Covid-19 — a new approach to the pandemic

Covid-19 — a new approach to the pandemic

There is new information on the prevalence of covid-19 that changes the way America as a nation needs to approach the pandemic.

Covid-19 has no known definitively effective treatment other than support for the symptoms. Until now our best information was that the disease had a fatality rate of between 2-5 percent and hospitalization rate about four times that. It has been the need for hospital support of so many of those infected that caused panic in the medical community due to lack of enough ICU beds, ventilators, and protective supplies. Due to this immediate shortfall in medical facility capacity, the strategy was to slow the dissemination of the disease by social separation and a general shutdown of activity. Fortunately, the medical systems have quickly ramped up and are adequate to handle larger patient loads. Thus there is less need to restrict economic activity. The virus, which is highly contagious, eventually will affect the vast majority of Americans. The ultimate solution to this disease is either the development of a vaccine (probably at least a year away) or herd immunity.

Recent random antibody testing gives us a better insight into the prevalence and complication rate of covid-19. It appears that the real mortality of the disease is between 10 to 50 times less than originally modeled. This means a morality rate of between 1 in 250 to 1000 and a hospitalization rate of 1 in 50 to 250. The original models of 1 to 2 million deaths in the United States were widely inaccurate and the current numbers are closer to the H1N1 flu of 2009.

Furthermore, with adequate medical facilities, no lives are saved by restricting activity. However, many lives are lost by restricting activity. Best estimates are that every 1 percent increase in unemployment causes approximately 37,000 deaths per year.

Covid-19 is a terrible disease, but our approach has to change given the new information and our enhanced medical capacity, lest our cure hurt us more than the disease. The morbidity and mortality of stalling the economy at this point is far greater than letting the disease pass through the system, which we are now able to handle as well as it can be handled. There is little benefit and enormous harm to keeping America closed for business now that every patient afflicted with covid-19 will receive adequate medical care.

So what is the best way to proceed?

We have several models to look at. Of particular interest is Sweden. This country has kept its industry and economic engine intact and restricted activity for those at high risk while the rest of the population is active and working. Allowing the working low-risk population to continue activity is making the nation as a whole less contagious. The estimate is that herd immunity in Sweden is between 2 to 4 weeks away and the unemployment rate remains steady. They have social isolation only for the most vulnerable (the elderly and those with comorbidities) in the interim.

Random antibody testing in New York indicates 10 to 20 percent of the population in New York City has been exposed and is presumably immune. This means that activity except for the most vulnerable should resume and the sooner the virus passes through the system the better off we are. It will be short term painful, but better to have short term pain than long term pain and economic death. Many more lives will be lost by standing still than by forging through this as America has done since our founding.

Press conferences can emphasize that no lives will be saved by stalling the economy now that the medical system is prepared for the disease. There will be some short-term increases in the disease, but long term many lives and ability for America to thrive depends on our pushing our way through this.

Short term pain, long term gain.

See also: Covid-19 — a new approach to the pandemic by Dr. Kenneth Prager