The pandemic coronavirus now sweeping the country is revealing some interesting differences in how Americans young and old, rich and poor, liberal and conservative view the realities of life and death – not to mention the inherent trades offs between safety, freedom and economic health.
Polling by Rasmussen Reports hit on some of this last week when pollsters found a majority of Republicans – 51 percent – saying it was time to end a national lockdown and put people back to work while only 27 percent of Democrats were of that view.
PEW Research Center polling found similar results and noted a big generational difference influencing opinions.
“Millennial voters (born 1981 to 1996) have had a Democratic tilt since they first entered adulthood; this advantage has only grown as they have aged,” PEW noted. “Democrats enjoy a 27-percentage-point advantage among Millennial voters (59 percent are Democrats or lean Democratic, 32 percent are Republican or lean Republican).”
That block led the Democrats wanting to continue an indefinite, stay-at-home lockdown. These results should not come as a surprise.
When Americans were polled by Gallup in November 2018, “the economy” topped the list of issues of concerns for Republican and Republican-leaning voters. It was number six on the list of concerns by Democrats and Democrat-leaners who put “health care” at the top of their list.
The economy and health care are now in a life-and-death struggle.
The polls don’t shed any light on how other demographics shape views, but it is possible to find some by parsing the data from a report compiled by the Seattle Coronavirus Assessment Network (SCAN) in Washington’s Seattle and King counties.
SCAN is a public health surveillance program set up on March 23 to try to get a handle on the spread of COVID-19 in the greater Seattle area. In order to do this, it has been recruiting volunteers wanting to be tested for the disease. They can request a “Swab-and-Send” kit by logging on to the SCAN website,” the organization says, then swab themselves and send the kit back.
As might be expected in a situation like this, most of the people – 2,700 of 4,092 – requesting kits as of April 6 reported a “COVID-like illness.” As it turned out, according to the report, 1.2 to 2.2 percent were found positive for COVID-19, or SARS-CoV-2 as the disease has been referred to Europe and is increasingly referred to in this country.
The data also revealed something of a portrait of the people worried about having the disease. The majority were:
- And 30 to 49 years old.
“At this time, SCAN is not yet achieving a representative sample of the population in the greater Seattle and King County region,” the authors of the report admitted. “Relative to our population, SCAN participants differ in terms of age, geography, income, race/ethnicity and other factors. These differences are documented below, and we are working to reduce them. However, all results and conclusions of this report are limited by this lack of representativeness.”
Certainly there were people who volunteered to participate in the study purely because they wanted to contribute to science. It is impossible to sort out those people, but assuming that they generally trend in the same directions as the majority of people participating because of concerns about personal illness the data is interesting:
- 67 percent of SCAN participants were white although they comprised only 59 percent of the population in the study area.
- 52 percent were age 30 to 49 in an area where only 31 percent of the population fits in that age block.
- 31 percent reported earning $150,000 or more per year in an area that boasts only 6.3 percent of the population making that much money.
The numbers for those most fearful are strangely at odds with who should be fearful. The Centre for Evidence-Based Medicine at Oxford University documents SARS-CoV-2 as a killer of old people, not those in their 20s, 30s and 40s.
The fatality rate for people 49 and under hospitalized in China was 0.32 percent, the Centre reports. In Italy, it ranged from 0.16 to 0.70 percent for women in that age block and 0.72 to 1.16 for men.
The risk rose rapidly with age, however. The Italians calculated that a man over 60 admitted to an Italian hospital with SARS-CoV-2 had a near 7 percent chance of death and it went up to near 30 percent for a man over 80.
Italy is somewhat unique. The country’s hospitals have a deadly problem with antibiotic-resistant bacteria. Many of those in Italy were weakened by COVID-19 only to die after contracting bacterial pneumonia that then raged out of control.
Italy, the Oxford Centre noted, has the “highest rates of antibiotic resistance deaths in Europe.” It accounts for about a third of such deaths in Europe.
Along with age and general health-compromising medical conditions, race also appears to be playing a role in the U.S.
“In Chicago, more than 50 percent of COVID-19 cases and nearly 70 percent of COVID-19 deaths involve black individuals, although blacks make up only 30 percent of the population,” Northwestern University Dr. Clyde W. Yancy reported in the Journal of the American Medical Association (JAMA). “Moreover, these deaths are concentrated mostly in just five neighborhoods on the city’s South Side. In Louisiana, 70.5 percent of deaths have occurred among black persons, who represent 32.2 percent of the state’s population.
