Militant Medicine Breeds Bad Pandemic Policies

Perhaps you noticed how public health officials direct the war on coronavirus.  The generals obsess over “cases” and “deaths” while hiding numbers of “recoveries” and “cures.” The military paradigm has led pandemic policies seriously astray, as explained by Norman Doidge in his Tablet article Mad Science, Sane Science.  Excerpts in italics with my bolds.

There are more reasonable approaches to science and COVID-19 than the ‘eradication’ mentality that we lean on.

One cannot underestimate the extent to which modern medicine took up Bacon’s military metaphor of conquest and applied it to itself. This involved rejecting the ancient Hippocratic idea of healing, which—being part of that Greek worldview that saw us as of nature, and not against it—saw the physician as trying to work in alliance with nature, the patient (mind and body and spirit) and the patient’s family. But by the mid-1600s Thomas Sydenham, who became known as the “English Hippocrates,” saw medicine in a new way: “I attack the enemy within by means of cathartics and refrigerants, and by means of a diet”; he wrote, “a murderous array of disease has to be fought against, and the battle is not a battle for the sluggard …” Little has changed since. We see ourselves as engaged in endless wars: “The war against the virus,” “the war against cancer,” or against AIDS, “the war on drugs,” the “battle against heart disease,” we “combat” Alzheimer’s, and so on. As modern physicians came to see themselves as warriors and disease as “the enemy,” treatments became “weapons,” and drugs went from being healing potions to “magic bullets” and vaccines became “shots.”

We combat the enemy with “doctor’s orders,” from the medical “armamentarium,” or “arsenal” as we physicians call our bag of therapeutic tricks.

This military metaphor in medicine gives rise to a mentality that esteems invasive high-tech treatments as somehow more serious than less invasive ones—any collateral damage be damned. Of course, there is a time for a martial attitude in medicine, as, say, in emergencies: If a blood vessel in the brain bursts, the patient needs invasive surgery and a neurosurgeon with nerves of steel, to operate. But there are times when it sets us back. Today, rather than work with the patient as a key ally, we physicians often barely have time to listen to him or her speak. In this metaphor, the patient’s body is less an ally than the battlefield, and the patient is rendered passive, a helpless bystander, as he watches the confrontation that will determine his fate between the two great antagonists, the doctor (plus the scientific research establishment) and the disease (or pathogen). And of course, in the “war against the virus,” it is total “eradication” of such an enemy that is the goal. That, it would seem to us, Bacon’s offspring, as the only sensible approach.

As it turns out, so much of what ails us today are products of modern science and technology gone wild: lethal antibiotic-resistant organisms that our “total eradication of disease mentality” produced because we vastly overused the antibiotics we had (which, by the way, were originally natural products of nature, not the lab); pollution (of every element), chemicals in our baby food, toys, floors, and mattresses causing skyrocketing childhood illnesses; bioterrorism; loss of biodiversity affecting the food chain; fabulous totalitarian surveillance tools called cellphones, global networks that allow our enemies thousands of miles away to reach into the controls of our electrical grids, water systems, food delivery systems, banks, nuclear systems, computers, and control them, turning them on and off with a keystroke; 3D printers to make assault weapons in the basement, nuclear weapons to empower lunatics, industrialized death camps with cyanide showers, and, not to mention man-made environmental disruptions causing ecological catastrophes.

On this list of course, is also a pandemic that spread so rapidly because of air travel, and the “efficient” design of our urban centers which maximize overcrowding—and a microbe that may have originated in a lab known to be unsafe, and experimenting with bat viruses. “Just last year,” an article in Newsweek reported, “the National Institute for Allergy and Infectious Diseases, the organization led by Dr. Fauci, funded scientists at the Wuhan Institute of Virology and other institutions for work on gain-of-function research on bat coronaviruses.”

“Gain-of-function research” in this case means augmenting the virus’s contagiousness, and even lethality for the purpose of getting a head start on developing therapeutics or vaccines should it mutate in that direction. Such research is also the meat and potatoes germ-warfare research.. . . Whether or not Wuhan’s gain-of-function work involved creating an artificially enhanced coronavirus has been made almost impossible for outsiders to ascertain, because that lab’s government conveniently insisted it destroy its virus samples and records before an outside investigation could be done.

We are so reliably surprised and caught off guard by the unforeseen consequences of our technologies, and there are now so many serious cases of “science going wrong,” that it might be argued that, in practice, modern science (and the tech it produces) seems to be a machine designed to generate and maximize unintended consequences. And is hence, along with being powerful, also, quite often, ridiculous.

All of this is relevant to the current pandemic. In a way, there are three grand “strategies” to deal with a pandemic. But only one of them indulges the more lunatic strains of military metaphor in medicine.

  • The first strategy is never let it in.
  • The second, the approach most widely used at present, is to go to rather blunt lockdowns, while we develop therapeutics and vaccines to eradicate the virus.
  • The third is to resist lockdowns whenever possible, and instead focus on more differentiated measures than total societal closures, again while we develop therapeutics and vaccines to eradicate the virus.

If the virus doesn’t get in, people are not dying, there isn’t talk of eradication and the military metaphor isn’t used. That strategy has worked so far in Nauru, an island speck, in the paradise of Oceania, a country that is isolated, and small enough to walk across and around in one day, and which, along with Oceania’s Tuvalu, is tied for the record as being the least visited country in the world.

Even the relatively isolated, double-island paradise of New Zealand, was still too connected with the rest of the world to keep the virus out. When it did arrive there, New Zealand tried the second strategy, to eradicate it with a blunt lockdown.

The military metaphors began. Prime Minister Jacinda Ardern set the goal of “complete elimination of the virus.” France’s President Emmanuel Macron said, “We are at war … The enemy is there—invisible, elusive—and it is advancing.” Donald Trump described himself as “a wartime president.” War requires emergency measures, which require emergency powers, which demand the immediate suspension of civil liberties—with executives not bothering to go to legislatures because the enemy is coming at us “in waves,” and “surges,” is “killing us in droves.” We “hunker in our bunkers”—in total lockdown. Home’s the only place that’s safe. We must “mobilize” all society in immobility. Punish those who disobey orders. We do it, too, for the health care workers, the heroes on “the frontline,” who risked their lives.

But these undeniable similarities do not mean that medicine is war, any more than war is healing.

Perhaps the biggest problem with the military metaphor, is how it causes us to narrow our focus almost exclusively on “eradicating the virus,” and “cases of the infected.” This causes us to miss other important ways of dealing with it, that might help us survive it. Public health officials in the “the eradication mode” almost never mention how we can boost our immune systems with vitamins D and C, and zinc, exercise and weight loss. Not their focus. And the narrow focus on eradicating the virus is now causing serious “collateral” harm and death.

But it was not maliciousness but rather the virus eradication mindset that has caused much of the harm. That mindset has led many politicians, and also public health officials, to become oblivious to the death, illness, and devastation that have resulted from the lockdowns. Tedros’ own language speaks this obliviousness, when he says he knows people are “understandably frustrated with being confined to their homes” as though “frustration” is the extent of the problem. What is actually happening is that people’s worlds are collapsing. Fauci early on called the lockdown measure “inconvenient.”

Tedros and other lockdown supporters are almost all themselves employed, and working comfortably, many from home.

They are part of a class that has government, bureaucratic, educational, media, and corporate salaries, or are in Big Tech, which thrives in lockdown. With an often staggering indifference, they gloss over that fact that the measures they recommend “for all of us” are devastating to those working-class people, the poor, and small-business owners who are losing or have already lost their life savings, health insurance, health, and who are at risk of, or who have already been evicted from their apartments. By September we knew that nearly 60% of (mostly small) businesses that had been forced to close in lockdown were destroyed so their workers would have no jobs to return to. Many more have gone under since. They were closed by often illegal edicts, that left their large corporate competitors like Costco and Walmart open. Thus, instead of going to small widely separated community stores, that admitted a few at a time, people crowded into a few stores without social distancing—the complete reverse of a sensible, scientifically based policy. How did public health officials get away with destroying small business? This is war! Ignore that a meta-analysis of 10 countries and their regions, shows that during last spring, stringent stay and home and business closures did no better in slowing the virus than those that rely on voluntary measures (such as hand washing, social distancing, discouraging travel and large gatherings, successful case tracking, and testing). Gov. Andrew Cuomo’s own latest scientific statistics confirm that 74% of all New York COVID-19 transmission comes from indoor gatherings in private homes, and only 1.4% from in-restaurant dining (all set up for COVID now). The commander in chief says no to indoor restaurant dining in December. Now, even the WHO, which supported lockdowns, is claiming that closed Western economies are devastating poorer countries that are trading partners, and its special envoy for COVID-19, Dr. David Nabarro, has said the WHO anticipates a doubling of world poverty and a doubling of childhood malnutrition because of lockdowns.

