Fighting for the death

In the past couple of days there have been protesters spread across the front pages of newspapers across the country. If you'd have asked me to guess what people would be willing to break isolation to protest over, I would not have guessed that they'd be demanding that more people be allowed to die of SARS-CoV-2, but that's apparently what the kids are into these days. But then, there are a whole lot of well-funded organizations convincing them that it's a grave injustice that we should sit at home for a couple of months in the hopes of saving a few hundred thousand lives. Organizations tied to Betsy DeVos, the Koch brothers, Adolph Coors, who'd like to have their workforce back and aren't worried if a few of them have to die for the cause.
And I want to talk about some of the points that some of the protesters and their online supporters have been making, because some of them actually seem to have merit when you look at them out of context, and it's actually not impossible to imagine being so convinced by aspects of the small picture that the big picture gets out of focus.
I keep encountering people online who insist that we're all just being crazy and anxious and over-the-top. We're so scared of getting sick that we've abandoned all reason. Now that most places aren't seeing the nightmare scenarios that were predicted early on, this is an especially tempting view. Even though the nightmare scenarios were projections of what would happen if we didn't take aggressive containment measures, anti-climaxes are anti-climactic. Now it's true, the public does panic unnecessarily all the time, over really foolish stuff. Politicians too. Remember how everybody freaked out about those 4 Ebola cases in 2014 and everybody was losing their minds and demanding the president close the borders? Heck, we've done that over every major Ebola outbreak. Remember when everyone wanted to shut the country down over SARS? MERS?
But do you remember who was remaining calm and telling Americans "there's no reason to worry, we got this"? The Centers for Disease Control and Prevention. The National Institutes of Health. Doctors. Scientists. Epidemiologists. They worked efficiently and with great urgency with the international scientific community to contain those illnesses, and to get treatment to those who needed it. They told us we didn't need to worry and they were right. The researchers who have been working to protect Americans from infectious diseases are world-class. They've got a thousand years of historical data to draw from, some of the most advanced technology on the planet, and they know a lot better than Karen on Facebook how diseases work. If every infectious disease expert on the planet is saying "this is the one we need to worry about," then this is the one we need to worry about.
There is no reason, y'all, that all the infectious disease specialists would band together to sell you a big old lie. In fact, every one of them would kill to be the one that discovered the silver bullet that ended the international nightmare. Setting aside saving lives and all that nonsense, the researcher who figured out a way to contain or cure the disease without shutting down the economy would have a Nobel prize, a book deal, and every cent of research funding they wanted for the rest of their lives. They'd be the greatest hero on the planet. Not a one of them wants to have to tell you to stay at home if you want all your loved ones to stay alive.  

Now, I've heard a number of people suggest that what we need to do is reopen the economy but leave all the old people at home while everybody else develops herd immunity. Because they heard the expression "herd immunity" once and decided to start using it without actually understanding how it works. Here's the problem with that plan.
We're sitting at about 30K new cases of COVID-19 per day, with social distancing. Of those 30K, 6,000, or 20% will be admitted to the hospital (not counting people who are treated in the ER and sent home). A significant number of those 6,000 people will die without prompt medical attention. Unfortunately, those patients don't go home after a day. Many will remain weeks, some a month or more.
The good news is that, except for in hot zones like New York, our hospitals, for the most part, have the capacity to handle this. For now, most have the beds and the staff to get prompt and effective treatment to everybody. Doctors and nurses in some areas are working past the point of exhaustion, which, of course, makes deadly mistakes more likely. Hospitals across the country still lack adequate masks and gowns, which means that doctors and nurses are getting sicker at a much higher rate than necessary, and that's causing some staffing issues that are for the most part manageable. So far. Because of social distancing.
So what happens if we stop social distancing tomorrow?   
There will be a spike in new cases. I don't know how big - you'd have to ask an epidemiologist - but I do know that if we're adding tens of thousands of cases a day despite half the country being in underground bunkers, the spike's gonna be somewhere between massive and staggering.
Hospitals don't have enough beds to accommodate a massive spike. Hospitals don't have the staff to accommodate a massive spike. And when hospitals are short-staffed, people die. People with COVID-19 who could have been saved would die because doctors didn't get to them in time. People with conditions completely unrelated to COVID-19 would die because doctors couldn't get to them in time.
The ICU fills up with COVID-19 patients, leaving no room for people with other life-threatening emergencies. Ambulances can't keep up with the demand and people with COVID-19 and without will suffer or die because there aren't enough EMTs in the city to respond to every emergency in a timely fashion.
But it gets worse. If we reopened the economy tomorrow, hospitals would not have enough PPE to keep themselves safe. Medical professionals would continue to get sick at much higher rates than the rest of us. 20% of doctors, 20% of nurses, 20% of respiratory therapists, will end up being hospitalized and unable to work, leaving hospitals even more short-staffed, which leaves more COVID and non-COVID patients dead. 

