Getting Utah Back to Work
Later this month we need to start putting Utah back to work. We’ve slowed COVID-19’s spread but at huge cost both to individuals and businesses.
Some early warnings about COVID-19, based on very little data, predicted an impending apocalypse. As more data has accumulated, those predictions are being scaled back dramatically.
Neil Ferguson of the Imperial College London is the scientist whose apocalyptic virus forecasts helped inspire aggressive measures by authorities in the U.K. and the U.S. On March 16 he co-authored a widely-read report which described COVID-19 as “a virus with comparable lethality to H1N1 influenza in 1918” which the federal Centers for Disease Control estimates killed 50 million worldwide.
Ferguson forecast as many as 2.2 million Americans and 510,000 British deaths. News media in both the U.K. and the U.S. rose to the occasion: nothing sells news like impending doom. Panicked politicians couldn’t be seen, doing nothing — and mandated lockdowns followed.
Last week with more data in hand, Ferguson told parliament that the virus death toll could end up being “substantially lower” than 20,000 in the U.K., with most of those fatalities among people who would have died later this year anyway.
Ferguson said these deaths “might be as much as half or two-thirds of the deaths we see because these are people at the end of their lives or who have underlying conditions.”
These revisions are beginning to make COVID-19 look a lot like seasonal flu. For example, the Centers for Disease Control estimated that 80,000 Americans died in 2018 as a result of that year’s flu.
Interestingly, the National Institutes of Health estimates that only about 12,469 deaths occurred in the United States due to 2009’s H1N1. The relatively lower number of H1N1 deaths illustrates a very important difference between H1N1 and COVID-19. The NIH explains that 87 percent of H1N1 deaths were children and adults under age 65, while deaths for those over age 65 were only one-fifth of those in a typical seasonal flu.
While it’s too early to project COVID-19’s impact by age group with certainty, preliminary data indicates that COVID-19 is having a disproportionate impact on those over age 65.
Data from China shows a sharp increase in fatalities with increasing age, culminating in a 14.8 percent death rate for those over age 80. In contrast, China had no child fatalities and the death rate began to climb significantly only for those over age 40.
In hard-hit Italy, the average age of those who’ve died is 81. Incomparably inflicted Spain, two-thirds of deaths have occurred for those over age 80.
Further, we have a variety of data showing that many who test positive for the virus nonetheless feel fine and have no symptoms. For example, a majority of NBA players who tested positive were symptom-free.
We can be certain that large numbers of people worldwide who have not been tested have the virus and therefore fatality percentages being reported so far are too high, likely by as much as a factor of two or more.
Given all the above, my recommendations likely will differ from what you’ve been reading elsewhere, but are surprisingly similar to those provided by the Southwest Utah Public Health Department.
Government-imposed lockdowns have slowed the coronavirus spread, mitigating a peak in COVID-19 cases that would otherwise overwhelm our hospitals with the exception of a few densely populated hot spots like New York.
Closer to home, Utah Gov. Herbert has asked residents to “Stay Safe, Stay Home” until April 13th. I’m okay with that, but then – barring a sharp upturn in our state – it’s time to get back to work!
If you are under age 40 without other risk factors, it’s flu season: nothing more, nothing less. Cover your cough, don’t shake hands, wash your hands regularly and avoid those with symptoms. There is no COVID-19 vaccine but less than half the country bothers to get a flu shot each year anyway, in spite of extensive publicity.
For those between ages 40 and 65, “you pays your money and you takes your chances.” Individuals in this age range should be free to make their own decisions with government support for those who choose to isolate.
As for us older folks, “keep on keeping on.” Stay home and away from others to the extent possible. You’ve had plenty of practice by now. And tell your family in the Wasatch Front to stay there and keep COVID-19 up north no matter how much you want to see each other.
Isn’t my recommendation flying in the face of medical professionals who recommend locking us all down? Public health officials and doctors provide guidance to save every possible life without regard to the cost. But government leaders and the public need to find a balance when so many are affected so dramatically.
We didn’t shut down the country in 2009 for H1N1. Yet for those under age 65, H1N1 was more likely to be serious than is COVID-19. So let’s get Utah back to work!
