Bringing Some Sanity to the COVID-19 Outbreak
I wrote this as a post on Facebook in March of 2020, and have still found some people interested in reading it, so I am reposting it here on my substack. Realize that the beginning addresses a hoax that was circulating widely on Facebook at the time.
Bringing Some Sanity to the COVID-19 Outbreak
This is a bit long, but I hope you can hang in with me as we explore this important topic that is affecting the lives of people around the world. Whether by the end you agree with me or not, I'd like to look and some facts and try to dispel some myths regarding the virus and it's spread, and hopefully at least confer some understanding so that people can think about all of this calmly and rationally. (considering the time I spent putting this together and that I wanted to get it posted quickly have led me to proof it less than I typically do with something like this, so forgive me if my thoughts come across less organized than they could be or if I ramble on any particular point)
There is a lot of information (and misinformation) being propagated regarding the COVID-19 outbreak. We have 24/7 media coverage (much like after a major tragedy, such as a space shuttle explosion or mass shooting), with a continual watch over the numbers of confirmed cases, deaths, and recoveries. Politicians hold daily press conferences talking about all that they see happening, on what aspects of the outbreak their task forces are focusing or working, and what measures they are taking to keep us safe. Here in the US, the government which is tasked with protecting our rights to life, liberty and the pursuit of happiness is now trampling those rights under the guise of "protecting" us. Is this a warranted response?
Some of the articles and posts floating around out there are much better than others, and certainly better researched. One that is not helpful at all (and easily dispelled as bogus simply from the improper use of terminology at the outset of the article) begins as follows:
"Easy to understand Explanation of CV19 by microbiologist:
Some of you might want to take the time to read this...
AN EXPLANATION from a microbiologist at the CDC:
Feeling confused as to why Coronavirus is a bigger deal than seasonsl flu? Here it is in a nutshell. I hope this helps. Feel free to share this to others who don’t understand...It has to do with RNA sequencing.... i.e. genetics.
Seasonal flu is an “all human virus”. The DNA/RNA chains that make up the virus are recognized by the human immune system. This means that your body has some immunity to it before it comes around each year... you get immunity two ways...through exposure to a virus, or by getting a flu shot.
Novel viruses, come from animals.... the WHO tracks novel viruses in animals, (sometimes for years watching for mutations). Usually these viruses only transfer from animal to animal (pigs in the case of H1N1) (birds in the case of the Spanish flu). But once, one of these animal viruses mutates, and starts to transfer from animals to humans... then it’s a problem, Why? Because we have no natural or acquired immunity.. the RNA sequencing of the genes inside the virus isn’t human, and the human immune system doesn’t recognize it so, we can’t fight it off.
... [original content removed for brevity and lack of pertinence]
Now, here comes this Coronavirus... it existed in animals only, for nobody knows how long...but one day, at an animal market, in Wuhan China, in December 2019, it mutated and made the jump from animal to people. At first, only animals could give it to a person... But here is the scary part.... in just TWO WEEKS it mutated again and gained the ability to jump from human to human. Scientists call this quick ability, 'slippery'"
In this particular version of the post, it claims to have originated with a microbiologist from the CDC. I can guarantee, no microbiologist at the CDC authored this information, and I'll explain why. First, the assertion about our human immune system recognizing a supposed "all human virus" is only partially correct at best. While an infected cell is able to signal the immune system via various mechanisms that there is a virus infecting the cell (one of those mechanisms being through "displaying" portions of proteins produced by the virus), recognition of these viruses it possible regardless of whether it originated from human or animal sources. Where the virus originated is largely irrelevant. For a somewhat simplified and fairly straightforward explanation of how the human immune system responds to viruses, there is a good article here:
https://www.immunology.org/public-information/bitesized-immunology/pathogens-and-disease/immune-responses-viruses?fbclid=IwAR1Fbs5ocUrC3YGZ682VMYzXw2Sj6scekcb-3xVzgeMpCMwKsgSnQLvHeIA
Next, the term "novel" in reference to a virus does NOT mean it comes from an animal - it simply means it is something "new", a virus we have not seen before. A pathogen that is transmitted from animals to humans is actually known as a zoonosis (pronounced zoh-uh-noh-sis) or a zoonotic pathogen.
Here is another terminology lesson for the author of this post. Scientists do NOT call the ability of a virus to mutate "slippery." In health sciences, the term "slippery" is actually applied to nucleotide sequences in mRNA strands that cause a pause in translation of the mRNA, and the pause results in a "shift" forward or backward in the mRNA sequence resulting in a protein that is not the same as the actual protein coded in the mRNA (mRNA or Messenger RNA is what is used as the basis for protein synthesis inside a cell and is generally the type of RNA found inside a virus). This is a process called ribosomal frameshifting (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009743/ ).
