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Welcome, new readers!

I was pleasantly surprised—if puzzled—to see a recent surge in subscribers. Then I saw why. Newt Gingrich had recommended my newsletter on Fox News:

Claire Berlinski writes an amazing blog called “Claire’s Invariably Interesting Thoughts.”

She recently wrote a series headlined “The Years of Living Hysterically: Reflections on Joe Biden, Tara Reade, #MeToo, and our Hysterical Culture.”

The concept of “the hysterical culture” explains much of what I have been wrestling with living in Rome during the pandemic. …

Thank you very much, Mr. Speaker! That was kind of you. I appreciate very much the recommendation and the new readers you sent my way.

But I disagree so strenuously with the rest of your article that I spent the weekend fretting about what to do. Should I simply say, “Thank you,” and ignore it? Should I respond? Would it be ungrateful and ungracious to explain, at length, why I think you’re absolutely right about how terrific this newsletter is but absolutely wrong about the pandemic and our response to it?

I was so torn up about this that I didn’t send out a newsletter at all. I didn’t want to bite the hand that fed me, but it seemed disingenuous to say nothing.

Finally, I decided that Newt Gingrich has been reading this newsletter for a while; indeed, he’s been reading my work for a while. He knows that I often disagree with him—strenuously, at that—and besides, he has thick skin. Perhaps he even enjoys a lively debate. So he will, I hope, take the following comments in the spirit intended.

I am concerned your readers will be swayed by your arguments. We can see that they take your views seriously because many of them signed up for this newsletter on your say-so. So I feel a responsibility to lay out the counter-argument. After that, they’re adults. They can make up their own minds.

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Speaker Gingrich takes my concept of the “hysterical culture,” and applies it to our reaction to the pandemic. He thinks we—that is, I presume, the United States—have grievously over-reacted to Covid-19:

The concept of “the hysterical culture” explains much of what I have been wrestling with living in Rome during the pandemic. I have had the opportunity (requirement) to avoid meetings and travel and have had the time to watch and reflect.

Two generations of over-protecting our children, seeking safe places, announcing “trigger warnings,” hyperventilating on social media, and having radio and TV starving for things to fill continuous 24/7 cycles have all built up to a crescendo of noise.

“If it bleeds it leads” is an old rule of local news. You can add to that the need to create suspense and to hype each event as big, bigger, the biggest ever (just think of weather reports during hurricane season).

The bigger the threat the better.

The larger the number the better.

Well, perhaps. Some of this is true, some of it is irrelevant. Many Americans, I agree, over-protect their children. Just as many under-protect them. The United States has the highest rate of child mortality among the world’s twenty most developed countries. Some of this is owed to a higher rate of mortality among infants born prematurely. The rest is owed to a high rate of accidental injuries—caused by burns, drowning, falls, poisoning and traffic accidents. Although, mercifully, the rate of childhood death from accidents has been sharply falling, it is still needlessly high. The data does not suggest we are over-protecting our children. If anything, it suggests we are still too cavalier.

I find the phrase “trigger warning” odious. I also find the objection to the phrase “trigger warning” odious. They have both become mindless markers of one’s status in the Eternal Culture War. And the claim that alarm about SARS-CoV-2 devolves from two decades of trigger warnings is a non-sequitur. It fails, moreover, to account for global alarm about this virus. No one in Indonesia has ever heard the phrase “trigger warning,” but the hashtag #LockdownOrDie is trending there and Indonesians are terrified. Is this because Americans have retreated to safe spaces?

It is true—and I’ve said so in this newsletter many times—that sensationalism drives the news cycle. “If it bleeds, it leads” is an ancient newspaper maxim. The news and entertainment industries are hopelessly conflated. Fear sells newspapers. No argument from me.

But now and again, genuinely terrifying events happen. The pandemic is such an event. To suggest that the media’s response, and ours, has been hysterical, and to draw an analogy between this and the argument I make about our morbid fear of sexual harassment, implies that Covid-19 is not, in reality, worth worrying about. But it is.

