On April 2,2020, I proposed a four-point plan to resuscitate the U.S. economy. Here ’tis:
- Young and middle-aged healthy adults go back to work now.
- Young and middle-aged healthy adults and children return to usual social interactions and school, using 6-foot distancing and face masks if desired.
- Extreme social distancing for those at risk for serious illness from COVID-19 for the next 2–3 months, then re-evaluate the situation. The goal is NO EXPOSURE to those who may transmit the virus to them. Protect the medically frail who are over 60, particularly if over 70 or 80.
- Continued isolation of COVID-19 cases until they’re no longer infectious.
See a section below for details of extrema social distancing for those at risk for serious illness from COVID-19, the disease caused by coronavirus SARS CoV2. But first…
Background: Panic and Over-Reaction?
Around mid-March, federal and many state authorities recommended extreme social distancing for most of the U.S. population. Whether strongly recommended or “do this under penalty of law,” we were told to avoid groups of over 50 people, then it was 10 people, then close your restaurant, bolt the door to your bar, chain the doors to the gym, shutter your house of worship, and stay at home unless your job is considered “essential” by ONE person, usually a state governor. This looks like “house arrest,” with permission to go the grocery store and walk your dog (but no more than 100 yards from the house). (Admittedly, seven or eight states did not go on “lock-down.”) Municipal, state, and federal parks were declared off limits. Beaches were closed. A man in Colorado was arrested for playing ball with his daughter in an empty park. A paddle boarder was arrested at Malibu pier for asserting his right to pursue happiness. Walton County in Florida even closed some backyards. I’ve heard of fines for up to $1,000 in some jurisdictions if you get caught, and/or up to six months in jail (the paddle boarder). In some states, e.g., Rhode Island, these measures bordered on martial law. Whether these restrictions were constitutional is a question for another day.
How did our rulers justify these draconian measures? To “flatten the curve” of the epidemic so that medical resources (especially hospitals) wouldn’t be overwhelmed and, of course, to “save lives.” I understand those goals and agree with many of the measures taken early-on when we didn’t know much about this virus. We couldn’t trust information coming from China, where this pandemic started. When Italy became an apparent disaster, it really got my attention; that’s when my wife and I started prepping (a few days before I published prepping advice on March 20).
With restaurants, gyms, bars, and other service businesses being stifled, and hotel occupancy down by 70%, 17 million people lost their jobs and applied for unemployment benefits. And this was just in the first three weeks of “shelter in place” orders. The unemployment rate has exploded from 3.5% to an expected 15–20% almost overnight. Undoubtedly, thousands of businesses will be filing for bankruptcy within the next few months.
What should we have done instead in early April or even earlier? Extreme social distancing for those at risk of serious illness. They are the ones who would overwhelm hospitals when they contract COVID-19. Yes, I know young, previously health folks have come down with the virus and tragically died, but they are a small minority of those needing ICU care (intensive care and a ventilator). When you peruse the list of those at risk of serious illness from coronavirus, be aware that risk increases as conditions stack up in an individual. The more risk factors you have, the more extreme must be your infection-prevention measures. I’m at risk myself, being 65 and having hypertension, but I’ve been blessed otherwise with good health (and work at it, too), so I’m going into the hospital to work my shifts, potentially exposing myself to the virus. I’m not worried even though Dr Anthony Fauci says I should stay home. (My wife and children worry.)
My Advice on Extreme Social Distancing for those at risk of Serious Illness From COVID-19
Essentially, don’t let other people bring the virus to you and don’t go out and expose yourself to virus carriers who may look and feel healthy.
Give the virus time to “burn itself out” in the healthy population. Allow time for “herd immunity”: increasing numbers of people who have been infected and beat the virus will no longer carry the virus and transmit it to you. Viruses are not alive; they propagate only in living organisms that pass the virus from one organism to another. Don’t be that viral host. People can be “infected” with the virus and have no, or minimal, symptoms. That tends to be young healthy folks. After 2–3 months, we’ll re-evaluate the situation. For now:
- Isolate yourself. As much as possible, stay in your residence and don’t let others in. Have groceries and other supplies delivered to the front door. Don’t invite deliverers in, and don’t shake hands.
- If you have to go out, wear a surgical mask and stay at least six feet away from others.
- If you have to go out and you are in proximity to someone coughing and/or sneezing, move far away immediately. Even if they’re wearing a mask.
- If you need to see your friends or relatives, use iPhone face-time, Skype, Zoom, WebEx, or similar internet options.
- If you’re in a nursing home, skilled nursing facility, or other sort of senior living facility, insist that they abide by these restrictions. They need to severely restrict who enters the facility.
- If you’re mostly independent but need a little assistance, consider moving in temporarily with someone who’s in your same situation, needing a little help. Help each other.
- If over 60–65 and still working, consider quitting your job temporarily, or retiring. Let a younger, healthier person take over. Unemployed Gen X, millennials, and Gen Z folks are looking for opportunity! Millions of them are now unemployed.
- If you live with others or live in a multi-generational household, spend more time in your room, wear a surgical mask, stop hugging and kissing, practice social-distancing within the home. Housemates who are younger and/or healthier than you are going out into the community, potentially picking up the virus. You can’t know if these symptom-free housemates are carriers and transmitters of the virus.
- If you need medical care, see if your physician is willing to practice “telemedicine”: talk by phone or examine and chat via Doxy.me, WebEx, Zoom, Skype, iPhone face-time, etc. Note: these options may not be HIPAA-compliant, which will inhibit your doctor.
A Few More Things to Get You Through This Crisis
- Endeavor to ensure your chronic medical condition is being optimally managed and under as good control as possible.
- While isolating yourself, don’t do anything that will worsen or exacerbate your underlying conditions. E.g., if you have lung or heart disease, don’t smoke. Liver disease? Don’t drink alcohol or take too much acetaminophen. Kidney disease? Don’t take NSAIDs.
- Maintain or improve your level of physical fitness via exercise.
- Eat healthful foods, not junk.
- Of course, practice frequent hand-washing and don’t touch your face after contact with anyone or anything that might transmit the virus.
Hang in there! This is a temporary situation and we’ll get through it. Remember the H1N1 Swine Flu pandemic of 2009? Very few do. But that virus infected roughly 100 million Americans, killing about 75,000, the CDC estimates. As of early AM April 10, 2020, the U.S. death toll from COVID-19 is a little under 17, 000.
The history of this pandemic will be written a couple years from now. If truth be told, it will be a story of panic and over-reaction.
Steve Parker, M.D.
PPS: I strongly disagree with Dr Ezekiel Emanuel that we have no choice. Emanuel was an architect of the Affordable Care Act, aka Obamacare. From Dr E:
Realistically, COVID-19 will be here for the next 18 months or more. We will not be able to return to normalcy until we find a vaccine or effective medications. I know that’s dreadful news to hear. How are people supposed to find work if this goes on in some form for a year and a half? Is all that economic pain worth trying to stop COVID-19? The truth is we have no choice.
PPPS: It turns out that northern Italy isn’t very similar to the U.S., given the severe air pollution in Lombardy, the many Chinese living there, the very old population, and mis-coding of causes of death.