1. RISK
Runaway exponential growth hasn't happened anywhere. With the possible exception of Iran, the epidemic has exhibited marked consistencies. The virus is "behaving well", but people have been less consistent than the virus.
The purported reason for lockdown was to prevent overburdening of healthcare resources. Massive overprediction of demand happened nearly everywhere. Instead, the real problem was that hospital utilization fell so low that the sustainability of hospitals was jeopardized.
Non-Covid Deaths at home have skyrocketed. Elective procedures, cancer screening & doctor visits that didn’t happen have caused or will cause death and health impacts. It is likely excess deaths coincidental to the epidemic arose because treatment wasn’t sought or provided.
Initial Chinese case fatality rates were obvious overestimates of the infection fatality rate. Using cases is complicated. Countries define them differently. Cases should be defined by a positive test AND presence of symptoms. Recording cases on a test only is unsound.
Assessing fatality rates using cases is a mistake, because the denominator is underestimated. For every confirmed case there are multiples more infections, although the vast majority are asymptomatic.
Even seroprevalence studies overestimate the fatality rate because some portion of the population have immunity through mechanisms other than antibodies. Severe viral pneumonia is a small fraction of infections.
Hard-hit places have higher than 700 deaths per million, whether they locked down hard or did nothing. Some places have very low death rates in the order of 10 per million and we don't yet know exactly why.
Covid mortality is sharply age-differentiated, with a 1,000-fold risk difference between the old & the young, for whom it’s less severe than flu. Every yr there are flu deaths among kids. Not with Covid. Among 1.8m Swedish children who stayed at school there were 0 deaths.
"Second waves" of cases in countries are not generally accompanied by second waves of deaths. Where they are, they are instances of "filling in" places that weren't impacted initially. They don't seem to occur in the same location.
2. IMMUNITY
Calling Covid a "novel" coronavirus was a mistake. Coronaviruses are far from new and this one is closely related to ones that have circulated among humans for ages.
The scientific evidence for t-cell mediated immunity is very strong. It is very clear that there is long-lasting protection from prior infection. This is no surprise. It happens with many diseases.
Herd immunity is not a "strategy". It is the inevitable outcome, whether through natural infections, vaccines or, most likely, a combination of both. The longer you drag that out, the harder it is to protect the vulnerable.
The idea of herd immunity is not about doing nothing or letting the virus rip. It's the inevitable end-state of an epidemic. The point is that an age-targeted approach is the best route to herd immunity, as a vaccine is unlikely to be available for first waves.
The goal of a vaccine is herd immunity. Covid is never going to be eradicated. It will be endemic. The reason there are few cases in New York is mostly because of immunity, not guidelines.
Seroprevalence is an unreliable guide to assessing whether herd immunity has been attained. Antibody production declines over time, yet immune memory persists much longer & is very effective at protecting recovered people from contracting the disease when exposed again.
3. LOCKDOWNS AND OTHER NPIs
Structuring society simply to limit the number of covid cases is a mistake. A holistic approach is the only one that is fair. Age-targeted strategies are crucial.
Mandates to wear masks: The evidence doesn't suggest they're effective in slowing spread, yet they cause social strife. There aren't sufficient benefits to require them. In general, it's better to provide advice than issue mandates. Instead of sowing panic, provide info.
General lockdowns, closing schools, businesses & beaches, cause serious public health problems, increasing total deaths. Lockdowns should be off the table. Another would be disastrous. It’s healthy for the young to go to bars & restaurants. The elderly should avoid crowds.
It is not possible to discern benefits from lockdowns and NPI mandates in the data. Coercive mandates in general our contra-indicated. If we could lock down at zero cost, it would maybe be useful, but we can't.
The benefits of lockdown are small and the costs are enormous and catastrophic. We know this as a matter of certainty. Lockdowns have never in history eradicated a disease. Countries that are continuing with lockdowns are harming their populations.
Efficacy of coercive non-pharmaceutical intervention mandates in general is not evident in the data, with the exception of hand-washing. For example, mask mandates are uncorrelated with disease spread. Mask-wearing by kids at school does not make sense.
A frequent mistake is to interpret continuing decline in the disease as evidence that an intervention is effective. Continuing decline in the change in daily deaths is the natural pattern of the disease.