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BY DR. SCOTT W. ATLAS, OPINION CONTRIBUTOR
\nThe Hill<\/p>\n
The tragedy of the COVID-19 pandemic appears to be entering the containment phase.\u00a0Tens of thousands of Americans\u00a0have died<\/a>, and Americans are now desperate for sensible policymakers who have the courage to ignore the panic and rely on facts. Leaders must examine accumulated data to see what has actually happened, rather than keep emphasizing hypothetical projections; combine that empirical evidence with fundamental principles of biology established for decades; and then thoughtfully restore the country to function.<\/p>\n Five key facts are being ignored by those calling for continuing the near-total lockdown.<\/p>\n Fact 1:<\/strong>\u00a0The overwhelming majority of people\u00a0do not\u00a0have any significant risk of dying from COVID-19.<\/p>\n The recent\u00a0Stanford<\/a>\u00a0University antibody study now estimates that the fatality rate if infected is likely 0.1 to 0.2 percent, a risk far lower than previous World Health Organization\u00a0estimates<\/a>\u00a0that were 20 to 30 times higher and that motivated isolation policies.<\/p>\n In New York City, an epicenter of the pandemic with more than one-third of all U.S. deaths, the rate of\u00a0death<\/a>\u00a0for people 18 to 45 years old is 0.01 percent, or 11 per 100,000 in the population. On the other hand, people aged 75 and over have a death rate 80 times that. For people under 18 years old, the rate of death is\u00a0zero per 100,000.<\/p>\n Of all fatal cases in New York\u00a0state<\/a>, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness. Of 6,570 confirmed COVID-19 deaths fully investigated for underlying conditions to date, 6,520, or\u00a099.2 percent<\/a>,\u00a0had an underlying illness. If you do not already have an underlying chronic condition, your chances of dying are small,\u00a0regardless of age. And young adults and children in normal health have almost no risk of any serious illness from COVID-19.<\/p>\n Fact 2:<\/strong>\u00a0Protecting older, at-risk people\u00a0eliminates hospital overcrowding.<\/p>\n We can learn about hospital utilization from\u00a0data from New York City<\/a>,\u00a0the hotbed of COVID-19 with more than 34,600 hospitalizations to date. For those under 18 years of age, hospitalization from the virus is 0.01 percent per 100,000 people; for those 18 to 44 years old, hospitalization is 0.1 percent per 100,000.\u00a0Even for people ages 65 to 74, only 1.7 percent were hospitalized. Of 4,103 confirmed COVID-19\u00a0patients<\/a>\u00a0with symptoms bad enough to seek medical care, Dr.\u00a0Leora Horwitz<\/a>\u00a0of NYU Medical Center concluded “age is far and away the strongest risk factor for hospitalization.” Even early\u00a0WHO<\/a>\u00a0reports noted that 80 percent of all cases were mild, and more recent studies show a far more widespread rate of infection and lower rate of serious illness.\u00a0Half of all people testing positive for infection have no symptoms at all. The vast majority of younger, otherwise healthy people do not need significant medical care if they catch this infection.<\/p>\n Fact 3:<\/strong>\u00a0Vital population immunity is\u00a0prevented\u00a0by total isolation policies, prolonging the problem.<\/p>\n We know from decades of medical science that infection itself allows people to generate an immune response \u2014 antibodies \u2014 so that the infection is controlled throughout the population by \u201cherd immunity<\/a>.\u201d\u00a0Indeed, that is the main purpose of widespread immunization in other viral diseases \u2014 to assist with population immunity. In this virus, we know that medical care is not even necessary for the vast\u00a0majority<\/a>\u00a0of people who are infected. It is so mild that half of infected people are asymptomatic, shown in early data from the\u00a0Diamond Princess<\/a>\u00a0ship, and then in\u00a0Iceland<\/a>\u00a0and\u00a0Italy<\/a>. That has been\u00a0falsely\u00a0<\/em>portrayed as a problem requiring mass isolation. In fact, infected people without severe illness are the immediately available vehicle for establishing widespread immunity. By transmitting the virus to others in the low-risk group who then generate antibodies, they block the network of pathways toward the most vulnerable people, ultimately ending the threat. Extending whole-population isolation would directly\u00a0prevent\u00a0that widespread immunity from developing.<\/p>\n Fact 4:<\/strong>\u00a0People are\u00a0dying because other medical care is not getting done due to hypothetical projections.<\/p>\n Critical health care for millions of Americans is being ignored and people are dying to accommodate \u201cpotential\u201d COVID-19 patients and for fear of spreading the disease. Most\u00a0states<\/a>\u00a0and many hospitals abruptly stopped \u201cnonessential\u201d procedures and\u00a0surgery<\/a>. That prevented diagnoses of life-threatening diseases, like cancer screening, biopsies of tumors now undiscovered and potentially deadly brain aneurysms. Treatments, including emergency care, for the most serious illnesses were also missed. Cancer patients deferred\u00a0chemotherapy<\/a>. An estimated 80 percent of brain surgery cases were skipped. Acute stroke and heart attack patients missed their only chances for treatment, some dying and many now facing permanent disability.<\/p>\n Fact 5:<\/strong>\u00a0We have a\u00a0clearly defined\u00a0population at risk who can be protected with targeted measures.<\/p>\n The overwhelming evidence all over the world consistently shows that a clearly defined group \u2014 older people and others with underlying conditions \u2014 is more likely to have a serious illness requiring hospitalization and more likely to die from COVID-19.\u00a0Knowing that, it is a commonsense, achievable goal to target isolation policy to that group, including strictly monitoring those who interact with them. Nursing home residents, the highest risk, should be the most straightforward to systematically protect from infected people, given that they already live in confined places with highly restricted entry.<\/p>\n The appropriate policy, based on fundamental biology and the evidence already in hand, is to institute a more\u00a0focused\u00a0strategy<\/a>\u00a0like some outlined\u00a0in the first place:\u00a0Strictly protect the known vulnerable, self-isolate the mildly sick and\u00a0open most workplaces and small businesses with some prudent large-group precautions.\u00a0This would allow the essential socializing to generate immunity among those with minimal risk of serious consequence, while saving lives, preventing overcrowding of hospitals and limiting the enormous harms compounded by continued total isolation.\u00a0Let\u2019s stop underemphasizing empirical evidence while instead doubling down on hypothetical models. Facts matter.<\/p>\n Scott W.\u00a0Atlas, MD, is the David and Joan Traitel Senior Fellow at Stanford University\u2019s Hoover Institution and the former chief of neuroradiology at Stanford University Medical Center.<\/em><\/p>\n\nADVERTISEMENT<\/div>\n<\/div>\n\nADVERTISEMENT<\/div>\n<\/div>\n\nADVERTISEMENT<\/div>\n<\/div>\n