The Dangerous Tension between Politics and the Pandemic

Sanford Weinstein, Ed.D, M.S.W

Professor Emeritus, New York University

The internet provides opportunities to do homegrown, no cost, armchair research into many important problems. Its information is easily accessible but at times hard to sort out, biased, and dishonest. Still, a persistent and discerning reader with a laptop can get good data plus free software to analyze it. Currently, COVID-19 and US election politics are our most serious problems. The internet is rich in information about both and this investigation uses it to study the interplay between them.

Why This Investigation?

We have 4.5% of the world’s population but nearly 20% of COVID cases and deaths. Simple arithmetic shows we would have 9.8 million (78%) fewer cases and 195,123 (75%) fewer deaths as of November 24, 2020, had our mitigation effort equaled other countries’. The US has the acumen and resources to do better but is inundated with avoidable deaths, economic misery, and social costs.

This investigation measures chaotic and disruptive national leaderships’ contribution to the suffering. The absence of a coherent unifying national policy led state and local governments to create a hodgepodge of mitigation strategies that are inconsistent, politicized, and conflicted. Policy observers warn that mitigation varies between states and ranges from weak to strong. Donald Trump handed mitigation over to state and local governments but is antagonistic to their efforts. Internet data provides an opportunity to examine the impact of these tensions on COVID-19 spread and mitigation.

Medical science and other countries’ successes led to health policies that change social behavior, regulate travel, promote wearing masks, and advocate diligent hygiene. Violators face legal penalties where policies are stringent. When policies are weak, patience and discipline are de rigueur to mitigation. The recent COVID-19 surge confirms the uncertainty of public adherence to mitigation guidelines.

The White House, courts, government officials, religious and political views, and baseless conspiracy theories push against guidelines and spread confusing misinformation. All are amplified on Twitter, Facebook, and other social media.

Donald Trump ridiculed guidelines, courts vacated mandates, some governors will not impose them, and mask-wearing is politicized. Some government officials misrepresent COVID-19 spread when financial opportunity knocks, and rush to open the economy and schools. Trump removed COVID-19 data from CDC control in July. The recent release of a trove of that data exposes its existence and concealment.

Several Florida news sources criticized Governor and Trump loyalist Ron Desantis for similar actions. Desantis ordered scientist Rebekah Jones to manipulate data prior to college students’ traditional Ft. Lauderdale pilgrimage. Jones refused so he fired her.

Jones blew the whistle and created an independent website parallel to Florida’s COVID-19 dashboard. She offers it as true to the facts.

Desantis retaliated using a warrant signed by a new judge he had recently appointed. On Dec. 7, 2020, Jones video recorded Florida State police entering her home to confiscate phones and computer hardware. The video shows that police menaced her and possibly her family with guns drawn. National news reports included the video evidence of Desantis’s effort to stifle her.

Such recordings permit the public to view primary evidence of possibly historic actions and events. Trump often complains that hostile journalists write “fake news” reports about him. But, recordings of his statements verify what he said, enable fact-checkers to confirm or disconfirm their truth and let the public view his actions. Rebroadcasts refute later denials.

Bob Woodward’s tapes aired, in Trump’s voice, early truths Trump knew and hid about COVID-19. The tapes confirmed Woodward’s journalism. Trump claimed he concealed those truths to avoid public panic.

More likely, Trump wanted to avoid closing an economy he thought would help his reelection. So, he touted a wishful fantasy that the pandemic would soon go away spontaneously. The subsequent spread of COVID-19 ended that dream and blighted the economy.

The public has a recorded chronology of Trump’s mistakes. First, he delayed national mobilization and we heard him say the virus would simply vanish by this or that date. When it did not, he dismissed COVID-19 as a hoax or minor flu-like ailment. Next, the increasing death rate forced him to acknowledge its virulence. He implied that the virus was beyond his capability to suppress and excused his passivity by saying it is deadly but “it is what it is.”

That 4-word cliche exposed his unwillingness to use the power of his office for mitigation. That healthcare workers still face national shortages of PPEs and testing supplies supports this interpretation. Claire Rezba, physician and COVID-19 tracker, estimated in August 2020 that 200,000 workers had become infected and nearly 800 had died by that time. Epidemiologists report that healthcare workers’ risk of infection is 12-times higher than other people’s. Those numbers have grown and the US testing effort has failed.

Next, we watched Trump search for a miracle cure. Viewers saw and heard him promote ineffective risky medicine such as hydroxychloroquine, and in April, suggest that COVID-19 patients drink household disinfectants to treat the illness. Poison control centers reported 16,000 industrial bleach poisonings by September.

