Ever since Trump took office, conversation with many friends and most of my family has been a challenge. They feel about him the way some of  my conservative friends and colleagues feel about Hillary Clinton. When feelings are strong, reason declines and facts lose their context. I like a loud argument as much as any Irish American, but I don’t like an intellectual joust that leaves emotional bruises. Those bruises last longer when ideology insinuates itself into argument. Ideology leads to groupthink. Groupthink leads to war. And war is always destructive.

When news of the coronavirus broke, there was every reason to believe we were in a global crisis. Crisis often galvanizes otherwise opposing factions to band together against a common enemy. I hoped, naively, that this would be the case. Alas, it did not happen. The threat of COVID-19 became, almost immediately, an ideological topic.

The reports we were hearing from China and Europe through the World Health Organization (WHO) were positively frightening. But the numbers associated with those stories didn’t make any sense. So I began to write about it and do some research on my own. The more I studied what was being said, the less I believed it. And when the shelter-in-place solution was introduced as the “scientific” protocol for reducing the eventual death rate from COVID-19, I was challenging it in my blog posts and conversations.  

That was not well received by my friends and family members who were getting their information from the mainstream press. They were convinced not only that sheltering-in-place was the right course of action, they believed that the USA had been hobbled by Trump by not putting it into effect sooner. It didn’t seem to matter to them that Trump’s earlier doubts about  it were not his, but the recommendations of the WHO, the CDC, and the White House panel of experts headed by Dr. Fauci.

We do agree on one thing: The Trump administration bungled its response to the threat. But my friends/family think the mistake was in implementing mass quarantines too late. I think the mistake was in implementing them in the first place. 

 

Living in Fear of the Fear of COVID-19 

“Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety.” – Ben Franklin

I want to resume my wrestling, but K is worried that I will catch the virus from a training partner and infect the family.

My brother-in-law is worried about the throngs of (mostly young) people that have descended on Atlantic Avenue and its restaurants since they reopened a week ago. “It’s all bullshit,” he says. “Nobody is keeping social distance or wearing masks. Even some of the servers aren’t wearing masks.”

My fellow members of The Mules, the book club I belong to, want to have our next meeting virtually, as we’ve had the last two.

It’s difficult for me to speak about the virus with any of them because I know they are seriously frightened. But I believe their fear is unsubstantiated by the facts. And it angers me to think that they have been prompted into that level of fear by politicians and media that are using this crisis to further their political objectives.

So when I do speak about it, I find it difficult to restrain my anger. I state my opinions in definitive terms in hopes of shocking my friends/family out of their panic. It is a foolish approach. My sister reminded me of that yesterday, and she was right. So I’m writing this today, another essay on what I’ve learned about the coronavirus and why I believe the fear they are living with is based largely on misinformation.

I want to begin with some facts. But before I do, I implore you to read these facts with an open mind. Keep in mind that they all come from sources that you probably trust: the WHO, the CDC, Dr. Fauci and team, and several dozen studies done by respectable research institutions since the last essay I published on the virus itself.

*Fact One: Based on current death rates, COVID-19 ranks 13^th on the list of the ailments that people, worldwide, die from each day. It is exceeded by cardiovascular disease, cancer, respiratory diseases, lower respiratory infections, dementia, digestive diseases, neonatal disorders, diarrheal diseases, diabetes, liver diseases, kidney diseases, tuberculosis, and HIV/AIDs. It is also exceeded by road injuries and suicide (which is on its way up). The number of people that die from cardiovascular diseases is more than 20 times greater. (This would not have been true had you made the comparison when the death rate was at its peak, but it is true now.)

You may be thinking that you are not interested in comparing COVID-19 to cancer or heart disease, since they are not contagious. In terms of my topic – which is fear – I think that is an illogical position. But put that aside…

* Fact Two: Of contagious diseases, it ranks 7^th, after lower respiratory diseases, neonatal disorders, diarrheal diseases, digestive diseases, tuberculosis, and HIV/AIDs.

The fatality rate of COVID-19 is the primary reason that some epidemiologists were so concerned about the disease in the first place. Early reports had it at double digits, then at 6%, and then at 3.4%.

Those were the numbers that spurred the call for mass quarantining. But those numbers were based on case fatality rates.

As I explained in every essay I wrote on the subject, this is an useless and potentially misleading statistic. The case fatality rate does not measure a disease’s actual lethality rate. It measures only how many people died compared to how many people have been diagnosed as positive.