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Mr. Sierer,
Though your article is compelling and charmingly written, your proposal is reckless. Though the disease is most dangerous to the elderly and to those with chronic diseases, it can still strike badly and dangerously with a case mortality much worse than flu among the middle-aged and otherwise healthy. Furthermore, it is more contagious than H1N1 and *far* more contagious than the seasonal flu, and though it is appalling that only ≈37% of American adults are vaccinated for the flu each year, that factor still makes a great difference. The number of middle-aged people who would require hospitalization would itself strain the medical system––not to mention that young people and healthy people interact with old people and weaker people. They share communities, houses, and grocery stores with them. If e.g. a healthy, middle-aged woman goes back to work, she can no longer share a bedroom with her hypertensive husband, nor can she drive her immunocompromised daughter to school, nor can she even spend time in the kitchen. Few families are rich enough that they can conveniently segregate the family into halves that never meet. Finally: we don’t know enough about this virus yet. We do not truly know how it spreads or what precautions––besides social distancing––are effective. Yes, prolonged distancing is economically ruinous. A rampant plague is economically catastrophic, socially transformative, and wildly lethal. I would sooner have my children grow up poor than have them grow up without their grandparents, without the old folk of my church. I would sooner have them grow up poor than rich with blood-stained money.
I invite your reply. I hope dearly that I am wrong: that we can go back to work without catastrophe. However, I do not believe it is so.
Respectfully yours,
Ian Johnson
Thanks for your thoughtful comment. Please note that I recommend that all of us take the precautions we would take during any flu season. Reasonable precautions would address the special situations you offer as examples relating to those who are particularly vulnerable. In particular, I recommend caution for those ages 40-65 and continued isolation for those over age 65. Please note that my recommendations are more restrictive than those of the Southwest Utah Public Health Department whose recommendation to return to work is made without regard to age. (See the hyperlink in the column.) If you feel strongly about your concerns, I suggest you contact the SUPHD.
I agree with Howard that we need to get to work. The numbers just aren’t adding up for these restrictions to be put in place (or to continue as they are). As of last week for every death “linked” to Covid 19, 100 people lost their job. Is the cure worse than the virus? Ian and Josh, once the restrictions are lifted the virus will still exist. How long do you plan on hiding from it? I have a friend with an auto immune disease who contracted the virus several weeks ago. His symptoms have been no worse than the common cold. He has a wife and several kids and other family whom he has come in close contact with and none of them are showing any symptoms. As I asked before, is the cure worse than the virus?
P.S.: You note that “Ferguson forecast as many as 2.2 million Americans and 510,000 British deaths. News media in both the U.K. and the U.S. rose to the occasion: nothing sells news like impending doom. Panicked politicians couldn’t be seen, doing nothing — and mandated lockdowns followed.
Last week with more data in hand, Ferguson told parliament that the virus death toll could end up being “substantially lower” than 20,000 in the U.K., with most of those fatalities among people who would have died later this year anyway.”
He forecast “as many as…510,000 British deaths,” but he also forecast as few as ten thousand deaths. The range of estimates was due to the range of possibilities: it was not yet clear whether social distancing protocols would be implemented. Now that social distancing has been implemented for the medium-term future, it is toward the lower figure because social distancing saves lives. The revision is not a sign of the model’s weakness, but of its strength.
Thanks for your thoughtful comment. As has happened throughout the pandemic, news media and politicians immediately react to the highest number in any forecast, making it the only number most of the public sees. Hand wringing and overreactions are the result. Ferguson would have been well advised to wait a week to publish since governments reacted to his worst case. I have little doubt that Trump’s forecast of 240,000 American deaths is made so that when the actual count turns out to be less, he can claim that his administration’s actions saved many thousand lives.
Imagine suggesting that we should increase the death toll just to have some more economic stability. This is a reckless and dangerous article, and shows that some people care more about generating capital than actual people.
The author of this article is not a leading medical expert, yet is proposing we trust his optimism over the healthcare professionals who are telling us hundreds of thousands of Americans are going to die from this disease. Ignoring these estimates is simply not a risk we, as a country, should even entertain. Yes there are going to be hardships ahead, but how dare anyone suggest that the old and sickly should take one for the team and risk their lives all so the rest of us can have a bit more prosperity?
