A few days ago I came across "THE
REAL COVID-19 STORY" on a DiNK Gesprek (THINK Discussion) Facebook forum post below.
Please be patient with me here. You're first going to have to read through the
following bit, before the fun starts afterwards.
Skim through it if you have to get the gist of it, but please don't get too
bogged down in the blah, blah, blah... as that would divert from the intended lighthearted intent of this post.
When reading, please bear in mind what journalist H.L. Mencken once said:
"For every complex problem there is an answer that is clear, simple and wrong."
____________
Logical and rational people make
decisions based on evidence.
However, the main problem in reviewing
“evidence”, particularly in complex issues like virology and medicine is
differentiating between cause and effect with respect to evidence. It’s not
always easy to do.
Let’s take the issue of flattening the
curve as an example. The objective of this exercise is clear – it is solely to
retard the rate at which the infection progresses in order that the rate at
which patients that require intensive care present, do not overwhelm the
medical facilities’ ability to deal with the problem. The degree to which the
curve needs to be flattened is therefore directly related to the particular
state’s medical care capacity and this will differ from country to country and
district to district.
The objective of flattening the curve
is never about reducing the amount of people that become infected nor is it
about reducing the ultimate death rate from the disease except insofar as it
ensures that there are no “excess deaths” due to medical care capacity
constraints.
In the absence of a vaccine and/or
effective treatment, the ultimate outcome in terms of death rate per person
infected will converge regardless of whether you advocated hard lockdown or a
soft lockdown ala the Swedish model. The Swedes are taking the inevitable
deaths upfront and inflicting minimal (but not zero) economic damage. Other
countries have adopted hard lockdown which reduces upfront deaths but inflicts
serious economic damage (which in itself causes death) and are now faced with
the need to find a way to come out of lockdown and deal with multiple future
recurring outbreaks and deaths.
On face value therefore, both Sweden
and most hard lockdown countries have evidence to show that their strategies
worked in terms of keeping infections below hospital capacity (Lombardy in
Italy and New York in the USA are notable exceptions). Uninformed commentators
however, look at evidence of current deaths per million and claim that this is
evidence that the strategies followed by Norway and Denmark for example, are
more successful than that of Sweden. This is incorrect as the real measure of
success on the score of overall mortality will only be known 12-24 months from
now. The fight against Covid19 is a marathon, not a sprint. Claiming success
for Norway is the same as claiming success for the 42km marathon runner who
passes the 1km mark first. Clearly nonsense, as the guy that’s in 100th place
at the 1km mark may well be the guy who has paced himself perfectly and who
will cross the 42km finish line in first place. We cannot predict yet who will
win the Covid19 marathon. My money is on Sweden because their strategy is
evidence and logic based, rather than being based on mass hysteria and a
political need to be perceived as taking hard action. However, I also cannot be
sure as the end point is still far in the future. What I do know though, is
that Sweden has done the least damage to its economy and will therefore suffer
the least economically induced deaths.
The hard reality is that in the absence
of a vaccine and/or the ability to sustain a permanent hard lockdown, this
particular airborne virus will infect around 60% of the population (the precise
% is unknown as it is a factor of the contagiousness of the disease).
The second hard reality is that in the
absence of effective treatment or drugs for people getting sick with the
disease, the % of the population that will die is dictated by the IFR
(Infection Fatality Rate) which is not yet known, but preliminary research puts
it at somewhere between 0.1 and 0.3%, with some research suggesting 0.6%. It’s
definitely not the 2-3% numbers bandied about by uninformed commentators who
confuse CFR (Case Fatality Rate) with IFR.
Nothing we can do, short of an
effective treatment drug or vaccine or permanent lockdown, can stop 60% people
getting infected and the IFR deaths occurring. The average citizen doesn’t
understand this though and politicians don’t seem to either. The reality is
that we will have to learn to live with this virus and the good thing is that
the human body has evolved to become a remarkable machine in achieving exactly
this. We live in symbiosis with a multitude of microorganisms both within and
around our bodies and our immune system (at least in the average healthy
person) is remarkably efficient at adapting to new threats. That’s also
evidenced by the low death rates by Covid19 which is a brand-new virus that our
bodies have not encountered before.
