“Reports about do-not-resuscitate orders being contemplated by hospitals began overwhelming the airwaves until Dr. Deborah Birx directly and publicly disputed these claims.”
When paddle boarders in Malibu are being arrested for ignoring stay-at-home orders, it might be time to reassess our COVID-19 mitigation strategies. In the face of unprecedented media coverage, dire predictions, and daily death counts, it remains difficult to remember how we got here. While every death from the virus is a tragedy, especially to the loved ones of the deceased, it is important to keep everything in perspective. The Centers for Disease Control and Prevention (CDC) estimates—as of April 20th—that COVID-19 has infected 746,000 Americans and is responsible for approximately 39,000 deaths. According to an early April report by the CDC, only three American children have died from the virus. During the 2017-18 influenza season, the flu infected approximately 45 million Americans, killing roughly 61,000, including an estimated 643 children.
The recent shuttering of the American economy due to COVID-19 has shattered retirement savings, bankrupted family businesses, increased the suicide risk and potential for substance abuse, as well as domestic violence. Furthermore, there is a precedent for economic downturns affecting health outcomes. For example, a 2016 study from Harvard University concluded that the financial crisis of 2008 resulted in over 260,000 excess deaths from cancer alone. Before we broaden this self-induced recession, we ought to take a breath. We seem to have lost some perspective. As such, let’s recap the series of events that got us to where we are today.
Ratings for major cable news networks, particularly CNN, skyrocketed by as much as 193% as viewers tuned in for coverage of the unfolding pandemic.
In the beginning stages of this pandemic, mortality estimates of between 3-4% were reported by the World health Organization (WHO). Reports such as these—along with President Donald Trump’s initially tepid response to the pandemic—created an opportunity for media outlets to not only politicize COVID-19 but also to tap into growing public anxiety. Ratings for major cable news networks, particularly CNN, skyrocketed by as much as 193% as viewers tuned in for coverage of the unfolding pandemic. Models predicting millions of deaths were disseminated by academics aiming to have their work noticed. Politicians all over the world started to outflank each other, each posturing to prove their “leadership” qualities. Public policy was being heavily influenced by the media, and the media, in turn, pointed to these public policy responses as evidence of the legitimacy of their reporting. Contrarian viewpoints were rebuked on television and social media as being naïve and heartless.
The initial mortality estimates of 3-4% have been dramatically revised. First, the revision was down to 1.4%, then to 0.66%, and more recently to between 0.2% and 0.12%, which is approximately 1/20 of the original WHO estimate. This makes it hard to imagine if we had this information a month ago, that we would have chosen this same path of response. The problem is that it is now too late for those in positions of political authority to re-evaluate their approach. High-powered reputations and political careers are on the line. As such, backing down at this point would be tantamount to admitting to causing an overreaction that resulted in massive and needless economic devastation.
One might argue that it was, in fact, necessary to take these extreme lockdown measures a month ago in case the initial mortality statistics were correct. However, weeks ago, a study from the town of Vo in Italy, analysis from the Diamond Princess Cruise ship, and a testing program by deCODE Genetics in Iceland, all indicated that the COVID-19 mortality rate was considerably lower than the rate that was being widely reported. This information has been consistently referenced by multiple leading epidemiologists, including Stanford’s John Ioannidis. (Ioannidis made many of these points in his recent Wall Street Journal piece “Is the Coronavirus as Deadly as They Say?) Arguments in the vein of Ioannidis’ have also been furthered by studies out of Gangelt, Germany and the City of Los Angeles. Extreme downward revisions of initial mortality rates of pandemics are common and, thus, can be expected. During the 1976 swine flu outbreak, as Victor Davis Hanson explained in City Journal, experts hysterically compared the outbreak to the 1918 Spanish flu. This resulted in a needless push for a “rushed and unproven vaccination.” As a result of this vaccination, there were increased cases of the paralyzing Guillain–Barré syndrome, yet the 1976 flu outbreak ended up being quite mild. More recently, during initial stages of the 2009 H1N1 Swine Flu pandemic, government agencies and experts initially estimated a mortality rate 10-50 times higher than the true mortality rate.
Instead of reporting on the declining mortality rate, much of the media continued to sensationalize the pandemic, beginning with reporting about the number of younger people dying from COVID-19. The story of a 34-year-old man in Los Angeles County dying from COVID-19 went viral—along with a number of other highly anomalous reports. It was soon demonstrated through multiple studies—and confirmed by the White House Coronavirus Task Force—that the virus presents an incredibly low risk to younger people. Cable news outlets were once again forced to shift their focus. Reports about do-not-resuscitate orders being contemplated by hospitals began overwhelming the airwaves until Dr. Deborah Birx, the White House Coronavirus Response Coordinator, directly and publicly disputed these claims. Cable news outlets immediately pivoted to reporting on the nation’s critical lack of ventilators, which was bolstered by New York Governor Andrew Cuomo’s public proclamation that his state was in desperate need of 40,000 ventilators. It is currently estimated, however, that 19,000 ventilators are needed for all hospitals in the United States at the peak of the COVID-19 outbreak. And, at the beginning of this pandemic, the United States was estimated to possess between 160,000 and 200,000 ventilators. (The United States also comes close to leading the world in the rate of intensive care unit beds per 100,000 inhabitants.) Despite this, the media continued to inundate the public with warnings of ventilator shortages, causing many people (particularly older Americans) to worry about being denied lifesaving medical care.