The officials, blinded by the eradication at all costs mentality, discarded the practical wisdom required to respond to such a crisis, and endorsed an intervention that defies the standard public health practice of taking a holistic approach and always taking into account a measure’s total effects, and not just its immediate effects on the pathogen labeled as “the invisible enemy.”

“COVID denial” is real. So is “COVID-management-induced-devastation denial.”

What does a scientific approach look like, one that takes the best of our modern instruments that Bacon helped to facilitate, but which does not get us tangled up in the military metaphor, or make delusional attempts to artificially cut us off from the rest of nature?

That would be the approach of Janelle Ayres, Ph.D., a brilliantly original and constructive molecular and systems physiologist, and expert in both immunology and evolution, who heads two labs affiliated with the Salk Institute. Ayres’ work opens up a radically different approach to infectious disease—radical in the original sense of the word, meaning having to do with the root, i.e., the broader biological foundations of infectious disease and health in the “biome,” the sphere of living organisms in which we dwell, and which dwell within us. Thus, to my mind, her work has echoes with some of the ancient insights and intuitions about biological interconnectedness, though I’ve not seen her make this claim.

Ayres’ work is helping us reconceive our relationship to microbial organisms, including pathogens, and showing how they can, for instance, influence our evolution, and we theirs, and it gives us a much more detailed picture of how we actually survive serious infections. She happens to have written one of the best articles ever on COVID-19, that shows a breadth and depth of biological comprehension that is extremely rare among modern scientists who are often specialists in very circumscribed areas, who analyze things into ever smaller parts, and know an incredible amount about incredibly little. Ayres is both a first-rank specialist, and a big-think generalist.

She says, “The way we have been thinking about treating infectious diseases is that we have to annihilate the pathogens through vaccines and antimicrobials.” She completely reframes the problem, and challenges our thinking:

“Instead of asking how do we fight infections, we should be asking ‘how do we survive infections?’”

Changing that single word—“fight” to “survive”—transforms everything. Consider, for example, that new organisms, and strains are evolving all the time. A new coronavirus strain identified in December is said to be 70% more transmissible. Some new strains may be resistant to our existing vaccines and antivirals. Developing different antibiotics or vaccines to eradicate each of them, is not always possible, and when it is, generally takes a long time, and costs a fortune. But if, as is often the case, death is caused by our bodies’ own reactions to the infection, reactions which are very similar, regardless of the pathogen that caused them, learning to block the body from going into overdrive should help people survive multiple infections. As well, there is no reason to believe this approach will cause antibiotic-resistant, antiviral-resistant, or vaccine-resistant strains, because it is not targeting the pathogen per se.

In cooperative co-evolution, there is an incentive for us (or any infested animal) to develop methods to both prevent collateral damage to ourselves, as well as fix it when it occurs. That is the essence of the tolerance system. What Ayres and her colleagues are doing is describing these mechanisms—in minute molecular detail—in the body, and learning to read how organisms that are co-evolving with their hosts are communicating with them—sending signals back and forth. Ideally, the lab would ultimately learn how to use this information to enhance co-evolution in some way, to treat disease.

Ayres’ approach to COVID is not to minimize other approaches but point out that “if we can step beyond our focus on the virus,” there is much more we can learn. For instance, it was assumed early in the pandemic, that severe cases were caused by high viral load, and now we know it is the secondary collateral damage caused by our bodies that is the real killer.

Fewer and fewer medical schools now require the graduating physician to take the ancient Hippocratic oath, the first recorded articulation of medical ethics, that sanctified medical confidentiality and the idea that the doctor worked for his or her patient, and not a third party. How sad, how telling.

It is the same Hippocrates, who boiled all medicine down to two principles in his Epidemics Book I, “Practice two things in your dealing with disease: either help or do not harm the patient.”

And, in this light—of doing no harm, or at least far less—we might remember that we are part of nature, depend on it, it lives in us, and we have links to parts we think remote from us, that we often cannot even see. We might consider setting aside the utopian dream that always becomes a nightmare, because all too often we can’t conquer nature without conquering ourselves.

See Also:

The Virus Wars

Rx for Covid-fighting Politicians

Twelve Forgotten Principles of Public Health




John Christy Rebuts Climatist Fake Smear Job

The cancel culture is driven by fears that a contrary point of view might be truer than one’s own way of thinking.  Dissing the messenger, and deplatforming if possible, is easier than reflection and self-examination.  Thus has John Christy been attacked and recently responded in his quiet and reasonable manner.  The article at is John Christy: We don’t ‘attack science’.  Excerpts in italics with my bolds.

On Nov 2nd 2020 InsideClimate News (ICN) and published a fairly long (5,000 words!) profile on the climate research that Dr. Roy Spencer and I perform at The University of Alabama in Huntsville. They spent a good bit of time criticizing our satellite data as well as my personal life. The article seems schizophrenic at times, bouncing from highly critical assertions to a depiction of me as a sort of nice, hardworking, churchgoing Alabama scientist.

A major problem here is the technique of quoting antagonists of our work, without giving us a chance to respond. This is the modus operandi of advocacy-journalism. Add to that the numerous editorialized opinions such as, “… Christy’s data have been corrected repeatedly and his conclusions contradicted time and again …” A look at the record indicates this is not so.

But with all of the misleading claims, I’m able to forgive the reporters because they also say, “… he looks 69 going on 50 …” Awesome. How could a 69-year-old not love that?

Unfortunately, ICN ran the story as part of series called “The Anti-Scientists” that explores “the Trump Administration’s attacks on the science underlying environmental protections.” However, kudos to for including a link to my congressional testimony so the reader could hear my on-the-record story.

It should be clear to all that this agendized “hit-piece” (as we call it), is designed to discredit me, but the truth is, we don’t “attack science,” we “employ science.” Now, I’ve always been told, never pick a fight with someone who buys ink (cloud-storage) by the barrel (terabyte), but here it goes.

In 1990, Roy and I created and today still publish monthly values of the global temperature of three atmospheric layers from satellite measurements. A 1997 paper suggested our dataset had abrupt “downward” jumps. In response, we demonstrated the purported jumps were found in the sea water temperatures they used, not in the deep atmosphere we measured – so they were mixing apples and oranges. The next claim stating there are gaps in the satellite record is just false as every new satellite is directly calibrated to a satellite already in orbit. Later, scientists in Washington State misled the community with papers that (1) allegedly discovered “contamination” of one of our products by stratospheric influence, and (2) that our correction to account for the satellite’s east-west drift over time was wrong.

Neither complaint applied to our datasets. We had always published accurate representations of what our products measured including the stratospheric impact.

In fact, 12 years earlier we created one without the stratospheric influence to deal with this issue directly. The second complaint was moot because we had already adopted an advanced, observations-based adjustment for the east-west drift, while their proposed model-based correction had serious problems.

Early on, though, the very clever scientists at Remote Sensing Systems in California discovered two issues with our dataset, both of which were immediately remedied 15 and 20 years ago respectively with only very small impacts.

While we recognize no dataset is perfect, a detailed evaluation of our temperature products was published in 2018, demonstrating that ours outperforms other satellite products when compared against independent data. Why was this not mentioned?

Another scientist appears to refute our explicit conclusion that climate models are unrealistically aggressive in depicting the atmosphere’s warming rate. This is important because regulatory policies advocated in the media which include price-hikes for all our energy, are based on fears engendered by these models.

Again, our conclusion has stood the test of time, (that scientist published a similar result later). Even this year, more published studies continue to show climate models are poor tools for policy decision—they can’t reproduce the climate that has already happened, and they don’t agree with each other about the future.

Then, the clumsy attempt to connect me with an anti-evolution movement was misguided. The reporters would be chagrined to learn that I had testified before the Alabama State Board of Education advocating the removal of the “Evolution Disclaimer” from biology textbooks. Even the NY Times, of all places, took note and quoted me on the issue (Feb. 1, 2005.) So again, doing a little fact-checking rather than following today’s “jump-to-(my-biased)-conclusion” reporting style, would have saved us all some trouble.

