Stupid! Stupid! Stupid!

We see the signs of an imminent second pandemic: Reopening Economies.

A study recently released by two folks from the Hoover Institution at Stanford University suggest that increased COVID-19 testing is actually lowering the death rate. That’s simply true. Any time you increase the denominator (people who contract COVID-19) while holding the numerator constant (confirmed COVID-19 deaths), you lower the quotient (COVID-19 death rate). And, they argue with a lower quotient (death rate), the less we have to fear AND the more ill-advised the earlier decision to shut down the economy. In other words, we blew it.

This argument even calls into question our nation-wide attempts to flatten the curve (COVID-19 infections) by isolation and social distancing. Why bother, so the argument goes, in retrospect the new testing data shows we over reacted. Indeed, even Tucker Carlson now opines that COVID-19 is not deadly. How stupid have we been?

When I was in graduate school, we studied research methodology. I saw first hand how two aspiring doctoral candidates could agree on whether a study employed a reasonable methodology to arrive at its findings, yet completely disagree on the meaning of the reported data and findings—wildly disagree even. By the way, receiving a doctoral degree didn’t change this phenomenon. But hey, that’s what makes science a dialectic.

Our friends see their position reflected in all of the new (and better) data from increased testing are convinced the COVID-19 problem is really small—it always has been—and it’s getting smaller all the time. Our reaction has been disproportionately large and overblown causing real damage of another sort to our economy. That we may, in fact, have unintentionally murdered the goose that laid the golden egg.

Here’s my counterargument: Whatever the true number of seriously ill COVID-19 patients, those critically ill are overwhelming our critical care capacity in hospitals at the same time there are fewer hospital resources to throw at this problem.

To begin with, I have yet to see an interview of healthcare workers who joyfully exclaim, “No problem here! You all come on out. Your hospitals and critical care units have resources to spare, including the lives of those very same workers.” Yet, that’s exactly what the president is calling for as are too many governors of our fifty states.

Take Georgia as an example. This state has closed a significant number of local (i.e., read “rural”) hospitals over the past ten years. I’m talking in the double digits of closures. So the state has fewer hospitals, in general. It has fewer hospitals within reasonable geographic distance of Georgia’s rural citizenry. The hospitals that remain have fewer resources. Too many are on the cusp of remaining financially viable—and open.

Lest you think this a uniquely Georgia problem, it isn’t. It’s a national problem. Lest you think this is uniquely a rural problem, it isn’t.

The Stanford University Hospital recently announced it was imposing salary reductions and lay-offs in the middle of a critical care emergency no less. Stanford is not in the middle of poor, rural America. Stanford is not a hospital without financial resources.

Decades of a broken political system with warring political elites has inflicted serious harm on our healthcare system and specifically to hospitals. When an influx of COVID-19 patients descends on a hospital, it drives out all of the many elective services and procedures that constitute the bulk of a hospital’s income. Too many COVID-19 patients are so critically ill they consume almost every resource a hospital has to offer.

Yes, the number of seriously ill people is small relative to our overall population. Yes, more testing will only make that portion of the population smaller, since there are so many COVID-19 afflicted who are asymptomatic or only mildly affected. To this small group, however, COVID-19 isn’t to be confused with a flu. Their hospital stays are longer. They demand more critical care resources while they’re hospitalized. And, if they are intubated, they continue to draw on these resources until they die.

We tend to hear about the critical care units being overrun in New York City and several other major metropolitan areas. We don’t hear much about this same problem in rural America—but it’s there too. The governor of Wyoming had to intercede to transfer very ill COVID-19 patients from a hospital in Jackson Hole to healthcare facilities in Idaho. I have a family member in Wyoming who calls this bit of confirmed fact as “Fake News.”

Hot spots of COVID-19 are springing up all over rural America. It’s where meat packing plants are located, where power plants exist, and other bits of America’s industrial base where people have to work in close proximity. A sudden rush of seriously ill patients is already on the way to rural hospitals. Relax the stay-at-home orders everywhere, and flyover country specifically, and rural America will take it on the chin. Red states and blue states will suffer alike.

ER docs in some rural Georgia counties have hit their panic buttons. The remaining small rural hospitals in Georgia lack the beds, equipment, and staff to mount a prolonged campaign against COVID-19. And may the good Lord watch over you, if you have any other health emergency, like a heart attack or a stroke where getting prompt treatment is key to a recovery. Worse yet, local citizens are clued in to the state of their nearby, local hospitals. Many, with serious symptoms, aren’t even bothering to go to their ER for diagnosis and treatment. This increases the death and impairment rates for non-COVID-19 incidents, like hypertension, diabetes, cholesterol, appendicitis, many forms of cancer, hydroxychloroquine poisoning, and bleach poisoning.

Furthermore, there are reports concerning “recovered” COVID-19 patients—and it isn’t good. Across all age groups there are reports of blood clotting, stoke, kidney failure, permanent lung damage, and heart problems all of which require a serious healthcare commitment to those in the post-recovery phase of COVID-19. For many folks in rural areas where health insurance may be out of reach and the number of healthcare professionals per capita is low, hospital emergency rooms are an over utilized first line of defense. In the best of times, the ER is not only an uneconomic healthcare delivery point, it is ill-equipped for this role. In the time of COVID-19, these problems grow significantly worse. The result: rationed healthcare. Only the sickest receive treatment. Those who can afford to do so, seek out healthcare where it is still available. 

During the great Obamacare debates, much was made of alleged “death panels.” These decision-makers were believed by many to decide whether your grandmother lived or died. The Obamacare plans never delivered on death panels, because it wasn’t in the legislation as too many people were conned into thinking. But those death panels are in full force today in urban hospitals, and now in the surviving rural hospitals lacking resources to meet their local healthcare obligations during the COVID-19 pandemic.

Where’s the outrage over death panels today? Answer: Missing in action. If you believe some of the pundits, sending your grandparents to the undertaker is now a reasonable trade for a healthy economy. The Texas Lt. Governor made that statement for the record. There are even those who believe a 2-3% “loss” among children, teachers, and staff is an acceptable trade-off for opening the public schools now. The president wants school systems opened for the balance of the current school year, because too many parents can’t return to work and leave their young children unattended at home.

The very people who employed the death panel claim to mortally wound Obamacare are very much okay with death panels today. Today, death panels serve a much higher democratic ideal, the sovereignty of our nation’s vibrant economy.

Death panels are REAL. Hospitals are forced to make decisions about who lives and who dies. If you believe income inequality is a serious problem in this country, how is the state of critical healthcare not? Who lives, who dies from COVID-19 is as basic an income inequality condition as any we’ve ever encountered.

Copyright 2020, Howard D. Weiner