The Exodus recorded in the Bible was so the Hebrew people could escape the bondage of slavery in Egypt and find freedom in the Promised Land. A new exodus is happening as people seek escape from a modern-day slavery – bondage to government overreach. People are moving to new states to find freedom from overbearing governance.

A steady movement of people from blue states to red states was already happening before the Covid pandemic due to high taxes, high real estate prices, and rising crime rates. But Covid has added to the incentives to leave blue states due to government lockdowns, mask and vaccine mandates, and school closures.

James Freeman, writing in The Wall Street Journal, says the change seen in the District of Columbia is the most dramatic. The U.S. Census Bureau reports on data covering the period July 1, 2020, through July 1, 2021, and states:

“Over the past year, the District of Columbia’s population declined by 2.9%, or 20,043 residents, to a population of 670,050 in 2021. This was the largest annual percent decrease in the nation. The decline in the District of Columbia’s population can be attributed to negative net domestic migration (-23,030), which was large enough to offset gains from natural increase (2,171) and net international migration (1,128).”

Freeman says the media industry certainly devoted plenty of time during the Covid pandemic to instructing citizens that it was safer to live in areas ruled by coercion than ones reliant on individual judgment. Apparently, many Americans are just not listening! The Biden Census Bureau notes the remarkable trend of citizens moving into states governed by the most notorious liberty-loving villains of contemporary media:

“The South, with a population of 127,225,329, was the most populous of the four regions (encompassing 38.3% of the total national population) and was the only region that had positive net domestic migration of 657,682 (the movement of people from one area to another within the United States) between 2020 and 2021. The Northeast region, the least populous of the four regions with a population of 57,159,838 in 2021, experienced a population decrease of -365,795 residents due to natural decrease (-31,052) and negative net domestic migration (-389,638)…With a population of 29,527,941 in 2021, Texas had the largest annual and cumulative numeric gain, increasing by 310,288 (1.1%) and 382,436 (1.3%), respectively…

The largest net domestic migration gains were in Florida (220,890), Texas (170,307) and Arizona (93,026).”

Freeman recalls that television networks like CNN and MSNBC frequently lauded New York’s political leadership during the period studied, but for whatever reason, Americans on the move didn’t share the media’s opinion of Empire State governance. The Census Bureau notes:

“New York had the largest annual and cumulative numeric population decline, decreasing by 319,020 (1.6%) and 365,336 (1.8%), respectively. New York’s declining population in the last year was attributed to negative domestic migration (-352,185).”

This would seem to suggest that travelers forced to watch these programs in airport departure lounges aren’t taking them seriously.  Freeman suggests they may even view them as cartoonish entertainment.

But don’t look for changes in places like the District of Columbia. According to a report in The Washington Post, “Meanwhile, the city is doing what it can to lure people back: Mayor Muriel E. Bowser this past week said coronavirus vaccines would be required for patrons to enter restaurants, gyms, and other businesses starting in mid-January, and a mask mandate was reinstated amid rising coronavirus case counts. These measures, said Deputy Mayor John Falcicchio, are part of a long-term strategy to make D.C. visitors and residents feel secure. “We want to make sure when people come back and enjoy the vibrancy the city has to offer that they know we’ll put in more steps to make the city safe,” he said. “We’re on our way to a comeback.”

Freeman says, “And what better way is there to “enjoy the vibrancy” of a city than to be forced to wear a face covering? In the city that brought us protest tourism, perhaps all things are possible. But the latest Census data say that Americans prefer liberty.”

Once again, I am reminded it is a blessing to live in the free state of Florida.

The word “lockdown” was unfamiliar to most of us until March 2020. The rising tide of Covid-19 cases that month prompted public health officials to advocate a lockdown for “fifteen days to slow the spread” as it was promoted. Now, nearly two years later, it seems a good time, if somewhat belated, to evaluate why that course was chosen and how effective it was in containing the virus.

Phillip W. Magness and Peter C. Earle give us a good history of the effectiveness of lockdowns in an article published in The Wall Street Journal. Before March 2020, the mainstream scientific community, including the World Health Organization, strongly opposed lockdowns and similar measures against infectious disease. Those conclusions came from historical analysis of pandemics and an awareness that society wide restrictions have severe socioeconomic costs and almost entirely speculative benefits. Our pandemic response, premised on lockdowns and closely related “non-pharmaceutical interventions,” or NPIs, represented an unprecedented and unjustified shift in scientific opinion from where it stood a few months before the discovery of Covid-19.

