By Dr. Douglas Skelton and Jack Bernard
"I'd rather have the people stay. I like the numbers being where they are. I don't need to have the numbers double because of one ship that wasn't our fault.”-Trump, in early March, advocating for a cruise ship’s sick American passengers to stay on board… not for medical reasons, but because disembarking would raise the national number of US COVID-19 patients
With 643 cases, Coweta County has been hit hard by the virus, and it's getting worse with 93 of those cases coming just last week (as of 6-29-20). Although Coweta was hit not nearly as hard as neighboring Troup, which has one of the highest case rates per capita in the USA (1,338 cases in a much smaller county). But our state never really went down much regarding new cases and is now rapidly going up again. There are many reasons for this, as detailed below. One is the fact that 50% of all cases in the state are now in the 25-34 age group, a cohort that has been particularly bad about heading public health warnings.
A month ago, one of the authors (Dr. Skelton) was asked how many deaths he anticipated from COVID 19. He replied 300,000 to 500,000… but obviously hoped there would be less. His estimate was based on the country’s need to reach “herd immunity”, at least 60% of the US population of 328 million (196 million) infected… with a 1.3% mortality rate resulting in 2.5 million deaths absent any public health or medical interventions. Of course, there have been interventions and public health guidance issued, although these measures have not been as effective as we would have liked.
His estimate was reasonable given that the World Health Organization stated in March that mortality rates for those over 60 ranged from 3.6% to 14.8%, depending on age of seniors. In a March column, the other author (Jack Bernard) used the higher age adjusted WHO mortality rate (3.6%) for Americans over 60, projecting a similar number of deaths for seniors and those at risk (roughly 100 million) unless a strong pandemic public health strategy was put in place.
We both knew public health measures, antiviral drugs, and a vaccine could markedly lower deaths, but doubted drugs or a vaccine would be available anytime soon to counter the three surges of infections: initial, after “too soon” reopening, and in the Fall. This left public health mitigation efforts to reduce the death rate, including: social distancing; hand washing/disinfecting; sheltering in place; avoiding large groups; and mandated closures of non-essential businesses
We did not believe those efforts alone will get the ultimate number of US deaths lower than 300,000 to 500,000. Periodically, we have considered lowering the projection. But after seeing an excellent staged opening plan from the Coronavirus Task Force rejected by many Governors and an increasing number of individuals ignoring safe practices… and in some instances joining armed protests against government closure orders designed to protect them…plus a Wisconsin Supreme Court decision saying that that their Governor had no right to mandate emergency public health measures, we have not lowered the projection.
In addition, when the CDC staff attempted to issue very detailed and well-reasoned reopening guidelines based on science, they were stopped by the Trump Administration. The Associated Press did get a copy which included reasonable guidelines for churches, such as trying to hold services via video where possible. However, the Trump Administration deemed the religious guidelines to be unconstitutional, even though they are really only advisory. Subsequently, the guidelines were issued, but in a watered-down form.
Also, the Administration did not want anything done by way of public health measures contained in the guidelines which might lessen the economy from fully returning ASAP, once again placing money before lives. Obviously, per numerous polls, Trump is in trouble regarding his 2020 election chances. His only major accomplishment, a strong economy along with low unemployment, is gone.
Regrettably, public health national, state, and local efforts… valiant as they are… as of today are overwhelmed by lack of resources, denigration of scientific evidence and a marginalized CDC. Plus, we have a President and some Governors refusing to accurately count COVID-19 deaths in some settings like meat packing plants (at least one Governor exempted them from reporting), nursing homes (not reportable in many states), and prisons (underreported due to lack of testing in city/county/state/federal jails). Early on, younger and healthier people who were screened over the phone and told that they probably have COVID-19, were also told that there were no tests available locally. They should just isolate themselves. These individuals were also not counted.
We don’t believe that we will ever know the true COVID 19 death toll in the United States. And, it’s evident that President Trump simply does not want to know. In fact, that may well be why he has deemphasized testing, worried about the rising number of deaths, acting as though the tests were why people were getting sick rather than the virus.
In fact, it’s been reported that in March Jared Kushner discouraged the President from adequately addressing testing, fearing that the stock market might be affected(https://www.gq.com/story/kushner-too-much-testing). Kushner, who has no scientific background at all but is the President’s son-in-law, has been a key person behind the scenes, supposedly coordinating key aspects of the Administration’s disastrous virus response.
It’s still our fervent hope that this anti-science President will come to realize that applying scientific principles is the only way to get us out of this disabling crisis. Lies and scapegoating the Chinese, whistleblowers, experts, Governors and Democrats will not magically make the virus disappear, as he seems to believe.
Jack Bernard, a retired SVP with a national corporation, was the first Director of Health Planning for Georgia. He was Chair of the Jasper County Commission and Republican Party. He Chaired the Association of County Commissioners of Georgia's Tax Committee. He is currently the Fayette County Vice-Chair of the Board of Health.