(May 1, 2020) As of this writing, 49,963 Americans have perished to covid-19 and 869,172 US cases have been confirmed. 

In response, governors across the country are following CDC guidelines and have issued shelter-in-place orders with exceptions for essential services only. 

Over 26 million Americans are now unemployed, wiping out the post-recession employment gains. We have all been touched by covid-19 in some way; whether you or someone you know has contracted the virus, become unemployed or worst case, perished from this horrible disease.  

What’s clear is that we are all scared and that is understandable.

A phased approach to re-opening the economy has now been developed. The three phases are intended to balance the risk of contracting the virus with the dire consequences of the current remedies. 

While the decision lies with the governors of each State, the CDC and White House have issued guidelines that are based on up-to-date data and readiness, mitigating the risk of resurgence, and protecting the most vulnerable. 

We now turn to our state leadership to Lead. The safe and easy response is to go slow and avoid additional deaths attributed to the virus. However, what is needed is a balanced approach that avoids systemwide risks. 

We will defeat covid-19, but at what human costs if we move too slowly? 

Let’s look at some less-discussed statistics. Suicide hotline calls and reported domestic abuse cases have increased 10-20 percent since shelter-in-place orders were declared. 

Calls to suicide hotlines in Philadelphia have increased about 10 percent in the last few weeks, said Omoiye Kinney, the communications director at the Department of Behavioral Health and Intellectual disability Services (DBHIDS) which oversees two hotlines.

Of 22 law enforcements polled by NBC News in early April 2020, 18 agencies stated that they had seen a rise of domestic abuse reports in the previous month ranging from 5 percent to well over 20 percent. 

In the United States, an average of 20 people experience intimate partner physical violence every minute. This equates to more than 10 million abuse victims annually, 1 in 3 female murder victims and 1 in 20 male murder victims are killed by intimate partners. 

Seventy-two percent of all murder-suicides are perpetrated by intimate partners.  This rise in covid-related domestic abuse cases and suicide hotline calls can account for tens of thousands of deaths nationwide and many more worldwide. 

We have yet to understand the effect of long-term closures on those with addiction issues. The United States was struggling with an opioid crisis long before this outbreak. 2018 data shows that every day, 128 people in the United States die after overdosing on opioids. 

Could a longer “shutdown” have a more devastating effect on those involved in an opioid or other type of addiction?

According to Republic National Distributing Company (RNDC) a $20 billion wine and spirits distribution company, sales of spirits jumped by around 50 percent for the week ending March 21. According to Nielsen data, the overall increase nationally for the week, was a 55 percent spike in sales. 

An estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States. The first is tobacco, and the second is poor diet and physical inactivity. 

The closure of schools and gyms is contributing to a lack of physical activity and a poor diet for children dependent on school lunches.

While shelter-in-place orders minimize the physical risk of contracting covid-19, these orders have clearly caused a rise in psychological and emotional risks that are known to result in equally devastating physical consequences that will endure well after we defeat the risks associated with contracting this virus. 

Today, The New York Times published, “Instead of coronavirus, the hunger will kill us,” citing the World Food Program estimates that 265 million people could be pushed to the brink of starvation by the end of the year.

The White House and CDC phased approach tries to balance both sides of this equation.  The governors must do the same.  

We must not move too quickly so as to overwhelm and imperil our healthcare systems. But we cannot move so slowly that we do not account for the enduring damage done by closing our economies and shuttering ourselves indoors.

Here is my message to my governor.

1) Strengthen our statewide healthcare system.  Protect the staff and workers, ensure adequate facilities and supplies, increase capacity by balancing the load statewide, recruit a reserve and ready healthcare workforce: doctors, nurses, EMTs, etc.

2) Test, test and test more. Set up safe and efficient screening and testing sites. Prioritize not only symptomatic individuals but also those most vulnerable. 

Trace contacts of covid-positive results, test and isolate if needed. Provide added assistance and resources to those most vulnerable; the elderly, those with pre-existing conditions and/or addictions.

3) Pay close attention and respond accordingly to psychologically induced consequences such as increase in suicides, domestic abuse or alcohol- and drug-related incidents.

4) Follow the White House and CDC gating criteria closely, but don’t hold back. Place confidence in your healthcare system and begin opening the economy as soon as the criteria are satisfied.

5) Monitor the situation closely and be prepared to make changes. Create plans by region so as not to create undue stress in areas that are less affected. 

(Mr. Grasso, a resident of Lewes, Delaware, is the former president and CEO of The MITRE Corporation, a not-for-profit company operating federally funded research and development organizations.

 He held the position from 2006-2017 and currently serves as a consultant. He is a member of the Defense Science Board and a former member of the Army Science Board. He is a Ted Talk participant, and is a member of the National Academy of Science’s Government, University and Industry Research Roundtable).

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