Lockdowns won't stop it now
April 10 | Posted by mrossol | American Thought, Coronavirus, EconomicsWe are where we are; we need to live with our decisions to-date. Dr Ladapo has perspective worth consideration.
The pandemic crisis now rests on a fulcrum. On one side is Covid-19 and every possible action that might prevent people from contracting and dying from infection. On the other side is everything else that matters: livelihoods that allow people to feed and shelter their families; civil liberties; the education of children; social well-being, including the prevention of loneliness, isolation and domestic violence; and all other medical conditions, from cancer and heart disease to dental emergencies. The belief that it is worth sacrificing anything and everything at the altar of flattening the coronavirus curve is foolish. But many leaders are behaving that way. We need a clearer picture of all that is at stake before those at the helm burn down the village to save it.
Examples of bad actions, often by well-intentioned leaders, are proliferating. The mayor of Chicago warned joggers that a stay-at-home order means they may not go on long runs without risking arrest, a flagrant disregard for the American values of liberty and prudence, not to mention the common-sense benefits of exercise. A city in Texas threatens to fine residents up to $1,000 if they (and their children) don’t wear masks in public. New Jersey Gov. Phil Murphy recommends a policy of social distancing within your own household. “Keep your distance between yourself and other family members,” he cautioned recently. More broadly, governors have ordered shutdowns to slow the coronavirus without acknowledging what these shutdowns cost.
Encouragingly, this has also been a time of extraordinary action by private citizens. The largest volunteer network in New York, New York Cares, decided that instead of closing up shop, it will press on to serve the community. Grocery stores have created special shopping hours for seniors and healthcare workers. The New England Patriots used its team plane to fly a million N95 masks from China to Boston. The list of courageous acts is lengthy.
To help set the right course for our country, we must grasp some simple—but tough—facts. The novel coronavirus is highly contagious and tragically lethal to many. There is no guarantee of a vaccine within the next 18 months. We have taken measures to slow the virus, but these can’t stop it. The only thing that can stop the virus at this advanced stage of community transmission is a complete lockdown, which can happen in authoritarian countries like China, but not in the U.S.
Are shutdowns enough? No. Despite the efforts, there is still enough human contact to ensure the virus will spread. Take a look at the long list of “essential” services and exemptions on California’s Covid-19 website, for example. Shutdowns will cause the virus to spread more slowly, but it will spread nonetheless.
When shutdowns end, the virus will spread and Covid-19 deaths will increase. Without a vaccine and community immunity—often called “herd immunity”—this outcome is all but guaranteed.
Stopping Covid-19 and protecting the economy are one and the same, but it is too late to do either.
A closed beach in Long Beach, Calif., April 2. BRITTANY MURRAY/ORANGE COUNTY REGISTER VIA ZUMA WIRE
The only thing that will temporarily quell it in the near term, short of a miracle treatment, is another shutdown. But states will get only one pass at this. Once lifted, the appetite for a repeat shutdown will be tepid at best, even in left-leaning states. The reality of the shutdown’s costs—the upheaval caused by school closures, economic hurt, social isolation and lost lives and livelihoods—will be fresh. Some argue that stopping Covid-19 and protecting the economy are one and the same. Although this is true, it is too late to do either.
Accepting this reality will help us make better decisions. The modeling predicts that the number of sick patients is likely to be profound and exceed anything seen in generations. It’s therefore clear that building health-care capacity—adding hospital beds, converting and building coronavirus-only treatment facilities and sourcing ventilators—is the right step to take.
Embracing reality also makes other things clear. If we can’t shut down for 18 months on the gamble that an effective vaccine will arrive, how long will it be worth committing millions of families to poverty and uprooting lives, education and every other part of the economy? Politicians have largely dodged this question.
Already, ethicists are helping us think about how to allocate ventilators when hospitals run short. And how many older doctors and nurses have to die before we seriously discuss allowing older health-care workers—say, above 59—to opt out of dangerous settings like emergency departments and hospital wards? My experience caring for patients with suspected or diagnosed Covid-19 infections at UCLA has made it clear to me that treating them in the same setting as patients with other diagnoses is unsafe, even with personal protective equipment.
Many difficult decisions lie ahead. We stand the best chance of making good decisions if we consider everything at stake, and not only the singular goal of reducing Covid-19 deaths.
Dr. Ladapo is an associate professor at UCLA’s David Geffen School of Medicine
Leave a Reply
You must be logged in to post a comment.