In considering the human dimensions of wars, floods, airplanes demolishing tall buildings, plagues and other mass tragedies, one needs benchmarks for perspective. My standard benchmark has long been U.S. highway deaths, currently 38,000 per year. Most of us recognize this number as a tragedy, representing not only tens of thousands of human lives but also bereaved families and friends plus financial burdens and business disruptions. Yet we continue driving automobiles, accepting the deaths as the regrettable cost of personal mechanized transportation.
Is covid-19 acceptable in this sense? Last week, the number of U.S. covid-19 deaths reached 100,000, nearly all during March, April and May--nearly three times annual U.S. highway deaths, and it will surely go higher. If this rate continued for a year, it would reach 400,000--10 times the U.S. highway death rate. The real figure could turn out to be far less, or it could turn out to be far more.
For further perspective: Covid-19 currently kills 1,400 Americans every day (averaged), the capacity of five large passenger jets. The number of Americans killed during World War II was 407,000, four times the number of covid-19 deaths during just three months. America's deadliest day in World War II was D-Day, when 6,600 died--the number killed by covid-19 every five days. Other notable American death totals: 3,000 in the 9-11 attacks; 2,400 in the Afghan war; 4,400 in the Iraq war. During the Vietnam War, 58,000 American soldiers died over nearly two decades, far less than the number killed by covid-19 in just three months.
By any measure, covid-19 is a profound American tragedy. It's monstrous to suggest that the shutdowns and social distancing are unnecessary affronts to American values, and that we should simply accept these deaths.
The reason for the shutdowns was to "flatten the curve" during the disease's early spread when cases were doubling regularly. The danger was that exponential growth could overwhelm hospital capacities. Although we started shutdowns two weeks later than we should have, we were largely successful. Hardest hit was New York City where new cases rose exponentially in early March, then rose more slowly ("linearly"), peaked in mid-April, then slowly declined. Strict shut-downs flattened the curve not only in NYC but all over. The shutdown saved thousands of lives every week in NYC alone, and many more in other hard-hit cities (Chicago, Detroit, others) that managed to flatten their curves.
Without shutdowns and social distancing, the tragedy would have been far worse. The 1918-1919 flu pandemic offers perspective: According to the U.S. Centers for Disease Control, 50 million died (yes, you read that correctly) including 675,000 Americans. The disease occurred in three waves, peaking in June 1918, November 1918 and March 1919. The second wave was the deadliest--a relevant warning for us today. U.S. hospitals were tragically overwhelmed. Shutdowns, stay-at-home orders, mask requirements and other measures were mostly local, sporadic and (as today) aggressively opposed by many.
Unfortunately, many anti-shutdown campaigns were successful in 1918-1919. The most notable example was San Francisco, where the "freedom" campaign produced one of the nation's highest casualty rates, according to the CDC and University of Michigan researchers. Similar campaigns occurred around the nation, contributing to the large number of deaths. See the May 1 article in Time magazine by Nancy Bristow, author of American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic.
While new cases and deaths in NYC have declined enormously since peaking in April, the rest of the nation has maintained a slow rise. In May, new U.S. cases hovered around 23,000 per day at the time of this writing.
I agree that our approach to the slow rise should differ from the shutdowns required to flatten the initial exponential burst. Continued shutdown is not sustainable socially, economically or politically. But we dare not open up recklessly. Mistakes can cost tens of thousands of lives, as we learned from the consequences of President Trump's mistaken beliefs that the number of cases was "going very substantially down, not up" (Feb. 26) and that "It will go away; just stay calm" (March 10). So we took no action until March 15. According to an analysis by researchers at Columbia University, the 65,000 U.S. covid-19 deaths by May 3 could have instead been only 11,000 if shutdowns had started a mere two weeks earlier, on March 1.
That's 54,000 lives that would have been saved if Trump had been smarter--roughly the number of Americans killed during the entire Vietnam War.
Commentary on 06/02/2020
Print Headline: Covid-19 in perspective