Thursday, May 14, 2020

Its not open versus closed. Its targeted versus scattershot.

In the past few days, it has struck me that we are framing the lockdown debate incorrectly. No matter what the announced policies are by state, there is high variance within and among the states in terms of whether and to what extent the lockdowns were ever even observed.

The crystallizing example has been Sweden which everyone has held up as an alternate model with no lockdowns. Which is technically true and pragmatically untrue. No one has been forced to quarantine in place but a majority of people have elected to quarantine in place. They are free to make the risk-weighted decision they feel most appropriate and in practical terms, most have adhered to what amounts to a lockdown without ever being compelled to do so.

Despite the abuse hurled at Florida, Georgia, and to a lesser extent Colorado, American states have begun opening up.

But that isn't a particularly good description. Populations everywhere have elected to comply with self-quarantining whether compelled or not. I think South Dakota has been the only state without any forced quarantine; but many did choose to quarantine anyway.

Among all the rest of the states with more or less draconian and more or less lengthy lockdowns, most of them had reasonably stringent lockdowns.

While the goal might be opening up each state, how they are doing it is different than implied by "relaxing the quarantine".

When you read the details, an alternative description emerges. We are not shifting from quarantine to open. We are shifting from scattershot quarantining to very targeted quarantines based on age, density, and underlying health conditions.

Its as if at the beginning, we woke to find an intruder had broken into the house and we blasted away with a shotgun in the dark just hoping to connect with the danger. After some period of time, we had a chance to don our night vision goggles. We still can't see clearly but we have a much better bead on the intruder. Now we have switched the shotgun for a handgun. We can now target more selectively.

Five months into this, we now know that there is a connection between Covid-19 deaths and density, age, sustained exposure, underlying health conditions, hypertension, etc. The scatter shot approach of "just do something" can now be replaced with more targeted policies. Focus on retirement communities and the very aged. Focus on those with poor health. Apply stringent distancing and hygiene measures in those areas with the greatest density and concentration of cases.

Almost everyone is still to a greater or less extent in lockdown, voluntary or otherwise.

What is happening now is not the getting rid of lockdowns. In most places we are merely better targeting the lockdowns. The corollary is that with more targeted lockdowns, those not in a risk category have, at their discretion, the opportunity to restart.

It is not open versus lockdown, it is scattershot versus targeted.

No comments:

Post a Comment