We have been told for months “to follow the data” regarding Covid-19 public policy yet when scientific information becomes available to us through reputable sources, and is confirmed several times over and when subject to strict peer review monitoring our public leaders turn around and follow their feelings instead of the science. Over the past 2 weeks, as the media has been focused on the USA Presidential Election, incredible data has been generated regarding the Covid-19 pandemic.
First of all if you are under 70 years old and get infected with the virus you have a 99.9% chance of recovering without any significant debilitating sequel. If you are over 70 you have a 99.9% chance of a full recovery. Length of stays in hospital rooms is down 35% and 25% in ICU rooms. The use of ventilators is down and with new therapies being deployed like mono and polyclonal antibodies, aggressive anticoagulation, high dose steroids early on in the disease and the use of antiviral agents. There is great hope moving forward. With the coming on line of vaccines a testimony to the marriage between free enterprise private sector incentives to drug companies and the implementation of an emergency military style supply chain, this will have been the greatest mobilization of medical pharmacopeia and medical expertise ever.
Having said all that, we have new reason for hope. In a recently published New York Times article reporting on 16,348 NYC school children and staff, 28 students tested positive and 20 staff tested positive. Testing in the hot spots of Queens and the Bronx showed less than a 4% positive rate in 3300 tests of the same group though adult teachers and administrators were over represented in both studies.
In reviewing insurance claims data from over one half of the nation’s children 0-18 who had no comorbid conditions and who had symptoms or tested positive for the virus, there were zero COVID-19 deaths. Of the 165 children who died from COVID-19 complications all had preexisting comorbid conditions. Studies from Brown University of the same age group of children showed a positivity rate of 0.013—1.3% in children. Dr. Oz when reporting on this same Brown study said that the chance of transmittal from a child to an adult at home was less than 1/1000.
We also need to discuss the collateral damage being done to school age children because they aren’t in school learning. The most hurt are those 30% living on the margins who don’t have internet access or access to any form of on-line learning. These are also the ones not having access to school lunch and preschool meals and who are not getting their vaccinations for measles and polio. And most important and as reported by Dr. Makaray from the John’s Hopkins Department of public health is his holistic assessment of the problem and I will paraphrase: Studies have NOT shown that school closures to be effective at slowing the COVID-19 Virus spread in the community or at school, and we now know that with closure there is significant collateral public health, social, and cognitive damage to those living on the margins.
Finally, Dr. Makaray said this about reviewing data banks and causes of deaths amongst children between the ages of 0-18. A child is more likely to die of drowning, automobile accident, middle school boys in sports accidents, poisoning, and here comes the kicker—jellyfish stings and swallowing of toothpicks!
Our clinicians have done an incredible job in keeping patients alive and improving morbidity and mortality over the past 8 months. BRAVO and thanks. Our public health experts have given our politicians raw data without context. God Bless those who have died or been adversely affected by the disease and God Bless the caregivers. But how about some context please. A young medical student yesterday told me that the COVID-19 Pandemic is the worst event to happen to the USA including WWII! That just isn’t true. During Colonial times there were 4 great Small Pox Pandemics that would wipe out up to 30% of the population. In Philadelphia, in 1793 there was a yellow fever epidemic that killed 5000 people in 3 months in a town with a population of 50,000 people. That number extrapolated to a US population today of 330million would mean deaths from the Covid19 pandemic would reach 33million souls. We are off that number by almost a factor of 100. When looking for perspective look to CDC and Medicaid yearly deaths in our country. In 2018 we had 2.8 million people die in our country for a death rate per hundred thousand of 731. That number for 2020 with COVID-19 will go up to 800 from all causes including collateral unattended disease because of Covid-19 decreasing access to care for other diseases. Life expectancy will not change at all because a disproportionate of those dying have already exceeded their own individual life expectancies.
So from the very beginning, I have argued for Type 3 mitigation strategy. In my family’s case with a daughter in law who has recently undergone chemotherapy and a splenectomy she should be at home with her family and avoid public gatherings. She should get outside under the sun for at least 1 hour a day (Vit D) metabolism is important in fighting viruses of all types). She should have a doctor and a treatment plan in place including having access to antivirals, monoclonal antibodies, and COVID-19 protocols Most of us living without comorbidities should get about and get along with the business of opening up our society and economy.
Most of all we should keep our schools open. A kid at school has less of a chance of getting COVID-19 than if she were at home, and has almost zero chance of spreading the disease from school to home. That is what the science says.