Public health scholars: Stay-at-home orders not best approach to pandemic

A faction of public health scholars says there may be a better way to approach the coronavirus pandemic than the shelter-in-place rules that have brought the U.S. economy to a screeching halt.

Their views are outside the current mainstream of the medical community. But their scientific take is anchored in two statistical threads that have held up in data collected from around the world over several weeks.

Namely, the virus is most lethal among the old and the sick, and as more data becomes available, the mortality rates appear to more closely mirror seasonal flu.

“It is very clear from the data that older people and people with underlying chronic conditions are at higher risk of mortality from infection,” said Jay Bhattacharya, professor of medicine at Stanford University.

“The key guide to public policy in the coming days will be the population prevalence of antibodies,” he said. “Communities that are very far along the epidemic curve might cautiously have stay-in-place orders relaxed. Those early along the epidemic curve will need support to avoid overcrowding of medical facilities.”

A handful of Stanford researchers independently came to similar conclusions, said John Ioannidis, a research professor at Stanford’s School of Medicine.

“Based on what I have seen so far, the infection mortality rate does not appear to be so horrible, it may be in the same ballpark as seasonal flu,” Dr. Ioannidis said.

All of the physicians who discussed this topic with The Washington Times stressed the coronavirus, which has swept across the world since first infecting people in Wuhan, China, is a serious threat and one that deserves a robust public health response.

The argument comes down to a balancing act, however, between the economic and mental health repercussions of sustained closings and quarantines, and the need to maintain economic activity.

“I don’t want to underestimate its potential to spread,” Dr. Ioannidis said. “But there’s a difference between freezing everything and events that bring thousands of people together. There has to be some solution between these extremes.”

While a decided minority, the Stanford researchers are not alone in questioning the popular defense against the virus.

“I am deeply concerned that the social, economic and public health consequences of this near-total meltdown of normal life — schools and businesses closed, gatherings banned — will be long-lasting and calamitous, possibly graver than the direct toll of the virus itself,” Dr. David Katz, founder of Yale University’s Prevention Research Center, recently wrote in The New York Times. “The unemployment, impoverishment and despair likely to result will be public health scourges of the first order.”

Across the pond, too, voices have been raised in objection to coronavirus’ social and economic shackles, which Dr. Sucharit Bhakli, a German microbiologist, labeled “grotesque, absurd and very dangerous.”

“The horrifying impact on the world economy threatens the existence of countless people,” Dr. Bhakli said. “All these measures are leading to self-destruction and collective suicide based on nothing but a spook.”

Most politicians have come to favor that more sweeping approach. Federal and state authorities also have promoted more extreme tactics to stymie the spread of COVID-19, the disease caused by the coronavirus.

Holdouts such as Georgia and Florida announced stay-at-home orders last week. Just five states — Arkansas, Iowa, Nebraska, North Dakota and South Dakota — have no stay-home orders in place.

Nearly 300 million Americans live in areas that have imposed such measures.

“This is tough. People are suffering. People are dying,” said Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases who is a key member of the White House coronavirus task force. “It’s inconvenient from a societal standpoint, from an economics standpoint to go through this, but this is going to be the answer to our problems.”

His support for blanket stay-at-home orders increased as the disease spread and the death toll climbed.

As of Monday, the U.S. had more than 338,000 confirmed cases, more than 9,600 deaths and a total of 17,582 patients who recovered from COVID-19, according to data compiled by Johns Hopkins University.

The death rate from the virus varies widely around the globe, from 2.8% in the U.S. to 4% in China, 10% in the U.K., 12% in Italy and 1.5% in Germany, according to available data.

The rates vary, in part, depending on the extent of testing to gauge the spread of the virus.

Seasonal influenza has an annual death rate of about 0.1%, according to the Centers for Disease Control and Prevention.

Some of the dire models used by the White House have come under fire. A prominent model from the Institute for Health Metrics and Evaluation (IHME) wildly overshot the estimate of hospital beds that would be needed.

The IMHE predicted the U.S. would need 193,165 hospital beds for COVID-19 patients on April 2 when the actual figure turned out to be 27,069.

As more data becomes available, experts say it will reveal a lower mortality rate than what is currently on the books.

“When you look at Italy and some other places, you see the mortality rate is maybe slightly higher than seasonal flu,” Dr. Ioannidis said.

Among the factors that have contributed to what seems a much higher mortality rate in Italy is an elderly population that smokes more, as well as a relatively mild seasonal flu season that left what statisticians call “a deficit of death,” he said.

“These people survived the flu season and then coronavirus hit them,” he said.