By Dr. Anthony Policastro

Preventive medicine is a good thing. The one problem with it is that no one knows if it is successful. If you prevent something from happening, then that is not a news story. You cannot say something did not happen.

A good example of this is the Delaware Healthy Mother Infant Consortium (DHMIC). This committee was formed in 2005. One goal was to reduce infant mortality.

When the committee began, the number of infant deaths in the state were 9.3 per thousand live births. Between 2005 and 2018 that number gradually decreased. That decrease did not happen by accident. There were many different approaches taken.

An example of this is the Healthy Women Healthy Baby Program. There are seven sites throughout the state. They enroll high-risk pregnant women. They help them control factors that might affect pregnancy. A typical example is the decreased smoking rate for these mothers.

The result is a decreased likelihood of premature delivery. This is important because premature birth is far and away the leading cause of infant mortality in Delaware.

The DHMIC developed review committees to look at infant and maternal deaths after the fact. The goal was to try and identify high-risk factors that might be preventable in the future.

They worked to help educate mothers on safe infant sleeping practices.

They worked to help increase the rate of breastfeeding. They developed a Community Health Worker Pilot program in Wilmington.

A website titled was developed to further promote educational objectives. The education includes best practices. Grant money was provided to community organizations to address social determinants of health.

There are multiple other programs available. Each is aimed at addressing aspects that might help decrease infant mortality.

The DHMIC is also looking forward. There are plans to continue with new programs over the next few years to see if the mortality figures can improve even further.

It is likely that those children who survived because of this program will never know that they escaped being a mortality statistic. It is also likely that much of the population is unaware of the activities that are being conducted at a statewide level.

What is important is for everyone to realize several things. The first of those is that there is an active group looking at reducing infant mortality. The second is that over the last 15 years that group has been very successful in doing so.


The national news continues to concentrate on the total number of new COVID cases. That is the wrong viewpoint. If you remember when this all began what I talked about was rate of rise.

New cases were doubling every 48 – 72 hours. At that rate half of the country’s population would have been infected by May 8. That didn’t happen.

The last time the number of new cases doubled in the U.S. was on June 14. It took 45 days for that to happen. At the current rate of new cases, it will double again in 43 days. At that rate, it will not infect 50 percent of the population until about April 2021. The delay from May 2020 to April 2021 is important. It allows medical resources to handle the number of cases. It buys time for a vaccine to be available.

Delaware last doubled its number of cases on May 19. It took 35 days for that to happen. That was 55 days ago. At that time there were 8,037 cases. We now stand at just about 13,000. It will be much longer than 60 days for it to double.

Sussex County last doubled its number of cases on June 6. It took 38 days for that to happen. That was 37 days ago. At that time there were 4,342 cases. We now stand at about 4,400 cases. It will be much longer than 60 days for it to double.

So while the national news media might be trying to convince everyone that the sky is falling, we need to be careful about that Chicken Little approach.

Another thing being talked about is that the mortality rate appears to be lower than it had been. Everyone is looking for a single explanation for this. It is clearly caused by multiple factors.

We are identifying more cases because we do more testing. More younger people are getting the virus and surviving. Medical facilities have learned how to improve treatment.

Nursing home patients accounted for many of the early fatalities. There is not going to be a single factor.

It seems like every day that a story about someone causing a stir about wearing a mask goes viral on the Internet.

People act surprised at some of this behavior. It is not really surprising at all. People who refuse to wear masks have taken a stand. They feel they are free to do as they want.

They are the same individuals who needed MADD to cut down on drunk drivers. They are the same individuals who opposed smoking in public places bans.

They feel that they are smart enough to know what they are doing. When they are told they are wrong, they see it as a loss of that freedom or of that innate self esteem.

So they react like any loss. There is denial (I don’t have to wear a mask). There is anger (clearly this is the thing that makes the headlines). There is bargaining (Could I do it this way instead?).

Then it moves to mourning and acceptance. It is like any other loss. Just like other losses some people have trouble getting past the anger stage. It is normal human behavior.