What a Prolonged Shutdown Will Cost in Human Life
Ezekiel Emanuel, adviser to presidential candidate Joe Biden and Obamacare architect, just called for a 12-to-18-month lockdown to battle COVID-19, asking us to abandon our livelihoods, religious services, and “contact with friends and extended family.” He claims we have “no choice” and that the alternative is hundreds of thousands of deaths.
He has also said that COVID-19 is a “great argument for universal health care coverage.” His plan is politically motivated — and deadly.
When President Trump expressed concerns about the shutdown, his critics presented a false choice between mitigating deaths and the economy. In reality, a great number of the most vulnerable American lives will be lost from economic shutdown, and Emanuel makes it clear that we have reached the moment where we must plead their case.
A prolonged shutdown could bring tens of thousands of deaths through spikes in rates of suicide, heart attack, missed cancer diagnoses, domestic violence deaths, substance abuse, and more. We have evidence that these deaths are coming, and the shutdown is only a month old.
A suicide spike is almost certain. One study in Taiwan indicated a 10% increase in the unemployment rate yielded approximately 30,000 suicides annually. Another global study linked the 2008 recession to a 20% to 30% increase in the relative risk of suicides.
We already had a suicide epidemic in this country before the virus, with nearly 50,000 Americans taking their own lives, and an additional estimated 1.4 million attempting to do so, in 2018 alone.
The Federal Reserve Bank of St. Louis estimates over 52 million will be laid off just by the second quarter of 2020, for a 32.1% unemployment rate, far higher than Great Depression estimates of 20% to 25% unemployment. Should these predictions materialize, and if history can be our guide, we are going to lose tens of thousands of American lives to suicide ... or more, if these impacts of a three-month shutdown were extended to realize Emanuel’s plan of 12-18 months of shutdown.
After only a few weeks of lockdown, calls to crisis hotlines increased from 1,000 to 25,000 a day in Indiana and 8,900% (Los Angeles), with the latter reporting that one in five calls express “suicidal desire.”
Expect an increase in heart attacks, too. Disruption-related stress attacks the heart. The National Institutes of Health reported that just the one-hour, fully anticipated Daylight Savings Time change correlates with a 24% increase in daily acute myocardial infarction (“AMI” or “heart attack”). What will be the increase in heart attacks when the disruption to our lives is not just one hour, but instead 12 to 18 months?
As “elective” routine cancer screenings are delayed, we should expect missed cancer diagnoses and an increase in cancer deaths. Cancers with routine screening include breast (200,000-300,000 new cases annually), colorectal (140,000 new cases), prostate (200-300,000 new cases), melanoma (96,000 new cases) and cervical (12,000 new cases).
Domestic violence spikes in times of home confinement. After only one week of “shelter-in-place,” women’s shelters in the Dallas-Fort Worth region were fielding an increase in “extremely violent calls that are COVID-19 related,” according to Paige Flink, CEO of The Family Place. Running out of space, they diverted victims from shelters to hotels.
Also, as early as March 22, north Texas saw a spike in “severe” child abuse cases – including death. “We knew an increase in abuse was going to occur, but this happened faster than we imagined,” said Christi Thornhill, director of the Trauma Program at Cook Children’s Hospital. “. . . this happened in a week.”
For each of the above causes of death, the death toll would surely mount, depending on severity and duration of the economic lockdown. Over 12-18 months, could deaths reach hundreds of thousands? Conversely, would COVID-19 deaths reach original projections if we end the lockdown? No. Those estimates assumed we did nothing. Americans are now too educated and concerned to not take precautions. For example, a new Seton Hall poll shows that 72% of Americans have said they will not attend a sporting event until a coronavirus vaccine is developed. Trust Americans to make caring and smart decisions.
Biden adviser Emanuel warned that, “Many Americans have not yet seen first-hand what devastation a positive test can inflict.” True. Would a COVID-19 diagnosis — with a single-digit chance of death — be any more devastating than discovering a family member after a suicide? More devastating than dying in a hospice?
A narrative that pushes a false choice between the economy and human life has deadly consequences. An honest debate acknowledges that there is human life to be lost regardless of which path we choose. Let’s trust Americans to make a plan that considers life on both sides of the ledger.