Why North Carolina should open for business

Here's a look at why North Carolina should open for business...

1. We achieved the goal of "flattening the curve"

From the outset, the goal of the lockdown/shutdown strategy was to "flatten the curve," which meant to lower the number of COVID-19 cases so that we would not overwhelm the hospitals. Not overwhelming the hospitals was the goal of flattening the curve and the good news is, this goal has been accomplished.

From the IMHE modeling site that U.S. leaders have been using to project the demand on hospitals, North Carolina is now five days beyond the expected peak hospital resource need. Even at the projected peak, NC hospital beds were expected to be at just 7% utilization and ICU beds were at about 20% utilization.

Also worth noting that these revised projections were far below the projections from just a few weeks ago that helped guide the shutdown/lockdown decision, when on around March 30 the models predicted 2,400 NC deaths (now projecting 251 deaths) and a hospital bed shortage:

Now that the goal of preventing hospital overload has been accomplished, North Carolina should re-open.

2. We cannot simply "move the goalposts" and stay closed to "defeat the virus"

Now national leaders are trying to "move the goalposts" and establish that communities must stay in lockdown for a different goal, namely to stop/defeat/mitigate COVID-19. They talk about maintaining some form of lockdown until a vaccine is developed, or until universal testing can be implemented.

Moving the goalposts and enforcing a longer-term shutdown will result in cataclysmic economic and life ramifications. With 22m unemployed nationally, this cataclysm may already have happened. But if the shutdown continues, it will all-but guarantee that the "cure" of shutdown will be worse than the disease of the virus.

Second, it is unclear if the virus can be stopped. The virus is extremely viral. One community in Massachusetts appears to already have reached 32% infection and recovery. Experts have always know that this virus will continue to advance through society at some level. "Flattening the curve" was simply to space out the infections over a longer period of time. Plus, the promise of a virus for the general population is at a minimum 12-18 months if not years away. At some level, as a society we must learn to "live" with the virus.

We cannot just "change the rules" and impose a longer lockdown to stop the virus. We must learn to live with the virus.

But there is good news.

3. The virus is not nearly as deadly as experts originally thought

Original estimates of the infection mortality rate (the percentage of people who will die after contracting the virus) were as high as 3-4%. The best data coming out of antibody testing to determine how many people have already had the virus and survived it with little or no symptoms now indicates the infection mortality rate is closer to .1-.3%. (Germany test .37% fatality rate; DENMARK: antibody test reveals .16% fatality rate estimate; Santa Clara CA test here and here)

The difference changes everything. If the fatality rate is .2% or .1% instead of 3% or even 1%, then the mortality risk is similar to that which Americans experience every year from the flu. This is not to say COVID-19 isn't serious, especially since unlike the flu there is no vaccine and fewer solid treatments. Still, the risk of death appears to be more like 1 or 2 in 1,000 instead of 3 or 4 in 100.

It now appears the infection mortality rate and risk are reasonable from a public policy standpoint. Of course, individual citizens can weigh the risks for themselves and decide what precautions they want to take.

4. The virus' lethality targets a narrow demographic of society

The vast majority of the fatalities from COVID-19 come from the elderly and specifically those with co-morbidities. In Italy 99% of the victims had at least one co-morbidity and the average age at death was around 80. In America, the numbers are similar although the average age at death is a few years younger. The risk of death for healthy people and for those under 60 is extremely low. (In fact, the mortality risk for children is so low that North Carolina should re-open schools immediately.)

A recent study concluded: "People <65 years old have very small risks of COVID-19 death even in the hotbeds of the pandemic and deaths for people <65 years without underlying predisposing conditions are remarkably uncommon. Strategies focusing specifically on protecting high-risk elderly individuals should be considered in managing the pandemic."

These characteristics of COVID-19's lethality profile (elderly and co-morbidities) gives North Carolina the unique opportunity to target the ongoing post-shutdown response to protecting the most vulnerable while re-opening business (and schools) immediately.

5. COVID-19 mortality has been low in North Carolina

Thankfully, COVID-19 deaths have been far below the original projections. Currently, less than 200 have died of COVID-19 in North Carolina and 251 deaths are projected through August (as compared to projections just a few weeks ago of 2,400 deaths in NC).

This is compared to more than 450 deaths on average every day in North Carolina. So for the five-month span of March through July, it is likely that more than 67,500 people will die in North Carolina of any cause. The current projected COVID-19 deaths for that time would represent about .4% of that total. Even the projection of 2,400 deaths from a few weeks ago would have represented just 3.5% of the total NC deaths.