Former director of the Biomedical Advanced Research and Development Authority (BARDA) Rick Bright opposed dangerous drugs pitched by politically connected opportunists. Trump ousted and demoted the noted vaccine expert in April 2020 and Bright resigned in October.

In May 2020, Trump stifled our participation in international containment efforts by removing the US from the WHO. He claimed WHO was expensive and inept. Trump accused China of intentionally misrepresenting the COVID-19 threat that originated in Wuhan. This reduced US-Chinese cooperation and access to China’s scientific resources. He often called COVID-19 the “China virus.”

In July, he moved tracking from CDC to HHS so he could control public disclosure of tracking information. As the recent data release indicates, he was able to obscure the full extent of COVID-19’s spread and impact.

In August 2020, Trump brought Stanford professor and radiologist Scott Atlas to the White House Task Force. Trump sought authoritative support and to deflect criticism. Atlas was not an infectious disease expert but was in sympathy with others who promoted anti mitigation fringe theories including the discredited herd immunity strategy.

Recordings show Atlas pitching that strategy and later denying it. Echoing Trump’s earlier call to “liberate Michigan,” Atlas urged people to “rise up” against Michigan’s containment policies. Then, he denied he intended to incite violence. Prominent public health experts denounced and Stanford’s Faculty Senate condemned Atlas for promoting views that ignore medical science. He left Trump’s task force after less than 4 months.

Trump urged the public to embrace his own cavalier attitudes and behavior. He ridiculed masks and we saw him maskless with maskless crowds at rallies and the White House. Trump survived infection but prominent rally attendee Herman Cain died. The White House became a super spreading hot spot.

Experts warned that the 2020 holiday season would be perilous. But, Trump urged families to join crowded Thanksgiving gatherings and has invited crowds to 20 White House Christmas parties.

Trump’s regressive influence is broad, powerful, and cult-like. Zealots echo his prevarications, emulate his risky behavior, dismiss COVID-19 as a hoax, and complain that health policies infringe on personal freedom. Astonished doctors and nurses speak of like-minded COVID-19 patients who deny their infection as they lay dying.

Republican politicians reinforced Trump’s outrageous claims. Loyalist, science-denying Governor Kristi Noem rejected warnings by an “elite class of so-called experts.” She and the Sturgis Town Council welcomed 450,000 Motorcycle enthusiasts to a summer rally. They spread COVID-19 across South Dakota, surrounding states, and nationally. She did the same for a State Fair that drew 107,000 people and refuses to mandate mask-wearing though her state is among the world’s worst hot spots.

Trump is detached from the US mitigation effort and has been AWOL from COVID-19 Task Force meetings for months. He reappeared recently wanting credit for Operation Warp Speed’s (OWS) success in accelerating vaccine development. Great vaccines came out in record time, but Trump’s role is unclear.

The program originated in 2019 in Congress, not the White House. Democratic congressman Joe Courtney (Conn.) sponsored an act under a different name as an Obama-Care tax relief measure. With the emergence of COVID-19, the senate changed its title and purpose in March 2020. It became the CARES act and OWS is part of that act.

Trump signed and announced CARES legislation in mid-May 2020, and laid claim to OWS. He pressured scientists to rush their work so he could add a vaccine to his pre reelection resume. Scientists refused to rush, but Trump’s actions shook public confidence. People fear that scientists cut corners and took shortcuts because of political pressure.

Pfizer was the first company to produce a safe and effective vaccine and immediately declared it took no OWS funding. Pfizer announced success after Trump lost the 2020 election. He complained that Pfizer purposely delayed its announcement to thwart his election ambitions.

Moderna was the second company to report success. Moderna got BARDA and National Institute of Allergy and Infectious Diseases funding in March and April 2020 prior to Warp Speed’s May 15 opening. OWS added support in August after much of Moderna’s work was complete.

Led by immigrant scientists, Pfizer and Moderna appear to have distanced themselves from the xenophobic Trump. They declined his invitation to attend a White House Vaccine Summit following their widely heralded success.

Now, the US may face vaccine shortages because the Trump administration refused Pfizer’s earlier offers to sell it more. Confusion about quantities and shipping is slowing distribution and Pfizer reports millions of vaccine doses languishing in storage. The US ranks first in the world’s infections and deaths and 32nd in the emerging vaccine supply chain.

Public health experts cry out against Trump’s policy failings and to choke back misinformation. Experts show that COVID-19 is real and virulent. Scientists see it in Petri dishes and lung tissues, detect it in tests, have decoded its DNA, and find it in human waste and wastewater. Their microscopes provide pictures of the virus and its attacking lung cilia.

