Richard A. Epstein, law professor whose projections that the COVID-19 epidemic would first only kill 500 Americans and then he updated his projection and threw a junior assistant under the bus by projecting a death toll of 5,000 Americans , and serious policy influencer in the conservative movement has come up with a new justification to have societal wide re-openings far sooner than the public health experts want. He writes that most of the people who are dying of COVID are not really dying of COVID:
How should physicians report and health departments record deaths in individuals with comorbidities like asthma, cancer, heart disease, diabetes, and the like? Treating everyone who dies with the coronavirus as if they died from the coronavirus necessarily overstates the number of cases by some uncertain amount. But the evidence is overwhelming that the virus by itself kills few individuals. The CDC reported that “approximately 90% of hospitalized patients identified through COVID-NET had one or more underlying conditions heavily concentrated in people over 70 years of age (where the comorbidities are more severe).”
The upshot is that no matter how one counts these cases, it makes no sense to shutter large number of businesses.
WOW!
That is both morally atrocious and also wrong on so many levels. Comorbidities (diseases/chronic conditions that people have) don’t work like that with mortality. Very few conditions have short term prognosis leading to death. The common and treatable comorbidities of America are long term, chronic, underlying conditions.
My mother is 67 years old. I’ve mentioned before she is a medical zebra full of weird 1 in a million conditions. She also has a few of the fairly typical comorbidities of old age — her blood pressure is a bit high, as well as her blood sugar and she could afford to lose a few pounds. In a non-COVID world, there is a pretty damn good chance that she’ll see at least a few of her grandchildren graduate high school (the oldest is a 6th grader). Her friends with good blood pressure, no diabetes and a BMI in the low twenties have a decent chance of outlasting her. And this is still the case that is likely to occur for, as of last Sunday’s Anderson Family Zoom Call, both of my parents are physically isolating at their house and show no symptoms.
Absent COVID, my mother is likely to live most of a decade.
Conditional on my mother becoming infected without good therapeutics being available, her life expectency is less than a counterfactual version of herself that is in perfect health. But if she was to die three weeks after being infected by COVID, it would be COVID that killed her and took a decade of life that she otherwise would have been statistically likely to have occurred even with her comorbidities. Comorbidities can increase the odds of death conditional on a COVID infection, but the “but for” cause of death is COVID.
MattF
It’s almost unfair to debunk arguments from partisan hacks who are plainly just hoping to score a few Trump-points and sow confusion. But it has to be done.
Omnes Omnibus
Christ, this is elementary torts and criminal law stuff. If someone has been poisoned and will die within an hour and I cut his head off, I still killed him. Epstein knows this. He is, at best, a hack.
Ten Bears
On the home front my growing concern is the long running monthly visits, checkups, etcetera postponed now going on three months. Wonder how that factors into his consideration.
Azelie
Just the idea that we’re haggling over what counts as a COVID death rather than doing what we can to keep the already massive loss of life from getting worse is mind boggling. When Evillene (don’t nobody bring me no bad news) was elected among the unsettling things to me was that it meant that the bottom for the GOP was lower than I even thought, and we seem to be finding new depths all the time.
satby
They keep trying this one out but it won’t fly. Us olds know roughly how long we can expect / hope to live based on our general health and family history, and we’re well aware that catching Covid-19 could shorten that expected lifespan a lot. Our kids are just as aware. I’m 65 next month, fat, and have asthma, but if I caught the bug and died when my chain-smoking, veggie-hating, massively medically non-compliant mother lived to be 86 people I know won’t blame my asthma.
The right wingers keep getting slapped in the face with reality.
WereBear
@Azelie:
Sadly so. Just like during the Third Reich in Germany, we are discovering how many malignant psychopaths lurk among us.
I think we have to keep a certain level of civic accountability to keep the infection state low: much like people with a chronic virus state take precautions and medication to suppress the disease state.
WereBear
@satby:
Yes, our mutual enemy will only respond to sense and science. I’m sorry it was THIS, but at least something came along that doesn’t care about Right Wing bullshit.
