Healthcare professionals: We have flattened the curve, now we’re behind it.

{child_byline}By: Karl W. Lambert, Dr. Gillian Shaw, Amy Wood, Shawn Needham, Janet Needham{/child_byline}

Okanogan County health officials want to reduce any risk that might create new Covid-19 cases. As independent healthcare professionals, we contend this is not a realistic or appropriate health policy goal.

The original justification for the economic shutdown and stay-at-home order was to “flatten the curve.” This was a nuclear strategy that many healthcare professionals felt compelled to support in the context of a rapidly-evolving landscape surrounding an unfamiliar virus. However, with data accumulation we have learned that the virus is less deadly than originally feared and primarily harmful only for a specific, identifiable portion of the population. Stanford data and other epidemiologists are reporting an infectious fatality rate closer to 0.1 to 0.2%, a risk appreciably lower than previous World Health Organization estimates 20 to 30 times higher. The outdated WHO estimates are still being cited by state and local health officials to justify the continued lockdown.

According to the latest data from the state Department of Health, 90 percent of all Washington Covid-19 deaths are individuals 60 or older and more than half are age 80 or older. Sixty-one percent of Covid-19 deaths are associated with long-term care facilities. These older, vulnerable individuals should be protected, and we should concentrate our quarantine and isolation efforts where they will be effective.

It is neither prudent nor responsible to suggest that healthy individuals under the age of 60 remain at home indefinitely. People have done exactly what they were told. They stayed home, closed their businesses, and flattened the curve. Most of the rationale and data supporting the shutdown has collapsed, but some health officials and government leaders won’t let it go. Unless we want to annihilate all faith in public health authorities, we shouldn’t move the goalpost from “flatten the curve” to “no new cases.” In fact, we can expect the number of Covid-19 cases to rise as testing increases.

Perhaps the most damaging, unsubstantiated, and unproven theory surrounding Covid-19 is that of asymptomatic spread. Initially, because many people tested positive without displaying symptoms, it was posited that these individuals were silent carriers. Because the virus was new, it was thought safest lock down even seemingly healthy individuals because of the risk that they may be disease vectors. While it has yet to be proven that asymptomatic transmission of Covid-19 can’t happen, there is no evidence that this is occurring on a wide scale. The idea that we should live in a perpetual state of fear that any healthy person could be spreading the virus is not backed by scientific evidence.

In King County, the epicenter of Washington’s outbreak, public health officials have now estimated that the transmission rate of the virus has been consistently below 1.0 since March 29. This is great news! We should be following the science and data toward resuming our lives.

Washington schools were prematurely canceled for the entire year, despite a growing number of reports from public health and infectious disease experts suggesting children spread the virus far less than adults. Montana and Idaho are sending their kids back to school. And while other states are reopening, Washington counties are expected to go three weeks with no new cases in order to move to Phase 2.

In March, model after model predicted severe hospital bed and ICU shortages, even with social distancing. Thankfully, these models were wrong. The predicted shortages never manifested. We have beds. We have ICU capacity. We have ventilator capacity. The system is not overwhelmed. In fact, we dismantled our field hospital and sent 500 ventilators to New York. Meanwhile, hospitals all over the state are furloughing thousands of healthcare workers amid multi-million-dollar budget shortfalls.

Many health officials in rural and non-profit hospitals are receiving substantial government grants and subsidies to remain operable, but that doesn’t mean they should ignore the financial plight of other Washington hospitals and businesses that are hemorrhaging.

It is futile to attempt to bring the risk of contracting COVID-19 down to zero. Free people make choices every day that increase their risk of dying. Your chances of dying while driving a car is almost double your chance of dying while driving an SUV. We don’t ban cars. Hundreds of children drown in pools each year. We don’t ban pools. Five thousand Americans choke and die on solid food every year. We don’t ban solid food. The truth is, we have accepted that there are trade-offs between the risk of death and quality of life, and we make them every day.

The virus shutdown is trading lives too. Depression, anxiety, suicide, obesity and all of the other risks from inactivity and isolation will result in death. As healthcare professionals, we are seeing them in our practices and we are alarmed.

There is no clinical data supporting the restraint and quarantine of healthy individuals to prevent the spread of a virus, and that is proving true with COVID-19. It is a travesty that our response to this crisis has been to saddle future generations with crippling debt, bankrupt hundreds of businesses, and force unemployment to Great Depression levels.

The “no new cases” criteria put out by Governor Inslee is not realistic for most communities. The virus is here to stay. We must learn to live with it and mitigate its effects to the best of our ability. Washington should be following New York Governor Cuomo’s lead by allowing statewide restrictions to expire and returning control to the local governments that are in the best position to monitor the needs of their communities. If a local area has sufficient hospital bed and ICU capacity and the transmission rate is below 1.0, then a community is in a good position to begin safely reopening.

Many health professionals disagree with our government’s current plan but are afraid to speak out. We can no longer remain silent. It’s time to change course. In Washington, we have flattened the curve, and now we’re behind it. We must protect and shelter the aged and vulnerable and allow the healthy population to resume living.

By: Karl W. Lambert, Medical Director, ARNP, Redimedi Integrative Clinic; Dr. Gillian Shaw, MD, Cashmere Redimedi Integrative Clinic; Amy Wood, ARNP, Redimedi Integrative Clinic; Shawn Needham, R.Ph and Janet Needham, R.Ph, Moses Lake Professional Pharmacy.