Last night, after we reported on a pair of ER doctors arguing that the US states should lift their lockdowns immediately (during the course of their argument, which was mostly rooted in trends they've witnessed first hand, they apparently made the error of bringing up 'personal liberty' and 'the Constitution', words that prompt progressives to stop listening and start squawking about killing grandma to further enrich the billionaires) YouTube decided that their argument constituted 'misinformation' about the coronavirus outbreak and deleted the video after it racked up more than 5 million views.
We found that curious, since even doctors and epidemiologists have told mainstream news organizations that our understanding of the virus is still developing, and things we thought weren't accurate just weeks ago and now being re-examined. One such aspect is the heavy handed lockdown response implemented across the US, and elsewhere. Urban leftists and out-of-touch Silicon Valley billionaires simply don't understand that there are millions of Americans out there - many of whom happen to be white - who are absolutely terrified about losing their livelihoods, and don't understand why all of this is necessary to combat a virus that leaves the vast majority of those infected unscathed.
The first rounds of 'surveillance' testing in the US, carried out in New York and in California's Santa Clara County (the Cali effort was part of a private study, while New York State is testing random samples of the population to try and discern how widely spread the virus has already become) have suggested that the number of total cases is much, much higher than official numbers reflect. The most recent data released by Gov. Cuomo suggest that 1 in 4 people in NYC might already be infected, a figure that rises to 40% in some poorer areas like parts of the Bronx, where most workers are 'essential'.
Many have blamed politicians for sending 'mixed messages' to the public, but the truth is, the message has changed along with our understanding and experience dealing with the virus.
And now, an ER doctor at a hospital in the Bronx is arguing that it's time to reopen the economy, while pointing out that many thousands of unnecessary deaths could result if we don't reopen quickly enough, as millions of Americans delay or skip critical preventative care, including people with heart disease and other health issues that make doing so particularly dangerous.
Daniel Murphy, an emergency room physician at St. Barnabas Hospital in The Bronx. Murphy contracted the virus during the early days of the outbreak, and accidentally spread it to members of his family. Luckily, they all quickly recovered and he returned to work in time for the big rush.
Murphy readily acknowledged that the outbreak has been by far the worst public health emergency of his 30-year career in medicine.
COVID-19 has been the worst health-care disaster of my 30-year career, because of its intensity, duration and potential for lasting impact. The lasting impact is what worries me the most. And it’s why I now believe we should end the lockdown and rapidly get back to wor.
From mid-March through mid-April, the ER staff at St. Barnabas huddled in groups of about 20 every morning. We asked ourselves what had happened over the previous shift. We generated a list of actionable tasks for the following 24 hours. At first, we addressed personal protective equipment and the management of patients with mild illness who were seeking COVID-19 tests.
Two weeks ago, Murphy said, their ER was slammed with calls, and patients were dying from severe COVID-19 left and right. But as the curve has 'flattened' - a trend closely documented by data collected by New York State - Murphy and his team have noticed a massive drop in emergency patients with COVID-19.
Then came the wave of critically ill patients in numbers none of us had ever seen. This lasted for two weeks. The number of patients on ventilators accumulated in the ER and throughout the hospital. We witnessed an unprecedented number of deaths. The tone of the huddles became more somber. We became accustomed to the morbidity; we did our jobs.
It is precisely what I have witnessed that now tells me that it’s time to ease the lockdown. Here’s why.
Then, all of sudden, on April 7 at 1 pm, Murphy noticed that the non-stop parade of ambulances carrying critically ill COVID-19 patients seemed to have stopped suddenly. From that point on, the number of ER admissions started to decline precipitously.
First, the wave has crested. At 1 p.m. on April 7, the COVID-19 arrivals slowed down. It was a discrete, noticeable event. Stretchers became available by 5 p.m., and the number of arriving COVID-19 patients dropped below the number discharged, transferred or deceased.
That drop was "striking", as the doctor explained, because the community he serves is overwhelmingly poor, and sported high rates of infection. The surveillance data released by NY State so far suggests that the area surrounding the hospital may have seen infection rates climb as high as 40%.
The mechanics of this ebb and flow have led Dr. Murphy to suspect that the lockdowns have actually done little to blunt the 'peak', a conclusion that's supported by Sweden's policies and outcomes.
This was striking, because the community I serve is poor. Some are homeless. Most work in “essential,” low-paying jobs, where distancing isn’t easy. Nevertheless, the wave passed over us, peaked and subsided. The way this transpired tells me the ebb and flow had more to do with the natural course of the outbreak than it did with the lockdown.
Whatever Murphy's first-hand experience might suggest about the usefulness of lockdowns, what's wrong with waiting a few more weeks, just in case he's wrong? Well, Murphy explains, even if we set aside the economic damage and its long-term ramifications for personal health, there's an even more urgent issue at hand: Because of the lockdowns, too many Americans are delaying critical non-COVID-19 care.
The problem is that in addition to the drop in coronavirus patients, the hospital has also reported a massive drop in patients of all types and categorizations as more people are apparently staying home despite injuries or symptoms that are probably critical for fear of catching the virus. There's simply no other explanation for such a statistically significant drop.
Without a doubt, many of those who aren't healthy but have opted to delay care that could prevent lethal strokes, heart attacks or other diseases.
Second, I worry about non-coronavirus care. While the inpatient units remain busy with sick COVID-19 patients, our ER has been quiet for more than a week. We usually average 240 patients a day. For the last week, we averaged fewer than 100. That means our patients in this diverse, low-income community are afraid to come to the ER for non-COVID care.
Gotham-wide, the number of 911 ambulance runs declined to 3,320 on April 18, down from a peak of 6,527 on March 30, according to New York Fire Department data. The current nadir is significantly below the average.
A large share of those staying home surely have emergency medical and surgical conditions not related to the novel coronavirus. The growing numbers dying at home during this crisis must include fatal myocardial infarctions, asthma exacerbations, bacterial infections and strokes.
Another huge problem that has been almost completely ignored is that child vaccination rates have plummeted during the pandemic.
Meanwhile, our pediatric volume in the ER has practically disappeared. Visits to primary-care pediatricians are also down, with vaccine schedules falling behind. Everyone seems to be avoiding the health system — an important and unfortunate consequence of the stay-at-home strategy.
Third, inordinate fear misguides the public response. While COVID-19 is serious, fear of it is being over-amplified. The public needs to understand that the vast majority of infected people do quite well.
And finally, as we noted above, Dr. Murphy argued that the virus is already much more pervasive than official data reflect.
Finally, COVID-19 is more prevalent than we think. Many New Yorkers already have the COVID-19 infection, whether they are aware of it or not. As of today, over 43 percent of those tested are positive in The Bronx. We are developing a significant degree of natural herd immunity. Distancing works, but I am skeptical that it is playing as predominant a role as many think.
There's no question that testing is "important work", Dr. Murphy added. But there's no reason it can't happen "in parallel" to an economic reopening. And even as it stands, scientists continue to find flaws with tests that call their results into question. All of this will likely take months, if not years to sort out. And we simply can't wait that long without making the 'cure' more damaging than the 'disease'.
More testing will better establish the numbers among those with mild illnesses and no symptoms. My professional experience tells me the number of infected people will be high. Testing is important work, but it should happen in parallel to the immediate resuscitation of the economy and getting people back to work.
At present, the testing is imperfect. We can’t wait months. We must protect the vulnerable and mitigate without destroying the economy.
So, will Google and YouTube censor Dr. Murphy, too?