I am going to try in a very simplified manner that appeals to common sense to help people think about why our mitigation strategies may essentially be futile and certainly are imposing a level of health, economic, social and educational costs that are not justified by whatever minimal benefits those measures are providing, and they certainly appear pretty minimal right now. I encourage you to just consider these two very relevant circumstances.
The first is that Minnesota has been living under the same set of restrictions for several months, no change whatsoever since at least July, and we actually got stricter in July when the Governor added the mask mandate. Minnesotans’ behavior in regard to that set of restrictions has not changed by any objective set of measures in the last few weeks. Mask wearing behavior has actually increased. Mobility patterns have stayed the same into fall on a seasonally adjusted basis. If you look at the regular Department of Health reports on sources of transmission, only 7% of all cases are traced to a community outbreak, for the whole epidemic. Look at the chart over time, those community outbreaks have been declining very substantially as a percent of all cases. Bars, restaurants, other gathering places are not the source of significant amounts of transmission or of the case growth. People are not going to group settings and being irresponsible and causing lots of cases. The data is right there in front of your face. The Health Department officials have acknowledged this in the briefings. This is why I react so strongly to the suggestion that Minnesotans are to blame for the increased transmission.
Notwithstanding that the set of restrictions hasn’t changed substantially for months, except for the mask mandate, and Minnesotans’ compliance behavior has if anything improved, cases have increased substantially. How are we to attribute that change to sudden mass failure to follow the mitigation requirements? We can’t. And if it isn’t attributable to behavior changes, to what circumstances or factors is it due? That answer is also obvious. There is a very clear geographic pattern to spread. Whatever the precise factors are has yet to teased out, but like most respiratory viruses, as the sunlit hours wane and the temperature and humidity drops, transmission increases. I have repeatedly listed the potential direct causes, and I am heavily focused on any research papers that address these, but it must be a combination of more favorable environmental conditions for CV-19 to remain viable longer in the air and on surfaces, people being indoors more frequently and therefor more susceptible to exposure of an infectious dose and perhaps changing vitamin D levels or other biochemical changes that occur as colder weather develops and we receive less sunlight. In the summer I said we would have to wait and see what the fall brought for the spread of the virus; it is now very apparent that it is following the pattern of other respiratory viruses and the seasonal coronaviruses in particular. Our mitigation measures have obviously done nothing to stop that pattern from developing.
Now consider a second circumstance. There is basically no influenza at a time when seasonally flu transmission and cases should be picking up. We see in both Minnesota and national data that this is not occurring. Why? One explanation may be that CV-19 is more infectious in some aspect that allows it to out-compete influenza and infect people first and then somehow exclude influenza from establishing a co-infection. There are some co-infections but they have been at a low level. Something is going on, and researchers are trying to disentangle that mystery as well. But it is also possible that our mitigation of spread measures are somehow effective at limiting influenza transmission but not CV-19. Why would that be? CV-19 is a somewhat smaller particle, so perhaps it is better at evading masks. It may have an enhanced ability to transmit in aerosol form or to survive on surfaces. It appears to have a greater ability to down-regulate the immune system. It may take a substantially lower dose of CV-19 to create infection than it does for influenza. But something is clearly going on that implies that our mitigation tactics may be working against influenza but not CV-19. If so, this is more evidence of the futility of at least the current set of mitigation of spread tactics against this virus. As I said at the start, these two sets of circumstances are something that should give everyone pause–why is this happening and what does it tell us. And again, be incredibly grateful that this actually is not a very lethal pathogen, particularly for the vast majority of the population, since it does appear to be extremely hard to control.
I understand that a lot of people would like to believe that there is some tactic or set of tactics that would magically make the virus stop spreading. Sometimes we just have to accept the limits of human control over the world. Sometimes we may have to question whether the tactics we have deployed are actually making the epidemic worse. And at all times we should be evaluating all the consequences of government actions and asking whether they are really providing the greatest benefit for all the people. We have done incredible damage to the health of the general population, to the social and educational welfare of children and to the economic lives of millions. There are alternatives, and a certain country I mention frequently is a shining example of one of those alternatives.