Amir Khalid
Lockdown is a public-health measure. Any anti-lockdown argument that isn’t based on public-health grounds is specious nonsense, and anyone presenting such an argument is full of shit.
laura
Richard A. Epstein and those who consider him an intellectual heavyweight are morally and intellectually bankrupt. Also monsters who are willing to sacrifice you and I and all who we love. Because reasons.
SFBayAreaGal
Lawyers, Guns, and Money, has been ripping Richard A. Epstein apart for a couple of weeks. Go over and take a look at what they say about him.
Ken
@Omnes Omnibus: Yeah, or the argument made by the Saw killer. “I didn’t kill that man with that bomb. He had a choice between cutting off his own leg, or remaining chained in the room with the bomb. He made his choice.”
Omnes Omnibus
@Ken: Well, not quite.
RSA
The ways we have of thinking about causality, the ones I’m familiar with at least, all lead to COVID-19 being considered the cause of death.
It’s also obvious that this is special pleading. Epstein isn’t calling for, say, deaths due to car crashes to be re-analyzed because drivers and passengers may have had chronic illnesses.
Fair Economist
Comorbities as an excuse is ridiculous in principle but even more so if you look at the specific one: the biggest are high blood pressure and obesity, and the percentages aren’t much higher than in the general population. The only common comorbidity that’s probably really contributing to deaths in a meaningful sense is renal failure – and even there people are still basically dying from COVID; it’s a vastly higher contributor to the risk of death by a factor of about 100.
RepubAnon
@Omnes Omnibus: precisely. It sounds more like a law professor discussing causation putting out a red herring for students to refute than a defensible principle.
Immanentize
So, according to Epstein, my wife died not from stomach cancer, but only from respiratory collapse and heart failure? Who knew?
Enhanced Voting Techniques
This makes him qualified to comment, how? Jesus Christ I am tired of having to deal with self anointed epidemiologists.
Spider-Dan
Epstein is an intellectually bankrupt liar.
His infamous “500 US deaths” prediction is only the tip of the iceberg. As noted, he later claimed that number was an “error” and that he originally intended to give a number 10 times higher (i.e. 5,000 US deaths).
But now, he has deleted the original article and replaced it with a new article, in which “5,000 US deaths” is the original prediction and he actually intended to say a number 10 times higher than THAT (i.e. 50,000 US deaths). Outside of the obvious issues of fraudulent revisionism, the entire premise of the original article doesn’t even make sense if you expect 50,000 Americans to die in the next two months!
see: https://www.lawyersgunsmoneyblog.com/2020/04/the-old-man-and-the-internet
Omnes Omnibus
@Enhanced Voting Techniques: He is arguing about legal causation and intentionally trying to muddy the waters.
burnspbesq
Epstein has long been an embarrassment to the profession. We would all be better off if he would put a sock in it.
Aaron
Epstein doesn’t bother with healthcare overload at all. Even if he is right that other conditions would kill the same people soon, COVID-19 is sending them at once. So people in car accidents with no comorbidities can’t get an ICU bed or a ventilator
oldster
“That is both morally atrocious and also wrong on so many levels.”
Thank you for saying this. You are exactly right.
If two people go down on the Titanic, and one is a healthy fit youngster while the other is an aging diabetic with COPD, then there’s a better chance that the healthy person will tread water long enough to be rescued. And that the diabetic will drown.
According to Epstein’s reasoning, that means the diabetic didn’t drown.
Nosirree! The diabetic died *with* salt water in their lungs, but not *of* salt water in their lungs.
What an arrogant, immoral, asshole — who fails Causal Reasoning 101.
Many years ago, I turned down an offer of admission to Stanford. With every passing day, I am more and more glad not to be associated with that institution.
burnspbesq
@oldster:
Hoover is colocated with Stanford, but rightly or wrongly I don’t think of it as part of that great university.
I associate Epstein with the University of Chicago law school, which has long been a hospitable environment for right-wing crackpots. I sometimes wonder how my eminently sensible friend who teaches there keeps his head on straight. Probably should thank the Jesuits who gave him his undergraduate education.
oldster
@burnspbesq:
I agree that Chicago Law is closer to the origin of the disease. But the Hoover institute is one of the prime vectors.