So, while there is merit to this reporting on the amount of PPE available, it is quite ironic that without the media’s sensationalism of this pandemic, this problem might not exist.
The next major storyline, which still permeates today, is the shortage of personal protective equipment (PPE) for healthcare workers. What is neglected in reporting is that much of the PPE is being used by anxious individuals making inessential purchases of such equipment, as well as by the hordes of panicked regular flu patients showing up demanding testing and hospital admittance. Currently, many patients showing up for COVID-19 testing are diagnosed as indeed having flu-like symptoms, but not having COVID-19. (In states such as Pennsylvania, for instance, there were nearly four times more instances of COVID-19 tests coming back negative than positive.) Panicked people inundating hospitals and testing centers demanding needless COVID-19 tests continue to take up PPE needed by healthcare professionals. So, while there is merit to this reporting on the amount of PPE available, it is quite ironic that without the media’s sensationalism of this pandemic, this problem might not exist.
The next wave of reporting focused on the inevitable shortage of hospital beds. This led to the conversion of commercial spaces into make-shift hospitals, as well as the arrival of the United States Naval Ship (USNS) Comfort into New York Harbor. Similarly, the USNS Mercy arrived in Los Angeles. In early April during New York’s COVID-19 outbreak, Comfort tended to less than 20 patients, despite its 1,000-bed capacity, and Mercy, along with its 800-person medical staff, was treating 15 patients. During the 2017-18 flu season, the flu was responsible for approximately 800,000 hospitalizations in the United States, which far surpasses projected COVID-19-related hospitalizations expected this year. Instead of reporting on the fact that the United States’ hospital system was not overrun—or juxtaposing this virus to the much greater hospitalizations necessitated by the flu—much of the media decided instead to report anecdotal horror stories out of the world’s epicenter of the virus: Queens, New York. We were told that these were unprecedented times, and that New York City was a battleground like never seen before by a health care system. Yet, one could turn to a 2018 Los Angeles Time piece (“California hospitals face a ‘war zone’ of flu patients — and are setting up tents to treat them”) on the regular flu for context: “Hospitals across the state are sending away ambulances, flying in nurses from out of state and not letting children visit their loved ones for fear they’ll spread the flu. Others are canceling surgeries and erecting tents in their parking lots so they can triage the hordes of flu patients.”
Recently, cases, hospitalizations, and deaths from COVID-19 have begun to decline across the country, and the worst seems to be behind us. The estimated number of COVID-19 deaths is expected to be lower than those caused by the 2017-18 flu season. Ventilators remain plentiful, hospitals are operating with excess capacity, and the estimated mortality rate of this virus has plummeted to a fraction of original estimates. Instead of reporting on these positive developments, many media outlets continue to focus on a new supposedly horrific problem: the lack of sufficient testing. A recent New York Times story suggested that the United States must triple its current testing capacity before people can be allowed out of their homes—or can return to work. This position was, in turn, then pushed by a number of cable news networks.
People, sadly, are dying, and we are going through troubling times. However, that does not mean we can’t remain rational. Nobody is suggesting that our current COVID-19 mitigation strategy did not likely save lives—or that we would not greatly benefit from more robust testing. Similarly, nobody is asserting that we should not continue to take effective measures to protect the immunosuppressed and elderly. However, a rational, evidence-based reaction to a problem necessitates perspective—not sensationalism. We ought not have this myopic focus on every problem, as though it is the only piece of information we have. A deep recession caused by an overreaction to this crisis will lead to dramatic increases in homelessness, suicides, drug abuse, as well as delays in providing heath care for those with other conditions. These delays might, in fact, cause more loss of life to Americans than COVID-19. Furthermore, we have spent countless dollars attempting to mitigate the impact of COVID-19, and some of this spending could have addressed preventable deaths caused by heart disease, diabetes, or obesity. We are not fighting COVID-19 in a vacuum. Every dollar spent could also be spent potentially saving lives in other capacities. Every day that we are ordered to remain inside causes American families to lose their primary source of income. The media continues to sensationalize this pandemic and report on issues in a vacuum. We need to pull together as a society, look at the totality of the evidence, and take actions accordingly.
Brett Oppenheim is an attorney and business owner in Los Angeles.
