COVID-19 mortality, I have performed a second calculation. In this case, I have taken a majority of Trump or Clinton voters in a given county to indicate “local political control (RL/DL).” Further, I have included the political party of the governor of the given state to indicate “state political control (RS/DS).” 

If a county has local Republican control (RC) and state Republican control (RS), all of the deaths in the county are assumed to be the fault of Republicans. Likewise for DL and DS, all deaths are assumed to be due to Democrats. For split counties (e.g. Republican governor but the county voted for Clinton) half the deaths go in the Republican and half in the Democrat column. 

The results, shown in figure 2, are the number of deaths per day weighted by the political control of the county. Here the data indicate that an even larger percentage of deaths in the first wave were in democratic-controlled jurisdictions. The second wave is far more evenly distributed, however, and even has a slight bias toward Republican-controlled states and counties.

The total numbers of deaths, in this case, are approximately 122,000 under Democrats’ control and 58,000 under Republicans’ control.

A Ghastly Sideshow

The numbers show clearly that roughly 18,000 more Clinton voters have died from the pandemic than Trump voters. While this is interesting to quantify it is not particularly surprising given the epidemiology and underlying demographic factors. 

The question lurking at the back of the COVID-19 discussion, and made explicit by Rubin’s columns (to say nothing of various Hollywood cranks who claim that Trump has killed more than 185,000 Americans) is who is responsible for those deaths? The simple calculation of figure 1 does not answer that question and figure 2 only suggests an answer.

In Rubin’s original thesis, she posited that Republican governors and local officials, through their denial of the gravity of the pandemic, were behaving “recklessly” and that the abundant Trump supporters in those places were going to pay the price. 

Stripped of the snarkiness and Trump obsession, and, generously, conceding to Rubin that what she really meant was the number of COVID-19 deaths going forward after the entry points and coastal urban density were discounted, Rubin’s argument is one of policy and it is entirely reasonable. 

It is wrong. But it is reasonable. 

Everyone is trying to figure out the right balance between opening the economy and reducing the incidence of disease. At its simplest, Rubin’s argument is just a call for greater caution and slower opening.

But it is also a bad faith argument, as she fails to even acknowledge that far more dominant epidemiological factors (New York City subways, for example) are at play.

My personal view, and this may be heterodox, is that everyone—from Donald Trump to Governors Gavin Newsom (Calif.), Brian Kemp (Ga.) and Andrew Cuomo (N.Y.) and many others in between—is doing his best in an unprecedented crisis. They all deserve to be cut some slack. What constitutes an “adult conversation” about the pandemic, and Lord knows we need one, is a recognition of this fact—a recognition that motivations are, for the most part, not sinister and that in 21stcentury America, appreciable competency exists in our executive offices for analyzing and countering pandemics like this one. 

But reflexive and, as this data shows, preposterously wrong claims—like Rubin’s—about expected Republican/Democratic mortality stemming from an obsession with Trump’s historically unique maladies is nothing more than a ghastly sideshow—one that, alas, we feel compelled to watch.

Still, we can hope for the brighter day when a future lethal, terrifying, and utterly nonideological threat to our nation is met with bipartisan comity and the collaboration of all. Now that is wishful thinking!

My wife and I recently spent a week in the hill country of Texas. What a contrast from life in our California hometown! In Texas, at least in that part of Texas, people mostly didn’t wear masks. In fact, virtually no one did, except for employees serving the public who were required to wear them—waiters, store clerks, and the like.

When we talked with Texans about their decision not to mask up, the replies were much the same. The term “sheep” was often used. The idea was that the American people were being conditioned to get used to and to accept tyrannical rule.

I think the hill country Texans have it about right. 

My wife and I live in the California Soviet—which means a kid riding his bike to the beach will be wearing a mask as he pedals his way down a mostly empty street, and the occasional driver going by will also be wearing a mask. Around here, they take this mask business very seriously. It seems like only yesterday when failing to remember to bring your reusable shopping bag to the grocery store elicited the same level of disapproval that going out without a mask does today. The obsession with reusable shopping bags disappeared and quickly was replaced with the mask obsession. Carrying a reusable bag once meant that because you were toeing the line, you were an acceptable person, just as mask-wearing does today.

This strange new attitude of many American citizens has been developing for some time now. The 9/11 horror was used by government officials to oppress citizens just as the Chinese flu has been, and Americans knuckled under with little real pushback.

The only thing as strange as everyone wearing masks are the ridiculous “security” measures imposed on Americans at airports. 

