Our Political Leaders Could Have Prevented Mass COVID-19 Deaths. They Chose Not to.

The US has never seriously considered far-reaching responses to the coronavirus pandemic like a national lockdown or a universal basic income that would allow people to stay at home without immiseration. The result: unnecessary mass deaths, with more on the way.

A paramedic takes a patient from an ambulance to an emergency arrival area at Elmhurst Hospital during the outbreak of COVID-19 in Queens, New York. (Ninian Reid / Flickr)

Last night, on the fiftieth day of his presidency and the one-year anniversary of the World Health Organization declaring COVID-19 a global pandemic, President Biden addressed the nation and announced, “America is coming back.”

Among the first steps of that return will be ensuring that nearly all schools return to normal in the next two months. Thanks to $125 billion in the new $1.9 trillion COVID relief bill dedicated to the effort and an aggressive vaccination push for teachers and staff, Biden declared “the number-one priority of my new secretary of education” will be “opening the majority of K-8 schools in my first hundred days in office.”

To imagine what it might be like in those schools, the country could turn to teachers like Mary.

Mary, who asked to not use her real name to protect her job, teaches at a parochial school in Louisiana for K-12 students. Aside from a brief shutdown at the school last March, she has been teaching in person ever since the pandemic began. She has spent her days thinking about building ventilation and distances between desks, imagining the microscopic viruses floating through her classroom and settling into the lungs of her students and colleagues.

All told, Mary knows six of her colleagues and eight of her students who have contracted the virus. Two of those students, including one middle-schooler, had serious complications and ended up in the hospital, she says.

After the second student was hospitalized, she says the school did not mandate quarantines for their contacts. Nor has the school’s administration been forthright in divulging new cases among faculty and the student body. According to Mary, one school official advised students not to get tested, while another dismissed the virus as “not that contagious.”

“We are just plain lucky nothing worse has happened to one of our kids,” Mary laments. “But of course, there’s no official, transparent contact tracking — so there is no knowing the residual effects on the community. How many people got sick and died from community transmission from our own sick kids?”

Mary’s choice between safety and continued employment is one faced by millions of Americans as every level of the government continues the push to reopen, despite the ongoing pandemic.

The country’s approach to the pandemic has been one of suppression over elimination, of acceptable losses and acceptable spread. While other countries have been able to better control the spread of the virus through ambitious zero-COVID strategies, the United States has never once seriously considered far-reaching responses like a national lockdown or a universal basic income that would allow people to shelter in place. For both Donald Trump and now Biden, the political risks of such moves were too great, despite the arguments of scientific experts, the pleas of many of those on the front lines.

The result is a year of devastation that could have been smaller, thousands of deaths that could have likely been avoided.

While COVID infections have leveled off after weeks of decline, about 528,000 Americans have died from the virus since it reached the United States last March and there is no complete end in sight. Some experts are now suggesting that COVID may become endemic, meaning it would become a permanent part of life, like the flu. The combination of uncontrolled spread and sluggish vaccine rollout is enabling mutations and creating new variants of the virus — some of which have shown some signs of vaccine resistance, including one strain identified in California. There is concern among some in the medical community that eventually our current vaccines could be rendered ineffective.

Complicating matters, the long-term effects of the virus in adults and children remain uncertain, but very real. Even asymptomatic cases can leave lasting lung damage. A recent study by the UK’s Office of National Statistics found that 13 percent of children ten and younger reported at least one symptom five weeks after confirmed infection.

None of that has stopped the relentless push to reopen the country  — even though the earliest projected date for the United States to have enough vaccines for every American is still two months away.

That means there will soon be many more struggling, terrified teachers just like Mary.

Setting the Course

Perhaps the most successful virus-suppression model is that of New Zealand, which locked down early while providing generous government relief until the virus had been nearly eradicated within its borders. Other examples include Taiwan, which closed its borders early, and Vietnam, which implemented clustered lockdowns respectively.

By contrast, the US government allowed individual states to chart their own course without providing much guidance or relief. To date, only five states have some kind of stay-at-home advisory in place. Texas and Mississippi announced last week that they were reopening fully and lifting mask mandates.

The Trump administration set the course. Sensing a threat to his reelection chances in a prolonged public health crisis — and seemingly unwilling to provide sustained relief through a lockdown — President Donald Trump withheld information from the public that the virus was airborne, downplayed the risks it posed, politicized mask-wearing, and began a push to fully reopen the country in March after most states locked down.

“Don’t forget, this has never been done,” Trump told Fox News on March 24. “We’ve had flus before; we’ve had viruses before … I gave it two weeks…. And we’ll give it some more time if we need a little more time. But we have to open this country up.”

