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A Science-driven COVID Strategy

August 10, 2020 By SomervilleTom

An excellent piece in this morning’s New York Times presents a science-driven strategy for successfully addressing the COVID pandemic.

Here are some highlights (emphasis mine):

In just weeks we could almost stop the viral fire that has swept across this country over the past six months and continues to rage out of control. It will require sacrifice but save many thousands of lives.

We believe the choice is clear. We can continue to allow the coronavirus to spread rapidly throughout the country or we can commit to a more restrictive lockdown, state by state, for up to six weeks to crush the spread of the virus to less than one new case per 100,000 people per day.
…
At this level of national cases — 17 new cases per 100,000 people per day — we simply don’t have the public health tools to bring the pandemic under control. Our testing capacity is overwhelmed in many areas, resulting in delays that make contact tracing and other measures to control the virus virtually impossible.
…
To successfully drive down our case rate to less than one per 100,000 people per day, we should mandate sheltering in place for everyone but the truly essential workers. By that, we mean people must stay at home and leave only for essential reasons: food shopping and visits to doctors and pharmacies while wearing masks and washing hands frequently. According to the Economic Policy Institute, 39 percent of workers in the United States are in essential categories. The problem with the March-to-May lockdown was that it was not uniformly stringent across the country. For example, Minnesota deemed 78 percent of its workers essential. To be effective, the lockdown has to be as comprehensive and strict as possible.
…
If we do this aggressively, the testing and tracing capacity we’ve built will support reopening the economy as other countries have done, allow children to go back to school and citizens to vote in person in November. All of this will lead to a stronger, faster economic recovery, moving people from unemployment to work.
…
This pandemic is deeply unfair. Millions of low-wage, front-line service workers have lost their jobs or been put in harm’s way, while most higher-wage, white-collar workers have been spared. But it is even more unfair than that; those of us who’ve kept our jobs are actually saving more money because we aren’t going out to restaurants or movies, or on vacations. Unlike in prior recessions, remarkably, the personal savings rate has soared to 20 percent from around 8 percent in January.

Because we are saving more, we have the resources to support those who have been laid off. Typically when the government runs deficits, it must rely on foreign investors to buy the debt because Americans aren’t generating enough savings to fund it. But we can finance the added deficits for Covid-19 relief from our own domestic savings. Those savings end up funding investment in the economy. That’s why traditional concerns about racking up too much government debt do not apply in this situation. It is much safer for a country to fund its deficits domestically than from abroad.
…

This exemplifies the science-driven, targeted, and short-term management strategy I’ve been calling for. It calls for strong and effective action. It calls for that action to be applied state-by-state (and, by implication, county-by-county, town-by-town, and even neighborhood-by-neighborhoos — that’s what “hyper-local” IS). It sets a specific and measurable target — less than 1 new case per 100K population per day using a 7-day rolling average. It sets a specific and measurable duration — six weeks.

It is specific about the crucial importance of providing economic relief to working-class families hardest hit by the pandemic, and clearly identifies a strategy for how to pay for it — leverage the dramatically increased savings rate of US families.,

This is the kind of science-driven policy that America desperately needs. I invite you to share it with our elected officials and demand that they follow something similar to this.

We need a national policy driven by science and data rather than prejudice and passion.

Please share widely!
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Comments

  1. johntmay says

    August 10, 2020 at 11:16 am

    I was deemed an “essential worker” and as such, unable to not work and collect a check each week. My net pay each week was $525, that included an extra $2 per hour that lasted until recently. I
    I worked in tight conditions with co-workers at times and had to deal with customers who simply did not agree or care that they might infect me with a deadly virus. I am 65 year old, asthmatic with high blood pressure. If I get hit by Covid, my odds of survival are slim. I am not alone in this. Contrary to public opinion, the majority of people who work in grocery stores are not teenagers or moms with kids in school. Many of us are 50 + and have pre-exiting conditions.