There are many sources, in our culture, of disproportionate alarm. We overestimate the risk of sexual harassment, the kidnapping of children, terrorism, airplane crashes, and becoming the victim of a mass shooting. Survey after survey shows that Americans’ perception of these risks is exaggerated. But we consistently underestimate other sources of risk: motor vehicle accidents, influenza, obesity, suicide.

The novel coronavirus is now the leading cause of death in the United States. If you fear that you or one of your loved ones will die from this virus, it is not irrational at all. In April, more Americans died from Covid-19 than from accidents, chronic lower respiratory disease, cancer, or heart disease. Particularly if you live in New York State or New York City, you would be insane to be unconcerned:

It is not rational to be excessively concerned for yourself if you are quite young and healthy. But if, like the great majority of us, you are not, or you have parents or grandparents, it would be heedless to be unconcerned about this illness; and if you are reckless about transmitting it—which is all too easy to be, because it is frequently asymptomatic—you are irresponsible.

No, Speaker Gingrich’s argument that our reaction to the pandemic has been hysterical, and relevently akin to our hysteria about sexual harassment (as defined by the Supreme Court in Bundy v. Jackson and Meritor Savings Bank v. Vinson) doesn’t stand up to scrutiny. If you are over the age of 50, and particularly if you overweight, you are far more likely to die or be severely sickened by Covid-19, or to know someone who has been or will be killed or severely sickened by Covid-19 than you are to be sexually harassed.

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Speaker Gingrich proceeds to say,

When the Imperial College of London reported in mid-March that its model predicted the COVID-19 virus could kill as many as 2.2 million Americans and more than 500,000 Britons if governments did nothing to control the spread of the virus, it became the benchmark for radical policies that were unbelievably destructive to society.

The fixation on this Imperial College report, which I’ve noticed now in many quarters, at first baffled me. Why, I wondered, were people suddenly ravening on about this? Then I realized the report and its author—Neil Ferguson—had been the object of a deliberate media hit by the Telegraph. I don’t understand the politics of this, but they are peculiar to the UK and they have nothing to do with the United States, or any other country.

The vilification of epidemiologists is a populist deflection designed to distract from the real failures of governance we’ve witnessed. The conceit that the ivory-tower eggheads, with their abstruse models, have caused undue panic is not only a misrepresentation of reality, but a dangerous one. It is easy to stir up and exploit populist sentiment at a time of crisis, but the reality, first, is that this is a crisis; and second, the only people who can get us back out of it are the epidemiologists, data, models, molecular biologists, mathematicians, and experts—not “supposed” experts, but real experts.

The notion that our problems are owed to elite, pointy-headed academics—as opposed to a novel, single-stranded, positive-sense RNA virus—is sinister. We are not in this mess because of “expert modelers.” The mess is far worse than it needs to be because we ignored them. I have no brief for scientism. But I have a great deal of time for science. Without it, we may as well be medievals confronting the Black Death.

Nor do I believe for a moment that Donald Trump was influenced by reading Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. I do not believe he read it at all. I do not believe he reads anything. In the unlikely event that someone tried to explain it to him, I do not believe he listened. We are talking about Donald Trump, here. The idea that he read and carefully considered projections made on March 16 by the Imperial College Covid-19 modelling team is, frankly, ludicrous:

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The Imperial College study was influential and widely publicized in the UK, but it was not “the benchmark” for “radical policies.” Arguably, it changed policy in the UK. It had little impact elsewhere. By the date it was published, Europe was already center of the pandemic, reporting more cases and deaths than the rest of the world combined, China apart. That is what changed policies.

The World Health Organization had already urged the following guidance upon “government authorities, health workers, and other key stakeholders” in every country:

Allowing uncontrolled spread should not be a choice of any government, as it will harm not only the citizens of that country but affect other countries as well. 

We must stop, contain, control, delay and reduce the impact of this virus at every opportunity. Every person has the capacity to contribute, to protect themselves, to protect others, whether in the home, the community, the healthcare system, the workplace or the transport system. 

