America's Bizarre Relationship With Health

Why are we fixated on an uptick in COVID-19 cases when a bigger health crisis is unfolding?

Photo by Anna Shvets/Pexels

I try to keep this Substack as apolitical as possible because I believe the biggest problems we face transcend politics. Of course, it’s almost impossible to do this with anything related to COVID-19 because nearly every aspect of the pandemic has been politicized. Yet whether we supported lockdowns, masking, or vaccine mandates, I think all Americans can agree on one thing: when it comes to public health, all lives matter.

Why is this important? Because there’s an alarming trend emerging in public health that isn’t being addressed or even discussed. The silence is disturbing. But before we dive into that, let’s step back in time a few years.

Like most people, I was anxious and frightened during the first weeks of the pandemic. Almost immediately, the CDC and public health agencies launched an aggressive campaign to control spread of the virus through social distancing and mask protocols. This made sense, of course, because there was an urgency in stemming a rising tide of deaths from a novel pathogen of unknown origin and consequences. By mid-April, however, my fear gradually subsided when it became clear that those most at risk were elderly or had underlying conditions, and I was neither.

But as the pandemic wore on, I began nursing a different emotion: confusion.

Seldom acknowledged or discussed was the fact that poor health was the single biggest driver of COVID-19 hospitalizations and deaths. The virus claimed a disproportionate number of Americans— the highest of any Western country — because we are, per capita, one of the “sickest” countries in the world. To put the dire state of American health into perspective, consider that during the entire pandemic we’ve lost a total of 1,170,000 Americans to COVID-19. By contrast, heart disease and cancer claim 700,000 and 600,000 lives each year. 140,000 more are lost to stroke, and 100,000 to diabetes. In other words, we lose more Americans to these other diseases and conditions in a single year than we have lost to COVID-19 in the past three years. Moreover, these aren’t diseases or conditions that most people are born with; like COVID-19, they are easily preventable.

To put it bluntly, too many Americans were low hanging fruit, ripe to be plucked. Yet the people charged with protecting our health all but ignored this reality in our pandemic response.

There was never a concerted effort to address the underlying health conditions that caused the vast majority of COVID-19 deaths (a staggering 75% of victims had four or more comorbidites). No attempt to galvanize Americans to improve our collective health so we have a better chance of weathering the Alpha strain or future variants and other viruses. No PSAs urging us to exercise and adopt a more wholesome diet that reduces the risk of heart disease, cancer, and other chronic illnesses and diseases. Given the urgent interest in saving lives, the lack of attention to these issues seemed odd to me.

Six months into the pandemic, I became more confused. That’s when Dr. Anthony Fauci opined that vitamin D deficiency might impact susceptibility to COVID-19 infection. Coincidentally, that same month a University of Chicago study found that vitamin D deficiency actually increased the likelihood of COVID-19 infection. The following month, researchers at a hospital in Spain discovered that more than 80% of hospitalized COVID-19 patients were Vitamin D deficient. As science goes, this seemed like good stuff, the kind of information we could use to help us better navigate our way through this crisis. Right?

But that’s when things got weird.

Almost immediately, a flurry of fact checks discredited the use of Vitamin D, ignoring the University of Chicago study and the clinical evidence in Spain. Experts cautioned against Vitamin D “misinformation” (this time Russians weren’t responsible) and the potential for overdose. The World Health Organization chimed in, warning that Vitamin D couldn’t cure or treat COVID-19.

Much like hydroxychloroquine and Ivermectin, this innocuous and commonly used supplement suddenly became the subject of controversy. The consensus in the medical and scientific communities seemed to be that even if Vitamin D provided some protection by increasing the body’s natural defenses, it didn’t have a proven “antiviral effect” against COVID-19, specifically. It wasn’t a silver bullet, so best not to use it. Our best and only weapon against the virus would be the vaccine, when it became available. Until then, we were advised to keep masking and stay 6 feet safe.