Just a year before in March 2019, WHO held a conference in Hong Kong to consider NPI measures against pandemic influenza. The WHO team evaluated a quarantine proposal – “home confinement of non-ill contacts of a person with proven or suspected influenza” – less indiscriminate than the Covid lockdowns. They called attention to the lack of data to support such a policy, noting that “most of the currently available evidence on the effectiveness of quarantine on influenza control was drawn from simulation studies, which have a low strength of evidence.” The WHO issued a statement that large-scale home quarantine was “not recommended because there is no obvious rationale for this measure.”

The conclusions of the WHO were supported by a September 2019 report from Johns Hopkins University Center for Health Security. They stated, “In the context of a high-impact respiratory pathogen, quarantine may be the least likely NPI to be effective in controlling the spread due to high transmissibility.” This was especially true of a fast-spreading airborne virus.

Where did they come up with these conclusions? The Covid-19 pandemic is certainly not the first, or the last, pandemic to spread throughout the world. Perhaps the greatest, though tragic, experience came with the Spanish flu pandemic of 1918. In 2006, the WHO issued a report following their study of this pandemic and concluded “forced isolation and quarantine are ineffective and impractical.” In particular, they referenced the example of Edmonton, Alberta, where “public meetings were banned; schools, churches, colleges, theaters, and other public gathering places were closed; and business hours were restricted without obvious impact on the epidemic.” Using data from a 1927 analysis of the Spanish flu in the U.S., the study concluded that lockdowns were “not demonstrably effective in urban areas.”

It is precisely in urban areas where we have seen the greatest emphasis on lockdowns, especially in New York and Los Angeles.

Medical historian, John Barry, who wrote the standard account of the 1918 Spanish flu, concurred about the ineffectiveness of lockdowns. “Historical data clearly demonstrate that quarantine does not work unless it is absolutely rigid and complete.” This statement comes from a report in 2009, summarizing the results of a study of influenza outbreaks on U.S. Army bases during World War I. Of 120 training camps that experienced outbreaks, 99 imposed on-base quarantines and 21 did not. Case rates between the two categories of camps showed “no statistical difference.” Barry concluded, “If a military camp cannot be successfully quarantined in wartime, it is highly unlikely a civilian community can be quarantined during peacetime.”

This begs the question why lockdowns were promoted in March, 2020. Even the once heralded, but now embattled, Dr. Anthony Fauci questioned the wisdom of lockdowns in January, 2020. When the Wuhan region of China imposed harsh restrictions on January 23, 2020, Fauci said, “That’s something that I don’t think we could possibly do in the United States. I can’t imagine shutting down New York or Los Angeles. Historically, when you shut things down, it doesn’t have a major effect.”

It seems the blame for the lockdowns that began in March, 2020, falls at the feet of the Imperial College London. In April, 2020, the journal Nature credited the Imperial team, led by Neil Ferguson, with developing one of the main computer simulations “driving the world’s responses to Covid-19.” The New York Times described it as the report that “jarred the U.S. and the U.K. into action.”

After predicting catastrophic casualty rates for an “unmitigated” pandemic, Ferguson’s model promised to bring Covid-19 under control through increasingly severe NPI policies, leading to event cancellations, school and business closures, and ultimately lockdowns. Ferguson produced his model by recycling a decades-old influenza model that was noticeably deficient in tis scientific assumptions. For one thing, it lacked a means of even estimating viral spread in nursing homes.

Magness and Earle say the record of Mr. Ferguson’s previous models should have been a warning. In 2001 he predicted that mad cow disease would kill up to 136,000 people in the U.K., chastising conservative estimates of only 10,000. The actual death toll by 2018 was only 178. He also miscalculated predictions of catastrophes for mad sheep disease, avian flu and swine flu that never panned out.

These authors calculated the performance of Imperial’s Covid-19 predictions in 189 different countries at the first anniversary of their publication, March 26, 2021. Not a single country reached the predicted mortality rates of their “unmitigated spread” or even the “mitigation model” – the latter premised on social-distancing measures similar to what many governments enacted. For example, Imperial predicted up to 42,473 Covid deaths in Sweden under mitigation and 84,777 under uncontrolled spread. The country, which famously refused to lock down, had some 13,400 deaths in the first year.