When America was attacked by jihadis, the response of the government was to harass travelers. Soon after 9/11, I watched in amazement as TSA agents conducted themselves very carefully so as to avoid being charged with profiling. A group of obviously Middle Eastern young men who weren’t speaking English among themselves—that is, a group of men who perfectly fit the terrorist profile—were waved through while the agents, as I recall, searched for weapons on an elderly woman in a wheelchair and a middle-aged man who looked like a rancher. After 9/11, instead of profiling potential bad guys, the government imposed what has rightly been called “security theater” on American citizens exercising their unalienable right to travel in America. Everyone knows that what goes on at airports in the name of security is a fraud and a huge waste of taxpayer money, but it now seems Americans by and large accept it without question.

The arrival of the Chinese flu has given those who think of themselves as our rulers a new opportunity to exert control over the rest of us who are simply going about our daily lives. Rule-makers are running wild, giving wonderful opportunities to the kind of people who crave the power over others that “public service” provides them and also to the kind of people who, although they are not government employees, are keen to associate themselves with those who make and enforce the rules. 

Those rules lately have included imposing house arrests on American citizens who have done nothing wrong, who are simply living in America, and forcing those who dare to venture out to wear masks. People in the media, the elites who get to make the rules, and Americans who are eager to make sure their neighbors comply,  don’t seem to mind that the proliferation of rules has been wrecking the economy and destroying people’s lives. 

Of course, you already know that the “news” media are in lockstep on the Democratic panic—I mean the pandemic—and that people who challenge the pandemic narrative are being censored on social media. All this seems very un-American, and more like the way people in China behaved during the Cultural Revolution. It wasn’t safe to deviate from the party line in China back then, or for that matter, in China, and increasingly in America, today.

Four months ago, I wrote a column titled “The Worldwide Lockdown May Be the Greatest Mistake in History.” I explained that “‘mistake’ and ‘evil’ are not synonyms. The lockdown is a mistake; the Holocaust, slavery, communism, fascism, etc., were evils. Massive mistakes are made by arrogant fools; massive evils are committed by evil people.”

Regarding the economic catastrophe in America and around the world — especially among the world’s poor who are dependent upon America and other first-world countries for their income through exports and tourism — I wrote, “It is panic and hysteria, not the coronavirus, that created this catastrophe.”

Unfortunately, I was right.

The world should have followed Sweden’s example. That country never locked down and has even kept children under 16 in school the entire time. As Reuters reported on July 15, the number of Swedish children between 1 and 19 years of age who have died of COVID-19 is zero. And the percentage of children who contracted the illness was the exact same in Sweden as it was in Finland, which locked down its schools.

As regards teachers, Sweden’s Public Health Agency reported that “a comparison of the incidence of COVID-19 in different professions suggested no increased risk for teachers.” Nevertheless, with few exceptions, teachers in Los Angeles and elsewhere refuse to enter a classroom that has students in it. Their disdain for their profession has been superseded only by that of the Los Angeles teachers union, which announced that teachers will not resume teaching until the police are defunded.

People who defend lockdowns and closing schools point out that Sweden has the eighth-highest death rate per million in the Western world. But, needless to say, this has no bearing at all on the issue of whether Sweden was right to keep schools open or whether our country was wrong to close them, let alone keep them closed now. The overwhelming majority of deaths from COVID-19 in Sweden were among people over 70 years of age, and most of those were people over 80 and with compromised immune systems.

Reuters reported that three separate studies, including one by UNICEF, “showed that Swedish children fared better than children in other countries during the pandemic, both in terms of education and mental health.”

For more than a month, Sweden has had almost no deaths from COVID-19 while the entire society remains open and almost no one wears masks. (In Holland, too, almost no one wears masks.) For all intents and purposes, the virus is over in Sweden.

I live in California, a state governed by that most dangerous of leaders: a fool with unlimited power. Despite the fact that California ranks 28th among the 50 states in deaths per million, Gov. Gavin Newsom has destroyed and continues to destroy tens of thousands of small businesses and untold numbers of livelihoods. His continuing to forbid — a half-year after the onset of the pandemic — indoor dining in restaurants is leading to a projected permanent closure of approximately 1 in every 3 restaurants in the state. The same catastrophic destruction will likely affect retail businesses and services such as hair and nail salons. But all this human tragedy — not to mention increased depression and suicides among the young and increased abuse of children and partners — means nothing to Newsom, to Los Angeles Mayor Eric Garcetti or to the Los Angeles Times, whose editors and columnists continue to advocate for the lockdown while they receive their salaries.

Why can people eat with no mask in an airplane — inches, not six feet, from strangers — but cannot eat in a California restaurant, which is so much bigger than the inside of an airplane, while sitting six feet from others? Because Newsom ordered it, the Los Angeles Times supports it and, like sheep, Californians have accepted it.