We need to put aside hysteria, deal
with the real facts and evidence we have, and move towards regaining some form
or normality. The new normal will be different to the old normal and we will be
obliged to protect those whose immunity is compromised. However, the rest of
society must get on with life. Children must go back to school and people must
go back to work. We must all strive to live a healthier life and protect and
build up our immune systems, because there is one thing we can know for sure -
there will be future pandemics coming our way and we cannot hide from
them.
____________
This seems like a reasonable argument if you don’t dig any deeper because it’s
generally very well written and lots of disparate ideas are intelligently
(although not logically) woven together. And if you were not reading it critically,
you’d think it was a pretty decent perspective.
This is just as recent misinformation such as Plandemic seems reasonable, if
you don't challenge it by digging deeper and employing your critical thinking
.
Here’s my critique as an example of
such an exercise. And you're more than welcome to be critical of my criticism
if you think it's deserved. Note that it was modified somewhat for dramatic
effect.
____________
COVERT-20: A Tale of TRUE Fruits
Your argument is devoid of facts, logic
and rationality. I don’t have the whole day to waste so let me state the most
obvious.
Firstly, you’re attempting to compare apples with pineapples as if they’re the
same kind of fruit. And then after by biting in each concluding that you like
the apple more because the pineapple tastes leathery and spikes your mouth. In
doing so completely disregarding that it is best to truly get to know the
nature of the fruit only once it's peeled.
Let’s say Sweden is the apple in this
tale. Yes you can compare Sweden and Norway because they are both apples for
the purposes of analogy (a Granny Smith and Pink Lady for argument's sake).
And yes the death toll is significantly worse in Sweden and the economy is
currently better. And yes, they made an informed logical decision in this
regard, and I would argue it could pay off for them in the long run.
Economically that is.
But that’s only because the Swedes are
the Swedes. As Carl Bildt, a former PM, indicated in a CNN interview, the
Swedes are already naturally socially distant. And with small modifications in
behaviour, have the discipline to pull it off without any major measures.
What about countries who adopted strong early measures, and are now
are good to go? Prime example being New Zealand where the virus had essentially
been eliminated in very short time. And despite a significant drain on the
economy, and infrastructure that does not remotely compare, South Africa is not
doing badly on the death and infection front (and therefore one can legitimately argue that the lockdown is too severe, though there’s some complexity here and is an argument for a post of it's own).
On the other hand, what about the UK? The pineapple in the argument, let’s say.
Because they were late at implementing measures, arguing for the herd immunity
argument Johnson made, they now are experiencing a massive death tol.
That is with an eventual very
restrictive lockdown.
Now what would’ve happened had they
not?
Estimations are that a few hundred thousand would’ve died given the rapid
exponential growth of COVID-19, had they not done so. Notwithstanding these
eventual measures, because they were late to respond Britain who is now per
capita the worst case is exactly where they are because they employed your
underlying logical assumptions.
The USA is now relaxing social distancing and the forecast is that the death
rate would exceed 3,000 in three weeks, and that 200,000 would be dead by
August according to a John Hopkins projection if America opens up now.
Notably the common thread between the
three countries with the worst outcomes are that they are run by populists: the
USA, Britain, and Italy. In this case I would say the USA, particularly because
of Trump, the banana – or should that rather be, paw paw (specifically the
orangeier version, otherwise known as a papaya) – in the basket.
Another illogical argument is the way you made irrational inferences from the
“flattening the curve” model.
The model’s two graphs shows a
mathematical area under the curve that theoretically shows the same number of
patients. But it’s employed to do exactly that, compare apples with apples to
simplify the theoretical argument, basically the “Epidemiology for Dummies”
version. To take this literally, as you indicated that would eventually result
in the same amount of deaths, is like saying ceteris paribus as they do
economics, i.e. all other things being equal, in order to make sense of complex
systems.
