As America continues its re-opening, there is ongoing debate among our government leaders on what is appropriate and what is not. Even within some states, there are differences in views from local authorities with their governor. Good public policy decision-making is based on facts, not on political biases nor personal inclinations. There is the common sense recognition that we the society cannot solve every problem, let alone one problem perfectly. There is the law of diminishing returns we cannot escape. There are always limited resources and budget, and we must deploy the appropriate measures so that “the cure is not more costly than the problem.” A corollary to this principle is “do no harm”—we cannot harm others knowingly in the process of saving some. We cannot drive like speed demons, causing cars to swirl and hit other cars, even as we race an injured person to the ER.
In assessing COVID-19 as a dire health risk to the population, we must consider all the other health risks to the population. The death rate, specifically death rate/100,000 people, is the standard number used by the CDC and most health agencies on health considerations. This number is “absolute” because it is not depending on the accuracy of diagnosis for a particular disease; it is the number of deaths caused by a particular disease for every 100,000 people in the population for a given year or a specific time period. A comparison of COVID-19 death rate (The COVID TRACKING Project, as of May 19) with the death rates of the major diseases (CDC, final annual numbers from 2017) is shown in Chart 1. For a more robust assessment, historical annual numbers are used for benchmarking.
COVID-19 accounts for less than 5% of all deaths caused by major diseases. If COVID-19 deaths double by the end of 2020, COVID-19 will account for less than 10% of all deaths caused by major diseases. A continual “shut-down” mitigation strategy (with the majority of healthcare resources focused on COVID-19) will cause more deaths overall because of neglect of patients with chronic diseases and cancer. These patients are also the most vulnerable to death by COVID-19. This is a DOUBLE WHAMMY!
On a local / state level (see Chart 2), nearly three-quarter of all states have death rates less than 20 (benchmark for deaths from poisoning accidents) and over half of all states have death rates of 10 and under (benchmark for deaths from motor vehicle accidents). Only 5 states (New York, New Jersey, Connecticut, Massachusetts, and Louisiana) have death rates above 50 (benchmark for deaths from all accidents). Over half of the deaths of New Jersey, Connecticut, and Massachusetts are from long-term care facilities/nursing homes which could have been avoided with better health guidelines.
Given these risk assessments, it is evidently clear that we need to shift our focus away from COVID-19 and to more important matters such as proper healthcare for the population and restarting our economy. The latter presents the greater risks. We cannot make “the cure more costly than the problem!”