The Emergency is Over

The Commonwealth of Virginia has been in an official state of emergency because of the COVID-19 epidemic since March 12, 2020. Governor Ralph Northam (D) declared as much in Executive Order 51, which remains in effect until amended or rescinded. In mid-March, Virginia was just beginning to see its first cases of COVID-19, the illness caused by the SARS-CoV-2 virus that originated in Wuhan, China, last year.

By then we knew we were in a pandemic, but we knew little else with certainty. A careful analysis of the available data suggested that COVID-19 was worse than the seasonal flu, but not drastically so . . . but we did not know that for sure. The fear-mongers in the press began to issue fire-and-brimstone pronouncements with little basis in reality, and, soon enough, lots of people were demanding that their governments take drastic action.

Parts of the U.S. were beginning to lock down, as were other countries around the world. Virginia imposed its first social distancing restrictions on March 23, and then a full stay-at-home order on March 30. Although I can (and did) quibble over some of the details, the restrictions, at the time they were imposed, were generally prudent. Had I been governor I would have made fewer orders and more recommendations, since I err on the side of letting people make their own choices, but in truth I have few real complaints about Virginia’s early handling of the crisis.

Two key metrics for tracking the progress of the epidemic in Virginia—the percentage of COVID-19 tests returning positive and the number of daily hospitalizations—peaked before the end of April and have been trending downward ever since. Another set of key metrics—the doubling rates of cases, hospitalizations, and deaths—climbed above thirty days in mid-May and continue to trend higher (for these, higher is better). The worst of this crisis was past before the end of May . . . in part because of the natural course of the epidemic, and in part because people were taking steps to slow the spread.

Remember that the goal was to slow the virus down . . . not to stop it. The presumption has always been that everybody will be exposed sooner or later. All of the efforts we made—the social distancing, the masks, the closure of the schools, the cancellations of gatherings—were meant only to give our health care system some space to cope. We wanted to ensure that those who got very sick could get the care they needed to have the best possible outcomes.

Our efforts to slow down the virus in Virginia worked. Our hospitals were never above eighty percent of capacity, and never came anywhere close to needing to use their surge capacity. COVID-19 patients never accounted for more than fifteen percent of hospital capacity utilized. Aside from a couple brief spikes, hospital utilization by COVID-19 patients has been below ten percent since June 5. The curve was flattened. If anything, we overdid it.

When we slow the virus down more than needed, we are hurting more than we are helping. If a fifty percent lock-down is enough, then locking down to seventy percent is doing more harm and providing no benefit. Sadly, lots of people still don’t get this. Many seem to think we need to be doing more, not less, even though our hospitals are doing just fine.

We also have enough data to estimate how dangerous and deadly COVID-19 really is . . . and it’s nowhere near as dangerous or deadly as the fear-mongers (and some early data) led us to believe. Published studies, like one that appeared in JAMA, estimate that there are at least ten times more cases than the official numbers suggest. Why? Because the vast majority of people who catch COVID-19 never have any symptoms at all and never go get tested for it. With this information, the equations for calculating estimated hospitalization and death rates are simple:

H / (10 * C) = Hospitalization Rate
D / (10 * C) = Death Rate

H = total reported hospitalizations
D = total reported deaths
C = total reported cases

Now we just plug-in the latest numbers from the Virginia Department of Health:

Hospitalization Rate:
9569 / (10 * 120594) = 0.0079348 = ~0.8%

Death Rate:
2580 / (10 * 120594) = 0.0021394 = ~0.2%

If you are infected with COVID-19, there is about a 0.8% chance that you will get sick enough to need hospitalization. There is only about a 0.2% chance that you will die. Those aren’t typos or errors (I checked, and checked again). You have a less than one percent chance of even needing to go to a hospital if you catch this bug. Your odds of dying are less than one quarter of one percent. That is worse than the flu, yes, but not by much.

All of these metrics and trends have been tracked here on Off on a Tangent; I have provided near-daily updates based on Virginia Department of Health data since April 25.

The White House Coronavirus Task Force issued guidelines for reopening America in April—three phases of lessening restrictions, each of which lasting at least two weeks. States or localities would move through the phases based on when they reached key gating criteria: fourteen days of downward trends in cases or percentage of tests returning positive, paired with sufficient hospital capacity.

Northam, for some reason, generally refused to allow Virginia’s localities to move forward independently. He chose to keep the state together, though that meant holding back much of the state until its few “hot spots” cooled. Later on, he allowed Northern Virginia and Richmond to go slower than the rest of the state, but he never allowed any locality, even those that never had a serious outbreak, to move faster.

Based on the statewide trends and the White House gating criteria, Virginia should have entered the first phase on May 5. Northam held us in phase zero until May 15, eleven days later.

Virginia should have entered the second phase on May 18. Northam held us in phase one until June 5, eighteen days later.

Virginia should have entered the third phase on June 1. Northam held us in phase two until July 1, thirty days later.

The governor’s unnecessary delays in reopening were at least somewhat understandable. I watched Northam’s performance carefully throughout this ordeal and he, like many other public officials at all levels, was in way over his head. When he should have been led by the science, he was instead led by fear, and by the demands of a fearful public that had been worked into an angry, terrified froth by the press. So he moved far too slowly and cautiously. But, up ’til the third phase, Northam was never more than a month behind schedule. That’s annoying, but forgivable.