All of this should be a warning to those who would impose lockdowns again, in the face of rising case numbers, but not deaths, from the new Omicron variant. By now it should be clear to everyone that “following the science” does not mean lockdowns.

In an earlier post, I pushed for more emphasis on Covid therapeutics (Covid Therapeutics Take a Back Seat). I mentioned fluvoxamine in a list of promising drugs that should be considered. Today, I want to talk more about this old drug that might be just the right answer for this new pandemic.

Two new oral treatments of Covid were just approved by the FDA last week, Paxlovid and Molnupiravir. Paxlovidhas reduced hospitalizations by about 90% and Molnupiravir has reduced hospitalizations by about 50%. While these drugs are exciting new therapeutic options for Covid treatment, they are currently available in very limited quantities. Pfizer expects to manufacture 180,000 courses by the end of 2021, but that’s far from the needed supply. Molnupiravir may be in even scarcer supply. This means rationing of treatment with these drugs. There are also some concerns Molnupiravir may cause DNA mutations in rare cases.

Fluvoxamine, however, is a pill that has been in widespread usage since 1994 for treatment of obsessive-compulsive disorders. Doctors often prescribe it for other disorders, such as anxiety, depression, and panic attacks, a practice known as “off label” usage. This is quite common in the medical profession as a drug or device is approved for one use, but doctors then find it is also useful for another condition.

Allysia Finley, writing in The Wall Street Journal, tells us studies show that fluvoxamine is highly effective at preventing hospitalization in Covid patients, and it’s unlikely to be blunted by the new Omicron variant. Doctors hypothesize that fluvoxamine can trigger a cascade of reactions in cells that modulate inflammation and interfere with virus functions. It could thus prevent an overreactive immune response to pathogens – a process known as a cytokine storm. Cytokine storms can lead to organ failure and death. Fluvoxamine can also increase nighttime levels of melatonin – the hormone that makes you sleepy – which evidence suggests can also mitigate inflammation.

What is the clinical evidence that fluvoxamine works? A large study in France during the early months of the pandemic found that Covid-19 patients treated with selective reuptake inhibitors, such as fluvoxamine, were significantly less likely to be intubated or die. A small randomized control trial last year by psychiatrists at the Washington University School of Medicine in St. Louis was a spectacular success: None of the 80 participants who started fluvoxamine within seven days of developing symptoms deteriorated. However, 6 of the 72 patients in the control group got worse, and four were hospitalized. These results were published in November, 2020 in the Journal of the American Medical Association (JAMA), inspiring a real-world experiment.

Soon after the study was published, there was a Covid outbreak among employees at the Golden Gate Fields horse racing track in Berkeley, California. The physician at the track offered fluvoxamine to the workers. After 14 days, none of the 65 patients who took it were hospitalized or still had symptoms. But of the 48 who didn’t take the drug, 6 (12.5%) were hospitalized and one died. Twenty-nine had lingering symptoms, which might have resulted from inflammatory damage to their organs.

Other studies have had similar dramatic results. Researchers at McMaster University in Hamilton, Ontario, last winter launched a large clinical trial in Brazil. The results from their trial were published in the Lancet medical journal in October. Fluvoxamine reduced the odds of hospitalization or emergency care by 66% and death by 90% among unvaccinated high-risk patients who mostly followed the treatment regimen – compared to monoclonal antibodies. There was no difference in adverse effects between the fluvoxamine and placebo groups.

Here is the best part – a 10-day course of fluvoxamine costs $4, compared with the $2100 the U.S. government has been paying for monoclonal antibodies, and $530 to $700 for a course of the Pfizer and Merck oral treatments. Multiple drug makers manufacture fluvoxamine and could ramp up supply without much difficulty were demand to increase.

There is no need for the FDA to grant Emergency Use Authorization (EUA) for doctors to prescribe this drug now. However, many doctors may be reluctant to prescribe it without EUA or NIH recommendations. Physicians have been investigated by state medical boards for prescribing other “off label” drugs for Covid, such as ivermectin.

The perfect Covid treatment would have the following characteristics:

• Effective in reducing hospitalizations and death
• Oral treatment available at home
• Proven safety record over many years
• Readily available
• Low cost

Fluvoxamine checks all of these boxes. What’s not to like? It’s time the FDA, CDC, and NIH all realize this may be the drug we have all been waiting for.