The Doctor is in the VFM House

The Doctor is in the VFM House!
The View from the Middle

I’ve shared with you before that a brilliant doctor who just happens to be a friend of mine is also a faithful reader of The View From the Middle. He occasionally calls me with comments on my articles, especially those that have any kind of healthcare theme. He recently called me about my coverage of the Coronavirus and we talked at length about almost every aspect of this virus. I was amazed at how much we agreed on, but he also had one warning that he asked me to convey.

He agreed with my statement that no matter whose numbers you believe, 99.9% of America with survive this virus. Many, in fact, will have mild symptoms and a large number (we don’t know how many yet for obvious reasons) will be asymptomatic or display no symptoms at all. The fact that many will exhibit mild to no symptoms is both a blessing and a curse. The blessing is obvious, but the curse is that these asymptomatic people can transmit this virus to a more vulnerable portion of the population, and that was his biggest concern.

The difference in the projected mortality rate for the Covid-19 has been absolutely amazing. In the beginning, Dr. Anthony Fauci suggested that the overall mortality rate for this disease was one percent, which also meant that 99% of those infected would survive. Recently that mortality rate has been lowered to 0.1% to 0.5%, depending on which expert you listen to. There are, however, groups of people who are at a much higher risk from this virus.

At first look, it appears that the higher mortality rate is driven by age. The death rate, for example, for people over 80 years old who contract this disease is almost 15% according New York City Health. For people between 70 and 79 it is 8.0% and for those between 60 and 69 it falls to 3.6%, which is still a pretty big number especially when I consider that I’m in that group.

But when you dig a little deeper, it is underlying health issues that lead to this increased death rate. In this same study, it was demonstrated that a healthy person that was 75 years old or older had the same likelihood of dying as a person between 18 and 44 years of age. The underlying conditions that this survey listed were cardiovascular disease, diabetes, chronic reparatory issues like asthma, hypertension and cancer. A 75-year-old without any of these pre-existing conditions, however, is almost as rare as a unicorn.

My good friend the doctor’s point is a good one. This virus is about twice as contagious as the seasonal flu and for people with underlying health issues it is much more likely to be fatal. With that in mind, many of the mitigation actions that we are taking like washing our hands more often, cleaning commonly used surfaces and social distancing are a small price to pay to protect this more vulnerable slice of our society. My friend even suggested that wearing a mask is worth the inconvenience, and he suggested this knowing that I am not a big mask wearer. I guess I’m going to have to rethink that stance.

He did agree, however, that we also need to open up our economy. As President Trump said, “the cure cannot be worse than the disease” and there will come a time when the financial, emotional and even physical damages to our people from our lockdown will exceed those of the Coronavirus. We must open up this country to save our small business owners and workers, but we must do so with an eye on protecting the most vulnerable in our country. We can do both things at the same time, and in fact, we MUST!