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Why Did We Treat Coronavirus So Differently Than Other Epidemics?
A three-column article in the local daily recently revealed the alarming news that Arizona State Sen. Lupe Contreras and members of his family had tested positive for the coronavirus. I wish Sen. Contreras and his family well. He seems like a good guy. But in a sane world without the hyperbolic, breathless press treatment of all matters coronavirus, the headline would read “state senator and family get the flu“ which, of course, isn’t a news story at all.
Nothing remarkable here, folks, just another among the countless attempts of the media to convince us that Wuhan flu is vastly more threatening than any other health challenges faced in the past. Yes, viral epidemics are nasty. People get sick and die. But compared with others America has faced in its history, this virus is worse than some, not as lethal as others.
Regrettably, the media blitz has succeeded. The virus may not be the most destructive of all time, but the panic-driven reaction to it could be the worst public-health blunder in our history.
The Spanish flu following WWI was far more severe than COVID-19. At least 50 million people died worldwide, 675,000 in the US, or roughly 10 times the COVID-19 tallies. Worse, mortality extended to all age groups including those under five and previously healthy people.
Americans practiced basic preventive measures but didn’t destroy the economy. The rapid comeback produced the Roaring Twenties.
A more apt comparison would be the Hong Kong flu (obviously named by xenophobic racists) of 1968-69. This illness, like COVID-19, was highly contagious, had the ability to mutate, was fatal mostly for the elderly and already ill, and most infected people didn’t get that sick.
Hong Kong flu killed over 100,000 Americans, then with a population of 200 million. Yet Americans didn’t freak out. Schools stayed open since children weren’t in serious danger.
Again, common-sense measures to avoid exposure to the virus, sanitize hands and surfaces, and protect the vulnerable were taken. But there was no lockdown, people went to work, and life pretty much went on.
Is it possible, as experts claim, that COVID-19 has produced fewer fatalities because of the self-imposed lockdowns? In a word, no. There was never any evidence that lockdowns reduced overall death rates and now that we have some experience, it is becoming clear that lockdowns at best change only the timing of fatalities.
A recent study looked at how soon states went into lockdown after reaching the threshold of one death per million. Although lockdowns are still touted by the “experts,” the data clearly showed that whether states locked down early, late, or not at all had no effect on death rates.
Fortunately, as Sweden is demonstrating to the world, certain characteristics of the coronavirus render it vulnerable to herd immunity. Most people that develop immunity don’t get that sick, vulnerable populations are easily identified, and the others are almost totally protected.
Under newly calculated death rate determinations, people aged 18 to 45 have a death rate of 0.01% while for those under five, the death rate is effectively zero. Meanwhile, of 8,000 NYC deaths investigated, 99.2% had identifiable underlying conditions.
This means that, rather than hectoring productive workers to “stay home!“ (and then showering them with handouts for not working), it makes more sense to allow them to work and keep the economy alive with suitable protections for the vulnerable. That would allow herd immunity to develop. Our one-size-fits-all lockdown strategy resulted in a double whammy: economic devastation and the prospect of more infections and deaths due to lack of herd immunity.
Whether we can recover from this national nightmare and reclaim our free and prosperous nation depends on what we have learned and how we change. Will we realize that life is worth the risk and that avoiding pain and death is not always possible? Will we learn to resist groupthink and media sensationalizing? Will we become more future-oriented and responsible for the well-being of Americans yet to come?
We have to do better or go down in history as the generation that let the American experiment fail.
Published in Economics, Healthcare
Agree. I have never seen this many stupid people in my lifetime. It’s a virus with a 99% recovery rate. The whole thing has been political from the start. Just unbelievable.
Italy.
I think there was some reaction based on a context that suggested a much higher death rate. I also think that this could only have happened in our tech connected world after multiple Hollywood films about pandemics.
Another chance to get the bad Orange man.
It was all based on “models” which were a bunch of guesswork and some of which were purposely concocted to create panic. And then, like you said, suddenly my first row of Netflix selections were all movies about pandemics including (of course) Pandemic, Outbreak, Contagion, and others.
A lot of very old people.
It’s important to always start from the point “Orange Man Bad.” From that point it’s all clear.
Yes, and as more information has come out, we learn that a huge percentage of them, according to one doctor, died of other causes. While they may have had the virus, he said they died WITH Covid-19 rather than OF it.
99% of deaths had comorbidities but you completely overlook that well over 100 MILLION Americans have comorbidities- a fatal oversight for many. H3N2, H2N2, and H1N1 (the worst flu pandemics since WW2) were all less lethal than SARS-CoV-2 and significantly LESS contagious. Remember with H1N1 we urgently immunized 40 million people to contain it. Typically the flu only requires about 30% immune to acquire herd immunity but the SRS-CoV-2 requires an estimated 70% must be immune to achieve herd immunity- if one is ever really gets long term immunity from the infection. The flu hasn’t killed over 0.1% of NYC residents in a few weeks in the last 100 years.
