Monday, May 04, 2020

The Unseen Death Toll of COVID-19 Measures

The accumulating death toll from COVID-19 can be seen minute-by-minute on cable news channels. But there’s another death toll few seem to care much about: the number of poverty-related deaths being set in motion by deliberately plunging millions of Americans into poverty and despair.

In the first three weeks since governors began shutting down commerce in their states, 17 million Americans filed for unemployment, and according to one survey, one quarter of Americans have lost their jobs or watched their paychecks cut. Goldman Sachs predicts that the economy will shrink 34 percent in the second quarter, with unemployment leaping to 15 percent.

Until the COVID-19 economic shut-down, the poverty rate in the United States had dropped to its lowest in 17 years. What does that mean for public health? A 2011 Columbia University study funded by the National Institutes of Health estimated that 4.5 percent of all deaths in the United States are related to poverty. Over the last four years, 2.47 million Americans had been lifted out of that condition, meaning 7,700 fewer poverty-related deaths each year.

It’s a good bet these gains have been completely wiped out, and it’s anyone’s guess how many tens of millions of Americans will have been pushed below the poverty line as governments destroy their livelihoods. It’s also a good bet the resulting deaths won’t get the same attention.

And that doesn’t count an unknown number of Americans whose medical appointments have been postponed indefinitely while hospitals keep beds open for COVID-19 patients. How many of the 1.8 million new cancers each year in the United States will go undetected for months because routine screenings and appointments have been postponed? How many heart, kidney, liver, and pulmonary illnesses will fester while people’s lives are on hold? How many suicides or domestic homicides will occur as families watch their livelihoods evaporate before their eyes? How many drug and alcohol deaths can we expect as Americans stew in their homes under police-enforced indefinite home detention orders? How many new cases of obesity-related diabetes and heart disease will emerge as Americans are banished from outdoor recreation and instead spend their idle days within a few steps of the refrigerator?

I have participated in many discussions among top policymakers in Congress and the Administration over the last few weeks. Such considerations are rarely raised and always ignored. Instead, policymakers fixate on epidemiological models that have already been dramatically disproven by actual data.

On March 30, Drs. Deborah Birx and Anthony Fauci gave their best-case projection that between 100,000 and 200,000 Americans will perish of COVID-19 “if we do things almost perfectly.” As appalling as their prediction seems, it is a far cry from the 200,000 to 1.7 million deaths the CDC projected in the United States just a few weeks before. And even their down-sized predictions look increasingly exaggerated as we see actual data.

Sometimes the experts are just wrong. In 2014, the CDC projected up to 1.4 million infections from African Ebola. There were 28,000.

Life is precious and every death is a tragedy. Yet last year, 38,800 Americans died in automobile accidents and no one has suggested saving all those lives by forbidding people from driving – though surely we could.

In 1957, the Asian flu pandemic killed 116,000 Americans, the equivalent of 220,000 in today’s population. The Eisenhower generation didn’t strip grocery shelves of toilet paper, confine the entire population to their homes or lay waste to the economy. They coped and got through. Today we remember Sputnik – but not the Asian flu.

It’s fair to ask how many of those lives might have been saved then by the extreme measures taken today. The fact that the COVID-19 mortality curves show little difference between the governments that have ravaged their economies and those that haven’t, suggests not many.

The medical experts who are advising us are doing their jobs – to warn us of possible dangers and what actions we can take to mitigate and manage them. The job of policymakers is to weigh those recommendations against the costs and benefits they impose. Medicine’s highest maxim offers good advice to policymakers: Primum non nocere -- first, do no harm.



Boss of tiny Oxford firm is 'extremely optimistic' over one-a-day pill it has developed to combat coronavirus

A tiny British company could beat the world’s pharmaceutical giants in the race to defeat Covid-19 after developing a one-a-day pill that is as convenient as aspirin.

Thousands of scientists at the world’s drug giants are battling to find ways of combating coronavirus, but experts at BerGenBio, a British-Norwegian company with just 38 staff, believe they have found the key.

Their bemcentinib drug, originally developed for cancer, defends against coronavirus by stopping it from entering cells and preventing it ‘switching off’ one of the body’s most important antiviral defence mechanisms.

Bemcentinib has been fast-tracked to be tried on NHS hospital patients in Government-backed trials, one of only a dozen or so drugs to be picked.

Last night, BerGenBio chief executive Richard Godfrey told The Mail on Sunday that he was ‘extremely optimistic’ the pill would save lives. ‘I think there’s an 80 per cent probability of it working and being of benefit to patients,’ he said.

When US drugs firm Gilead last week announced that tests of its antiviral treatment remdesivir helped patients recover four days earlier from the virus, stock markets in the US and Asia soared.

But the impact on death rates is less clear, with eight per cent of those given it dying, against 11 per cent of those who did not get the drug. The difference was not big enough for scientists to be sure it was having an effect.

But Mr Godfrey said of bemcentinib: ‘I’m expecting something bigger because it’s so different to anything else that’s been tried. We are stopping the virus surviving.’

 When the drug was used in the laboratory on live SARS-Cov-2 – the coronavirus that causes Covid-19 – it showed ‘some very big effects that dwarf what I’ve seen’ from other drugs, said Mr Godfrey.