According to the California Association of Museums, “Museums are losing over $22 million a day due to the statewide quarantine. As of August 1, 2020, California museums have lost more than $2.9 billion in revenue. Museums have a $6.55 billion financial impact on California’s economy, support 80,722 jobs, and generated $492 million in tax revenues for the State of California in 2017 and over $1 billion in federal taxes.”

And the American Alliance of Museums issued results from a survey on July 22, 2020, that warned 1 out of every 3 museums may shutter forever as funding sources and financial reserves run dry.

On Aug. 3, The Wall Street Journal wrote, “In March … There was broad public support for the prudent goals of preventing hospitals from being overwhelmed and buying scientists time to develop therapies.” But the left — the media and Democratic governors and mayors — immediately moved the goal posts to “bending the curve” and “saving one life,” enabling them to get away with destroying lives and livelihoods.

I conclude with the words of a Swedish medical doctor, Sebastian Rushworth:

“Covid is over in Sweden. People have gone back to their normal lives and barely anyone is getting infected any more. I am willing to bet that the countries that have shut down completely will see rates spike when they open up. If that is the case, then there won’t have been any point in shutting down in the first place … Shutting down completely in order to decrease the total number of deaths only makes sense if you are willing to stay shut down until a vaccine is available. That could take years. No country is willing to wait that long.”

The lockdown is a crime. But even more upsetting is that it is supported by so many Americans. This country is unrecognizable to those of us who lived through the 1968-1970 pandemic, which killed, according to the Centers for Disease Control and Prevention, approximately 100,000 Americans — the 2020 equivalent of 170,000 Americans. Nothing shut down. Not one mask was worn.

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While discussing many pandemic-related issues with friends and colleagues, we were reminded of the quip of journalist and satirist H.L. Mencken: “For every complex problem, there is an answer that is clear, simple, and wrong.”

As we battle the SARS-CoV-2 virus, and the illness it causes, COVID-19, the “fog of war” continues on both the medical and epidemiological fronts. On the public health side, different studies, especially those that involve modeling, seem to reach conflicting, or at least ambiguous, conclusions. And politicians and pundits have jumped in to make the fog denser, with many policy prescriptions contaminated by misinformation, ideological spin, and partisan politics.

                                                       Obtaining clarity about many aspects of COVID-19 has been elusive. Dr. Anthony Fauci has emphasized the virus’s unique “protean manifestations”: “I have never seen a virus in which you have 20 percent to 40 percent of individuals who could have no symptoms at all, to individuals who get mild illness and do not need to go to a hospital, to people confined to their beds at home for weeks with multiple post-viral syndromes,” he said. 

SARS-CoV-2 is also unusual in being able to infect a broad spectrum of body tissues beyond the respiratory tract, including the digestive tract, neurons that mediate smell and taste, kidneys, and most critically, the heart and lining of blood vessels. 

Infection often leads to widespread inflammation and tiny clots, which cause secondary deleterious effects. Moreover, an Italian research study found that upwards of 85 percent of patients who had been hospitalized have persistent, sometimes serious aftereffects that can drag on for an indeterminate amount of time, and possibly permanently. (The virus is too recent to know conclusively.)

The clear lesson is that efforts to prevent infection are critical. But, absent a vaccine, which is still likely far off, that’s complicated and involves difficult cost-benefit calculations.

Widespread Rapid Testing Is Crucial—And Expensive

The modes of transmission for this virus remain somewhat unclear, with scientists still working to understand the amounts of virus that constitute an infectious dose, and how infected individuals spread infectious virus. 

Recent evidence suggests that SARS-CoV-2 can pass from person to person both in large droplets that travel only short distances and also in tiny droplets (smaller than five microns in diameter) called aerosols that waft through the air and that can linger longer and travel further. A better understanding of those phenomena is critical, because the expelled droplet size (which varies across breathing, speech, singing, yelling, sneezing, and coughing) determines the distance of travel and duration of presence in the air.

These uncertainties make it difficult to evaluate transmission mitigation measures. One initiative, however, is of indisputable value: ubiquitous, frequent, and rapid-response testing for active infection, especially in places where transmission is potentially high (e.g. offices, school buildings, gyms, stores, etc.). 

Dealing with known infected individuals is a much easier proposition than coping with the impact of potentially infected people who can spread the virus while waiting for test results, and individuals who become ill and spread the virus while in the pre-symptomatic stage or who are asymptomatic and see no need to be tested.

This implies a need to refocus our testing capacity and implementation on screening for infected individuals in something close to real-time. 