Tragically, they see and report terrible injuries in survivors and cadavers. Post mortems and obituaries describe productive lives cut short.

Noted expert Anthony Fauci often contradicted Trump’s false assertions and earned his ridicule. Fauci’s words run true to polls showing the pandemic to be Biden voters’ first ranked priority and the economy their second. Trump voters ranked the economy first and the pandemic second.

The Investigation’s Design

Election counts are votes cast in each of the 50 states plus Washington, DC as reported by the Associated Press on November 15, 2020 (https://www.google.com/search?q=2020+election+results&rlz=1C1CHBF_enUS814US814&oq=20&aqs=chrome.1.69i57j69i59l4j0i131i433i457j0j0i433.5382j0j8&sourceid=chrome&ie=UTF-8). Projections made Joe Biden the Electoral College winner by that time. This date marked the start of the fall surge in COVID-19 cases and deaths and lies just within a 2 week quarantine period after election day.

Worldometer’s website provided data for cases and deaths per million (https://www.worldometers.info/coronavirus/country/us/ for 11/15/2020). Statista provided data for percent of positive tests (https://www.statista.com/statistics/1111716/COVID-1919-us-positive-tests-by-state/). Hospitalization data came from the COVID-19tracking.com website (https://COVID-19tracking.com/data for 11/19/2020).

These sources send information to the general public. They present data in readable tables that list states in the left-most column and data labels along the top-most row. An easy cross-reference by column and row locates a state’s number for any datum figure.

PSPP (https://www.gnu.org/software/pspp/) is a free statistics package for analyzing the numbers and has a useful data recording program. Hand entered numbers from website tables became the PSPP data set for voting and COVID-19 tracking.

The data are erratic and volatile as tracking numbers climb and reporting problems distort them. Rapid and continuous change causes figures to be instantly obsolete. Data entry for each state started on November 15 with 11.4 million cases and 252,000 deaths, nationally. These numbers increased to 13.25 million cases and 266,000 deaths as of November 29, in just two weeks.

Also, the data are an aggregate from a population with large and growing numbers of unreported, obscured, and hidden cases. CDC estimates true incidence to range from 6 to 24 times the number of reported cases. Recently, CDC estimated reported cases to be 12.5% of an 8-times larger population. So, the representativeness of case reports is unknowable for a population whose parameters are unknown. The elderly, those with underlying health conditions, and people of color appear disproportionately among reports.

Oxford University’s policy scale awards points to a state’s total score for COVID-19 policy strength. Strong policies earn more points and weak ones fewer. Oxford’s scientists rated states and rank-ordered them by score. For this investigation, a state’s rank was its policy score.

The New York Times (Nov. 19, 2020) provided Oxford’s table of rankings (https://www.nytimes.com/2020/11/19/world/states-that-imposed-few-restrictions-now-have-the-worst-outbreaks.html). The Times did not report states’ scale scores.

The scale’s content is about what it intends to measure and the data here adds to evidence that it does measure as intended. Higher rankings correlated with fewer cases per million, fewer positive tests, and a higher rate of testing. These correlations are consistent with evidence that policies mitigate spread, and support the use of the scale to measure the strength of those policies.

The Times report did not say a rater would produce equivalent scores for repeated ratings of one state, or if several raters’ scores for a state would be equivalent. But, the correlations mentioned above support an inference that the scale does produce consistent measurements.

Despite limitations, the data permitted a comparison of COVID-19 measures for states favoring Joe Biden (Blue) and states favoring Donald Trump (Red). COVID-19 containment responsibility rests with state and local governments because the Trump administration passed it off to them and has no coherent unifying national containment policy. So, another analysis compared states with Democratic governors to states with Republican governors. Wikipedia provided information about governors’ party affiliation. (https://en.wikipedia.org/wiki/List_of_current_United_States_governors).

Comparisons of averages for COVID-19 spread and containment scores are the focus of this investigation. Statistical tests of the difference between averages estimate the likelihood of differences being chance findings. A finding is significant here If the odds of it occurring by chance are 5% or less. Large differences between groups for measures that have small variation among a large number of cases are most likely to satisfy the 5% criterion. The 51 cases here divide almost equally with 26 Blue and 25 Red. Twenty-six governors are Republican and 25 are Democrats.

The percent of difference on measures of spread and policy ranking for Red and Blue states, and for Democratic and Republican governors appear in the summary below. No details of statistical procedures appear except for statistical significance.