The advice they issued was based on long-established traditional models for containing pandemic influenza and reflected longstanding scientific consensus about the best way to control epidemic disease. It was uncontroversial, as it should have been. You may download the document here.

Far from having “no scientific rationale,” the guidelines derive from the germ theory of disease. The science behind it was no more controversial than the suggestion you refrain from injecting yourself with Lysol.

It’s worth your time, if you are tempted to believe that “radical” policies around the world were based upon a single study from Imperial College, to read this advice in full. These suggestions are based upon years of careful, empirical study of pandemic disease. The research has been widely corroborated and replicated. There are genuine controversies in science and medicine; this is not one of them.

While many questions remain to be answered about Covid-19, there is no disagreement among anyone familiar with basic hygiene and epidemiology that the policies Speaker Gingrich describes as “radical” are, in fact, the standard of care. They are described in detail in all of our national pandemic strategy documents:

• National Strategy for Pandemic Influenza, Homeland Security Council, 2005

• HHS Pandemic Influenza Plan, 2005

• National Strategy for pandemic influenza: Implementation Plan, Homeland Security Council, 2006

• Pandemic Influenza Preparedness, Response, and Recovery Guide for critical infrastructure and key resources, Homeland Security, 2006

• Pandemic Planning Update II, Department of Health and Human Services, 2006

• Pandemic Planning Update VI, U.S. Department of Health and Human Services, 2009

• Updated Preparedness and Response Framework for Influenza Pandemics, CDC, 2014

• Pandemic Influenza Plan, U.S. Department of Health and Human Services, 2017

• Pandemic Influenza Plan 2017 Update, U.S. Department of Health and Human Services, 2017

See also:

• Specific Laws and Regulations Governing the Control of Communicable Diseases, CDC, 2019

• Legal Authorities for Isolation and Quarantine, CDC, 2020

These policies are, unfortunately, the only remedies available to a society once a lethal and contagious disease, without a vaccine or a cure, has escaped initial surveillance and spread widely throughout a community that possesses no natural immunity to it.

It is true that some countries reacted swiftly enough to the threat to contain the disease by means of the “test, trace, and isolate” strategy. This is what East Asian democracies such as Taiwan and South Korea did. So did Germany.

But once that initial window of opportunity was lost and the disease had spread, there was no viable strategy but the “radical” option Speaker Gingrich deplores. Had we reacted swiftly, as our allies in Asia did, it would have been different. Had we used the past months wisely—by implementing a massive testing and contact-tracing regime—we would now be able safely to emerge from this quarantine and begin the slow process of economic recovery.

But we did not.

We squandered this time. Americans’ immense personal and economic sacrifices have been for nothing. We are no better prepared, nor are we less at risk, than we were when these policies went into place. This is scandalous—it is beyond scandalous—and I hope Mr. Speaker will be persuaded by my argument and henceforth use his influence and prominent position to say so.

The Imperial College study was but one of many. Far more influential were facts on the ground. On March 16, before the publication of the study in question, French president Emmanuel Macron announced mandatory home confinement, along with the closure of schools and universities. The next day, Prime Minister Édouard Philippe banned gatherings of more than 100 people. The following day, the prime minister ordered the closure of all non-essential public places, including restaurants, cafés, cinemas and nightclubs.

France clearly was not responding—it could not have been responding—to the Imperial College study, which had not yet been published. It was responding to the rapid spread of the virus between February 17 and 24 throughout eastern France, which threatened to overwhelm the capacity of the French medical system. It was an incredibly close-run thing. Only heroic, last-minute improvisation prevented the Parisian hospital system from collapsing entirely.

You can see from this timeline that the Imperial College’s projections—again, published on March 16—had nothing, but nothing, to do with France’s response:

To the contrary, the French government was reacting to the terrifying reality of an exponentially-rising death toll:

Unfortunately, France reacted too late. Had the lockdown gone in place a week earlier, thousands of lives, perhaps tens of thousands, might have been saved.