    While I am in 100% agreement that a month long (or longer) shelter in place law is the only real solution to the problem at this point, we need to, in the very least PAY those who are working a hell of a lot more money, or, as my niece said (she’s an RN), you can stop the compliment, take down the lawn signs that thank essential workers….keep the hero’s capes…..just PAY ME!

    • SomervilleTom says

      August 10, 2020 at 11:24 am

      Agreed, enthusiastically.

      I also think government has an obligation to provide complete and no-cost health care to you. In particular, I think you and every essential worker should be receiving COVID tests at frequent intervals.

    • Christopher says

      August 10, 2020 at 12:23 pm

      It’s too bad your net pay didn’t even match the $600+ those on unemployment were getting for a while. Those who feel vulnerable should have had the choice to work or not and if not be able to collect sick leave or unemployment. When Republicans complain that $600 incentivizes people to stay home my two responses are that may be just what the doctor ordered at least for some, and that if you were making more on unemployment than at your job that says more about your job than it does about unemployment.

      • johntmay says

        August 10, 2020 at 12:31 pm

        To be fair, my net pay did not include my 401K, profit sharing, medical insurance, and a few other things, but yes, it did sting to realize that if i had been a clerk in a shoe store instead of a clerk at a food store, I would not be putting my health at risk and getting $600 per week.

        If I was making the $525 and even half of the $600….it would be less of a slap in the face

  2. jconway says

    August 11, 2020 at 11:23 am

    I’ll add this is exactly what I’ve been calling for for a long time. A lockdown based on the successful European and East Asian approaches that stemmed the spread of the virus. This is exactly what Italy did and it worked, their cases were much worse than ours initially and now they are ready to go back to work and go back to school.

    It would also buy us enough time to resume traditional in person learning, maybe as soon as October, without missing too much of the year, and without the risks and uncertain of hybrid. Unfortunately our hasty reopening, even in Massachusetts, will make this stricter lockdown much harder to pull off.

    • SomervilleTom says

      August 11, 2020 at 1:25 pm

      It may seem insignificant to you, but there are several aspects of this that I do not recall seeing in your earlier proposals:

      • Explicit state-by-state invocation
      • Specific data-driven threshold to attain: 7-day rolling average of 1 new case per 100K population per day
      • Explicit mechanisms for addressing the economic impact of the pandemic on working-class families — especially in minority and Hispanic communities
      • Explicit time limits (six weeks per state)

      Here, for comparison, is the 7-day daily case rate per 100K person for Massachusetts counties last Sunday (yesterday’s data is still being processing on my site) ranked from highest to lowest:

      County: 9-Aug | 2-Aug | Delta (%)

      Suffolk: 8.779 | 8.157 | 7.63%
      Essex: 8.328 | 7.858 | 5.98%
      Bristol: 5.838 | 6.116 | -4.55%
      Norfolk: 5.478 | 7.519 | -27.14%
      Nantucket*: 5.013 | 3.76 | 33.32%
      Middlesex: 4.662 | 4.973 | -6.25%
      Hampden: 4.074 | 5.636 | -27.71%
      Worcester: 3.698 | 5.538 | -33.22%
      Plymouth: 3.563 | 3.563 | 0.00%
      Hampshire: 3.375 | 4.086 | -17.40%
      Barnstable: 2.884 | 4.293 | -32.82%
      Berkshire: 1.258 | 1.601 | -21.42%
      Franklin: 1.221 | 2.036 | -40.03%
      Dukes*: 0.824 | 0.824 | 0.00%

      *Small-number outlier

      This data suggests that all of MA should be shut down. Suffolk and Essex counties are particularly troublesome — they’ve got the highest new case counts in the state, and their trend is in the wrong direction.

      Whatever happens in the rest of the nation, we should and must do more to manage this pandemic here in Massachusetts.

      • Christopher says

        August 11, 2020 at 4:51 pm

        Doesn’t this say that everywhere except Essex, Suffolk, and the Islands (the latter you point out as small outliers) is headed in the right direction and therefore we don’t need a whole state shutdown? I also wish we had more information on case severity. I’m not really concerned about those who can recover at home or were never symptomatic and IMO those should not really be informing any need to impose restrictions.