What Did the Investigation Find?

The summary shows Red States to have 20% more cases per million people, 12% more positive COVID-19 tests, and 29% weaker containment policies than Blue states. Republican governors’ states have 13% more cases per million, 25% more positive tests, and 29% weaker policy ratings.

Though not reported in the summary, the data showed no meaningful correlations between Republican or Democratic vote counts and COVID-19 case or death rate per million. This was true for votes overall and for Red and Blue states separately.

Biden’s narrow-margin Blue State victories suggest that COVID-19 deaths among republican voters may have cost Trump Electoral College votes. Though deaths numbered 251,901 nationally, not enough were in narrow-margin Blue states to make a difference. Even the .1% gap of the narrowest state margins was too wide to bridge in the unlikely event that all deaths were Trump voters.

Red states reported lower death rates and hospitalizations than did Blue though the difference was not statistically meaningful. Blues had 20% fewer cases per million so should suffer proportionately lower death rates and hospitalizations than Red.

Higher Democratic vote percentages correlated with stronger state containment while higher Republican vote percentages correlated with weaker containment. Reporting is an important element of containment.

Blue states occupied the top eleven policy rankings and Red occupied the bottom 13. Policy stringency correlated with testing which is a reporting method. Blue states reported 369,079 more COVID-19 tests and a higher test rate per million people than Red states but had 84,276 fewer positive test results.

Presidential voting and Governors’ party affiliation are not independent. Red states usually have Republican governors and Blue states have Democrats. But, five Red states have Democratic governors and six Blue have Republicans.

These eleven hybrids do not differ meaningfully from Blue states on COVID-19 measures but they do significantly better than Reds. Averages for hybrids lay between those for Blue and Red states on all COVID-19 measures. The Red States with Democratic governors differ from Blue States with Republican governors. COVID-19 spread and containment policies favor the later group on all measures.

A recent nationwide COVID-19 surge prompted additional analyses. The surge started near November 15. As of December 10, Blue states’ infection rate had increased by 13,494 cases per million, and Red states by 18560. Both increases are statistically meaningful.

Red states continue to have significantly higher infection rates than Blue. And, the jump between November 15 and December 10 is significantly greater in Red states than in Blue states.

Republican governors’ states reported 11254 more cases per million than Democrats’ which is a statistically meaningful difference. As of December 10, Democratic governors’ infection rate increased by 14948 cases per million, and Republican governors’ rate by16967. The difference between democratic and Republican governors in size of the increase is not significant,

What Does it All Mean?

This analysis indicates that states with Democratic preferences for president and governor mitigated COVID-19 spread more effectively than those with Republican preferences. The data for Hybrid states indicates that Red or Blue presidential preference is more influential than the governor’s party affiliation. Blue states with Republican governors have lower infection rates, fewer positive test results, and stronger containment policies than Red states with Democratic governors.

Hybrid status appears to have a moderating influence on mitigation efforts and outcomes. Their measures are better than Red states but worse than Blue.

Democratic preferences are also associated with more effective responses to the current surge. On November 15, the 20% difference favoring Blue states translated into 15,213 extra cases per million or 2,133,684 extra cases among 140.25 million Red state residents. On December 10, the same 20% difference translated into 2,844,158 extra cases per million, an increase of 710,474 in less than a month.

Cyber Security Director Christopher Kreb, Georgia’s Secretary of State Brad Raffensperger, and US Attorney General William Barr are prominent among those who assured us about the 2020 election. So too have state election officials and the courts. They confirm election numbers and coincidentally that voting data in this study is credible.

COVID-19 reports are not subject to intense scrutiny as were 2020 voting and vote counting. Incentives for under-reporting are strong and data manipulation is easy for those so inclined.

The ill may stay home without medical attention, many asymptomatic cases go undetected, and testing is often sought by the worried well. Trackers can alter definitions and criteria for reportable cases arbitrarily. Hospital physicians test to verify COVID-19 diagnoses and report the cause of death, but this is not always so for people who recover or die at home. Clearly, opportunities for omission and misrepresentation are abundant.

The evidence reported here indicates that under-counts align more strongly with economic priorities than mitigation priorities. For these reasons, tracking figures are suspect for states favoring Republican leadership. And, the gaps between Democratic and Republican-leaning states’ rates of spread are probably wider than reported here.

Artificially lower tracking numbers support economic priorities just as does actually flattening the curve. Republican and Democratic leaders must show that their states meet infection rate criteria to open for business. So, reports of infections and deaths have become sensitive social, political, and economic issues. They are issues because stringent containment impedes commerce and stirs the political pot.