To that end, Republicans in the Senate pushed a corporate liability shield as a provision in COVID relief bills, though it never passed. Meanwhile, Republican-controlled states were the first to attempt a return to normalcy despite surging cases, but it wasn’t long before Democratic states, driven by the lack of federal assistance as well as pressure from business groups, followed suit. Lockdowns became politically toxic, inspiring public resistance and even violence. Anti-maskers became a thing. In October, a group of domestic terrorists in Michigan even plotted to kidnap Governor Gretchen Whitmer over her partial lockdown order.

While it was pushing to reopen the country, Trump’s White House was routinely interfering with reports coming out of the Centers for Disease Control and Prevention (CDC). According to emails obtained by the House and published earlier this month, political pressure even helped shape the CDC’s public health guidance on testing.

The Push to Reopen Schools

Biden promised to be a different kind of president, one who would let the facts dictate policy rather than the other way around. In August, Biden told ABC: “I would be prepared to do whatever it takes to save lives. Because we cannot get the country moving until we control the virus.”

“I would shut it down,” Biden said. “I would listen to the scientists.”

Members of Biden’s inner circle seemed to embrace the elimination strategy. Andy Slavitt, an administrator of the health care nonprofit United States of Care who Biden chose as a senior advisor on COVID, tweeted in July: “Herd immunity is just herd thinning.”

“And that assumes we understand how immunity works,” he wrote. “Which we don’t. I’m not willing to lose 500,000 mostly older & low income people.”

But after the election, Biden and company changed their tune. On November 19, Biden told reporters that “there is no circumstance which I can see that would require a total national shutdown.”

“I think that would be counterproductive,” he said.

Edmunds Elementary School in Des Moines, Iowa resumes in-person schooling. (Phil Roeder / Flickr)

In December, Biden announced that his key COVID priorities for his first hundred days in office included school reopenings. Today, he is still actively moving forward on that plan.

“I think it’s time for schools to reopen safely,” Biden told CBS’s Nora O’Donnell last month, sitting at a notable distance across the room from the interviewer. During a February 6 CNN town hall, he told a scared second-grade girl not to worry about COVID because she was unlikely to get the virus or spread it to her parents.

Predictably, the push to reopen schools has been met with backlash, particularly from educators. Teachers in Philadelphia have been demonstrating against a planned reopening, demanding additional safety measures. Chicago’s teachers union just reached an agreement to reopen schools and avert a strike that included more teacher vaccinations and other safety protocols.

In the face of that backlash, the CDC has largely sided with the Biden administration. Five days before Biden’s CBS interview, CDC Director Dr Rochelle Walensky told Rachel Maddow that “there is accumulating data that suggests that there is not a lot of transmission that is happening in schools when the proper mitigation measures are taken.”

Nine days later, the CDC released guidelines to reopen schools which provided that “at any level of community transmission, all schools have options to provide in-person instruction (either full or hybrid), through strict adherence to mitigation strategies.” The plan did not include vaccinating teachers as a precondition for in-person learning.

While Walensky had highlighted proper ventilation as an important mitigation measure in her Maddow interview, the guidelines did not establish standards for ventilation systems — a problem shared by the administration’s new Occupational Safety and Health Administration (OSHA) guidelines for reopened workplaces.

Media outlets have also gotten onboard with a return to normal schooling. The Atlantic ran an article purporting to explain the “truth” about in-school spread, citing three studies. Vox published an op-ed by Dr Benjamin P. Linas, an infectious disease physician and associate professor of epidemiology at Boston University School of Medicine, that argued the benefits of school reopenings outweigh the risks involved.

“I appreciate that returning to in-person learning carries some risk for educators,” Linas wrote. “There is no immediately foreseeable scenario in which there will be truly no risk of COVID-19 infection in school settings. However, insisting on a zero-risk scenario for school reopening is a commitment to long-term remote learning, which most people agree is not acceptable.”

Mounting Evidence

For Dr Deepti Gurdasani, the push to reopen schools is alarming. A clinical epidemiologist and senior lecturer at Queen Mary University of London, specializing in machine learning in genomic and clinical prediction, she has found herself waging a Twitter war on misinformation surrounding school reopenings.

“I’ve been a hearing a lot about how children are more infectious *now* & contribute to transmission because of the B117 variant, but didn’t before. This is a myth,” Gurdasani tweeted in a thread that was shared thousands of times. “Children & schools have always played an important role in transmission. Time to lay this to rest.”

Gurdasani is a signatory to the John Snow Memorandum — an open letter to the world, named for one of the founders of modern epidemiology, urging a rejection of pandemic management strategies that rely on herd immunity. Speaking to the Daily Poster, she acknowledges the difficulty in getting her message out.

