Death By Policy

[George K]

Alternate title: "How Many Deaths Has The Lockdown Caused?"

Deaths from chronic, non-emergent conditions also increased as patients put off maintenance visits and their medical conditions deteriorated. In the second study of excess deaths, the five states with the most Covid-19 deaths from March through April (Massachusetts, Michigan, New Jersey, New York, and Pennsylvania), experienced large proportional increases in deaths from non-respiratory underlying causes, including diabetes (96 percent), heart diseases (89 percent), Alzheimer’s disease (64 percent), and cerebrovascular diseases (35 percent). New York City—the nation’s Covid-19 epicenter during that period—experienced the largest increases in non-respiratory deaths, notably from heart disease (398 percent) and diabetes (356 percent).

Cancer diagnoses were delayed for months as patients were unable to obtain “elective” screening procedures. For some, this will result in more advanced disease. Diagnosed cancer cases—normally treated with surgery or inpatient medical treatments—were treated with outpatient treatments instead. While some oncologists rationalized that the results might be just as good, physicians were clearly deviating from the standard of care.

The lockdowns led to wide unemployment and economic recession, resulting in increased drug and alcohol abuse and increases in domestic abuse and suicides. Most studies in a systematic literature review found a positive association between economic recession and increased suicides. Data from the 2008 Great Recession showed a strong positive correlation between increasing unemployment and increasing suicide in middle aged (45–64) people. Ten times as many people texted a federal government disaster mental-distress hotline in April 2020 as in April 2019.

As we consider how to deal with resurgent numbers of Covid cases, we must acknowledge that mitigation measures like shelter-in-place and lockdowns appear to have contributed to the death toll. The orders were issued by states and localities in late March; excess deaths peaked in the week ending April 11. Reopening began in mid-April, and by May 20 all states that had imposed orders started to lift restrictions. In June, as the economy continued reopening, excess deaths waned.

[Loki]

Measured in years of life lost it gets much more dramatic.

[jon-nyc]

Haven’t clicked the link but how do the authors tease out the difference between treatment avoidance due to fear of the virus vs treatment avoidance because of policy proscriptions?

[Copper]

Elective death doesn’t sell papers.

[jon-nyc]

I’ve now read it, they don’t tease it out at all. So ‘death by policy’ is in many - probably most - cases just ‘death by virus’.

[jon-nyc]

I delayed treatment for a chronic condition (immunosuppression) in March and delayed a PFT in April. I’m about to delay another PFT later this month. I delayed lab work by a month.

It’s conceivable these decisions could have harmed me. Or could still.

None were because of policy. None were the decisions of any physician. All were my decision trying to balance my own risks as I perceived them.

[George K]

@jon-nyc said in Death By Policy:

I’ve now read it, they don’t tease it out at all. So ‘death by policy’ is in many - probably most - cases just ‘death by virus’.

You mean death by "fear of virus." as you pointed out in your subsequent post.

[jon-nyc]

Managing the risk presented by the virus is probably the best description.

[LuFins Dad]

Risk of coming into contact with the virus, contracting the virus, and becoming COVID Symptomatic is > Risk of complications by not having these treatments?

[Copper]

@LuFins-Dad said in Death By Policy:

Risk of coming into contact with the virus, contracting the virus, and becoming COVID Symptomatic is > Risk of complications by not having these treatments?

That depends on whether you are buying or selling.

[jon-nyc]

@LuFins-Dad said in Death By Policy:

Risk of coming into contact with the virus, contracting the virus, and becoming COVID Symptomatic is > Risk of complications by not having these treatments?

Weighted by downside potential, yes.

Obviously these are not precisely defined risks, but questions of judgement.

For example, I was due a quarterly infusion of IVIg in late March. This involves a nurse coming to my home and giving me the infusion for 3+ hours. My nurse is a lovely young lady who also works in a hospital in the Bronx and lives in New Rochelle, then the national hotspot for Covid. I took a pass on that.

In late May, I had her come. The situation had changed.

[Jolly]

An alternative question: If there were no lockdown, how many deaths would be caused by a saturation of medical services?