Would a Long-Term COVID-19 Shutdown Be Detrimental to Public Health?
Since the outbreak of the coronavirus pandemic in China late last year, misinformation has become prevalent. Chinese authorities, under the iron fist of their government, attempted to cover up the reality on the ground. When the virus hit our shores, the World Health Organization (WHO) peddled falsehoods, some of which were propagated by Beijing itself. Keyboard warriors and pundits are now frequently transmitting misinformation as well, such as claiming half the country would soon be infected. It is in this environment, filled more with fear than facts, elected officials must consider their next steps.
Without question, lawmakers’ short-term emergency orders were necessary to protect the public health while the country’s leaders awaited more facts and data. That said, some governors are now suggesting that the country needs to close for a few months. The New York Times has demanded that the president should order the nation closed for 14 days. He has rejected such talk as premature and counterproductive, and I couldn't agree more.
As doctors, we are trained from the first day of medical school to examine evidence and facts before making decisions. That’s why I believe while we can and should protect our nation from the present virus, we should hold off on committing to making the quarantines long-term until we've had a chance to examine the evidence surrounding COVID-19.
As more testing comes online, the number of Americans inflicted with the virus will rise – that said, mortality rates have flatlined around the two-percent range. At the same time, most deaths from the coronavirus, and there are exceptions, have come from people with multiple morbidity factors. Given this information, it is imperative that our officials determine whether a long-term shutdown may do more harm to the public’s health than good.
For one, it can mean millions of people losing their health coverage. Half of the country receives their insurance through their employer, and yet 3.28 million filed for unemployment insurance last week alone. Some can qualify for Medicaid, while others can continue purchasing their employer insurance through government programs at higher out-of-pocket costs. Still, millions of others will be left without any coverage for themselves or their families altogether. This will translate into a spike of Americans going untreated and undiagnosed with a whole host of life-threatening medical problems.
Studies have also shown how long-term quarantine is bad for personal health, which will only add further strain to the healthcare system. The tax that quarantines can have on the mind is well-covered. They increase cases of post-traumatic stress disorder, alcoholism, and depression, to name a few. After the Great Recession of 2008, researchers even found that every rise of 1 percent in unemployment prompted an increase in the suicide rate by roughly 1 percent. According to data released in January from the Centers for Disease Control and Prevention, 48,344 died by suicide in 2018. That means that even a 5-percent rise in unemployment stemming from a long-term economic shutdown could potentially increase the number of suicides by over 2,400.
A complete shutdown could also mean trillions more in government spending, taking away needed funding to combat the virus. As it stands, Treasury Secretary Steve Mnuchin stated Wednesday that the two trillion-dollar stimulus bill is designed to last up to three months. Every dollar we spend propping up the economy is a dollar directed away from fighting COVID-19. Committing significant resources long term before we have the data to make such a decision is reckless and damaging to the overall containment effort.
While most medical experts believe that the virus will recede in the late Spring and Summer, they also agree that it will come back in the Fall and Winter with a vengeance – adding to the importance of getting workers back on the job when possible. The public sector-dominated response has already proven unsustainable over the long term. National Institute of Health (NIH) leader Dr. Anthony Fauci pointed this out when he showed how the CDC has already proven incapable of delivering the amount of tests needed for adequate COVID-19 testing. This means that, in all likelihood, the longer large swaths of the private sector remain shut down, the longer the most vulnerable will lack the tools they need to combat this epidemic.
The country can and should continue taking every precaution available to protect the public against COVID-19, but the states need to think long and hard about how long their economic shutdowns should last. It’s important they don’t end them too early, but having them go on for too long can have significant health consequences as well. Having statisticians and health care experts examine the numbers closer before making long-term decisions will help allow politicians to make more sensible decisions for the citizenry at large, mitigating the effects of this terrible disease on the fastest timeline possible.
Benjamin Alli, M.D., Ph.D., is a Sakellarides professor of medicine and surgery and the chancellor of the Royal College of Physicians and Surgeons of the United States of America.