How great a killer is COVID?

When Americans sent their sons and daughters off to fight in Vietnam a generation ago, did they say: "Most soldiers will come home alive, it's not serious"?

When a patient is diagnosed with an aggressive cancer, does her family say: "Most people survive cancer, it's not serious"?

Of course not. But that's the way millions of Americans are treating the COVID pandemic that has swept the world this year. They compare it to the flu, they say most victims survive with mild symptoms — it's not serious.

Consider the thousands of motorcyclists who packed bars in Sturgis, S.D., last month, or the thousands of college students who flocked to campus parties this month, or the hundreds of people who gathered on the White House South Lawn last week — all seated close together and without masks.

This is not the way Americans have responded to other grave threats to human life in our past. Why? Apparently many people haven't grasped that COVID is a real killer.

So we decided to see where COVID stacks up against other major calamities, military and medical, that have taken American lives over the years. The numbers are startling.

On the bloodiest day of the Vietnam War, in 1968, 246 U.S. soldiers died in combat. The nation's ghastly opioid claimed 137 lives per day last year. Auto accidents took 106 lives a day in 2019.

COVID, by contrast, is killing close to 1,000 Americans every day. That approaches the daily death toll at the Battle of Gettysburg, one of the bloodiest and most horrific episodes of the Civil War.

It's true that most COVID patients recover, many having had only mild symptoms. But that doesn't mean it's not a serious killer. This year, COVID is on track to being the third-leading cause of death in America, behind only heart disease and cancer. It is killing almost six times more Americans than automobile accidents and gun violence combined. More than 300,000 Americans will die from COVID this year if the current mortality rate continues — nearly 10 times more than flu kills in an average season.

Here's what's really frustrating: Reducing the COVID death toll doesn't require costly measures or a technological miracle. It doesn't require the nation to mobilize for war. It doesn't require invasive medical procedures. It just requires more people to wear masks, avoid large social gatherings and observe the Centers for Disease Control and Prevention recommended physical separation of more than 6 feet.

Other countries have shown that these strategies work. Ireland, with a population of 4.9 million, reported just 14 COVID deaths in August. Japan, with a population of 126.4 million, has recorded just 1,255 COVID deaths this year. Japan has had 10 deaths per million, compared with 564 per million for the United States.

We know that Americans consider themselves individualists. They chafe at taking orders and resent public-health measures that impinge on their freedom or impede the economy. But wearing a mask and observing physical separation don't shut down the economy. Quite the opposite, they are the key to reopening our economy and getting back to something like a normal life.

Our message isn't about politics, it's about practicality. If the Irish and the Japanese — and most of the rest of the world's citizens, for that matter — can control this killer disease, so can Americans. But we have to work together, as if we were at war — as we have many times in our history. This war is killing four times more Americans each day than the daily death toll of our soldiers in World War II. So let's take this killer disease seriously and do what needs to be done, everyone and every day.

Peter Marshall is a retired Minneapolis VA pain management physician. Dave Hage is a Twin Cities journalist and former health and environment editor at the Star Tribune.