And this might have made sense, except that within six months of the vaccine rollout things got weirder. That’s when it became clear that the vaccine wasn’t a silver bullet, either; it couldn’t prevent serious illness or death, or even infection. At best, when combined with rigorous masking, vaccination could only reduce the likelihood of these outcomes. Of course, it would be naive to expect that any vaccine can guarantee protection from infection, illness, or death, and it would be irresponsible to recommend that people at risk take Vitamin D in lieu of getting vaccinated. But once again, I couldn’t help but ask common sense questions:

If COVID-19 was devastating to those with weak immune systems, wouldn’t it make sense to add Vitamin D to their arsenal to make it easier for the vaccine to protect them? In fact, wouldn’t it also make sense for healthy people to take Vitamin D to reduce their risk of infection and transmission to those at risk?

Given that the supplement was cheap, readily available, and had a low probability of harm, wasn’t it worth at least giving it a chance? After all, in a public health crisis shouldn’t we take advantage of everything at our disposal that can possibly help?

And looking at the bigger picture, beyond the pandemic, shouldn’t improving the immune systems and general health of all Americans be an urgent public health priority?

I mention the Vitamin D story because it’s a striking example of the perplexing and often counter-intuitive public health priorities that I observed throughout the pandemic. For the past three years, the urgent concern for American health seemed to begin — and end— with COVID-19. Keeping people from getting infected, hospitalizing them if they became seriously ill, and vaccinating them regularly to reduce their risk from this particular virus and its many strains.

Even after the emergency passed, when we recovered from lockdowns and masking, got back to “normal,” and wrung our hands over 1 million deaths, there was never a “What went wrong?” or “How did we let things get this bad?” moment among public health officials. There was no discussion of how we might prevent people from becoming vulnerable to strains of COVID that outpace our ability to manufacture vaccines, so we can avoid another pandemic that disrupts every aspect of our lives. We never saw the Department of Health and Human Services pour millions of dollars into a “Let’s Get Fit” campaign to start reversing the dire state of American health. The FDA didn’t lean on the multi-billion dollar Food Complex that contaminates our fruits and vegetables with pesticides and fills grocery store shelves with chemical-laden, cancer-causing, packaged products.

I knew I wasn’t alone in asking the obvious question: If our government was willing to sacrifice our economy, our children’ education and development, and even our sanity for the sake of our health, why weren’t they taking these simple, proactive steps to avoid another public health crisis in the future?

This experience prompted me to pull focus, look at the bigger picture, and ask another obvious, but more unsettling question: is our government as concerned about our health as it says it is?

And this brings us to current events.

Although COVID-19 has finally moved from pandemic to endemic and hospitalizations are down 82%, last week we started hearing a phrase that can still trigger PTSD: an uptick in cases. Granted, this uptick isn’t a “surge” (in fact, it’s not even clear how many cases constitute an “uptick”?). And cases and hospitalizations have been trending up and down for the past year without a lot of fanfare. Moreover, there’s no indication that the newest variants are more lethal than Omicron. But the news is already causing low-level panic.

Media outlets quickly swung into action, warning that “it may be time to break out the masks again.” Lionsgate Studios reinstated mask mandates, and a New York hospital restored its mandate (only one month after ending the policy). Across the country, more schools and colleges are following suit. CDC director Mandy Cohen weighed in, assuring Americans that vaccines are still our “arsenal against the virus.” NBC’s Ann Thompson reinforced this message by encouraging everyone to get boosted as soon as new vaccines are available. So, what to do until then? According to Thompson, stock up on at-home tests and keep a mask handy. That’s it.

No mention of spending more time outdoors to dose our bodies with Vitamin D and boost our immune systems in the waning summer months. No suggestion of starting or stepping up our exercise regimen in advance of cold and flu season. No recommendation to cut back on alcohol or add more fiber to our diet to reduce the risk of cardiac and pulmonary diseases that make us prone to COVID-19.