Finally, a broader question to ask is this, “Why was so much effort and expense proffered to try to discredit a scientist like me?”

By the way, the title, “When Trump’s EPA needed a climate scientist, they called on Alabama’s John Christy” misinforms. I saw a federal notice asking for applications for the EPA Science Advisory Board and sent mine in, just like the others. I was eventually selected, based on my credentials, to be one of its 45 members.

But, the line that still carries the day for me is, ” … he looks 69 going on 50.”

Footnote:  Christy quote:

“The reason there is so much contention regarding “global warming” is relatively simple to understand: In climate change science we basically cannot prove anything about how the climate will change as a result of adding extra greenhouse gases to the atmosphere.

So we are left to argue about unprovable claims.”

John R. Christy | Climate science isn’t necessarily ‘settled’

See also: Christy’s Common Sense about Climate

Note: John Christy of the University of Alabama at Huntsville testified before the House of Representatives Natural Resources Committee on May 13, 2015, but his opening statement has been purged from the committee’s website.  In addition to the video above, his statement that day is available here.

Desire for Power Hiding Behind Health and Climate Concerns

Theodore Dalrymple writes at Epoch Times The Desire for Power Hiding Behind Health and Climate Concerns.  Excerpts in italics with my bolds.

There is a threat of creeping totalitarianism in western societies that comes from health and climate activists. Who (except unfeeling monsters) could possibly be against the saving of human life or the preservation of the planet from future catastrophe? Often the two strands of redemptive enthusiasm go together: after all, environmental degradation is hardly good for health.

Since almost all human activities have health or environmental consequences, especially bad ones, it follows that those who want to preserve either human health or the environment, or both, have an almost infinitely expansible justification for interfering in our lives, indeed they have it to the nth degree.

These days, much medical research that is published in the general medical journals such as the Lancet or the New England Journal of Medicine is epidemiological rather than experimental.

It finds associations between factor a (shall we say, the consumption of bananas) and illness x (shall we say, Alzheimer’s disease).

Once an association is found that is unlikely to have arisen by chance (unlikely, that is, but not impossible), an hypothesis is put forward as to why the eating of bananas should conduce to the development of Alzheimer’s disease. Before long, the statistical association and its alleged explanation leaks out into the press or social media, and people start to be afraid of bananas. The more enthusiastic and less sceptical of the epidemiologists begin to call for banana controls: anti-banana propaganda, extra taxes on bananas, no bananas on sale within a hundred yards of anywhere there might be a child, and so on.

And of course, a reduction in the demand for bananas will assist those tropical countries large parts of which are given over to environmentally-degrading banana monoculture. Banana republics are not called bananas republics for nothing.

Often in the medical literature, the statistical associations are weak: someone who consumes a is, say, 1.2 times more likely to develop disease x than someone who does not. This is described as being a statistically significant increase in risk, but it is not significant in any other humanly important way, especially where the initial risk of contracting the disease is very low in any case. These caveats are often, even usually, missing from not only the scientific literature itself, but from the reports of it that filter into the general public’s awareness.

Not infrequently, sweeping policy changes are proposed on the basis of weak evidence which not only is likely to be superseded in time by new research (though dietary recommendations for the most part they are not very different from those recommended by physicians such as Dr. George Cheyne in the first half of the eighteenth century), but which fail to take into account that health, while an important consideration, is not an all-important consideration, and sometimes must be balanced against others.

For example, it would be easy to reduce the fatal road accident rate to zero by forbidding everyone to leave his house, but this might not be a wise prohibition. Sport is one of the most frequent causes of injury in the western world, yet sport is encouraged because of its other (alleged) benefits.

Good Intentions a Smokescreen

Supposed good intentions are often a smokescreen for an almost sadistic desire to exercise power, or at least influence. A writer of editorials for the influential British newspaper, the Observer, Sonia Sodha, has suggested, for example, that meat should be rationed. She suggests such a measure not because there is a shortage of meat, but because the environmental cost of producing it is too great.

She opposes a tax on it to lower consumption because raising the price would affect the poor more than the rich. The only other solution is to ration it, so that everyone has access to an equal, but small, quantity.

The author is honest enough to admit that she is a hypocrite in the sense that, while she strongly believes meat consumption should decrease in order to save the planet, she will continue to eat it in her accustomed quantities so long as it is available to her. She needs a dictator to get her to do the right thing.

The really striking thing in her article is that she does not consider the kind of apparatus that would be necessary to ration a commodity such as meat. Someone would have to set the ration and many people would have to enforce it.

Evidently, she has never heard of or experienced black markets; nor does she seem to be aware that, where a bureaucracy allocates or distributes goods and services, especially when they are in short supply, privilege flourishes rather than withers.

Nor does she acknowledge that meat is far from the only commodity with a high environmental cost, and that the argument for the rationing of meat could be used for the rationing of many, if not most or even all, commodities.

What the author is proposing, then, implicitly or explicitly, is a kind of communism, in which an administrative class under the direction of an even smaller class of enlightened and informed individuals doles out to the populace what it thinks it ought to have—for its own ultimate good, of course.

The author is certainly intelligent enough to realize that this is the implication or corollary of what she writes (and, to do her justice, she writes very clearly), so one must conclude that a society in which a great deal, if not everything, is rationed first in the name of protecting the environment and second in the name of social justice is one that would be pleasing to her—at least to contemplate in the abstract, if not actually to live in.

That this drastic and very far-reaching scheme is based upon evidence that is itself far from rock-solid or indisputable would probably not worry her very much, because the end result (the theoretical end result, that is, not the end result in practice) is one which she desires a priori: in other words, first the policy, and then the evidence to justify it.

As it happens, more and more young people in western countries are turning to vegetarianism by means of persuasion. I have no objection to this; I think on balance that it is probably a good thing. But no giant state apparatus was necessary to bring this about. It is a change that has welled up from below, not imposed from the top down, and requires no corrupting means of coercion to enforce.

Theodore Dalrymple is a retired doctor. He is contributing editor of the City Journal of New York and the author of 30 books, including “Life at the Bottom.” His latest book is “Embargo and Other Stories.”

Hydroxychloroquine: A Morality Tale

Norman Doige writes in The Tablet A startling investigation into how a cheap, well-known drug became a political football in the midst of a pandemic.  Excerpts in italics with my bolds.

We live in a culture that has uncritically accepted that every domain of life is political, and that even things we think are not political are so, that all human enterprises are merely power struggles, that even the idea of “truth” is a fantasy, and really a matter of imposing one’s view on others. For a while, some held out hope that science remained an exception to this. That scientists would not bring their personal political biases into their science, and they would not be mobbed if what they said was unwelcome to one faction or another. But the sordid 2020 drama of hydroxychloroquine—which saw scientists routinely attacked for critically evaluating evidence and coming to politically inconvenient conclusions—has, for many, killed those hopes.

Phase 1 of the pandemic saw the near collapse of the credible authority of much of our public health officialdom at the highest levels, led by the exposure of the corruption of the World Health Organization. The crisis was deepened by the numerous reversals on recommendations, which led to the growing belief that too many officials were interpreting, bending, or speaking about the science relevant to the pandemic in a politicized way. Phase 2 is equally dangerous, for it shows that politicization has started to penetrate the peer review process, and how studies are reported in scientific journals, and of course in the press.

What is unique about the hydroxychloroquine discussion is that it is a story of “unwishful thinking”—to coin a term for the perverse hope that some good outcome that most sane people would earnestly desire, will never come to pass. It’s about how, in the midst of a pandemic, thousands started earnestly hoping—before the science was really in—that a drug, one that might save lives at a comparatively low cost, would not actually do so. Reasonably good studies were depicted as sloppy work, fatally flawed. Many have excelled in making counterfeit bills that look real, but few have excelled at making real bills look counterfeit. As such, as we sort this out, we shall observe not only some “tricks” about how to make bad studies look like good ones, but also how to make good studies look like bad ones. And why should anyone facing a pandemic wish to discredit potentially lifesaving medications? Well, in fact, this ability can come in very handy in this midst of a plague, when many medications and vaccines are competing to Save the World—and for the billions of dollars that will go along with that.

