In a lengthy post on social media Wednesday, Dr. David L. Katz, a disease prevention research scientist and founding director of the Yale-Griffin Prevention Research Center, informed his followers that he has just been tested for COVID-19 due to experiencing what appear to be symptoms of the virus. Whether he ends up testing positive or not, Dr. Katz explains, his current situation highlights a warning he has made all along about the widespread measures the U.S. is taking in an attempt to curb the spread of the virus.
In the post, published on LinkedIn Wednesday, Katz reveals that he is “just back from being tested for COVID19” and likely will not know the results of the test for 3 to 5 days, though he “very much” suspects that he does because he feels “moderately sick,” like many who contract coronavirus.
“If I do have COVID19, it is for the very reasons I have been writing about since before the pandemic reached our shores: lack of advance preparation, lack of risk stratification, and lack of policies predicated on risk differentials,” he writes. “What I mean is this: my most likely exposure is from my adult children sent back to the family home when (A) universities closed down, and (B) businesses closed down and laid people off.”
“I am not saying these things didn’t need to happen — but they needed to happen with some careful consideration of risk tiers,” he adds.
He then explains that he is currently residing in the same house as one of his daughters, who was working in a restaurant in New York City that officials have mandated be closed. “She is a very healthy young woman (in fact, ran the 2019 NYC Marathon) — and thus is in a group that appears to be at very, very low risk of severe coronavirus infection,” writes Katz. “I, however, am a 57-year-old man. I’m not in a high-risk group, but the global data certainly suggest my risk of severe infection to be much higher than my daughter’s.”
While he is in excellent health, he notes, many others in similar circumstances aren’t as fortunate. “I am very concerned about my contemporaries around the country — the many hundreds of thousands of late 40-something, 50-something, or early 60-something parents who are not in perfect health, and some far from it, now huddling at home with adult children sent home, infectious status unknown, from the large populations of universities, and in many cases, big cities,” he explains. “I am all the more concerned about those households with yet another generation under that roof, namely the grandparents of those young adults.”
From the start of the pandemic, Katz says, he has expressed concern about a national approach that is “not focused on risk tiers” and thus would “spread our very limited resources far too thin to protect anyone reliably.”
“I have been suggesting from the start that — given how ominously ill-prepared we have let ourselves be — that we must think through targeting the resources we do have to those who most need protection,” he explains. “Evidence from other countries with much better data than we have so far shows that to be: the elderly, and those with chronic disease like heart disease and/or diabetes, and those with significant immunocompromise.”
What we need to do as quickly as possible, he argues, is to “pivot to a more risk-based concentration of protections” — not only to reduce the chance of overwhelming the health care system but also because many people simply cannot afford to weather such widespread shutdowns financially or psychologically.
“Many people in this country are financially marginal, living pay check to pay check,” he writes. “They are now subject to true destitution, desperation, ruin, food insecurity, hunger, and the fallout from that: addiction, domestic violence, suicide. Colleagues and I looking at all that don’t know if the deaths from coronavirus will be less, or more, than the deaths resulting from societal collapse. Does anyone want to argue that deaths and misery resulting indirectly from this pandemic are less important than those resulting directly from it?”
“Every argument I’ve made is predicated on this simple idea: there is more than one way to lose or ruin a life, devastate a family- and any of them is bad,” Katz underscores (emphasis his). “Preventing any of them is good. Our goal as a society should be to use the best data we can amass, to inform the best policies we can devise, to minimize total harm. Our job is to save the most people, and families, possible from every variant on the theme of calamitous ruin and loss. Some of this can be done with federal financial support; but much of it cannot.” (Read the full post here.)
One of the op-eds that Dr. Katz references in his post is his piece for The New York Times published on Friday, in which he calls for the “surgical strike” approach to combating the virus rather than the “open war” approach. By the former, he means focusing our prevention efforts on the most vulnerable, the elderly and those with certain preexisting conditions.
“What we know so far about the coronavirus makes it a unique case for the potential application of a ‘herd immunity’ approach, a strategy viewed as a desirable side effect in the Netherlands, and briefly considered in the United Kingdom,” Katz explains in the op-ed. “The clustering of complications and death from Covid-19 among the elderly and chronically ill, but not children (there have been only very rare deaths in children), suggests that we could achieve the crucial goals of social distancing — saving lives and not overwhelming our medical system — by preferentially protecting the medically frail and those over age 60, and in particular those over 70 and 80, from exposure,” he writes.
“I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly graver than the direct toll of the virus itself,” he asserts. (Read the full op-ed here.)