Well, I’m relieved. Here I was, worried that we weren’t taking the threat of a second wave triggered by a premature reopening seriously enough.
But now I’m told we could reopen U.S. schools and only lose a few million people. Why wasn’t I informed sooner?
Or am I misunderstanding him? Watch this clip, which is making the rounds of political Twitter today.
DR OZ: “Schools are a very appetizing opportunity. I just saw a nice piece in The Lancet arguing the opening of schools may only cost us 2 to 3%, in terms of total mortality. Any, you know, any life is a life lost, but … that might be a tradeoff some folks would consider.” ? pic.twitter.com/aifMeKTsIv
— Aaron Rupar (@atrupar) April 16, 2020
There’s confusion over whether he meant (1) two to three percent of the *current* U.S. COVID-19 death toll, which is a little north of 30,000, (2) two to three percent of *all American schoolchildren*, or (3) two to three percent of the *entire U.S. population.* It can’t be number two, I think; one of the few certainties about this disease is that it almost never kills children, certainly not at a rate anything near two to three percent.
If this is the Lancet article to which he’s referring then he means two to three percent of … the entire population.
School closures were deployed rapidly across mainland China and Hong Kong for COVID-19. However, there are no data on the relative contribution of school closures to transmission control. Data from the SARS outbreak in mainland China, Hong Kong, and Singapore suggest that school closures did not contribute to the control of the epidemic. Modelling studies of SARS produced conflicting results. Recent modelling studies of COVID-19 predict that school closures alone would prevent only 2–4% of deaths, much less than other social distancing interventions. Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered. Other less disruptive social distancing interventions in schools require further consideration if restrictive social distancing policies are implemented for long periods.
That “2-4%” figure appears to be a reference to the now famous Imperial College model, which predicted millions of deaths in the U.S. and hundreds of thousands in the UK unless social distancing measures were adopted. One of their models imagined a two to four percent reduction in total deaths in Great Britain if all Boris Johnson’s government did was close schools and nothing else. The point of the Lancet article is that, under the Imperial College model, school closings have a relatively weak effect on containing the disease while doing major damage to children’s education, so policymakers should look for more effective and less disruptive social-distancing measures to limit deaths.
The point was not — not — that we should feed two to four percent of the population to the fire so that kids can get back to learning their ABCs.
At Reason, Robby Soave offers a fourth possibility. Maybe Oz meant two to three percent of the death toll based on current projections.
Dr. Oz was not describing a death toll in the millions. He said the cost could be “2–3 percent in terms of total mortality,” not among all school-aged children or the population at large.
That Lancet article argues that school closures may not be a particularly effective social distancing measure. It cites modeling from Imperial College London that estimates the U.K.’s school closures will reduce overall deaths by about 2–4 percent. In other words, if there are 100,000 COVID-19 deaths despite the schools being closed, having had the schools open anyway would have yielded 2,000–4,000 additional deaths. That’s thousands, not millions.
The IHME model expects 70,000 or so dead by August. The White House’s model announced a few weeks ago projected 100-240,000 dead total depending upon how diligent we were about social distancing. Two to three percent of those numbers are still big numbers, but they’re orders of magnitude removed from millions.
I think that’s what he probably meant. I hope that’s what he meant. It seems like we’ve come a long way in a short time down a dark path since the start of this national debate over whether pandemic calamity or economic calamity is worse. At the beginning there was a semi-serious argument over whether the virus or an economic depression engineered to contain it would kill more people. The virus will bring thousands of deaths from disease, the depression will bring thousands of deaths from despair. But of course the virus will also bring some deaths from despair, and (weirdly) the economic slowdown will also inadvertently save some lives. E.g., there are bound to be many fewer fatal car accidents in April 2020 due to so many people being off the roads. Putting together a serious model of which option will cause more human misery would be difficult and complex, but it’s worth doing. At some point the toll from a sustained economic shutdown certainly would exceed the toll from the epidemic. A thoughtful inquiry into when that might be would be valuable.
We’re not really having that debate anymore, though. The debate now is between “the American people cannot conceivably bear a lockdown past May 1, no matter the price” versus “yeah, they can.” Comparative deaths, whether containment measures are in place — that’s really all secondary. May 1, whatever the cost.
Or at least, that was the debate until 6 p.m. today. Maybe it’ll be different now. Anyway, among the many stories I’ve read about COVID-19 over the past month, this passage from — of all things — a Sports Illustrated piece about the prospects of playing baseball again soon is among those that have stuck with me. After 9/11 the thought was that America should bear any burden to save innocent lives. Less so now.
“If people just decide to let it burn in most areas and we do lose a couple million people it’d probably be over by the fall,” says [epidemiologist Zach] Binney. “You’d have football. You’d also have two million dead people. And let’s talk about that number. We’re really bad at dealing with big numbers. That is a Super Bowl blown up by terrorists, killing every single person in the building, 24 times in six months. It’s 9/11 every day for 18 months. What freedoms have we given up, what wars have we fought, what blood have we shed, what money have we spent in the interest of stopping one more 9/11? This is 9/11 every day for 18 months.”
9/11 every day. We’re almost there now. Despite 95 percent of the population being locked down, despite school closures everywhere, despite a herculean effort to contain the disease that’s resulted in the national economy being shattered, almost 2,500 Americans died of COVID-19 yesterday alone. Imagine the number if the country went back to work without any sort of containment strategy on the ground.
Update: Here’s Oz walking it back in a new clip released late this afternoon.
I’ve realized my comments on risks around opening schools have confused and upset people, which was never my intention. I misspoke. pic.twitter.com/Kq1utwiCjR
— Dr. Mehmet Oz (@DrOz) April 16, 2020