Coronavirus and the Mass: Following the science

Avatar

By Deacon Rob Lanciotti

Deacon Rob Lanciotti is a permanent deacon at St. Elizabeth Ann Seton in Fort Collins and holds a doctoral degree in Microbiology. He was employed as a virologist for the Centers for Disease Control & Prevention (CDC) for 29 years.

Back in June as we began returning to Mass, I wrote from my perspective as a virologist with experience in public health that attending Mass for most people was a relatively low risk event. 

The past several months have convinced me that this is still the case. Mass attendance under the guidelines that we are following in the Archdiocese of Denver is reasonably safe, and at this point most of us should be participating in the weekly liturgy. Here I would like to reiterate a few previously stated points in support of this, with the addition of new and valuable data.

It is unfortunate that most news organizations are emphasizing case numbers and other rare outcomes of the disease.  We may read about the 10-year-old who died of COVID-19, yet the story fails to place this rare event into perspective.  For example, there have been 72 deaths due to COVID-19 among the 0-14 age category (of over 200,000 total fatalities), whereas we typically have 700 deaths due to drowning per year in this same age cohort.  COVID fatalities are not even within the top 20 causes of death for this age group.  Media emphasis on these rare outcomes has led to a generalized fear that is unfounded for most of the US population.  The facts are clear; the disease is of low incidence overall and severe outcomes and fatalities are occurring among an identifiable sub-set of the population – a subgroup that can be protected.  Overall, the public health response and the media focus has been disproportionate to the threat.  Catholics should focus on the facts and not be manipulated by the press.

The overall rate of infection among the entire population has been determined by randomized testing in 10 separate cities throughout the US.  New York City is clearly the exception, with an infection rate of around 20%.  All other sites are at 5% or less.  For comparison the 1918 flu pandemic caused infections in well over 30% of the population.  

Secondly, as has been observed from the outset of the pandemic, there is a clear age and health relationship between COVID-19 infection and serious outcomes.  Coronavirus infection is significantly less serious than annual flu for those in the 0-24 age category, about the same as annual flu for the 25-45 category, more serious than flu for those in the 45-64, and significantly more serious in those over 65; especially with pre-existing health conditions.

With these facts in mind, it is clear that most people are at low risk of serious outcome and thus should feel safe returning to Mass; especially with the precautions in place at the Sunday liturgy.  

Moving forward, there are two principles of Catholic social teaching that I would like to reflect upon that can be applied in dealing with response to the pandemic; subsidiarity and the common good.  The principle of subsidiarity teaches us that those closest to the situation under consideration are best suited to make correct decisions.  Applied to this current scenario this means that individuals and families (not necessarily the government) are best suited to decide the appropriate level of precautions necessary.  For example, a healthy couple with young children should approach returning to Mass differently than an elderly couple with pre-existing health conditions, because the risk is objectively different for the two categories.  Secondly, the common good, the health of others, must also be considered.  Although the couple with young children is facing a disease of low consequence for them, they must consider the potential of infecting those in higher risk categories.  Combining these two principles, it is possible for individuals and families to make prudent decisions.  As an aside, I can attest from my 30 years of experience in public health that government & public health officials detest subsidiarity, because they believe that it is their role to inform and guide your decisions.  Unfortunately, they are unable to assess every situation and therefore generally overreact.

The National Center of Health Statistics website reports that among the 0-44 age category, automobile traffic deaths (19,663) significantly exceed COVID-19 deaths (4,638).  What this means is that for those in this age category, the drive to Mass poses a much greater risk than attending Mass! My advice is that each individual & family determine their own health risk of attending Mass, consider the risk to others, and then make a decision.  In this process, it is essential to focus on the data and ignore the media’s bias.  Even statements by Public Health officials must be taken “with a grain of salt,” since they believe that individuals are unable to make good decisions, and that it is their role to tell you what to do.  Without hesitation, I can say that for the majority of individuals, attending Mass at this time is a low-risk endeavor.  Finally, as should be obvious to us, Mass attendance is of paramount importance for our salvation and therefore we should do all we reasonably can to participate in this great liturgy! 


Sources:

  • For example, there have been 64 deaths due to COVID-19 among the 0-14 age category (of 180,000 total fatalities), whereas there have been 700 deaths due to drowning.
  • COVID-19 fatalities by age from: cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
  • Deaths from other causes: worldlifeexpectancy.com/usa-cause-of-death-by-age-and-gender
  • The overall rate of infection among the entire population has been determined by randomized testing in 10 separate cities throughout the US. NY City is clearly the exception, with an infection rate of around 20%. All other cites are at 5% or less. For comparison the 1918 flu pandemic caused infections in well over 30% of the population. 
  • Seroprevalence study data from: cdc.gov/coronavirus/2019-ncov/cases-updates/commercial-lab-surveys.html
  • 1918 Influenza infection rate: ncbi.nlm.nih.gov/pmc/articles/PMC3291398/#:~:text=An%20estimated%20one%20third%20of,pandemics%20(3%2C4).
  • Coronavirus infection is significantly less serious than annual flu for those in the 0-24 age category, about the same as annual flu for the 25-45 category, more serious than flu for those in the 45-64, and significantly more serious in those over 65; especially with pre-existing health conditions.
  • COVID-19 fatalities by age from above compared to influenza infection fatality rate average of 0.12%
  • The National Center of Health Statistics website reports that among the 0-44 age category, automobile traffic deaths (19,663) significantly exceed COVID-19 deaths (4,638).
  • COVID-19 fatalities by age from cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
  • Auto traffic deaths by age from: www.worldlifeexpectancy.com/usa-cause-of-death-by-age-and-gender

COMING UP: Lessons on proper elder care after my mother’s death

Sign up for a digital subscription to Denver Catholic!