One can say it’s the apple pie (sprint) versus
apple cider (marathon) analogy, albeit the exact same number of apples were
used.
Unlike your assertion that they will
reach the same conclusion (i.e. a marathon vs a sprint), flattening the curve
is ultimately about lowering the overall death rate.
Indeed, the argument should be
reversed. The sprint being about rushing to open up at all costs, resulting in
a deadly peak because hospital capacity is overwhelmed. This though can play out over many months, with an eventual very
high death rate.
The marathon is in fact about
mitigation measures to flatten the curve. This requires a longer term view, but
which can be considerably shortened if earlier mitigation measures are enacted.
Again, New Zealand being the prime example.
The assertion that we generally get the same amount of deaths in the long
run whether we flatten the curve or not – "the ultimate outcome in
terms of death rate per person infected will converge regardless of a hard or
soft lock-down (as per Sweden)" – is blatantly incorrect for a
multitude of obvious reasons. Clearly you are confusing overall death tole with death
rate, the former being a factor of death rate times infectivity.
It is not virulance which you were alluding to. In fact it's virulance, that you actually become very sick when the virus inhabits your body, is clearly not the case with COVID-19. But this very low virulance is actually what makes it deadly to the overall population as it increases the R-0 – it's overall infectivity – because of asymptomatic spread.
If it is not obvious to you, please read my tedious footnote below. [i]
And you were implying that it’s a
generally mild virus and that it’s not so deadly?
Are you referring to the one
Boris had? If you're wondering who I'm referring to, he's the head of
the pineapple factory.
Now, to your reference to the impact on
the economy?
Do I really have to go down there other
than to say this. The fear of omnipresent death and knowing that there’s a
mostly undetectable deadly disease on the prowl – like a covert (as
opposed to COVID, get it?) KGB assassin – generally does not promote
healthy economic activity.
That’s unless you’re a cool Swede (just kidding if there happen to be any
Swedes reading this response).
Oh, and a last one before I go.
Yes, there will be lots of deadly
viruses and diseases out there in the future that you need to prepare for, the
flue for instance. But when do you suppose the next once-in-a-hundred-year
plague would befall us in your estimation?
Just curious.
____________
His personal post went abuzz with how
much of a genius he is. Clearly his followers were greatly impressed with his
writing acumen.
However, besides the general logical floors of the argument, be generally weary
of anyone who claims they are giving “THE REAL...” from their narrow
perspective, let alone “THE REAL COVID STORY”.
And I also wonder who the “uninformed commentators” are?
As irony wild would have it, this particular informed expert happen to be a
very well educated gooseberry farmer.
Met ander woorde, ‘n APPELliefie boer.
Note that I’m generally not such a
prickly pear as I was in my retort, but the arrogance of this guy really got
under my skin.
Unlike in this case, I’m usually
thicker skinned.
More like a pineapple, but without the
pines, I suppose.
And no, a pineapple minus pines, doth
not an pineapple maketh.
En net ingeval jy gewonder het, nee, 'n appeliefie boer is nie net maar 'n gewone appel boer met 'n groot liefde vir appels nie😊
[If you are interested in a transcript of the subsequent FaceBook discussion go to this link for pdf download]
The reality is that the death rate varies from around 2% as in South Africa, to
as high as 15%. This though is dependent on the number being tested, but in
Europe this is generally accurate. That's notwithstanding asymptomatic
spreaders which are generally not tested. This adds to the overall infectivity
of COVID-19, and therefore also to it's deadliness and scariness as it
unknowingly lurks in society.
This death rate for most countries that are not Sweden, is causally linked to
the ability of the hospital system to cope with patients, and therefore to give
quality treatment. Even Italy and UK with the best hospital systems in the
world, largely crumbled. And this is with very strong lockdown measures in
place.
If they had started with social distancing a week or two earlier, they could've
stretched the effects over a longer period, with significantly less consequent
deaths. That’s let alone that treatment methodologies improve with time, which
will significantly lower the overall death rate as well. Let alone a vaccine or
other definitive cure which could stop the disease potentially dead in its
tracks.