“In Michigan, 33 percent of COVID-19 cases and 40 percent of deaths have occurred among black individuals, who represent 14 percent of the population. If New York City has become the epicenter, this disproportionate burden is validated again in underrepresented minorities, especially blacks and now Hispanics, who have accounted for 28 percent and 34 percent of deaths, respectively (population representation: 22 percent and 29 percent, respectively).”
Why the SCAN data shows minorities and old people less concerned about SARS-CoV-2 than younger, wealthier, white people is unexplained. So, too, the opposite.
Some experts on infectious disease have observed that SARS-CoV-2 acts almost like two different diseases in the way its attacks the young and the old differently. Dr. Robert Katz, the founding director of Yale University’s Yale-Griffin Prevention Research Center, caused a stir when he wrote an op-ed for the New York Times (NYT) suggesting the government recognize this oddity and act accordingly.
“Why does this matter?” he wrote.
“I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself. The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.”
How much Trump’s erratic behavior and the Trump Derangement Syndrome epidemic in the media is complicating a rational discussion of how to deal with the pandemic in the U.S. is worth its own study.
Whatever the case, protests against the lockdown have now broken out in parts of the country. Politico describes them as “right-wing anti-lockdown protests,” but not all of those questioning the lockdown are conservatives.
Anchorage’s Donald Craig Mitchell – an attorney, author and old liberal who was deeply involved in the development and implementation of federal Native policy in Alaska, two weeks ago wrote an op-ed for the Anchorage Daily News (ADN) that thoughtfully laid out a case for largely ignoring the projected deaths among elders and saving the economy for younger Americans.
“After weighing the pros and cons, my view is that a national lock-down whose objective is to reduce the number of mostly Boomers who may die to a number below the 2.2 million the researchers at Imperial College have estimated is not worth the economic, and attendant social, damage that a lock-down will inflict on everyone else,” he concluded. “And I get to say that because I am a 73-year-old Boomer who until three weeks ago had been planning on living for another ten or twenty years.”
Mitchell’s view appears to reflect that of some number of other Boomers. His column did not run in the ADN, though Mitchell has been one of the newspaper’s featured writers.
Mitchell does not expect it to be published. His queries as to what happened to the piece have gone largely ignored. The state’s largest newspaper is not a media outlet noted for challenging journalistic orthodoxy, or any other orthodoxy for that matter.
And Mitchell’s Grandpa’s-gotta-die-sometime take on the prevailing fear of the day is undeniably blunt, as is his assessment of the economic crisis facing the country and the world.
“There are 128 million households in the United States. A recent survey the Federal Reserve conducted revealed that 20 percent of those households have less than $400 on hand, and another 20 percent would have to struggle to pay an unexpected $400 bill,” he wrote.
“On average there are 2.6 individuals in a household. If you do the math, there are 133 million Americans who live pay-check to pay-check. And there undoubtedly actually are tens of millions more.”
For some of those with financial means – as well as for those wrapped in the arms of what have become economically protective American bureaucracies – the pandemic has become an extended spring break.
For others – those with pitiful little cash on hand – the lockdown is quickly becoming a financial disaster.
Mitchell’s April 10 take on the issue is reprinted below. One significant correction is in order since it was written. The pandemic model created by the Imperial College of London that projected 2.2 million American deaths has been revised in part because of social distancing, which slows the spread of the disease, and shifts in the infection fatality rate, which indicate more people than once thought are getting sick and recovering, or being infected without ever suffering symptoms.
A model from the Institute for Health Metrics and Evaluation at the University of Washington is now projecting about 300,000 deaths nationwide. A Northeastern University model projects 163,505 to 575,616 deaths if nothing is done to mitigate the spread of the disease, and 30,490 to 88,286 deaths if a strict “stay-at-home” policy is instituted.
Other models produce different numbers, but all are well below the earlier forecast of millions dead. For comparison sake, a total of approximately 2.8 million people die in the U.S. in a normal year.
What should be done
By Donald Craig Mitchell
“Iatrogenic” is a medical term that means an illness that has been caused by treatment. For example, when doctors vaccinate children against polio they know the vaccine will give one in every 2.4 million children the disease.
But preventing millions of children from being crippled is worth making one terribly unlucky child sick. But what if rather than one child the vaccine gave a thousand children polio? Or a hundred thousand? Or a million? At what point is the harm an iatrogenic illness causes not worth the benefit derived from the treatment?
That can be a difficult question for the medical profession to answer. The same can be said when considering the national response to the coronavirus pandemic that is disrupting day-today life in America in ways that a month ago would have been unimaginable.
According to a study by researchers at Imperial College in London whose findings finally belatedly got the attention of Donald Trump, by the time the pandemic abates 81 percent of all men, women, and children in the United States will have been infected. Of that number, 4.4 percent will need to be hospitalized, and 2.2 million of those who are hospitalized may die, most, but by no means all, of whom will be Boomers sixty years of age or older, many of whom have an underlying medical condition such as emphysema, cancer, or heart disease.
