It is fair to say that Covid-19 has taken over the national consciousness. I receive dozens of daily emails related to it. Updates are given daily and, in some venues, hourly. The media has essentially suspended coverage of everything not related to Covid-19. Even the presidential campaign, arguably the most anticipated and controversial in my lifetime, has essentially come to a halt. Our nation is in real, not virtual, shutdown and society is in stay-at-home lockdown for anything but essential outings for food, medications, and such. This is unprecedented and the consequences are unknown, even as the toll on society and the economy is growing by the day.

It is now widely acknowledged that the harm from closing schools will be a generational loss of learning that may never be recovered, and the most hard hit were the poor. The trillions of dollars thrown at the pandemic in pandemic related subsidies has created unprecedented inflation and increased the cost of goods and services to where many businesses have closed and many families are living paycheck to paycheck. Well-established actuarial formulas tell us that there is a real cost in human lives from the economic downturn caused by the mismanagement of the pandemic response.

The overarching, repressive response to the virus comes down to a single word: fear. Fear that we are all at risk of acquiring the virus and, therefore, at risk of becoming very ill and dying. Even our experts know that we cannot prevent the spread of this virus; all we can do is stretch out the time table for its spread, i.e. “flatten the curve”, so as not to overwhelm our medical resources and thereby, hopefully, save some extra lives. We know the epidemic will end when enough people are infected and become immune, what is referred to as “herd immunity”, such that the virus peters out of it own accord. In other words, mitigation, not prevention, is the goal. What is lost in this discussion is the effect of prolonging the current state of national social quarantine and economic standstill, possibly for months. Those who raise concerns about the effects of the current situation on the economy are accused of weighing lives against dollars. This is a false equivalency. We are weighing lives lost due to the virus versus lives lost due to suicide and depression, lack of medical care from loss of jobs and health insurance, substance abuse, and all the other real medical consequences of a collapsed economy. This is more difficult to measure but no less real.

If we respond to this virus as though loss of single life justifies the current measures, then we need to rethink everything from use of automobiles to treatment of mental health issues, to homelessness, to gun violence, and even to our response to seasonal flu. The toll from Covid-19 has yet to approach that of seasonal flu and current models suggest that it may not equal it. Early predictions of a million US deaths have been downgraded to 100-200,000, and now to perhaps 60,000 or so. This is still terrible but equivalent to a bad flu season, for which we do not shut down our nation.

To this day, we do not have an accurate, agreed upon counting of deaths due to Covid versus deaths of other causes in persons who tested positive for the virus. Hospitals were incentivized by government subsides to count every patient who died and had a positive Covid test as a Covid death. This included even patients who died of accidents and injuries, or who were at the very end of life and would likely have died soon in any event. FEMA paid up to $7000 to families of patients whose death was attributed to Covid, lending a real incentive to seek to have this listed as a proximal cause of death.

With some extreme exceptions, such as New York and a few other metropolitan areas, the dire predictions of overwhelming demand on existing medical resources has simply not come to pass. To extrapolate these exceptional, unique situations to the nation as a whole is a stretch.

My comments are not to be taken as an excuse to avoid following recommended guidelines as currently enacted. The US populace has, for the most part, responded admirably and cohesively, to the restrictions handed down from federal, state, and local government, even when these seem unduly burdensome and difficult to understand. It is incumbent, however, for those in authority to constantly reassess our response as we acquire new knowledge about this virus.

Those who argue that these improved projections are directly due to the extreme measures currently in effect need may be right, but they also need to step back and use the information we now have, which is substantial, to enact more measured and targeted efforts to deal with the virus among those we know are susceptible to its most serious effects. They need to let the rest of us get back to some semblance of normalcy and return to work as quickly as possible. It is a medical truism that curing the disease is a pyrrhic victory if you kill the patient in the process.

Of the many mistakes and missteps of our public health experts- closing down the economy, quarantining a healthy population for the first time in history, universal masking, unsupported measures like the six foot social distance, the one-size-fits-all approach to managing Covid, the politically guided vaccine roll out, vaccine mandates, demonization of front line physicians treating patients with repurposed drugs, ignoring naturally acquired immunity, and throwing obscene amounts of money at the pandemic, perhaps the worst failure was to not adapt the policies and recommendations to allow for the increasing information about the virus over the course of more than two years. Even today, there are those who feel they did nothing wrong and will undoubtedly open up the same playbook for the next pandemic. We cannot allow that to happen.

This post is not to suggest that I had some special information or insight regarding how Covid should have been managed in the early months. The sad fact is that the information was there for all to see, but for reasons that remain inexplicable outside of incompetence or malfeasance, were ignored or actively resisted by the public health officials from Anthony Fauci to Redfield to Birx to Collins and on down the line to petty bureaucrats and Pharma. Little wonder that conspiracy theories about this abound. There was much collateral damage in the aftermath of the Covid pandemic. Perhaps the most significant was the loss of trust in our medical institutions- the CDC, NIH, FDA, NIAID, and others. I know my trust in these has been shattered and made me rethink much of what I once believed to be true. Never again…………

Richard T. Bosshardt, MD, FACS