And this is where my confusion peaks. While public health agencies and the media are busy mobilizing to protect us from the latest COVID-19 variant with another round of vaccines, they’re ignoring a bigger story that’s unfolding under the radar: young people are dying in unprecedented numbers.

Based on data from the Centers for Disease Control and Prevention

It comes as no shock that excess mortality — defined as more deaths than normally expected — rose during the pandemic. What’s curious is that excess deaths aren’t declining post-pandemic. More alarming is the fact that many of these deaths, ranging from heart and circulatory issues to neurological disorders, have nothing to do with COVID-19. In fact, even as COVID-19-related deaths have steadily declined through 2022, excess mortality continues to persist.

In the twelve months ending April 30, 2023, and more than a year after the last of several pandemic waves, at least 104,000 more Americans died than expected. Working people age 35 to 44 years old are being hit especially hard, with 34% more deaths than expected in the last quarter of 2022. The head of Indianapolis-based insurance company OneAmerica found the death rate of their working age policy holders was up a stunning 40% from pre-pandemic levels. Without question, some of these people had pre-existing conditions, but most likely weren’t at risk of dying from COVID-19 since more than 83% of deaths RELATED TO THE DISEASE occurred in those over the age of 60.

Data from other insurers confirms that since the end of 2021 the mortality of all working age Americans has increased dramatically, especially white-collar workers whose education, income level and access to health care would predict better outcomes. Even more disturbing? This trend shows no sign of easing. The increase has been so astonishing that insurance industry leaders have formed a coalition to investigate this “baffling” and sustained rise in excess mortality. In the words of one analyst, “[i]t was the fire insurance industry that got together and created fire departments...We need some fire brigades, because things are on fire.”

So, what’s causing this dramatic increase in deaths among working age Americans? No one knows for sure, but there are theories. Some experts attribute these excess deaths to delayed and unavailable healthcare during the pandemic which led to delayed diagnosis, and even direct and indirect effects of the pandemic such as mental illness, suicide and drug overdose.

Yet there’s no evidence that excess deaths are concentrated in states that locked down for longer periods, or that they aren’t occurring in states that eschewed lockdowns or only locked down briefly. Moreover, it seems unlikely that so many working age people (especially those under 30) were at heightened risk of disease simply because they delayed health care during a year of lockdowns. And while it’s reasonable to assume that lockdowns created an environment that drove some to despair, it’s also reasonable to assume that as despair eased post-lockdown, excess deaths would decline — but they haven’t.

The bottom line is that we don’t know what’s causing this dramatic increase in excess deaths, but what we do know is that public health agencies don’t seem particularly interested in finding the answer. In fact, they’re not even asking the question. And that’s what’s so troubling. Even the media, which can always be counted on to sensationalize any injury or death, are giving this crisis scant attention.

How many of you reading this now are aware of the “uptick” in the deaths of working age Americans? Have any of your friends and family mentioned it? When a novel virus was taking lives, it immediately became breaking news. Tickers ran across our screens 24/7 reminding us of the daily toll from the virus. Our government moved heaven and earth to ensure our safety. But now tens of thousands of Americans in the prime of their lives — many in their 20s — are quietly dying, often suddenly, for unknown reasons. And there’s radio silence. Why?

Based on what we’re seeing now, I have a strong suspicion that COVID-19 is going to consume more of our lives in the coming months. This latest “uptick” feels different, and the panic brewing in the media seems to have legs. And if there’s one thing we’ve learned in the past few years it’s that when the media want us to focus on something, they have no trouble doing it. But as COVID-19 mania ramps up again, I would encourage you to occasionally look in the other direction. Start paying closer attention to the general health of those in your circle, especially friends and family under the age of 50. Because COVID-19 clearly isn’t the only threat out there now. And judging by the numbers, it’s certainly not the biggest one.