(If you’re curious about the French response, I recommend this superb five-part analysis in Le Monde; it is perfectly accessible, even if you don’t read French, via Google Translate. If you’d prefer an English-language summary, try this synopsis by France24: Pandemic disarmament: Why France was ready for Covid-19 a decade too soon.)

Well before the publication of the Imperial College report (again, on March 16), Italy’s coronavirus death toll surpassed China’s. This, not a mathematical model from Imperial College, is why Italy issued “radical, draconian public health restrictions.”

Also well before the publication of the report, California issued a shelter-in-place order for its 40 million residents. It is unclear whether California’s lower death toll, compared to New York, reflects this early measure. It is possible the strain of the virus in California is a less lethal one. But inarguably, California’s death toll has not been as high—nowhere near as high, in total or per capita—as New York’s.

Well before the the publication of the Imperial College report, Haiti entered a full lockdown. So did Belgium. The European Union closed its borders. So did Russia. So did Bolivia. San Francisco closed its public schools. Malaysia introduced a movement-control order. Colombia closed its borders. Germany closed its borders. So did Sudan. Hungary and Spain closed their borders. Egypt suspended all flights. Switzerland closed its borders, banned public events, and closed its shops. None of this had a thing to do with two decades of trigger-warnings and safe spaces on American college campuses.

Two days before the publication of that report, Austin banned large gatherings. Italy suspended all civilian flights. Colombia closed its border with Venezuela. New Zealand mandated self-quarantine for everyone entering the country. Turkey suspended flights to Europe.

On March 13, Utah and Massachusetts banned large gatherings. Denmark, Poland, Ukraine, and the Czech Republic closed their borders. Sixteen American states closed their schools. Louisiana postponed its primary elections. Spain declared a state of emergency.

On March 12, Montana, Virginia, Tennessee, and New York City declared states of emergency. Portugal closed its schools. Greece closed its entertainment venues. Ohio, Israel, and France closed their schools. New York and Oregon banned large gatherings.

On March 11, Arizona and Washington, D.C., declared states of emergency. The NBA suspended its season. Austria closed its schools. Italy closed all commercial venues. The UN reported that the schooling of 20 percent of students globally had been suspended.

By March 9, Italy’s emergency medical facilities were so overwhelmed that doctors were forced to perform a kind of triage seen previously only in wartime. This, not the advice of Imperial College, is why Italy declared a nationwide lockdown. Italian doctors and citizens begged the world to learn from their experience and do the same before it was too late. Some did. Spain closed its schools. Israel imposed a quarantine upon incoming travellers.

Before that report was published, on March 6, SWSX cancelled its festival. On March 3, Iran freed 54,000 prisoners. On February 29, Washington State declared a state of emergency. On February 27, the United States and South Korea postponed critical joint exercises. Saudi Arabia suspended visas for the hajj. Iraq barred public gatherings.

On February 25, US senators received a classified briefing on the Administration’s coronavirus response. This was infamously followed by the curious rearrangement of the stock portfolios of Senators Richard Burr and Kelly Loeffler.

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Not a bit of this had anything to do with Imperial College. It was not “the benchmark” for policy, nor the cause of it.

The policies implemented to contain the virus have, indeed, been economically ruinous, and as Speaker Gingrich says, “unbelievably destructive to society.” But Imperial College is not to blame—nor, indeed, was anyone who conveyed the accurate message that this virus posed a massive danger to public health.

The attacks on Imperial College, and upon Neil Ferguson in particular, have been scurrilous. They represent nothing more than the ancient instinct to shoot the messenger.

What has destroyed our economy is a virus. If you are looking for people to blame, don’t look at the scientists who told us what anyone watching the carnage in China and Italy already knew. Blame the governments that ignored these warnings, allowed stockpiles of critical equipment to atrophy, and failed to impose quarantines quickly enough. In the case of the United States, blame the government that has squandered month after month after painful month without building anything like the minimum necessary public health infrastructure to contain the virus’s spread.