        • SomervilleTom says

          August 11, 2020 at 7:56 pm

          Did you read the thread-starter?

          The threshold for lockdown is:

          less than one new case per 100,000 people per day

          People “who can recover at home or were never symptomatic” are just as likely to spread the virus as the rest — the severity of symptoms is not related to how contagious the victim is.

          The point of a lockdown is to stop the SPREAD of the virus.

          • Christopher says

            August 11, 2020 at 8:16 pm

            I admit I skimmed and missed that detail, but I’m not convinced that needs to be the goal. I understand severity doesn’t relate to contagiousness, but I care less how contagious it is if so many cases aren’t that bad anyway.

            • SomervilleTom says

              August 11, 2020 at 11:05 pm

              Your comment is exactly equivalent to Climate Change Deniers who say “I don’t care about global warming, because I don’t think it’s so bad”. You listen to scientists tell you what it takes to stop a pandemic and your response is “I’m not convinced that needs to be the goal”.

              Your commentary on this issue epitomizes the anti-science stance that is making this pandemic so extreme — and that is causing is to lose the fight against global warming.

              • Christopher says

                August 12, 2020 at 12:21 pm

                Do you think we would, or need to, shut down if there were no hospitalizations or fatalities? I certainly hope not. I categorically reject the climate change metaphor and have never denied the science of COVID. I have only debated HOW to address it, just as reasonable people may have different ideas as to how to address climate change.

                • SomervilleTom says

                  August 12, 2020 at 1:47 pm

                  I posted a quote from a leading epidemiologist who stated a threshold that must be met in order to halt the pandemic. This is precisely analogous to climate scientists stating a threshold of atmospheric carbon emissions.

                  Your response was “I’m not convinced that needs to be the goal”. That is exactly analogous to a climate change denier who says “I don’t believe climate change is a problem”.

                  “Reasonable people” do not debate whether or not climate change is a problem. It is not “reasonable” — by any stretch of the word — to assert that COVID is not a serious disease.

                  Your first question misses the point. We already know that COVID is FAR more dangerous than seasonal flu, pneumonia, and some argue even TB. The CDC data shows that US deaths from the flu average about 37,000 per year for the last nine years (https://www.cdc.gov/flu/about/burden/past-seasons.html). The current death toll from COVID is already 164,000 with five months left to go. That’s an annual rate of at least 275,000 per year.

                  So the current death toll is ALREADY more than four times the annual death toll from the flu, and we still have five months to go.

                  We already know that about 20% of those infected require hospitalization. That number is already high enough that a key driver for these interventions is to avoid saturating our limited hospital resources with COVID patients. We also know that many of those hospitalized patients end up on respirators. We know that there are age groups where our current experience is that virtually every patient who ends up on a respirator dies (cf. Herman Cain).

                  While there is still much to learn about morbidity and risks, it is simply irresponsible for anyone — either you or Donald Trump — to assert that this is not a dangerous disease.

                  Too many people have already died from COVID. Our national incompetence means that more people will unnecessarily die from COVID whatever we do (because we have already missed the time when we could prevent widespread infection with the virus).

                  We must not compound this tragedy by attempting to ignore or deny it.

                • Christopher says

                  August 12, 2020 at 4:04 pm

                  Is it just me or is your own assessment getting more severe? I still say in some ways we are being presented with a false choice. It’s been a long time since I’ve heard concern about hospital capacities, and I don’t see us cancelling our lives over climate change. The virus is dangerous to some, but not to others. I just wish we could as we do with most diseases, leave this to the medical community, public policy makers, and those who have unfortunately contracted the virus and their families, leaving the rest of us alone until such time as we are all asked to line up for our vaccinations.

                • SomervilleTom says

                  August 12, 2020 at 5:46 pm

                  Indeed, my own assessment is getting more severe. That’s because the assessment from epidemiologists is getting more severe.

