Keeping the lockdown: Science or Acela Corridor parochialism?

What do Itasca County, Minn., Iron County, Mich., and Langlade County, Wis., all have in common? They are places with no confirmed coronavirus cases — and places about which the New York-centric national media doesn’t care a whit. These three rural counties are just a small sample of hundreds of places — counties, as well as small and mid-sized cities — where the virus has infected relatively few people and caused few, if any deaths. Yet the drumbeat from the big East Coast media is staunchly in favor of the most draconian restrictions for the country.

Are the demands for heavy restrictions driven by science and data or just New Yorker tunnel-vision demanding that “flyover” country follow their lead regardless of the facts? Is the fact that multiple people at the major cable news channels have been infected with the virus impacting coverage and demands? (Note: All data are as of Sunday, April 26 and primarily sourced from reuters.com.) 

The New York numbers as compared to the rest of the country are stark. As of April 26, the New York City CMSA had experienced over 400,000 confirmed coronavirus cases (41 percent of the nation’s total) and over 28,000 deaths (over 51 percent of the nation’s total). With just 7.3 percent of the country’s population, the greater New York region has a confirmed death rate over 7 times that of the nation as a whole and nearly 6 times the confirmed infection rate.

When you add the other large northeast metro areas (Boston, Philadelphia and Washington-Baltimore), confirmed infections rise to over 523,000 (53 percent of the national total) and nearly 34,000 deaths (over 61 percent of the national total). The epicenter of the epidemic radiates out from New York and encompasses the center of US news media, not just the main cable news networks, but The New York Times, The Wall Street Journal, Washington Post and the television network news operations. Not only do the reporters, producers and newsreaders experience the effects of the epidemic every day, but they know colleagues who have died, have been infected and melodramatically infected.

But once you remove yourself from the northeast — from the Acela Corridor — the situation changes. While large metro areas with international links (i.e. cities with airline hub airports that have significant international air travel) have high levels of confirmed infections and deaths, many metro areas are much less affected.

Metro Pittsburgh has seen fairly low levels of confirmed infections. At less than 2,400 confirmed infections (1 per 979) and 160 confirmed deaths (1 per 14,375), Pittsburgh has a rate far below that of the Philadelphia region. Calculating just the Pennsylvania counties in the Philadelphia MSA, their rate is 1 confirmed infection per 179 people and 1 death per 3,946. Meanwhile the New York CMSA has rates of 1 confirmed infection per 59 and 1 death per 832.

But the summary data doesn’t tell the whole story. The Western Pennsylvania region has had no shortages of critical care beds or ventilators. The region’s largest health care system is reporting just 2 percent of hospital beds in use by coronavirus patients. In Pennsylvania as a whole, more than 60 percent of deaths were “associated with” nursing or personal care homes. For much of Pennsylvania, the danger from the coronavirus is focused on the elderly.

In Michigan, metro Detroit unquestionably experienced a serious outbreak with significant shortages.  But the Detroit area is where the epidemic is heavily concentrated. Metro Detroit has 91 percent of confirmed deaths and 85 percent of confirmed infections. For the rest of Michigan, 25 counties have experienced zero deaths and 26 counties have fewer than 10 confirmed cases. The same story exists throughout the Midwest, Mountain states and much of the South — significant outbreaks in the largest metro area and much lower rates elsewhere.

The reality is that the coronavirus epidemic is a complex phenomenon that has highly uneven impacts. In addition, we are still lacking critical information about the true rates of infection and recovery. Two recent California studies (Los Angeles and Bay Area) suggest that the virus may have been circulating since January and that real infections since the start of 2020 could be 55 times higher than the confirmed cases. It should be noted that the study had a small sample size and small studies are susceptible to error. However, with more data, it seems quite likely that the undercount of infections is significant.

Outside New York and the northeast, a much more selective outbreak is occurring. Protestors seeking to open up the country are reacting to what they have experienced in their own communities in a fashion no different than parochial New Yorkers reacting to their own circumstances.

The difference is that, unlike the New York-centric media, the protestors are not seeking to impose their own views on New York.

Based on the information we have now, loosening restrictions in areas with low levels of confirmed infection and low or no growth seems prudent. If anything, we need to collect data on a less restrictive quarantine regime. Outside of densely populated New York, it may be that simply having strong restrictions for the most vulnerable populations would suffice. Keeping the virus away from the elderly is the primary cause for Germany’s low death rate.

Yet everything with this virus is a double-edged sword. Just because a community has few cases now does not mean that a serious outbreak cannot occur.

In South Dakota, the virus tore through the Chinese-owned Smithfield Foods plant, resulting in hundreds of cases and giving the county in which the plant is located over 80 percent of the state’s total confirmed cases. Once in a community or an environment conducive the spread (or where appropriate precautions are not followed), the virus can quickly infect a high number of people — which means that any area that reduces restrictions will need to remain vigilant and prepared for quick intervention.

The reality is that there is still a great deal we do not know about the coronavirus.  We do not know the true number of infections and thus all the statistics from cases to deaths to recoveries are far too low. It is reasonable to assume that a recovered patient has some level of immunity, but there have been re-infections, and we do not know the true rate or danger of re-infections.

We do not know if the virus will return in the fall or winter, nor if it will moderate in the summer.

Given all the unknowns, any re-opening of the economy needs to be done surgically and cautiously with strong monitoring and data-gathering. A free-for-all would be a big mistake. But it would also be a mistake to let one part of the country impose a draconian lockdown everywhere just because Chris Cuomo was stuck at home.

Keith Naughton, Ph.D., co-founder of Silent Majority Strategies, is a public affairs consultant who specialized in Pennsylvania judicial elections. Follow him on Twitter @KNaughton711.