I'm not even going to get into the assertions made about how it suddenly "mutated and made the jump from animal to people", about "natural or acquired immunity", or the supposed mutation that granted the virus the "ability to jump from human to human." Suffice it to say, this article is clearly bogus and should be dismissed as such. If you see it, please ignore it and/or inform the person spreading this misinformation that it is just that. Please help stop the spread of such ignorance.
I'd like to move on now to much more important information and misinformation circulating, what I believe is at the heart of the matter: the statistics. This seems to have the greatest effect on people's perception of this virus, and having the numbers recounted for us on an hourly basis on the news does nothing, IMO, but create fear and panic. There are dashboards available that are tracking the numbers of confirmed cases. One of the most often used is here:
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html?fbclid=IwAR2NGv_pBdSGhn7RBS7o39Y0_cO6bSRD35a7K4NyGVabUE0MLXc10DTHoq4#/bda7594740fd40299423467b48e9ecf6
It shows confirmed cases by country, deaths, recoveries, and heat maps of virus outbreaks across the world. Unfortunately, these numbers are far from accurate. Before I address why I make that assertion, there is a rather lengthy article, loaded with graphs, charts and statistics, that appears to have had quite a large number of views and is being used by many, not only as the source for their position on this issue, but also as the justification for the current approach to handling the outbreak (essentially shutting down the country). The article is called "Coronavirus: The Hammer and the Dance":
https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56
Admittedly, it's a rather scholarly article and has garnered quite a bit of scholarly support. It is for this reason, and it is because of its approach to the numbers, that I'm choosing to use it as an example. Most people seem to view the numbers in a similar way to the approach espoused in this article, and I believe that approach falls apart based on false premises. Since people's arguments generally follow the same reasoning, I will pull a few tidbits from the article in order to address why I believe the numbers to be incredibly deceptive, and not only unproductive but counterproductive. So, I'll use some of the information in this article in an attempt to address the statistics we're seeing and why I believe the conclusions are false. Let's begin.
There is a lot in the introduction to the article, most of which is nothing more than fear-mongering assertions that the author believes he justifies through the rest of the article. One of the assertions, which is first in his list of "takeaways" is that "Our healthcare system is already collapsing." This assertion is leveled at the U.S., is patently false (again, it's simply fear-mongering), and the article provides absolutely no support for this assertion. What he's really getting at is the number of available ICU beds in the U.S., which he puts at under 100,000, based on a study from Johns Hopkins: http://www.centerforhealthsecurity.org/cbn/2020/cbnreport-02272020.html (it estimates medical ICU beds at 46,500 and "perhaps an equal number of other ICU beds that could be used in a crisis"). The reason you'll see people reference statistics such as this is because of their interpretation of the numbers and how many critical care beds they believe will be needed for acute COVID-19 cases. Then, as the argument goes, when all of the critical care beds are taken up as a result of COVID-19 patients, other patients requiring critical care for other ailments will be unable to get the care they need and they will die. It's all very compelling. Italy is constantly being used as a case study on this, but this is a faulty case for several underlying reasons that I will address after addressing the numbers.
What do the numbers say? If you look to articles like this one, every country that has an outbreak sees a rise in cases that graph like a hockey stick.
Figure A:
Figure A from the article shows corona virus cases per country as of 3/4/2020, of which only three countries exhibit spikes in the number of cases.
Figure B:
Figure B from 3/18/2020 is then provided for comparison. According to this graph, the U.S. went from zero cases on or about March 2 to somewhere in the neighborhood of 8,000 cases on March 18. The author then makes the point that, "As predicted, the number of cases has exploded in dozens of countries." Was his prediction accurate? We'll see. He next contemplates the socio-economic status of the affected countries: "Do you notice something weird about this list of countries? Outside of China and Iran, which have suffered massive, undeniable outbreaks, and Brazil and Malaysia, every single country in this list is among the wealthiest in the world." What follows is perhaps one of the most astute observations the author makes in the entire article: "It’s unlikely that poorer countries aren’t touched....
The most likely interpretations are that the coronavirus either took longer to reach these countries because they’re less connected, or it’s already there but these countries haven’t been able to invest enough on testing to know." Aha! Testing. Testing is a crucial key to the numbers. Testing, or lack thereof, is also the most integral reason for the inaccuracy of the numbers. That, however, doesn't stop the author from making further inferences based on the reported numbers. He then goes on to postulate, as do most of the pundits and experts we see in the media, how these numbers will play out if we continue to let them run their course.
