Ep. 988 - Trouble With The Curve

Episode Summary

Executive Summary: The episode centers on early signs that U.S. COVID-19 deaths and hospital strain may be flattening sooner than feared, while stressing the uncertainty and policy consequences of flawed models. Shapiro argues that media coverage is reckless, advocates realistic reopening plans focused on protecting the vulnerable, and contrasts media narratives with the hydroxychloroquine debate and Alyssa Milano’s selective “believe all women” standard.

Main Topics: Coronavirus curve flattening and changing projections (Priority: 5/5): The show opens with discussion of U.S. and New York death totals, arguing that daily deaths may be plateauing earlier than expected and that updated models have lowered projected deaths and resource needs. Limits and uncertainty of epidemiological models (Priority: 5/5): Shapiro argues that widely cited models are highly uncertain, frequently revised downward, and lack transparent counterfactuals, which could undermine public trust in experts and policy decisions. Lockdowns, reopening, and protecting vulnerable populations (Priority: 5/5): He questions indefinite lockdowns, proposes a more targeted approach that shields the elderly and immunocompromised while reopening lower-risk segments of society, and notes the economic and social costs of prolonged restrictions. Hospital capacity, ventilators, and treatments (Priority: 4/5): The episode discusses reports that ventilator demand is being met and contrasts media focus on ventilators with discussion of hydroxychloroquine as an experimental but potentially useful early treatment. Media criticism and institutional credibility (Priority: 4/5): Shapiro attacks CNN, the New York Times, NBC, and others for sensationalism, partisan framing, and propagating dubious narratives, arguing that this erodes trust at a moment when institutions need credibility. Alyssa Milano, #MeToo, and due process (Priority: 4/5): He highlights Milano’s support for Brett Kavanaugh accusations versus her skepticism toward Tara Reade’s allegations against Joe Biden, using it as an example of partisan hypocrisy and a rediscovery of due process.

Key Arguments: Daily deaths and confirmed cases appear to be flattening earlier than many models predicted, suggesting the curve may be bending before expected. The University of Washington model was repeatedly downgraded, especially on deaths, hospital beds, ICU beds, and ventilators, showing how uncertain the forecasts are. Models without clear counterfactuals make it impossible to judge whether lockdowns are justified if death totals end up far below worst-case predictions. A prolonged full lockdown is economically and socially unsustainable; a more targeted policy should protect elderly and high-risk people while allowing lower-risk people to resume work. Expert guidance remains valuable, but experts have not been transparent about uncertainty, which risks discrediting institutions if predictions prove too wrong. Ventilators are not a cure; once a patient reaches ventilator support, they are already critically ill, so early treatment options like hydroxychloroquine deserve at least serious consideration. The media are undermining trust by selectively applying outrage, especially in their treatment of Trump, hydroxychloroquine, and sexual assault allegations. Alyssa Milano’s earlier absolutist posture on Kavanaugh contrasts sharply with her cautious stance on Biden, illustrating how political affiliation changes standards for evidence and due process.

Data Points: U.S. total deaths: over 11,000 - Reported as the national total during the episode’s coronavirus update. U.S. daily deaths: about 1,255 - Approximate deaths in the U.S. on the previous day. New York daily deaths: 599 - Reported via Worldometer/JHU data in the discussion of New York’s toll. New York City total deaths: 4,758 - Cited as the city’s cumulative coronavirus deaths at that point. University of Washington projected U.S. deaths: reduced from 94,000 to 81,000 - Model revision discussed as evidence of improving outlook and model volatility. Hospital beds needed at peak: reduced from 260,000 to 140,000 - University of Washington model downgrade in projected resource demand. ICU beds needed at peak: reduced from 39,727 to 29,210 - Updated model estimate for intensive care demand. Invasive ventilators needed at peak: reduced from 32,000 to 19,000 - Updated projected ventilator requirement. New York City deaths with underlying conditions: most deaths had comorbidities; e.g., 18–44 age group: 144 of 180; 45–64: 25 of 777; 65–74: 9 of 789; 75+: 9 of 1,454 had no underlying conditions - Used to argue that risk is highly concentrated among those with preexisting illnesses. Age-specific COVID acquisition rate in NYC: 75+ about 1.3%; 65–74 about 1.25%; 45–64 about 1.2%; 18–44 about 0.7%; 0–17 about 0.69% - Presented to emphasize differential vulnerability by age. New York City health data category list: diabetes, lung disease, cancer, immunodeficiency, heart disease, hypertension, asthma, kidney disease, GI/liver disease - Examples of underlying conditions associated with deaths. Ventilator mortality: 50% to 90% of people on ventilators will die - Quoted from a UCSF doctor to underscore ventilator severity. Japan new virus cases: 120 new cases on Sunday - Mentioned as Japan considers a state of emergency. Italy deaths and cases: 636 deaths and over 3,500 new diagnosed cases in one day - Used to show Italy still had substantial spread while discussing reopening. Norway deaths and cases: 5 new deaths and 178 new diagnosed cases - Referenced as Norway considered easing restrictions.

Pivotal Quotes: "If we are plateauing, we are plateauing at a very high level, and there's tremendous stress on the healthcare system." — Andrew Cuomo: Used to explain that flattening is helpful but not sufficient if the death count remains high. "What do you have to lose?" — Donald Trump: Trump’s framing of hydroxychloroquine as a possible early treatment with limited downside, as quoted during the briefing. "But that does not mean at the expense of not, you know, giving men their due process." — Alyssa Milano: Milano explaining her more cautious response to Biden allegations, contrasted with her prior Kavanaugh stance.

Implications: The episode argues that reopening plans should become more targeted and realistic, with high-risk groups protected rather than society kept fully shut down indefinitely. It also warns that overstated certainty from experts and media could damage trust long after the pandemic.