So this story is twofold. It’s about the discussion that unfolded (and is still unfolding) around hydroxychloroquine, but if you’re here for a definitive answer to a narrow question about one specific drug (“does hydroxychloroquine work?”), you will be disappointed. Because what our tale is really concerned with is the perilous state of vulnerability of our scientific discourse, models, and institutions—which is arguably a much bigger, and more urgent problem, since there are other drugs that must be tested for safety and effectiveness (most complex illnesses like COVID-19 often require a group of medications) as well as vaccines, which would be slated to be given to billions of people. “This misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence,” Yale professor of epidemiology Harvey A. Risch recently argued. Why not start studying it now?

Norman Doige tells the story in some detail (see article link in red at the top)

  • the history of quinine, chloroquine, and HCQ medical effectiveness;
  • how HCQ was used against SARS CV2 early on;
  • how Raoult was the one in his lab who came up with the idea of combining the two older drugs, HCQ and azithromycin, for COVID-19;
  • the criticisms of the French studies exemplifying “unwishful thinking”;
  • Trump’s interest in HCQ and the media backlash against the medicine;
  • the failure of ICU treatment protocols with ventilators and no alternatives to off-label prescribing;
  • the insistence upon Randomized Controlled Trials (RCTs) as the only valid test for HCQ;
  • the confounding factors in such studies and the problems replicating RCT results; and,
  • the publication in high-profile journals of studies structured for HCQ to fail to help infected patients.

Conclusion from Doige

Lots and lots of COVID-19 studies will come out—several hundred are in the works. People will hope more and more accumulating numbers—and more big data—will settle it. But big data, interpreted by people who have never treated any of the patients involved can be dangerous, a kind of exalted nonsense. It’s an old lesson: Quantity is not quality.

On this, I favor the all-available-evidence approach, which understands that large studies are important, but also that the medication that might be best for the largest number of people may not be best one for an individual patient. In fact, it would be typical of medicine that a number of different medications will be needed for COVID-19, and that there will be interactions of some with patient’s existing medications or conditions, so that the more medications we have to choose from, the better. We should be giving individual clinicians on the front lines the usual latitude to take account of their individual patient’s condition, and preferences, and encourage these physicians to bring to bear everything they have learned and read (they have been trained to read studies), and continue to read, but also what they have seen with their own eyes. Unlike medical bureaucrats or others who issue decrees from remote places physicians are literally on our front lines—actually observing the patients in question, and a Hippocratic Oath to serve them—and not the Lancet or WHO or CNN.

As contentious as this debate has been, and as urgent as the need for informed and timely information seems now, the reason to understand what happened with HCQ is for what it reflects about the social context within which science is now produced:

  • a landscape overly influenced by technology and its obsession with big data abstraction over concrete, tangible human experience;
  • academics who increasingly see all human activities as “political” power games, and so in good conscience can now justify inserting their own politics into academic pursuits and reporting;
  • extraordinarily powerful pharmaceutical companies competing for hundreds of billions of dollars;
  • politicians competing for pharmaceutical dollars as well as public adoration—both of which come these days too much from social media; and,
  • the decaying of the journalistic and scholarly super-layers that used to do much better holding everyone in this pyramid accountable, but no longer do, or even can.

If you think this year’s controversy is bad, consider that hydroxychloroquine is given to relatively few people with COVID-19, all sick, many with nothing to lose. It enters the body, and leaves fairly quickly, and has been known to us for decades. COVID vaccines, which advocates will want to be mandatory and given to all people—healthy and not, young and old—are being rushed past their normal safety precautions and regulations, and the typical five-to-10-year observation period is being waived to get “Operation Warp Speed” done as soon as possible.

This is being done with the endorsement of public health officials—the same ones, in many cases who are saying HCQ is suddenly extremely dangerous.

Philosophically, and psychologically, it is a fantastic spectacle to behold, a reversal, the magnitude and the chutzpah of which must inspire awe: a public health establishment, showing extraordinary risk aversion to medications and treatments that are extremely well known, and had been used by billions, suddenly throwing caution to the wind and endorsing the rollout of treatments that are entirely novel—and about which we literally can’t possibly know anything, as regards to their long-term effects. Their manufacturers know this well themselves, which is why they have aimed for, insisted on, and have already been granted indemnification—guaranteed, by those same public health officials and government that they will not be held legally accountable should their product cause injury.

From unheard of extremes of caution and “unwishful thinking,” to unheard of extremes of risk-taking, and recklessly wishful thinking, this double standard, this about-face, is not happening because this issue of public safety is really so complex a problem that only our experts can understand it; it is happening because there is, right now, a much bigger problem: with our experts, and with the institutions that we had trusted to help solve our most pressing scientific and medical problems.

Unless these are attended to, HCQ won’t be remembered simply as that major medical issue that no one could agree on, and which left overwhelming controversy, confusion, and possibly unnecessary deaths of tens of thousands in its wake; it will be one of many in a chain of such disasters.

Norman Doidge, a contributing writer for Tablet, is a psychiatrist, psychoanalyst, and author of The Brain That Changes Itself and The Brain’s Way of Healing.


Update: Stories vs. Facts

This post revisits a previous discussion of how public discourse is increasingly governed by stories at the expense of facts.  The recent street violence provides another example.  NYT columnist Bari Weiss provides an insider’s look at how the media produces stories instead of reports.

Bari Weiss Twitter Thread

The civil war inside The New York Times between the (mostly young) wokes the (mostly 40+) liberals is the same one raging inside other publications and companies across the country. The dynamic is always the same. (Thread.)

The Old Guard lives by a set of principles we can broadly call civil libertarianism. They assumed they shared that worldview with the young people they hired who called themselves liberals and progressives. But it was an incorrect assumption.

The New Guard has a different worldview, one articulated best by @JonHaidt and @glukianoff. They call it “safetyism,” in which the right of people to feel emotionally and psychologically safe trumps what were previously considered core liberal values, like free speech.

Perhaps the cleanest example of this dynamic was in 2018, when David Remnick, under tremendous public pressure from his staffers, disinvited Steve Bannon from appearing on stage at the New Yorker Ideas Festival. But there are dozens and dozens of examples.

I’ve been mocked by many people over the past few years for writing about the campus culture wars. They told me it was a sideshow. But this was always why it mattered: The people who graduated from those campuses would rise to power inside key institutions and transform them.

I’m in no way surprised by what has now exploded into public view. In a way, it’s oddly comforting: I feel less alone and less crazy trying to explain the dynamic to people. What I am shocked by is the speed. I thought it would take a few years, not a few weeks.

Here’s one way to think about what’s at stake: The New York Times motto is “all the news that’s fit to print.” One group emphasizes the word “all.” The other, the word “fit.”

W/r/t Tom Cotton’s oped and the choice to run it: I agree with our critics that it’s a dodge to say “we want a totally open marketplace of ideas!” There are limits. Obviously. The question is: does his view fall outside those limits? Maybe the answer is yes.

If the answer is yes, it means that the view of more than half of Americans are unacceptable. And perhaps they are.

“A plurality of Democrats would support calling in the U.S. military to aid police during protests,…
President Trump on Monday threatened to call in the United States military in an effort to curtail protests across the United States, and it turns out most Americans — even some of those who think the president is doing a poor job of handling the demonstrations against police brutality — would support such an action.”

Background from Previous Post

Facts vs Stories is written by Steven Novella at Neurologica. Excerpts in italics with my bolds.

There is a common style of journalism, that you are almost certainly very familiar with, in which the report starts with a personal story, then delves into the facts at hand often with reference to the framing story and others like it, and returns at the end to the original personal connection. This format is so common it’s a cliche, and often the desire to connect the actual new information to an emotional story takes over the reporting and undermines the facts.

This format reflects a more general phenomenon – that people are generally more interested in and influenced by a good narrative than by dry facts. Or are we? New research suggests that while the answer is still generally yes, there is some more nuance here (isn’t there always?). The researchers did three studies in which they compared the effects of strong vs weak facts presented either alone or embedded in a story. In the first two studies the information was about a fictitious new phone. The weak fact was that the phone could withstand a fall of 3 feet. The strong fact was that the phone could withstand a fall of 30 feet. What they found in both studies is that the weak fact was more persuasive when presented embedded in a story than alone, while the strong fact was less persuasive.

They then did a third study about a fictitious flu medicine, and asked subjects if they would give their e-mail address for further information. People are generally reluctant to give away their e-mail address unless it’s worth it, so this was a good test of how persuasive the information was. When a strong fact about the medicine was given alone, 34% of the participants were willing to provide their e-mail. When embedded in a story, only 18% provided their e-mail.  So, what is responsible for this reversal of the normal effect that stories are generally more persuasive than dry facts?

