Writing in The New York Times Friday, Dr. 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.
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.
Compare U.S. rates of infection (10%) and death (0.1%) to Europe, and tell me again how our response is overkill.
You can rebuild an economy. You can’t get the people back.
He also says the lockdown is not protecting those who are vulnerable. The disease is not reaching natural herd immunity.
I would still like to see a comparison chart comparing total infected, total death from each the FLU and China Virus and enter a final column to show how many affected had a flu shot this year. Figures with certifications!
In the 2 days since he wrote this article the number of deaths has gone from “less than 200” to more than 400.
And while he favorably cites the experience in South Korea as you noted, he also points out their widespread testing which limited the spread and allowed them to contain, for now, the virus, as opposed to the incomprehensibly terrible way this administration has handled testing (“if you want a test you can get a test even
though you really can’t and let’s blame the media for anyone that can’t and the democrats for everything else.”)
Anyone care to support the actions of “libertarian” Rand Paul who, while waiting for the results of his test (apparently if he wants one, he can get one) went to the Senate gym and worked out leading to a whole list of Senators that are now in self-isolation.
I asked the question earlier about libertarians and how they see this disease from a philosophical standpoint as it relates to their “non-aggression” principle and in light of Rand Pauls stupidity I’ll ask again: does his conduct violate the principle of nonaggression?
As to “herd immunity” the biggest issue is how long it would take to build up such an immunity and how many lives and resources it would cost.
The U.K. Did their analysis and decided against it.
Certainly, there is judgement to be made with limited information. I agree that overreaction can be as or more damaging than underreaction. Only hindsight is likely to tell us the real answers. That being said, I can see at least four factors which have exacerbated this whole problem. 1) The CDC had its funding cut by a third since the end of the Obama Administration, leading to things as ridiculous as a major face mask shortage. 2) The Pandemic response team was fired by the Trump Administration. Hard to hit the ground running when your experts have been pushed out the door. 4) As measured by Trump’s rosy forecasts until only a week or so ago, and with supporters on camera only a few days ago, the response of the federal government was clearly underwhelming, demonstrated not only by Trump’s words, but his complete disregard for even basic, inexpensive prevention measures as evidenced by the fact that he insisted on shaking hands with supporters and getting up close and personal on camera only a few days ago. Great example, Pres.
I’ve contrasted before the superb and inexpensive measures taken by Taiwan with almost miraculous success with the anemic, late, and now superexpensive response seen in this country.
While it’s possible that we are just panicking, that seems somewhat incompatible with the fact that the first emphatic response to this epidemic that I recall was the NBA cancelling its season, quickly followed by the NCAA, NHL, etc. on a voluntary basis. Hard to imaging that the hard nosed executives of these leagues took this action voluntarily, undergoing this multibillion dollar business loss without some very firm and compelling reasons. More likely, they saw the writing on the wall before our federal government did. I also have to ask why these sports leagues, which all are incurring huge losses, took aggressive action before our federal government, though this what we pay our government to do. It’s their job!
Come to think of it, about the only major action by the feds seems to be in the form of addressing the economic fallout by throwing money around, adding even more to our national debt (didn’t they roast Obama for that?) I can’t honestly think of any major action taken by the Trump Administration that involved the medical side of this, except for maybe the infamous test kit fiasco.
And many of you still think he’s doing a great job. Apparently the Kool-Aid tastes good.
This just in: “Several months before the coronavirus pandemic began, the Trump administration eliminated a key American public health position in Beijing intended to help detect disease outbreaks in China.” https://www.nbcnews.com/news/us-news/u-s-axed-cdc-expert-job-china-months-coronavirus-outbreak-n1166186
Ain’t smaller government wonderful?
FactCheck.org: “It’s true that the president’s budget proposals have consistently called for reduced funding for the Centers for Disease Control and Prevention, but Congress hasn’t enacted those cuts.”
Another perspective on school closures with good citations to studies involving prior instances including during the 1918 Influenza Pandemic.
“Q: How about proactive school closures, before there are any infections associated with a school? Are they helpful?
A: Proactive school closures—closing schools before there’s a case there—have been shown to be one of the most powerful nonpharmaceutical interventions that we can deploy. Proactive school closures work like reactive school closures not just because they get the children, the little vectors, removed from circulation. It’s not just about keeping the kids safe. It’s keeping the whole community safe. When you close the schools, you reduce the mixing of the adults—parents dropping off at the school, the teachers being present. When you close the schools, you effectively require the parents to stay home.
There was a wonderful paper published that analyzed data regarding the Spanish flu in 1918, examining proactive versus reactive school closures. When did [regional] authorities close the schools relative to when the epidemic was spiking? What they found was that proactive school closing saved substantial numbers of lives. St. Louis closed the schools about a day in advance of the epidemic spiking, for 143 days. Pittsburgh closed 7 days after the peak and only for 53 days. And the death rate for the epidemic in St. Louis was roughly one-third as high as in Pittsburgh. These things work.”
The link again:
Children were more susceptible to the Spanish flu.
And of course even the article you cited stated that long term school closures were very successful.
Thank you for the correction, Thomas. I should change my statement: As ineffective as the Federal government has been, it would likely have been even worse had Trump gotten his way in reducing CDC funding. Kind of like the difference between murder and attempted murder. Different, but not greatly.
The answer to your question is ….. yes.