Anger…Bargaining…Acceptance?

It's been a busy week in state government: analyzing different scenarios to reopen schools, working on a refined COVID-19 testing strategy, preparing for the possibility of a gap in $600 weekly benefits for 135,000 New Mexicans, and answering an unusual number of letters, emails, and even an OpEd from angry and/or alarmed physicians about recent initiatives to try to address our record number of daily cases here in New Mexico.

While we welcome and encourage debate on these matters, using the word "insanity" to describe the state's approach is perhaps based on some old data, faulty math, and imprecise methods. To help readers weigh the merits of the arguments, we have included references to support ours.

Both of us, after initially grumbling, exercise regularly with masks and find that we no longer complain. Is there a reason, then, why some people still won't wear them? After hundreds of emails from constituents and colleagues, one appealing theory is that in order to learn to live in a COVID-positive world, we need to reach acceptance about what must change for a year or so until we are vaccinated. This includes masks.

Many of you are familiar with the five stages of grief: denial, anger, bargaining, depression, and acceptance. A quick review of COVID-19 related OpEds and letters to editors over the past four months highlight the fact that many New Mexicans are working with us through these stages. But denial and anger won't change the infectivity of the virus. So let's go through a quick fact check.

Do masks cause the retention of CO₂?  Not according to the World Health Organization and Vanderbilt University.[1]^,[2]

Is the flu deadlier than COVID-19? No. The data shows the flu fatality rate is 0.2% while COVID-19's is much higher at 1.3.[3]

Did California "epidemiologists estimate there are 50 to 80 untested COVID-19 cases for every one reported case?" Yes. But the scientific community quickly reached the conclusion that the data was overstated as a result of faulty antibody tests (with high false positive rates).

Yesterday, the CDC reported a ratio of known to unidentified cases of 1:6 to 1:20 but also acknowledged potential issues with antibody testing. We do a lot of testing in New Mexico and calculate this ratio in our state to be 1:4.8. But we are nowhere close to herd immunity. In Sweden, officials let the virus spread unimpeded by any public policy initiatives. They have still failed to achieve herd immunity with a rate of only 7.3 percent.^[4]  Plus, new research suggests that only 17% of people develop an immunity that lasts 3 months or more.^[5]

Does controlling the spread cost jobs? No. The Washington Post compared New Mexico's cautious approach to Arizona where they opened up restaurants, gyms, and bars much faster. While more jobs returned initially, their death rate grew to three times our number and they shut back down again. We are now in the exact same place economically.[6] And Sweden's strategy did not result in more jobs and has instead left them with a far deadlier outbreak than their Nordic neighbors.[7]

Saying that we need to trade lives for jobs is a false choice. By slowing the spread of COVID we get to the same place economically while keeping more of our friends and neighbors alive. And the only way to restore our economy and begin the long march back to prosperity is to defeat the virus – those two goals are not mutually exclusive; in fact they reinforce one another.

Our governor has been accused of "insane policies" that are "driving people to despair and suicide." Many New Mexicans who are glad for the safety and health of their families and loved ones strongly disagree. The medical literature is now replete with data which documents profound worldwide increases in alcohol and drug intake, depression and anxiety that occur after peaks in COVID cases. Every New Mexican should know that their lives are valuable, and that help is just a phone call away at 1-855-662-7474. We believe that these behavioral health consequences come a result of the effects of the pandemic itself, as they occur everywhere, independent of public policy decisions.

And anger is a common symptom of depression, a symptom that can be prolonged and indeed lead to severe depression and death unless we each move through our stages of grief towards acceptance of our new lives in a COVID positive world, at least for the next year.

By David R. Scrase, MD, Secretary, Human Services Department and Bill McCamley, Secretary, Department of Workforce Solutions

[1] https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

[2] https://www.vumc.org/coronavirus/latest-news-you-asked-we-answered/does-prolonged-wearing-facemask-cause-harm

[3] https://www.cathlabdigest.com/content/study-reports-staggering-13-death-rate-us-among-those-infected-who-show-symptoms

[4] https://www.mercurynews.com/2020/05/20/swedish-antibody-study-shows-little-sign-of-herd-immunity/

[5] https://www.medrxiv.org/content/10.1101/2020.07.09.20148429v1

[6] https://www.washingtonpost.com/business/2020/07/21/arizona-struggles-neighboring-new-mexico-found-more-cautious-path-sustained-growth/

[7]  https://www.businessinsider.com/sweden-coronavirus-strategy-high-death-toll-no-economic-gain-data-2020-7