The authors suggest that stories may impair our ability to evaluate factual information.

This is not unreasonable, and is suggested by other research as well. To a much greater extent than you might think, cognition is a zero-sum game. When you allocate resources to one task, those resources are taken away from other mental tasks (this basic process is called “interference” by psychologists). Further, adding complexity to brain processing, even if this leads to more sophisticated analysis of information, tends to slow down the whole process. And also, parts of the brain can directly suppress the functioning of other parts of the brain. This inhibitory function is actually a critical part of how the brain works together.

Perhaps the most dramatic relevant example of this is a study I wrote about previously in which fMRI scans were used to study subjects listening to a charismatic speaker that was either from the subjects religion or not. When a charismatic speaker that matched the subject’s religion was speaking, the critical thinking part of the brain was literally suppressed. In fact this study also found opposite effects depending on context.

The contrast estimates reveal a significant increase of activity in response to the non-Christian speaker (compared to baseline) and a massive deactivation in response to the Christian speaker known for his healing powers. These results support recent observations that social categories can modulate the frontal executive network in opposite directions corresponding to the cognitive load they impose on the executive system.

So when listening to speech from a belief system we don’t already believe, we engaged our executive function. When listening to speech from within our existing belief system, we suppressed our executive function.

In regards to the current study, is something similar going on? Does processing the emotional content of stories impair our processing of factual information, which is a benefit for weak facts but actually a detriment to the persuasive power of strong facts that are persuasive on their own?

Another potential explanation occurs to me, however (showing how difficult it can be to interpret the results of psychological research like this). It is a reasonable premise that a strong fact is more persuasive on it’s own than a weak fact – being able to survive a 3 foot fall is not as impressive as a 30 foot fall. But, the more impressive fact may also trigger more skepticism. I may simply not believe that a phone could survive such a fall. If that fact, however, is presented in a straightforward fashion, it may seem somewhat credible. If it is presented as part of a story that is clearly meant to persuade me, then that might trigger more skepticism. In fact, doing so is inherently sketchy. The strong fact is impressive on its own, why are you trying to persuade me with this unnecessary personal story – unless the fact is BS.There is also research to support this hypothesis. When a documentary about a fringe topic, like UFOs, includes the claim that, “This is true,” that actually triggers more skepticism. It encourages the audience to think, “Wait a minute, is this true?” Meanwhile, including a scientists who says, “This is not true,” may actually increase belief, because the audience is impressed that the subject is being taken serious by a scientist, regardless of their ultimate conclusion. But the extent of such backfire effects remains controversial in psychological research – it appears to be very context dependent.

I would summarize all this by saying that – we can identify psychological effects that relate to belief and skepticism. However, there are many potential effects that can be triggered in different situations, and interact in often complex and unpredictable ways. So even when we identify a real effect, such as the persuasive power of stories, it doesn’t predict what will happen in every case. In fact, the net statistical effect may disappear or even reverse in certain contexts, because it is either neutralized or overwhelmed by another effect. I think that is what is happening here.

What do you do when you are trying to be persuasive, then? The answer has to be – it depends? Who is your audience? What claims or facts are you trying to get across? What is the ultimate goal of the persuasion (public service, education, political activism, marketing)? I don’t think we can generate any solid algorithm, but we do have some guiding rules of thumb.

First, know your audience, or at least those you are trying to persuade. No message will be persuasive to everyone.

If the facts are impressive on their own, let them speak for themselves. Perhaps put them into a little context, but don’t try to wrap them up in an emotional story. That may backfire.

Depending on context, your goal may be to not just provide facts, but to persuade your audience to reject a current narrative for a better one. In this case the research suggests you should both argue against the current narrative, and provide a replacement that provides an explanatory model.

So you can’t just debunk a myth, conspiracy theory, or misconception. You need to provide the audience with another way to make sense of their world.

When possible find common ground. Start with the premises that you think most reasonable people will agree with, then build from there.

Now, it’s not my goal to outline how to convince people of things that are not true, or that are subjective but in your personal interest. That’s not what this blog is about. I am only interested in persuading people to portion their belief to the logic and evidence. So I am not going to recommend ways to avoid triggering skepticism – I want to trigger skepticism. I just want it to be skepticism based on science and critical thinking, not emotional or partisan denial, nihilism, cynicism, or just being contrarian.

You also have to recognize that it can be difficult to persuade people. This is especially true if your message is constrained by facts and reality. Sometimes the real information is not optimized for emotional appeal, and it has to compete against messages that are so optimized (and are unconstrained by reality). But at least know the science about how people process information and form their beliefs is useful.

Postscript:  Hans Rosling demonstrates how to use data to tell the story of our rising civilization.

Bottom Line:  When it comes to science, the rule is to follow the facts.  When the story is contradicted by new facts, the story changes to fit the facts, not the other way around.

See also:  Data, Facts and Information

Coronavirus Statistical Games

Robert Stacy McCain writes at the Spectator Coronavirus: Statistical Stupidity Excerpts in italics with my bolds and images.

Why were “smart” people so wrong about this pandemic?

Two weeks ago, Dr. Deborah Birx warned against doomsday predictions that millions of Americans might die from coronavirus. At a White House press briefing on March 25, the coordinator of President Trump’s task force condemned media speculation based on claims that as much as half the country’s population might become infected with COVID-19. “I think the numbers that have been put out there are actually very frightening to people,” said Birx, adding that reported rates of infection in China, where the virus originated, were “nowhere close to the numbers that you see people putting out there. I think it has frightened the American people.”

Birx did not name MSNBC personality Chris Hayes, although he was one of the worst scaremongers in the media mob. On his March 23 program, Hayes warned that “millions of lives are on the line” if the economic lockdown response to the virus was not extended indefinitely: “There is no option to just let everyone go back out and go back to normal if a pandemic rages across the country and infects 50 percent of the population and kills a percentage point at the low end of those infected and also melts down all the hospitals.” Applying simple arithmetic to that sentence — treating it like one of those word problems we learned to do in middle-school math class — we find that 50 percent of the U.S. population is more than 160 million people infected with COVID-19. If just 1 percent of those infected died from the virus, that would mean a death toll of at least 1.6 million.

The word “if” signifies a hypothetical contingency, but the way Hayes used the word implied a predictive quality to his speculation about “millions of lives” at jeopardy in a rampaging coronavirus outbreak. And who can say, really, what might have happened in some imagined alternative scenario? As it happened in real life, however, Trump decided to extend the “social distancing” policy to April 30, most Americans took the recommended precautions seriously, and there is already evidence that we have begun to “flatten the curve,” so that the final U.S. death toll of COVID-19 will likely be a mere fraction of the “millions” about which Hayes warned last month.

Chris Hayes is not stupid, and neither are the scientists whose forecasting models wildly exaggerated the trajectory of this pandemic. Smart people can be wrong, too. Monday, just hours after I called attention to the failure of these doomsday prophecies (“Coronavirus: The Wrong Numbers”), the widely cited Institute for Health Metrics and Evaluation (IHME) made headlines by revising their forecast: “Key Coronavirus Model Now Predicts Many Fewer U.S. Deaths” (New York magazine), “Dramatic Reduction in COVID-19 Disaster Projections” (National Review), and “Coronavirus Model Now Estimates Fewer U.S. Deaths” (U.S. News & World Report), to cite a few.

Why were the original IMHE projections, first published March 26, so far off the mark? We don’t know. Perhaps the scientists underestimated the efficacy of the “mitigation” measures Trump announced March 16. Or possibly the use of chloroquine — which Trump controversially called a “game changer” — to combat the virus was more successful than any of the president’s critics are willing to admit. But the fact is, the projection models were wrong, and the gap between what was predicted and what actually happened became apparent within a matter of days. By April 1, as Justin Hart pointed out, the number of COVID-19 patients hospitalized was less than a third of the number projected by the IHME model. In their revised forecast issued Monday, IHME lowered its estimate of total U.S. coronavirus deaths by 12 percent, from 93,531 down to 81,766.

Even this revised forecast may be too pessimistic, however. At his Tuesday press conference, New York Gov. Andrew Cuomo, whose state is the epicenter of the U.S. outbreak, spoke of a “plateau” in the number of COVID-19 cases in the state’s hospitals, with about 17,500 patients currently hospitalized, about 4,600 of those in intensive-care units. This is very bad, but it is not the system-crashing catastrophe Cuomo was anticipating when, at a March 24 press conference, he angrily shouted that a shortage of ventilators would cause 26,000 unnecessary deaths in the state. While we cannot predict future events, it appears that New York now has more ventilators than will ever be needed to cope with the coronavirus outbreak — and this is good news.

