Why We Can’t Just “Open Up”

This was a response to a friend of mine, after we had a discussion about the “lockdown” in this pandemic. He made some points about why COVID is being overblown. This text (with some minor edits) was sent to him, as I tried to understand and pull apart his arguments.

I would like to give you some thoughts. We could always get together to talk. I don’t expect you to respond to this (it’s gonna be long), but you could and that would be great. I mostly wanted to clarify, and even expound on some thoughts. I appreciate the points you brought up, as it gave me more to think about.

To help me think through this, I’ll break this up by some of the main thoughts I heard from you. If I mis-remember exactly what you said, I apologize and feel free to correct me.

“We need to open everything up.”

I guess I need to understand more fully what you mean by “open up.” Because when I look in our community, the only thing that I see as severely limited is schools. Is that what you mean? Because restaurants are open, and people are back at work. Grace has had in-person services since the end of May, and many other local churches have had a similar pattern.

There are two extremes that we could think of in terms of open or closed. One is that we close everything and make everyone stay in. Of course, this is not feasible, though we do know that if we could, the virus would be gone in 2 weeks. (A virus can only “survive” if it transfers from one host to another.) The other end of the spectrum would be to allow everyone to do anything, with no restrictions (like we were a year ago). As I tried to say the other day, and where I still hold, is that this would be disastrous. I’ll go into this below, as a response to some other things you said.

I would counter that we need to open up wisely. Something in the middle of the two extremes. I don’t want you to think that I’m saying that we need to restrict everything — only to be wise and loving.

“The percentage of deaths is so small.”

You calculated the death rate by dividing the deaths from COVID with the total population of the USA. This is the wrong way to think about it. What you should be dividing is the total deaths from COVID by the number of cases. That’s the death rate. Now, you could take that and extrapolate to what the death number could be if 300 million Americans caught COVID. That’s one main difference between COVID and swine flu (an example you brought up) — how much deadlier this disease is.

Another number that we need to be thinking of in terms of disease is the R value. That number means how many people (on average) an infected person will pass the disease onto. For example, measles is very high, with a number of 15. The seasonal flu is around 1.5. COVID-19 is somewhere around 2–6. Studies in the UK showed that the number was around 4 before lockdown, and about 1.2 after. If you do the math (and I can if you want), you’ll see that a disease with R=2 is exponentially more contagious than one with R=1.2 or 1.5. And to have a R=4 would be an incredibly rapid spread.

With an R value of 1.5 or 2 (or more), to open things up and have it spread means this disease will snowball. And the bigger that snowball, the harder it will be to deal with it.

“Most people recover.”

Another number we need to look at is hospitalization rate. That’s currently about 5% of all people who contract COVID. That’s pretty significant, and the whole reason for the talk of “flattening the curve” in the spring. Yes, there are hospitals across the country who are dangerously close to being overwhelmed. See Utah right now. (And I know we heard about this fear in the spring, and it mostly didn’t happen — but that’s a good thing, and probably a result of the lockdowns.) Not having enough medical personnel and space and resources (medicines, etc) will only increase the death rate.

Furthermore, when I said something about long-term effects, I wasn’t giving a hypothetical guess for the next few years, but what are the effects for many folks months after they contract COVID. It’s a small but significant number, maybe 5%? We’re talking about people whose lungs / breathing hasn’t recovered, neurological issues (like persistent headaches). I just listened to a talk about one main concern with teenage and college age athletes who contract COVID — inflammation of the heart.

So we can’t just talk about the extremes of dying or recovering. There’s a lot of people in-between.

“If someone dies of anything, and they have COVID, it’s reported as a COVID death, because of money.”

I hear you that there is a difference between someone dying of COVID and someone dying with COVID (like with your example of someone having stage 4 cancer). But is that what’s happening with preponderance of the cases? How many people are dying of COVID vs with it.

You also said that the death rate is being reported as high because hospitals and doctors make more money if the death is from COVID. I have a couple of counters with this: 1) That is true for some situations, but mostly for medicare patients (that’s from research that I’ve read into). 2) If it was just about money, then why do we see similar death rates in countries that have socialized medicine (where money wouldn’t be the incentive)?

So, yes, I see what you’re saying, but there are still a lot of people who have died primarily of complications with COVID. (Maybe coupled with other conditions, but just because someone has diabetes and then gets COVID and dies, doesn’t mean that we need to discount COVID).

“Just open things up, and people who feel the need to stay safe need to stay home.”

Again, this is not how diseases work. If things are opened up, the disease will spread rapidly (R=4, remember). That will affect us as a country.

And are you saying that all those people who have preexisting conditions, or who need to protect themselves and their family, just need to stay home until this passes over? What are those people to do for income? I work with people like this, who need to work. And think about the families of some of the guys we coached this year.

This is one of the reasons why the disease has hit lower-income communities especially hard. People with jobs like me and you and most other middle class folks could work from home and such (actually, my current job is less accommodating for that, but even so, I have a buffer where I could miss work for a few weeks or maybe even a couple of months and be ok). But for those in a service industry, they can’t do that. How are they going to survive? They have to work, and the more this disease spreads, the more risk they face.

Again, the point is to be wise and loving. If we (especially those of us who have more resources and more choices and more privilege) can make some sacrifices to love others who don’t have that margin, I think we need to do that.

“Why can’t we just let people make their own choices?”

Do we do this as a country? No, we are constantly setting governmental rules, for the benefit of individuals and as a country. Are you that much against mandatory seat belts? Seat belts are estimated to save about 15,000 lives a year. That’s it. We also have laws about having to wear shirts and shoes in restaurants. So why are people making such a big deal about masks?!?!