The primary worldwide strategy since the coronavirus pandemic has been to shelter at home, close down industry, and social distance. The purpose of this approach was to “flatten the curve” of serious illness to avoid putting too much pressure on health care systems. High numbers of seriously ill patients were projected by modelers, and there were not enough beds or ventilators to care for them all.
The goal was not to fight the infection. That battle would cbe fought with effective vaccines, proven therapies, and herd immunity. There was and is not any scientific evidence that these protective devices would have been realized at all, let alone within a time frame to avoid catastrophe from the cure of shutting down economies.
We need a lot more information to make a science-based decision on the best course to follow. This requires tests that are proven and reliable. Such testing may not be possible if the immune response is inconsistent. It may be a long time before we know how long the immunity lasts, whether someone can get re-infected or infected with an altered version of the virus, or the reliability of this immunity. Testing may not be the answer we hope for.
We also need data on the geography and demographics of those who are the sickest and dying. We have learned that long-term care facilities are an important source of the rising mortality. Relative risk factors are being defined.
The strategy of shutting down is a big experiment. It has never been done on a worldwide scale before. Does it work?
There are other important questions that should be currently prominent in the public discourse. But they are not prominent enough, yet.
Are people with mild chronic problems – like heart disease or diabetes – delaying treatment? Do these patients then get sicker from their primary disease before contracting COViD-19? It is possible that, in their morbid state, they are dying because of the virus? Would they have survived if they had had the care they needed of their primary illnesses?
Many people needing elective surgery – like a gallbladder removal or a routine hip replacement – had their operations delayed because of the shutdown. The gallbladder could become infected. The hip patient may fall or get a bedsore. If someone with such disease complications is then exposed to the coronavirus, are they more likely to die? Does this raise the numbers for COVID-19 deaths?
How many of the deaths reported as “due to” coronavirus are actually more “associated with” coronavirus?
Infant and childhood vaccination rates are down in the last 2-3 months. How much will this contribute to illness and death in the years to come?
What will be the increased morbidity and mortality from psychological illness stemming from loss of jobs?
What are the consequences of people with minimal symptoms not receiving proper care and, thus, allowing some mild disease to progress to severe illness? Many deadly diseases initially present with dismissible symptoms. This is especially true in an environment where people are fearful of going out because of the expert advice to shelter at home.
Some nationwide pharmacies have reported significantly reduced rates of new prescriptions. Is this a canary of disease to come?
How many driving deaths have occurred because of wide open roads and poorly-informed people speeding?
What are the health and societal consequences of increased alcohol, marijuana, and other drug use during the shutdown?
As people remain in their homes, will they develop more problems from overweight, eating the wrong types of foods, and reduced exercise? As the restrictions are lifted, and working from home becomes a new normal, will previously healthy lifestyles be less sought? Will the elderly find it more difficult to regain their fitness after this time away from exercise? Will that lead to more illness? It is already difficult enough to take off excess weight the older we get.
If a new economy of working-at-home emerges, will that accelerate the incidence and severity of Hypertension, diabetes, and cardiovascular disease?
Were there other grand experiments for how to survive this pandemic? Could we have set up safe work zones unique to each industry that permitted people to return to work earlier? Are there precautions that can be taken now that protect people in restaurants, movie theaters and other entertainment venues, malls, and elsewhere?
Would it be possible to redesign long-term elder care facilities to prevent spread of disease to this vulnerable population?
Was there a way to have children stay in school at least 1-2 hours a day without massive virus spread and proliferation?
In previous blogs, I have discussed barriers. We could create clear plastic walls to isolate people. these will effectively prevent spread of the virus we are still learning our options. The approach of using barriers is being tried in some restaurants and nursing homes.
We have to be doing much more than closing businesses. The massive amounts of financial aid being approved could also be applied to overcoming the obstacles to reopening rather than reinforcing and supporting the closing.
Health and Spirit by Dr. Jack Zoldan 