‘So I’m extremely optimistic and think there’s going to be something quite profound [in human trials].’

Two-thirds of BerGenBio’s staff are based in Oxford, with the rest in Bergen, Norway.

Mr Godfrey said the drug had been tested on 300 cancer patients, had a good safety record and was relatively easy to manufacture.

It works by stopping the virus from utilising a naturally occurring protein called AXL, which it uses to trick cells to allow it entry. The virus also uses the protein to cut production of interferon, the body’s own antiviral substance.

The drug should stop coronavirus ‘hijacking’ AXL, making it harder for it to replicate and leaving it more vulnerable to the immune system.

The first of the 120 trial patients is due to be given the drug at Southampton General Hospital in the next few days. Results are expected at the end of June.



Incredible scenes at Michigan Capitol as anti-lockdown protesters armed with rifles storm Senate gallery while lawmakers wearing BULLETPROOF VESTS vote against extending Gov. Gretchen Whitmer's state of emergency

Lawmakers were seen wearing bulletproof vests as armed protesters stormed Michigan's Capitol in Lansing just moments before the state's House of Representatives denied Gov Gretchen Whitmer's request to extend her state of emergency. 

Photos from inside the Michigan House Chamber showed elected officials wearing bulletproof vests while men holding guns stood above them.

'Directly above me, men with rifles yelling at us. Some of my colleagues who own bullet proof vests are wearing them. I have never appreciated our Sergeants-at-Arms more than today,' Sen Dayna Polehanki tweeted Thursday afternoon.

In Michigan, guns are permitted inside the state's Capitol as long as they are visible and carried with lawful intent.

Protesters, who weren't wearing masks, were seen yelling within inches of officers from the Michigan State Police.

Others were heard chanting: 'Let us in! Let us in!'

The 'American Patriot Rally' which was organized by Michigan United for Liberty, drew in hundreds of residents who carried pro-Trump banners and held anti-Whitmer signs while protesting outside of the Capitol.

Demonstrators began descending on the Capitol at 9am Thursday morning while lawmakers were trying to decide whether to extend Whitmer's state of emergency request for 28 more days. 

Ultimately, the lawmakers denied the governor's request and passed a resolution authorizing the Speaker of the House to commence legal action, which will challenge the governor's actions during the pandemic. Whitmer is unable to veto the resolution. 

Whitmer has acknowledged that her order was the strictest in the country.

Protesters, many from more rural, Trump-leaning parts of Michigan, have argued it has crippled the economy statewide even as the majority of deaths from the virus are centered on the southeastern Detroit metro area.

Organizers of a mid-April protest in Michigan took credit when Whitmer recently rolled back some of the most controversial elements of her order, such as bans on people traveling to their other properties.

Whitmer's stay-at-home order is set to continue through May 15, though she has said she could loosen restrictions as health experts determine new cases of COVID-19 are being successfully controlled.

On Wednesday, she said the construction industry could get back to work starting May 7

The slow reopening of state economies around the country has taken on political overtones, as Republican politicians and individuals affiliated with Trump's re-election promoted protests in electoral battleground states, such as Michigan.



Almost 18,000 more people could die of cancer due to coronavirus, study shows

Research has shown that amid the crisis, one in 10 people would not contact their GP even if they discovered a lump or a new mole that remained for a week

There could also be a 20 per cent spike in fatalities of newly-diagnosed cancer patients, according to research by University College London (UCL) and DATA-CAN, the Health Data Research Hub for Cancer.

The figures stem from real-time hospital data for urgent cancer referrals and chemotherapy attendances, which have experienced a 76 per cent and 60 per cent fall respectively.

While England’s top cancer doctor has urged people to not hesitate in seeking help or being checked.

The advice from Professor Peter Johnson, the NHS clinical director for cancer, comes after worrying research showed nearly half of the public have concerns about seeking help.

Moreover, the poll by Portland revealed one in 10 people would not contact their GP even if they discovered a lump or a new mole that remained for a week or more.

After analysing data from 3.5 million patients, experts predicted before the Covid-19 crisis that approximately 31,354 newly-diagnosed cancer patients would die within a year in England.

But the pathogen could lead to at least 6,270 extra deaths in newly-diagnosed cancer patients — a rise of more than 20 per cent.

While the figure jumps further to 17,915 excess deaths if all people currently living with cancer are included.

There have been 21,678 fatalities from the virus at the time of writing, including more than 100 NHS staff and care home workers.

The main reasons for the increased likelihood that the public would ignore symptoms stems from a fear of contracting the virus itself by leaving quarantine.

There is also the selfless feeling from some that notifying their GP would further burden the NHS during this unprecedented time, though this has been rebuffed by Professor Johnson, who insists the opposite may be true if the public fail to seek help.

“NHS staff have made huge efforts to deal with coronavirus but they are also working hard to ensure that patients can safely access essential services such as cancer checks and urgent surgery,” said Professor Johnson.

“From online consultations to the roll-out of cancer treatment hubs, we are doing all we can to make sure patients receive the life-saving care that they need.

“We know that finding cancer early gives us the best chance to cure it, and ignoring potential problems can have serious consequences now or in the future.”


For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCHPOLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

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