By: John C. Lesher
I’ve been writing blogs on this pandemic for several weeks now, but this one is, to me, the most serious of all. We’ve been locked down for the better part of two months and the most obvious effect has been the startling rapidity of the collapse of America’s economy. The standard reason given for immuring more than 300 million citizens is the health and personal safety of those millions. Government’s primary obligation in a liberal democracy is the security of those it serves, and health is a vital part of that obligation. The fact that the US has had over 60,000 deaths from Covid 19 is testament to the need for dramatic action on the part of government, and my sympathy goes out to those who have suffered loss from this terrible disease.
Now comes the “But.” At what point does the lockdown become more harmful than a re-opening of our way of life? I have no crystal ball to give an unerring date or roadmap in answer to that question. I only know that the concept of “health” has different perspectives from which it can be viewed.
Attempting to stop or slow the coronavirus is a major component of the current evaluation of the term “health,” but there are deleterious side effects that are inextricable from the lockdown. They consist of the negative physical, mental and economic pressures directly caused by the social distancing and business curtailment restrictions under which we now live.
At the moment, national news outlets are saying that 95% of dental care in America has been eliminated along with almost 100% of elective surgery. Local hospitals and emergency rooms are devoted to coronavirus cases and are very reluctant to use the time of their doctors and their beds and equipment for any but the most pressing admissions. The medical group to which my doctors belong has sent out e-mail messages stating that virtual office visits will commence this week, but seeing a doctor “live” is still verboten. In sum: the standards of care to which we have been accustomed are no longer there and no one can predict when they will return.
How long can we go before dental issues become more serious than mild toothaches, or elective procedures degrade to surgery being “medically indicated?” How many visits to doctors’ offices must be deferred before the lack of follow-up testing resulting from those missed visits permits the widespread continuation of undiscovered complications that would have been revealed under normal circumstances?
Mental and economic health are closely linked. The mental pressures on those millions who live on weekly paychecks with little cash in reserve are enormous. Thirty million new unemployment claims in the past four weeks says all that is needed to know. Governor Phil Murphy admitted on national television that he re-opened state and county parks out of concern for the mental health of New Jersey’s residents.
I believe it is time that we ask a difficult question: how long can these restrictions go on before the benefits produced by disease control measures are superseded by detrimental physical, mental and economic effects on the populous—when more people are adversely affected by lockdown than by coronavirus--when the cure is worse than the disease? Logically, there is a point at which the trend lines cross. Would we keep the nation in lockdown for six months after the last Covid 19 case was reported? That’s a rhetorical question and the obvious answer is “of course not.” That said, what benchmark will we employ to evaluate the need for continued lockdown or a release from confinement?
Another way of phrasing this is: what levels of morbidity and mortality will we accept as the cost of re-opening America? We accept 35,000 road deaths per year and two million injuries because we consider cars and trucks to be integral to our lifestyles. We can’t realistically say that coronavirus will be wiped out in the coming few months, so, are we willing to make a similar qualitative/quantitative choice regarding Covid 19?
I don’t believe that the lockdown orders will morph into widespread civil unrest, but I do expect non-violent civil disobedience to grow because Americans want—very badly—to work. Let’s be clear-eyed about this. We are soon going to have to make a very hard evaluation: continued lockdown or a tentative and careful re-emergence of our economic structure, knowing full well that more deaths will ensue.