The Forgotten Victims of COVID-19
Canada is in the fifth week of economic and societal shutdown in our fight against COVID-19. We just passed the grim mark of 1000 deaths from the virus, and in my hometown it is spreading with particular virulence in long-term care homes. Even with the depressing numbers we see here, it is nothing compared to what some other countries have faced. I am deeply worried about my grandparents, my older congregants, and my relatives and friends with underlying health conditions. Would I be human if I were not afraid?
But the time has come to start preparing to lift the lockdown.
I am not talking about the country being “opened up and just raring to go” overnight, like The Orange One said to millions of horrified people. The only saving grace the American people have from him is that people who are at least marginally more intelligent and decent than him serve as his advisors, or perhaps more accurately, handlers. And whoever told him to say that the cure must not be worse than the disease spoon-fed him one of his extremely rare stopped clock moments. The fact is that bringing society to a grinding halt is doing unprecedented damage to the economy and to us as a species.
It is hard to express concern about the economy without someone shrieking at you that you are a monster who cares more about lives than money. Someone who doesn’t care if people die as long as you line your pocket. Who has let greed blind them to value of human life.
But here is the thing: for most people their lives depend on the economy. The rich of this world have far, far less to lose from this shutdown than ordinary people. They could not work another day in their lives, and simply live off their cash and secure assets for the rest of their lives, even if their investments tank.
Does that describe you? Does that describe your neighbour who just lost their job and does not know how they will pay their rent and feed their family?
No, I didn’t think so.
I strongly encourage everyone to read this article from Johns Hopkins, entitled “The Unequal Cost of Social Distancing” : https://coronavirus.jhu.edu/from-our-experts/the-unequal-cost-of-social-distancing?fbclid=IwAR0yZsXqlbMuC-OR2WSQXeD4iuTtXJYg9gIAMyxLXhLDRs4H18nQc2k8USQ . These professionals, better informed and better writers than myself, perfectly articulate the concerns I have been expressing since people were ordered to go home and stay there:
“With each passing day, there are aggregate economic effects that become difficult to bounce back from. Moreover, with each passing day, the burdens placed on families rise. As this pandemic goes on, the likelihood of the people who suffer the highest costs of social distancing remaining compliant with public health guidance will go down. This is not sustainable, nor is it an acceptable sacrifice to expect people to make.
We must immediately start testing systematically sampled subsets of the population to understand basic information like infection and mortality rates. Right now, efforts to stem the global COVID-19 pandemic are stymied because this information is either nonexistent or difficult to interpret due to lack of systematic randomized testing. Eventually, when COVID-19 is better understood, such information may lead to targeted interventions with lower economic costs. Instead, we are forced to institute radical, blanket measures to stem the spread of the virus, imposing staggering costs on those least able to incur them.”
A crumbling economy is not about millionaires losing out on investments or billionaires not being able to buy a new yacht. It is about keeping roofs over people’s heads, food in their stomachs, and providing them with basic health care. Is that so much to ask? The Canadian government’s massive aid package will pay Canadians who have lost their jobs $2,000.00 a month for the next four months. While that is a generous and appropriate use of our tax dollars, the hard truth is that for many (especially those in single-income households) that is simply not enough, especially in larger cities where the cost of living is insane. The Premier of Ontario has put a moratorium on evictions, hydro rates have been lowered, and banks are working with people to defer payments and help small businesses. I am very grateful for all of this, but all it does is buy a little time.
Another crucial problem we are facing in this province is the disruption in the provision of non-COVID-19-related health care. Doctors’ and dentists’ offices are mostly closed except for urgent/emergency matters (although there has been no universal definition given for those terms), which means people are not getting routine healthcare. Specialist appointments booked months ahead have been cancelled or re-scheduled. All elective surgeries have been cancelled, which sounds reasonable until you learn that the definition of “elective” is pretty damn wide [https://calgaryherald.com/opinion/columnists/smith-how-we-can-end-the-devastating-covid-19-lockdown/wcm/34c35a46-9441-4280-affb-a0a65b24c761/], encompassing any surgery not required to prevent imminent death. It’s not just facelifts and boobs jobs, it’s also cataract surgery and surgeries to treat cancer, like mastectomies [https://www.macleans.ca/opinion/i-have-breast-cancer-and-cant-be-treated-because-of-the-coronavirus/].
