This is the column that former UnitedHealthGroup general counsel Kevin Roche has sought to place in the Star Tribune under the heading STOP THE ECONOMIC SUICIDE. The Star Tribune has refused so far to accept the ad or to offer a comprehensible explanation. Kevin writes:
A variety of extreme measures completely upending our economy and the lives of every American, including threatening job loss to tens of millions, mostly low-income workers, have been taken in response to the coronavirus. These measures have been taken in light of a feared worst-case effect of the virus and with no balancing of the harms the measures are themselves causing. It is time to have a real discussion about what the appropriate measures should be.
First, we need to be more realistic about the actual threat of this virus. We all have coronaviruses present in our daily lives, so they are not some new threat. While this coronavirus appears more virulent, particularly to the elderly and those with pre-existing health conditions, it is clearly a minimal threat to the vast majority of the population.
The best evidence of the threat the virus poses is found by the unintended experiment of the Diamond Princess cruise ship. There were over 3700 passengers and crew on the vessel. Everyone of them undoubtedly had constant, heavy exposure to the virus in close quarters. Using gold standard testing, less than 20% of the 3711 people were positive, meaning they were actually infected. And out of those positive tests, a little over half were actually symptomatic. 8 people died, or about 2% of those with symptoms or .2% of percent of the vessel population. The cruise ship population skewed older than a general population and was therefore more susceptible and obviously had far more contact with the virus than the general population will.
These are very encouraging numbers when you consider the extensive exposure to the virus on the ship, which is completely unlike all our daily living situations. In the real world, this means a very large percent of people won’t become infected even if exposed to the virus, of those exposed, well under half will have any symptoms, a very small percent will become seriously ill and the fatality rate of those infected will be down in the one-half percent range or less. This is the most realistic picture we have of the actual effect of the virus. You cannot trust other percents or numbers you see because, unlike the cruise ship, we have not tested the entire population, but logic tells us that the numbers will be smaller in the real world. The average person has basically a zero chance of having a serious illness from the virus, even if they were in heavy contact with it.
So the threat is actually low, consistent with a serious flu year. Yet we are rushing into relatively severe reactions with the goal of virus suppression, reactions that are wreaking economic havoc. You should all go to the CDC website and look at the timeline for swine flu in 2009-2010, look at the details of the reaction to that epidemic. Even though it caused widespread illness and deaths in children, unlike coronavirus, there was no substantial number of school closures, no shutdown of the economy, no declaration of any national emergency until ten months after the epidemic began, and then only for limited purposes.
And what are the harms from the actions we are taking? Unlike the uncertainty around the exact toll of the coronavirus, we know for a certainty what the economic and health toll of the economic lockdown will be. Already, whole sectors of the economy have shut down, leading to loss of tens of millions of jobs, homelessness, lack of food, lack of access to health care. We are talking about a recession far more severe than the great recession we endured in 2008 and 2009. Even an average recession has been shown to lead to increased suicides and excess deaths from lack of health care and stress-induced exacerbations of illness. And low-income citizens are disproportionately affected.
The real tragedy is that all these efforts to completely suppress the virus are likely futile. Like the influenza virus, coronaviruses, including this variant, are here to stay. While it makes sense to attempt to limit the surge in demand on the health system, continued suppression efforts only spread the economic pain out further and further, without creating any meaningful overall decline in the eventual total number of illnesses and deaths. A far more reasonable strategy, and one which was used with swine flu, would be to mitigate the effects, protect the most vulnerable but not intentionally inflict massive economic damage that has health and other effects far worse than the virus itself, and that weakens the ability of society and government to respond.
We need to immediately embark on a different course, before the damage we inflict on ourselves is beyond repair. Open the schools. Let bars and restaurants open. Encourage stores to be open. Encourage businesses to keep employees and get them back to work. Continue to mandate careful hygiene. Continue testing and enforce quarantine of the infected. Close senior residences to visitors, keep their staff infection free, and take other steps to protect vulnerable populations. And people who have reason to fear becoming infected or are just afraid to go out in public can stay home, that should be their choice. But locking down the economy is too severe a harm to be justified.
So we should call on Governor Walz, our legislators and other political leaders, to consider that they are only delaying, that is right, not preventing, only delaying, the loss of a few lives, while promulgating measures that likely will lead to, indeed have already led to, enormous job losses and financial ruin, creating widespread anxiety and emotional distress. Our leaders need to do what they are supposed to do—consider what is THE GREATEST GOOD FOR THE GREATEST NUMBER of people, or put another way, DO THE LEAST HARM. Don’t be afraid of being accused of not taking extreme actions to save lives from the virus, if you know that the actions that have been taken are wreaking far more havoc on the citizenry.
And all of us need to force a real discussion and debate on what the appropriate actions should be. No one person, for any extended period of time, should have the right to unilaterally impose such severe measures? The Governor should immediately call the legislature into session; there should be hearings in which those whose lives are being so substantially affected can testify, and the legislators should make their decisions based on what their constituents ask them to do and what they know does meet the criteria of the greatest good for the greatest number. So call and write the Governor, call and write your legislators and insist that your voice be heard. And get accurate information about what the risks from the virus really are and demand that you hear accurate information about the consequences of the economic lockdown.
For those who are suffering from the consequences of the economic lockdown, share your story at #thecureisworsethanthedisease so people know the real-life tragedies that are occurring to millions of households that live paycheck-to-paycheck. And if you want to get more information and help encourage this debate, go to www.commonsensecommongood.com. Thank you all.
Kevin Roche’s personal site is The Healthy Skeptic.
UPDATE: Kevin advises that the Star Tribune accepted his ad this morning (“not sure why”). It is to run this coming Saturday.