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I do some work for a national corporation that provides various consulting services for medical practices and other medical businesses all over America. We had a big Zoom meeting today, with an update on COVID-19. This corporation has spent an enormous amount of time and money tracking COVID data, partially to assist their clients with planning and management of the crisis, but also to look for business opportunities in all this chaos. I will not share the name of the company, because this meeting was not public. But I’ll share some of their findings because they’re in the public domain and I find them remarkable.
First, the speaker pointed out that physician retirements are way up, and they anticipate that, by the end of 2020, thousands of physicians who were not expected to retire yet will do so. The quarantine has also limited the training of medical students and residents, so there may be a doctor shortage for some time. Also, since we’ve cut way back on joint replacements, MRIs, cosmetic surgeries, bypasses, and so on, hospitals have taken a huge financial hit. He listed hundreds of American hospitals and other acute care facilities that are expected to close and not re-open. Naturally, he saw that as an upcoming opportunity in the market. But that’s his job. Anyway, that’s all interesting, but his death statistics were even more concerning.
If you track the number of American deaths from suicide, alcoholism, drug overdoses, homicide, and similar things, America has a certain number of deaths per month. Since COVID-19 started, we’re over our predicted number by 100,000–250,000 deaths.
We are also anticipating increased deaths from pneumonia, cancer, etc., because of delays in screenings, elective procedures, vaccinations, delayed chemotherapy, and so on. That is a more difficult number to predict, but their best guess was 200,000–400,000 deaths more than would have been expected. Those numbers are large because these are very common causes of death, which is why we put so much time and effort into prevention and early treatment in those fields.
Or, at least, we usually do.
Heck, I had an elderly woman die of a bladder infection because she was scared to come into my office. She thought she was playing it safe, avoiding COVID-19 in a medical office. And a week later, she dies in the ICU of urosepsis. The week before, I could have fixed that with five dollars worth of antibiotics. But she didn’t call. Again, she thought she was playing it safe.
When we limit access to health care, things go wrong sometimes.
Let’s just take those two categories of deaths, and take the midpoint of each range. So, 175,000 additional suicides, drug overdoses, etc. Plus 300,000 additional deaths from pneumonia, cancer, etc., that might otherwise have been prevented. Together, that’s nearly a half a million avoidable deaths, caused by our response to COVID-19. 500,000 people are dead, which would not have been dead otherwise. 500,000 people. Dead. And they’re never coming back.
That’s equivalent to every man, woman, and child in Atlanta. If the Chinese nuked Atlanta and killed every resident of that city, we’d be peeved. But the Chinese didn’t do that.
Of course, sometimes drastic action is necessary. Which is why I never want to be president. But sometimes, some people must be sacrificed to save many more others. Life is messy.
So how many deaths have been prevented by our response to COVID-19? Probably some. I think. Although I’m really not sure.
Someone on the Zoom call asked that question, and the speaker answered that is was simply impossible even to guess at this point. And he’s right.
Many countries around the world have taken many different approaches to this, with varying levels of competence and compliance, and their death rates don’t seem to correlate to their response. So does national response affect death rates? I would think so. But based on the data we have, it’s really hard to say.
Ok, suppose we can’t figure out how many deaths from COVID-19 we’ve prevented. Fine. How about this – have we avoided more than 500,000 deaths? Perhaps. That’s possible.
But geez – I don’t know.
Note that none of this considers the economic devastation and emotional impact that this has had on hundreds of millions of people. A couple of weeks ago, a patient of mine died alone because the hospital wouldn’t let his wife in the room with him. All I could think was, “There had better be a [expletive] good reason for this…” And perhaps there is.
But geez – I don’t know.
And no one else knows, either. Our data is a mess. Lots of presumptions, guesses, and extrapolations. It will be years before we sort all this out. And we may never really know what happened.
I’m not criticizing our leaders, because they’re trying to make impossible decisions with faulty data. Good luck. I doubt I could do any better.
And I’m not saying that we should have ignored this virus. I’m just wondering how effective our response was. Again, I doubt I could have done any better.
But I predict that 10-20 years from now, when medical students are studying this episode, a lot of our responses are going to look pretty ridiculous in retrospect.
We’ve killed around 500,000 people. So far.
And for what? I’m not exactly sure.
Again, I can understand why these decisions were made, based on the information they had. And I certainly agree that the benefits may have outweighed the price we paid. Perhaps. That’s possible.
But geez – I don’t know…
I keep thinking of the ancient teaching of Hippocrates that is drilled through every medical student’s skull for years:
First, do no harm.Published in