Such hopeful signs that we have avoided the worst-case scenarios are probably little comfort to doctors and nurses working double shifts to cope with the COVID-19 patient load in New York City and its suburbs, or in other places around the country dealing with severe local outbreaks of the virus. At Monday’s White House briefing, Birx spoke of her team’s tracking of the pandemic at a “county by county” level, citing Detroit and New Orleans as examples of the hot spots where federal authorities are helping communities cope with the problem. At a time when more than 1,000 Americans are dying daily from this disease, the good news — that the pandemic is falling short of the catastrophe previously predicted — is a matter of comparison between a reality that is still quite bad and a doomsday scenario where MSNBC viewers were told that “millions of lives” might be lost.

What was Chris Hayes doing when he hyped fears of a raging pandemic that would overwhelm the health-care system and kill 1.6 million Americans, 200 times more than the 80,000 currently projected by the IMHE model? He was blaming Trump for having failed to prevent the approaching “doom and death.” The more deaths, the more blame — that was apparently why the Greek chorus of media fear-mongers (Hayes was by no means alone in this) were so eager to promote the worst-case scenarios that did not materialize. America’s coronavirus death rate (39 per 1 million residents) is currently a fraction of the rates in several European countries, including Spain (300 per million), Italy (283 per million), France (158 per million), and Belgium (176 per million). Trump’s critics accuse our president of failing to prepare America for this crisis, but where is their criticism for the leaders of the European countries, who, as measured by statistics, failed far worse? Dead people are not statistics, of course, and many thousands of Americans are now fighting for their lives against this Chinese virus.

Oh, wait — we’re not allowed to mention where this disease came from, are we? One might hope that Chris Hayes and the other media fear-mongers would spend more time blaming the communist regime in Beijing and less time accusing our president of malicious indifference to American lives. But we should not think the media’s failures prove that they’re stupid.

They’re smart people who know exactly what they’re doing. And they should be ashamed of themselves.

See Also: Canadian Flu vs. Kung Flu

A Lesson in Mortality

Coronavirus Infographics

Daily Disease Deaths 23032020

H/T Vaughn Pratt for pointing to this graphic providing context for the current pandemic.

Update March 23: CV updates and Additional slides at end

For each COVID-19 death per average day, 105 people die of worse diseases as measured by average daily death rate.

This is the 9th graphic in the Covid 19 Coronavirus Infographic Datapack at Information is Beautiful.

The final graphic is this one:Covid19 media mentions

Update March 23:  Since so much concern is driven by the death statistics, bear these facts in mind:

CV19 mild screen


CV19 Conditions

CV19 Conditions +Risk

Update March 29. 2020

Roger Kimball quotes Dr. John Lee regarding the implications of the above charts in his article It’s Not a Choice Between Lives or the Economy

Finally, a word about the difference between “from” and “with.” Over the past few weeks, I have been predicting a modest fatality rate from COVID-19. I began by predicting no more than a couple of hundred deaths and then upped my prediction to a 1,000-1,200. As of today, the number of deaths attributed to the virus is just over 2,000. So I was wrong about that.

Or was I? It is one thing to die from the effects of the coronavirus, quite another to die with the virus. Let’s say you are 87 years old, diabetic, with congestive heart failure and emphysema. You are infected with the coronavirus, get sick, and die. Did you die from it, or merely with it?

This is a point that Dr. John Lee, a retired professor of pathology in the United Kingdom, made in Spectator USA. “There is a big difference,” he writes, “between Covid-19 causing death, and Covid-19 being found in someone who died of other causes. . . . Much of the response to Covid-19 seems explained by the fact that we are watching this virus in a way that no virus has been watched before. The scenes from the Italian hospitals have been shocking, and make for grim television. But television is not science.”

First do no harm.” Dr. Lee is right to warn that the panicked response to this new virus has neglected that age-old medical advice. “Unless,” he notes, “we tighten criteria for recording death due only to the virus (as opposed to it being present in those who died from other conditions), the official figures may show a lot more deaths apparently caused by the virus than [are] actually the case. What then? How do we measure the health consequences of taking people’s lives, jobs, leisure and purpose away from them to protect them from an anticipated threat? Which causes the least harm?”

That is an excellent question. Also excellent is his concluding observation that “The moral debate is not lives vs. money. It is lives vs. lives.”

Dr. Drew: Stop the Press to Stop Coronavirus Panic

At Real Clear Politics, Coronavirus Panic Must Stop, Press Needs to Be Held Accountable for Hurting People.  Excerpts in italics with my bolds.

Dr.Drew Pinsky talks with CBS Local’s DJ Sixsmith about coronavirus: “The panic must stop. And the press, they really somehow need to be held accountable because they are hurting people.”

CBS NEWS: “So you’ve seen pandemics over the decades, how does this one compare with everything?”

DR. DREW: “A bad flu season is 80,000 dead, we’ve got about 18,000 dead from influenza this year, we have a hundred from corona. Which should you be worried about influenza or Corona? A hundred versus 18,000? It’s not a trick question. And look, everything that’s going on with the New York cleaning the subways and everyone using Clorox wipes and get your flu shot, which should be the other message, that’s good. That’s a good thing, so I have no problem with the behaviors. What I have a problem with is the panic and the fact that businesses are getting destroyed that people’s lives are being upended, not by the virus, but by the panic. The panic must stop. And the press, they really somehow need to be held accountable because they are hurting people.”

CBS NEWS: “So, where do you think the panic started? Besides the press, like what was the impetus in terms of mass hysteria?”

DR. DREW: “I saw it, there’s a footage of me on a show called The Daily Blast Live a month ago, going ‘shouldn’t we be scared about this?’ and me going ‘no, there’s gonna be as potential for panic here, shut up everybody, stop talking about it, I could see the panic brewing, and I could just see it the way the innuendo and the every opportunity for drama by the press was twisted in that direction. Let me give you an example: so the World Health Organization is out now saying the fatality rate from the virus is 3.4%, right? Every publication from the WHO says 3.4% and we expect it to fall dramatically once we understand the full extent of the illness. No one ever reports the actual statement. We go 3.4% that’s 10 times more than the, whatever five times more than the flu virus and yeah it’s gonna be a little more [than the] flu probably. Still not a bad flu season.”

CBS NEWS: “Right, we’re gonna hear about more cases, more people died.”

DR. DREW: “There are probably several people in this building that probably have it and don’t know it.”

CBS NEWS: “Right, well it was also just the process of letting the public know, the stock market, the number of tests that were available, there was so much happening, I think people were freaking out as a result of that.”

DR. DREW: “I think there was it was a concerted effort by the press to capture your eyes and in doing so they did it by inducing panic. There’s, listen, the CDC and the WHO, they know what they are doing, they contain pandemics, that’s how they know how to do it, they’re doing an amazing job.”

CBS NEWS: “What about the global implications of this because we were talking off-camera about Italy, there’s China as well, there’s some little outbreaks where you should avoid.

DR. DREW: “There are, I would look out where there flus out breaking bad to. I ended up getting the bird flu, I got H1N1 and it was horrible. It was no fun. … There’s certain things having been a physician for almost forty years, there are certain things I just know … and there’s certain things I just know by virtue of all the experience I’ve had and so when I saw this one coming, the corona, I thought I know how this is gonna go, I see kind of what it is and then I saw the excessive reaction the press, so I have to respond and then people, the weird part on social media towards me as people are angry with me, angry with me for trying to get them to see reality and calm down.”

Then there are wise words from Czech Microbiologist Dr Václava Adámková , posted at Lubos Motl’s website Reference Frame Czech microbiologist on the Covid panic  Excerpts in italics with my bolds.

Well, I would criticize them for purposefully and uselessly manipulating with the populace of the laymen. And the tone in which the news are being presented – there is one case here… Well, there’s one case here, five cases a day or eight cases a day today. It’s 8 cases. During that time, much more serious infectious diseases, viral or bacterial ones, actually kill many more people. And that’s something that is not included in the context of that information. So the announcements seem populist, one-sided, and they resemble a politician’s campaign before the elections when the politician focuses on one topic and he escalates it.