                  Several things have changed in the past few weeks:

                  • Several studies have shown that asymptomatic individuals are just as contagious as symptomatic
                  • As more antibody test results are becoming available, more and more research says that immunity lasts for 30-90 days. That means any vaccine will be more like a flu vaccine and less like a more effective intervention.
                  • The pandemic is now so widespread that contact tracing and individual testing provide little to no value in slowing the spread. This disease will be with us for the foreseeable future — it’s too late to eradicate it.

                  If it’s been a long time since you’ve heard concern about hospital capacities, it is because:

                  1. You aren’t listening to the experts and the mainstream media is no longer reporting that information, and
                  2. Starting on 15-Jul-2020, the Donald Trump administration has captured ALL the real-time data about hospital capacity (https://www.cnn.com/2020/07/14/politics/trump-administration-coronavirus-hospital-data-cdc/index.html).

                  I just wish we could as we do with most diseases, leave this to the medical community, public policy makers, and those who have unfortunately contracted the virus and their families, leaving the rest of us alone.

                  Sort of like the initial reaction to HIV/AIDS, you mean? You continue to deny that it is the “medical community” and informed “public policy makers” that are raising the alarm. It is the Donald Trump administration and its deplorable and ignorant followers who are demanding to left alone.

                  This disease is too contagious and to deadly to allow “the rest of us” to be left alone. I don’t want die of this. I don’t want you to infect me, my loved ones, my family, or my friends — no matter how much you want to be left alone.

                  None of us happy about this. The worst thing we can do is bury our heads in the sand and pretend it isn’t happening.

                • Christopher says

                  August 12, 2020 at 8:54 pm

                  Here in Lowell they actually closed a makeshift hospital at UML because they no longer needed the extra beds.

                  I thought we always knew, or at least assumed, that the asymptomatic could transmit. Wasn’t that the whole justification for assuming everyone was sick even if they couldn’t tell?

                  Regarding AIDS my recollection is that the public policy makers were themselves ignoring it, whereas I explicitly said they should be among those paying attention and taking appropriate measures. Besides, the analogy doesn’t really hold because you can count on the fingers of one hand the specific behaviors you need to avoid to protect yourself. We weren’t asked to cancel our lives nor did we need to be.

                  More than half of the less than 2% of cases relative to US population have been closed, 94% of which are recoveries. I wish we would subtract recoveries from the total reported cases. I’m still very comfortable with these stats, at least to the extent it doesn’t require such drastic action. Many states have a majority of deaths in nursing homes which says to me we should have done more to target such facilities for quarantine and put a huge dent in fatality numbers. I don’t want anyone to die either of course, but I just don’t see that big a risk and refuse to live my life in fear.

                  I ran out of what was left of my already little patience for this a couple of weeks ago. Earlier this spring I was offered a seasonal position in the National Park Service which potentially would finally open a door at 42 years old to an actual career. (You didn’t think substitute teaching was part of the grand plan, did you?) It was going to start the last week of April, but delayed a couple of times as the park waited to see when it could open. I think others may have moved on rather than wait around, but I was patient because it’s hard to get into the NPS the first time, particularly if you are not a veteran (which I am not) and I really wanted that foot in the door. The last plan was to open the park in July with their returning staff and start new staff like me this coming weekend. Then a couple of weeks ago I learned that the park decided that on account of space limitations and less programming on account of COVID they would not add new staff at all and use only returning staff. My job offer was rescinded and I don’t even get rehire status despite having already filled out all the paperwork and gone to Boston (which incidentally I diaried a while back) to obtain my federal ID. For one of the precious few times in my adult life I deprioritized job-hunting because I assumed I had one.

                  I still feel that I have not really been impacted by the virus itself, but rather by the reaction (I would argue overreaction.) and on account of the above I am more angry and frustrated than I have ever been. There’s no guarantee I will get that opportunity back, but even less of a chance I will contract the virus.

