As a family clinic RN, I’m considered a front-line healthcare worker in the COVID-19 pandemic. Some of my responsibilities include triaging phone calls from concerned (read, panicked) patients wondering if they have the virus, monitoring our clinic’s quickly dwindling supply of PPE (personal protective equipment), and taking shifts in our hospital’s COVID-19 testing clinic. Many people have asked me, as an RN directly involved with COVID-19, for my opinion on the pandemic and how it’s being handled. I generally share two observations: (1). Officials have mismanaged the pandemic—it’s government decisions that have crippled our economy, not COVID-19—and (2). our nation has a penchant for panic that’s unwarranted and unhelpful in the moment.
Surgical Strikes, Not Mass Quarantines
I agree with several other healthcare professionals when they write that the federal and state governments’ approach to “flattening the curve” of COVID-19 spread is ineffective and will ultimately lead to more fatalities than more precise measures would have. Dr. David Katz, president of True Health Initiative and the founding director of the Yale-Griffin Prevention Research Center, argues in The New York Times that the nation needs “surgical strikes” against Coronavirus, not widespread quarantines. (To be fair to President Trump, his recent statements about re-opening businesses by Easter have been more in line with what Dr. Katz argues here, and for what it’s worth, I’d hoped President Trump would be successful.)
Dr. Katz states the current approach is preventing herd immunity from taking effect by universally forcing people to stay away from each other instead of letting the young and healthy catch the virus, develop immunity, and thus protect the most vulnerable (a similar approach to how vaccines work). The vast majority of people with COVID-19 develop a mild to moderate cold and recover without any medical intervention.
With most severe COVID-19 infections and deaths occurring in those over age 60, Dr. Katz writes, it makes little sense to send college students who have not been tested and may be carrying COVID-19 asymptomatically home to spend long periods of time with their 50-something parents and their 60–80-something grandparents—all of whom are more likely to have complications and die from the virus, and would have benefited from separation from their younger family members. Dr. Katz predicts that without a shift in policy aimed at protecting the most vulnerable instead the entire US population,
The path we are on may well lead to uncontained viral contagion and monumental collateral damage to our society and economy.David Katz, “Is Our Fight Against Coronavirus Worse Than the Disease?” The New York Times, March 20, 2020.
Related to the actual fatality rates of COVID-19, two professors of medicine at Stanford published an editorial in the Wall Street Journal (article behind a pay wall) criticizing the presentation of the fatality rate from COVID-19. They argue that “selection bias in testing” has led to a fatality rate based on confirmed positives, instead of a fatality rate based on the actual infection rate.
Kansas, for instance, has a complex set of testing requirements, including specific symptoms that must be present, and we do not generally test patients who had those symptoms but have since recovered. Like many other major cities, areas of Kansas City have ceased testing now that community spread is rampant. What this means, though, is that the fatality rate is inflated because our number of confirmed cases is far lower than actual infections. Some patients carry the virus asymptomatically while others were simply never tested due to the scarcity of tests, rapidly changing testing criteria, or because their symptoms were too mild to meet the criteria. The authors note that South Korea performed widespread testing and thus had a far lower fatality rate. They write that the amount of data being gathered on actual infections can transform our understanding of COVID-19’s kill rate:
it could make the difference between an epidemic that kills 20,000 and one that kills two million. If the number of actual infections is much larger than the number of cases—orders of magnitude larger—then the true fatality rate is much lower as well. That’s not only plausible but likely based on what we know so far. . . . If our surmise of six million cases is accurate, that’s a mortality rate of 0.01%, assuming a two week lag between infection and death. This is one-tenth of the flu mortality rate of 0.1%. Such a low death rate would be cause for optimism.Eran Bendavid and Jay Bhattacharya, “Is the Coronavirus as Deadly as They Say?” Wall Street Journal, March 24, 2020.
Dr. Deborah Birx, a member of President Trump’s Coronavirus Task Force, recently issued a similar warning against accepting models predicting mass COVID-19 fatalities because of insufficient data. Is there cause for concern that our healthcare system will be inundated in some areas of the country? Yes. Does it merit the panic and fear that seem to have taken hold of the American people? Absolutely not.
Threats to Life Are Nothing New
Undoubtedly, our whole nation—indeed, much of the world—has experienced the tension surrounding the COVID-19 pandemic. Some of you may have given in to the panic that spread so quickly two weeks ago, and some of you may be living huddled in your homes, wondering if your family will make it through this outbreak. But this isn’t the first time humanity has faced a new threat to our lives and welfare, and it won’t be the last. Erik Larson in his newest book The Splendid and the Vile paints a picture of the atmosphere in WWII England as people worried about German bombings and invasion:
[Writer Rebecca] West recalled how people sat in chairs among the roses, staring straight ahead, their faces white with strain. “Some of them walked among the rose-beds, with a special earnestness looking down on the bright flowers and inhaling the scent, as if to say, ‘That is what roses are like, that is how they smell. We must remember that, down in the darkness.’” But even invasion fears could not wholly obliterate the sheer seductiveness of those late spring days. Anthony Eden, Churchill’s new secretary of war—tall, handsome, and as recognizable as a film star—went for a walk in St. James’s Park, sat on a bench, and took an hour-long nap.Erik Larson, The Splendid and the Vile (New York: Crown, 2020), 46.
The Gospel Coalition highlights a short response from C.S. Lewis regarding the atomic bomb in WWII England, challenging readers to replace each instance of “atomic bomb” with “Coronavirus”:
This is the first point to be made: and the first action to be taken is to pull ourselves together. If we are all going to be destroyed by an atomic bomb, let that bomb when it comes find us doing sensible and human things—praying, working, teaching, reading, listening to music, bathing the children, playing tennis, chatting to our friends over a pint and a game of darts—not huddled together like frightened sheep and thinking about bombs. They may break our bodies (a microbe can do that) but they need not dominate our minds.“On Living in an Atomic Age” (1948) in Present Concerns: Journalistic Essays
COVID-19 can be a deadly virus for high-risk individuals (defined as those over age 50 and/or whose health is compromised already), and we should take it seriously. If you’re in the high-risk category or have a family member who is, take appropriate precautions. But Larson and Lewis remind us that life still goes on—our responsibilities to our families and those in our care do not stop, our spiritual leadership is not on pause, and the need for relaxation, leisure, and good old fashioned hard work hasn’t gone away. As Christians, let’s not live as people given to fear and panic, but as those who have been given a spirit of power, love, and a sound mind (2 Timothy 1:7), as those who enjoy hope in Christ and who can offer peace and encouragement to those in our community that no government intervention could ever provide.