The researchers at Imperial College also said nothing can be done to reduce the number of deaths except to try to “flatten the curve” by suppressing the rate of infection so that the finite medical resources that are available can be used as efficiently as possible.
But to be effective suppression needs to last until a vaccine is available, which may be as long as eighteen months from now. If it does not the rate of infection soon will return to what it was before the actions to flatten the curve were initiated.
In recognition of that reality, California Governor Gavin Newsom has issued an executive order that mandates that all forty million residents of the nation’s most populous state “stay home or at their place of residence,” not for thirty or sixty days, but “until further notice.”
But the Imperial College study concludes by noting that, while “suppression is the only viable strategy at the current time,” it is “not at all certain that suppression will succeed long term” because “no public health intervention with such disruptive effects on society has been previously attempted for such a long duration of time.”
Insofar as those disruptive effects are concerned, there are 128 million households in the United States. A recent survey the Federal Reserve conducted revealed that 20 percent of those households have less than $400 on hand, and another 20 percent would have to struggle to pay an unexpected $400 bill.
On average there are 2.6 individuals in a household. If you do the math, there are 133 million Americans who live pay-check to pay-check. And there undoubtedly actually are tens of millions more.
Insofar as their collective fate is concerned, an economist at the Federal Reserve Bank of St. Louis now estimates that by the end of June as many as 47 million Americans will be unemployed. If they are that will be an unemployment rate of 31.1 percent.
By comparison, during the worst of the Great Depression the unemployment rate was 25 percent. The social consequences of massive unemployment are potentially dire. The Los Angeles Times has reported that “gun sales are surging in many U.S. states, especially in those hit hardest by the coronavirus.”
And Francis Suarez, the mayor of Miami, has expressed fear that the social order in his city could deteriorate to the point of becoming “apocalyptic” because “people get pretty desperate when they don’t have some of the basics.”
Doctors Anthony Fauci and Deborah Birx, the most knowledgeable and trusted members of the White House corona virus task force, have said that if the entire nation is locked down like Governor Newsom has locked down California, and if the lock-down continues until a vaccine is available, rather than 2.2 million, 100,000 to 240,000 Americans still are going to die.
After weighing the pros and cons, my view is that a national lock-down whose objective is to reduce the number of mostly Boomers who may die to a number below the 2.2 million the researchers at Imperial College have estimated is not worth the economic, and attendant social, damage that a lock-down will inflict on everyone else. And I get to say that because I am a seventy-three-year-old Boomer who until three weeks ago had been planning on living for another ten or twenty years.
On March 22 Donald Trump, who undoubtedly has never heard of iatrogenic disease and knows nothing about the ethically difficult choices it can present for the medical profession, reasoned to the same conclusion and then tweeted: “We cannot let the cure be worse than the problem itself.”
But then in a meeting in the Oval Office Doctors Fauci and Birx persuaded him to reverse course and recommend that the nation stay locked down and that the economy remain shut down until April 30. But then a day later he obfuscated the April 30 date by vouching that by June 1, rather than May 1, “we will be well on our way to recovery” and “a lot of great things will be happening.”
I hope that by June 1 great things are happening. But I have no expectation they will be. Which is why it is not just regrettable but profoundly tragic that three weeks ago the president of the United States was not willing to level with the American people by telling them: “Over the next eighteen months more than two million mostly Boomers who get infected with the coronavirus may die before they otherwise would have. I am sorry about that. Watching that happen is going to be awful. We will do absolutely everything we reasonably can to help them, but that is what is going to happen.
So while Boomers and individuals who have an underlying medical condition should stay home and keep their social distance until the coronavirus pandemic runs its course, everyone else needs to continue living their regular lives, which are organized around going to work and spending money and running up debt on their credit cards to buy stuff much of which they really don’t need in order to keep the consumer-driven economy on which we all depend up and running.
If that sounds cynical and lacking in empathy it is not. What it is is realistic. Because as George Friedman, one of America’s most respected geopolitical forecasters, has concluded:
“Canceling social life for months is likely the path for defeating the virus. But it cuts against not only the economy but, even more, what it means to be human. Social distancing is another way to say that we should halt the most human of activities in order to suppress death. But humans play with death in all sorts of contexts, because it is social and necessary.”
If you do not agree with George Friedman and me that’s fine. Because at this extraordinary moment in world history every American gets to decide for him and herself what the right thing to do is. But you owe it to your children and grandchildren, your neighbors, and your nation to think through why you have decided