Even in phase three, the trends in Virginia continued moving in a positive direction. And phase three, like those before it, was supposed to be a step in a process toward a return to normal. We had to take at least fourteen days to meet the gating criteria, and then, if we did, we could to move on to the next step.

By the metrics—and by the science-based guidance from the White House, CDC, and VDH—the Commonwealth of Virginia should have completed the third phase on June 15 . . . before Northam had even allowed us to enter the third phase. It is now two and a half months later, and two months after we finally did enter phase three. Despite the stability in all of our key metrics, Northam keeps us stuck where we are. We are still in a formal state of emergency. There are still restrictions on gatherings, and capacity limits at churches, recreational facilities, and entertainment venues. We are still required to wear masks indoors.

Normally, the government does not have the authority to impose these kinds of restrictions, but this was an emergency. Emergencies give governments permission do things they cannot do in normal times, but these greater authorities only exist as long as they are needed. In an epidemic like this, any restrictions imposed must be clearly justified by the science and by the scope of the threat, and they must be removed as soon as conditions allow. While some conservatives understandably chafed under the heavy hand of government, I have followed the rules and have not complained about them much. The situation warranted the restrictions. Even those I thought were unnecessary could be justified by the uncertainty or by differing expert opinions.

But is there any remaining justification for limiting the size of gatherings? No. For setting arbitrary capacity limits on churches and businesses? No. For keeping the schools closed? No. For requiring masks when in close, indoor proximity? Eh, maybe, but the science remains iffy-at-best on their effectiveness.

I’m not saying everybody should go a hundred percent back to normal. I’m saying that the scope of the situation as it exists now no longer justifies the government telling you what you can and can’t do except in a few limited ways. You may not feel safe going to a large gathering right now. That’s your choice to make. But if others feel fine about it, that’s their choice to make too. You may also choose whether or not you wish to wear masks, and others, if they are worried about unmasked people exposing them to the virus, can choose to stay more than six feet away from them. And while the schools should reopen, parents should have the option to keep their kids home if they want (and the schools should make every reasonable accommodation for them).

COVID-19 is still with us, but it’s not the end of the world. It is clear—and is becoming more clear by the day—that we overreacted and we continue overreacting. The impositions on individual freedom, while justifiable at the height of the crisis, cannot be justified now . . . at least not in Virginia. (Other states may have different conditions and my assertions in this article may or may not apply to them.) In Virginia, the emergency was over on June 15. By Northam’s over-cautious scheduling, it was over before the end of July. Fear and politics are all that hold us in phase three now.

What will happen if we open back up? Well, cases will spike . . . and possibly hospitalizations and deaths will too . . . but these are cases, hospitalizations, and deaths that were going to happen anyway. We’re just playing with the timing. That’s what “flatten the curve” was all about, remember? The goal was never to stop the spread, but to slow it down enough that the hospitals could handle it. Well, Virginia’s hospitals are doing just fine and have plenty of surplus capacity. We can roll back the remaining restrictions (with caution) and our health system will be able to handle it just fine, and we can finally start getting COVID-19 behind us.

If there was a big, unexpected spike or if the hospitals did start to get overwhelmed, then we can pause the reopening process or, in the worst case, take a step backwards for a little while until the situation stabilizes. There is always risk of this happening until the virus completely runs its course. But the extreme measures we’ve taken to “flatten the curve” well beyond what was necessary to maintain healthcare capacity have just prolonged the pain. We have two choices now: we can drag this out another six months or a year, or we can hurry up and get it over with. Since the number of illnesses and deaths will be the same in either scenario, faster is obviously better.

It is time to cast aside the unscientific drivel and political nonsense. COVID-19 is now on a low simmer, and it was never as dangerous or deadly as the fear-mongers insisted it was. The worst of it is long past. It is reasonably safe to resume our normal lives—to go back to school or work, especially, but also to resume recreational and entertainment activities. People in high-risk groups should continue to take precautions, and there may be a good argument for a continued mask mandate (though I’m personally not sold on it), but that’s about it. You, as an individual, can choose to take additional precautions if you believe it is necessary to do so . . . but you can no longer impose those precautions on others.

Of course, I can’t make Northam come to his senses. I suspect he’ll keep us in this third phase until he’s forced by public outcry to end it, and no outcry seems forthcoming. Too many people have been convinced that the state has not done enough, when it has in fact done too much. Too many people are led by irrational fear, and either don’t understand or don’t believe the facts about this virus. Worse, they’ve wound up their opinions about the epidemic with their politics. Those on the left seem to think we should cower indoors until hell freezes over, and those on the right seem to think we should have opened everything up well before the data supported doing so.

As is often the case, I’m somewhere in-between. Most of the restrictions Northam imposed were prudent at the time, and, until we made it to phase three, he was moving us forward at a slow but mostly-reasonable rate. Then we stopped. We’ve been frozen for no apparent reason. We can’t go on that way; the cost in lives and livelihoods (and public debt, for that matter) is too great. It is time to reopen Virginia and leave it to each of us to decide what level of risk we are willing to accept for ourselves.

The emergency is over, whether Governor Northam chooses to admit it or not.

After today, Off on a Tangent will no longer provide ongoing daily updates on the COVID-19 epidemic in Virginia. Coverage may be reinstated if we experience a serious spike or if conditions significantly worsen. Until then, it’s back to business as usual here.