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Day 137: COVID-19 Is There Really an Epidemic Anymore? (Part 2)
Increasingly as I think and write about COVID-19 I am having trouble staying focused on the medical rather than the political. Are there medical questions that remain? Of course. There continues to be professional debate about effective therapies for the suffering. But even there it is problematic to divide the medical from the political.
The President is taking HCQ, plus presumably zinc, prophylactically. (I am assuming his physician will not be prescribing azythromycin or doxycycline absent symptoms.) And thus there was a rush to debunk HCQ and the Lancet obliged. But now that study has been withdrawn.
There is work on the vaccine and anti-virals. Although there has never been a successful vaccine developed against a coronavirus several organizations are trying and the broad scale of infection from SARS-CoV-2 compared to Ebola and earlier SARS outbreaks has ensured a level of investment in the effort to produce something. The historic death count attributed to COVID-19 will lend energy to the chase whether or not a second wave shows up. See, there again I have difficulty separating the medical from the political. It is the express or implicit demand of the public driving government that dictates action, not the evolving professional assessment of future need. And that professional assessment is not itself purely scientific.
“Science” is word increasingly requiring quotes. Science is a process, a method, a tool, not the basis for ending debate. Yes, if in using the scientific method something has been reproduced endlessly, it can be said that doing so the umpteenth time is not worth the effort, i.e. “settled”. But more things are claimed to be “settled” than are truly settled. And there is the phenomena of numerating conjectures: By giving assumptions numeric values and then applying accepted mathematical processes, the outcomes tend to have more substance than is justified by the assumptions being used. In short, “garbage in, garbage out” — regardless of the size and complexity of the algorithm.
In the end, public health is exactly that: public. Individual considerations are subordinated to the needs of the public at large. People become data, not people, to public health officials. Just as people become votes, not people, to politicians. Public health sits between medicine and politics, neither one nor the other. It has attributes of both. Thus an epidemic is not solely a medical emergency. Those exist at the individual level. They only become a public health issue when enough people are threatened with illness and at a severity level that puts the normal functioning of society at risk.
We decided that SARS-CoV-2 was a virus that put a functioning society at risk. There was some evidence justifying that decision. But whether or not it truly would have done the harm that was feared in the absence of state police action is a counterfactual. And that police action has itself truly interfered with the normal functioning of society, the consequences of which we continue to struggle. But the same police powers seem to be absent with respect to rioting. So have we decided that there is no longer a public health risk? The mere fact of a possible spike in SARS-CoV-2 infections due to large gatherings of people milling about together in close proximity, does not mean there is a public health risk unless it results in an impact to the normal functioning of society.
How will public health officials close down the economy again if there is a spike? Will the public accept that police powers need to control the behavior of healthy workers but not rioters? That society is more adversely affected by COVID-19 than looting and arson? I suspect that the public will see future public health pronouncements less medical and more political.
[Note 1: I will be arbitrarily ending the daily COVID-19 posts on Day 150. It is clear now more than ever that this is not a public health crisis, it is a public policy crisis dressed in whatever garb best suits those that promote government control over our lives. That will be the constant battle of the remainder of my life. But it has nothing to do with the disease we labeled COVID-19.]
[Note 2: Links to all my COVID-19 posts can be found here.]
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Published in General
My favorite medical anecdote is that there has never been a double blind study in the effectiveness of zinc … because they cannot make a placebo that tastes as awful as zinc.
I wonder if anyone is going to track whether there is a spike in cases reported in the next two to three weeks in those cities with protestors and rioters. I’m not sure the data would be helpful, since if people contract the virus, they could be asymptomatic. But it would sure be interesting to know.
No, as someone has said elsewhere today, if there is an increase in number of virus infections after the riots, that increase will be charged to racism in America; because if it weren’t for the racism there would not have been a “need” for the rioting (I’m not going to call what has been happening “protests” or “demonstrations.”
Very much a state by state thing. We are seeing a surge of new cases in Arizona. As of right now 33 states have reported today and AZ is #1 in new cases with more than NY+NJ. Positive PCR tests going up. Here in Phoenix metro positive test rate was 5% first 3 weeks of May, 9% two weeks ago and 10% last week. Hospitalization of known or suspected Covid patients up 28% Statewide in past 4 days. We had hoped hot weather, which we’ve had a for month, would slow things down.
It would be interesting to know the demographics.
Yet, hospital resources are not stretched in Arizona, per the state charts. We will see if that changes on the next weekly report, Sunday.