I am not quite a virologist, closer to a bacteriologist. Anyway, coronaviruses have been with us from the beginning. It is a large group of viruses that cause respiratory diseases, runny nose, cough, exceptionally diseases of the lower respiratory tract. But when we statistically test the coronaviruses every year, they cause up to 18% of respiratory infections. No one talks about it. These viruses attack all age groups, from babies to seniors. That’s how things work. Sometimes they appear along with other viruses, most often with influenza viruses. The coronaviruses have always been here, are here, and will be here. When the virus mutates, merges the genes with something, that’s how Nature and biology works. They may do whatever seems good in their context. We see it in flu, too.

I don’t really believe that the Wuhan virus differs. If we look at it from the healthcare perspective, according to symptoms – Covid is mostly about mild symptoms in the upper respiratory tract, especially among young and not immunocompromised people. And even the fatalities described in the context of this virus are compatible with the biology of this virus. Even the other coronaviruses may kill a weakened individual. But the available mortality numbers, let’s accept them, simply describe the reality. In comparison with SARS and MERS, Covid has a much lower fatality rate. Nevertheless, SARS and MERS didn’t get this much attention.

Some 3 months ago, the WHO was just warning about the infectious disease, most likely a viral and not bacterial one, that may quickly spread due to the widespread travelling. The main WHO virologist just made this speculation. It’s interesting that this has happened. It may easily spread, in theory. However, in practice, the propagation of the news occurs much more quickly than the propagation of the virus itself. It is spreading like a computer virus, not a biological virus, because the numbers of infected ones remain low. Around 80,000 Chinese is a tiny fraction of China’s 1.4 billion people. If they published how many people have flu or tuberculosis at the same moment, the numbers would be vastly higher. So I think it is like the propagation of a Trojan horse or a computer virus.

Coronavirus Data is Still Misleading

The Streetlight Effect: Looking in the light is the first reaction to a crisis, but the truth may actually be in the darkness and yet to be discovered.

Joon Yu writes at Worth Coronavirus Data Is Still Misleading. Here’s What the Latest Numbers Don’t Tell You.  Excerpts in italics with my bolds.

When the existing prevalence of a virus is high and endemic, the rise in incidence of testing can create the appearance of a rise in incidence of a virus.

Photo courtesy of

The world is caught in the vortex of the coronavirus story. So what happens from here?

I don’t know, and no one else does either. That said, my intuition—based on the temporal and spatial dispersion of the first 16 domestic cases of coronavirus serologically confirmed in the United States—is that the situation is not inconsistent with a high-prevalence virus that has been endemic in America during this flu season and is still circulating. But what happens as more and more testing kits are delivered into an existing high-prevalence setting?

Prevalence starts getting counted as incidence, and that could send people running for the hills.

Consider the following analogy. Think about prevalence as the gold that was sitting in the Sierras in early 1848, and incidence as the collection of eureka moments thereafter. Just because gold diggers discover more and more gold in the Sierras doesn’t mean gold is spreading. What is spreading is the word about gold, which attracts more gold diggers, who discover more gold, forming a self-reinforcing frenzy.

The prevalence of coronavirus, of course, is more dynamic. Unlike gold, it does spread. But also unlike gold, it disappears when a patient gets better, which we know has been happening in the vast majority of cases so far. What we don’t know is the true prevalence, and how endemic it has been this season—it could be in the millions for Americans already—because we weren’t looking for it until this particular story entered our collective consciousness in recent weeks. And now the labs are playing catch up.

But here’s the catch. A surge in testing—one that seems poised to commence after a slow rollout and criticism—will inevitably show a significant increase in serologically confirmed cases. When the existing prevalence of a virus is high and endemic, the rise in incidence of testing can create the appearance of a rise in incidence of a virus.

Nonetheless, the demand for such circumspection, or any circumspection for that matter, during the current hysteria is understandably anemic. Instead, this is that part of the horror movie where the good intentions of good actors—the companies and agencies rising to the challenge of producing testing kits at an exponentially faster rate than during the 2003 SARS panic—end up serving the interest of the antagonist (the mob) rather than the protagonist (public interest). In an environment when the increasingly unhinging mob is already competing with each other to paint the worst possible portrait of the next several weeks, the bad-news industrial-complex is about to strike gold: They will soon get to spread the word “spread.”

From there, the panic can drive itself. As more cases are serologically confirmed, perceptions of a spreading plague will spread, triggering demand for more testing, which will lead to more confirmed cases in a self-fulfilling prophecy. Such vicious cycles that promote runaway growth of fear are the anathema of a society that relies on stability, security and confidence. Feed-forward loops are the preferred algorithms of all self-expanding beasts, including cancer.

Confidence is already in short supply in some quarters.

Even basic things like numbers and definitions are being called into question. Meanwhile, people are panic selling the stock market and panic buying the remaining stock in supermarkets. Discretionary events are being cancelled in droves and handshakes are becoming an etiquette indiscretion. Adults are working from home, and kids with sniffles of any origin are being sent home from school to join them. During this “seeing-UFOs” phase of mass hysteria, everything from allergies and anxiety can start to look like the coronavirus given the fluidity of definitions and overlapping symptoms. Imagine the specter of this potentially absurd situation: The background prevalence of endemic coronavirus may be falling as the flu season fades, but the bad news bearers keep pointing to the rising incidence of test-affirmed coronavirus.

The numbers are bound to look dramatically worse in the coming days and weeks, so the worst of the panic may be ahead of us.

If all of this feels a bit like we are in the Twilight Zone, that’s because we are. What I mean is that we are already in the twilight of the flu season. If SARS CoV2 turns out to be just a Kafka-esque guest who has been among us for the 2019 to 2020 flu season, then at some point the meticulously recorded and earnestly reported “incidence growth” of coronavirus will stall and fall—thereby releasing the spellbound public from self-captivity and other forms of quarantine. Before we know it everyone will be saying, “I knew it,” and this horror story about the plague of the century could fade into a vague memory as if it never happened.

But before that happens, we should really get to the bottom of this while we are caught in the vortex of fear lest we want to be visited by unwanted sequels every two to five years. At the center of this powerful vortex is the principal agent problem that infected human civilization at its roots at the end of the kin tribe age of human social evolution. Whereas humans were once fed, informed and governed by those who had our best interest at heart (a biological algorithm known as inclusive fitness), in post-diaspora melting pots we are fed, informed and governed by those who have their own best interest at heart. Without mutual kin skin in the game to protect against self-dealing, powerful institutions began arising all over the ancient world that ruled over instead of on behalf of the people. Today’s fake news, fake foods and fake leadership culture are all catalyzed by the same underlying cause of misaligned incentives that have been derailing human sociality and befuddling revolutionaries for thousands of years. It was The Who—not to be confused with the WHO—who pointed out that the new boss is always the same as the old boss.

So what I hope happens to the story from here is that we begin addressing the first-order cause of human social dysfunctions rather than whack-a-moling its second-order symptoms. Simply put, our family values did not scale as we globalized, but virality has. The aggregate sum of everyone’s wonderful instincts to provide for family—the profit motive in today’s world—has produced the unintended externality of the principal agent problem in the post kin tribe era of human evolution. We propose a radically different path forward: by innovating new forms of inclusive stakeholding beyond just kin skin in the game—to align institutions with the people and people with each other—competition and natural inclinations will select for race-to-the-top global outcomes rather than race-to-the-bottom ones.

That’s a self-reinforcing trend I can get behind.

Joon Yun, MD, is the president of Palo Alto Investors and coauthor of the book Essays on Inclusive Stakeholding.

Footnote: Facts on the 2003 Global SARS Outbreak (Source: CDC)

How many people contracted SARS worldwide during the 2003 outbreak? How many people died of SARS worldwide?
During November 2002 through July 2003, a total of 8,098 people worldwide became sick with severe acute respiratory syndrome that was accompanied by either pneumonia or respiratory distress syndrome (probable cases), according to the World Health Organization (WHO). Of these, 774 died. By late July 2003, no new cases were being reported, and WHO declared the global outbreak to be over. For more information on the global SARS outbreak of 2003, visit WHO’s SARS websiteExternal.

How many people contracted SARS in the United States during the 2003 outbreak? How many people died of SARS in the United States?
In the United States, only eight persons were laboratory-confirmed as SARS cases. There were no SARS-related deaths in the United States. All of the eight persons with laboratory-confirmed SARS had traveled to areas where SARS-CoV transmission was occurring.









