There has been much discussion about the infectivity, virulence, morbidity and mortality of the Covid virus and unfortunately the discussion by the media and the progressive democrats has driven a false narrative that is purely politically motivated. Today we are told that yesterday there are 88,000 new Covid cases and 1000 new deaths. WE aren’t told according to yesterday’s WSJ with the increased testing being done we have an increase in cases of 150% and a decrease in deaths by 88%! WE are learning to take care of the disease while at the same time 85% of people that test positive are either asymptomatic or have minimal symptoms.
My 1st article was written on March 16th and I opined that the Public Health Specialists would cry for tests and more tests, and that there would be much discussion about what the tests would mean. I argued in that article that a transition would have to be made early on from a public health model to a clinical model where scarce resources would have to be diverted from population health strategies to patients. In my opinion, this was done later rather than sooner and people were hurt.
I believe I was correct in that assessment, but I was wrong on several fronts. When the experts at The University of Washington and here in Boise said that we would have 2-5 million deaths I said that number would be 150,000—200,000. WE may get up to 500, 00. I was wrong but less wrong by a factor of 10 than the experts. WE were originally told in March in Idaho that we had 3000 hospital beds and 300 ICU beds in the State. Both numbers have been cut in half—they stopped counting ICU beds in stepdown and cardiac units and surgical hospitals, but even then the number of ICU beds being utilized has never been an issue, nor have vents. It was hard early on to see how Idaho took care of their at-risk patients, especially the elderly in nursing homes and extended care facilities. My guess is that we came out at the middle of the pack amongst the states, but looking at the Tri-State area back east and Washington State around Seattle that is not saying much. I think Dr. Hahn has been exemplary in doing her job of consulting with our governor and the task force, but I also feel they have deferred to her exclusively—especially most recently instead of conferring with her. They made a big mistake in not having a practicing ICU or ER nurse on the panel to tell them the reality of what was happening (not happening) in our hospitals They should have had a virologist on the panel..
But here is the reality about the last 9 months and the media won’t say this. President Trump has done a magnificent job managing the Covid. Unlike our Governor who “deferred” to the experts our president “conferred”. Our President as a businessman understands the concept of OPPORTUNITY COSTS. He understood that by shutting down the economy for a long time there would be significant collateral damage not only to the economy with lost jobs and increased dependency on government programs, but also in the healthcare world where ICU’s and hospitals in some locals were briefly under stress—but even in NYC and the tri-state area, the logistical support provided by our President and the military provided for 3000 hospital beds and 3000 health care providers that were never utilized. In the United States of America, there has not been one patient who needed treatment for Covid that was denied access to services or medicine. There has not been one person who was denied care because they couldn’t pay. There was never a patient denied access to an ICU bed or a ventilator in our country or our State. There have been many patients with cancer or heart disease, or in need of total joint surgery, or even routine medical care for diabetes and high blood pressure that have suffered because of the misallocation of resources and personnel. There will be morbidities and mortalities that we will see in coming months and many health care experts have opined that they could be at least half as many as have died from the Covid virus.
But the bad side of health care in our country has also been exposed. The supply chain shenanigans and upcoding abuses by providers have never been exposed and are costing our country trillions of dollars. The media has not given our President the proper credit for his strategic use of the Defense Production Act that when deployed just 4 times hasn’t had to be used since. All an executive can do is plan for the future and ensure that the means of production under his control are directed in an efficient and efficacious fashion. Far more people have been hurt and died because of mistakes by the likes of Governor Cuomo and public health specialists in NY State when they let thousands of patients testing positive for Covid 19 out of hospitals and back into nursing homes where they exposed the most vulnerable to the virus resulting in over 40,000 deaths, than any mistakes by the Federal government. Overall 50% of the Covid deaths in the tri-state area came from the 0.5% of the population that were elderly and most at risk. The main reason for this was the “harvesting and upcoding” of increased reimbursements under the CARES ACT whereby any inpatient with a Covid-19 code would result in an increased payment for services—sometimes to the tune of $135,000/patient.
Our prayers and our hearts go out to all the people who have died or been made less whole by the virus. But let’s not let empathy be confused with compassion. One of the great tragedies is the people who died without their families at the bedside or Priests available to them to give them last rights or hear their last confessions. Or what about people who have gone to daily Mass or Sunday Church for a lifetime and were then denied that great central part of their lives? What about all the students who have been shut down—those living on the margins have been far more affected academically than those of means who either go to private schools or have access to more sophisticated online learning programs? And what about the increased rates of domestic violence, drug overdoses, and increased substance abuse during the pandemic?
Mr. Trump has approached the pandemic in a holistic fashion siding as often as he can with the public health specialists, but always understanding that there is a bigger picture. Collectively we as a nation could be more hurt with a shutdown than we could by the virus and here is the proof. In 2018 according to the CDC and MACROTRENDS, there were 2,850,000 deaths in the USA for a death rate per 1000 of 8.8. Next year using an upside estimate of 400,000 deaths from Covid our rate will go up to 8.9— better than most of the world today. And this number gets even lower when adjusted for “life years” as most of the people dying from the Covid are over 70 years as opposed to other pandemics were children with over 60 years of life left to live were the ones dying—Measles 1%, Variola minor 1%, Variola Major—Small Pox 30%! And polio 1%.
Mr. Trump rightly knows that the cure can be worse than the disease.
I was taught by a great Christian surgeon to advise all my cancer patients even those with a short-term terminal prognosis this advice: “Today is the best day of the rest of your life. You can choose to start living or start dying—the choice is yours.” That advice is true if you have 70 years left to live or just a few days. It takes courage to always chose life.
Mr. Trump has demonstrated great courage throughout the pandemic. He understands this. Not everybody does.