Figure C:
Figure C shows the predicted outcome if we allow the virus to spread in the U.S. unmitigated. As with the others, this figure uses numbers based on current reported information regarding number of cases, estimated transmission rates, morbidity statistics, and a few other estimates. All of this seems very academic and well-reasoned, so why question it? Let's go back to the testing, and a few other assumptions made in order to support this line of reasoning.
First, look again at Figure B. It shows the first case (outside of China) as occurring, or being identified, on 2/19/2020 in South Korea. If we consider the time line of events, the WHO on December 31, 2019 announced that dozens in China were being treated for a mysterious pneumonia (I actually had a "mysterious" case of pneumonia that led to extreme breathlessness back in December as well - no fluid in my lungs, no positive test for pneumonia, x-rays showed a small bit of potential scarring of my lungs - hmmmm.....what do those symptoms sound like?). When this was announced, what was the response? Nothing. January 7, the illness is identified as a new coronavirus. The response? Still nothing. January 11, China reports the first death attributed to the virus. The response? On January 17, airports began scanning passengers arriving from Wuhan for symptoms of COVID-19. January 20, presumed cases begin arising in other countries. Still no response. On January 21, the a man from Washington state is diagnosed with the first known case of COVID-19 in the U.S. (he arrived prior to airports beginning to screen - keep this one in mind - it's somewhat important). January 23, the Chinese government locks down Wuhan (population ~11 million), the death toll reportedly rises to 17. What does the U.S. do? Still nothing. January 30, the WHO declares an international public health emergency, and thousands more cases reportedly arise in China. Finally, on January 31, the U.S. restricts (but does not completely shut down) travel from China. Two days later, the first death outside China attributed to COVID-19 is reported. This is just a portion of the timeline (timeline information was taken from these two articles: https://abcnews.go.com/Health/timeline-coronavirus-started/story?id=69435165 and https://www.worldatlas.com/articles/a-timeline-of-major-events-surrounding-the-covid-19-outbreak.html). If the virus did indeed first start infecting people in December, and some reports have it now as far back as November, there was almost two full months during which travel between China and the U.S. (not to mention China and other countries and travel between other countries and the U.S.) continued unrestricted. There is very little likelihood that during this time zero infected people managed to leave China, and that zero infected people managed to reach the U.S. As well, I don't think any of us should be trusting information coming from the communist government of China. Communist governments have historically lied in order to indoctrinate their own citizens as well as benefit themselves on the world stage. Therefore, there is a good chance this has been happening at least since November, and there is equally as good a chance that there have been far more cases in China than are being reported.
If, as I believe, COVID-19 arrived here in 2019, then if we also accept the estimated transmission rate of 2.4 (i.e. each infected person infects another 2.4 people), then we have had far more cases here for far longer than anyone realizes. Again, part of the problem with estimating this number is the lack of knowledge that the disease even existed. Another part of the problem with estimating this number is that, even once we knew it existed, we didn't know it was here. We also have to take into account that this was all occurring in the middle of flu season. The CDC estimates that, between Oct 1 and Mar 14, there were 38,000,000 - 54,000,000 cases of flu in the U.S. (https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm - this gets updated weekly, so the numbers may be different if/when you check this link). How many of these may have been COVID-19? They have several overlapping symptoms and present similarly, at least according to WHO (https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2). Many people may not have sought medical attention for their symptoms, so these cases wouldn't be registered; though for flu, the CDC uses other factors to account for cases not reported and come up with their estimates (you can read a little about their method here: https://www.cdc.gov/flu/about/keyfacts.htm under the heading, "How is seasonal incidence of influenza estimated?"). Many people may have sought medical attention and tested negative for illnesses like flu and strep and been told they had an unknown virus and just been sent home or perhaps given antibiotics or steroids (I know quite a number of people who had this happen this flu season). These cases also may have been COVID-19 and gone unreported. Many people may even have been hospitalized for severe flu-like or pneumonia-like symptoms and treated accordingly, though these people may actually have had COVID-19 (again, I know one person whose daughter went to the hospital because she was having difficulty breathing and felt like she was drowning, but doctors could not figure out what she had - likely COVID-19). Since we really don't know when the first case arose in the U.S., we only know the first date a case was diagnosed in the U.S. was January 21, any estimates beginning from this date alone with this Washington patient as case #1 is fundamentally flawed. This is why the graphs in Figure B are highly misleading at best. If you look at those particular graphs, the first case in the U.S. doesn't even seem to appear until some time in late February. Considering there was a diagnosed case on January 21, that alone shows it is flawed. In addition, though graphs tracking the outbreak, spread, and recession of a virus typically follow somewhat of a bell curve, these graphs are shaped more like hockey sticks. Why? Again, due to lack of information on the true inception of the virus in the U.S. (or any country really) and how many since have been infected cannot be captured on this graph, based on the reasons I've already provided. Using the rate of the spread of the flu (according to CDC estimates and WHO in the previously-referenced article) and the estimated transmission rate of COVID-19, assuming this virus first arrived in the U.S. in December (being generous - it could have arrived in November), there would at this point be a vastly greater number of cases than is being reported, despite our current "social distancing" measures. Even if it arrived mid-December and spread slightly less quickly than the flu (again, according to the aforementioned WHO article, influenza has a shorter median incubation period and shorter serial interval so it is able to spread FASTER), then COVID-19 would have infected a large number of people. Consider that at the low end, the CDC's estimated number of flu cases between Oct 1 and Mar 14 averages out to approximately 229,000 new cases DAILY. Now, we know that's not quite how a virus spreads, it's not an even number of new daily cases, but rather, an outbreak starts somewhat slow and ramps up almost exponentially (this is the reason for the shape of the curve when an outbreak is graphed). Taking that into consideration, and guesstimating just from December 15 through March 1 (the White House did not declare a national emergency until March 13), there could potentially be upwards of 10,000,000 cases already in the U.S. (again, assuming it is as contagious/transmissible as we're being told).
