Oh Say Can You See?

There’s a meme making the rounds on social media:  What do you get when you mix medicine with politics?  Politics. 

Because we feared our hospitals would be overwhelmed by a sudden spike in patients requiring intensive care and ventilation, we shut down the $22 trillion national economy thus replacing that fear with an absolute certainty that the world would be plunged into a depression which, upon final analysis, will claim the lives of far more people than any virus. 

Rather than quarantining the sick and those most at risk, we attempted to quarantine the sick and the healthy alike, which was an impossible proposition that was doomed before it began. Nobody believed we could quarantine everyone. Lists of essential workers and businesses were drawn up, and with them the idea of quarantining the healthy went up in smoke.  

The shutdown was intended to ensure the hospitals would not be overrun. The evidence shows that they were not overrun. We have successfully slowed the spread of the virus.  But the price of that success has been that many hospitals are decimated, their staff reduced dramatically, furloughed; their ability to handle a major inflow of cases diminished. 

Meanwhile, routine visits to the doctor have been curtailed.  Procedures not considered to be an emergency have been postponed.  How many diagnoses of critical illnesses such as cancer will be missed?  How many deaths of one sort are we prepared to trade for deaths of another sort?

For fear of temporary hardship, we opted for the certainty of prolonged hardship. More of such genius coming from “the experts” we can do without.   

Eminent and sound-thinking doctors from the best universities¹ around the world have been reviewing the models and projections being used to shape the actions of nations while at the same time collecting real-time data the analysis of which has compelled them to plead for a reassessment of our response.

As the data began piling up, it became increasingly clear that ~ 60-fold more people had the virus than the numbers used to create the models which fact drastically reduced the projected mortality rate of this COVID virus to levels not much greater than the seasonal flu.  Their conclusions were that for the young and healthy, the virus does not pose a significant risk of death.  For the aged and those with chronic, underlying health problems the virus is a significant risk. By locking down the economy and society at large, rather than the elderly and sick, we have done a great job ensuring that fewer people will have the antibodies. Serological testing through March and April has yielded data that indicate that in most urban areas somewhere between 1 and 4% of the population has had the virus.  In New York City, that number is more like 25%.  Overall, the number is less than 1% of the population that has tested positive for the COVID-19 related antibodies.  Given that it takes something on the order of 75% of the population with antibodies to stop the spread of a virulent virus, our efforts have had the effect of prolonging this pandemic. 

We should all understand this:  We cannot eradicate this disease by staying locked down.  It is not possible to shelter in place until there is no longer danger from COVID-19. So far, there has never been a vaccine for Coronavirus. 

A viral contagion is “beat” when a significant percentage of the population possess sufficient antibodies that provide immunity.  Those antibodies can be obtained by having had the virus and or by having been administered a vaccine.  Period. 

In addition, a significant percentage of those with the virus are asymptomatic yet presumed contagious, thus presenting yet another reason to encourage the elderly and those with chronic conditions to self-quarantine.   

Sweden’s response to the virus did not include a general lock down of its population nor a shutdown of its economy and the results have been roughly the same as countries that did those things.  Except, they did not decimate their economy.  Some will point out that Sweden’s results have included a modestly greater number of deaths per capita, to which the answer is – exactly.  The Swede’s are getting through this pandemic more rapidly as they race to achieve herd immunity.  In the end, deaths per capita in Sweden will be similar to the rest of the world.

And still our leaders ignore the facts and now talk about transitioning from shelter in place to test and contact trace.  With a disease such as Ebola, testing and contact tracing is the right strategy. With Ebola, there are no asymptomatic carriers.  The numbers overall are fewer and manageable.  With COVID-19, massive-scale testing to find those who are presently sick is impossible.  If I test negative today, what about three days from now?   Or tomorrow?  Shall we test everyone daily?  How will we know who is tested?  While we are turning our Nation into a police state, we may as well jump forward to tattooing our prisoner numbers on our arms while we dance on the remnants of our constitution. 

For fear of the virus we did our best to prevent its spread, even though its spread, and the resultant antibodies in the population, was exactly what was required to overcome the virus.

For fear of our hospitals– and let’s be clear, that meant certain hospitals in urban areas— being temporarily overrun, we voluntarily stepped out on a high wire walk over the pit of economic despair with no possibility of turning back because politicians can never admit they were wrong. 

Did no one think about creating a massive fleet of ventilator equipped patient transport vehicles to disperse the critically ill to hospitals that were not overrun? That perhaps such a plan would be several million times less costly than shuttering the economy? 

Military hospitals were deployed. Warehouses were turned into temporary morgues. A military hospital ship was anchored at New York City.  Quietly, the temporary hospitals were disbanded unused, the temporary morgues shuttered and the ship sailed away.

For fear that something awful might happen we ensured even more awful things will happen. Now, even in areas with very low COVID-19 related numbers, many of the young and healthy peek out from their sheltering in place, gripped with fear and seemingly insensible over the authoritarian withdrawal of our freedom and liberty.  We are no longer the home of the free and the land of the brave. We are prisoners in “Lock Down”.  

The elderly and the compromised are right to self-quarantine. The young and healthy must get back to work, back to being Americans, free and unfettered, pursuing happiness, turning risks into rewards and pressing on the accelerator of our economy. 

For those whose immediate reaction is that the ideas presented here are nothing more than the callous trading of deaths for money one can only wonder at the sad state of their mental health. 

Continuing this lock down will not have any impact on the danger from COVID-19.  It will, however trade deaths for deaths. 

• Deaths from lack of treatment and diagnosis
• Deaths of despair
• Countless deaths from Tuberculosis presently spiraling in under-developed nations
• Deaths from mal-nourishment and starvation as the supply chains of humanitarian aid dry up

The right answer is to end our unconstitutional imprisonment.

• Ask the elderly – those of retirement age – to self-quarantine
• Ask those with underlying, serious and chronic health issues to self-quarantine
• Protect our elderly and at risk in long term care facilities through stringent sterilization practices, routine testing of staff, and the like
• Mobilize an army of volunteers from faith-based groups, and other organizations, each of whom would be regularly tested for the virus, to deliver groceries, meals, prescriptions and other necessities, along with a little human kindness, to those in self-quarantine, all of which could be financed via the federal funding already flowing to cities and towns all over the Nation  

We ought to face this threat as free Americans, with our actions based on reason and supported by clear-headed thinking based on medical science and actual data.  In other words, we ought to avoid the toxic admixture of medicine and politics. 

If we don’t soon wake up from this national debt-induced anesthesia, this social media-exacerbated holiday from critical thinking, we will truly have something to fear.

1:

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/
https://www.medrxiv.org/content/10.1101/2020.04.05.20054361v1