Institutions contempt for Trump are behind lockdown rationales

Lockdowns show negative impact on health; Watch Healthcare in Politics Oct. 7 Reopen panel

In the third part of Healthcare in Politics,  speakersDuncan Davidson (Partner, Bullpen Capital), Leslie Krigstein (Vice President, Government Affairs, Livongo), Phil Kerpen (President, American Commitment), Emily Barson (Executive Director, United States of Care) joined us.

This panel focused on Reopening the economy or remaining shut down. The conversation first focused on reopening the schools due to the significant amount of research showing schools are not more likely to transmit COVID and that there are more deleterious effects on mental health. The conversation then morphed into an attack on our institutions, largely due to their political leanings. 

Here's what was covered:

12:55 -- Phil responds to a question about the Abbot Lab's new tests purchased by the administration and plans by the White House to deliver 150 million tests to local jurisdictions to reopen up economies. Phil points to Cherokee County in Georgia that has 41,000 students in its district. The schools opened during peak community spread of 15 percent positivity, said Phil. He referred to weekly studies of cases, and show of those thousands, cases are under 30. A recent report (ending Oct 9) shows 32 infected students. The tests can help in reassuring parents and teachers that schools are safe. But Phil argues we also need to educate society that schools are actually safe. Phil also said schools should consider the NFL protocol for testing. Use rapid tests as initial screen and then do lab tests for confirmation.

19:00 -- Duncan says we shouldn't even consider lockdown now. And even if we looked back at March, it would have been hard to lock down for more than a week or supply chains would have broken down. But even before this year, we had a profound failing on the institutional part. Duncan referred to a plan initiated by President Bush in 2005 for pandemic preparedness. Under Bush, the stockpile of PPEs were 100 million. But when President Obama came into office and the H1N1 virus hit, the stockpile whittled down to 12 million. According to reports, the stockpile was never replenished under Obama. Duncan's point was there was institutional failing prior to the current administration.   

24:35 Emily starts discussion that public sentiment of government is low but that there is little confidence about the plans in place to open schools. She also said that the federal government needs to provide resources to create safe infrastructure. Bambi asked if federal funds are finding their way to create safe environments. Phil Kerpen said that funds do exist from the federal level but they get held up in the states. The money isn’t getting to the ground level, Phil said. He also said that risks to faculty are largely exaggerated. He pointed to studies that showed schools have less adult interaction as other situations and that transmission risk in schools is relatively lower risk than other places. Phil also pointed out to studies showing greater risk to students who don’t attend school, such as greater suicides and school dropouts. 

38:55 - Leslie said Livongo has seen an increase of 30 percent in stress and more people with higher blood pressure. She said there’s no denying the correlation between what’s going on with lockdowns and how that’s impacting the average person’s mental resilience.  

45:27 Duncan: Media is amplifying the noise. How do we trust people like Phil, who says data says it’s safe to go back to school but then no one trusts Phil.  Rajiv says there is an established literature on the science you generate and use when you have a pandemic. There’s a game plan. The whole country has been off the game plan and he holds the CDC responsible for that irrespective of Trump. In the case of the H1N1 virus, Rajiv suggested that the CDC provided more data around generalizable risk. But today, there’s no such data and it’s “scientific negligence.”   

50:05 -- Rajiv suggests confusion reigns because of animosity between health institutions and Trump. There’s no organizational leadership at the CDC. There’s political control at the high management positions. Public health is now power. Power they’ve wanted for a long time.  Archana asks how we can fix the CDC. Rajiv says it’s transparency. Allowing data to be viewed and reviewed.  

57:00 -- Phil notes that people inside the CDC dislike Trump as well as the CDC director. The director and the CDC website often contradict themselves, he points out. [Trump picked veteran virologist Robert Redfield to director in 2018. He was criticized for not having enough public-health positions. Trump has also clashed with Redfield on the efficacy of wearing masks vs vaccines, as well as when a vaccine would be widely available. Critics said Trump is using politics to bend science. Reports also show internal strife inside the organization.]

1:02 -- Bambi brings up the question of whether mental and financial risks due to the shut down are greater than the secondary risks of getting the disease. Duncan turns to excess deaths. [Excess deaths is the gap between the observed and expected deaths. One study showed excess deaths rose 20 percent from March to August 2020]. If we get down to the normal level is that there’s all kinds of other problems occurring that people aren’t looking at. Economy has bounced pretty well and now it’s stalling. Why? The shutdown is affecting so many who really have to work. Duncan’s conclusion is that we open up. Rajiv observed that there’s increases in heart-related, diabetes deaths. These are not COVID deaths, but deaths of neglect. Looking at excess deaths were not all COVID deaths. The country should not have neglected the long-term care facilities. He believes care at long-term facilities was faulty and is the reason we have high deaths. First it was the hospital crisis, then death crisis, then case crisis, now secondary effects crisis. He also

1:09 -- Phil says the shifting rationales for continued lockdown betray the principle motivation of our politicians. The way this ends is they will quietly adjust figures. They will quietly change the definition of PCR and the numbers and they’ll say “We beat it.” But this might depend on if we get a president they like first. Rajiv talks about how we fix this. We need scientists and doctors who are non-partisan. 

Healthcare in Politics is hosted by Bambi Francisco Roizen (Founder & CEO, Vator), Archana Dubey (Global Medical Director, HP) and Mark Goldstein (Chairman, UCSF Health Hub)