Economy, Culture & the Family
Review of state’s pandemic response includes warnings
September 16, 2020
To better prepare for future pandemics, state lawmakers conducted a review this week of state and local government responses to COVID-19. Among the takeaways: Many challenges early in the pandemic were the result of the government itself.
“We started with, really, nothing,” said Oklahoma Commissioner of Health Lance Frye.
Frye told members of the House Public Health Committee that Oklahoma government faced multiple self-created obstacles during the early days of the pandemic, including inaccurate early modeling that dramatically overestimated the virus’ lethality, the use of online “check the box” training at state agencies that left them unprepared for a pandemic, the use of paper systems at agencies when online data is the private-sector norm, redundancies within agencies, and a lack of communication between government entities.
“There were many times where people had the information and were sitting in the same room with somebody else that needed that information, and they just weren’t communicating it well,” Frye said. “I think that is just a cultural development that has probably been around the health department for a very long time.”
Many of those obstacles have been addressed since last spring and, despite the challenges, Frye said Oklahoma has fared better than many states.
In Oklahoma, 1.3 percent of COVID-19 infections have resulted in death. That compares to a national average of 3 percent, Frye said.
“We’ve done that in a state that’s not necessarily known to be the healthiest in the nation, and we’re less than half the mortality rate,” Frye said.
Hospitalizations have now hovered between 500 and 600 for many weeks, which Frye said can be handled by state hospitals.
Oklahoma’s overall state response to COVID-19 received measured praise from one doctor who addressed lawmakers.
“I think that Oklahoma has actually done a very, very good job in addressing the pandemic, much better than many other states,” said Chad Chamberlain, who practices comprehensive ophthalmology in Tulsa.
But Chamberlain, who stressed that he believes COVID-19 “is a potentially serious and deadly virus that absolutely warrants precautionary measures,” also warned officials that too many policies were enacted based on beliefs that proved false.
He noted many government policies were adopted in the spring based on data indicating the mortality rate for COVID-19 was 3.4 percent for the general population.
“We’ve learned a lot since then,” Chamberlain said. “And now the U.S. mortality rate, which is based off the CDC (Center for Disease Control) infection-fatality rate, is 0.26 percent, so it’s a dramatically different landscape than we had before but I think the fear factor is still based on the 3.4 percent.”
He said policy responses should focus on the fatality rate among specific age groups. Nationally, Chamberlain said individuals age 54 and below have “relatively low risk of fatality,” although he noted COVID-19 complications remain an issue for that group.
“The fatality rate is actually extremely low,” Chamberlain said. “In many cases, the zero to 34 (age) range, their infection-fatality rate is much lower than that of influenza, which is a controversial statement, but it’s actually three times less likely than annualized accidental-injury fatality rate—just conducting your lives. But that’s, surprisingly, the age group that’s the most fearful, according to the polls.”
On the other hand, for those age 65 and above, and particularly age 75 and above, Chamberlain said it is “absolutely critical that they be protected and stay away from this disease.”
Dr. Jim Meehan, who also practices in Tulsa, also said the risk of COVID-19 is low for young and middle-aged Oklahomans.
“This is much less lethal and dangerous than the influenza virus in anyone under the age of, approximately, 44,” Meehan said. “We shouldn’t be masking our children, because their risk is extraordinarily low.”
Meehan is the former editor of a medical journal and said he has been involved with more than 1,000 peer-reviewed studies. He also knows the reality of the virus firsthand.
“My whole family had COVID-19 about two months ago,” Meehan said. “My allergies are worse than my COVID-19 case was.”
Lawmakers were also told the impact of many COVID-19 policies have negative consequences that should not be ignored by policymakers.
“We talk about the measures that we have in place, and of course the idea of lockdown keeps coming in, but there’s a significant trade-off,” Chamberlain said. “And the legislators and policymakers need to know that no matter what the decision is there is a mortality associated with it. No matter what it is—doing nothing or doing something.”
For example, Chamberlain noted “deaths of despair” surged because of lockdown policies. That group includes those who die from suicides, overdose, and domestic abuse. Some researchers have estimated such deaths will increase nationally anywhere from 27,000 to 154,000 over the next 10 years due to the ripple effects of COVID-19 shutdowns. For each one-percentage-point increase in a state’s unemployment rate, research shows suicides increase 1.6 percent, Chamberlain said.
In addition, he said the lives of at-risk children are more likely to be lost due to shutdown measures that close schools to in-person instruction.
“The bottom line is that if kids aren’t in school because of decisions we made from lockdown measures, we have to recognize we are killing more children by keeping them at home,” Chamberlain said. “It’s an inconvenient fact, but it’s a fact.”
Both doctors told lawmakers the sensitivity of COVID-19 testing has also created perception problems that undermine good decision-making. Chamberlain said recent research indicates up to one-half of Oklahomans who have tested positive for COVID-19 may not have been contagious because of the high sensitivity of the testing.
Meehan stressed the same point.
“We are tracking a case-demic, not an infection-disease pandemic,” Meehan said.
While policymakers have often cited science as justification for the most far-reaching government responses to the pandemic, Meehan said the data do not support many of those policies.
“Government mandates, lockdowns, masks—they don’t work,” Meehan said. “That’s what the science says.”
A recent study by the National Bureau of Economic Research reviewed 25 U.S. states and 23 countries and concluded that “non-pharmaceutical interventions” such as lockdowns, event bans, quarantines, curfews, and mask mandates “do not seem to affect the virus-transmission rates overall,” Meehan said.
“When you look at the data, all over the world, all of the curves end up looking the same,” Meehan said. “There’s a high increase of transmission and then it slowly declines. When you look at that data in context with the dates and times that mask mandates were implemented, it didn’t change anything.”
He said mask mandates are now associated with increases in bacterial pneumonia and anxiety disorders. In part, Meehan said that is driven by the fact that few people wear masks properly. While doctors wear a mask once and dispose of it, the general public often wears the same mask for days on end without cleaning, wears masks that are not truly sanitary, and then don’t wear masks properly, he said.
“People in the community are not wearing them in a way that is going to mitigate disease,” Meehan said. “They’re wearing them in a way that is likely to increase the risk to their own health.”
Frye, who supports mask wearing, acknowledged the data has yet to show masks provide conclusive benefit in reducing virus spread in Oklahoma. He said the state has tracked data from every city that implemented a mask mandate. While some cities, such as Tulsa and Oklahoma City, experienced subsequent reductions in COVID-19 cases, cause-and-effect was not as clear as proponents suggest.
“When we looked at their epi curves of the disease compared to when the mask mandate was started, some of them started really early when they really didn’t have very many cases and you really didn’t see much of a change,” Frye said. “Others started, for instance in some of our urban areas, started mask mandates after the curve had already started to come down. It was a significant change afterwards, but whether that was from the mask or not is very difficult to say. My personal feeling is masks work. I think it did help, and I really want our data to support that. But I can’t say for sure that it all does.”