The medieval strategy of lockdown

The article linked below is a discussion of the COVID-19 policies and enforcement in New Zealand written by Phillip W. Magness and published by the American Institute for Economic Research:

 https://www.aier.org/article/how-the-virus-penetrated-fortress-new-zealand/

Phillip brilliantly (and disturbingly) weaves into his discussion a short story by Edgar Allan Poe, Masque of the Red Death.

The fact that the lockdown policies were imposed without legislative participation should be familiar to all by now:

On March 22, the nation’s government announced a month of sheltering in place. The order came from on high with the stroke of a pen, without legislative deliberation or even the process of law. Enforcement persisted for nine days despite having no legal justification – just an illegal executive decree by Prime Minister Jacinda Ardern. Months would pass before the country’s high court censured this abrogation of democratic governance. It did not matter. Ardern’s actions were “unlawful, but justified” to halt the pandemic, the bold actions of a “hero” who knew better than her own people.

The economic  damage will also sound familiar:

Like much of the world, the lockdowns left New Zealand’s economy in tatters. The country posted its largest GDP contraction in three decades for the first quarter of 2020. Much of the contraction likely stems from the country’s tourism-heavy economy, which seems unlikely to recover anytime soon as it is effectively proscribed for an indefinite term by government mandate. 

The strategy to eliminate the virus includes the use of detention facilities: 

You see, Ardern’s strategy for lifting the internal lockdowns rested upon maintaining one of the world’s most restrictive border entry policies. The New Zealand border remains closed for all intents and purposes for foreign visitors prohibited save for a tiny number of exceptions. New Zealand residents who were stranded abroad at the start of the pandemic – likely numbering in the tens of thousands – may only return after going through a mandatory 14-day quarantine under strict guard at a designated border facility. 

Persons who do not qualify for a handful of exemptions must also foot the bill themselves – a total of $4,000 (NZ) for the privilege of being cooped up in a government-managed hotel room.

For all intents and purposes, Ardern created Fortress New Zealand – a bubble strategy in which the internal reopening rests entirely upon the government’s ability to erect and maintain a nearly impermeable barrier to entry from the rest of the world. Furthermore, such a strategy must continue indefinitely until there is a coronavirus vaccine or cure.

After 100 days of zero new cases, the virus reappeared:

It happened on the 102nd day, and it took the world by surprise. The festivities of the milestone and the associated electoral campaign had yet to dissipate, but COVID-19 was back in New Zealand. A family of four tested positive in Auckland, triggering a panicked government plan to contain its spread.

Within 24 hours the country’s largest city was back under lockdown. Police checkpoints, internal travel restrictions, police and military in the streets, arrests for violating lockdowns, runs on supermarkets, appeals to snitch on violators – a mad rush to contain the spread by any means necessary.

Far from a paragon of science-guided policy, the New Zealand approach hearkens back to the time of medieval plagues and associated superstitions – of walling oneself off in a castellated abbey in the countryside for the duration, of hoping, praying the crisis will pass by your fortress as it ravages the outside world, and of inevitably letting one’s guard down at a moment of frivolity and celebration.

The Ardern government’s current low case count only conceals a much greater and self-inflicted vulnerability that arises from the lockdown strategy. The policy of eliminating COVID-19 by shutting out the rest of the world only “works” if one assumes that they can perfectly maintain the bubble until somebody on the outside discovers a vaccine, or the virus dissipates globally from external herd immunity.

But the medieval strategy of lockdown-imposed isolation is inherently fragile – so fragile, in fact, that it can collapse into chaos at any moment, precipitating a mad rush to regain the illusions of control over the situation.

Far from adopting this strategy as a model, the world must avoid the corner of perpetual recurring lockdowns in which New Zealand now finds itself. And New Zealand’s government would be wise to drop the hubristic pretensions of commanding and controlling a virus through medieval self-isolation, seeking instead an alternative strategy that is robust to unexpected setbacks and equipped for long-run recovery.

Is New Zealand being used as a role model for Hawaii and other island nations/states?  If so it is time to revise the government imposed strategy of lockdown and isolation.

A glimpse into the future of health care

The link below is for a Mises Institute article about rationing of health care in Pennsylvania during the current Coronavirus pandemic:

Pennsylvania Is Playing Politics with Drug Rationing

The future of healthcare is described by these paragraphs from the above article:

Just as a reminder of the kind of central planners we are dealing with, this is the same Pennsylvania Department of Health that decreed on May 12 that nursing homes "must continue to take new admissions, if appropriate beds are available, and a suspected or confirmed positive for COVID-19 is not a reason to deny admission." Months later, nearly 70 percent of coronavirus fatalities in the state have occurred in nursing homes.

Not being content with causing such a disaster, the state health department has issued guidance on how healthcare facilities should ration the limited supply of the new drug Remdesivir in the event that there are not enough doses to go around, but notes that the guidelines should apply to any scarce form of treatment. While certainly an unpleasant subject to address, it is true that in the face of scarcity the limited supply of Remdesivir or any other treatment will need to be rationed and that some kind of method of choosing will be needed. Scarcity is simply a fact of life that must be dealt with. However, because the distribution of Remdisivir has been taken over by the federal government, which distributes it to state governments, which in turn distribute it to healthcare providers, the process has unavoidably become political.

Putting all the jargon aside, the guideline is very clear about several points. First, it is not considered acceptable to distribute care via a random lottery, or on a first-come-first-served basis. Rather, healthcare providers must take into consideration "community-benefit" when rationing care and the department recommends the use of a weighted lottery system.

As you can see, the example lottery that the health department provides uses three different criteria to determine how a patient’s lottery chance is weighted: membership in a disadvantaged community, being an essential worker, and likelihood of death in the next year.

This is just the beginning.  As healthcare becomes more controlled by the State the more politics will be involved in decisions.  Scarcity is a fact of economic reality that can not be eliminated.  There will always be a need to ration drugs, procedures, equipment, and practitioners.  The rationing should be accomplished based on medical necessity and the attempt to provide the highest quality care to the largest number of patients at the lowest possible cost.  When the State makes the rationing decisions the results will always be subject to politics.  Pennsylvania is providing us with a glimpse into the practices that we will be subjected to under "Medicare for All".