Have we seen evidence of this? Maybe, maybe not. We don't know how many cases have been diagnosed as flu, pneumonia or something else. We don't know how many people could be (or could have been) infected but not sought medical attention. We haven't had accurate or readily-available testing that could positively identify COVID-19, and even since it's become available, how many people have been tested? Well then, what are we to make of all of this? There is not much to make of it. Either we have had hundreds of thousands (or even millions) of cases in the U.S. already, and we haven't seen the incredibly high death rates that are being projected, or the disease doesn't spread as quickly or easily as we're being told. Based on the number of "confirmed" cases worldwide, and I believe this number is low compared to actual cases, I suspect this virus does spread fairly rapidly, perhaps on par with the flu. This being the case, I also believe the projected death rates are highly overestimated, which is why we don't see the numbers of people critically or terminally ill from this virus that the pundits are propounding.
This brings us back to Italy. Why do I say Italy is an invalid comparison? There are several reasons. One thing none of these models seem to take into account is population density and none address per-capita infection and morbidity rates. By nature, areas of higher population density tend to exhibit a greater number of cases than those of lower population density. Despite my disagreement with the overall numbers, this is actually exhibited well with the outbreak heat maps on the Johns Hopkins dashboard I referenced earlier. Italy has a fairly high population density. They have a little over two times the population of Texas, but in half the land area, Italy is (on average) about five times as densely populated as the state of Texas, and ~70% of that is urban. "The population density in Italy is 206 per Km2 (532 people per mi2). The total land area is 294,140 Km2 (113,568 sq. miles).
69.5 % of the population is urban (42,006,701 people in 2020)." (https://www.worldometers.info/world.../italy-population/)
Texas, by comparison, has an average of about 105 people per square mile, though there is a good portion of that population concentrated in several separate urban areas. (https://worldpopulationreview.com/states/texas-population/)
Figure D:
According to figure D, Italy also ranks fourth among European nations in the number of doctors who applied to migrate to other countries from 1997 to 2016 (taken from the following article: https://www.politico.eu/article/doctors-nurses-migration-health-care-crisis-workers-follow-the-money-european-commission-data/ ).
Italy also has a rather large percentage of elderly in their population (22% in 2014) with a median age of 45.5 (compare this to Texas with a median age of 34.4, a median age of 38.5 in the U.S., and that in 2017, about 16% of Americans in general were 65 or older). Italy has the "oldest population" in Europe (https://www.livescience.com/why-italy-coronavirus-deaths-so-high.html ).
Aside from losing doctors, Italy's system of socialized medicine was already underfunded and struggling. According to this article in Time (https://time.com/5799586/italy-coronavirus-outbreak/), "Italy’s current national health service, known as Servizio Sanitario Nazionale (SSN), provides free universal care to patients yet remains under-funded. Investments in public healthcare make up only 6.8% of the country’s gross domestic product (GDP), which is lower than other countries in the European Union including France and Germany." Consider this in light of the fact that most countries with socialized medicine struggle to keep up with everyday medical needs. They were already struggling and, though they created a coronavirus task force a month before the first case was reported, it is no surprise they were severely unprepared for what was to come. Other interesting statistics regarding the outbreak in Italy include that the average age of those who died from COVID-19 was 81 (with the majority over 65), and over 98% of those had underlying medical issues.