We can only know the actual fatality rate (some call it the infectious fatality rate) when we know how many people have died compared to how many people have been actually infected.

That was impossible to determine in March or even April because test kits were limited and no one was doing randomized tests of people that showed no symptoms.

Those tests have been conducted in the last four weeks. And what they are showing us is that the earlier case fatality rates overestimated the true fatality rates by a factor of 10 to 50.

For example:

* Fact Three: A new randomized study of 3000 people in New York State found that 13.9% of those tested for antibodies were positive. That means 2.7 million New Yorkers have already contracted COVID-19. When this was reported, there were 257,216 cases with 15,302 deaths. That equates to a case fatality rate of 6%.

But as I explained above, the case fatality rate is meaningless until you know the number of people infected, not just the number diagnosed. I suggested in my April 8 essay that it must be at least 10 times higher because symptoms for so many were flu-like and because of the lack of testing available then.

Adjusting for the latest findings, we can see that the actual lethality rate is a bit more than 10 times case the fatality rate, coming in at about 0.5%.

* Fact Four: This same study found that 21.2% of those tested in New York City were diagnosed as positive for COVID-19 antibodies. New York City’s population is 8.4 million. Extrapolating on that, we can assume that about 1.78 million denizens of the Big Apple were already infected with COVID-19 at the time. This means that even in the worst hot spot in the country, the actual fatality rate was 0.6%.

* Fact Five: These findings are similar to those from antibody studies done in Santa Clara, CA; LA county; and Kansas. Dutch, German, and French studies also show a much higher incidence of the virus than case studies would suggest – which means much lower real lethality rates.

My friends and family members that have a different view than I do tell me that the actual death count from COVID-19 is higher than reported. They tell me that there were surely people that died from it in the early days that were not diagnosed. I don’t doubt that. But if you understand the protocols that were put into place in by the CDC in early March, you can deduce that this must be a fraction of the distortion that occurred during the period of time when the death count was in the thousands.

* Fact Six: The CDC’s recommendations for reporting COVID-19 deaths included patients that died with “symptoms” of the disease, even if they didn’t die “of” the disease. In other words, if a patient that died of pancreatic cancer happened to test positive for COVID-19, the cause of death should be noted as COVID-19. (Note: When the state of Colorado did a study of this recently, differentiating those people that died with COVID-19 symptoms from those that died of COVID-19, the COVID death rate dropped by 25%!)

It’s hard to understand why the CDC would have made this recommendation, since it is patently unscientific. Most symptoms of COVID-19 are similar to flu and other respiratory diseases. Even in hot spots, less than half of those with COVID-19 symptoms test positive. Several emergency room and ICU doctors have commented publicly on this anomaly, complaining that they feel pressured to report deaths as due to COVID-19 when there is no certain reason to think it is so.

A fatality rate of 0.5% is considerably higher than the 0.1% or 0.2% fatality rate of influenza. But as I have explained, there is an important difference between COVID-19 and influenza. COVID-19 does most of its killing among populations of older people that have other life-threatening, “comorbidity” issues.

* Fact Seven: A study by the AMA found that 94% of hospitalized COVID-19 patients in New York City had serious underlying conditions. 53% had hypertension, 42% were obese, and 32% had diabetes. The median age was 63.

* Fact Eight: In New York, the fatality rate for COVID-19 patients between 18 and 45 is 0.1%. For children, the fatality rate is statistically zero percent.

These numbers correspond to the analysis I did in March. Also, multiple studies have shown that children are not significant “vectors” of COVID-19. That means they don’t spread it very well.

The chances of contracting COVID-19 are much greater in confined spaces than they are in the open air.

* Fact Nine: A Chinese study of 3000 COVID-19 deaths found that all but one of the patients contracted the disease indoors. (The one exception contracted it through contact with someone that had just arrived from Wuhan province.) Yet many state governors, like New York’s Cuomo, were forcing elderly COVID-19 patients into nursing homes – which accounts for the severe contagion and death rates that we saw in those facilities across the globe. (This policy has just recently been reversed, weeks after the results of this study were reported.)

There have been several new studies suggesting that herd immunity for COVID-19 might be much lower than the 60% to 80% that was originally projected. I haven’t had time to locate these studies, so I can’t call this a fact. I know the projections are between 10% and 40%. 10% makes no sense. But 40% could explain why we’ve seen the recent drop in mortality.

