Is the lockdown of schools and businesses creating more problems than it solves?

Writing in The New York Times Friday, Dr. David Katz, founding director of the Yale-Griffin Prevention Research Center at Yale University in Connecticut, suggests that the all-out war against the spread of the coronavirus just might result in greater danger to those most vulnerable to the disease in addition to devastating the economy and destroying countless jobs and individual well being.

Katz is urgently calling for a more “surgical strike” approach, instead of this carpet bombing approach adopted by the governors of Nevada, California, New York and Illinois — closing businesses and schools. “This can be open war, with all the fallout that portends, or it could be something more surgical,” Katz says. “The United States and much of the world so far have gone in for the former. I write now with a sense of urgency to make sure we consider the surgical approach, while there is still time.”

He notes that data from South Korea indicate 99 percent of cases are “mild” and do not require medical treatment. It is the older population that is of greatest risk — “those over age 70 appear at three times the mortality risk as those age 60 to 69, and those over age 80 at nearly twice the mortality risk of those age 70 to 79.”

According to Science magazine, South Korea has been highly successful in battling the disease through its use of widespread testing. “The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today (March 17), down from 909 at its peak on 29 February. And it has done so without locking down entire cities or taking some of the other authoritarian measures that helped China bring its epidemic under control.”

South Korea tested and isolated those carrying the virus. It conducted 5,200 tests per million people. The U.S. has tested 74 people per 1 million.

Katz further pointed out that closing businesses and schools winds up putting family members in close proximity. Because of the lack of testing asymptomatic youngsters may be infecting parents and grandparents.

“I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself,” Katz warns. “The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.”

Worse, he says, we are actually doing little to contain the disease itself.

In fact the Centers for Disease Control and Prevention has stated that closing schools has little affect on the spread of the coronavirus. “Available modeling data indicate that early, short to medium closures do not impact the epi [epidemic] curve of COVID-19 or available health care measures (e.g., hospitalizations). There may be some impact of much longer closures (8 weeks, 20 weeks) further into community spread, but that modelling also shows that other mitigation efforts (e.g., handwashing, home isolation) have more impact on both spread of disease and health care measures. In other countries, those places who closed school (e.g., Hong Kong) have not had more success in reducing spread than those that did not (e.g., Singapore),” the CDC reports.

Katz concludes:

This focus on a much smaller portion of the population would allow most of society to return to life as usual and perhaps prevent vast segments of the economy from collapsing. Healthy children could return to school and healthy adults go back to their jobs. Theaters and restaurants could reopen, though we might be wise to avoid very large social gatherings like stadium sporting events and concerts.

So long as we were protecting the truly vulnerable, a sense of calm could be restored to society. Just as important, society as a whole could develop natural herd immunity to the virus. The vast majority of people would develop mild coronavirus infections, while medical resources could focus on those who fell critically ill. Once the wider population had been exposed and, if infected, had recovered and gained natural immunity, the risk to the most vulnerable would fall dramatically.

A pivot right now from trying to protect all people to focusing on the most vulnerable remains entirely plausible. With each passing day, however, it becomes more difficult. The path we are on may well lead to uncontained viral contagion and monumental collateral damage to our society and economy. A more surgical approach is what we need.

Medics transport a patient in Seattle. (Reuters pix via NYT)