“Very early on in the pandemic — at least in the western world, or in Europe and the US — this sort of narrative was built that children were somehow exceptional or unique in that they were less susceptible to SARS-CoV-2 infection and less likely to transmit,” Gurdasani tells the Daily Poster. “And this narrative very quickly got entrenched in political decision-making, as well as in the scientific community, despite having very little evidence behind it.”

Gurdasani explains that many of the studies cited as evidence that children are not major spreaders of the virus relied on symptom-based testing. Children, Gurdasani explains, are not likely to be symptomatic.

“When you do symptom-based testing in a household, you could very often pick up adults who were infected actually from children but classify them as the index case who brought infection to the household because the actual index case, who was a child, was silent,” she says. “Similarly, transmission to children is being missed if you base testing on symptoms.”

Indeed, a study from last month funded by Austria’s Federal Ministry of Education, Science and Research noted the failure of several previous studies to take into account asymptomatic spread by children and other flaws. Gurdasani told the Daily Poster that new evidence actually suggests that children are more likely to spread the virus to households than adults.

“We don’t know very much still about susceptibility in children, but it’s very clear that they’re exposed to a greater extent because — particularly in schools — they just have a much higher number of contacts than adults and when they’re infected, they may actually transmit more than adults as well,” she says.

Such was the finding of a study from the Office of National Statistics (ONS) in England published in late December. Researchers found that young people ages twelve to sixteen were seven times as likely as those older than seveteen to be the first case in their household. They also found that children ages two to sixteen were twice as likely as those over the age of seveteen to spread the virus to family members.

Another ONS study released last month found that teachers were at high risk, ranking fourth among the twenty-five professions surveyed. The ONS studies are part of a growing body of research suggesting that open schools spread the virus. A Princeton study from September, which surveyed more than half a million people in India, found that children and young adults made up one-third of COVID cases and were especially key to transmitting the virus. Similarly, a study released the month before in the Journal of Pediatrics found that children could be “super-spreaders” even without displaying symptoms of COVID, due to the amount of the virus in their systems.

Meanwhile, the evidence on school closures cutting the spread of COVID is mounting too. A study from October based on data gathered from 131 countries found that school closures could reduce viral transmission by 15 percent. The next month, another study, which looked at a number of mitigation strategies, found that closing educational facilities ranked as the second most effective measure.

Research studies aren’t the only evidence that students are fueling the virus. Where schools are open, COVID is spreading. In the UK where Gurdasani is based, cases are surging among children ages five to fifteen, while dropping among other demographics.

On February 21, Democratic Iowa State Senator Rob Hogg tweeted that roughly three thousand children had contracted COVID since Republican Governor Kim Reynolds reopened schools with no restrictions in late January.

A week earlier, public health officials in Onondaga County, New York, where schools are open, warned that they were seeing a rash of new cases among children — around fifty to sixty per week — likely due to the prevalence of the new UK COVID variant.

“When you look at global evidence, school closures emerge as one of the most important and most effective interventions in reducing [the spread of the pandemic],” Gurdasani says.

A Lack of Political Will

Robert Morris has spent the pandemic deeply troubled, watching public officials make poor decision after poor decision. A physician and epidemiologist, Morris boasts an impressive resume, having taught at the Tufts University School of Medicine, Harvard University School of Public Health, and the Medical College of Wisconsin as well as having served as an advisor to the Environmental Protection Agency (EPA), CDC, National Institutes of Health (NIH) and the President’s Cancer Panel. Speaking to the Daily Poster, he says that the biggest hurdle the country faces in terms of responsible pandemic management is a lack of political will.

“We can eliminate this,” he says. “We just have to have the political will to do it.”

On February 22, Morris published a post in his newsletter “Ahead of the Curve” arguing that the United States ought to adopt strategies that have worked elsewhere to get the virus under control.

“If we had simply matched the performance of Canada, we would have reduced deaths in the United States by 62%,” Morris wrote. “But Canada didn’t get it right. Japan had a death rate 96% lower than the United States. And matching top-performing countries like New Zealand, Vietnam, or Taiwan would have saved over 485,000 American lives. What did these countries do differently?… From the very start, they had a single goal. Zero COVID.”

The post includes a stark warning about the likelihood of containing the pandemic at the current rate of vaccine rollout. Morris compares it to taking a dose of antibiotics too low to kill all the bacteria, facilitating the rise of resistance.

Vaccine manufacturing. (Flickr)

“Every time a person develops COVID-19, those virus strains most capable of replicating and transmitting infection to others will be selected,” it reads. “As time goes on, these new variants will look less and less like the virus used as the model for existing vaccines.”

Morris tells the Daily Poster that there is still time for the United States to cut its losses and embrace elimination, accepting that “it’s harder now because we’ve wasted so much time and lives.”

