Bum Ticker
We see it every day..
The death ticker.
The chyron at the bottom of the screen, the frame to the side of the newscasters. The count of the Covid-19 afflicted and dead, both US and worldwide. Accompanied by somber phrases: “grim milestone”, “unrelenting crisis”, “no end in sight.”
The Covid death ticker is easily the most effective graphic communicating the tragedy of the pandemic; inspiring an escalating sense of dread that in turn leads to a clamor for action.
Such tickers are not new. Environmental groups sponsor a climate-change carbon-tonnage chyron in Times Square, running ever upwards by the minute. Past Republican party conventions had a similar ticker for the national debt, though it doesn’t appear to have much effect on how the GOP votes.
The ticker both promotes awareness and deflects arguments. It conveys a sense of urgency, a drama that must be addressed now. In turn, the ticker serves as a shield against criticism, against proposals for more moderate strategies. The ticker implies that any counterargument is deliberately ignorant of the tragedy. How can we countenance moderation in the face of such inexorable death – do not these escalating numbers prove that the human cost justifies any and all measures?
For Covid-19, our challenge is that the death ticker does not depict the full human cost: it excludes all the lives lost from the measures taken to combat the coronavirus itself.
In short, we need a second ticker. Only by juxtaposing the lives lost due to Covid with the lives lost due to lockdowns can we chart a balanced path forward. All decisions have positive and negative consequences; cost/benefits between choices must be calculated to properly inform our leaders and our society.
With most media concentrating exclusively on the tragedy of Covid, we are missing the tragedy of the lockdowns – typically dismissed as complaints about bar curfews in recalcitrant red states.
But this Lancet study shows the potential magnitude of the toll: the 2008-2009 Great Recession was estimated to have caused 260,000 excess deaths due to cancer alone. Driven by financially constrained healthcare-systems and suddenly-impoverished populations, all too many people failed to receive the screening and treatment for otherwise survivable illnesses.
The US share of Lancet’s excess deaths was 36,000 – when measured against Covid’s 500,000 US deaths as of this writing, the trade-off would seem acceptable.
But…
We need to consider that Great Recession unemployment peaked at 10% in 2009, while 2020 Covid job losses topped out at nearly a third higher: 14.7%.
We also need to consider that the Lancet study was limited to cancer. Citing my own experience in the Veterans Health Administration, we were averaging 300,000 patient encounters a day prior to Covid. Midway through the pandemic, that number fell by two-thirds, to just over 100,000 daily encounters. This was not economically driven: VHA understandably prioritized resources in preparation for Covid, deferring Veterans treatment for elective procedures.
The problem is that elective became a synonym for unnecessary. There are consequences for postponing routine medical procedures – with colonoscopies, mammograms, blood panels, heart disease, diabetes and other screenings all reduced by double digits. The VHA downturn was further exacerbated by many Veterans’ media-driven apprehension that going to a hospital in the midst of the pandemic was tantamount to a death sentence.
Now extrapolate VHA’s experience for 9 million Veterans treated in 172 hospitals to America’s 330 million citizens across 6,000 hospitals. It’s safe to conclude that non-Covid excess deaths will sail far past the 36,000 lives lost to cancer during the Great Recession.
We’re further challenged by the political perception that a death from Covid is somehow worse than a death from other causes.
Non-Covid deaths are a lagging indicator – it will be years before the full consequences manifest. But there will clearly be a toll. Then add in the non-fatal, but still quantifiable tragedies of mental illness, addiction, domestic abuse and life-long economic loss stemming from a full year of home confinement and the 1.8 million small businesses that closed either temporarily or permanently.
Lockdowns are highly regressive, disproportionately impacting the working class in terms of risk, transportation, access, employment and more. Forty percent of workers making less than $40K annually have lost their jobs this year. Knowledge workers, zooming from home, are far more able to ride out the lockdowns with minimal impact to income and medical care.
And then there’s the elephant in the room: the 56 million American children who are embarking on their second year of school closures, with the concurrent loss of education and socialization – a burden particularly acute for impoverished and minority populations. No one can yet predict the consequences of such an unprecedented experience – but it’s safe to say it won’t be positive.
None of the above appears on the Covid death ticker today. It may very well be that the balance of human loss will still justify the lockdowns years hence. But it’s imperative that we know the full story before we blithely adopt such measures for the next pandemic.