We Need A COVID Reality Check: An MD Shares His 5 Reasons Why

Rather than coming together as a society, so many have taken the path of extremes when it comes to COVID-19. Picture it: There are those huddled in their homes—the "hunker downers," we'll call them—hoping for a vaccine before even entertaining the thought of venturing out. On the flip side, there's the dismissive party, quite literally partying with no qualms of any risk at all. What's more, there's a moral assertiveness attached to which camp you fall into; if you're a hunker downer, you're easily afraid and weak. If you're dismissive, you're immoral and selfish.

The loss we're experiencing is heartbreaking. Not to mention, we're acutely aware that the virus is disproportionately affecting impoverished and BIPOC communities.

As for preventive medicine specialist David Katz, M.D.? He believes it's time for a COVID reality check, no matter which side you're on: "It's like looking both ways before you cross the street," he says. "We have one camp that says only look left, and the other says only look right. We should look both ways." 

We may know that 98% of COVID cases are mild, but according to Katz, that number may be even bigger—but we don't have that data. "In any outbreak, what comes to your attention if you wait for data to come to you, is hospitalization and death," he says. "You overlook mild cases, unless you go out and seek it."

A lot of this has to do with media attention (which we'll get into later), but the sample size itself is flawed. According to Katz, the antibodies we measure are deep-seated in our blood, but they are not actually the first lines of defense. So while an antibody test may be negative, your body might have protected you against the virus before those immune cells were even activated.

A large chunk of the COVID conversation revolves around the hopeful notion of the vaccine. But according to Katz, "the idea that we can hide under our desks until we have a perfectly safe vaccine is a fantasy."

That's because most pandemics end with herd immunity—meaning, 80% or more of the population safely contract the infection and become immune. That's not to say no one will become severely ill: "Even if you have herd immunity, it's still going to do bad things; think yellow fever, influenza, even air pollution," Katz says. "There is stuff that's out in the world that kills people."

What makes this pandemic unique from any other, says Katz, is the prevalence of the internet. It's an "info-demic," he explains, with constant attention directed at this one threat, news cycle after news cycle. So much so, he notes, that "people believe were it not for COVID, nobody in America would die." 

"In the U.S., poor diet quality kills 500,000 people prematurely per year1," Katz explains. "With COVID, all those slow-burning chronic diseases that affect you over time can kill you tomorrow."

Which raises the question: Why are we not talking enough about metabolic health or the power of our immune system? Because rest assured, there will be a next infection upon us. The key, according to Katz, is to address those chronic health problems rather than finally sensing peril when there's an acute threat. 

"The acute threat of COVID shines a light on the wider net of health," Katz continues. "We've always had a reason to make people healthier. Now there is an acute threat in the picture. Eat better, stay active, and manage your stress. All this can affect your infection." 

It would be dismissive, however, to brush this off with a simple, "Let's get healthy!" campaign, as we know obesity disproportionately affects lower income, vulnerable populations, and minorities who have limited access to good food, as well as information on how to change conditions.

The pervasive opinions have been either "hunker down and hope for a perfect vaccine" or "let's be dismissive." Needless to say, this is a pandemic of polarization with very little middle ground. But that middle ground is exactly where the science is. "Those are two silly extremes, yet all too few people have found their way to the middle path," Katz remarks. "And the middle, where science occurs, is routinely neglected." 

If we really learn to combine sense and science, we'd know that COVID is a highly dangerous virus for a small segment of the population. Of course, we also don't know what the long-term health implications are for people who have had mild or severe exposure to the virus; there's not nearly enough data for us to recommend either extremes. That said, we shouldn't ignore the risks entirely or throw our hands up in panic.