We had the plans. We did not follow them.

We knew how lethal this virus was. We ignored the warnings.

We knew what we needed to do. We did not do it.

Americans would have died from this virus under the most organized and competent of administrations. But had we done anything right—had we simply gone by the book, and followed the plans we ourselves wrote—we would not now face the utter catastrophe of 80,574 dead Americans—a number that will be much higher by the time I press “publish.”

We would not be facing tens of thousands, perhaps hundreds of thousands, of deaths still to come. We would not face economic ruin. We would not be experiencing the permanent loss of our prestige and our status as the world’s uncontested premier power and the leader of the community of free nations.

We would not have lost an unfathomable 20.5 million jobs almost overnight. We would not face levels of unemployment unknown—unimagined even—since the Great Depression. We would not be confronting the greatest political and economic calamity we have faced in a century. We would not be looking at a dangerously destabilized world and a long, terrifying period of sheer global anarchy.

Americans would not—rightly—be terrified to return to work. We would not face years, perhaps decades, of social turmoil, discord, division, and bitter recriminations.

Young Americans would not be entering a bleak and hopeless job market and a lifetime of depressed earnings. The United States would not now be synonymous with incompetence and death, a global object of fear, horror, and pity; and an object lesson the world around in the perils of populism. Nor would older Americans be terrified—or dead.

This is not Neil Ferguson’s fault. It is ours. Nothing stopped us from doing what Taiwan, South Korea, and Germany did. Nothing.

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The virus is as diabolical as people believe. The Imperial College study was based upon sound assumptions. So far it has proven roughly correct.

I strongly recommend reading it. Trust no one but yourself. Read the study to see what it really says. It is not too difficult for lay readers to understand, particularly if you read it along with this introduction to viral reproduction numbers.

Global reactions to the pandemic were not chiefly motivated by this paper. But to the extent the UK’s policy was based upon it, it is only a pity the UK didn’t take these warnings seriously sooner.

The Imperial College model was not faultless—an unreasonable expectation—but it was fine. It was based on the standard epidemiological SIR models that have been used since the early 20th century. No voodoo involved.

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Speaker Gingrich claims that Covid-19 is a disease akin to the 1957-1958 Asian Flu, the 1968 Hong Kong Flu, or the 2009 H1N1 flu, during which time “economic and social life proceeded with minimal disruption.”

No. SARS-CoV-2 is significantly different in its etiologic agent, epidemiology, and severity. The key numbers are the reproduction number, the lethality, and the number of cases. Those flu viruses were pikers compared to SARS-CoV-2 .

In the most severe wave of the 1957 pandemic, the Asian flu caused 16.59 deaths per 10,000 among the elderly. Covid-19 causes 340 deaths per 10,000 among the elderly. It is twenty times more lethal. As Speaker Gingrich notes, H2N2 led to 116,000 American deaths. These deaths occurred, as he notes, without drastic social distancing measures. They took place over a period of several years. Covid-19 is on track to kill the same number of Americans within a matter of months, despite drastic social distancing measures.

R values represent the difference between an epidemic that is controllable and causes moderate illness, and those that cause a significant number of illnesses and can only be controlled through intensive mitigation strategies. The median R value for 1918 was 1.80. The median R value for 1957 was 1.65. The median R value for 1968 was 1.80. The median R value for 2009 was 1.46. Any number above one is dangerous. The basic reproduction number associated with the Covid-19 Italian outbreak? Somewhere between 2.43 and 3.10. A/H2N2 and A/H3N2 were, by comparison, barely contagious at all.

What’s more, we had both a degree of herd immunity to seasonal influenza—and we had vaccines. We have neither in the case of SARS CoV-2. We are completely immunologically naive. We have neither a vaccine nor effective therapies.

Between 2009 and 2010, the H1N1 flu virus infected some 1.4 billion people. The mortality rate was about 0.02 percent. The mortality rate of Covid-19 is closer to 3.4 percent.

