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Everybody is going to come into contact with the Wuhan virus at some point, unless the person chooses to live the life of a hermit, the virus is not likely to just disappear. Efforts to mitigate the transmission of the virus can at most delay contact with the virus, those efforts cannot prevent for all time contact with the virus.
The probability that a person not already living in a nursing home will have serious medical consequences from contact with the Wuhan virus is extremely small. Very few people who come into contact with the virus will suffer significant negative medical consequences.
Governments, businesses, organizations, and people have imposed or implemented many virus transmission mitigation efforts including closing businesses, schools, churches, public events, and social activities, preventing travel, forcing people to remain physically distant from one another, and building physical barriers to separate people from one another, including extra walls, face masks, etc. These virus transmission mitigation efforts have and will continue to impose significant costs on society and on individuals. “Costs” are not just monetary, but also medical, psychological, and social.
The early justification for strong virus transmission mitigation efforts was to spread out over time the number of people who had serious medical consequences from contact with the virus so that they wouldn’t all show up in the medical system at the same time. If we spread the transmission of this serious illnesses over time, the medical system would not be overwhelmed. But it now appears unlikely that the number of people with serious medical consequences from the virus will overwhelm the United States medical capacity.
Now I hear as justification for continuation and enhancement of those virus transmission mitigation efforts a need to “stop the virus.” Politicians and others speak as though the virus can be eradicated. But that’s an impossible goal. The virus now exists in so many places that eradicating it is not a possibility.
Other times I hear the justification is to “slow the spread of the virus.” What are the public health benefits of slowing the spread of the virus?
Politicians and media often use “total case count” or “active cases” numbers when justifying virus transmission mitigation efforts. But those numbers are almost meaningless from a public health standpoint. “Public health” is (or should be) about serious medical issues, not people testing positive for a virus that causes them no significant consequences. Such a small fraction of people who test positive (and thus become a “case”) have any significant health consequences that public health policies implemented based on the “total case count” or the number of “active cases” are not likely to be focused on the real health risks.
Slowing the spread of the virus may keep people who are likely to have serious medical consequences from contacting the virus until after a vaccine is developed, assuming an effective vaccine is developed. I recognize that several developers of vaccines are confident that an effective vaccine will be developed and widely distributed in a matter of months. But it also appears that a large portion of the population is likely to resist taking the vaccine. So, waiting for the widespread taking of a potential vaccine may not be the ultimate solution.
Doesn’t slowing the spread of the virus delay the time at which society achieves “herd immunity”? I understand there is a lot of uncertainty about the conditions at which “herd immunity” will be achieved. But isn’t “herd immunity” the ultimate long-term solution?
The early disease prediction models predicted millions of deaths would occur before “herd immunity” set in. Those models now seem inaccurate. There is some evidence that locations that did not impose some of the severe virus transmission mitigation efforts early on may now be achieving some type of “herd immunity.” Sweden is sometimes cited. Sweden is not representative of the rest of the world (Sweden has a small, relatively isolated genetically, culturally homogenous population with a strong social history), so results in Sweden might not be replicated elsewhere. But it’s a piece of information.
Many of us have mocked New York Governor Andrew Cuomo’s recent bragging about the reduction in Covid-19 deaths in New York as compared to the very high death rate in March and April. Some of us have even joked, “Of course the death rate is going down in New York. They already killed off the most vulnerable people early on.” Well, what if that joke is actually the truth? What if those people who died in the early days of the pandemic were going to die when they encountered the virus anyway, whether that contact was in April 2020, or would have been in October 2020 or in April 2021? Did Gov. Cuomo’s early policies really increase the total number of deaths in New York, or just cause them to be concentrated in time? Are our current efforts to mitigate virus transmission really preventing deaths and serious illness, or just delaying them?
I understand that politicians, heads of organizations, and especially media people are more concerned about tomorrow’s headlines than they are about real long-term consequences. But, I still think we should at least give some thought to the long term objectives of our policies. Isn’t the difference between preventing deaths and delaying deaths important in determining whether the costs of the social and economic shutdown and other efforts are really justified? The modelers at the University of Washington cited by @RushBabe49 advocated certain policies based comparing the numbers of deaths by December 2020. But, from a public health standpoint, how much does it really matter if a policy prevents a death from occurring in November 2020 if that death occurs anyway in January or February 2021? For statistical comparison purposes, cut-off dates generally need to be applied, but we shouldn’t totally ignore what happens after those cut-off dates.
See also the post “Covid-19 It’s Over, But How Do You Convince People That It’s Over? Part 2 by @Rodin just below here.
A few people have suggested that long term public health might be better served by policies that get us more quickly to “herd immunity” by letting the virus spread through the less vulnerable population (children, younger adults, the generally healthy even if older, etc.). Yes, there would be an increase in the number of recorded deaths. But, those deaths would likely occur anyway, just somewhat later. So wouldn’t we just be concentrating the eventual outcome into a shorter time frame, but then could allow society to resume operations without the costly virus mitigation efforts?
Current efforts to mitigate virus transmission will not ultimately prevent people from coming into contact with the Wuhan virus. And the people who are going to have adverse medical reactions to the virus are going to have those adverse reactions, whether now or in several months. So what is supposed to be the ultimate goal of these virus transmission mitigation efforts? What is the long-term justification for imposing the virus transmission mitigation costs on society and the people who make up our society?Published in