John M. Mandrola. We Can’t Ignore the Harms of Social Distancing – Medscape – May 01, 2020

We Can’t Ignore the Harms of Social Distancing

John M. Mandrola, MD

May 01, 2020

The problem with such thinking is it belies both the timeline and endpoint of the COVID-19 intervention. The virus will not be eradicated (unless New Zealand wants to close its borders to all tourism for years). SARS-CoV2 will spread, and it will kill people. But so will our interventions.

Less restrictive policies combined with attentive public health surveillance do not equate to the idea of sacrificing the vulnerable. Rather, they attempt to balance the nondichotomous continuous nature of both COVID and non-COVID mortality.

COVID-19 is only one cause of death; there will be many more non-COVID deaths over the next 2 years. That is why the endpoint of this experiment is not this summer or next summer, but possibly the summer after that. And at that endpoint, we mustn’t count only COVID-19 deaths but all deaths.
 

Conclusion

A decision to treat a medical illness comes with benefits and harms. When there is not a cure, and there rarely is, we consider outcomes of both the disease and the intervention.

Sometimes the best answer is no intervention, sometimes a moderate intervention, and occasionally, aggressive action is best. But whatever the choice, we cannot ignore the realities of the situation, however stark they may be.

Coronavirus is bad, but we can make it worse by avoiding candid discussion of the important questions.

John Mandrola practices cardiac electrophysiology in Louisville, Kentucky, and is a writer and podcaster for Medscape. He espouses a conservative approach to medical practice. He participates in clinical research and writes often about the state of medical evidence. 

John M. Mandrola. We Can’t Ignore the Harms of Social Distancing – Medscape – May 01, 2020.