“My fellow Americans, we all need to be aware of a deadly menace in our midst. It is a new virus to which none of us is immune. The vast majority of us will recover on our own, but it could infect so many that if we do nothing, the death toll could be very high. We have a plan, however, and with your cooperation, we can minimize the damage. And let us keep our faith and perspective: We all are mortal. There are 330 million of us, and in a normal year, death takes 2.8 million. With this virus that might rise to 2.9 million or 3 million.”
Do you wish this is what our president had told us months ago, when this pandemic was just hitting our shores? Does suddenly being told that COVID-19 could kill 240,000 of us motivate or paralyze you? With good reason, the campaign against this pandemic is being called a war. Whether or not it is fair to say truth has been one of the first casualties, context and perspective certainly have. We could use more of both. COVID-19 is deadlier than seasonal flu, but neither is it a biblical plague that will kill one-third of us.
Stay in shape
“In the short term, your lives will change dramatically. Almost all of you will be working or attending school from home, as we must eliminate all gatherings and minimize in-person contact to slow the spread of this virus. But that does not mean you should become couch potatoes. Regular aerobic exercise is protective against almost all of our major health threats, including heart disease and stroke, which together kill 793,840 Americans each year. Now is no time for a marathon or cross-country vacation, but aerobic fitness is vital. Stay home, but stay in shape.”
We have all heard “Stay home.” “Stay in shape” deserves equal emphasis. To his credit, Gov. Phil Murphy has recognized that exercise is “essential,” allowing us outside for a walk, run or bike ride close to home. But we are not being told we need to do these things, and too many local officials are making it nearly impossible. Beaches, boardwalks and entire park systems have been closed, when access could have been limited. Establish one-way loop trails and a website for citizens with camera phones to report social-distance violators. Auction beach badges online, with proceeds going to the New Jersey Pandemic Relief Fund.
Make it easier to exercise
“We know that in our urban areas, providing opportunities for outdoor exercise while maintaining 6 feet of separation is a challenge. Therefore, we will be converting numerous city streets to pedestrian malls and highways to biking and hiking paths. And these changes will be permanent. The result will be a healthier and more livable New Jersey.”
As usual, we are letting a crisis go to waste. The Blue Zones Project promotes healthy-living practices based on lessons learned from communities around the globe that enjoy exceptionally long and healthy lives. One of its tenets is that good health depends not so much on self-discipline as on living in an environment that makes physical activity unavoidable. It would be a big step forward if we could just make it safe; too many of us risk our lives just going for a jog. With the president calling for $2 trillion in infrastructure spending, now is the perfect opportunity to fix that.
Mitigate collateral damage
“We recognize that the steps we are taking to slow the spread of this virus jeopardize other vital public health initiatives. We understand that the stress of prolonged isolation risks increases in substance use disorder, smoking, domestic violence, depression and suicide. We ask experts in these fields for their suggestions on how to minimize these unintended consequences.”
As with any war, this one risks inflicting collateral damage. We need to plan now to mitigate it.
On an individual basis, we need to assess our personal health risks, some of which may be deadlier than COVID-19. If you have a family history of heart disease, a drink with dinner might be beneficial. If your family history includes alcoholism, probably not. Alcohol kills 88,000 Americans a year. Living on junk food? That contributes to 678,000 deaths each year. Feeling stressed by all of this? Please don’t start or return to smoking. Smoking-related diseases kill 1,300 of us every day.
Other dangers to public health
At the level of national and statewide planning, we need to remember that COVID-19 is far from our only public health menace. Nationwide, we lose 67,000 lives annually to drug overdoses and another 47,000 to suicide. If we are not careful, we could unintentionally make those statistics worse.
There are probably hundreds of ways that could happen, so I will suggest just one scenario. A residential program for women in recovery from substance use disorder has banned all visits, including family and class instructors, and canceled all social programs outside and inside the facility. Without such social supports, how many will slide back into addiction? What if this goes on for seasons rather than weeks? What if COVID-19 never goes away, but returns each year like the flu?
Right now, we need all available protective gear for our frontline health care workers, first responders and essential employees like grocery cashiers. When more becomes available, who will be first in line to get it to facilitate a return to normal? Will it be ambulatory surgery centers, assisted living facilities, domestic violence and homeless shelters, residential treatment programs, schools for disabled children who cannot be taught online, schools without the technology to conduct online learning?
These are difficult decisions. We need to keep reminding ourselves: No life is expendable, but we all are mortal.
No life is expendable. The corollary is that the life of a COVID-19 patient, actual or potential, is not more valuable than the life of someone grappling with substance use disorder, a despondent teenager flirting with suicide, a cancer patient whose treatment is delayed, or someone whose heart disease or diabetes goes undiagnosed.
We all are mortal. We will all die of something. We must not allow a myopic focus on killing this virus (something we have only ever done once, with smallpox) to blind us to other public health threats and the victories against them that are achievable.
We must keep the health and well-being of all of us paramount. We need to stay calm and maintain our perspective.