COVID19 Pandemic: Government Should Use the New Data

We are in a shutdown because the government put us there. Back in February, we really didn’t know what COVID19 was capable to do. According to the news, there was a very high death rate in Italy and Milan (10%) which scarred almost all of us. It was definitely appropriate for the government to shut down the economy and try to contain this virus.

The government instituted rules for social distancing, and this did slow the rate of viral infections. The goal was to slow the rate so healthcare facilities would be able to take care of the sickest people. The goal was never to ultimately stop the spread of the virus. It is simply too infectious. The shutdown did achieve this goal, but should we be continuing to shut down and have all these restrictions?

Death Rates and Co-Morbidities

We now know that those people who get the severe sequelae of COVID19 and die are primarily those with co-morbidities. Almost 95% of all people who die from COVID19 infection are obese (50% increased risk if BMI is over 30) and/or have diabetes; are smokers with COPD (over 50% increased risk); have severe heart disease; or are immunocompromised, such as certain cancer patients.

It appears that if you are healthy, not overweight, and don’t have these preexisting problems, the chances of you dying from COVID are very rare. Thus, if you want to do something about decreasing your risk of dying from COVID19, get healthy. Lose the weight, exercise, and get fit, including cardiovascular fitness.

In addition, young people rarely are even symptomatic from COVID19 infections. They get the virus but quickly develop immunity to it to prevent them from becoming symptomatic. It has been theorized that this may be due to the fact that children have a rather larger thymus gland that activates T-cells to be more efficient. T-cells kill viruses. As you grow older and further into adult life, your thymus gland shrinks, and your immunity to viruses and bacteria gets worse, allowing the virus to overwhelm your immune system and cause the many problems COVID19 does.

We discussed rates of infection and fatality rates in the prior blog on this subject. Although incidence rates are rising, fatality rates are staying steadily low and possibly falling. Therefore, should we continue to shutdown America? Perhaps yes in certain areas and no in certain other areas.

Studies have shown the following:

  • 4 in 10 deaths occurred in nursing homes
  • Four of five deaths were Age>65
  • <1% of deaths were Age <35
  • 6% people w/COVID are hospitalized
  • 2% hospitalization rate in New York
  • Nursing homes saw 42% of all deaths from COVID19 (June 1)
  • Nursing homes are 1% of the population
  • 10 states accounted for 70% of COVID cases and 3/4th of deaths (May 11) (Badger and Micel’s analysis)
  • New York and New Jersey accounted for 35 percent of all cases and 44% of COVID deaths.
  • <1% of counties accounted for >50% of COVID deaths.
  • >60% of counties had <1% of deaths

Putting this into perspective, if <1% of those age <35 get the severe sequelae of COVID, they have an even greater risk of getting killed in an automobile accident. However, they still drive their cars. It’s a tragedy in both cases, but should we be stopping these people from working and have normal social activities with continued shutdown.

 

This is especially pertinent in in the 60% of counties in the U.S. that had <1% of the deaths. Their daily lives should not be interrupted with fears of severe COVID19 and government interventions that probably do very little toward the slowing of the spread of the virus in those counties. These comprise over 50% of the U.S. Remember the goal is to slow the spread, not to prevent the infections.

The government should indeed continue restrictions on nursing homes, especially in high risk areas, since COVID19 seems to cause the most fatalities in these facilities (40% of all deaths), yet they comprise only 1% of the population. With 80% of deaths occurring in people over 65, and most of these had co-morbidities, shouldn’t we be emphasizing actions to get these people more fit instead of only saying they need protection. Indeed, they should be extra cautious, but that’s not the only thing they should be thinking about.

Many states have low populations and the 10 states with higher populations had 70% of COVID cases. Total U.S. blanket restrictions should not be done, and each state should make its own decisions regarding restrictions for individual counties. But these restrictions should be reasonable and based on evidence, not just what a governor or mayor “thinks” is the correct thing to do. We need good responsible government and requiring government to make rules based on the most recent data on COVID19 is what is needed in all states.

Hydroxychloroquine and COVID-19

Studies have been mixed regarding the effectiveness of hydroxychloroquine (HCQ) and COVID19. However, the latest study confirms prior studies and suggests that HCQ, when given early and in adequate doses, can decrease the severity of HCQ by 39%. See recent blog articles on this to get the whole story, which also discusses the impact of continued closing the economy to the increased stresses that are consequences of this continued action.

Open Schools or Close Them?

This question plagues most ISD’s. Children are primarily asymptomatic when they acquire COVID19, but the fear has been that they could infect the older adults in the household with the virus. However, at least according to the WHO studies using cell phones for tracking cases, asymptomatic transmission of COVID19 is rare. Thus, this fear of transmission does not appear to be warranted.

In addition, by not allowing our children to get the virus when they are young we are preventing them from developing immunity to COVID19 while allowing the infection to be asymptomatic in them at a young age. Think of chicken pox. We expose children to chicken pox when they are young because when they get it when they are old, chicken can be a very damaging and fatal disease. COVID19 acts similarly, so we should take lessons from the chickenpox teachings.

Children also need the social interactions they get at school, and this has been a concern of many educators. In addition, internet schooling does not work for everyone and has been shown to be inferior to classroom education. We may be doing a disservice to our children’s education by continuing to close schools for fear they could transmit the disease to their elders.

Wouldn’t it be better for the elders and parents to take control of their lives, lose weight, eat right, exercise and get in better health to fight off the virus, rather than forcing a poorer education system on the kids?  Certainly elders should be protected, as the statistics above show, but they should also make a decision to follow the route to better fitness since this will also decrease a fatal outcome from COVID19, plus it will decrease their risk of developing chronic medical diseases too.

Comparison of the Flu and COVID

The WHO has stated that 35% of people with COVID19 are asymptomatic. There are very few cases of the flu that are asymptomatic. According to the WHO, the overall fatality rate is 0.5% when you include these asymptomatic cases. The fatality rate from the flu is around 1%, less than that from COVID19.

In essence, we are dealing with a virus that is even more benign less fatal than the flu. We don’t shut down the economy for the flu, we don’t require social distancing for everyone, we don’t’ require people to wear face masks for the flu, so why should the government pass rules on these and not do it for the flu. Doing so simply places extra stresses on everyone, and these may not be justifiable considering all the ramifications that these restrictions force on the people of the U.S.

Conclusion and Putting it All Together

To summarize, we have learned a lot about COVID19 and the information we now have should be used as evidence-based decisions are made by government officials instead of blanket restrictions that have no foundation to them. Should we go back to work, back to eating at restaurants, continue strict social distancing, mandatory face masking, opening up our schools? Evidence will help point the way.

We all are most likely going to get the virus at some time in the future, it does not seem to be going away. However, the more fit we are the less chance we will get the severe sequelae of the disease. Young people <35 are at low risk of the severe disease and fatalities, and children have even less. In fact, most kids are asymptomatic. The more they get the disease at an early age, the more likely they won’t develop the severe form when they get older, a benefit of youth.

We should protect those over the age of 65 and those with comorbidities. But we should also emphasize getting into shape, losing weight, and preventing any of us from getting the severe form of COVID19 even if we get the infection. If we do get it, consider getting on HCQ as soon as you can when you first become symptomatic to decrease the severity even more.

Instead of being afraid of this virus, we should look at the positive and fight it. It may be less severe than the fu. All of us have a choice to change our attitude about it and about how we want to tackle the problem. Having the positive attitude that we can fight this nasty COVID19 into submission is much better than simply fearing it.

 

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