Virginia’s cases, hospitalizations and deaths have been dropping consistently for the last 3-4 weeks. Of the 1400+ assumed deaths in the state, 57% have been in long-term care facilities, 77% in those age 70 and up, 91% age 60 and up. 32 of VA’s 95 counties have had no deaths. Our county of 88,000 has 388 positive tests and 4 deaths. The peak for hospitalizations and deaths was the 3rd week of April. For cases, the peak was the 3rd week of May.
Is Arizona in air-conditioned environments right now?
If so, that could be drying out the upper respiratory track, which causes mucous to form as a way of overreacting to the dryness, which then creates a medium for the virus.
Presumably, people are experiencing symptoms, which is driving them to call their doctors, who are recommending they get tested.
In other words, it may seem like a surge, but perhaps these are asymptomatic carriers who have been there all along–the new frontier in the study of viruses–who are now reacting to the virus presence.
This is the big mystery with this virus: what is the contagious status of asymptomatic carriers? We’re assuming people are developing antibodies two weeks after exposure, but perhaps they are not. We need to find out. It will give us a better idea of what will happen next fall.
That said, a pediatrician once told me that summer and viral pneumonia go together and that those pneumonia cases are the worst for doctors to treat. They hang on a long time, and they are very bad.
It’s hard to sort all this out. :-)
I went back and checked and it is interesting. Can’t find statewide data but did for Maricopa which is 60% of the population. Over the past month those testing positive have moved towards a younger profile.
As of May 4 this was breakdown:
0-19 5%
20-44 38%
45-64 33%
65+ 25%
Over the past month:
0-19 11%
20-44 47%
45-64 28%
65+ 14%
Also realized I made a mistaken when I stated hospitalizations were up 28% in past 4 day. More precisely it is positive or suspected inpatient Covid patients.
As a once very involved anti-pesticide crusader, I can’t tell you how many times we activists would have made certain situations much healthier – except for the rules and regulations that had been created both at the state and Fed levels for the “sake of public health.”
First instance, when a group of us sought to help teachers understand the best ways to keep their classrooms insect-free, we found some teachers were accepting of the idea that vinegar can keep many noxious pests away. Vinegar totally discourages wasps. It totally discourages ants. When around children, why use Raid and whatever the heck toxic chemicals are in it, if a burst or two of vinegar would accomplish the same goals?
But then the principal would point out that since the EPA had not concluded a study on the safety of vinegar around humans using it to stop insects, it was basically forbidden. (Some teachers did I think go on to use vinegar if they thought they could get away with it.)
We now face the same scenarios in so many aspects of “science” that is brought about to approve or discount medical remedies. Sometimes what is needed is banned due to Big Bad Industry having enough monies to stop a cheaper remedy. Other times what appears to be evil in its conception is just an omission due to ignorance.
Plus what was bad yesterday may be good tomorrow. A FB friend was telling me that the bacillus that causes tuberculosis is now being considered as a remedy for some types of cancer, including the one she suffers from: bladder cancer.
Too true. Have seen that happen over and over again.
I have seen two reports recently, one from Italy and one from Pittsburgh, which say the the virus is mutating to a less virulent and less contagious form.
Edit – here are links:
https://www.reuters.com/article/us-health-coronavirus-italy-virus-idUSKBN2370OQ
https://www.dailymail.co.uk/news/article-8390849/University-Pittsburgh-doctors-say-coronavirus-appears-declining-potency.html
Don’t discount how AC con complicate and cloud the spread.
Us Philadelphians remember Legionnaires Disease.
I’m all about the media exaggerating for an agenda, but regardless of hoaxes and me memes this coronavirus IS an infectious bug that has real consequences, and shows no favors.
The very fact that it incubates so long may be because the virus moves within the host, until it finds the weakness of its specific host that will permit it to set up residence.
For all we know, this virus lies dormant, waiting for a weakness to appear in the host. Maybe a month, a year, or a decade.
Until about 10 days ago I thought we were on a good track. Indicators continue in wrong direction today. Inpatients now up 32% in past 5 days, and ED visits up 51%. Maricopa cases up 8% in one day, 13% among those under 45.
The number of new cases in Florida has gone up over the last couple of weeks, and is running about a thousand new cases per day for the last week or so (up from about 700 new cases/day). Most of the increase has been driven by the Miami area.
However, deaths have gone down. Dramatically. Three weeks ago, we were seeing about 45 deaths per day. Lately it’s been under 30 – and down to under 10 for the last couple of days.
It really does sound like the virus is mutating, or something is making it less virulent.
The politicization of this by both sides has been disgusting.
Irreparable damage has been done to organizations we count on for basic health care information.
I think a large number of lives are going to be lost because of this going forward.