Letter to President Trump from 500 doctors
Was the shutdown of the American economy necessary to deal with the coronavirus? It’s a question we are hearing more and more often these days. Let’s look at some facts.
First, 80% of the U.S. COVID-19 fatalities occur in the 65 and older group. Federal health officials apparently assumed that Americans 65 and over and others with underlying health conditions did not know enough to take care of themselves and many would wind up being admitted to hospitals. Those same health officials must have decided that people under 65 could not be responsible either.
So what happened? Those health experts recommended that most of the economy be shut down to avoid over-crowding hospitals.
Guess what? The hospital over-capacity concern never materialized and yet threats and scare tactics continue today from some federal health officials, some governors, and the media. One study showed that as of early May two-thirds of counties in the U.S. had one or no fatalities.
More than 25 million jobs have already been lost and many of those jobs are not coming back. In addition, thousands of businesses are now bankrupt because of the mandated economic shutdowns. Here is some perspective: the job loss in April alone was more than double the cumulative job loss during the Great Recession.
Pandemics have occurred before and the Wuhan virus is just the latest. Had the Chinese Communist Party been transparent and forthcoming about their virus, the rest-of-the-world may have been able to avoid many of the deaths.
Instead as of yesterday, there were approximately 98,000 U.S. deaths from COVID-19. Let’s say by year-end COVID-19 deaths double to 196,000. The U.S. total population was 328 million in 2019, which would place the death rate, as a percentage of the total population, at 0.09%. This is a similar death rate as occurred in the 1968 flu pandemic and slightly below the 1957-58 pandemic death rate.
These facts have caused a lot of discussion in the medical community. Doctors and health experts alike are challenging the necessity of shutting down our economy based on flawed modeling which has since been revised multiple times.
Recently, 500 doctors sent a letter to President Trump expressing their dismay and concern about the deleterious and potentially deadly impact of the economic shutdown on the health of millions of Americans. These doctors make a lot of sense.
Here is that letter.
President Donald J. Trump
The White House
1600 Pennsylvania Avenue, NW
Washington, D.C. 20500
May 19, 2020
Dear Mr. President:
Thousands of physicians in all specialties and from all States would like to express our gratitude for your leadership. We write to you today to express our alarm over the exponentially growing negative health consequences of the national shutdown.
In medical terms, the shutdown was a mass casualty incident.
During a mass casualty incident, victims are immediately triaged to black, red, yellow, or green. The first group, triage level black, includes those who require too many resources to save during a mass crisis. The red group has severe injuries that are survivable with treatment, the yellow group has serious injuries that are not immediately life-threatening, and the green group has minor injuries.
The red group receives the highest priority. The next priority is to ensure that the other two groups do not deteriorate a level. Decades of research have shown that by strictly following this algorithm, we save the maximum number of lives.
Millions of Americans are already at triage level red. These include 150,000 Americans per month who would have had a new cancer detected through routine screening that hasn’t happened, millions who have missed routine dental care to fix problems strongly linked to heart disease/death, and preventable cases of stroke, heart attack, and child abuse. Suicide hotline phone calls have increased by 600%.
Tens of millions are at triage level yellow. Liquor sales have increased 300-600%, cigarette sales have increased, rent has gone unpaid, family relationships have become frayed, and millions of well-child check-ups have been missed.
Hundreds of millions are at triage level green. These are people who currently are solvent, but at risk should economic conditions worsen. Poverty and financial uncertainty is closely linked to poor health.
A continued shutdown means hundreds of millions of Americans will downgrade a level. The following are real examples from our practices.
Patient E.S. is a mother with two children whose office job was reduced to part-time and whose husband was furloughed. The father is drinking more, the mother is depressed and not managing her diabetes well, and the children are barely doing any schoolwork.
Patient A.F. has chronic but previously stable health conditions. Her elective hip replacement was delayed, which caused her to become nearly sedentary, resulting in a pulmonary embolism in April.
Patient R.T. is an elderly nursing home patient, who had a small stroke in early March but was expected to make a nearly complete recovery. Since the shutdown, he has had no physical or speech therapy, and no visitors. He has lost weight, and is deteriorating rather than making progress.
Patient S.O. is a college freshman who cannot return to normal life, school, and friendships. He risks depression, alcohol abuse, drug abuse, trauma, and future financial uncertainty.
We are alarmed at what appears to be the lack of consideration for the future health of our patients. The downstream health effects of deteriorating a level are being massively under-estimated and under-reported. This is an order of magnitude error.
It is impossible to overstate the short, medium, and long-term harm to people’s health with a continued shutdown. Losing a job is one of life’s most stressful events, and the effect on a person’s health is not lessened because it also has happened to 30 million other people. Keeping schools and universities closed is incalculably detrimental for children, teenagers, and young adults for decades to come.
The millions of casualties of a continued shutdown will be hiding in plain sight, but they will be called alcoholism, homelessness, suicide, heart attack, stroke, or kidney failure. In youths it will be called financial instability, unemployment, despair, drug addiction, unplanned pregnancies, poverty, and abuse.
Because the harm is diffuse, there are those who hold that it does not exist. We, the undersigned, know otherwise.
Please let us know if we may be of assistance.
Simone Gold, M.D., J.D. & >500 physicians
(signatures attached to original document)