There is a fair argument to be made that the elderly and more susceptible should self quarantine. I am part of this subgroup and have no problems with income or work. I am also a retired physician and have made certain that we, and some of my family in California, have a supply of hydroxychloroquine adequate to treat an exposure or early signs of infection. The political hysteria over that cheap long established drug has contributed to the problem. Physicians, traditionally small businessmen (and a few women), were conservative but that is no longer the case. Medical students are 60% female and many male physicians are on salary since Obamacare. Obamacare was supported by insurance companies and hospital administrators who have seen physicians as a troublesome component most usefully lumped as “providers,” since we tended to advocate for patients who, in the free market system, were our customers. Hospitals bought up medical practices after Obamacare took over medical funding. In the hospital where I practiced for 25 years, physician specialists I have known for 30 years are no longer allowed to admit their patients without the permission of hospital employee doctors functioning as “Gauleiters” to use the old Nazi term.
Medicine has become politicized and I suspect politics has driven the decisions on treatment more than peer reviewed journals. Cost had become a major factor before I retired and I was used to arguing with non-clinical types on such topics as how big an aortic aneurysm had to be before I was allowed to repair it. A friend of mine, a gastroenterologist I have known 30 years, was recently pressed by the hospital CEO to start doing some of his endoscopies in the hospital endoscopy suite instead of the well equipped suite he built 25 years ago. It was on the order of “Nice little practice you have there….” He agreed to read some charts of hospital cases and found excessive laboratory billing in every chart. Much was explained. I haven’t asked him how much tribute he has paid.
I wonder how many cases of Wuhan virus have not received HCQ because of politics?
You are absolutely right. I think the panic was only made possible by social media. As someone recently pointed out, if we had to read about this in newspapers, it would be over and done with before we even knew what was happening. The panic is unprecedented and unnecessary.
I also kind of wonder how the numbers would change if they were telling people to take a vitamin D supplement each morning and get outside more. No, it’s not a panacea, but likely a factor.
Heck, 71% of young Americans between 17 and 24 are ineligible to serve in the United States military. More than 1/2 of those ineligible are due to some things that are listed as comorbidities of Corona virus.
I wonder about that, too. We know the CDC has considered HCQ an effective treatment for coronaviruses for at least 15 years. Why the sudden backtrack by the CDC, even as doctors in other countries say it’s the most effective treatment right now. Why the sudden obsession with Remdesivir, a very expensive pateneted drug with serious side effects that must be given intravenously, instead of cheap, readily available in tablet form, long-proven safe drug ?
Am I wrong to say “Follow the money”? Is that cynical?
I’ve been reading that Vitamin D and Vitamin C are both thought to offer protection from the WuFlu.
(And I’m calling it the WuFlu, because a bunch of nags on Facebook told me that it was a racist term. And I will not be language-policed by nags.)
I think the point is not the existence of any comorbidities, but the contribution of same… Doctors who declare causes of death are not stupid about that. Although the CDC directs them to contribute to covid stats simply because it is present, they generally don’t list, say, “hypertension” as cause of death simply because it exists. In my town, for instance, they don’t report it simply as “comorbidity.” They say “died with serious underlying conditions.”
There was some study that showed vitamin D deficiencies in severe cases, but not in mild cases. That doesn’t prove causation, but it is interesting. Also, people in nursing homes and dense cities are abnormally impacted. Those who spend very little time outside. Again, that’s not proof of anything, but it’s interesting… And supported by as much (or more) evidence than that nonsense about catching it from passing by people in the grocery store and therefore everyone needing to wear surgical masks.
This is the best description of the immune system I have read yet, and it explains why older people are having such a tough time with this particular virus.
And *you* want to be my latex salesman…
https://www.washingtonexaminer.com/opinion/what-does-isolate-the-vulnerable-even-mean
https://legalinsurrection.com/2020/05/researchers-believe-nyc-is-the-primary-source-of-wuhan-coronavirus-infections-across-u-s/
https://www.washingtonexaminer.com/news/travel-from-new-york-city-seeded-the-nationwide-covid-19-crisis
https://www.ft.com/content/be7e66c0-1243-45dd-829f-8b192c18acff?shareType=nongift
Danny, whatever we may disagree on, it is clear that we share a love of Seinfeld.
Plus Chinese workers. Plus gross under-preparedness documented beforehand, placing Italy behind Mexico in pandemic readiness, while America was far and away #1 in readiness and ability to respond.
I was surprised (and somewhat heartened) by an article yesterday in NEJM reporting that 59% (811/1376) of Covid patients at New York Presbeterian/Columbia Hospital in Manhattan were given HCQ. If there’s any group of physicians you would expect to have a knee-jerk reaction against Trump’s recommendations, it’s academic doctors in Manhattan.
There’s also this large randomized clinical trial of HCQ as post-exposure prophylaxis being run by the University of Minnesota. The PI of this trial has a Twitter feed full of anti-Trump posts yet is still leading perhaps the most ambitious (and promising) study on HCQ.
