The only thing we have to fear

We are in the middle of Covid-19 madness. There is no better way to describe it. I am filled with indignation and anger looking at what we are doing to ourselves. Governments and the media whipping up the panic, shutting down the economy in full display of their incompetence. It reminds me of the Katrina fiasco, perfectly described by Lew Rockwell. Overreaction, incompetence, but above all, a display of power. When I ventured outside my home yesterday, I felt as if I was walking on a post-apocalyptic zombie movie set. Everything is shut down, everything is closed. Stores are empty. I went to see my doctor, found a notice on the door saying that they are closed in the interest of public health. I wonder if any of the people working there saw the irony. When they would be needed the most, health care workers go into hiding. I don’t think that they are really needed. All of this is happening in a place where there isn’t a single diagnosed case within a fifty kilometers. (correction: in the two days since I wrote this, there are two cases reported in Simcoe county) It would be reasonable to cancel hockey games, but not practices. My son is telling me that policemen are chasing away people from the beaches in Mexico in the name of protecting public health. Countries with a few dozen confirmed cases (but no fatalities) are under complete lock-down to protect against the dangers of the pandemic. But when you look at the actual numbers, the hysteria whipped up by the media and politicians does not make much sense. Let’s look at some facts:

The facts

• Yes, we are facing a pandemic.

• Yes, it may be spreading faster than the seasonal flu (BUT maybe not)

• Yes, it has a long incubation period (10 days as opposed to 2 with the seasonal flu), during which the infected are contagious.

• Yes, the mortality rate is higher, but not significantly. We may not even be able to know what the actual mortality rate is. (see the diamond Princess section below for details)

• The US infection rate as of 2020-03-18 is 7,087 confirmed cases with a death toll of 97

• The US seasonal influenza infection rates are 36-51 million with a death toll of average 35,000 Yes, that is an average thirty-five thousand EVERY YEAR. The death rate from covid-19 would have to increase 360 fold to match the rate of the seasonal flu. The most likely victims are the same, the elderly and people with pre-existing conditions

• The Canadian numbers are similar (for a smaller population, of course): Covid-19 cases: 569; death toll is 1 (yes, that is a number one) Seasonal influenza cases for the season, (as of 2020-02-29) is 35,356 cases. Average death rate for a year is 500-1,000

These are the simple facts behind the pandemic so far. It would have to become hundreds of times worse to match the impact of the seasonal flu that most of us don’t even bother to get inoculated against. There is a reason to be concerned here, but there is no reason to panic. There is no reason to shut down the economy.

The Diamond Princess

The Diamond Princess case turned out to be the perfect accidental experiment. The people were in a closed place under quarantine and the epidemic had a chance to run its course. Everyone on the ship was exposed and everyone was tested. 83% of the exposed did not get infected. 50% of the people who did get infected showed no symptoms. They developed the antibodies, but did not get sick. Out of 700 infected, 8 people died. In the outside world, with such a high percentage of infected, but asymptomatic or mildly symptomatic we may not know the actual rate until we have a chance to run large scale studies on representative samples of different populations. This article is a short and well illustrated summary of a scientific paper analyzing the case. This is another article coming to the conclusion that the actual mortality rate is likely less than 1% What the Diamond Princess experiment suggests is that we should give the medical attention to those who need it while allowing the contagion to run its course. Understanding, that this is the worst-case scenario. The suggestion, that we should allow the virus to run its course and focus all of our attention to tend to the sick in need of medical attention has been made by some epidemiologists.

The reactions

None of the above points mean that we do not need to take the problem seriously. Italy, with the second oldest population on the planet was hit much harder than the rest of Europe. China handled it with authoritarian swiftness, and by now, they are over the crisis. Their epidemic S curve is now completely flat. The Koreans, with their less than 1% death rate are getting there fast as well. The reaction to this real, but not particularly serious problem is a virtual shut-down of the entire economy of the Western World. The thing political power can do best is displaying its might. Showing that it is in control. Grabbing a little more at any chance it gets. Politicians around the world got the Rahm Emanuel message: never let a good crisis go to waste. This one looked very good at its start, but it still needed some media whipping. It still needed some theatrics. It still needed some decisive action. Shutting down public events, ‘protecting’ government workers, shutting down trade, closing borders, restricting all public life. Scaring people into panic mode survival shopping and into liquidating their investments. The small things are the most ridiculous and most annoying. The extent to which governments try to alarm and to control their citizens at the same time. Scaring them into complete obedience and compliance with the most ridiculous demands. The threatening display of power. I went to Costco a few hours ago. They built a labyrinth leading to entrance to line up people into a single file. Their buffet was practically closed. They were ordering us to line up by little yellow dots on the floor where we were supposed to stop with our cart. At least a dozen extra people working on crowd control. Everybody seemed to be grumpy. In the second biggest country in the world with a 0.18% mortality rate from this virus (1 out of 569 confirmed cases).