I've heard a few people make the argument that sure, social distancing might be necessary in big places like New York, but in small towns, it won't spread like that. Well, in fact, COVID-19 is barreling its way toward rural America and experts don't think rural America is ready. See, the smaller the town, the smaller and less well-equipped the hospital.
There would be other dire consequences to reopening the economy too soon. COVID-19 is already ravaging nursing homes. How much worse will it be when every staff member's kids are back in school/at daycare? How are businesses going to thrive if the open back up only to have all their employees get sick at the same time? Who is going to maintain order if all the cops get sick at the same time? This isn't just a normal bug - this is every employee who gets sick going on mandatory quarantine for two weeks, assuming they don't get hospitalized, assuming they don't end up on disability because the disease ripped up their organs.
Look, y'all, this shut down sucks. It sucks so much. I am bored and I can't stop eating and I'm getting really antsy about not having a job and I miss my family and I legit cannot breathe through that stupid mask. But Fauci’s gone from estimating death rates in the hundreds of thousands to the tens of thousands. The peaks we were so worried about have turned to gentle slopes. Look, for instance, at Ohio, which took some of the earliest and the strictest social distancing measures in the country. The yellow shows what researchers were predicting with no intervention at all. The blue shows what Ohioans have accomplished by just staying home and being safe. 

“Our latest projection is 1,600 cases per day — still a lot of cases per day, still a load on our hospitals, but this is the effect you have done. In Ohio we took our prediction and you have basically done this… you have squashed this and you have stretched it. Honestly, this is you. This is what you have done. This is how you have saved lives.” Dr. Amy Acton, Ohio Department of Health Director

Ohio plans to start very gradually reopening businesses come May 1st, and I'm cautiously optimistic about the prospect. The health director and governor have been very clear that we won't return to business as usual for a long, long time, but hope that cautiously reopening some non-essential businesses will offset the financial hardship for struggling families.   
I will confess that I am more concerned about the economy than I am about my getting sick. I know that if I do get sick, even with my compromised immune system, my odds of surviving are still really good. I am unemployed and way, way more worried about my personal finances than I am about my slim chances of catching the plague. Yes, I get that it is vitally important to avoid another great depression. But we can not, must not grease the wheels of capitalism with the blood of our countrymen. We are all in this together.
So does the economy stay closed forever until we get a vaccine? I don't see how that's possible. Several medical models have indicated that we'll need rolling shutdowns from now until 2022 - that's when we expect to have a vaccine. I don't know enough to have an opinion on that, but I do know that, at the very least, Americans have a moral obligation to stay at home until every hospital has enough personal protective equipment to keep their staff alive. We cannot applaud doctors and nurses as heroes and then put their lives at risk by behaving irresponsibly. There are a lot of people talking about their rights to get their hair cut or eat at Applebees, but don't thinking about the fact that hospital employees have the right to live.  I love you all. Stay safe, and stay home!