Letter to the editor

Gov. Larry Hogan’s judgment and actions in responding to the COVID-19 virus should be seriously questioned, if for no other reason than lessons learned for the future.

On March 5, Hogan (R) issued a “Declaration of State of Emergency and Existence of Catastrophic Health Emergency — COVID-19.” The definition of a “catastrophic health emergency” is “a situation in which extensive loss of life or serious disability is threatened imminently because of exposure to a deadly agent” (Md. Code, Pub. Safety §14-3A-01). The reason for the emergency declaration was “the person-to-person spread modeled by the CDC and WHO indicates that extensive loss of life or serious disability is threatened imminently in all of Maryland.”

Based on the COVID-19 Hospital Impact Model for Epidemics, Johns Hopkins Emergency Medicine Group and the Institute for Health Metrics and Evaluation computer models, Hogan ordered the closure of the public schools, “nonessential” businesses and mass gatherings, and directed people to stay at home. However, the computer simulations were of unproven reliability. For example, a study found the IHME model was wrong as much as 70%, and its updates led to prediction ranges too broad to be useful. The Johns Hopkins model predicted 360,000 cases and 12,240 deaths by June 1 in Maryland. As of May 15, there were 37,968 cases and 1,842 deaths, an error rate of 90% and 85%.

Hogan’s determination of nonessential businesses consisted of closing what is not identified as “critical infrastructure” by the U.S. Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency. Hogan used it to conceptualize essential versus non-essential businesses rather than making a risk-based evaluation of what is safe versus unsafe and allowing health safety modifications instead of closures. Hogan’s ill-conceived decision essentially shut down the private sector economy, hiked state unemployment from 3.3% to approximately 15%, and did more harm than good negatively impacted employment in other ways.

Absent a vaccine, disease immunity gained through infection and recovery ultimately diminishes and ends an epidemic. Hogan, misled by computer models and bad advice, chose to target infections to avoid overwhelming the public health system. However, doing so slowed the spread of infection-induced immunity within the population. Consequently, his decision will extend the duration of the epidemic the duration of the epidemic is prolonged until population immunity reduces the susceptibility to the disease or a vaccine becomes available. If he had targeted deaths rather than infections and preferentially protected the most vulnerable — the elderly (age 60+), as evidenced by 84% of the deaths, excess infections and mortality would have been minimized while the low-risk population acquired immunity.

The purpose of public health laws is to protect the public’s livelihood — the means of securing the necessities of everyday life. There must be a balance between public health measures and community resilience — the ability to absorb, recover, and adapt to adverse events. The critical determinant of community resilience is individual self-reliance and self-sufficiency, which Hogan has been severely impaired.

The best that can be said is that Hogan acted in good faith, but grossly overreacted. Only the gullible will believe the dubious assertion that the avoidance of the computer predicted worst case is attributable to Hogan’s social distancing and closure orders. Drastic actions were taken to “flatten” an erroneous and theoretical statistical trend curve. The problem is there are no checks and balances in a public health emergency to ensure that the government’s dictates and actions are necessary, reasonable and rational.