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The Perils of Rushing to Judgment

On April 6, in an essay for the National Review, John Fund and Joel Hay asked the question, Has Sweden Found the Right Solution to the Coronavirus? and concluded it had. They praised Sweden's approach to the novel coronavirus, which included isolation for vulnerable populations but did not include a general lockdown. Fund and Hay boasted that Sweden, up to that point, had only seen 401 COVID-19 deaths.

In the United States, for the record, the number of COVID-19 deaths was already more than 13,000.

The low mortality rate in Sweden, the authors concluded, was proof that Sweden had found a better way to combat the coronavirus.

Fund and Hay didn't offer a hypothesis why letting younger people continue to congregate might reduce their chances of catching the disease. Their argument is, essentially, there's a lot we don't know about COVID-19 so anything is possible.

But is that the way the world works? Are we free to create our own reality whenever hard knowledge is scarce? If we imagine a scenario where increasing the opportunities to spread the disease actually results in fewer deaths, is it reasonable to expect the virus to pander to our fantasy?

And it's not just logic that argues against Fund and Hay's hypothesis. The human race has experience with previous pandemics, and if we look back we'll see that staying away from infected people really is the better strategy for remaining healthy. The example of the response to the 1918 swine flu pandemic in St. Louis and Philadelphia was, when Fund and Hay wrote their essay, being touted as a good example of the benefits of flattening the curve. Hay and Fund disagree.

Apart from the post hoc, ergo propter hoc nature of the argument, a key difference was that the GIs returning from World War I Europe who were carrying the swine-flu virus couldn’t fly nonstop from Paris to St. Louis. They had to land at East Coast ports such as Philadelphia. It’s therefore not surprising that the sick GIs rested and convalesced while spreading the virus on the East Coast, and they got better before continuing to St. Louis and other interior cities.

Unfortunately for their argument, there was a lot more to the 1918 pandemic than Philadelphia and St. Louis. Twin cities Minneapolis and St. Paul also had polarized responses to the flu. Minneapolis banned social gatherings on October 12, and did not fully lift the restrictions for 116 days—nearly four months. St. Paul, on the other hand, waited until November 6 to shut down—and then reopened 11 days later when the number of cases dropped during the lockdown.

Ultimately, Minneapolis had a death rate of 267 per 100,000 population, and St. Paul had a death rate of 452 per 100,000 population.

New York City, which began quarantining people with flu symptoms as early as September, implemented a plan in October that placed strict health regulations on public gathering places like theaters, and required business to stagger their opening and closing hours to reduce street congestion at rush hour, escaped with a death rate of 452—the same as St. Paul's. If—as Hay and Fund reasonably suggest—being a coastal city increased the risks, prudent measures to slow the spread could mitigate those risks. We've known how to slow the spread for more than a century, but Fund and Hay act like we are in uncharted territory.

And this idea wasn't even new in 1918. Fund and Hay allege, "This is, in fact, the first time we have quarantined healthy people rather than quarantining the sick and vulnerable." They quote European think-tank director Fredrik Erixon, who says, "The theory of lockdown, after all, is pretty niche, deeply illiberal — and, until now, untested. It’s not Sweden that’s conducting a mass experiment. It’s everyone else."

All of this may be technically accurate, but it doesn't match the reality of past epidemics. Fund and Hay have either misread their history, or competely ignored it. They claim Sweden is simply using an approach that has been successful in the past.

Nature’s got this one, folks. We’ve been coping with new viruses for untold generations. The best way is to allow the young and healthy — those for whom the virus is rarely fatal — to develop antibodies and herd immunity to protect the frail and sick.

But that's not the case at all. When a plague or an outbreak stuck a city, anyone healthy enough and wealthy enough escaped to the country, isolating themselves in estate houses. When yellow fever struck Philadelphia in 1793, about 20,000 residents chose this option. During a bubonic plague outbreak in London in 1665, Isaac Newton was one who escaped to a country estate, where he famously saw the apple that helped him work out the basics of universal gravity. Italian Renaissance writer Giovanni Boccaccio wrote a story about ten young people who escaped his hometown of Florence when the plague struck that city in 1348. So the concept of social distancing is not new at all. What's new, perhaps, is that so many people today won't do it without being told.

And, for what it's worth, most pandemics have struck young and healthy people no less severely than older people. The novel coronavirus is very unusual in this regard. So Sweden's approach to this pandemic would not have worked in previous ones.

But if Sweden is having success this time without a lockdown, isn't it something we should applaud and learn from?

Alas, here too Hay and Fund have misread or misunderstood the history. In this case, they didn't wait for the history to develop. By rushing to publish their conclusions before the virus played itself out, they risked looking foolish if Sweden ended up with cases and death totals an order of magnitude higher than those of their neighbors—a scenario which, with another couple months of hindsight, appears to be playing out. Sweden's deaths have ballooned in two months from 401 to more than 5,000, while Denmark has fewer than 600, and Norway and Finland only have about 570 combined. These three countries combined have only about half as many confirmed cases as Sweden, despite combining for 60% more population than Sweden, and despite all three having more extensive testing.

Will Sweden prove us all wrong in the end? Will the country develop herd immunity and beat this disease while the rest of the world struggles to contain it? It's hard to say, but it doesn't look nearly as promising as it did in April.

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