America is the wealthiest country on Earth; we will get through this and we can get through it without having to sacrifice the lives of our fellow countrymen.
Josh, my reply to your comment got posted as a separate comment. See below.
Josh, if you believe my recommendations are “reckless,” you should be appalled at even more sweeping “get back to work” recommendations from the Southwest Utah Public Health Department that can be accessed here:
https://swuhealth.org/covid/
The department’s recommendations are similar to ones they would issue for the seasonal flu and don’t even contain the same caveats that I recommend for older people. I don’t fashion myself as “a leading medical expert” and instead defer to those who are with a little more caution than they advise. You got completely carried away with your statement that “the old and sickly should take one for the team,” when I l clearly recommended just the opposite.
If you feel as strongly as you indicate, I recommend that you contact the SUPHD with your epidemiological insights and get them back on track.
The Southwest Utah Public Health Department only says that it’s currently okay for Utahns in southern Utah to continue working given the current number of cases in South-West Utah (40 at the time of this comment). This is not the same thing as saying Utahns should “get back to work” – meaning businesses that have voluntarily closed or laid off employees should reopen and/or bring employees back. On the contrary, the state of Utah suggests staying home as much as possible.
https://coronavirus.utah.gov/stay-at-home/
“Getting back to work” is the opposite of staying home wherever possible. For example: if restaurants were to bring back their servers and reopen dining areas, well this would only promote an increase in social contact and cause a faster spread of the virus. We are supposed to be flattening the curve, not spiking it.
Again, the SUPHD recommendations are based on the current amount of COVID-19 cases in southern Utah (40). Since this number is only going to increase due to the exponential nature of the virus seen literally everywhere else, this recommendation can and will likely change.
So I’m perplexed how you can even suggest we should decrease social distancing measures by “getting back to work” when the apex is still ahead of us. We all have a social responsibility to slow the spread and flatten the curve as much as possible so our healthcare system isn’t overloaded. We have a limited number of ICU beds and respirators; once these are all occupied then decisions have to be made about who lives and who dies. This situation is PREVENTABLE if we keep social contact to a minimum. Our civic duty vastly outweighs our economic duty right now.
The reason the numbers are lower is because social distancing work. I recommend you study the effects of the 1919 pandemic where when they relaxed their distancing, a 2nd wave hit that killed more than the first wave. Those who don’t know history are doomed to repeat it. There is enough evidence from Italy, NY and Seattle that validate the models. This proposal is in effective will for all intents and purposes be killing people.
Nowhere do I advocate abandoning social distancing. A prudent combination of social distancing and getting people back to work will accomplish both purposes. We’re seeing peaks in COVID-19 in several cities now thanks to social distancing and most forecasts show the country as a whole will peak later this month.
Shutting down the economy for months would eliminate the effects of virtually all communicable diseases. The annual seasonal flu has killed 37,000 people on average each year for the past decade in this country. Should we shut down the economy for four months every year starting in December? Apparently from your perspective, to do otherwise would “for all intents and purposes be killing people.”
You realize this is a pandemic which is not the same thing as seasonal illnesses?
https://www.cdc.gov/flu/pandemic-resources/basics/about.html
You are only looking at the current amount of deaths, as of right now, and are ignoring every other variable that makes this a big deal.
Edwin, my reply was posted as a separate comment below your comment.
Yes, I realize full well that COVID-19 is a “big deal” and different than the seasonal flu. That’s why I’ve addressed it in my columns. But so was the 2018 seasonal flu that killed about 80,000 Americans. I’m not looking only at the “current amount of deaths.” I am looking at the highly-regarded University of Washington’s Institute for Health Metrics and Evaluation forecasts for needed hospital beds, ICU beds, ventilators and deaths. Their latest forecast is for 81,766 deaths, certainly a “big deal” and as I said, similar to 2018’s virulent seasonal flu.
By the way, this year’s seasonal flu had killed over 20,000 Americans as of the end of February. Read much about that lately?