Overall, the data are evidence of Trump’s disregard for foreseeable consequences of his actions, and that he abdicated responsibility for “protecting the American people from the public health and economic impacts of COVID-19.” He is duty-bound to be a voice of reason, a model of healthy behavior, a purveyor of good information, a creator of strong policy and programs, and a dispenser of needed resources.

His words and actions undermined public health guidelines. He has no unifying containment policy despite scientific guidance to create one. His mendacity about the facts, his medicine show approach to quack therapies, his advocating and modeling high-risk behavior, his distancing from and silencing of scientific information sources, his failure to dispense testing materials and PPE’s, and his affinity for yes-men who espouse politically expedient but discredited strategy paint a compelling picture of him as a contributor to COVID-19 spread.

The damage attributable to Trump’s feckless response is clear, present, and obvious. COVID-19 tracking reports infection and death even though they are difficult to chronicle and worse than reported. Strain and degradation in the healthcare system are obvious and massive. Unemployment, small business failure, food lines and insecurity, loss of health insurance, and mounting foreclosures, evictions, and homelessness are evidence of severe economic harm.

The data adds to evidence that the pandemic is worse in Red states, where Trump’s influence is most obvious. Zealots listen, watch, and believe him about COVID-19. They reject reports of his malfeasance as “fake news.” They emulate his dangerous behavior, repeat his antiscience sermons, reject expert opinion, and crusade for his agenda. They threaten and harass those who oppose him or refuse to lie, cheat, and steal for him.

No surprise, they showed higher levels of COVID-19 spread and more resistance to mitigation. Just as Trump, they care not that spread among the rest of us inevitably follows.

COVID-19 Spread, 2020 voting Choice, and State Governor’s Party Affiliation

2020 Presidential Choice (26 Blue states and 25 Red states)

COVID-19 cases per million Red States 20% more than Blue*

COVID-19 positive tests Red States 12% more than Blue*

Policy Rank Blue States 29% stronger than Red*

Deaths per million Blue States 10% higher than Red (ns)

Hospitalizations Blue States 20% higher than Red (ns)

Percent of fatal cases Blue States 2% higher than Red*

Governor’s Party Affiliation(25 Democrats and 26 Republicans)

COVID-19 cases per million Repub. Govs 13% more cases per million than Dem Govs*.

COVID-19 positive tests Repub. Govs 25% more positive tests than Dem. Govs.*

Policy Rank Dem. Govs 29% Stronger policies* than Repub. Govs.*

Deaths per million Dem. Govs 13% higher than Repub. Govs. (ns)

Hospitalizations Dem. Govs 3% higher than Repub. Govs. (ns)

Percent of fatal cases Dem. Govs 0% different from Repub. Govs.(ns)

Hybrid States (11 Hybrid; 5 Dem Govs in Red States, 6 Repub Govs in Blue states)

COVID-19 cases per million Hybrid 18% lower than Red States*

COVID-19 cases per million Hybrid 4% more than Blue States (ns)

COVID-19 positive tests Hybrid 23% fewer than Red States*

COVID-19 positive tests Hybrid 14% higher than Blue States (ns)

Policy Rank Hybrid 30% stronger than Red States*

Policy Rank Hybrid 7% weaker than Blue (ns)

COVID-19 cases per million Red-Dem gov 23% higher than Blu-Rep Gov

COVID-19 positive tests Red-Dem gov 55% higher than Blu-Rep Gov

Policy Rank Red-Dem gov 5% weaker than Blu-Rep Gov

Associations

Higher Democratic vote count — — — — — →Stronger state COVID-19 containment policies*

Higher Republican vote count — — — — — — -> Weaker state COVID-19 containment policies*

Stronger containment policies — — — — ->Fewer COVID-19 cases per million*

Stronger containment policies — — — — ->Fewer positive COVID-19 tests*

Stronger containment policies — — — — ->More COVID-19 tests*

Stronger containment policies — — — — →More COVID-19 tests per million*

More Deaths — — — — — — — — — — — — — — — — — — — — — — — — — ->More Tests*

Higher Death Rate per million people — — — — — — — — →More tests*

Higher Death Rate per million people — — — — — — — — →HigherTest Rate per million people*

More Deaths and Higher Death Rate per million — ->More Hospitalizations*

More Hospitalizations — — — — — — — — — — — — — — — — — — — ->More Tests*

*Statistically significant ns not statistically significant

© 2020 [Sanford Weinstein ALL RIGHTS RESERVED]