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Fear and Trembling or The Sickness Unto Death

The Danish philosopher Soren Kierkegaard published Fear and Trembling in 1843, a treatise on the anxiety that must have possessed Abraham on his journey to the land of Moriah to sacrifice his only son at God’s instruction. In 1849, Kierkegaard published The Sickness Unto Death, a meditation on the despair of having to live suspended between apparent earthly knowledge and real infinite truth.

Is it little wonder that Kierkegaard’s writings are still of great relevance. Anxiety and despair have plagued the human race since its beginning and stories teaching us to cope preceded the written word. Wise men and women through the ages have recognized the destructive power of anxiety and despair. 

Today, we are being told by arrogant power-seekers and hapless repeaters that anxiety and despair are necessary and constructive. We must fear the virus. We must fear the lockdowns. We must fear opening up. We must fear our neighbors as well as strangers. We should be angry that our government has failed to protect us. A constant barrage of contradictory wisdom presses us all toward a state of anxiety and despair.

Calm down. Take a deep breath. Try to cope by looking at the numbers. You will find astounding comfort in the truth.

COVID 19 cases in the United States have increased in an amazingly straight line at around 25,000 per day before and during the lockdown. Our increased control of damage by the virus did not result from reduced growth in cases. Rather, our successes were avoiding increased contagion and learning how to treat and cure infected patients. In mid-April we saw 25,000 new cases per day and 2.300 deaths per day, a ratio of one death for every 9.2 new cases.  By early June, still with 25,000 new cases per day, we were seeing only 700 deaths per day or one death for every 36 new cases. Yes, you read that correctly… with no reduction in new cases per day and more finely tuned health care, in two months we were saving 1,600 lives per day. The lockdown accomplished its primary purpose.

Beginning on June 22, we saw two dramatic changes. First, there was an increase in new cases to 40,000 per day. There are two obvious causes.  Testing increased to over 500,000 per week. Seven to ten percent positive test outcomes explain 6,000 new cases daily.  These new cases are by definition less serious. Test subjects are no longer limited to those already with symptoms. Selection of those to be tested is more random and most who test positive are asymptomatic at the time. More of these patients will be cured because of earlier detection and more vigorous health. Fewer of them will die.

The remaining increase in new cases results from people being less careful.  This is not a good thing, but it is not surprising that many people see “opening up” as a time to function more freely. Before we panic, let’s look at the second important change. Deaths per case have more sharply decelerated. During the period from June 22-28, deaths fell to 308 per day or one death per every 83 of the 25,000 new cases per day experienced in the previous two months. Failure to focus on this statistic is an egregious omission. The declining death rate is a credit to thousands of doctors and hospitals and researchers who have created more tools and set new standards of care while discarding less effective approaches. This trend will continue and more lives will be saved.

Some point out anxiously that the virus is now attacking more young people.  How could it be otherwise? Many “clusters” have been reported at parties or crowded events. Seniors remain more careful, especially those in nursing homes.

Lets look ahead and see what we might fear the most.  Imagine if new cases increased to 75,000 per day, three times the rate of April and May, with no further decrease in toxicity. That would result in 900 deaths per day, about the same as we experienced in early June.

We will not triple our pre-lockdown level of new cases. We will not stop improving treatments. Every pause will be followed by accelerated progress. The current “surge” turmoil is a normal growing pain, not a crisis, not even to be remembered next year. Every state and community will continue to govern itself according to its individual demographics. Every individual American will continue to make decisions in the interest of his or her own health.  Most of us will never meet this virus, especially if we remember to wear our mask and wash our hands.  The economy will recover unevenly. How could it be otherwise? Those who call for fear and trembling and those who politicize the discussion do not do so in the interest of truth. Those who preach, “Wait for the vaccine,” are betting on a horse with no pedigree. There has never been a successful and safe vaccine for any coronavirus.  We will prevail with or without a vaccine. Those who wear their mask, and wash their hands will rarely face this sickness unto death.

Michael Moffitt

July 1, 2020