Is it time to rethink our response to Covid-19?

We are acting as though this is a totally new virus. It is not. We have seen corona virus, the family of viruses that includes SARS-CoV-2, infections before. It is “novel” in that it is a new strain and, as such, we do not know all the details of its behavior, which is not to say that we know nothing. Actually, we know a lot. Like most respiratory viruses, it is spread directly from one person to another by one of two mechanisms: droplet spread in the air via sneezing and coughing and by hand contact with a surface on which there is live virus, then touching one’s face (the virus can enter via eyes, nose, or mouth). The second mode is uncommon. We know it can be largely avoided by addressing these two methods of transmission, a relatively simple matter for anyone with a modicum of sense. We know it is most severe in those who are older and/or have compromised immune systems or other underlying conditions, such as chronic lung disease, obesity, asthma, and such. This is typical of most such viruses. Seasonal flu behaves this way. We know that, unlike flu, it appears to spare, to an unexpected degree, those who are very young.

It is fair to say that Covid-19 has taken over the national consciousness. I receive dozens of daily emails related to it. Updates are given daily and, in some venues, hourly. The media has essentially suspended coverage of everything not related to Covid-19. Even the presidential campaign, arguably the most anticipated and controversial in my lifetime, has essentially come to a halt. Our nation is in real, not virtual, shutdown and society is in stay-at-home lockdown for anything but essential outings for food, medications, and such. This is unprecedented and the consequences are unknown, even as the toll on society and the economy is growing by the day.

The overarching, repressive response to the virus comes down to a single word: fear. Fear that we are all at risk of acquiring the virus and, therefore, at risk of becoming very ill and dying. Even our experts know that we cannot prevent the spread of this virus; all we can do is stretch out the time table for its spread, i.e. “flatten the curve”, so as not to overwhelm our medical resources and thereby, hopefully, save some extra lives. We know the epidemic will end when enough people are infected and become immune, what is referred to as “herd immunity”, such that the virus peters out of it own accord. In other words, mitigation, not prevention, is the goal. What is lost in this discussion is the effect of prolonging the current state of national social quarantine and economic standstill, possibly for months. Those who raise concerns about the effects of the current situation on the economy are accused of weighing lives against dollars. This is a false equivalency. We are weighing lives lost due to the virus versus lives lost due to suicide and depression, lack of medical care from loss of jobs and health insurance, substance abuse, and all the other real medical consequences of a collapsed economy. This is more difficult to measure but no less real.

If we respond to this virus as though loss of single life justifies the current measures, then we need to rethink everything from use of automobiles to treatment of mental health issues, to homelessness, to gun violence, and even to our response to seasonal flu. The toll from Covid-19 has yet to approach that of seasonal flu and current models suggest that it may not equal it. Early predictions of a million US deaths have been downgraded to 100-200,000, and now to perhaps 60,000 or so. This is still terrible but equivalent to a bad flu season, for which we do not shut down our nation.

With some extreme exceptions, such as New York and a few other metropolitan areas, the dire predictions of overwhelming demand on existing medical resources has simply not come to pass. To extrapolate these exceptional, unique situations to the nation as a whole is a stretch.

My comments are not to be taken as an excuse to avoid following recommended guidelines as currently enacted. The US populace has, for the most part, responded admirably and cohesively, to the restrictions handed down from federal, state, and local government, even when these seem unduly burdensome and difficult to understand. It is incumbent, however, for those in authority to constantly reassess our response as we acquire new knowledge about this virus.

Those who argue that these improved projections are directly due to the extreme measures currently in effect need may be right, but they also need to step back and use the information we now have, which is substantial, to enact more measured and targeted efforts to deal with the virus among those we know are susceptible to its most serious effects. They need to let the rest of us get back to some semblance of normalcy and return to work as quickly as possible. It is a medical truism that curing the disease is a pyrrhic victory if you kill the patient in the process.

One Comment, RSS

  1. Ellen Wilcox

    OH, yes!  I have been talking to friends about everything you’ve mentioned, especially depression, suicide and substance abuse. I’m passing this on to many!  Thank you.

    Ellen Wilcox 352-409-1618 – Mobile 352-259-1547 – Fax

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