The health case for restarting the economy
We may already have traded one epidemic for another longer one, Adam Hofmann fears.
Quebec’s announcement that certain businesses will be allowed to reopen next month is a welcome step in the right direction — and I say that as a physician.
Businesses have been shuttered for weeks now, and unemployment has been skyrocketing. Economists have been debating just how bad the economic impact of the COVID-19 pandemic will be. But as a physician who specializes in scaling preventive medicine through clinical practice and physician-support AI tools, I’m concerned that the health effects of this economic shutdown will extend well past the time when we will remember the coronavirus actually happened. I’m worried we have traded a short-term epidemic for a long-term one, with potentially greater consequences.
The serious, short-term consequences of COVID-19 have to be weighed against the serious, long-term and potentially much larger impacts of self-inflicted economic hardships. While most of us will survive the effects of COVID-19, many more people will suffer and might even die from the effects of the economic crisis that ensues. This is not alarmism. It’s well established that families that experience poverty are at greater risk for domestic abuse and chronic diseases, including mental health disorders, diabetes, cardiovascular disease and obesity. Many of these chronic diseases are at least as deadly as COVID-19, only it will take longer to feel their effects and the cost will be higher, both in terms of human suffering and money.
A global study of suicide rates after the 2008 global recession found that in American countries, suicide rates rose the most in men ages 45-64, which seemed to be associated with rising unemployment. Children raised in poverty will suffer from long-term health effects,
Families that experience poverty are at greater risk for domestic abuse and chronic diseases.
and lower quality of life. I see this first-hand in my clinical practice, which primarily serves a low-income population. The crushing financial trade-offs, anxiety and mental illness afflicting my patients on a daily basis is both the cause of, and a costly barrier to, the treatment of their chronic diseases.
The closest recent analogy we can draw to the COVID-19 pandemic is the SARS epidemic in 2003. As microbiologists Neil Rau and Susan Richardson explained in an article in the National Post, COVID -19 doesn’t affect people the same way SARS did. Contact tracing and quarantine was a highly effective strategy for SARS, which transmitted only after people began showing symptoms, late in the course of the illness. COVID-19 can transmit when people are asymptomatic. This is why the social-distancing measures we have taken to date have proven to be only partially effective. It is time to change course.
Instead of using a hammer to “flatten the curve,” we can use what we know now to refine that strategy by redirecting quarantine measures and support toward those people who are the most vulnerable — the elderly and chronically ill — while also supporting economic stability.
For more than 80 per cent of people, the virus will seem like nothing more than a bad cold. And while it’s true that some young and healthy people will suffer acute and even fatal symptoms, that is true even of the seasonal influenza outbreak. Much like COVID-19, the seasonal flu can cause unexpected and severe illness in healthy people, though it tends also to predominantly impact the elderly. It’s not the number of cases in the population that matters; it’s the number of people who die or end up in the hospital that matters.
I fear we have not properly been taking into account the costs to us, both economic and human. Failing to do this accounting wisely is trading one epidemic which may last months for another one which will impact generations.
Adam Hofmann is a practising physician, a health technology entrepreneur and author. He cares deeply about his patients, the practice of medicine and examining the societal impact of technology on health care. He is the founder of several health technology and AI startups including Preventia Clinics and Preventia Technologies.