None of the situation in Italy can be compared to the United States. Between the age of the population, the population density, and the already-failing medical system, it's really apples to oranges. As an example, 12,000 hospitalizations overwhelmed their health system. During the current flu season (Oct. 1 - Mar. 14), U.S. hospitals handled over 500,000 flu-related admissions alone (CDC statistics give a range of 390,000 - 710,000). This figure does not include hospitalizations for other reasons. We are far better prepared to handle an outbreak, though seeing a similar rate of hospitalizations as Italy saw is not likely, as the numbers there and in other countries, as I have stated, are skewed and hospitalization rates cannot be accurately estimated or assessed.
This brings me to where we stand right now in America with our government's current response. We're basically shutting down America in order to stop the spread of a virus that's likely already spread far and wide and causing mild symptoms in the greatest number of cases, with moderate symptoms being next, and critical symptoms affecting a very small fraction of those infected. We're essentially creating job loss in the range of hundreds of thousands, not to mention the loss of businesses that people worked hard, and possibly spent their life savings, to build. We're creating an impact on the economy that will likely be felt by all for quite some time to come. All with a total estimated coronavirus-related death toll of 201. Yes, that is the currently reported number for deaths caused by COVID-19 in the U.S. Based on the timeline already discussed, we cannot at this point assume that the shutdown alone is responsible for the low death count. Is it possible that this death count is inaccurate and that the actual number of coronavirus-related deaths is higher? Absolutely. I'm sure there have been deaths attributed to flu or other respiratory ailments that were actually caused by COVID-19, however, we have no way to tell how many. Suffice it to say, it is still far lower than other illnesses. Even with flu, if we take the median of the CDCs numbers for this season, there were somewhere in the neighborhood of 41,000 deaths (23,000 - 59,000 is the given range). This averages out to 247 deaths per day for this flu season - more than the total number of overall reported COVID-19 deaths in the U.S. since the first infections in China. Worldwide there have only been 13,048 COVID-19 deaths (according to the Johns Hopkins dashboard as I'm writing this), less than 1/3 the total number of flu deaths in the U.S. in almost the same amount of time. Considering those numbers, though many want to say otherwise because of the current (incorrect IMO) speculations, I think comparing COVID-19 to flu is appropriate.
So, why don't we shut down the country for the flu every year? After all, we could save tens of thousands of lives. Isn't this the same argument being made for COVID-19, though simply with larger speculated numbers? This is why the numbers are so important, and why going down the path we're on based on such fallacious figures is dangerous. We live in a free society, and that necessarily entails risk. The government does not exist to remove the risk from our lives; it exists to preserve our liberties. According to our founding fathers, "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed" (second paragraph of the Declaration of Independence - https://www.archives.gov/founding-docs/declaration-transcript ). Right now, fear is being used to justify the government trampling those rights it is responsible to protect. This should not be acceptable to any American. Unfortunately, we've seen time and again that fear drives people to accept giving up their liberties in the hopes of receiving some perceived security, and as Benjamin Franklin said, "Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety." We should not be allowing the government to take away our liberties. In so doing, they are creating far damage to our country than COVID-19 is likely to cause. If we are concerned about safety in the midst of this outbreak, then we simply need to apply common sense:
- cover your mouth when you cough or sneeze
- wash your hands regularly
- if you're sick, STAY HOME! (unless you are going to the doctor or a hospital)
- if you're at higher risk (i.e. elderly and/or suffering from other underlying ailments), in as much as possible, avoid situations where you may be exposed
- if you're not at higher risk, be mindful of and helpful to those who are
This isn't rocket science - it's basic hygiene and courtesy. It certainly doesn't require shutting down the country. Having a task force is great. I applaud the President for forming one. They should be working diligently on understanding the virus and finding a cure. They should not be forcing businesses to close, costing inestimable numbers of jobs, losses of businesses, and financial hardships for countless numbers. That is simply tyranny.
If you'd like to read an article that covers more in-depth the problems with the numbers and is likely better organized, take a look at this: (edited because this article has moved) https://www.zerohedge.com/health/covid-19-evidence-over-hysteria?fbclid=IwAR1XOrZpFwp_JaXdaSSyme_eM4mLeltFFputPOA_4A1v4q35XnPhKYShRhE
Here is another good article that brings some perspective questioning, the numbers and shows how they are potentially being skewed:
https://www.hoover.org/research/coronavirus-isnt-pandemic?fbclid=IwAR0AA6FUTJ_aZ3P-wg9o-NlX9H9R4P443ZBvMeT4Nndwqe-F7zqS0b5qBgU