‘Disease Burden’ Is The New ‘Flatten the Curve!’ Bob Maistros
Flatten the Curve!”
It was the watchword of the wildly overreactive COVID-19 lock-down-everything-that-moves strategy – along with “Stay Safe. Stay Home” and the colossally annoying “We’re All in This Together” (uh, no we’re not, you eight-figure morning news anchors safely broadcasting from the Hamptons while the help watched the kids – and 30 million-plus regular folks lost their jobs).
Remember? We were all staying safely home apart together (or was it together apart?) for 15 days (or was it 30 days? or two months? or six months? or indefinitely?). The expressed goal: keep the “curve” of new cases, hospitalizations and intensive-care unit use from rising too quickly and overwhelming the health care system.
Been there. Done that.
Now, a new phrase is needed to explain why, amid the utter media panic so presciently predicted here, America should calm the [expletive deleted] down and stay open for business.
Florida Gov. Ron DeSantis, who rightly earned kudos for his handling of the virus from anyone with a lick of fairness or common sense (which excepts 100% of Democrats and 150% of the mainstream news media), in a Friday press conference provided just such a catchall catchphrase – one widely recognized by the global public health community.
“Disease Burden.”
All right. So the expression doesn’t exactly roll off the tongue. But it captures precisely why the media and the governor’s political opponents – hyperventilating as one and echoed by their fellows in other “hot spots” and nationally – need to breathe through their PPE into paper bags and gulp down a powerful chill pill.
Here’s Friday’s scare headline from South Florida’s Sun-Sentinel:
“Florida smashes record with almost 9,000 coronavirus cases in a day.”
Beneath that screamer on the paper’s homepage, a breathless lead-in paragraph practically demanded readers to click through: “Florida’s coronavirus cases are exploding again, … a new daily record … a relentless, monthlong surge of COVID-19 infections.”
Quick, round up those careless, thoughtless wild beach partygoers! Close the playgrounds! Shut down 10-member family gatherings! Good thing we didn’t get around to defunding the police yet!
Perhaps, like the wise commissioners of Palm Beach County, order everyone into masks – even mail four (two cloth, two disposable) to each of 660,000 households at the cost of $2.5 million – because don’tcha know, per Palm Beach Mayor David Kerner, “There are people on the streets who are dying.”
Well, now. In case you were wondering, a grand total of two deaths was tallied in PBC in the latest daily report. Not to make light of tragedy, but neither was reported to have occurred in a byway.
Or just maybe, take a listen to the Sunshine State’s ever-thoughtful chief executive as he provided context at his presser. That massive jump in cases? The result of a “data dump” involving a vastly larger number of test results than previous days – with just a slightly higher rate of positives as in recent weeks, a pattern that continued with a new “record” Saturday.
The governor did acknowledge an increase in what he refers to as “quote – ‘cases’” as a result not just of increased testing but also an infection rate rising from the 3% range in May to 10% to 15% in June.
But here’s where one view of “disease burden” comes into play – the real underlying issue, these cases’ actual effects on the public health.
The first factor in considering that burden is, in DeSantis’ words, a “radical” reduction in the median age of positive tests from 60-somethings to 33, an age at which the ill are much less at risk for serious clinical consequences. The 15-44 age group, showing positivity rates close to 20%, is largely asymptomatic or experiencing symptoms “so mild that they would not even have to seek medical attention.”
That reality is showing up in death counts. Despite “exploding” cases, fatalities have remained well below April, the height of the outbreak – dropping to six the day the record results were reported.
And even the Sun-Sentinel has admitted that the declining average age means that hospital patients “tend to be younger and healthier, requiring shorter stays or only outpatient care.”
Which brings us to the second factor: the health care system’s capability, which, again, we flattened the curve to provide time to build. DeSantis and hospital officials reported an abundance of personal protective equipment, ventilators, testing capacity, isolation units and ICU beds, as well as improved treatments. In fact, some increased ICU occupancy reflects use of these units for isolation.
Meanwhile, DeSantis continues to focus resources on protecting more vulnerable older populations, even adding entire nursing facilities dedicated to isolation.
So what if, instead of transfixing on frightening but ultimately meaningless stats such as “quote – ‘case’” counts, someone really smart were to come up with a meaningful daily “Disease Burden Index,” much like the “Misery Index” popularized in the 1970s that added inflation to unemployment? Maybe based on factors like symptomatic cases, length and acuity of hospitalizations, health-system capacity, and most important, death rates?
Such a DBI would be well down from April highs, if not still falling. Allowing policymakers to follow DeSantis in making informed as opposed to panicked decisions, and the rest of us to “keep calm and carry on” – together. Or apart together. Whichever.
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