President Trump has repeatedly used this reality as a rhetorical point in support of his push to get businesses to reopen. He’s repeatedly insisted that the “cure can’t be worse than the disease,” suggesting that, among other things, the number of people who might lose their lives as a result of the social distancing is comparable to the number lost to the virus itself — 80,000 confirmed deaths as of this week, a tally that’s clearly lower than the actual death toll.
During a news briefing Monday, Trump claimed that the number of people who will die of drug abuse or suicide might actually surpass that figure.
“Don’t forget, people are dying the other route,” Trump said. “You can go with the enclosed route: Everything is closed up, you’re in your house, you’re not allowed to move. People are dying with that, too. You look at drug addiction, you look at suicides, you look at some of the things that are taking place, people are dying that way, too. You could make the case it’s in even greater numbers.”
As is often the case, it was then incumbent upon the president’s communications team to justify that claim. So, speaking to reporters Tuesday, White House press secretary Kayleigh McEnany endeavored to do so.
“I would just point out a recent CNN article from Friday noted a national public health group that warned as many as 75,000 Americans could die because of drug or alcohol misuse and suicide as a result of the coronavirus pandemic,” she said. “So there are consequences to us staying closed.”
Again, it is true that there are consequences to staying closed. It is not the case, though, that the estimate to which McEnany points offers a robust counterpoint to the risk posed by the virus.
That study was from a group called Well Being Trust and was covered by The Washington Post’s health team this week. It uses estimates of how unemployment correlates to increased “deaths of despair,” meaning those from suicide or substance abuse. They developed a range of possible death tolls, determining that the most likely outcome was those 75,000 deaths to which McEnany referred.
But it’s important to understand what the group was actually considering. It looked at two metrics, the ratio of increases in the death toll relative to unemployment and how rapidly steep unemployment receded. The result was nine scenarios, from a low death-to-unemployment ratio in an economic downturn that resolves quickly to a high death-to-unemployment ratio in a downturn that recovers no more quickly than the recession of a decade ago.
Based on those assumptions, here’s how the estimates break down.
You’ll notice first that in the most optimistic scenario (low increase in deaths/fast recovery), 27,645 more deaths are projected. In the least optimistic, that surges to 154,037 deaths. But you probably also noticed that these changes occur over a four- (fast recovery) to ten-year (slow recovery) period. In other words, those 75,000 deaths aren’t deaths that will occur between now and the end of the year; they’re deaths that might occur between now and, say, the 2024 presidential election.
The difference in the mortality rate relative to unemployment rates is a function of uncertainty about the unique characteristics of the coronavirus response, like everyone staying home most of the time. The authors of the report figure that, given the circumstances, the 1.6 percent estimate might be the most accurate one. But the estimates in how many people might die a “death of despair” are linked to unemployment rates, a factor that will probably extend beyond the lifting of social distancing measures in even the hardest-hit places. The difference between reopening now and reopening in September is a vanishing one in this analysis, unless one assumes that the former shift will lead to a significantly shorter plunge in employment.
Regardless, the 75,000 possible deaths included in this analysis are broadly not comparable to the toll from the coronavirus. Comparing those estimated deaths to the current toll is similar to Trump’s repeated comparisons of the virus to the seasonal flu back when the death tolls from each were similar. That confirmed death figure will continue to grow, and eventually the government will develop an estimate for the coronavirus-related deaths that weren’t formally confirmed.
More importantly, as leading infectious disease expert Anthony S. Fauci testified Tuesday, scaling back economic shutdowns risks pushing the death toll higher. That’s precisely the point of the economic restrictions, of course: limiting the spread of the virus. Reopen the economy quickly because you’re worried about those deaths of despair, and you risk a spike in deaths from the virus.
There isn’t yet good data on how many people have been lost to suicide or substance abuse as a result of the shutdown. We might never have concrete data to that point. What we do know is that even with the economic restrictions in place, thousands of Americans are dying of the coronavirus each week. That alone should offer more pause than the Well Being Trust’s estimates.