Fauci clashes with Rand Paul: If you think NYC has herd immunity, you're the only one who does

Not the first time they’ve locked horns during Senate testimony, although this is the first time I’ve gotten a sense of just how radical Paul (a COVID survivor) is in his opposition to lockdowns.

The way the clip starts off, it sounds like he’s just rehashing his skepticism of “nanny state” experts. But given his interest in Sweden’s outcome and some of the dubious assumptions he makes about ours, I ended up getting the vibe that he thinks our approach to the virus should be … to just let it rip. Forget all the containment measures. New York got slaughtered despite its lockdown early on, right? And isn’t it true that, even if we flatten the curve successfully, we’re destined to have the same number of deaths from the virus as we’d have even if we did nothing to retard its transmission? Flattening the curve is about protecting hospitals by *slowing down* the spread of the disease, Paul notes. But over a long enough time horizon, COVID will eventually reach the same number of people it would have reached within a few months if it were allowed to spread unchecked. So maybe all these social-distancing rules and mask mandates are pointless.

Which is … idiotic. In a world where vaccines didn’t exist, you might make the case that it’s academic whether the virus spreads quickly or slowly. Herd immunity will eventually arrive either way. In a world where vaccines do exist — in particular, a world where a vaccine is mere months away — slowing down the spread of the virus will save countless lives. Imagine that COVID is destined to kill 700,000 people out of a population of 330 million. We can either kill them off quickly in three months by letting it rip Rand-style or we can kill them off slowly over three years by flattening the curve Fauci-style. But if a vaccine arrives at the start of year two, the entire population that’s vulnerable to COVID is already dead in Rand’s approach. Whereas under Fauci’s approach, maybe 300-400,000 are spared.

Even if a vaccine were impossible, it would still pay to flatten the curve and slow the virus down to give pharmaceutical companies time to develop effective treatments. Deaths from COVID as a percentage of infections have already declined significantly in the U.S. and Europe since March. Once antibody drugs hit the market, they should decline even more. Slowing the spread buys time. And extra time helps doctors save lives.

Trump’s getting hammered this week, including by me, for claiming that the virus affects “virtually nobody” but the elderly, but he’s a model of compassion compared to Paul. Leave it to the Senate GOP to provide daily reminders that Trump’s actually not the worst the country can do by way of Republican leadership.

As for what he says about New York, since when do Republicans regard the Cuomo apocalypse of March and April as some sort of fait accompli that simply couldn’t have been avoided no matter what restrictions were put in place? We’ve spent the past four months arguing the opposite, that Cuomo and Bill de Blasio doomed New York City to catastrophe by moving too slowly to shut things down in March despite evidence that the virus was spreading. Every Republican in America is by now familiar with Cuomo’s policy to send infected nursing-home residents back into their nursing homes, seeding fatal outbreaks. New York was destined to have a bad outbreak no matter what, I think, because it’s a major destination for foreign travelers and its large, dense population gave the virus a path to spread quickly. But there’s every reason to think it was much worse than it needed to be thanks to Cuomo’s and de Blasio’s incompetence.

But I guess Paul disagrees, or else he wouldn’t be straining here to treat the outcome in NYC as a matter of basic epidemiological fate that no lockdown could mitigate instead of a case of terrible management. Cuomo should call him up and thank him for letting him off the hook for the City’s outcome.

Finally, his point about NYC possibly having acquired herd immunity is interesting, and one I’ve raised myself. But Fauci’s right that there’s no hard evidence of it: New York has moved *very* cautiously on reopening since May, with most schools still closed as I write this and restaurants still a week away from reopening for indoor dining at limited capacity. Is New York’s positivity rate below one percent because everyone’s immune or is it below one percent because everything’s been closed for four months? (Some things will remain closed for many months to come.)

Before you answer, note these numbers. The overall positivity rate statewide remains slightly below one percent. But the virus is spreading in some neighborhoods.

All Paul and Fauci are ultimately arguing about is risk-tolerance. Fauci’s position is “better safe than sorry.” We don’t know exactly how many people the virus would kill if it were allowed to spread unchecked, but given that it’s already killed 200,000 despite all sorts of precautions, clearly it would kill a lot. Whereas Paul’s attitude is “let’s find out.” How lucky do you feel?

Oh, one last thing. It’s true, as Paul says, that America’s number of deaths per capita now exceeds Sweden’s, although the two numbers aren’t far apart. But Fauci’s rejoinder to that is also true, starkly: Sweden’s coronavirus deaths per capita are way, way, way higher than deaths per capita are in Norway and Finland, the two Scandinavian neighbors that are most comparable to Sweden in terms of genetics and lifestyle. Sweden currently stands at 581 COVID deaths per million people, 13th-highest in the world; Finland stands at 62 and Norway at 49, good for 82nd and 93rd in the world, respectively. If Paul wants to wonder why our pro-lockdown regime ended up worse than Sweden’s anti-lockdown approach, he should also ask why Sweden’s anti-lockdown approach performed horrendously worse than Norway’s and Finland’s more lockdown-friendly strategy.