Politicians and medical experts assert that: 1) COVID-19 is lethal to many beyond those that typically succumb to pneumonia in flu season (typically up to 60,000 in the United States annually; and 2) COVID-19 is still slowly spreading in major industrialized countries, implying there is still some potential benefit to the enormously costly social distancing and economic shutdown measures.
What if they are wrong? What if COVID-19 isn’t significantly deadlier than regular flu? What if COVID-19 has already spread everywhere possible? Are we engaged in the most expensive public health intervention in history without any possible payback?
Consider four points :
1. In Italy, where COVID-19 health care planning and medical management has been disastrous, there is a COVID-19 death rate of 124 per million thus far (which is has now slowed drastically according to our models). By comparison, in a typical year, the United States experiences 170 per million deaths from flu and pneumonia.
2. Countries that haven’t mandated social distancing measures, such as South Korea and the Netherlands, have lower rates of COVID-19 than China and the United States, who have slammed their cities and economies shut. Even countries as culturally and politically distinct as Iran and Italy have experienced the same 30-day epidemic growth curve flattening, as have the others.
3. The cost per death averted from these social distancing measures exceeds $300 million per life prolonged, far greater than the U.S. government’s own valuation of an American life at approximately $7-9 million per life.
4. The Children’s Hospital of Los Angeles, where the poorest, sickest, and frailest children in the United States are treated, has seen no deaths and only one case. If this virus is as lethal to anyone outside of the typical influenza risk groups (frail elderly, multiple comorbidities, poor lung function, etc.) as people claim, we would have already seen many more cases.
South Korea implemented the most comprehensive viral testing and contact tracing in the world. The COVID-19 epidemic peaked in South Korea at the beginning of March and, through today, has had 131 COVID-19 deaths. While 131 deaths are alarming, let’s put that in perspective: That is 2.3 deaths per one million Koreans from a respiratory illness that, like the flu, can end in fatal pneumonia.
Thus, this so-called COVID-19 pandemic would have barely registered among the 170 per one million deaths in the United States from flu and pneumonia. Unfortunately, nowhere in the world were there adequate test kits ready to detect and trace the rapid path of this global pandemic. The lack of statistically valid testing and the absence of serological/antibody testing has led to many false conclusions by physicians untrained in the science of epidemics.
All COVID-19 deaths are tragic. Yet, for every frail or chronically ill person (regardless of age) with underlying medical conditions (whether known or unknown) who succumbs to COVID-19, there are hundreds of people, mostly younger, healthier students and working age adults who will have their lives ruined for months or perhaps years by the economic collapse ostensibly created to control the epidemic. We estimate that the economic disruptions will destroy many more lives than the social distancing and economic shutdown would save.
Moreover, our econometric models, updated daily, are showing that new COVID-19 case reports and death reports are slowing drastically everywhere except in the United States, where there are greater variations in state-level test kit availability and significant delays in case reporting capabilities. We project a crest in U.S. reported cases and deaths in the next 3-4 weeks with COVID-19 mortality substantially lower than that for a typical influenza season (although total flu and pneumonia deaths may rise slightly).
It is disappointing that the public officials who implemented these drastic social distancing and economic shutdown measures show such extreme concern for slowing the epidemic without understanding the enormous price that all citizens and residents are already paying. They have resorted to the most expensive, intrusive and wasteful methods to try to flatten the infection curve, without any evidence that such measures work.
The Netherlands encourages its young people to mix socially, work and recreate normally, and create herd immunity while using social isolation measures only for those at highest risk (i.e., elderly with comorbid conditions and the immunocompromised). In the United States, some medical professionals already encourage such measures for chronically immunocompromised individuals, such as those undergoing chemotherapy.
Korea uses aggressive contact tracing to find and isolate known cases, but no social isolation measures for the general public. Both of these approaches are more effective and orders of magnitude less expensive than sending everyone home and shutting down the economy. This is public policy by panic.
• Joel W. Hay is a professor at the University of Southern California (USC) School of Pharmacy and at the USC Dept. of Economics (by courtesy). Cynthia L. Gong, is an assistant research professor at the USC Keck School of Medicine.
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