What America lacks right now is a plan as we veer into one reaction to this pandemic after another.
I am not an epidemiologist so I offer no professional opinion on just what that plan should be.
But, if you haven't yet read the
op-ed in the NY Times by David Katz of Yale University, you should.
An excerpt:
The data from South Korea, where tracking the coronavirus has been by far the best to date, indicate that as much as 99 percent
of active cases in the general population are “mild” and do not require
specific medical treatment. The small percentage of cases that do
require such services are highly concentrated among those age 60 and
older, and further so the older people are. Other things being equal,
those over age 70 appear at three times the mortality risk as those age
60 to 69, and those over age 80 at nearly twice the mortality risk of
those age 70 to 79...
The experience of the Diamond Princess cruise ship,
which houses a contained, older population, proves the point. The death
rate among that insular and uniformly exposed population is roughly 1
percent...
The clustering of complications and death from Covid-19 among the elderly and chronically ill, but not children (there have been only very rare deaths in children),
suggests that we could achieve the crucial goals of social distancing —
saving lives and not overwhelming our medical system — by
preferentially protecting the medically frail and those over age 60, and
in particular those over 70 and 80, from exposure...
If we were to focus on the especially
vulnerable, there would be resources to keep them at home, provide them
with needed services and coronavirus testing, and direct our medical
system to their early care. I would favor proactive rather than reactive
testing in this group, and early use of the most promising anti-viral
drugs. This cannot be done under current policies, as we spread our
relatively few test kits across the expanse of a whole population, made
all the more anxious because society has shut down.
This
focus on a much smaller portion of the population would allow most of
society to return to life as usual and perhaps prevent vast segments of
the economy from collapsing. Healthy children could return to school and
healthy adults go back to their jobs. Theaters and restaurants could
reopen, though we might be wise to avoid very large social gatherings
like stadium sporting events and concerts...
A pivot right now from trying to protect all people to focusing on the
most vulnerable remains entirely plausible. With each passing day,
however, it becomes more difficult. The path we are on may well lead to
uncontained viral contagion and monumental collateral damage to our
society and economy. A more surgical approach is what we need.
