I’ve written previously about the massive public health impact of government responses to the pandemic:
- The United Nations estimates that global poverty trends will be reversed for the first time since 1998, pushing “half a billion people into destitution.”
- The World Health Organization recently warned that lockdown-induced shortages and disruptions in vaccine distribution (reported in at least 21 countries) will result in the excess deaths of children around the world, deaths that would otherwise have been preventable. The WHO’s director-general Tedros Adhanom Ghebreyesus didn’t mince words: “The tragic reality is children will die as a result.”
- WHO also estimates that malaria deaths may reach a new high as a result of interruptions to malaria control services. They estimate that up to 770,000 may die due to malaria this year, the highest death toll in 20 years.
- A recent report estimates that lockdowns and disruption to medical services could lead to 1.5 million additional deaths due to tuberculosis over the next five years.
- Emergency rooms and urgent care centers across the the US are seeing enormous drops in patient numbers (e.g. visits from heart attack patients down by 50% in some places); since the lockdowns aren’t reducing rates of heart disease and cancer, it means these patients aren’t getting potentially life-saving care. The public health impact could be profound and felt for years.
- As Peter Orszag recently noted, the economic impact of the lockdowns will result in large companies becoming even more dominant, likely accelerating trends toward wealth polarization and inequality. “The strong get stronger.”
Researchers are beginning to grapple with these consequences. A study just published in the BMJ systematically details the many public health effects of social distancing and lockdowns. The situation is illustrated by the infographic below.
A brief, thoughtful piece by John Mandrola, MD, reflects this reality as evidence mounts of the profound, lasting consequences of the lockdowns:
“While uncertainty prevails, I worry that hard questions are being avoided. I will strive not to be tone-deaf, but in the same way we discuss prognosis with patients with cancer or heart failure, we must also address difficult questions concerning the COVID-19 crisis.
The social distancing policies are harming people—not potential harms, but real harms.
… A recent paper, in preprint form, suggests a substantial proportion of excess deaths observed in Scotland, the Netherlands, and New York during the current pandemic are not attributed to COVID-19 and may represent an excess of deaths due to other causes.
While the virus has been shown to harm minorities and the disadvantaged, it is also true that these same groups could be disproportionately harmed by our interventions. Shutting our clinics and reducing non-COVID care in hospitals threaten the poor more than the wealthy. Basic warfarin management in disadvantaged patients has been a huge challenge.
I don’t have an easy answer for societal inequities, but it does public intellectuals no favors to ignore the fact that decision-makers have the luxury of a job and the ability to work from home. Our public interventions have made the poor even poorer. Raj Chetty and coworkers have shown that lower wealth strongly associates with a shorter lifespan.”
“Of these deaths, only 43% in Scotland and England and Wales, 49% in the Netherlands and 30% in New York state were attributed to Covid-19 leaving a number of excess deaths not attributed to Covid-19. Conclusions: A substantial proportion of excess deaths observed during the current COVID-19 pandemic are not attributed to COVID-19 and may represent an excess of deaths due to other causes.”
In another piece on his blog, Mandrola discusses the shifting meaning of “flatten the curve,” and makes a point that seems little appreciated in public commentary during the pandemic: “Why can one safely critique a drug for COVID19 but not massive public health interventions?”