In 2009, we responded appropriately. Nine days after the detection of H1N1, the CDC uploaded the genetic sequence of the virus and began developing a vaccine. Four weeks later, the CDC began releasing supplies from their stockpile to prevent and treat it. Most American states had the laboratory capacity quickly to diagnose H1N1 without verification by a CDC test. 

Not Covid-19. American labs received faulty kits from the CDC. For weeks, the virus spread, undetected, through the entire population.

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“Today,” Speaker Gingrich argues, “the combination of news media desperation for something about which to be hysterical, the Chinese Communist Party’s role in hiding and then lying about the new virus, and absurdly overstated claims of supposedly scientific modelers has led to the greatest self-inflicted economic disaster in history.”

No. The virus has led to this disaster. The CCP’s role was malign. It unquestionably delayed our understanding of the virus by six days. But every subsequent day of failure is our own.

There have been many efforts to model the spread of the virus. Those that have been taken seriously are not “supposedly scientific,” but scientific. I have seen no evidence that the Imperial College model had any effect upon the White House, but some reporting suggests Trump has been influenced by the University of Washington’s Institute for Health Metrics and Evaluation. Other reports suggest the White House has built its own models. (These models appear to be absurd.)

The Imperial College model was hardly an outlier. Modeling is, of course, imperfect. But it’s all we have. The disease is entirely new. It is nothing like the flu. It causes an entirely new disease that we don’t understand. The models improve as data comes in. But we don’t have enough data, because we haven't done enough testing.

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Modeling an epidemic is not “a scandal.” The “extraordinary influence of supposedly expert modelers” is not “the second great scandal.” It is not a scandal at all, and holding congressional hearings into their “destructive impact” would be about as useful as holding congressional hearings into the “destructive impact” of engineers on the building of bridges. Models did not “completely [misinform] government leaders, the news media and ultimately the public about the scale of the threat.” The tragedy is that to the contrary, if they informed our government at all, they did so far too late. If government leaders are unable to understand these models, it is because they did not take the time to read them—not because the project of epidemic disease modeling is sinister.

Infectious disease models have been growing in accuracy. They are not like climate models, which are enormously complex. They are easy to understand. We are quite good at SIR models. Every year, some two dozen American labs model the flu season. They’re getting better and better at predicting its timing, peak, and lethality. Holding hearings to investigate the “destructive impact” of scientists who use a well-established and useful disease forecasting method would not only be a spectacular waste of taxpayer time and money, it would distract from the hearings that should be held to investigate why no one paid attention to the Covid-19 models.

The Imperial College model, Speaker Gingrich writes,

estimated more than 500,000 Britons would die and more than 2.2 million Americans would die if governments did nothing. The model projected that in both countries the hospitals, intensive care units and ventilators would be overwhelmed.

This is not correct. I can’t strongly enough advise my readers to read what Imperial College actually wrote: You don’t need to take my word for it. They examined a range of scenarios, from “people changing their behavior in no way whatsoever” to “severe modification of behavior.”

In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour, we would expect a peak in mortality (daily deaths) to occur after approximately 3 months (Figure 1A). In such scenarios, given an estimated R0 of 2.4, we predict 81% of the GB and US populations would be infected over the course of the epidemic.

Note: In the unlikely absence. Speaker Gingrich writes that “too few people examined the assumptions behind the Imperial College model,” and says that “the Imperial College predictions were based on a model of taking zero precautions. Of course, this is an entirely irrational assumption based on basic human behavior.”

This is not at all what it says. They say that this scenario is, just as Speaker Gingrich writes, unlikely. It is one of many assumptions they tested to see what the results would be. They entered a range of behavioral modifications into the model, from “stopping mass gatherings,” to “household quarantine or school and university closure.” They did not say—at all—that 2.2 million Americans would die if governments did nothing. They found that 2.2 Americans would die in the event no one did anything at all, which they explicitly said was “unlikely.” The only reason they did not say “impossible” is because such reports tend to eschew language like that as “unscientific.”