Morris’s recommendation is a strict five-week lockdown similar to what New Zealand did early on. This, he explained, would be preferable to what he called our “on again off again, half-assed lockdown strategy.” Five weeks, he explains, would allow us to get through two cycles of the virus and beat it.

While Morris blames the Trump administration for the pandemic reaching this point, he told the Daily Poster that he has concerns about the CDC backing school reopening, particularly due to the uncertain long-term effects of the virus.

“I don’t know what the calculations are going on, but obviously there’s tremendous political pressure to get schools open and businesses running,” he said.

Biden’s Strategy

The push to reopen schools is part of a larger strategy by the Biden administration to present a positive narrative about the pandemic that things are rapidly changing for the better, even as the president’s allies urge caution. In his address following the signing of the COVID relief bill, on the fiftieth day of his presidency, Biden announced, “America is coming back” because of the vaccines.

“There is hope and light and better days ahead,” he said. “If we all do our part, our country will be vaccinated soon.”

Last month, Biden said that every American would be able to get a vaccine by the end of July. Earlier this month, he moved the date up, suggesting the United States would have enough vaccines for everyone by the end of May.

But the optimistic projections have not come without warnings. Last month, CNN reported that an expert close to the administration was warning that Biden was “painting way too rosy of a picture” specifically in regards to the threat of COVID variants.

Dr Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota who served on the president’s transition team, has been issuing dire warnings in light of the new COVID variants cropping up.

“The Biden administration is going to have to address this issue and we’ve got to stop basically telling people we’ve turned the corner,” he told CNN. “At the rate we’re at right now, this is going to be a huge challenge.”

On Monday, the CDC released new COVID guidelines that fully-vaccinated people can congregate with other fully-vaccinated people or low-risk unvaccinated people “from another household” without masks. However, the news came with a warning:

“We’re still learning how vaccines will affect the spread of COVID-19,” it read. “After you’ve been fully vaccinated against COVID-19, you should keep taking precautions in public places like wearing a mask, staying 6 feet apart from others, and avoiding crowds and poorly ventilated spaces until we know more.”

The new guidelines still advise mask-wearing for fully-vaccinated people in public and recommends isolation if they experience symptoms. The CDC also noted that the efficacy of the vaccines against the new variants is still unknown.

Responding to the CDC’s new guidelines, Morris tells the Daily Poster, he’s “not sure what the rush is.”

“We’re still learning how well COVID-19 vaccines keep people from spreading the disease,” he says. “Early data show that the vaccines may help keep people from spreading COVID-19, but we are learning more as more people get vaccinated.”

Stay-at-Home Order

Locking the country down to one extent or another would require the president seeking authorization from Congress. Legally, such a move is possible, experts tell the Daily Poster.

William D. Araiza, constitutional and administrative law professor and vice dean at Brooklyn Law School, says that Biden could issue a mandatory stay-at-home order if Congress authorized it under the authority granted by the National Emergencies Act of 1976.

“There might be due process issues, but I suspect if the situation was dire enough a court would reject that kind of claim,” he says.

Araiza says Congress could also take measures short of confining everyone to their homes, like mandating remote work for remote-capable employees under the authority granted by the Interstate Commerce Clause. It could also delegate that authority to the president or an administrative agency.

Stephen Gardbaum, a constitutional scholar and MacArthur Foundation Professor of International Justice and Human Rights at UCLA School of Law, tells the Daily Poster Congress could protect workers who decide to work from home against the wishes of their employers.

“I think that would be well within Congress’ authority, especially if they excluded very small employers who don’t really engage in interstate business,” he says.

Gardbaum was less bullish on a national stay-at-home mandate, explaining that congressional authorization would ultimately depend on the courts, which in general have become more skeptical of such far-reaching moves as they have become increasingly populated by right-wing judges.

“I’m not saying a plausible and persuasive constitutional argument can’t be made, based on the pandemic’s huge impact on the national economy,” says Gardbaum.  ”But a national lockdown would likely be challenged in the courts and my prediction is that this Supreme Court would say no.”

At this point, all such scenarios are hypothetical. No one in power is seriously considering any sort of national policy aimed at keeping people home.

We Know How to Prevent Deaths

To Mary, the political calculations surrounding the pandemic are irrelevant. She recently received her first vaccination, due to new eligibility guidelines in her state. Sitting in her car after the shot, she broke down out of a sense of sheer relief.

But she recognizes that she is one of the lucky ones. And even now, she remains frustrated at the decision to not lock down the country, calling the move “shortsighted.”

“We know exactly what needs to happen to prevent deaths, we just didn’t feel like doing it,” she says. “We should have locked down hard last March. Biden should’ve instituted a lockdown this January and paid people to stay home.”