This post does not deny the effectiveness of social distancing or quarantine for COVID-19. I am not encouraging people to suspend these practices before official determinations have been made public. This post is to help physicians, thought leaders and public officials understand and weigh the risks and benefits of extended lockdowns versus more measured and earlier return to work measures.

We have already flattened the curve

Social distancing works. We have gone from predictions of millions of deaths, to hundreds of thousands and now we are predicting about 60 thousand deaths. This is with the likely over reporting of death. Dr. Birx admitted the attribution of death to COVID-19 has been liberal. If the death count were limited to deaths directly caused by COVID-19, it would likely be even lower than this.

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The most effective time for social distancing is early in a pandemic. Lockdowns also slow the development of herd immunity, which helps a society move past the virus.

We can still practice good hand hygiene, wear masks in public, and continue social distancing for the elderly and high risk, while we develop protective herd immunity for those most at risk. By the time the lockdowns began, COVID-19 had already been seeded in the US for months, limiting the effectiveness of the lockdowns in the first place as the virus was already widespread.

Economic collapse and unemployment are destroying families

Each day the shutdown continues, we are losing approximately one million jobs, as evidenced by 16.5 million initial weekly jobless claims in three weeks (since March 26). Many of these lost jobs will never return. If the lockdowns continue through April (essentially, a best-case scenario), we’ll be lucky if job losses are limited to 25 million. Many people see 6.6 million people as just a number , as Len Kieffer put it, it is the size of the state of Missouri. Twenty five million is almost the size of the state of Texas!

The 16.5 million jobs lost thus far are only counting people who have filed jobless claims that were processed through April 8, 2020; it’s likely that the real number is quite a bit higher than this. In addition, there are millions of people not-technically-unemployed who have seen their incomes plummet. One example would be so-called gig workers, such as Uber and Lyft drivers. It’s almost certain that realtors are suffering the same fate.

We have not saturated the health care system

In New York We came close. Although, the ER and ICU capacity has increased in many locations, overall healthcare system capacity has decreased dramatically, as all non-COVID and non-emergent care is being neglected. This has led to layoffs of healthcare workers and delays in care for countless patients, which will result in a range of negative consequences. Assuming the need for healthcare services has remained constant while availability of such services has plummeted, countless patients are not receiving the care they need in a timely manner. In medicine, timing is of the essence, so even receiving the same exact in the future comes at a price. Many important services are being delayed: blood donations, organ donations, screening colonoscopies, and many other elective procedures. It is very important to note that elective medical care is not useless medical care; rather, it’s simply meaningful and necessary medical care that is scheduled in advance and not performed on an emergency basis.