There is no disputing the fact that you can reduce the speed at which the virus spreads by social distancing and washing hands. This is the strategy of flattening the curve. But flattening the curve is about slowing the spread of infection – not necessarily decreasing the eventual death count – which is what happened because of measures like social distancing and hand washing, not the lockdown.

* Fact Ten: Studies from Germany and Switzerland found that the flattening of the curve of the contagion happened weeks earlier than originally believed. In every case studied, the peak appears to have been before lockdowns were implemented. What that means is that the lockdowns did not work. They were not the reason the curve flattened. They had, if any, only a negligible impact on the curves in those countries.

* Fact Eleven: According to an analysis by Stanford University, there is no statistical correlation between lockdowns and COVID-19 deaths between those states that locked down early and those states that locked down late.

Those are some of the facts. And all of them come, as I said, from the WHO, the CDC, and reputable university and scientific studies.

So this brings me to the point of disagreement I have with friends and family members that believe the lockdown was and still is necessary, and that the movement towards opening the economy puts them and others in danger of dying.

Spend five minutes thinking about the above facts, and you have to agree that the proper response to the coronavirus threat would have been to isolate the most vulnerable (which we did not do) and not shut down the economy.

In fact, there is an argument to be made that sheltering-in-place has caused and will cause thousands and potentially hundreds of thousands of additional deaths. Deaths from depression, suicide, and domestic violence, as well as the deaths of many people with symptoms of heart attack, stroke, etc. that should have gone to the hospital but didn’t because of the fear of getting infected.

* Fact Twelve: Vaccinations for children have abruptly fallen at an alarming rate since the shutdown. In Michigan, fewer than half of infants 5 months or younger are up to date on their vaccinations, which may allow for outbreaks in diseases like measles.

But I won’t make that argument. It’s more important to make another point.

Unless we develop a miracle vaccine in the next few months, there are going to be lots more people dying of COVID-19. We don’t know how many. But based on the facts I’ve listed above, I hope it’s clear that there will be no lowering of the death rate by any continuance of the lockdown.

And speaking of a miracle vaccine, we have seen an historically unprecedented acceleration of efforts, private and public, to find a vaccine. And according to reports on both sides of the argument, we are making progress. At least a half-dozen vaccines have been approved for initial, phase one testing.

But here’s another fact to consider:

* Fact Thirteen: 90% of drugs that are approved for initial, phase one testing fail to make it to phase two.

The logic behind the opinion that many hold – that mass quarantines will minimize future deaths because the spread of the virus will be slowed – is faulty. The opposite is the case.

The only valid purpose for the lockdown that ever made any sense was to flatten the curve and thereby prevent hospitals from being so overwhelmed that they could not properly treat COVID-19 patients. But I’ve not found a single report that verified a death caused by, for example, lack of access to a ventilator.

What the lockdowns did, without question, is slow the race towards herd immunity. That means (again, barring the development and approval of an effective vaccine in the next few months) we will almost certainly have a second and even a third wave of the virus. And when those waves come, they will likely be different – maybe more lethal – strains. Which would mean, for certain, that the lockdown strategy will have resulted in many more deaths.

That is what makes me angry. And that is why I am upset when I hear my friends and family members say that those that favor opening the economy are putting money ahead of lives. It’s simply not true. The facts don’t support it. If we want to reduce the eventual death count, we must allow the virus to spread among the large percentage of the population that has little to no chance of dying from it. We have to reach heard immunity before a new, more lethal strain comes back and infects us. (This, by the way, is what happened with the Spanish Flu of 1918.)

I am angry and I want to blame someone. But I can’t blame my friends and family members who are scared because of the misinformation they’ve relied on.

I blame the mainstream media for not investigating the pandemic with any seriousness. And I blame some newspapers and news programs for pursuing reporting that was evidently meant to scare people.

These reporters and commentators failed very early to do even the simplest arithmetic, which would have made them understand how misleading the early case fatality rates were. Since then, they have ignored the studies that have unearthed the evidence listed above. Why they continue promoting their false narrative is anyone’s guess.

But because they will continue to promote their false narrative, the people that have taken it for truth will likely continue to believe it. They will continue to find ways to blame the Trump administration for the deaths that will follow, ignoring the fact that the mistake it made is clearly the mistake of shutting the economy down.

