Another must-read article in STAT by Vinay Prasad and Jeffrey Flier: Covid-19, a ‘supernova in human history,’ will need multiple perspectives to understand and manage
Prasad and Flier emphasize a critical point that’s too often ignored; much of the current pandemic’s harmful impact on the world (measured by suffering and death, not soulless abstractions like GDP) will be due to more than infection alone. I’ve previously discussed some of these horrible effects, including a massive decline in preventive care and treatment of chronic diseases, deadly disruptions in the distribution of life-saving vaccines, and an abrupt reversal of the last 20 years in the fight against poverty that will devastate developing countries. Unfortunately, few public voices seem to be acknowledging this terrible reality.
Prasad sums up four ways the current situation is negatively impacting our world:
Will be important to separate the 4 ways covid leads to death in research
1. direct virus effect
2. overwhelming (some) systems
3. Fear -> behavioral change (lots of effects)
4. policy rules -> lots of things
Seeing daily & dangerous oversimplificationhttps://t.co/Z9nGDGI6lc
— Vinay Prasad (@VPrasadMDMPH) May 14, 2020
From the article:
“Covid-19 is a tragic infection that is killing hundreds of thousands of people around the world. But it is also far more than that. It is a supernova in human history: an expanding, all-encompassing set of events and responses to them that touch every aspect of the human condition, simultaneously worsening and improving human health in myriad ways, through immediate and delayed paths.
Over the next few decades, economists, epidemiologists, public health experts, historians, philosophers, sociologists, physicians, psychologists, and others will work to untangle the interwoven threads.
… The multifaceted effects of Covid-19 and responses to it mean that modeling its health effects must extend beyond tracking SARS-CoV-2 infections and deaths and also include the best estimates of health and social consequences more broadly. Though difficult, such efforts must be a major focus of future research.
Thinking about Covid-19 in this broad way can help us make better decisions.
… There is unlikely to be a one-size-fits-all solution, as the balance of the effects of Covid-19 will vary by community. Places with thin safety nets, such as India, may face unprecedented famine. Places with strong safety nets, such as Scandinavia, may be more resilient. Even within a single nation, such as the U.S., the impact in Oregon or Wyoming may be worlds apart from that in New York and New Jersey. These considerations will be particularly important as we step down the rungs of the ladder, and work to reopen the economy.
… we must recognize more explicitly that beneficial policy interventions can also bring harm. Acknowledging these unavoidable trade-offs rather than eliding them can clarify decision-making and lead to additional strategies to aid individuals and communities most harmed by Covid-19.
… At a time when the number of past and future deaths caused by Covid-19 — and those caused by our responses to it — remain uncertain, we should broaden the range of disciplines engaged in communicating and planning future policies to avoid being misled by overly narrow and simplistic narratives whose outcomes may not optimally promote the nation’s health.”