Looking at patients who had survived a critical encounter with COVID-19, a team of British researchers found that almost two-thirds suffered strokes, and just over a quarter were left with damage resulting in dementia. This lede was brought to you as a reminder that the death rate from COVID-19 is far from the whole story. From limb amputations to heart attacks to permanent brain damage, the blood clots caused by infections with the SARS-CoV-2 virus aren’t just occasionally devastating, they are often devastating.
Over the last four months, as the pandemic has spread around the planet, doctors have gained experience with COVID patients. They’ve learned that ventilated patients have better outcomes when moved to different positions, rather than being left on their backs. They’ve learned remdesivir can improve the odds for patients before they’re at the most critical phase, and that common anti-inflammatory steroids can help those who might otherwise have no hope. Experience and familiarity is genuinely improving the odds of patients who are hospitalized with severe or critical cases of COVID-19. Even so, and despite a real increase in the extent of testing, the rate of mortality in the United States remains above 5% and, as the British study shows, those deaths are just a small part of the swatch of destruction that this disease is carving. Which makes the CDC’s estimate that the number of cases is ten-times what the tests have so far revealed, far more frightening.
One other factor that has reduced the death rate over the span of the epidemic in the United States has been that the median age of COVID-19 patients has continuously skewed younger. A disease whose first significant U. S. outbreak was among the elderly at a Washington nursing home, has become one where those over 65 are the least likely to be infected. That’s almost certainly because older people are continuing to follow social distancing rules and being careful in their interactions, while many younger people seem to have completely discounted the potential of the virus. It seems that, no matter how many news stories run at this point about teenagers dying, twenty-something’s losing a limb, or young people left with lasting lung or heart problems, the idea this is an “old person’s disease” has been so baked in that it can’t be dislodged.
The decision made by many states to reopen in early May was so clearly wrong that experts everywhere warned of the the outcome—not the potential outcome, the certain outcome—of paring back social distancing rules at a point when the nation had over a million confirmed, active cases. Somehow, both citizens and state officials seemed to be convinced that they could handle a disease that had was by that point broadly disseminated through the population of every state in large numbers, better than one that had been entering into most areas only in dribs and drabs.
For example, when Arizona’s Republican governor issued a stay at home order on March 30, it came following the first day in which Arizona had more than 200 cases. Deaths in the state to that point totaled 20. But Arizona rescinded that order at a point when case counts were at 500, and deaths had passed 600. More importantly, they reopened at a point where there were 10,000 known active cases in the state, and over 10% of all tests were turning up positive. The same state government that had declared itself incapable of handling an relatively small outbreak in March, declared itself ready to take on a many times greater challenge six weeks later. That story was repeated again and again across the nation.
In Arizona’s case, the result is already tragic and getting worse. As The Washington Post reports, the state has “lost control of the epidemic,” with testing stations overwhelmed, hospitals on the brink, and a response that’s nothing short of pure chaos. Unwilling to demonstrate leadership, Ducey has left it up to city and county officials to take action. That’s made for a patchwork of shifting rules that are consistent only in their lack of enforcement. It’s also made for Maricopa County alone recording 2,000 new cases a day. On the state level, Arizona is breaking it’s one-day records on an almost daily basis, while also setting records for the use of hospital beds and ventilators. The kind of triage employed in Italy and New York city in the very worst days of March and April, appears to be coming soon to Phoenix and other Arizona cities.
The lack of federal leadership left the burden of handling this crisis on states. The lack of state leadership has cast the effort to meet this moment onto towns and counties woefully unprepared for the task. The levels of government with the most resources and options, are consistently pressing the responsibility for handling this catastrophe onto levels of government where both funding and authority are weakest. Addressing COVID-19 is not an issue that can be handled by local school boards and volunteer food banks. That it’s being treated that way is both ridiculous and tragic.