The explanations

The response is so seriously overdone, so unreasonable that it begs the question why? Why the overreaction? It makes no sense. What’s behind it? What is the real agenda? I get the point that it is too good an opportunity to waste, but to achieve what? What is the point of this fake crisis? My first impulse was that this is an excuse to close the borders. When I realized that governments are shutting down the world economy and international trade, I realized that this ‘pandemic’ was the perfect excuse to do just that. The overheated stock market was in a serious need for a correction. The European migration needed some control. The European Union needs to get prepared for its possible-likely-impending demise. Consumer spending and indebtedness had to be controlled. The entire galloping world economy needed its reins to be pulled. A thirty percent drop in the markets with a 2-3 months break in industrial production may be the jolt our wise leaders may think we need. Maybe it’s all of the above. It could also be, that I am just paranoid and our ‘only’ problem is the incompetence of our politicians.

Dealing with the problem

What would be a the most reasonable approach? Let’s look at the options!

#1 Brute force population control.

This is the one that is playing out in Europe and North America. The assumption is that if we can successfully suppress human interactions – and therefore the possibility of contagion, then the epidemic will go away, or at least it will be manageable. The social and economic cost is extremely high, and it is unlikely to solve the problem because it does not address either the problem identification part (universal testing) nor the solution (cure or immunization). But it is a great power high for those addicted to such things.

#2 Herd immunity

This is the British approach. The only true protection against viral infections is immunity. If a sufficiently large number of a population is immune, the contagion cannot spread. Without a vaccine, the only way to achieve that is allowing said population to develop the antibodies by going through the illness. All efforts should be focused on treating the serious cases. This is the approach fitting best a free, democratic society. Encouraging self isolation and social distancing without heavy lock-downs and punitive enforcement.

#3 All hands on deck, full control

This is the Chinese approach. Once the problem and the resource needs are identified, we have to throw everything at it. The Chinese built a hospital in 10 days. The problem with this approach is its authoritarian nature. They rounded up just about everybody to be tested. In the end it seemed to work, but it is not a solution for a civilized country. Even if the WHO liked it.

#4 problem identification

The Korean approach. The Koreans got it under control by aggressive testing, contact tracing and isolation of even the mildest cases to prevent further contagion.

“South Korea’s experience shows that “diagnostic capacity at scale is key to epidemic control,” says Raina MacIntyre, an emerging infectious disease scholar at the University of New South Wales, Sydney. “Contact tracing is also very influential in epidemic control, as is case isolation,” she says.” (emphasis mine)

#5 Preparedness

This was the case of Taiwan. They were hit hard by SARS in 2003 and as a result they had a plan in place to handle such emergencies in the future. They did the propaganda, the social distancing and limiting of public gatherings, but without the heavy-handed approach of Communist China.

The ideal response?

The question of the ideal response is a question of resource allocation. Where should we focus our efforts? Prevention? Control? Intelligence? Treatment? Research? Prevention needs to happen before you get hit by the problem, therefore pointless to focus on when you are dealing with it. Controlling the spread must be part of any effort, but it demands the most resources and it needs to be drastic to be effective. Large scale testing and contact tracking could be the most effective way to control the spread. Still, treatment is the most pressing concern of sick people. Researching a cure or vaccine should start the moment the problem is identified. My preference therefore would be to put the most effort into treating the sick, then into testing. Making tests available for the public and focused identification of the infected through contact tracking; then researching a cure and facilitating it by relaxing the regulatory barriers to quick availability. Testing should be readily available to anybody who is willing to pay for it. Trusting that to the market is the only way to ensure wide availability. Governments tend to screw it up. My preferences are based on my belief that the best long-term defense is herd immunity. Considering the low percentage of serious cases, it is reasonable to believe that we can save the largest number of people through allowing the natural development of immunity until vaccination is widely available. This is clearly not how we are doing it in Canada, the USA or most of Europe. Massive control, but without the any of the necessary other steps: testing and contact tracking. We should wonder why.

But there is good news

The speed of research and development of these drugs is unprecedented. No viral RNA has ever been sequenced as fast as this one. We have both preventive and remedial drugs already in clinical trial. The information available on this pandemic is unparalleled in history. There are some good examples on how to handle the problem. I am angry about the way this epidemic is handled. The fear-mongering, the dishonesty, the gross overreaction but no real and reasonable action dealing with the outbreak. But I am also optimistic; I believe that the outbreak will be over by the Summer and we will have tested and proven vaccination and symptom treatment medication by the next flu season. What I do not believe is that our governments will learn anything from this pandemic. The only thing we have to fear is fear itself. …….and the incompetence of our governments, of course. ........which is a bigger problem than the virus itself.