Thursday’s unemployment update confirms that over the last three weeks, nearly 17 million Americans have been laid off because of the shutdown. That’s one-tenth of the nation’s workforce. It’s not just an economic fact. It’s a public health disaster. If the shutdown is dragged on, as many public health experts recommend, it is almost certain to kill more Americans than coronavirus.
The academics and public health officials who have concocted models of the virus’s spread are telling us that we have to continue the shutdown to save thousands of lives. But none of their models considers the deaths that will be caused by unemployment.
Before the virus hit, America’s unemployment rate was 3.5%, the lowest in 50 years. Now Goldman Sachs predicts unemployment could spike to 15% by midyear. A St. Louis Federal Reserve economist grimly predicts 32% unemployment — worse than during the Great Depression.
No model or guesswork is required to foresee the deadly impact. Job losses cause extreme suffering. Every 1% hike in the unemployment rate will likely produce a 3.3% increase in drug overdose deaths and a 0.99% increase in suicides according to data provided by the National Bureau of Economic Research and the medical journal Lancet. These are facts based on experience, not models. If unemployment hits 32%, some 77,000 Americans are likely to die from suicide and drug overdoses as a result of layoffs. Scientists call these fatalities deaths of despair.
Then add the predictable deaths from alcohol abuse caused by unemployment. Health economist Michael French from the University of Miami and a co-author found a “significant association between job loss” and binge drinking and alcoholism.
The impact of layoffs goes beyond suicide, drug overdosing and drinking. Overall, the death rate for an unemployed person is 63% higher than for someone with a job, according to findings in Social Science & Medicine.
Layoff-related deaths are likely to far outnumber the 60,400 coronavirus deaths predicted through August.
This comparison is not meant to understate the horror of coronavirus for those who get it and their families.
But heavy-handed state edicts to close all “nonessential businesses” need to be reassessed in light of the predictable harm to the lives and health of the uninfected.
The shutdown was originally explained as a way to “flatten the curve,” allowing time to expand health care capacity, so lives would not be needlessly lost in overwhelmed hospitals.
When the shutdown is lifted, cases will increase. And some epidemiologists predict the virus could return in a second wave this fall. But as President Donald Trump reported Friday, hospitals are ready now, supplied with ventilators, caregivers and beds. Some cities are now oversupplied. Even New York state, with half the cases in the nation, reports enough beds. Temporary bed capacity there provided by the U.S. Navy and the U.S. Army Corps of Engineers is largely empty and unneeded.
Trump’s social distancing guidelines expire April 30, suggesting the possibility of restarting parts of the economy shortly thereafter.
To make any reopening possible, schools should resume in most places, so working parents can return to jobs. Even in New York state, the coronavirus epicenter with almost half the deaths, only one child under 10 has died. Some 84% of fatalities in New York are people over 60.
When America faced a polio epidemic in the 1950s, schools were shutdown because polio disproportionately impacted children. It makes little sense with coronavirus, which usually spares the young.
On Tuesday, Trump [announced] a committee focused on how to reopen America for business. That’s a reassuring sign. It won’t be done by a flick of the switch. It will depend on testing, on accommodations employers make to help workers feel safe and on the confidence level of consumers who ultimately decide when it’s again safe to patronize restaurants and theaters.
The president’s public health advisers are saying the virus will “determine the timetable.” Mr. President, listen also to the silent majority, who will suffer most from an indefinite shutdown. It’s not just their jobs that are on the line. Their lives are, too.
That’s not the only unintended consequence of shutting down the country. Amanda Prestigiacomo:
Veteran scholar of epidemiology Dr. Knut Wittkowski, formerly the head of the Department of Biostatistics, Epidemiology, and Research Design at Rockefeller University in New York City, argued in a interview published earlier this month that shelter-in-place policies could actually result in more deaths in the long term.
The general argument made by Dr. Wittkowski is that lockdown orders prolong any efforts in developing so-called herd immunity, which is our only weapon in “exterminating” the novel coronavirus outside of a vaccine, and that could optimistically take longer than 18 months. Focusing on shielding the most vulnerable to the virus (our elderly and folks with comorbidities) while allowing the young and healthy to build up immunity would, in the end, save more lives, Wittkowski argued.
“With all respiratory diseases, the only thing that stops the disease is herd immunity,” the epidemiologist said. “About 80% of the people need to have had contact with the virus, and the majority of them won’t even have recognized that they were infected, or they had very, very mild symptoms, especially if they are children.”
“So, it’s very important to keep the schools open and kids mingling to spread the virus to get herd immunity as fast as possible, and then the elderly people, who should be separated, and the nursing homes should be closed during that time, can come back and meet their children and grandchildren after about 4 weeks when the virus has been exterminated,” he continued.
Herd immunity, Wittkowski argued, would stop a “second wave” headed for the United States in the fall.
“If we had herd immunity now, there couldn’t be a second wave in autumn,” he said. “Herd immunity lasts for a couple of years, typically, and that’s why the last SARS epidemic we had in 2003, it lasted 15 years for enough people to become susceptible again so that a new epidemic could spread of a related virus. Because typically, there is something that requires cross-immunity, so if you were exposed to one of the SARS viruses, you are less likely to fall ill with another SARS virus. So, if we had herd immunity, we wouldn’t have a second wave.”
“However, if we are preventing herd immunity from developing, it is almost guaranteed that we have a second wave as soon as either we stop the social distancing or the climate changes with winter coming or something like that,” added Wittkowski. …
Dr. David L. Katz, president of True Health Initiative and the founding director of the Yale-Griffin Prevention Research Center, writing at The New York Times on March 20, suggested our “fight” against COVID-19 could be worse than the virus itself.
“The ‘unique’ nature of COVID-19 — that it results in only ‘mild’ symptoms in 99% of cases and that it appears to only pose a high risk to the elderly — Katz contends, makes it particularly suited for a more strategic containment effort, rather than our current unsustainable, society-wide approach that threatens to upend the economy,” The Daily Wire reported at the time.
“The clustering of complications and death from Covid-19 among the elderly and chronically ill, but not children (there have been only very rare deaths in children), suggests that we could achieve the crucial goals of social distancing — saving lives and not overwhelming our medical system — by preferentially protecting the medically frail and those over age 60, and in particular those over 70 and 80, from exposure,” Dr. Katz explained.
“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,” he added.
Moreover, John P.A. Ioannidis, a professor at Stanford University School of Medicine with focuses on medicine, epidemiology, population health and biomedical data science, warned last month that we are working off incomplete data and potentially causing more harm in our response.
What happens as well when the next bacteria- or virus-caused illness outbreak proves to be resistant to all our germ warfare of the past couple of months? (Note the numerous studies that report that children who grow up with pets are less likely to get serious illnesses than those who live in homes without dogs and/or cats. We have two of each, by the way.) It is safe to assume that nature is cooking up something that could make the coronavirus look like the sniffles, and how we are treating the coronavirus might make us suspectible to the next bad thing.