Restore our lives using medical science, data and common sense

Americans are anxious to get back to work and to send their children to school. The science backs them up. We have learned a lot over the past months, and we are putting that knowledge to use. We are capitalizing on the advanced capabilities that we have developed, as we redouble our efforts to protect vulnerable populations and deliver new and effective treatments in record time.

Here’s what we now know: 

We know who is at risk. Only 0.2 percent of U.S. deaths have been people younger than 25, and 80 percent have been in people over 65; the average fatality age is 78. A JAMA Pediatrics study of North American pediatric hospitals flatly stated that “our data indicate that children are at far greater risk of critical illness from influenza than from COVID-19.”

We may see more cases as social interactions pick up, because this is a contagious disease. However, the overwhelming majority of cases are now occurring in younger, low-risk people — decades younger, on average, than seen in the spring. And the vast majority of these people deal with the infection without consequence; many don’t even know they have it.

While we saw more cases in July and August, we are not seeing the explosion of deaths we saw early on. An analysis of CDC data shows that the case fatality rate has declined by approximately 85 percent from its peak. 

That is partly because we are much better now at protecting our most vulnerable, including our senior citizens. States have learned from those that experienced outbreaks before them, and they have implemented thoughtful policies as a result.

We are doing much better with treating hospitalized patients. Lengths-of-stay are one-third the rate in April; the fatality rate in hospitals is one-half of that in April. Fewer patients need ICUs if hospitalized, and fewer need ventilators when in ICUs.

We are progressing at record speed with vaccine development. This is due to eliminating bureaucracy and working in partnership with America’s world-leading innovators in the private sector.

Despite these gains, our economy has yet to fully reopen. At least 16 states have travel warnings and quarantines in place that are not consistent with Centers for Disease Control and Prevention (CDC) guidelines; in most states, retail stores are limited to pick-up or reduced shopping capacity. Even in states where cases are low, restaurants are often take-out only, and 42 states and territories have seating capacity limited to 25 percent or 50 percent. Fitness centers and gyms have largely reopened, but at reduced capacity. 

Beyond those business limits, schools in many cities and states will be opened this fall on a delayed or limited basis. According to the U.S. Department of Education’s tracking, of 5,425 major school districts (about one-third of districts nationwide), almost half plan to operate on hybrid models and another 20 percent plan to operate online-only. That not only harms children, it prevents many parents from working.

A key – but flawed – assumption driving these restrictions is that the number of cases is the most important metric to follow. Yet, whatever effect these restrictions may have on cases, they don’t eliminate the virus. And they impose harms on the country and its citizens, particularly when they require the isolation of large segments of the low-risk and healthy, working populations.

Unlike his critics, who have focused on the wrong goal and engaged in unfounded fear-mongering, President Trump has been implementing a three-pronged, data-driven strategy that is saving lives while safely reopening the economy and society, averting the disastrous calamities of continued lockdown.

First is protecting the high-risk group with an unprecedented focus. This is being done by relying upon highly detailed, real-time monitoring; a smart, prioritized, intensive testing strategy for nursing home staff and residents; deployment of massive extra resources, including point-of-care testing, personal protective equipment (PPE), infection control training and rapid mobilization of CDC strike teams for nursing homes; and extra PPE and point-of-care testing for the environments with elderly individuals outside of nursing homes, like visiting nurse in-home care and senior centers.

Second, we are carefully monitoring hospitals and ICUs in all counties and states with precision to prevent overcrowding, and rapidly increasing capacity in those few hospitals that may need additional personnel, beds, personal protective equipment (PPE) or other supplies.

Third, we are leveraging our resources to guide businesses and schools toward safely reopening with commonsense mitigation measures. We must safely reopen schools as quickly as possible, and keep them open. The harms to children from school closures are too great to accept any other outcome.  

While the lockdown may have been justified at the start, when little data was known, we know far more about the virus today. It’s time we use all we have learned and all we have done to reopen our schools and our economy safely and get back to restoring America. 

Scott W. Atlas, MD, is a senior fellow at Stanford University’s Hoover Institution. He is serving as a special adviser to the president and is a member of the White House Coronavirus Task Force.