Live Free or Die

Most everyone has heard the New Hampshire state motto, “Live Free or Die.”  Our nation was founded on that very principle and countless men and women fought and died to gain our “freedom” from Great Britain.  The COVID-19 pandemic threatened to produce widespread illness and deaths in the U.S.  The restrictions imposed in most states threatened many of our basic freedoms.  The President’s Task Force recommended social distancing, knowing that the virus was likely spread by respiratory droplets.  When it came to the recommendations that everyone “shelter in place” and all but “essential” businesses be closed, several states felt these measures too extreme.  To states with a more rural population and low infection rates, this seemed unnecessary.  What made the “essential” designation arbitrary is large corporate giants like Walmart, Target and others could remain open but small businesses (many of whom sold identical items) had to close.  Large corporate stores have the resources to weather the economic downturn whereas a small business can’t survive a prolonged closure.  The employees who work for a small business would be out of work for weeks or months with no income.  Governors wielded total (dictatorial) control over closures and sheltering in each state.  In some cases it appeared to turn into a political battle with the President over state control.  It is not surprising to see protests from workers who feel their ability to earn a living and support their family has been taken from them.  What we have learned from this COVID-19 virus is that the greatest threat from the virus is to those with underlying medical conditions.  The top conditions that increase an individual’s risk of serious illness are:  obesity, diabetes, hypertension, heart disease, kidney disease, pregnancy, immunosuppression, and age.    Nearly every patient requiring intubation had at least one or more of these conditions.  The virus was especially deadly for African-Americans who have had a significantly higher death rate from COVID-19 than Caucasians.  Many of the conditions known to increase the risk for serious infection (and death) are also more commonly seen in the black population.  There are a number of reasons for this discrepancy:  heredity, environment, lack of access to healthcare and others.  The virus is an opportunist and will seek out a susceptible host, regardless of the patient’s race.

The President made a statement that is often repeated in medicine, “the treatment can’t be worse than the disease.”  Our economy has suffered more than since the Great Depression of 1929.  For many workers, the loss of income and the inability to provide for their family is worse than the risk of infection.  As we have seen, the risk of infection to healthy individuals is low.  In most cases younger workers are willing to accept that risk to be earning a living for themselves and their families.  Workers who were previously employed before the coronavirus found themselves filing for unemployment and waiting in food lines.  This is particularly hard for them to accept when they see politicians flaunting their lavish lifestyles while sheltering in place.  What working class family lives in a mansion with a $25,000 refrigerator?  The furloughed workers have reason to be angry and their protests are simply asking that they be allowed to return to work.  If we had more antibody testing capability we could insure the safety of the workplace.  I believe we will find a sizeable portion of the population has antibodies to the virus and are therefore immune.  Herd immunity has been used by Dr. Fauci and Dr. Birx on several occasions.  Herd immunity is when enough of the population has either had the disease or been vaccinated so that the remainder of the population is safe from infection.  Our economy has suffered enough and it is time to move forward, continuing to use sensible distancing and establish the antibody status of as much of the population as possible.

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