Letter: Irresponsible actions in response to COVID-19
In the April 18 Vail Daily article, “As virus spread slows, county eyes reopening,” Heath Harmon, director of Eagle County Public Health and Environment, advocated following an official-sounding document titled the “National Coronavirus Response: A Road Map to Reopening” that is neither official nor medically or statistically sound. It was produced by our favorite right-wing nutjob organization, the American Enterprise Institute, largely financed by the esteemed Koch brothers, one of whom has thoughtfully passed recently.
“Those who do not learn from history are doomed to repeat it.”
Howard Markel, distinguished professor of the History of Medicine at the University of Michigan and director of the University of Michigan’s Center for the History of Medicine, and originator of the term “flatten the curve,” noted in the Washington Post the consequences of removing interventions during the 1918 Spanish Flu pandemic: “In every city we studied from this era there was public pressure to quit the social distancing measures as soon as the epidemic seemed to peak and then ebb. Thinking that the proverbial coast was clear, many communities lifted social distancing measures before the battle was truly over. After weeks of being denied their usual social outlets, people were eager to return to a life of normalcy, and they did so in one giant rush. In city after city, masses lined up for movie houses and performance theaters, crowds packed into dance halls and cabarets, and throngs flocked to downtown shopping districts, often on the very day that the closure orders were lifted. The result? Cases and deaths resurged. Most cities closed their schools once again. But the political, economic and social will to issue another round of sweeping business closures and gathering bans had evaporated as people grew weary of the dislocations of social distancing. In some cities, most notably Denver, Kansas City, Milwaukee and even the vaunted St. Louis, this second peak was even deadlier than the first.”
Note that Denver had a significant decline in deaths for more than 21 days, yet the pandemic came roaring back well after the “trigger to begin Phase II” — the reopening of schools and businesses — is called for in the document. Harmon advocates a risky response to a deadly situation.
Until we have the adequate testing capability in the community — and we may not for quite some time — it is irresponsible to risk public health on such a gamble. Not on seniors, not on kids, and not on the working community.
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An established metric to determine adequate testing is for fewer than 10% of test results to return with positive results. As of April 21, Eagle County had performed 2,292 tests and 507 tested positive. That’s more than 22%.
Second, the value of antibody testing is questionable. The World Health Organization does not currently recommend the use of antigen-detecting rapid diagnostic tests for patient care.
Finally, there is a business case for slowing the reopening — cities that enforced social distancing in 1918 emerged for that pandemic with stronger economies and more rapid growth.
“Primum non nocere” — First, do no harm. Why our public health director is using a politically motivated guide, provided by a questionable source, AEI, whose lead author, Scott Gottlieb, the former short-term FDA director who was a political hack, is beyond me.
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