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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 But now that study has been withdrawn.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.]