Coronavirus: Our new Age of Heroic Medicine is going to kill us all
Trump is right: We can’t let our response to coronavirus echo the Age of Heroic Medicine when doctors routinely killed patients on the way to curing them.
During his Fox News town hall, Trump was explicit: He’s set Easter as his target date for taking America off of its coronavirus footing and reverting to business as normal. I was very pleased to hear that, and that’s not just because my retirement fund went back up a bit after some troubling days in the dumps. Trump’s rationale for setting a deadline is just right: It’s no use destroying America in the name of saving her.
Given the speed with which events are moving, in the 2.8 weeks between now and Easter, we should be differently situated. We’ll know whether chloroquine and azithromycin work. We’ll know whether any of the other 77 drugs a supercomputer identified as possible treatments might work. We’ll have seen the curve-flattening effect of various urban shutdowns. We’ll have seen people’s fundamental behavior changes (handwashing, sanitizing, social distancing) flatten the curve. We’ll have more masks to protect hospital workers and more ventilators to treat those who are ill. We’ll have more tests to give a better sense of the disease’s spread and mortality rate.
With all that knowledge and change coming down the pike, the important thing now is not to kill the patient, with the patient, in this case, being America. After all, turning America into an economic basket case brings soaring mortality rates too: depression and suicide, drug addiction, increased crime, possible famine, the breakdown of the medical system.
Also, just to keep perspective, remember that, as of now, neither America nor the world as a whole is suffering much:
As of this writing, the number of dead around the world is 14,730. Even if China, Russia, and Iran are lying about their mortality numbers, the actual number probably isn’t higher than 20,000. (And the number could be lower because Italy may have been overstating its mortality rate.)
For a global pandemic that started creeping around the world only 90 days ago, 14,730 is an inconsequential mortality number, equal to only 0.0002 percent of the world’s population. On average, this means that 164 people per day have died from coronavirus, compared to the approximately 151,600 people who die every day from all causes.
Even within the United States, the 400 coronavirus deaths, while all represent a personal tragedy, are inconsequential. During the approximately six months of the 2017-2018 flu season,
Overall hospitalization rates (all ages) during 2017-2018 were the highest ever recorded in this surveillance system, breaking the previously recorded high recorded during 2014-2015; a high severity H3N2-predominant season when CDC estimates that hospitalizations captured through FluSurv-NET translated into a total of 710,000 flu hospitalizations that seasons [sic].
Other sources estimate as many as 959,000 hospitalizations. Most sources agree that more than 61,000 people died from the flu.
Over six months that equals 338 people per day from a single cause. Can you imagine how the flu season would have played out if every newspaper and TV news show in America devoted time and space to tell us how many people had been hospitalized or died from the flu that day? People would never have left their homes.
Take away the media hysteria and there’s very little going on in America. Now, I’m not saying it wasn’t worth getting worried in the first place. It was the fear that put us ahead of the curve. Thanks to the fear, Trump closed the border, doctors and scientists around the world shared data, hospitals geared up for a patient onslaught, drug manufacturers cranked out more potentially useful medicines, American ingenuity brought out a reliable test kit very quickly, etc. Without the fear, we might indeed have had a pandemic. But as of now, we don’t.
Moreover, what’s going on in Italy, while bad, may prove to be a case of misunderstanding the virus’s mortality rate, not just in the general population, but in the elderly and otherwise compromised population. Willis Eschenbach looked at the Italian numbers and noted, as others have, that most of those who died were really old (over 90) and had two to three comorbidities. As he said, “One thing I learned on this voyage was that the Italians distinguished between dying FROM the virus on the one hand, and dying WITH the virus on the other,” although all were listed as coronavirus deaths. The other thing he notes is that the largest number of people of all ages seem to have caught the virus while in the hospital setting.
Of course, that information means that our health care workers really are in the riskiest place of all and they need the most protection. They need those N95 masks and any other protective gear available. But it also suggests that, outside of the hospital setting, the disease may be both less contagious and less severe. I wouldn’t bank my life on it, but it’s certainly suggestive data. And again, almost three weeks may help sort out that information.
Someone else pointed out something very important, and I think it reflects a change that needs to take place in America and take place soon — those Asian countries that have best controlled the virus are those in which people are already used to wearing masks in public. The masks won’t protect you from getting the virus but, should you unknowingly be infected, they will prevent you from spreading it. That’s a major curve flattener.
So all in all, the news is good. That means, therefore, that we are crazy to destroy the U.S. economy. And that’s where my reference to the age of heroic medicine comes in. For those of you unfamiliar with the phrase, it relates to a time when doctors used deadly “medicines” to treat patients: bleeding, mercury, arsenic, purging, etc. The more you treated the patient, the more likely you were to kill the patient. Currently, America can’t stand too much more “treatment” for a disease that, to date, has killed only 450 people over two months.
Anyway, that’s my two cents. If we want the American economy to recover, we need to:
- Sequester vulnerable people, not all people.
- Pour huge energy into protecting people in hospitals and old age homes, whether patients, residents, or caretakers.
- Wash our hands really well.
- Disinfect vector surfaces, if we can.
- Keep our hands away from our faces whenever we’re in a setting in which our hands might carrying the virus.
- Practice social distancing.
- If possible, wear masks in public to prevent the virus’s spread.
With those habits in place, we can route this disease. It’s not Armageddon. It’s nowhere close. It’s just another weapon in Nature’s arsenal, which is always aimed at us.
This whole thing reminds me of the old joke about the skinflint who went into the general store and announced that he was going to train his donkey to do without food in order to save money. When he returned to the store a month later, someone asked him how the training went. “It went great,” said the skinflint. “Every day I gave him less and less food. The only problem was that the darn donkey died before I could complete the training.”
