With the COVID-19 pandemic, we are told to follow the science. But that science is wandering various paths to uncertain destinations.
And while science is always an ongoing process of discovery, with conclusions conditional pending new findings, formulating public policy during this process can be problematic. Ask anyone trying to stay employed, go to school or keep a business going during the coronavirus crisis.
With COVID-19, the only thing we know for sure is that no one knows for sure. Data are often inconsistent, impermanent and inconclusive. The many expert opinions and advice are frequently contradictory.
For example, while some health experts, like University of Michigan professor Howard Markel, fear that COVID-19 could rival the Black Death if draconian measures aren’t taken to manage it, other experts, like Monica Gandhi, an infectious-disease specialist at UC San Francisco, cite mounting evidence that the virus is more common and less lethal than first feared.
Antibody tests are finding that large numbers of Americans were infected but never became seriously ill or had any symptoms. When these mild and asymptomatic infections are included in coronavirus statistics, the virus appears less dangerous than first thought when panicked governments imposed lockdowns and social distancing mandates.
While the concern over COVID-19 is not unfounded, the drastic reaction to it has been an economic cytokine storm devastating the lives of tens of millions of people — many of whom will never recover their place in the economy.
That is deeply troubling. The reactions to suppress the coronavirus may do more overall, lasting harm than the virus itself.
Can forced shutdowns and all the pandemic protocols ever work to defeat COVID-19? Well, maybe, if a society could have near 100 percent absolute compliance, but for America — vast, politically bipolar and unruly —that is a fantasy expectation.
Moreover, intrusive efforts to suppress this virus, particularly with extended and recurrent lockdowns, have not been sustainably effective. As soon as lockdowns are lifted, the virus is rekindled. All it takes is an ember to reignite the viral wildfire.
New Zealand was hailed as the paragon of near perfection in suppressing the virus. After a near total lockdown of its society and imposition of strict prevention protocols, including banning international travel, New Zealand went more than 100 days without a new coronavirus case.
Mission accomplished?
No. On Day 105 there was an outbreak, prompting renewed shutdowns and the military patrolling ports of entry.
Renewed outbreaks are spiking in other nations that have followed a similar approach to quell the virus.
An insidiously stealthy virus so tiny that tens of thousands can dance on the head of a pin is very difficult to deter and certainly won’t be eradicated by lockdowns, masks and social distancing. Only herd immunity is going to do that, and that is what Sweden made its educated bet on.
Sweden’s approach to the pandemic has been much maligned around the world, but may turn out to be the more rational and effective — certainly it has been the least socially disruptive and the least economically damaging. While Sweden’s economy hasn’t escaped free and clear, it is in much better shape than ours.
Sweden considered the options and decided lockdowns and compulsory protocols would be more devastating to its society than letting the virus run its course to herd immunity — while each citizen decided what, if any, prevention protocols to follow.
Initially, that looked questionable because Sweden didn’t take precautions to protect its most vulnerable citizens, so mortality rates were relatively high. But, for weeks now, Sweden’s infection and mortality rates have plummeted to among the world’s lower levels, indicating that maybe it is approaching herd immunity.
Ultimately, Sweden’s COVID-19 death rate may be no greater and even less than that of other countries that took more draconian approaches to manage the pandemic.
Here in America, because of the gross dereliction of duty by President Donald Trump’s administration in preparing for and responding to this pandemic, there has been no national coordinated, comprehensive effort to manage it.
Therefore, by default, the United States is following a clumsy version of the natural herd immunity approach.
What might that mean for America?
The Centers for Disease Control and Prevention estimates that COVID-19 infections among the American population may be 6 to 24 times higher than reported.
Bolstering that estimate are a number of recent studies indicating that a significant portion of the population may have partial immunity due to previous coronavirus infections and childhood vaccinations that generated “memory” T cells that attack the new virus.
So, including the estimates of the population that has already been infected, how close is the United States to herd immunity? The most recent data indicate that attaining herd immunity requires far less than the early estimate of 70 percent of the population—more like 45 percent to 50 percent. Sweden’s situation seems to support the lower numbers.
The daily rate of known infections in the United States has ranged from more than 60,000 to around 40,000. So, it might take one or two more years to attain herd immunity here.
Realistically, Americans cannot and will not endure even one more year of lockdowns and social distancing protocols interrupting their lives and destroying their livelihoods. So, unless an effective vaccine is found and provided to inoculate the population pronto, what do we do?
First, stop the hysteria. Millions of Americans are wallowing in a toxic mental miasma of depression and anxiety. COVID-19 is serious, but it isn’t the Black Death.
At least 97 percent of people infected with the coronavirus have survived, and 90 percent of them have fully recovered at home in a week or two. A small percentage has experienced lingering side effects; although for how long or how severely remain undetermined. This is one of the most concerning unknowns.
If you are old, really fat, have a pre-existing medical condition or are just plain freaked out about getting infected, take any and all reasonable precautions for yourself, but don’t insist that society close down to reduce your risk. That is your responsibility.
With the best data available now, six months into this pandemic, how do each of us assess our risk?
If you get infected will you die?
Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore, says current overall data indicate the best estimates for fatality risk from COVID-19 are between 0.5 percent and 1 percent.
CDC data as of early August, has the U.S. mortality rate at about 3.1 percent of people actually diagnosed with COVID-19. That percentage skyrockets with age and medical condition. About 80 percent of coronavirus deaths are among those over 65, especially the obese.
If you get infected will you be hospitalized?
The CDC data shows that 9 percent of those diagnosed with COVID-19 are hospitalized, and of those only 5 percent require treatment in an intensive-care unit.
If you survive a COVID-19 infection will you have lingering health damage?
In limited random surveys of coronavirus patients, the CDC found that about 33 percent had not fully returned to normal health two to three weeks after diagnosis. Of those under age 34, it was 20 percent.
A new study published in the Journal of Medical Virology found similar percentages and identified the most frequently reported side effects of hospitalized COVID-19 patients. In order of frequency they were moderate to severe fatigue; new or worsened breathlessness (of these, two-thirds had pre-existing respiratory conditions and more than half were overweight); and PTSD symptoms.
To get a real grip on this pandemic, and those surely to come, America needs a more robust, centralized data-collection system managed by politically independent expert epidemiologists capable of ensuring accurate reporting from state and municipal health departments across the country.
The current CDC data system is limited mostly to body counts of deaths, infections and hospitalizations — which the news media headline daily along with scary anecdotes about the ravages of the disease.
We need a system that tracks and traces new cases nationwide; analyzes information, including side effects; and determines which communities and demographics are most vulnerable. To do this, America needs massive testing capabilities.
Harvard epidemiologist Michael Mina, an expert in disease testing, is an advocate for a testing strategy employing a cheap, daily, do-it-yourself test that several companies have already developed but that are stuck in the Food & Drug Administration approval process.
Such widely available tests would be, depending on public cooperation, very effective in interrupting COVID-19 transmissions by facilitating trace and quarantine efforts.
The hydroxychloroquine controversy presents a clear case why the efficacy of all COVID-19 treatments needs to be evaluated objectively, without deference to or interference by politics.
Right now, we don’t really have the robust information system we need, consequently we have a lot of unknowns — and nothing short-circuits rationality like fear of the unknown. That is certainly apparent in this pandemic, and it is causing some serious side effects on its own.
— Randy Alcorn is a Santa Barbara political observer. Contact him at randyaalcorn@gmail.com, or click here to read previous columns. The opinions expressed are his own.