It is unquestionably true that in the event no one did anything at all, hospitals and ICUs would have been overwhelmed and ventilators would have been insufficient. We did not need a model to know this. By the time this report was published, it had already happened in Italy. It happened in Spain, and came within minutes of happening in France.

Nor is the model, as Speaker Gingrich says, “based on a model of taking zero precautions.” (Again: It’s based on a standard SIR model. But again: Please read the report. You will see for yourself that what you’ve heard about this sinister model simply isn’t so.) This, in fact, is what it says:

… the impact of many of the NPIs detailed here depends critically on how people respond to their introduction, which is highly likely to vary between countries and even communities. … it is highly likely that there would be significant spontaneous changes in population behaviour even in the absence of government-mandated interventions.

It says, in other words, exactly the opposite of what the Speaker claims. If “too few people examined its assumptions,” this can only be because they didn’t read it in the first place. They add, moreover,

… there are very large uncertainties around the transmission of this virus, the likely effectiveness of different policies and the extent to which the population spontaneously adopts risk reducing behaviours. This means it is difficult to be definitive about the likely initial duration of measures which will be required, except that it will be several months. Future decisions on when and for how long to relax policies will need to be informed by ongoing surveillance.

“So,” Speaker Gingrich continues, “projections that were disconnected from common sense and reality were able to guide public policy. The truth is, we should have immediately expected these dire predictions to be complete bunk.”

No, there’s no disconnection between common sense and this report. Nor did it guide policy, for that matter—certainly not in any country but the UK.

Finally, alas, the dire predictions were not bunk. They were remarkably accurate, given the limited data with which the team was working.

Nor did the team seek to dictate policy. They are quite clear about this:

We do not consider the ethical or economic implications of either strategy here, except to note that there is no easy policy decision to be made. Suppression, while successful to date in China and South Korea, carries with it enormous social and economic costs which may themselves have significant impact on health and well-being in the short and longer-term. Mitigation will never be able to completely protect those at risk from severe disease or death and the resulting mortality may therefore still be high. Instead we focus on feasibility, with a specific focus on what the likely healthcare system impact of the two approaches would be. We present results for Great Britain (GB) and the United States (US), but they are equally applicable to most high-income countries.

The model is offered as a tool. They note, rightly, that it is the job of policy-makers, not modelers, to evaluate the economic and ethical implications of pursuing the various strategies they assess.

Nor has “the chief author, Neil Ferguson … become famous for making wildly absurd predictions about public health issues.”

This is a smear, and his colleagues have rightly objected to it.

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Apart from that, I agree completely, Mr. Speaker, with you: This is a great newsletter.

My new readers may, however, be confused. I would guess you subscribed for the bracing fusillades of shot and shell in our ravening culture war. Don’t be sad—you’ll get them! I want to keep my new subscribers! Welcome! Please don’t unsubscribe because this newsletter isn’t what you thought it was. Just come along for the ride.

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I should let new readers know that strictly speaking, this is not just a newsletter. It came into being because I crowdfunded money to write a book, Stitch by Stitch:

Stitch by Stitch argues that threat to liberal democracy comes in the form of a distinct, rival ideology that is at once historically familiar and genuinely novel: the New Caesarism, or illiberal democracy—a hollow form of democracy that spreads mimetically and consolidates itself through the new technologies of the 21st century.

When I finished, I began writing this newsletter, thinking I could use it to publicize the book. Then I realized, to my surprise, that more people were reading my newsletter than any book I’d ever published.

Surprised, I thought, “Well, if people like receiving newsletters more than they like buying books, why not publish the book as a newsletter? After all, Dickens published Great Expectations as a serial.”

So that’s what you’re reading. If you just subscribed, you might find it helpful to read, or at least skim, the archives. Begin on September 13, with the post titled, “Is Democracy Doomed?”

So stay tuned. We’ll find out.