                • Christopher says

                  August 12, 2020 at 9:14 pm

                  Sorry about the rant, but I’m at my wits end.

                • SomervilleTom says

                  August 13, 2020 at 9:48 am

                  Sorry about the rant, but I’m at my wits end.

                  
                  I empathize with your distress. It is a difficult and trying time for all of us.

                • SomervilleTom says

                  August 13, 2020 at 9:47 am

                  Regarding AIDS … the analogy doesn’t really hold because you can count on the fingers of one hand the specific behaviors you need to avoid to protect yourself. We weren’t asked to cancel our lives nor did we need to be.

                  My recollection differs from yours. My recollection is that the first thing America was told was that HIV/AIDS was a “Gay disease”. Religious leaders described it as “God’s punishment for sin”. In my liberal Brookline Episcopal church, when the Sunday prayer was extended to include prayers for “all who suffer from AIDS”, a parishioner said to me “I don’t see why we should pray for victims of their own immorality”.

                  The message then changed. Republicans, Democrats, conservatives, liberals — voices across the spectrum — united to say “sex is bad”. America was told “don’t have sex with someone you aren’t in a long-term committed relationship with. If you do have sex, wear a condom.” Teenagers were told that unprotected oral sex could transmit AIDS.

                  My recollection is that America chose to tell itself that sex was bad. I found that to be MUCH more intrusive than being told to wear a mask, work from home, and stop eating out for awhile.

                • Christopher says

                  August 13, 2020 at 10:03 pm

                  I guess that’s the prude in me. I see sex as completely optional and certainly can be done safely.

                • SomervilleTom says

                  August 13, 2020 at 12:37 pm

                  There’s no guarantee I will get that opportunity back, but even less of a chance I will contract the virus.

                  One more time — the purpose of these measures is to minimize the likelihood that you will transmit the virus to others.

                • Christopher says

                  August 13, 2020 at 10:03 pm

                  Which I can’t do if I never get it myself.

                • SomervilleTom says

                  August 13, 2020 at 10:42 pm

                  Christopher, you’re not making sense.

                  You seem to forget that you’re arguing AGAINST measures that prevent you from being infected.

                  The measures we’re talking about are the only ways we have to reduce the chance that you’ll be infected. That, in turn, is the only way to reduce the chance that you’ll infect someone else.

                  You continue to minimize the severity of this disease, and you argue against the measures that slow it’s spread.

                  There is a very good chance that the ONLY reason you don’t have the disease already is that these measures were in place earlier.

                • jconway says

                  August 14, 2020 at 12:24 pm

                  You do not know you do not have it unless you get tested. I’ve been treated twice now since the month started and can say to a high degree of confidence that I do not have it, but I still wear the mask as an outward sign of compliance and solidarity with society. You’re awfully libertarian on an issue where the shared values of our party, country, and faith dictate a communitarian approach.

                  Surely if we do not hang together we will hang separately, and that is the case with this pandemic. Simply saying it’s an issue that only affects nursing homes or only affects communities you do not live in is insufficient at best and insulting at worse. Especially as someone potentially going back to teach in person to one of the top four communities in the state and someone married to a nurse who lost half her nursing home patients to this pandemic. There’s a 9/11 every three days. This ain’t the flu, it’s a national emergency, and you’re denialism like Trumps only
                  makes the situation worse.

                  Fortunately your views have next to no influence on public policy, unfortunately his do.

      • jconway says

        August 14, 2020 at 12:28 pm

        I’ve written at length across
        multiple threads about how other nations responded more vigorously to the interconnected public health and economic crises of Covid-19 and how Massachusetts was only temporarily better off than the rest of the country.

        I always knew it would get worse again here since I said we prematurely reopened at the time, probably going as far back as phase 1. I appreciate your recent evolution in light of changing realities. It’s that kind of flexibility we need and do not see in our national leadership which thinks the power of positive thinking can overcome a deadly pandemic. Appreciate your raw data analysis as well, something I have not always had the time or ability to include in my own pieces.

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