This can now be accomplished rapidly and inexpensively with antigen tests that detect virus proteins (as opposed to the PCR tests that detect virus material, RNA, or fragments thereof). Because they are currently less accurate than PCR tests, however, their primary value is in screening, rather than diagnosis. Biweekly testing of everyone at schools and in certain workplaces with such tests, especially on pooled samples, could detect COVID-19 infections early on and keep the number of new cases to a manageable level, or even cause them to disappear in some locations.

This transformation won’t be easy or cheap. Among the hurdles facing widespread, repeat screening is the scarcity of such tests; and a national screening strategy likely would require at least 25 million fast tests per week, according to Jonathan Quick, who heads pandemic response for the Rockefeller Foundation. On July 16, the foundation released a national COVID-19 testing plan that calls on the federal government to spend $75 billion to provide 30 million screening and diagnostic tests per week.

A New COVID Infrastructure

Other kinds of interventions to lower virus transmissibility won’t come cheap either. One example is the improvement of indoor ventilation and filtration systems. Evidence is mounting that transmission of the virus outdoors in amounts that can cause disease is generally rare. Of course, close gatherings for extended periods (e.g. in stadiums) increase the risk, but many outdoor venues have sufficient air movement to dissipate and dilute potentially infectious levels of viral particles. 

Most transmission of the virus at levels that are infectious occurs indoors, so federal programs that encourage HVAC improvements, by direct or indirect subsidies, would be a sound investment that should reduce the incidence not only of COVID-19, but also of flu and colds. Presumably, such programs would be focused on workplaces, houses of worship, schools, and other places where strangers congregate.

Measures for which the cost is relatively low and the benefits are potentially huge include: regular masks for those with an average risk of being spreaders (especially indoors in stores, etc.), N95 respirators for those at greatest risk of contracting COVID-19 (especially indoors in environments with strangers), and distancing to the maximum extent feasible. Clearly, some situations such as workplaces and schools will have to find the optimal workable tradeoff between distance and density.

Avoiding indoor gatherings where movement is limited and exposure times are long (bars, arenas, large parties, etc.) is preferable, but the risk will depend on many factors, not the least of which is the degree of community spread in individual locales. (If the incidence of new cases and testing positivity are high, the risk of further spread is high.) These include the quality of ventilation and filtration, the feasibility of wearing masks (harder when eating or drinking is involved), and the demographics of the group. The tradeoff, of course, is that limiting these gatherings could bankrupt businesses and increase the public’s feelings of isolation and frustration.

Researchers at the University of Colorado, Boulder have modeled the risk of infection from SARS-CoV-2 aerosols in various scenarios, such as an indoor gathering, an energy-efficient office, a classroom lecture, strenuous outdoor activity, a subway ride, and so on, with and without masks. The graphs of estimated risk of infection versus time of exposure to those scenarios are instructive.

Don’t Be Stupid

It remains uncertain which additional interventions would be cost-effective, except in special environments such as long-term care facilities, where specific protocols can and should be implemented, given the hugely disproportionate death toll in people over age 75, especially if they have comorbidities. Additional interventions must also meet the test of not causing more harm than good, exemplified by restricting access to healthcare for non-COVID needs.

In formulating policy, at the top of the list of things that must be avoided are inconsistencies, illogic, and downright stupidity. The imposition of arbitrary, scientifically baseless constraints erodes public trust and deepens pandemic fatigue. (Should we even have to say that?) 

Michigan Governor Gretchen Whitmer has provided some worthy examples: a prohibition on people traveling from one of their houses to another of their own properties; a restriction on motor-boating, although sailing and rowing were permitted; and the requirement that large stores close off areas that display carpeting, flooring, furniture, gardening supplies, and paint.

In Honolulu, taxpayer-funded outdoor spaces—beaches, parks, and hiking trails—are shut down, while indoor businesses including retail stores, restaurants, gyms, tattoo shops, and massage parlors that have less ventilation and more person-to-person contact are open.

Finally, the Wisconsin Department of Natural Resources (DNR) is mandating its employees wear face masks during video conferences, even if they are home alone. The department secretary admonished employees, “wear your mask, even if you are home, to participate in a virtual meeting that involves being seen—such as on Zoom or another video-conferencing platform—by non-DNR staff . . . Set the safety example which shows you, as a DNR public service employee, care about the safety and health of others.” This is reminiscent of the sublime British TV spoof of government, “Yes, Minister.”

Worst of all have been statements from politicians and even some public health officials that the motivation behind dangerous large gatherings—whether political rallies or activists’ demonstrations—should take precedence over public health considerations. 

Such actions and statements severely undermine the credibility of those “in charge.” This kind of behavior needs to stop in order to inspire confidence in interventions that are actually useful. There are signs it already may be too late.

Getting through the worst of the pandemic won’t be easy, but we need to be smart, resilient, and disciplined, and go where the data take us.