On social media I keep seeing people questioning the need for shuttering non-essential businesses and asking whether we can just quarantine old people. As I said yesterday, at some point we’ll we need to balance additional deaths from COVID-19 with economic impacts.
But please, for the love of God, understand this. At this point there is no data-based argument for allowing nonessential businesses to remain open in any part of the US.
Texas Lt. Gov. Dan Patrick (R) went on Fox News today and said allowing COVID-19 to run rampant in his state is an opportunity for seniors to sacrifice in order to keep the country intact for their grandchildren. “Let’s get back to living… And those of us that are 70+, we’ll take care of ourselves.”
Italy tried that. Then they shut the whole thing down. Their hospitals are still overwhelmed and their fatalities surpassed China’s four days ago. The UK also tried that. Now they’re on lockdown as well. And heading for a similar catastrophe.
SF has 326 adult ICU beds and nearly a million residents. The overwhelm is inevitable at this point, the only question is how bad will it be.
Overwhelmed hospitals mean that people who need hospitalization don’t get it.
It would be great if COVID-19 only impacted people 80+ years of age. In Spain, 14% of their first thousand or so COVID-19 patients needing hospitalization were in their 20’s. 20% were in their 30’s and 40’s. 0.6 percent ended up in intensive care. 0.3 percent died.
COVID-19 can have a low fatality rate. But it depends on patients having access to hospitals, healthcare workers, and ventilators. US hospital administrators are already forcing nurses to work without masks, which will put many of them out of commission soon. (BTW, gangs in the Rio de Janeiro are enforcing a lockdown. Silicon Valley is buying masks for healthcare workers. Which one of them said this?: “If the government won’t do the right thing, organized crime will.”)
When patients overwhelm the healthcare system, the death rate increases across all age groups. Young Americans are already dying. Even among those COVID-19 doesn’t kill it can cause viral pneumonia, including among younger adults, previously healthy people, and some children. It can also leave previously young and healthy patients with permanent lung damage. That’s a lot of people out of work either because they’re dead, ill, recovering from illness, permanently disabled, caring for someone who’s ill, or dealing with a dead family member.
Leaving aside the moral implications of trying to just let the old people die in order to leave a thriving economy for the surviving young, it’s simply not possible. Mass death, as it turns out, is also expensive. For better or for worse, we’re all in this together.
All the available evidence I’m aware of points to the right move being to socially isolate as much as possible until we have widespread test and trace (which the WHO recommends), a la China and South Korea. This buys us time until we have an effective vaccine or antiviral (ideally both) and large numbers of people with immunity, at which point we can ease up on lockdown without risking mass death.
How am I doing, personally, you ask? Thank you. I’m well. Ate too much sugar today and didn’t get enough work done. But I did lift and clean my window in my bedroom. Talked to some folks on the phone. Read How not to be a jerk while ordering groceries during a pandemic and enjoyed it.
Still haven’t seen anyone I know IRL and don’t know how long it will be until I do. On the bright side, I’m saving money on makeup, clothes, and hair dye. I’m also eating extremely healthy overall and not drinking. My apartment has never been cleaner. I can barely recall the dig of a denim waistband. No one has street harassed me in a long time. Last time I checked there was a lot less poop on the street. I’m washing my sheets and towels more frequently. And I no longer have to worry about farting quietly. There are all kinds of advantages to physical isolation. 🙂
I love you babies. I know it’s frustrating. I know times are hard. So many people are getting laid off. It sucks and I understand the impulse to want to try to save the economy and get things back on track. It’s just not looking like it’s going to be possible. Not yet. Stay strong. We got this. <3
I got a text asking for blood donations yesterday and after fretting a little and thinking through precautions, I went to sign up. All the appointment slots were full by the time I got to the site. This made me at once grateful for the civicmindedness of my neighbors and relieved that for now I didn’t have to be the one taking the risk (even though it’s very likely less risky than going to the grocery store, it feels totally different because Medical Stuff is automatically scarier now). I’m trying to focus on the gratitude.
I saw Scott Wiener volunteering at the SF food bank and looked into it and wasn’t sure what to do. It’s admirable that you looked. Gratitude is always a good move. I’m working on that as well. Been gratitude journaling every day for about 5 months now. It’s been very helpful I think.
I agree that COVID-19 is bad in that it can turn other respiratory illnesses into comorbidity if they contract COVID-19. I also agree that the elderly are at the most risk here. I also agree that overloaded hospitals is bad news (I wonder why hospitals are so ill equipped to deal with rapidly increasing demand in a short period due to a pandemic?). It’s also important to point out that the exponential growth rate of this virus appears to be greater than previous flu contagions. I think the trade-off between corona-related deaths and economic loss is less clear than you are making it out to be though.
“But please, for the love of God, understand this. At this point there is no data-based argument for allowing nonessential businesses to remain open in any part of the US.”
Some people who work at nonessential businesses still make essential income to live. If they end up getting let go then they are in trouble if their essential supplies and savings are low enough. The data here is simply comparing the costs of living to various amounts of savings and starting supplies in a place of residence. These kinds of government induced poverty situations can lead to increased crime, starvation, death etc if the lockdown goes on long enough. Could we be in a situation where we must choose how different groups of people will die?
One other potential problem with government enforcing the lock down is that it signals an area is bad enough with the virus that people consider leaving the area. This can very well spread the virus to other areas more quickly as opposed to a government lock down causing a flattened curve. I think we need quarantines, but that doesn’t necessarily follow to government being the optimal institution to enforce it.
You know multiple sources are saying the loss of the sense of smell is an indicator of infection. Even in patients that are otherwise asymptomatic. So I feel like farting is just a good policy for checking in on the old sense of smell and possible infection. 🙂
One source: https://www.washingtonpost.com/health/2020/03/23/coronavirus-sense-of-smell/
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