Amesh Adalja: COVID19-A Path Forward

In his essay on COVID19: A Path Forward, Dr. Amesh Adalja, a virus, bio-security expert writes on the importance of how draconian measures to foght COVID-19 can be worse then virus itself:

Plans of prolonged, enforced confinement aimed at preserving life at any cost are premised on a misunderstanding of human life and what makes it worth living. When discussing treatment options with a patient, I often invoke the concept of “quality of life”. Patients regularly choose to take on some risk to their longevity in order to preserve or enhance their quality of life. Individual preferences and shared decision-making with physicians guide medical decision making and also should apply to each individual’s decision regarding the degree of social distancing that is appropriate for them.

A degraded quality of life, particularly over time, itself generates its own risks of death. If the lockdown is prolonged, we can expect increases in deaths from cancer, cardiovascular disease, stroke, mental illness, and substance abuse. How many cancers will metastasize while colonoscopies or biopsies deemed “elective” will be postponed?

Quality of life consists largely in the ability to engage in the activities that make up our lives, and central to these activities is work. Most of us need to work to support ourselves, and many people, including myself, derive meaning from their work. Moreover, humans, as a species, survive by productive work. Jobs cannot be easily parsed into “life-sustaining” and “non-life-sustaining” enterprises. All work consists in the creating of something we need to sustain human life physically and psychologically. Some of these needs are more acute than others, but all contribute to our ability and will to live. Stopping people from working is like depriving a limb of blood flow. Though action is sometimes necessary in an emergency, irreparable and irreversible harm will occur if it is prolonged. A prolonged freeze of the economy — even in the face of a deadly pandemic — will cause a long-term damage far greater than any purported benefit.

He also presents five recommendations, and concludes on a positive note:

In the past infectious diseases claimed more lives per capita than are projected to be at risk from this pandemic, but humans rarely responded by retreating from activity. In the years when smallpox ravaged the planet and rubella crippled babies, humans went to the moon.