So, we’re going to let people go blind, or let the cancer spread through their bodies and kill them, all in the name of saving lives? If people are not allowed to see their doctors and dentists for routine health care, emerging health problems will not be discovered, and worsening conditions cannot be addressed. Undiagnosed diabetes will go unchecked. Undiscovered cancer will have time to grow and spread. Oral health issues that could be easily fixed if caught early will go untreated and possibly lead to extremely painful and costly problems down the road. I could go on, but I think you get the point.
Then there are mental health issues, which are also a matter of life and death. Speaking from my own experience, those of us with pre-existing mental health conditions will certainly not get any better being kept away from the people we love and without any sense of normalcy. Stability and routine are absolutely critical for people living with mental health problems, and those two things are out of reach for people who have lost their livelihoods in this crisis. Loss of income also means loss of access to medication, therapy, healthy food, and stable housing, without which these diseases can and do become imminently deadly. Even for those of us who are still lucky enough to have jobs, and be able to work from home, any kind of routine we can develop while held in limbo is a poor substitute, especially when we are separated from those we love. The risk of suicide is real.
Even those who do not have existing diagnosed mental health conditions can develop them on a result of the stresses caused by the house arrest under which we have all been placed. Job loss has long been counted among the most stressful and traumatic things that can happen to a person, especially when it happens suddenly, as has been the case for tens of millions of people over the last few weeks. Depression can easily develop during times of stress and tragedy, and anxiety disorders can also grow out of external trauma. Add in the fear we all have for those we love who are at particular risk, and the uncertainty of where this situation is going, and everyone is at risk of severe mental health problems. And not everyone who takes their own life has clinical mental health problems.
The fact that so little is known about this virus, combined with a woeful lack of testing in most countries that has left us flying with poor visibility, adds to the challenges. But what we do know is that it is not the deadliest infectious disease we have dealt with in recent years, not by a long way. It could be a great deal worse, and the world needs to use this as a very rude wakeup call to be prepared for an even greater foe next time around. But for the moment let’s work with information that we have: as of yesterday, Worldometer reported 2,083,304 total cases worldwide, with 134,616 deaths, putting the death rate at 6.5%. It is a frightening number, but hold on a moment: by now you have probably heard various reports about the huge estimated numbers of unreported cases, including this one from Italy: https://www.thedailybeast.com/italys-covid-19-cases-likely-ten-times-higher-than-official-numbers-says-official. I have heard everything from 10 to 50 times higher than the confirmed cases, and given how easily this virus appears to spread, any of those scenarios is possible. But if that the case, then the death rate would be 10, 20, or even 50 times lower than originally thought. Can we really justify dooming an entire generation to destitution for a virus that has a 99+% survival rate?
The lives of COVID-19 victims are not more important than the lives of the people who will end up as “collateral damage” from the fight against this new threat. The media is happy to bombard us with the horrifying numbers of deaths caused by COVID-19 because it sells, and because those losses are easily quantifiable. The people who will die because of the new disease will be lost in the flashes of light surrounding those who died of the disease.
Even with all of the talk of death in the face of COVID-19, the fear of death can only control people up to a point. There will always be some people who would be happy to stay locked up in their homes forever simply to stay alive, but I would bet that they are quite a small minority. For the rest of us, if we continue to be deprived of our loved ones, isolated from other human beings, denied the basic pleasures of life, and kept from making a living, sooner or later we will lose our fear of death. If you take away everything that makes people’s lives worth living, eventually they will stop trying to protect their lives. And when they stop caring about preserving their own lives at all costs, many of them will lose sight of protecting the lives of others. This is just the reality of human nature. Human nature is not always pretty, but it is what our leaders have to work with, however inconvenient it often is for them.
Returning to any semblance of daily life will take time, and it should. We should not open the floodgates and have people breathing all over in each other in large crowded groups any time soon, and we all must be vigilant until such time as sufficient numbers of people are vaccinated. We will not be out of the woods for a long time to come. But we are very quickly approaching the point where the human cost of the economic and social shutdown will exceed the cost of the virus. We cannot save everyone. Anyone of us could be one of the casualties of this disease, whether directly or indirectly. There is no easy answer to the question of how long we can keep our foot on the brake before we are hit by a pile-up behind us. But it is coming.