The New England Journal of Medicine, one of the most highly-regarded medical publications in the country, puts it plainly: the C19 medical regimes put in place weeks ago are killing non-Covid patients.
Although canceling procedures such as elective hernia repairs and knee replacements is relatively straightforward, for many interventions the line between urgent and nonurgent can be drawn only in retrospect. As Brian Kolski, director of the structural heart disease program at St. Joseph Hospital in Orange County, California, told me, “A lot of procedures deemed ‘elective’ are not necessarily elective.” Two patients in his practice whose transthoracic aortic valvular replacements were postponed, for example, died while waiting. “These patients can’t wait 2 months,” Kolski said. “Some of them can’t wait 2 weeks.” Rather than a broad moratorium on elective procedures, Kolski believes we need a more granular approach. “What has been the actual toll on some of these patients?” he asked.Thankfully, states are starting to wake up to the reality. Georgia, Tennessee, and even Colorado will transition out of strict regimes within the next week or so.
Mr. R., a 75-year-old man with advanced heart failure, is another of Kolski’s patients for whom the toll has been great. Because he had progressive volume overload and delirium, Kolski referred him to a hospital for an LVAD workup in early March. Then, as his wife, Ms. R., told me, “the world went wonky, and everything went down the toilet.” Having begun admitting patients with coronavirus, the hospital told the couple it was kicking everyone else out. “They are telling me my husband has 6 to 12 months to live without this procedure,” Ms. R. said, “and now they are canceling it on us.” They were then quarantined at home — 2 hours away from the hospital — with no plan in place. Mr. R.’s health quickly deteriorated again, but his wife had been advised to keep him out of the hospital. When they finally had a video visit on April 9, he’d become so ill that the heart failure physician didn’t recognize him. Mr. R. was promptly admitted, and the LVAD was placed. Though Ms. R. is relieved, ongoing challenges include her husband’s persistent delirium, a visitor policy that allows her to be at the bedside only intermittently, and the need for nearby lodging that they can’t afford.
I have asked before (to receive no answer from anyone at all) so I will ask again: How many non-Covid-infected persons, especially children, are you personally willing to see die to keep the lockdowns in place? Give me an actual number and explain why preventing those persons' deaths is less desirable than preventing deaths from C19.
We need to heed what the NEJM says explicitly: these are "Trade-offs We Don’t Have to Make." The Economist knew in early April.
Covid-19 presents stark choices between life, death and the economy - The trade-offs required by the pandemic will get even harderAnd that same kind of tradeoff has already cost the lives of non-Covid patients who were denied lifesaving procedures because of the possibility that the medical facility might have a sudden, large inflow of C19 patients.
Imagine having two critically ill patients but just one ventilator. That is the choice which could confront hospital staff in New York, Paris and London in the coming weeks, just as it has in Lombardy and Madrid. Triage demands agonising decisions. Medics have to say who will be treated and who must go without: who might live and who will probably die
I have to be frank: I simply dismiss anyone's view that pretends there is no such tradeoff.
Stanford University's Hoover Institution Senior Fellow Scott Atlas, MD, former head of neuroradiology at Stanford University Medical Center, writing in The Hill, makes these points:
- The overwhelming majority of people do not have any significant risk of dying from COVID-19.
- Protecting older, at-risk people eliminates hospital overcrowding.
- ital population immunity is prevented by total isolation policies, prolonging the problem.
- [Non-Covid] People are dying because other medical care is not getting done due to hypothetical projections.
- We have a clearly defined population at risk who can be protected with targeted measures.
"The recent Stanford University antibody study now estimates that the fatality rate if infected is likely 0.1 to 0.2 percent." [That is almost exactly the same as seasonal flu. Important you note that it is .01% of the people who actually get the virus, not of the whole US population!]
Critical health care for millions of Americans is being ignored and people are dying to accommodate “potential” COVID-19 patients and for fear of spreading the disease. Most states and many hospitals abruptly stopped “nonessential” procedures and surgery. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred chemotherapy. An estimated 80 percent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.Also: "Pandemic 2020: Layoff-related deaths exceed covid-19 deaths by 41%"
According to data from the National Bureau of Economic Research and the Lancet, a medical journal, every one percent hike in unemployment will likely produce a 3.3 percent increase in drug-overdose deaths and a 0.99 percent increase in suicides.NBC News: "Social distancing could have devastating effect on people with depression"
For the year ending February 2019 (NCHS), 69,029 people died of drug overdoses, almost 7 out of 10 the result of opioids. Suicide, the tenth leading cause of death in the United States, accounted for 48,344 deaths (CDC), more than twice the number of homicides (19,510).
Lockdown-related deaths will likely exceed the base-case number of covid-19 deaths by 141%—and this offsets 60% of the highest estimate of 140,381 predicted by IMHE researchers.
In our studies of suicide in my Master program at Vanderbilt University, we learned that while not everyone with clinical or deeper depression commits suicide, almost every person who commits suicide was suffering from depression.
Toronto Sun: "The secondary harms caused by the lockdown get worse every day"
Tens of thousands of people in the UK and Canada have already died because their own non-Covid medical conditions were not treated in order to save beds for C19 patients. Who did not materialize in near the numbers predicted. [Ontario Health Minister Christine] said last week that,
... a number of hospitals and medical associations are actually saying that they now want to proceed with these postponed and cancelled surgeries. It’s the government that’s holding them back.
“We want to make sure we’re not going to have increased pressures with COVID-19 cases before we can start opening up those surgeries,” Elliott said on Tuesday.
But that FAO report appears to have answered that question. They found that, as of April 23, there were 9,345 empty acute-care beds and 2,191 empty critical care beds across Ontario, which is Canada’s second hardest hit province.
We were originally told that the point of the lockdown was to guarantee we don’t overwhelm the health care system. We haven’t.
So what’s the hold up on safely re-opening the Canadian economy? The secondary harms are getting worse by the day.