My take is that the data on HCQ is still too inconclusive to know whether it works, but I’m glad to see that at least some left-leaning clinicians are giving it a chance.
The question to ask is whether this is technically feasible.
Conservatives have been repeating this mantra of “it’s easy: just protect the vulnerable” for weeks without ever stopping to ask whether it’s actually realistic if the virus is given free reign through the rest of the population. Everyone just seems to assume it must be possible.
This is no different from lefties who argue that we should simply replace all fossil fuel-burning modes of transportation with battery-powered vehicles (even airplanes!) without ever giving serious consideration to whether this is even possible given the laws of chemistry and physics (spoiler alert: it’s not).
So what is the evidence so far of the feasibility of “protecting the vulnerable”? Sweden, held up here as model, specifically placed protecting the elderly as one of its top priorities in its strategy; yet its public health officials admit that part of their plan has failed miserably. Every other hard-hit country/region that had at least some time to prepare for Covid also made protecting the elderly a high priority; that also failed. So at some point we need to honestly ask whether “just protect the vulnerable” is indeed much easier said than done?
What frustrates me is the fact that there are about 50,000 shades of grey between “total lockdown” and “open everything up (except for the elderly)”. There are hundreds of partial interventions that are either demonstrated to lower transmission or have a decent likelihood of preventing transmission. Our goal should be to identify and implement the partial interventions that have the greatest cost:benefit ratio in addition to doing our best to protect the vulnerable.
Because Trump is President, so he needs to have a “Katrina” to bring his poll numbers down . . .
Of course, that’s not what the evil media reported.
I think you’re right, @cliffordbrown, IMO it’s pretty clear. But the only way this can ever truly be determined, or established, and where the weaknesses that did exist, existed, will be via an honest, thorough After Action Review. I have heard references to the failure of some states and previous administrations to replenish and maintain strategic stockpiles of critical supplies, following the previous SARS situation. Will there ever be an honest, thorough AAR? How much influence will those who failed to maintain those supplies have over the AAR? Can we trust those very people to be as honest and thorough as required for a true AAR?
Or is the fix already in? During an e-townhall a week or so ago, put on by our county health services agency, one of the guests was a member of the county board of supervisors – a lady who has in the past demonstrated a willingness to be brutally honest. The question to her had to do with the COVID-19 death statistic, published daily. She confirmed that whatever the cause of death, even being killed in an auto accident, if the decedent was found to have the virus, it was reported as a COVID-19 death. As I understand it, this would not be limited to this county. It would have to be in accordance with state criteria. Such a practice renders as meaningless, even dangerous, the reported COVID-19 lethality statistic. I have heard reports of the incidence of some other common causes of death as being extremely low, and reports of deaths assigned to the virus even without a test. First, I want to know more than just hearing these things. If true, then the COVID death statistic is even more skewed.
Curiously, this gross overstatement of the virus’ lethality might give some insight for why HCQ would appear to be so effective if, in fact, it turns out not to be so. How many of the people treated with HCQ would have recovered without it?
Again and again in the whole mess, I’m reminded of the phrase on the back cover of Huff’s outstanding book, How To Lie With Statistics:” “Figures don’t lie, but liars do figure.”
The point is that by claiming only those with comorbidities need fear death from COVID-18, that means that probably a majority of Americans should be concerned that they might die if they get it. If you die from an acute viral pneumonia & have hypertension, it is clear that the vast majority of the cause of death is the viral infection.
The data on HCQ isn’t there yet, but there are many ongoing studies-including prophylactic therapy in healthcare workers. NYC should provide the best source of data-b/c we can’t trust China and a significant number of European hospitals were frankly overwhelmed. Data from overwhelmed systems only shows the results of bad healthcare. Overall, NYC was stressed but not overwhelmed
Comparing the response to COVID-19 to the response to the Spanish Flu isn’t appropriate because too many things about the culture, the medical system, and attitudes toward infectious disease are so different. People had a much more fatalistic attitude toward infections back then. Children had to go through the gamut of infectious diseases; measles, polio, mumps, whooping cough, chicken pox, pneumonia, scarlet fever, etc.. Mortality was relatively high. The Spanish Flu was just another one of those only worse. The medical system was very basic — simple supportive care was all anyone could expect. They didn’t expect authorities to be able to do much.
By the same token more recent pandemics didn’t represent the kind of threat that COVID-19 does. They didn’t have the potential to crash the medical system leaving everyone without care for anything for a significant amount of time.
We are now much more intolerant of infectious diseases because they are much less a part of our lives. Nobody has to go through life wondering if they will be struck down in youth by pneumonia or crippled by polio. We expect the medial system to be able to stop infectious disease. Authorities are expected to act.
In my own experience, contributing factors could be entered on the death certificate. Usually these were serious factors like GI bleeding or pneumonia.