And whenever Stanford wants to cut their ties with that group of right-wing crackpots, they can do so publicly and explicitly. Until then, I may be less than precise about saying whether the Hoover Institute is *of* Stanford or only *with* Stanford.
But look, I also don’t want to create a contentious side-issue here. One of my brothers is a Stanford PhD, and he’s not a crackpot of any sort. I probably should just shut up about the Stanford issue instead of taking cheap shots — not worth sowing discord on this blog.
Dr. Jakyll and Miss Deride
I once sat on a jury in a murder case. The 80-year-old victim had three or four comorbidities, any of which might have killed him in a few years. The prosecution’s theory was that he actually died of being bashed in the head with a hammer 20 times by the defendant. (By coincidence, it took him three weeks to die.) Their expert witness made that case so convincingly that the defense attorney didn’t even bother to cross-examine. But if Epstein had been on that jury, he would have hung it.
burnspbesq
Gawd. Prior to reading his bio, I had no idea that Epstein started his career at USC, from which I got my J.D. ten years after he moved on. I feel like I need a long shower.
Oh, and NYU Law (from which I also have a degree and which constantly hounds me for money): not a dime as long as he’s on your payroll.
Paul T
David Dunning is co-author with Justin Kruger of the famous paper about: “Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments.” The Effect is named for them: The Dunning-Kruger effect.
Dunning called out Epstein with this tweet after the original interview with Isaac Chotiner:
David Dunning
@daviddunning6
New nominee for most paradigmatic of Dunning-Kruger cases. The DKE just states that people commonly aren’t in a position to see their incompetence. But mix in arrogant self-regard and the result can be virtuosic.
Interview with Dunning a few days ago discussing the rise of charlatans mansplaining the virus to us:
https://www.insidehook.com/article/news-opinion/david-dunning-armchair-epidemiologists-coronavirus
chopper
see, it’s like…you know, HIV doesn’t actually kill anyone. like itself, you know? woah.
Barbara
Even if you are terminally ill with only six months to live, you would like to have those six months and not die in 30 days because your disease riddled body was especially ill-equipped to fight off an intervening infection. So while it arguably might matter in the sense of tort liability whether COVID-19 can be said to have caused a death or merely contributed to the death, it doesn’t matter to an ordinary person with common sense who is trying to live through a pandemic. And the word “arguably” is virtually kneeling in pain it is doing so much heavy lifting in the sentence I just wrote.
Meyerman
I graduated from U of C Law School in 1992. Epstein was already a legend in his own mind back then. He has always pretended to being able to make judgments in any field based on a few months of reading and his galactic-sized brain. This hubris is a weakness of many smart lawyers, who are better at convincing others that they understand a complex field than actually understanding it.
Barbara
@Meyerman: Which gave us an entire generation of pompous ass judges who assumed that they had mastered economics and could decide virtually any case by applying the “laws” of economics.
artem1s
Lovely, they are lining up their excuses for an elderly genocide now. They are monsters.
But the evidence is overwhelming that
the virusbeing put in a ghetto or concentration camp by itself kills few individuals. TheCDCSS reported that “approximately 90% ofhospitalized patientsconcentration camp deaths … had one or more underlying conditions, heavily concentrated in people over 70 years of age (where the comorbidities are more severe).”randy khan
Even worse, Epstein keeps retconning his earlier writing. He’s trying to eradicate the original estimate of 500 (although he hasn’t been entirely successful, even in his edits to his own writing), and now has a “correction” that implies he actually meant 50,000 deaths in the first place and erroneously wrote 5,000.
varmintito
Since Epstein is a law professor, I’m a bit surprised he hasn’t pointed out the Black Letter Law that you cannot be prosecuted for killing somebody who is sick, old or frail. The “why prolong the inevitable defense” has been recognized in all common law legal systems since the time of Charles II.
