Today, Michigan and several other, Democrat-run states are in fairly broad COVID lockdown. The justification for this is that it is “THE science”, as if this were the only possible behavior if you believe the disease is deadly and contagious. The other fellows, the governors of Republican-run states are framed as deniers of the science. Strangely enough, although this disease is most -definitely contagious and deadly, killing 209,000 Americans so far, about 0.064% of the US this year, it is far from clear that a broad lockdown is the only way to stop the disease. Sweden avoided a general lockdown, leaving its schools and restaurants open, and has seen the disease follow an almost destructive path to that of the US, with a death rate that is currently slightly lower than ours. See the excess death plot below. Sweden seems to have avoided a second, summer spike.

It’s bad enough for “THE SCIENCE” when you see the anti-science, no-lockdown solution provide the same result, or close. Earlier in the summer I noted that Sweden and Michigan had near the same outcome, with Sweden slightly better. It’s now the case that Sweden is doing better than the US, and much better than the D-lead lockdown states. The highest six death rate states are all D-lead, lockdown states, NY, NJ, Mass, Conn, LA, and RI, and rates are double the US average in New York and New Jersey. Perhaps the solution is a general opening, like in Sweden, but before we rush to this, it’s probably worthwhile to do some re-thinking.

One thing that Swedes seem to have appreciated that the US experts didn’t is that the disease hardly affects those the under 18, and that’s basically the entire K-12 student body. Sweden therefore left their K-12 schools open, while we closed ours in the US beginning in early April. At right I’ve plotted the US deaths per week for under 18 for the last three years, that is from before COVID till now. There is no evidence of excess COVID-19 deaths for this group. If anything anything, the under 18 death death rate is lower after COVID than before. This resistance of this group helps explain part of why the Swedish approach didn’t cause increased deaths. Kids in Sweden got the disease, but didn’t die of it, and likely infected their parents. The Swedes didn’t bother trying to protect everyone, but only the most vulnerable, the old people. Sweden was not completely successful at this, but we were perhaps worse, despite the general lockdown.

But what about the middle-age people that the kids would have infected, the parents and teachers. For middle age people, those in the 18-65 range, it seems to make a difference how physically fit you are, and the Swedes tend to be fit. Obesity is a big co-morbidity for this disease, and Americans tend to be obese, with things getting worse during the lockdown. Swedes also wash their hands more than we do (or so is their reputation) and they go out in the sun. There is evidence that the sun helps, and vitamin D too. A stark way of seeing how much fitness helps, for even those over 18 is to consider that, of the 1.3 million men and women of the US military, there have been only 7 COVID deaths. That is a rate 1/100 of the national average for a population that is entirely over 18. This is not to say that the death rate is quite 5 per million, (7/ 1.3 million = 5 per million), but it’s probably below 50 per million. That is to say, at least 10% of the military was likely infected.

I’m inclined to agree with Dr. Fauchi that we are not yet at herd immunity, or even close, even in states like Michigan where death rates have leveled out. Only 20% of the state shows antibodies and real herd immunity would require 75% or so. Further supporting this, our death rates are 1/2 that of New Jersey. If we were at herd immunity, that could not have happened. It is possible though that we have a sort of pseudo herd immunity, where many people in the MI population have some level of T-cell immunity. T-cells do a good job eating disease (here’s a video) but they get overwhelmed when we are exposed to more than a low dose of virus. This dose-response is common in respiratory diseases, and Dr. Fauchi has related it to T-cell immunity, though he does not speak in these directions often.

T-cells can cause someone to be immune to a few viral hits, but not immune to higher doses. Assuming that’s what’s going on in MI and MA, and NJ, I’m inclined to suggest we can open up these states a bit, according to the Swedish model. That is make careful efforts to clean public transport, and encourage hand washing and surface cleaning. That we prohibit large gatherings, and we take care isolate those over 65 and protect old age homes. In the US, virtually all the deaths were of people over 65, and about half were people over 85, with men being particularly vulnerable. A heterogeneous opening of this sort has been recommended by scientists as early as March.

There are three major problems with lockdowns that keep us from all virus particles. These lockdowns kill the economy, they leave us with lousy education, and they likely leave us as at-risk for the disease later on, when the lockdown is lifted. Instead a heterogeneous opening leaves the economy running and exposes us to some small exposure, at a level that our typical level of T-cell immunity may be able to handle. Over time we expect our T-cell immunity will rise and we’ll be able to take off our masks entirely. It’s a nice route to a cure that does not require a vaccine.

The above approach requires us to trust that people will do the right thing, and requires us to accept that each may do it in his/her own way. Some may not wear the mask all the time, but may chose exercising, or staying in the sun and taking vitamin D. Some may keep to masks, or focus on hand washing. Some may try unapproved drugs, like hydroxychloroquine. We will have to be able to accept that, and our experts will have to be able to step back from running everything. In China and Russia, the experts tried run every aspect of farm production, using only science methods. The result was famine. A similar thing happened in Ireland and got a potato famine. It’s good to have expert advice, but as far as making the actual decision in each location, I put a lot of weight on the choices of those who will bear the consequences.

Robert Buxbaum September 30, 2020. As a summary, I’m for opening schools, opening most states, with masks, and hand-sanitizer, at lower occupancy ( ~50%), limiting large gatherings, going to zoom as much as possible, and isolating the aged particularly the old age homes. I also recommend vitamin D and iodine hand sanitizer.