On Bradley Beach on Sunday it was as if a switch had been thrown and I was transported back to last May, before the dawn of the Age of COVID-19.
The beach was in its full pre-Memorial Day swing and the boardwalk bustling as if the last several weeks was a bad science fiction dream.
The sound of kids playing chicken with the surf, ignoring parental instruction and the laughing cackle of seagulls filled the seashore air.
It felt over.
As my wife Debbie and I walked to the waters’ edge and we looked to our right and to our left as far as we could see in either direction, were hundreds of people of all ages, shapes and sizes without a mask.
That is of course, except for Debbie and me with our masks on. We appeared like Howard Hughes germophobes, clearly not looped in with the latest trending COVID19 collective risk assessment gleaned from Fox.
No doubt, aerial views would have shown beach towel encampments respecting social distancing. but at the water’s edge, most encounters were shoulder-to-shoulder, without masks.
Perhaps, I thought, there had been a miracle and COVID19 deaths had zeroed out. But, when I checked the latest data points I noticed that we had hit a high of 480 reported COVID19 confirmed deaths on Thursday but had dropped to 137 deaths on Sunday.
That must be the magic number I thought, the number of acceptable deaths that triggered this seaside deep sigh of relief. Perhaps these death numbers have become like the barometric pressure.
The kind of concerted collective action needed to beat the pandemic requires a consensus on the facts that inform this historical moment we appear incapable of attaining.
‘WORK WILL SET YOU FREE’
Over the last few weeks, as President Trump tweeted for his supporters to “liberate” states like Michigan where Governor Gretchen Whitmer, a Democrat, extended her state’s stay-at-home order, pro-Trump social media have accused the Center for Disease Control of inflating the deaths attributable to the highly contagious virus.
At the same time, the New York Times reported that starting this week 18 states were re-opening “even though health experts have expressed concern that a premature opening could lead to a spike in coronavirus infections that would not be detected in official case counts for weeks.”
In fact, “many areas are still seeing cases grow” in new cases the New York Times added. Last week, as the rate of increase in new cases continued to grow, states ignored the CDC’s advice that they have 14 days of declining cases before re-opening.
On April 28, Dr. Anthony S. Fauci, the nation’s top expert on infectious diseases, warned on CNN that states were “leapfrogging” over Federal government guidelines that advised they see a decline in cases before they “even think about going to phase one” of reopening.
“If you follow the guidelines, there’s a continuity that’s safe, that’s prudent and that’s careful,” he said. “The concern that I have is that there are some states … who are looking at that and kind of leapfrogging over the first checkpoint.
Dr. Fauci warned that local and state officials were “taking a bit of a chance” and that he hoped they could “actually handle any rebound that they see.”
But as much intellectual integrity as Dr. Fauci has demonstrated over the arc of his distinguished career, during the crisis he also has stood next to President Trump, whose public messaging included the suggestion that by ingesting bleach we could beat COVID19.
The President has downplayed the seriousness of the virus. He has warned that the public health restrictions to halt the spread of the virus would lead to a greater loss of life, with the inference that Americans would increasingly abuse drugs and alcohol or take their own lives, despairing over the loss of their livelihoods to the COVID19 Depression.
So, in an environment where the Federal government has instructed every state that they are on their own, it’s understandable Governors should see fit to ignore the Federal government’s advice on the prerequisites for re-opening. Afterall, our Federal government is led by a President who has maintained the whole thing is overblown and part of political plot to defeat him at the polls in November.
And so, in such a fractured and divided nation where the facts you ascribe to are based entirely on whatever supports your political predisposition, we hold our breath waiting for what will come next with experts warning the worst may lay ahead.
Even as the drum beat to return to business-as-usual intensifies, public health experts continue to warn that we are most likely in just the first few months of a cycle of virus that could last two years, as did the 1918-20 Spanish Flu that killed 50 million worldwide and 675,000 here in the United States.
Perhaps, one way we could get a better reconnaissance about just what we are in the midst of is by improving how we determine our situational awareness.
A BIGGER PICTURE
Currently, the Federal and state governments, along with the media rely on a COVID19 dashboard that includes new hospitalizations, admittances to intensive care, intubations and patient discharges along with the number of COVID19 deaths they describe as a lagging indicator.
These so-called COVID19 key indicators, upon which so much rests, do not account for deaths at home.
But even those numbers that are widely promulgated are the source of a red-hot partisan debate. President Trump’s boosters insist they are artificially inflated so that COVID19 appears more virulent than it actually is, bending the news wave back towards Mr. Trump’s original errant assessment that was just like the flu.
There are so many disclaimers that are footnoted with the COVID19 official data, it’s impossible for us to get a baseline upon which to guide our actions and planning going forward.
Perhaps, one additional data point on the COVID19 dashboard would be useful and help us get to the common ground we require to reach a reality-based consensus going forward.
On April 26, the Financial Times published a country by country analysis of the excess mortality experienced in 14 countries by comparing and contrasting the average level of recorded deaths before COVID19 and what those countries have experienced since the outbreak.
“The death toll from coronavirus may be almost 60 per cent higher than reported in the official count,” the Financial Times reported. “Mortality statistics show 122,000 deaths in excess of normal levels across these locations, considerably higher than the 77,000 official Covid-19 deaths reported for the same places and time periods.”
The newspaper continued. “To calculate excess deaths, the FT has compared deaths from all causes in the weeks of a location’s outbreak in March and April 2020 to the average for the same period between 2015 and 2019.”
The most pronounced spike in “excess mortality” flagged was in the “region surrounding the Italian city of Bergamo [that] registered the worst increase internationally with a 464 per cent rise in deaths above normal levels, followed by New York City with a 200 per cent increase, and Madrid, Spain, with a 161 per cent increase.”
David Spiegelhalter, professor of the public understanding of risk at Cambridge University, told the Financial Times the daily COVID19 counts in the UK, were “far too low” because they only accounted for hospital deaths.
“The only unbiased comparison you can make between different countries is by looking at all-cause-mortality,” he said. “There are so many questions about the rise we’ve seen in death that have not got COVID on the death certificate, yet you feel are inevitably linked in some way to this epidemic.”
No doubt, included in that excess mortality number will be deaths that resulted from people who avoided going to the hospital for fear of contracting the virus and technically died from a chronic, non-COVID disease.
Also, in the mix will be patients who actually went to the hospital for COVID19 only to be discharged and die at home.
The reality of it is, we don’t have the time to wait for the peer reviewed COVID19 body count that could still be years off to achieve the consensus that has still eluded us on global warming. What this would give us is an accurate sense of the scale of what we are in the midst of.
By including excess mortality, in our running daily COVID19 calculations, we would get an essential insight into what is happening more broadly, outside the confines of the hospital and in our homes where it has already been so deadly. Containing COVID19 is about more than managing our hospitals but taking the fight into the communities where the virus has gotten a foothold.
Having a sense of where the excess mortality is highest will be an essential real time heat map.