“First, do no harm.” It’s a saying almost as old as the idea of medicine itself. I heard it a lot in medical school. And it’s a saying that our state and national leaders need to think long and hard about right now.
In many respects, I am proud of the way our leaders and experts have stepped up to find ways of fighting the novel coronavirus, COVID-19. They acted quickly, on limited information, and based on varying levels of infection and death rates in other countries. But now, we have better data and experience that beg a more sophisticated approach as our nation grapples with balancing public health and the economy.
There’s another saying going around right now: “The cure must not be more deadly than the disease.” The more we delay re-opening, the more lives we endanger, violating the “do no harm” principle. For example, suicide and domestic violence have drastically increased after aggressive social distancing implementation.
Those who advocate for earlier business re-opening are often accused of devaluing human life. Yet, on April 16, the United Nations warned that the economic downturn would cause tens of millions to fall into extreme poverty and that hundreds of thousands of children could die.
Both sides must understand that social distancing and prosperity have value. Both COVID-19 and poverty take lives. There is a well-documented relationship between poverty and disease, just as there is between unemployment and suicide.
But advocates for later re-opening don’t seem to appreciate the notion behind a robust economy saving lives every day. Instead, predominantly the left makes rash arguments that those who discuss economic principles don’t value human life.
What began as the idea of “slowing the spread” has morphed into the argument that we should all stay home until a cure is found. That, I’m afraid, is not only an unreasonable mentality, but a fundamentally dangerous one.
There are things outside of our control. COVID-19 is one of them. Slowing the spread was never supposed to be a way to prevent transmission entirely, or to shut down the nation for 18 months or more to find a vaccine: it was to make sure hospitals could keep up.
Experts agree the total “area under the curve,” or the number of Americans who will contract coronavirus, ultimately won’t be changed. The virus will run its course. Although the goal of social distancing was originally to protect hospital capacity, the goal-posts have been moved to a focus on “saving lives.” Clearly, our hospitals are dealing with the demand just fine.
Human life is precious. We should take every reasonable measure to protect life. We can all agree on that. What we have to deliberate about now is what is reasonable.
It is not reasonable to keep people from receiving care for other illnesses and ailments to prevent them from getting or spreading another disease. It is not reasonable to ask people to permanently give up on their business or career to lower the possibility of overwhelming a hospital.
People die from cancer. They die from car accidents. They die from suicide. And they die from poverty.
What we hate is the loss of control. We are used to the illusion that we can control everything in comfort. But there are things we cannot control, and one of them is death.
Perhaps the most well-respected infectious disease doctor in the world, Paul Farmer, said, “We know that risk of acquiring HIV does not depend on knowledge of how the virus is transmitted, but rather on the freedom to make decisions. Poverty is the great limiting factor of freedom.”
In other words, poor people often don’t have the luxury of social distancing. They act out of necessity, whether they have knowledge of the disease or not.
One of the things we need to reopen as soon as possible is our health-care system. Our hospitals are not overrun with COVID-19 patients. Nurses are getting furloughed, and patients are suffering. Clinics are closing.
Our leaders should be paying attention to the massive death toll that economic devastation and closure of our health-care system takes on society at large. We’re treating COVID with blinders on. If our society were one of my patients, the doctor in me says we need to treat the whole patient, not just one symptom.
Re-opening business and the elective health-care system shouldn’t be viewed as devaluing human life. Rather, it should be seen as an act of love.