Will the shutdown in NC lead to more “deaths of despair” than deaths from COVID-19?
While I am concerned for the health of people who are at risk of serious illness and death from COVID-19, I ask you to also consider the serious injury being caused by the quarantine in North Carolina where fewer than 530 people have died from COVID-19 (as of May 8, 2020).
Historically, “deaths of despair” caused by increases in the unemployment rate, have been shown to far overshadow the predicted mortality rates from COVID-19 models. In an ongoing study, beginning in the 1940s, data consistently shows that a 1% increase in extended unemployment correlates to an increase in our nation's mortality rate by approximately 58,000 people per point. According to the Bureau of Labor Statistics, the unemployment rate for March of this year is 4.4% with the possibility of it rising past 30% in the next quarter. Roughly 25% of small businesses have already closed their doors in NC and more will continue to do so even after the quarantine ends. The permanent loss of jobs from closed businesses will lengthen the time people remain out of work, pushing unemployment numbers higher for a longer period of time.
There are factors not being considered in the drastic measures to contain the virus and "flatten the curve.” Violence at home is on the rise with victims trapped with their abusers due to stay-at-home orders. More children are calling the National Sexual Assault Hotline with reports of abuse that is escalating in frequency and severity. Suicide rates are predicted to rise dramatically due to the direct correlation between unemployment rates and suicide. Students requiring specialized school services and therapies are not being served and are impacted both in the short and long term.
With lost taxes due to shuttered businesses, public health programs suffer, impacting health services in the community. Young adults entering a poor job market for the first time are at risk for negative lifetime outcomes including unhealthier, shorter lives. All of these factors, and many others, must be considered when assessing the impact of wide spread shutdowns.
What can be done to save lives? We can open the economy back up to healthy people while protecting the vulnerable. Many highly respected professionals advocate for an approach similar to Sweden’s model, with resources directed to those most at risk from complications from COVID-19, including the elderly and immune compromised. By advocating for self-quarantine of high-risk categories, we protect the truly vulnerable. This allows low risk, healthy children and adults to get back to school and their jobs preventing vast segments of the economy from collapsing. Our current approach all but ensures death to many through inadequate health care, lack of resources, child abuse, domestic abuse, suicide, and depression. Let’s reduce deaths of despair while addressing management of the virus. There is a solution.