A swab taken from a French pneumonia patient in December was recently tested and came back positive for COVID-19. This means that the first known case in Europe was a month earlier than previously thought. Keep in mind that December is the same month that COVID-19 was discovered in Wuhan, and more than 3-1/2 months before New York and most other states locked down.
Given the traffic between Europe and the U.S. during the holidays and the fact that up to 80% of infected are asymptomatic or show mild symptoms, and further given how highly contagious the virus is, it now seems likely that tens of millions of Americans may have been infected with COVID-19 before we sheltered in place.
Why is this important?
Because as states around the country begin to "unlock," the media has repeatedly warned that leaving our homes and venturing outside will lead to a COVID apocalypse. We’re told that new “hot spots” are emerging outside New York and other major cities, cases and deaths are surging in rural communities, and more doom is on the way.
While it’s true that the number of cases has been rising throughout the country since shelter in place orders started lifting, the percentage increase in deaths has actually been evenly dispersed among cities and rural areas. Moreover, the uptick in both cases and deaths hasn't overwhelmed hospitals in the way we've been fearing. In other words, we aren't seeing New York play out around the country.
Could this change in the coming weeks? Maybe. But as I've written before, I think the COVID-19 crisis in New York is likely an outlier for many reasons, particularly due to the dense population in New York City and a heavy minority community that's especially at risk. By contrast, in lower-density states like Utah, North Dakota, and Iowa that never locked down or only took limited measures, the number of cases and deaths have remained among the lowest in the country, and their hospitals still aren't operating beyond or even near capacity.
As we continue to "unlock" in the coming weeks, I don't think we'll see most hospitals overwhelmed for one simple reason: the mortality rate is turning out to be much lower than the original WHO estimate of 3 - 4% (the rate may, in fact, be closer to .2% since the number of infected is clearly much higher than initially thought). And a lower mortality rate necessarily means fewer people who need acute care.
As I've been saying for the past several weeks, I strongly suspect that COVID-19 penetrated a significant portion of the population long before the lockdowns began. The horse was likely already out of the barn in December, so unlocking now isn't going to significantly change our trajectory. At this point, we're just trying to manage what has likely been with us for months.
The people who passionately argue for continued lockdown seem to be hoping for “containment” that translates to seeing no cases anywhere in the country. The problem is that kind of containment is wishful thinking.
Whenever we re-open, the number of cases is going to tick up again. So if we’re hoping to re-open the country and not see more infected people as we move throughout our communities, we’re fooling ourselves. Continued infection is unavoidable, as are more deaths, because a certain segment of the population will always be at risk no matter how long we remain locked down.
All doctors agree on one point: this virus isn’t going away. It’s going to be with us forever, and a vaccine is, realistically, more than a year away. The goal of the lockdown was to prevent hospitals from being swamped by acute cases. That's the containment we needed, and by all accounts, we have achieved it. At this point, developing herd immunity for the 99% of people who won’t become seriously ill is extremely critical before this virus mutates and becomes more deadly to more people.
But we can’t do that if we’re trapped inside our homes and driven from interacting with each other. We can’t do that if we hide our faces and pretend to be “safe” by wearing cloth masks that really don’t protect us. More people will fall victim to the second wave if we try to shield our immune systems and run away from the contagion that inevitably awaits us all. At some point, each and every one of us will meet COVID-19 — and the sooner we do it, the better.
There’s no easy way out of this, people. The path forward will require us to choose between the lesser of harms. But based on the number of cases vs deaths in new hot spots, a continued lockdown of the entire country will ultimately take more lives. Research has shown that for every 1% rise in unemployment, 37,000 lives are lost through suicide, heart disease, and other illnesses, not to mention an increase in mental health illness. These numbers don't even include the people who no longer have health insurance due to lost jobs and income, which puts them more at risk of falling victim to non-COVID related diseases and conditions.
The two-month lockdown already threatens to send unemployment to 32%. Do the math. Keeping the country sheltered for fear of repeating what happened in New York poses a greater risk to far more lives than COVID-19 will ever claim.
At this point, here's what we all need to focus on: assuming the economy begins to rebound in the next few months, what will we do when the virus returns in the Fall? Will we go underground again, strangling businesses, sending more families into unemployment and poverty, robbing them of the ability to survive non-COVID diseases and illnesses, and radically disrupting our childrens' education? Or will we take a more sensible approach and quarantine the most at-risk members of our population, exercising reasonable (not crazy) social distancing measures, and implementing common sense hand washing protocols?
Humans sometimes overreact in crisis. In doing so, our response can often be worse than the danger we’re trying to avoid. Let’s all work together and stay level-headed to make sure that doesn’t happen.
Don’t panic. Don’t overreact. We can get through this without completely upending the way we live or inflicting greater harm on the majority. We just have to use our common sense .