Alex
So it’s a zombie outbreak after all– the 6 in 10 US adults who have chronic conditions are all already dead and have been shambling around for years without knowing it! Or maybe it’s an outbreak of philosophical zombies, the ones that make certain kinds of people speculate that they themselves are the only ones with real inner consciousness, and everyone else is just a zombie who is really good at faking being a person. That seems to be the instinctive stance of a lot of these sociopaths anyway.
scav
I’d imagine his next trick will be to prove that as so many businesses were economically fragile before the pandemic and lockdown, it’s manifestly clear that the pandemic didn’t cause their collapse — thus Trump and team R managed the economy perfectly! Don’t blame them! (He’ll have to mutter fast past his logic that the lockdown has nothing at all to do with the economic distress of same companies).
Sab
@Barbara: Awesome last sentence there. Really.
Sab
Every day this pandemic goes on I love my stepchildren more. Apparently everyone else’s kids want their old parents to die already. Mine go shopping for us.
Don K
@Aaron:
After my heart attack, I was in an ICU bed for a week and a half, and on a ventilator for a week. Without these interventions, I would have died. In the brave new world of maxed-out ICUs and ventilators, people doubtless are dying of heart attacks, injuries from car wrecks, etc., and these deaths should all be counted as Covid-related. After this is over, some researcher should go back and count up all of the excess deaths over some measure of normal mortality to determine the true extent of Covid’s toll.
Sab
@Don K: A friend of mine lost a 27 year old nephew last week. He had a treatable respiratory infection, but he was afraid to go to the ER in the age of corona, so he stayed home and died.
I am so tired of being angry.
bystander
Did Mr. Anderson get the term “medical zebra” when he was picking out a Mother’s Day card?
Roger Moore
@Spider-Dan:
And, of course, we’re likely to surpass 50,000 deaths either today or tomorrow with no end in sight, so even his fraudulently increased estimate is going to be low by a large margin.
Barry
@oldster: “And whenever Stanford wants to cut their ties with that group of right-wing crackpots, they can do so publicly and explicitly. Until then, I may be less than precise about saying whether the Hoover Institute is *of* Stanford or only *with* Stanford.”
It is worth ragging on. The fact that that intellectual brothel is housed on the Stanford campus gives it reputational boost.
West of the Cascades
@Roger Moore: He’ll just increase his “original” estimate to 500,000 deaths.
Wag
@West of the Cascades:
This. In 3…2…1..
I just hope that he never has to correct himself and claim that he really meant 500,000 deaths…
LongHairedWeirdo
I saw another egregiously uninformed moron opining that “flattening the curve” doesn’t save lives.
Apparently, the durn fool realized that there are the same number of *cases*, and figured “since it kills a percentage of those it infects, it must kill the same percentage whether or not they receive medical treatment.”
This isn’t *as* stupid as the guy who claimed that we shouldn’t worry about global warming because economic growth would help us (as if global warming couldn’t *possibly* effect economic growth), because… um… never mind. They’re both maximally stupid. (Maximal is a math term – if a subgroup is maximal, for example, it’s the largest subgroup you could form, without including the whole set. There may be multiple maximal subgroups, just as there can be huge amounts of stupidity, all equally bad, but in different ways. Hence, maximally stupid.)
Just in case anyone needs it spelled out, flattening the curve, as a strategy, is intended to save lives, by ensuring there are medical resources available to save the lives that can be saved. If cases outstrip resources (high, early peak), more people die during the time resources are insufficient.
It is true, however, that the scary side of it is, is, we don’t expect it to reduce total cases, just to keep them occurring at a slower rate.
J R in WV
@laura:
Money and power is all the morally bankrupt fascist RWJ Republicans can think about. Until the bodies start to pile up in noteworthy stacks that can’t be hidden any longer.
THAT they have to process in a way they are not used to thinking!!
J R in WV
Richard A. Epstein…
Hmmm.
Wonder if there’s any relation to Jeffery Epstein, the late lamented pedophile?
Unusual last name spelled the same….
randy khan
@J R in WV:
I don’t want to burst your bubble, but it’s a pretty common Jewish name and that’s the standard spelling. That’s not to say they aren’t related, but there’s no particular reason to think they are.