Yale Daily News

Former Yale instructor David L. Katz SPH ’93’s New York Times opinion piece sparked opposition from current University epidemiologists — some of whom were quick to refute what they see as his suggestion that the United States is overreacting to the COVID-19 pandemic.

Katz, founding director of the Yale-Griffin Prevention Research Center, published “Is Our Fight Against Coronavirus Worse Than the Disease?” on March 20. He argued the U.S. should adopt a milder strategy to preserve the economy while stopping deaths from COVID-19. Three days later, on March 23, a cohort of Yale epidemiologists published a response letter that objected to a number of Katz’s claims — including his statements that young people should have reduced self-isolation restrictions and that certain businesses should be allowed to reopen.

“I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life … will be long lasting and calamitous, possibly graver than the direct toll of the virus itself,” Katz wrote in the March 20 op-ed.

Katz has since been tested for COVID-19 after exhibiting mild symptoms, he wrote in a March 25 online post he sent to the News.

In his opinion piece, he wrote that a “more surgical approach” is needed in response to the virus, laying out a situation where that U.S. could relax distancing restrictions on younger people — who generally experience milder symptoms upon infection — while focusing the health system’s resources on the older population. He wrote that as long as society protected the truly vulnerable, “a sense of calm” could be restored and society could develop natural herd immunity to the virus.

“The high-level issue is that indefinite lockdown with anxiety, uncertainty, and dread is potentially lethal for many — by means of despair, depression, destitution, hunger, addiction, suicide, and violence,” Katz wrote in an email to the News.

Katz also said that sending everyone home can also cause problems. For example, college students returning home from shuttered campuses may be carrying diseases and infecting elderly grandparents. Katz added that asking children to stay at home burdened families of health professionals who continue to work on the frontlines of the pandemic. 

Some University epidemiologists disagreed with claims made by Katz. Dean of the School of Public Health Sten Vermund, Yale epidemiologists Gregg Gonsalves and Becca Levy, and Director of the Yale Institute for Global Health Saad Omer signed onto the letter to the editor that opposed Katz’s claims.

The letter, headlined “The Wrong Way to Fight Coronavirus,” responded directly to Katz’s claim that younger people should no longer have to follow most social distancing recommendations. The writers argued that Katz’s approach would likely overwhelm the healthcare system and lead to many more deaths. Katz’s approach, they wrote, would also dash hopes of effectively beating back COVID-19 so that it does not reemerge every flu season. 

Vermund argued that it isn’t feasible to entirely separate at-risk groups from society, and that reopening society too early would likely result in a second wave of the pandemic. He advocated instead for taking a similar approach to China, which saw its number of cases decrease after an extended societal shutdown.

“We think it would be a bit self-delusionary to think that two weeks and all of a sudden the virus is gone,” Vermund told the News. “Many of us in the public health community think we should be cautious to try to reduce mortality and flatten the curve so we don’t overwhelm our health system.” 

The response letter also explained that it is more effective to limit community transmission entirely, rather than allowing some infections while attempting to protect vulnerable populations.

In addition, the four experts wrote that it is unclear exactly which populations are most vulnerable to the disease. As the virus has begun to sweep across the United States, CDC data showed that nearly 40 percent of COVID-19 patients sick enough to be hospitalized were aged 20 to 54. Last week, a 17-year-old boy from California died after a COVID-19 infection, and on Saturday, an infant in Illinois died from the disease.

But Katz said that the United States should accelerate its data collection of infection rates to identify vulnerable populations before re-evaluating its containment approach to see if different restrictions can apply to groups facing differing risks of serious symptoms. He also said he believes many young people with extremely mild symptoms did not go to emergency rooms, so many cases remain unreported.

Vermund explained that the widespread shortage of test kits made it impossible to conduct the community-wide surveillance necessary to see if restrictions could be relaxed in some areas.

“We still are fighting the epidemic with one hand tied behind our back,” Vermund said, adding that as a result, he favors a more cautious approach to combating the coronavirus.

The Yale epidemiologists advocate for compliance with current standards — including social distancing and stringent personal hygiene practices — until a COVID-19 vaccine as well as viable antiviral drugs are available.

“[Katz] favors letting the pandemic run its course, but somehow ‘walling off’ the most vulnerable,” the letter reads. “He argues that his strategy would preserve the global economy, while stemming deaths from COVID-19. We disagree.”

Katz’s claims have circulated broadly. Fox News host Pete Hegseth tweeted a link to the piece. Other NYT opinion pieces –– such as Thomas Friedman’s “A Plan to Get America Back to Work” –– cited Katz’s article to issue his own recommendations. Two days after the article’s publication, the message from the White House aligned with Katz’s argument, although leaders did not cite him directly. Government officials floated the idea of targeting restrictions to at-risk age groups while allowing the rest of society to resume its routine in the hope of preventing economic fallout.

Last week, New York governor Andrew Cuomo directly referenced Katz’s ideas as he questioned whether widespread quarantine had retrospectively been the best public health strategy. Cuomo echoed Katz’s theory that younger people could be exposing older relatives to the virus and mentioned his desire to get people back to work.

“What we could do is tell the public [that] this is not an indefinite hunker with your anxiety and dread and hope there’s a vaccine,” Katz told Anderson Cooper ’89 in an interview on CNN last week. “We’re going to hurt people in other ways than with the virus — people’s life savings are being lost, they’re despairing, they’re anxious.”

Although Katz has Yale University as his Twitter location, the Yale School of Medicine tweeted on March 23, “David Katz is not academically affiliated with Yale and has not held an academic appointment here since 2016.”

COVID-19 is the disease caused by the novel coronavirus.

Rose Horowitch | rose.horowitch@yale.edu

Meera Shoaib | meera.shoaib@yale.edu