How did we get to lockdown and did it save lives? Will a future pandemic trigger another lockdown? We’re told Santa Clara County (SCC)’s public health director (DPH) Dr. Sara Cody convinced six other Association of Bay Area Health Officers (ABAHO) to order shelter in place (SIP) mandates in a single day, which triggered the first U.S. lockdown. These health officers describe their decision-making in “Crisis Decision-making at the Speed of COVID19,” giving us insight to their thoughts and rationale.

What happened? According to the paper, “decision intelligence” begins with tackling the right problem to solve– if the primary problem is “insufficient hospital beds will cause unnecessary deaths,” then increasing hospital bed capacity solves the problem. Apparently, “Two weeks to flatten the curve” was a ruse. Their cited primary problem was “uncontrolled community transmission” and their solution was to increase countermeasures to control transmission. Cody explains that “a proven way to slow the transmission is to limit interaction among people to the greatest extent practicable” and asymptomatic spread means limiting gatherings since “gatherings result in preventable transmission.”

In their hurry to “control transmission” they abandon SMART (Specific, Measurable, Achievable, Relevant, Time-Bound) goals, which my kids created at the start of every school year from kindergarten to 8th grade? If my 8th grader had made his year’s goal to achieve “Zero Covid,” his teacher would request he choose an Achievable goal. Historically, no highly-transmissible respiratory RNA virus had ever been “controlled.” Once your goal is Achievable, you must define a Measurable benchmark, establish Relevance between the countermeasures and goal, and Time-Bound benchmarks to validate completion. The ABAHO members also questioned the goal’s Achievable status by acknowledging that “the efficacy of face masks, physical distancing, and increased ventilation as prevention countermeasures had not been established yet. Nevertheless, they push forward while ”there were too many unknowns, high stakes consequences, and no time for further deliberation.”

Lockdowns, now familiar to the world, may sound scientific – silo every person in prison-like, solitary confinement until the virus incubation period has expired. Without a new host the virus is unable to propagate and will be wiped out. Will this strategy work for SARS-CoV-2 if it doesn’t work for influenza? The proof, the authors state, is “Shelter-in-place (SIP) worked in China and in the 1918 influenza pandemic.” Their basis is unpublished Chinese data and a re-analysis of the 1918 pandemic of dubious scientific merit.

Who says SIP worked in 1918? ABAHO, founded to tackle HIV/AIDS in 1985, convened a Pandemic Influenza Working group in 2006 that ultimately created guidelines with trigger points for public health intervention by influenza severity levels. Funded by BigPharma and later the CDC, SCC likely adopted the 2007 CDC Pre-Pandemic Guidance which aligned with Bush43’s NSC pandemic planning manual. The CDC authors acknowledge that their plan of early, targeted, layered multi-non-pharmaceutical intervention (NPI) is based on “historical review, common-sense, and biological plausibility” so the CDC solicited research studies to bolster the scientific cred of lockdown and NPI. Never mind that lockdown or social distancing or SIP or masks had never proven effective. The CDC ultimately funded 11 studies, including mechanistic mask studies, border screening studies, and Merkle’s 1918 re-analysis frequently cited as proof of NPI’s efficacy.

Lockdown’s scientific basis was CDC consultant Howard Markel’s 43-city 1918 pandemic data subject to mathematical modeling, which concluded that “social distancing measures can be an effective community mitigation measure provided they are implemented early, are sustained, and are layered.” The layered approach involved combining the beneficial strategy of isolating the sick with dubious lockdown measures that include school closures, gathering size restrictions, and quarantining healthy contacts.Thus, while NYC and Chicago never shuttered schools, both cities began isolating the sick early, recruited nurses to make house calls, and required well-ventilated spaces – measures that kept its population healthy but also helped “prove” the utility of all NPIs. Thus, the benefit of isolating the sick is used to justify lockdown measures like closing schools and businesses.

2009 H1N1 was the first opportunity to test their theories, and San Francisco DPH Aragon wrote a first-person account of ABAHO pandemic influenza H1N1 response in real-time with interviews of each member’s local office. In response to the CDC recommendation that schools with high absenteeism or a single probable case shutter for 7 to 14 days, Aragon’s research reported that 5 of 12 ABAHO counties decided to close schools. One DPH describes “so we were in this awkward place where the formal recommendation says you have to do this but everyone thinks you don’t,” suggesting that school administration resisted closure. The CDC subsequently changed their guidance to request those with symptoms should stay home until 24 hours after full recovery.

The H1N1 pandemic assessment pushed ABAHO meetings to strengthen consensus-building, improve access to laboratory testing data, and coordinate school school closure protocols with school districts. In fact, the SCC Superintendent of Schools ordered all SCC schools closed on March 13, 2020 while DPH Cody ordered the most restrictive gathering size limits. Why didn’t Cody mandate lockdown on Friday, rather than wait to order a multi-county lockdown? What changed from the prior week’s commonsense recommendation of staying home when ill and requesting high-risk residents with underlying medical conditions stay home. Why mandate SIP when you could recommend SIP?

Was catastrophe averted or created? The authors self-declared that SIP proved victorious over COVID in their November 2020 self-assessment just as the deadliest winter wave started, reflecting their ineffectiveness at protecting the vulnerable rather than “control over transmission” or their claims of reopening the economy and schools without comprehensive SIP restrictions. In fact, most SCC schools stayed virtual until August 2021, and when school finally reopened, contact tracing kept 10% of students home isolating or quarantining on any given day. The SCC independent Covid-19 assessment was due March 2023 but no report is forthcoming.

ABAHO engaged in simulation exercises, including Dark Zephyr, like Event 201 and Crimson Contagion played elsewhere in the nation, which asks its participants to save their citizens from pandemic death. Each game uses lockdown, test and trace, masks, and vaccines as strategies and ends the simulation by reporting lives lost but acknowledging earlier threat detection could save one million more lives. Each iteration reinforces Neil Ferguson’s mathematical model (2006 Nature editorial) coded for their efficacious arsenal of strategies and based on influenza’s transmission characteristics. Since children are superspreaders, schools must shutter early, and layered mitigations work to reduce peak spread. The virtuous stay home and wear the mask to protect others. The narrative script, written and discussed for 15 years, made our ABAHO players the experts… – the psychology is inbred and nothing could deter them from their plans. Our gamer generation humans playing PANDEMIC will play again for the “win” while maintaining cognitive bias against evidence that their plan isn’t working.

These “experts” had been pandemic planning for so long that they couldn’t conceive of a world where their assumptions were wrong. Or perhaps cognitive dissonance didn’t allow them to see that their policy–which destroyed small businesses, drove a mental health crisis, robbed a generation of children, and led to millions of excess deaths– failed. In what game does the “expert” get to assess their own response?