Alex M. Azar II is U.S. secretary of health and human services.

President Trump’s top priority throughout the covid-19 crisis and his presidency has been protecting the health and well-being of Americans. Nothing exemplifies this leadership like our new Operation Warp Speed, which is marshaling the world’s best minds to develop and deploy a vaccine in record time.

The sacrifices Americans have made through social distancing have helped slow the spread of the virus and save lives. Moving forward, we need to confront the misconception that going back to “normal life” just means balancing the health risks of reopening against the economic costs of aggressive social distancing. Returning to normal isn’t about balancing health vs. the economy. It’s about balancing health vs. health: the health risks of covid-19 balanced against the health, social and economic costs of keeping Main Streets across the United States closed for business.

Getting this balance right isn’t simple. It will look different for every state, business and family. The Trump administration is committed to helping each state and all Americans have the information and tools they need to safely reopen.

The economic crisis brought on by the virus is a silent killer. Estimates suggest that each one percentage point increase in the unemployment rate translates into a 1 percent increase in suicide deaths and a more than 3 percent increase in opioid deaths, which means this virus-induced recession will likely cause tens of thousands of excess deaths. One study of the 1982 recession found that Americans who faced higher unemployment suffered approximately 40,000 excess deaths by age 65 — as well as more divorces and having fewer children. Shortening this economic crisis through a safe reopening could save thousands of lives.

Meanwhile, at a time of social stress, states are seeing a decline in reports of child maltreatment, which is likely going unreported because children are isolated from teachers and others who can help keep an eye on the vulnerable. On Monday, the president, first lady and vice president joined me and other administration leaders to discuss these challenges and potential solutions with governors.

The covid-19 response has also restricted access to health care. Data suggests the numbers of Americans receiving important preventive services are down significantly, with mammograms down 87 percent and colonoscopies down 90 percent.

More than 1.7 million new cancer cases are diagnosed per year in the United States. If we’re seeing an 80 percent drop in cancer cases identified, approximately, we could already have 200,000 or more undiagnosed cancer cases as a result.

According to Medicare data, breast cancer surgeries are down approximately two-thirds since January. A Centers for Disease Control and Prevention report found that vaccine administrations were down approximately 60 percent from early January to mid-March; that puts millions of American infants and children at risk for serious illnesses.

Forgoing all of these services also devastates our health-care system and the front-line heroes who have kept it running. Many health-care workers have been furloughed, and hospitals are seeing as much as 60 percent revenue declines from the cancellation of elective procedures. Hospitals in rural America operate on about a 2 percent to 3 percent profit margin, and urban hospitals have about a 5 percent to 6 percent margin. Extended disruption to our health-care system may permanently close some institutions, with lasting impacts on access to care, especially where access is a challenge already.

How can we avoid these costs? The Trump administration has laid out a phased approach for lifting restrictions on work, social gatherings and other activities over time.

Americans should be proud of the sacrifices they have made, abiding by lengthy stay-at-home orders to slow the spread of the novel coronavirus and buy time. Now, Americans should follow their states’ guidelines as they evolve, and leaders should be cognizant of the health, social and economic costs of maintaining restrictions.

We have a strategy for how to move forward: A combination of surveillance, widespread and easily available testing, containment of isolated outbreaks, and rapid development of vaccines and therapeutics means we will continue making progress against the virus in the months to come. 

As we learn more about the virus, we are developing new ways to protect the vulnerable, including the elderly, and ensure Americans can seek needed health care. Your doctor, for instance, will have precautions in place to protect you if you have a young child who needs an in-person visit.

Americans are rightly concerned about the risks of covid-19 — just as they’re frustrated about their inability to return to normal life. It’s because we care about Americans’ health and well-being above all that we have to safely reopen our country.

We cannot allow the virus to impose intolerable costs in terms of drug, suicide and alcohol deaths; forgone health care; and more lost jobs. Under the president’s leadership, we can safely reopen our country, protecting every American’s overall health and well-being today and in the years ahead.

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