As I’ll explain in a moment, though, none of that makes any difference. We are already fast into the opening process and that isn’t going to stop.

But before I get into that, a few words on what I think we should have done.

In retrospect, the smarter federal policy would have been to:

1. Allow those that had a near zero chance of dying from the virus (children and people under 28) to lead their normal lives, spreading the virus among their peers at a controlled but relatively free pace, so that we could move towards herd immunity as fast as could be reasonably done.
2. Advise healthy people in their 30s, 40s and 50s (whose chances of dying from COVID-19 are less than 1%) to act like responsible adults capable of making adult decisions.
3. Focus 80% of our resources to quarantine the 20% of our population that is most vulnerable to the disease.

In retrospect, the correct response from the CDC and the president’s task force would have been to recognize, immediately, that the arithmetic that gave us “official” lethality rates of 10% and 6.5% and 3.4% (and the early predictions of millions of US deaths) was obviously wrong.

In retrospect, state and local governments should have kept parks and beaches open so that people could get the exercise and the sun they needed. They should have advised anyone concerned about catching the virus or passing it on to their elders that the likelihood of that happening in the outdoors is tiny compared with the chances of catching it in any sort of “sheltered” place.

In retrospect, we should not have required nursing homes to take back their clients that had been diagnosed with COVID-19. That’s what caused the spike in deaths that we saw. We should have isolated those people and, thus, reduced the huge percentage of deaths that occurred in such facilities.

* Fact Fourteen: 41% of the Americans that have died from COVID-19 were in nursing homes. In Minnesota, the percentage was 81%. In New Hampshire, it was 72%. In Rhode Island, it was 75%. In a dozen other states, it was more than 60%.

The coronavirus is very contagious. And it is lethal to older people that have serious comorbidity issues. But it is not lethal to the rest of the population. To most of those that have been put on unemployment – mostly younger, healthier people – it isn’t a great threat at all. And to those that are vulnerable, shelter-in-place increased their chances of dying from it.

Those are, it seems to me, the facts.

The curve has flattened in most of America, but COVID-19 has not been conquered. Not at all. It will come back and it will continue to kill. In one of my early essays, I predicted that it would kill between 60,000 and 120,000 this year and as many as 600,000 if we don’t reach herd immunity.

The lockdown did not and will not diminish that number. Only herd immunity (either acquired naturally by spreading the infection or with the help of a vaccine) will do that.

In retrospect, it would have been better to if the WHO, the CDC, and the administration had reduced, rather than inflamed the panic that has spread like a virus across our country. It would have been better if they had admitted, early on, that the original arithmetic and modeling were bad and waited for the facts.

I would like to think that anyone that that is fearful now could get a realistic grip of reality by focusing on these facts, but that may not happen. When you have invested so much emotional energy into a fear about the future, it’s difficult to give it up.

I doubt, too, that when this is over, those that have accepted the viability of the lockdown will change their opinions. They will be suspicious of facts that don’t support the narrative they have been sold. And the media and public figures that sold that narrative aren’t likely to admit that they were wrong either.

They make minor adjustments to their stories to accommodate realities that cannot be refuted, but will hold on to the scientific evidence that is more difficult for lay people to understand. They will do this to protect themselves from the shame they must feel when they think about what they have created.

For my part, I’m going to do my best to bite my tongue whenever I hear fearful friends and family members fretting about the opening up of the economy. Biting my tongue is an easy price to pay to avoid saying something that pisses them off.

A tougher issue for me will be how I go about taking advantage of all these openings. For one thing, as I said at the top, I want to resume my wrestling. That would mean rolling around on the floor with young guys who, if they had COVID-19, would likely be asymptomatic. I understand why K has forbidden me from doing that. I believe the actual risk is infinitesimally small, but being wrong is not chance I’m willing to take.

I will have to put off my favorite form of exercise until K’s fear subsides. And I realize that’s not going to happen until the pandemic narrative she has been listening to gives up the ghost of its beliefs about the lockdown and shelter-in-place strategies.

That will happen well before we have an effective vaccine. I can see it happening already. K had her hair done yesterday. My brother-in-law hugged a friend. It is people like this, not the protesters that have been opposing the shutdown, that will bring the American economy back to life.

They will do it not because they believe the shutdown was wrong, but because they are sick and tired of being locked up.

There is only so long that a mentally healthy person can stay locked up in a prison of fear.

 

This essay and others are available for syndication. 
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