By Kevin Roche
Not much research, I am in the rare position of being largely caught up. So maybe a little recapitulation of the epidemic, which has gone on for over a year in this country. First a quick observation on our spring bump in Minnesota, and that is all it was. I think it has peaked, appears that way from the active case analysis and DD agrees. Much lower case rise than would have been seen last year if we were testing at the same level as this year. Very few deaths. And I am certain many of the cases are low and false positives. More on that in the next Coronamonomania post. (As a side note, someone wrote an editorial in the WSJ referring to Covid mania. I probably should have trademarked my phrase, but I think I got there first in any event).
While I think the risk from CV-19 has been grossly exaggerated, I don’t want to be heard to say that it isn’t a serious public health threat. It is, it has caused a lot of severe illness and a lot of deaths. The actions taken to mitigate or even suppress spread, however, are not only unprecedented but futile, actually exacerbate the epidemic in many cases, and ignore the harms caused by those actions. This has been the true disaster in the epidemic. The responses have undermined democracy and harmed society and citizens. Politicians have been irresponsible in their panic-spreading and their failure to rationally assess data and science in taking actions to mitigate spread. The lesson I hope that we learn from this epidemic is we cannot place decision-making authority in one person–they will make bad decisions–and we can’t let “experts” have any influence or power, they are wrong more than they are right, especially if they work for the government, where there are no consequences for being wrong.
So what do we know or think we know?
- The Pathogen. Coronaviruses have been around for a long time and we have all been infected by them and they usually cause mild illness, at worst. They infect a variety of hosts, and various strains can mutate and jump from one host to another. Coronavirus infects a lot of critters and has jumped to humans multiple times. This strain most likely arose naturally but I wouldn’t rule out Chinese lab involvement and we are never going to find out the truth from them. It is dangerous because it is more infectious than some CV strains, largely due to stronger receptor binding. It can infect vulnerable people with a relatively small dose and frequently causes immune system dysfunction, which leads to severe disease. It is a nasty little bug. Like all living things with a lot of replication, mutations arise and some may be favorable in the evolutionary race but so far none seem that much worse in terms of disease severity. More severe mutations arise in part because of of overly repressive efforts to limit spread.
- The Disease. Most people don’t even get what might be called a disease, which implies a somewhat serious impairment of some bodily function. A notable characteristic of the epidemic is the wide variability in disease. Almost all is mild, but it some people, most notably the frail elderly and the obese, it can be very severe and fatal. The difference in fatality rates between young and old is astounding. Many, many infections are never detected because of the lack of symptoms.
- Transmission. Transmission almost exclusively occurs by droplets, ranging from larger ones to smaller aerosols. Surfaces don’t appear to play any role. The lifetime of droplets and the viability of the virus in the droplets is uncertain and likely varies extensively depending on environmental and other conditions. People’s susceptibility to infection and their infectiousness also covers a wide range. Asymptomatic and mild infections appear associated with lower viral loads and shorter periods of infectiousness. No one knows the exact formula, but seasonality/geography are clearly the strongest factors influencing transmission, capable of creating conditions which are so favorable to transmission that mitigation efforts are overwhelmed. We have seen this repeatedly, and it may be mediated by effects on the virus itself (greater lipid envelope stability?), on transmission factors (longer lifetime and greater carrying distance of droplets and aerosols?) and on the human host (more time indoors, drier upper respiratory tract?). Other macro factors may be population density, demographics, and pre-existing health conditions. Variability in susceptibility is likely modulated at an individual level by some immune system boost from prior exposure to coronaviruses.
- The Course of the Epidemic. Left unchecked, the epidemic would clearly proceed in a series of waves associated with those favorable meteorological conditions. Those waves peak rapidly and fall rapidly as meteorological conditions change. Mitigation efforts appear to have a limited effect on epidemic curves. At some point a sufficient proportion of the population would have been exposed to slow transmission and eventually it would recede to a background level. This virus will not be eliminated and we must adapt to its presence and accept some number of cases, hospitalizations and deaths. Fortunately, CV-19 appears to be almost entirely substituting for influenza, likely because it has some ability to suppress flu infection in a host.
- Adaptive Immunity. Even mild or asymptomatic infection appears to result in a robust adaptive immune response. The quality of that response may vary somewhat by severity of disease and by age. The response is stronger in the T cell arm. The response appears to last for an extended time, likely years if the response to the original SARS and MERS are a guide. Reinfections are rare, and almost always result in very mild and short disease.
- Data and Science. For all our supposed technological skill, the use of data and the “science” relied on have been abysmal from the start. The initial modeling was catastrophically wrong, leading to lockdowns, and it hasn’t gotten much better, with almost no models incorporating seasonality. Our attribution of death to CV-19 is unprecedentially broad and contributed to the panic. The primary tests we use are wildly inaccurate at identifying who is actually infectious, which is the most important statistic for tracking the course of the epidemic. The alleged “science” behind social distancing, masking, excessive cleaning of surfaces and things like plastic shields is nonexistent and guidance has had to be withdrawn multiple times. Other science showing the futility of lockdowns and school closings and masks is ignored. Our “experts” have repeatedly issued completely inaccurate predictions.
- Mitigation Tactics. There can be no question now that not only have these largely not worked, they have consistently exacerbated the epidemic and caused more damage than CV-19 will. This is particularly true in regard to closing schools and to the terror campaign that accompanied the mitigation program. Notwithstanding widely varying mitigation programs, most states and countries appear likely to end up in the same place, when adjusted for factors like population age, health, density and prior coronavirus exposures.
- Coronamonomania. Our “experts” and the politicians they advise have completely ignored the effects of the mitigation measures on people’s economic, social, educational and spiritual lives. The ignore the health harms being done, they ignore the ruination of children’s lives in particular. There is no balance, no rational response except in a very few places, i.e. Florida. This is due to the suspension of democracy, which meant worse decisions as fewer opinions and data inputs were sought and frankly, people like our Governor became infatuated with their power. Our public health experts and physicians should be especially ashamed of themselves for their acquiescence in not considering the total good of the population.
- Vaccines. This is the bright spot, where technology did help. In an amazing short period of time, vaccines were developed, refined, tested and approved. They are impressively effective. They are very safe, when the number of doses and actual confirmed, caused side effects are considered. The vaccines may be what gets us out from under the dictators.
What’s next? My best guess is that by June we will have very few cases, due to prior infections, vaccination and seasonal factors. If we don’t see a southern/southwestern wave in late June and July, then we will know we have really slowed transmission. Will the idiots that govern us declare victory and stop the obsession? Don’t count on it.