“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-to-day life in America in ways that two weeks ago would have been unimaginable.
According to a recent study by researchers at the Imperial College in London — whose findings finally got the belated attention of the sycophants who swirl around 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 percent of those who are hospitalized will die, most, but by no means all, of whom will be Boomers sixty years of age or older.
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 18 months from now.
In recognition of that reality, last week California Governor Gavin Newsom signed an executive order mandating that all 40 million residents of the nation’s most populous state “stay home or at their place of residence,” not for the 15 days that Donald Trump suggested back on March 16, but “until further notice.” A day later New York Governor Andrew Cuomo did the same.
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 by 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, many of them children, who are members of families that live paycheck to paycheck. Insofar as their collective fate is concerned, economists at Morgan Stanley are predicting that the unemployment rate will soon surge to 12.8 percent, “the highest among records dating back to the 1940s,” and that by May as many as 17 million Americans will have lost their jobs.
After weighing the pros and cons, my view is that a national lockdown like the lockdown Governor Newsom has ordered in California in order to try to reduce the number of mostly Boomers who are going to die, is not worth the economic, and attendant social damage that a lockdown will inflict on everyone else. I get to say that because I am a 73-year-old Boomer who, until two weeks ago, had been planning on living for another 10 or 20 years.
On Sunday Donald Trump, who undoubtedly has never heard of iatrogenic disease reasoned his way to the same conclusion and then tweeted: “We cannot let the cure be worse than the problem itself. At the end of the 15 day period, we will make a decision as to which way we want to go.”
If the decision Don makes is to end, or dramatically reduce, the actions that are being taken to try and “flatten the curve,” the consequence will be that the rate of infection soon will return to what it was before the actions were initiated. Which is why it is not just regrettable but profoundly tragic that neither Donald Trump nor any other politician who wants to continue to be one is willing to level with the American people by telling them:
“Over the next 18 months more than two million, mostly Boomers, who get infected with the coronavirus are going to die before they otherwise would have. I am sorry about that. Watching that happen is going to be awful. We will do everything we reasonably can to help them, but that is what is going to happen. So everyone needs to go back to work and resume living your regular lives, which are organized around spending money and charging on your credit cards to buy stuff much of which you really don’t need in order to get the consumer-driven Ponzi scheme that is the national economy on which we all depend back up and running.”
If that sounds brutally callous and lacking in empathy it is not. What it is is realistic. Because as George Friedman, one of America’s most knowledgeable and 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 as you have.