CRI News

May 4, 2020
(original release dated April 30, 2020)
RE: CRI Policy Position on COVID-19
Looking at the worst-case scenario is our human default mechanism when faced with a new threat. Human nature boasts a powerful survival instinct. Our domestic policy started with that instinct when COVID-19 first presented itself.
With little actual knowledge or data on this virus, the country braced for dire outcomes. Early models estimated tens of millions of infections with one of every ten of those infections ending in death. 
The President, Governors, and health organizations in response, planned for the worst possible outcome and instituted some rather draconian measures to stem the spread of the virus. With the limited knowledge at the time, their decisions were prudent to ensure that our hospitals were not overwhelmed by those needing treatment.
Although there are still many unknowns with COVID-19, we have learned a few things. We know now that:
  • The virus is, in fact, very contagious. Multiple recent scientific investigations estimate up to 20 times more people have or have had the virus than are showing up through testing. (A large California study indicates most people infected were unaware they had it.)
  • The mortality rate, once thought to be between 3% to 10% of those infected, is actually somewhere between 0.3% to 1%. This rate is comparable to a bad seasonal flu.
  • Hospitals in Delaware are busy treating severe cases but are not currently overwhelmed. Statewide only about 15% of available ICU beds are filled with COVID-19 patients. Non ICU beds are operating at about 13% of capacity for COVID-19 patients. Hospitals are running well below capacity because of the dangerous cancellation of elective surgeries and a big reduction in emergency room volume due to fewer traffic accidents and fear of catching the virus.
  • While lockdown has slowed the pace of the viral contagion, its ability to spread continues and eventually everyone will be exposed. As many as 50 to 85 times the approximate 1,000 confirmed cases in Santa Clara, California’s population were infected despite severe lockdowns implying a mortality rate of 0.17%. A sewer system study in New Castle County (NCC) originally estimated that 15 times the number of residents have had the virus than official tests have been able to confirm. Revised figures from the sewer survey indicated that the number of residents infected could be up to 31 times higher than originally confirmed through testing. Official figures at the time of the sewer study accounted for 39,000 cases and NCC could have well over 50,000 cases now compared to about 1,734 confirmed cases and 70 deaths.
  • Using the updated infection estimates for NCC, the mortality rate for our most populous county is approximately 0.13% which is not unusual. 
  • Though there are outliers, the vast majority of fatal cases occur in the elderly and those with pre-existing health issues. Nursing homes account for 61% of deaths in Delaware. Of the recently reported cumulative 144 deaths in Delaware, all but 3 were 65 years or older. (As of May 1, 2020-with only 11 non-nursing home deaths, the NCC mortality rate for the general, mobile population impacted by lockdowns is only 0.03%.) 
  • Studies in Italy and the US show that nearly 99% of fatalities involve individuals with prior non-COVID-19 related health conditions such as hospitalizations for: heart problems, high blood pressure, pulmonary issues, and diabetes. 
Consistency in how we measure this epidemic is critical. To date, the state has changed how it measures confirmed cases three times. 
New testing measures are available that supply results in a day or minutes rather than many days. While the faster diagnosis is important for treatment and isolation, it also creates an artificial spike in newly confirmed cases.
An overview of all data would indicate Delaware cases peaked around April 22. The new testing regime essentially starts a new data set and will need to be analyzed separately, the spike is not indicative of new cases, merely more timely results. 
So what does that mean?
In short, the virus does spread rapidly. There is a high probability that we will all contract it regardless of government mandated isolation. The good news is that there is much less chance of dying from it than previously believed. Our hospitals have the capacity to treat critical cases.
The elderly, people in nursing homes, and those with health issues are at high risk. Measures, such as continuing to limit contact to protect these high risk groups should be taken. These precautions should be taken for most viruses including influenza.
Those of us without existing health problems need to remain cautious, but reasonably so. We must hold ourselves personally responsible for our health and the health of the community. We must do the following: 
  • Wash hands while singing the ABC song – twice.
  • Stay home if you are sick – even a little bit.
  • Covering your mouth when you sneeze.
  • Respect personal space when out in public.
  • Clean surfaces with disinfectants.
  • Make sure we are caring for our immune systems by eating healthy and getting enough rest.
Our ability to practice these measures will stem the tide and help us avoid future government controls. Prudence, not fear, must rule here.
The initial response, though understandable, is no longer the proper response. It is widely said that the battle plan changes the moment the first shot is fired. Isn’t it high time to change the battle plan? Our actions must be swift as businesses fail and families suffer. 
Government assistance has yet to materialize for most. Tens of thousands of people and hundreds of businesses have yet to receive unemployment or economic assistance and many may never see a nickel of what was promised to them.
If we continue down the current path without easing business and school lockdowns, we only guarantee dire economic consequences that will lead to far more pain and suffering in the end.
Co-Authors: David T. Stevenson, CRI Policy Director
Matt Lenzini, CRI Vice Chair
Dr. Christopher Casscells, Policy Director
Contributors: John Toedtman, Executive Director
Dr. John Stapleford, CRI Chair


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