We buried my Mom last month. 

In the summer of last year, I first drove her to her new memory care facility. My heart was breaking. She was so scared and vulnerable but was trying so hard to be brave. My brother said it was like taking your kid to pre-school for the first time. And never going back to pick her up. 

But we had to do it. She was far too confused for our 97-year-old Dad to take care of her. She didn’t recognize him. She would lock herself in her room, afraid of the “strange man” in their apartment. She wasn’t eating well, and with COVID restrictions we couldn’t get into her independent living facility to monitor her diet or her health. Worst of all, she would wander. Unable to recognize “home” and unable to convince anybody to come get her, she would set off by herself. Dad would realize she was missing and frantically try to find her. Fortunately for us, she always attempted her escapes when the night security guard was at his desk. But we were terrified that some evening she would get out while he was away, and she would roam out into the winter night. 

We knew that, without round the clock support, we couldn’t keep her safe in any of our homes either. So, we concluded that she needed to be placed in a secure memory care facility. I think it was one of the hardest decisions my family has ever faced. We researched. We consulted experts. We hired a placement agency. We came close to placing her in one home, then chickened out because we felt like the owner was pressuring us.  

Finally, we landed on what looked like the best facility for our needs. They specialized in memory care, and we were assured that the staff had been trained to care for people with dementia. They took notes about her diet, health, likes and dislikes. Most important, it was a secured facility. They knew that Mom wandered, and their secured doors and round the clock caregiver oversight seemed like the best way to keep her safe. It was the most expensive facility we had seen. But we figured her safety and well-being were worth it. 

On Jan. 12, Mom was found in that facility’s back yard. Frozen to death.  

She had let herself out through an unsecured exterior door, unnoticed and unimpeded, on a cold winter evening. No one realized she was missing until the next morning.  A health department investigator told me that she had been out there at least 12 hours. Which means caregivers over three shifts failed to recognize her absence. I’m told she was wearing thin pants, a short-sleeved shirt and socks. The overnight low was 20 degrees. 

We are devastated. Beyond devastated. Frankly, I don’t know that it has completely sunk in yet. I think the brain only lets in a little horror at a time. I re-read what I just wrote, and think “Wow, that would be a really horrible thing to happen to a loved one.” 

I debated what my first column after Mom’s death would look like. I have felt compelled, in social media, to celebrate the person my Mom was and the way she lived. To keep the memory alive of the truly amazing person she was. But I think I did it mostly to distract my mind from the horror of how she died. 

But I am feeling more compelled, in this moment, to tell the story of how she died. Because I think it needs to be told. Because others are struggling with the agonizing decision to place a parent in memory care. Because when we were doing our research, we would have wanted to know that these kind of things happen. 

I am not naming the facility here. It will be public knowledge when the Colorado Department of Health and Environment report is completed. From what I am told, they are horrified at what happened and are working very hard to make sure it never happens again.

My point here is much bigger. I am discovering the enormous problems we face in senior care, particularly in the era of COVID. I was told by someone in the industry that, since the facilities are locked down and families can’t get in to check on their loved ones, standards are slipping in many places. With no oversight, caregivers and managers are getting lazy. I was in regular communication with Mom’s house manager, and I raised flags every time I suspected a problem. But you can only ascertain so much in phone conversations with a dementia patient. 

Now, since her death, we have discovered that her nightly 2 a.m. bed check — a state mandated protocol — had only been done once in the ten days before her death. She could have disappeared on any of those nights, and no one would have realized it. 

I have wracked my brain, to figure out what we could have done differently. The facility had no previous infractions. Their reputation was stellar. Their people seemed very caring. Their web site would make you want to move in yourself. 

Knowing what I know now, I would have asked some very specific questions. How are the doors secured? Are they alarmed? Is the back yard accessible at night? Are bed checks actually done every night? Who checks the logs to confirm? 

I would check for infractions at the CDPHE web site. Then I would find out who owns the facility, and do some online stalking. Is this a person with a history of caring for the elderly, or just someone who has jumped into the very trendy, very profitable business of elder care? I am very concerned that, for many, this “business model” is built on maximizing profits by minimizing compensation for front line workers — the people actually caring for our loved ones. 

Dad is living with me now. We are not inclined to trust any facilities with his care. Watching him grieve has been heartbreaking. If you talk to him, do me a favor and don’t mention how she died. It’s hard enough to say good-bye to his wife of nearly 60 years, without having to grapple with this, too. 

I am, frankly, still in disbelief. I don’t know exactly where I am going from here. But I do know one thing. I want my Mom’s death to spur a closer look at the way we care for our vulnerable elderly. 

Because I don’t want what happened to my Mom to happen to another vulnerable elderly person again. Ever.