Coronavirus 101

The best overview I have seen comes from Rud Istvan at Wuhan Coronavirus–a WUWT Scientific Commentary  Excerpts in italics with my bolds

Basic Virology

What follows perhaps oversimplifies an unavoidably complex topic, like sea level rise or atmospheric feedbacks to CO2 in climate science.

There are three main types of human infectious microorganisms: bacteria, fungi, and viruses. (I skip important complicating stuff like malaria or giardia.) Most human bacteria are helpful; the best example is the vast gut biome. In human disease some bacteria (typhoid, plague, tetanus, gangrene, sepsis, strep) and certain classes of fungi (candida yeasts) can cause serious disease, as do some human viruses (polio, smallpox, measles, yellow fever, Zika, Ebola).

There are two basic forms of bacteria (Prokaryotes and Archaea, neither having a genetic cell nucleus). Methanogens are exclusively Archaean; most methanotrophs are Prokaryotes. Membrane bound photosynthetic organelle containing cyanobacteria are the evolutionary transition from bacteria to all Eukaryotes (cells having a separate membrane bound genetic nucleus) like phytoplankton, fungi, and us. Both Prokaryote and Eukaryote single cell (and all higher) life forms have a basic thing in common—they can reproduce by themselves in an appropriate environment.

Viruses are none of the above. They are not ‘alive’; they are genetic parasites. They can only reproduce by infecting a living cell that can already reproduce itself. The ‘nonliving’ viral genetic machinery hijacks the reproductive machinery of a living host cell and uses it to replicate virions (individual virus particles) until the host cell ‘bursts’ and the new virions bud out in search of new hosts.

There are two basic virus forms, and two basic genetics.


1. Viruses are either ‘naked’ or ‘enveloped’. (see image at top).  A naked virus like cold causing rhino has just two structural components, an inner genetic whatever code (only the two basic types–DNA and RNA–are important for this comment) and an outer protective ‘capsid’ protective viral protein coat. An example is cold producing rhinovirus in the family picornavirus (which also includes polio).

2.Enveloped viruses like influenza and corona (Wuhan) include a third outer lipid membrane layer outside the capsid, studded with partly viral and partly host proteins acquired from the host cell at budding. These are used to infect the next host cell by binding to cell surface proteins. The classic example is influenza (internal genetic machinery A or B) designated HxNy for the flavor of the (H) hemagglutinin and (N) neuraminidase protein variants on the lipid membrane surface.

Genetic Type

The second major distinction is the basic genetics. Viral genetic machinery can be either RNA based or DNA based. There is a huge difference. All living cells (the viral hosts) have evolved DNA copy error machinery, but not RNA copy error machinery. That means RNA based viruses will accumulate enormous ‘transcription’ errors with each budding. As an actual virology estimate, a single rhinovirus infected mucosal cell might produce 100000 HRV virion copies before budding. But say 99% are defective unviable transcription errors. That math still says each mucosal cell infected by a single HRV virion will produce about 10 infective virions despite the severe RNA mutation problem. The practical clinical implication is that when you first ‘catch’ a HRV cold, the onset to clinical symptoms (runny nose) is very fast, usually less than 24 hours.

This also explains why adenovirus is not very infective. It is a DNA virus, so mutates slowly, so the immune memory is longer lasting. In fact, in 2011 the FDA approved (for military use only) a vaccine against adeno pharyngoconjuntivitis that was a big problem in basic training. (AKA PCF, or PC Fever, highly contagious, very debilitating, and unlike similar high fever strep throat untreatable with antibiotics.) In the first two years of mandatory PCF vaccine use, military PCF disease incidence reduced 100 fold.

Upper Respiratory Tract viral infections.

So-called URI’s have only two causes in humans: common colds, and influenza. Colds have three distinguishing symptoms–runny nose, sore throat, and cough—all caused not by the virus but by the immune system response to it. Influenza adds two more symptoms: fever and muscular ache. Physicians know this well, almost never test for the actual virus seriotype, and prescribe aspirin for flu but not colds. Much of what follows in this section is based on somewhat limited actual data, since there has been little clinical motivation to do extensive research. A climate analogy would be sea surface temperature and ocean heat content before ARGO. Are there estimates? Yes. Are there good estimates? No.

Common cold URI’s stem from three viral types: RNA rhinovirus (of which there are about 99 seriotypes but nobody knows for sure) causing about 75% of all common colds, RNA coronaviruses, for which (excluding SARS, MERS, and Wuhan) there are only 4 known human seriotypes causing about 20% of common colds, and DNA adenoviruses (about 60 human seriotypes, but including lots of non-cold symptom seriotypes like conjunctivitis (pink eye and pharyngoconjunctivitis) causing about 5% of common colds.

Available data says rhinovirus seriotypes are ubiquitous but individually not terribly infective, coronavirus seriotypes are few but VERY infective, and adenoviruses are neither. This explains, given the previous RNA mutation problem, why China and US are undertaking strict Wuhan quarantine measures.

This also explains why there is no possibility of a common cold vaccine: too many viral targets. You catch a cold, you get temporary (RNA viruses are constantly mutating) immunity to that virus. You next cold is simply a different virus, which is why the average adult has 2-4 colds per year.

A clinical sidebar about URI’s. Both are worse in winter, because people are more indoors in closer infectious proximity. But colds have much less seasonality than flus. Summer colds are common. Summer flus aren’t.

There is a differential route of transmission explanation for this empirical observation. Colds are spread primarily by contact, while flus are spread primarily by inhalation. You have a cold, you politely (as taught) cover your sneeze or cough with a hand, then open a door using its doorknob, depositing your fresh virions on it. The person behind you opens the door, picking up your virions, then touches the mouth or nose (or eyes) before washing hands. That person is now probably infected. This is also why alcohol hand sanitizers have been clinically proven ineffective against colds. They will denature enveloped corona and adeno, but have basically no effect on the by far more prevalent naked rhinos.

There is an important corollary to this contact transmission fact. Infectivity via the contact route of transmission depends on how long a virion remains infective on an inanimate surface. This depends on the virion, the surface (hard doorknob or ‘soft’ cardboard packaging), and the environment (humidity, temperature). The general epidemiological rule of thumb for common colds and flus is at most 4 days viability. This corollary is crucial for Wuhan containment, discussed below.

The main flu infection route is inhalation of infected aspirate. This does not require a cough, merely an infected person breathing in your vicinity. In winter, when you breathe out outside below freezing ‘smoke’ it is just aspirate that ‘freezes’ and becomes visible. Football aficionados see this at Soldier and Lambeau Fields every winter watching Bears and Packers games. The very fine micro-droplet residence time in the air depends on humidity. With higher humidity, they don’t dry out as fast, so remain heavier and sink faster to where they don’t get inhaled, typically minutes. In typical winter indoor low humidity, they dry rapidly and remain circulating in the air for much longer, typically hours. This is also why alcohol hand sanitizers are ineffective against influenza; the main route of flu transmission has nothing to do with hands.

[Note: The flu virus is contained in droplets that become air borne by sneezing or coughing.  Unless you inhale the air sneezed or coughed by an infected person, the main risk is direct skin contact with a surface on which the droplet landed.]

Wuhan Coronavirus

As of this writing, there are a reported 37500 confirmed infections and 811 deaths. Those numbers are about as reliable as GAST in climate change. Many people do not have access to definitive diagnostic kits; China has a habit of reporting an underlying comorbidity (emphysema, COPD, asthma) as cause of death, the now known disease progression means deaths lag diagnoses by 2-3 weeks. A climate analogy is the US surface temperature measurement problems uncovered by the WUWT Surface Stations project.

There are a number of important general facts we DO now know, which together provide directional guidance about whether anyone should be concerned or alarmed. The information is pulled from reasonably reliable sources like WHO, CDC, NIH, and JAMA or NEJM case reports. Plus, we have an inadvertent cruise ship laboratory experiment presently underway in Japan.

The incubation period is about 10-14 days until symptoms (fever, cough) evidence. That is VERY BAD news, because it has been demonstrated beyond question (Germany, Japan, US) that human to human transmission PRECEDES symptoms by about a week. So unlike SARS where all air travelers got a fever screening (mine was to and from a medical conference in Panama City). Since transmission did not precede symptoms, SARS fever screening sufficed; with Wuhan fever screening is futile. That is why all the 14-day quarantines imposed last week; the only way to quarantine Wuhan coronavirus with certainty is to wait for symptoms to appear or not. Quarantine is disruptive and expensive, but very effective.

Once symptoms appear, disease progression is now predictable from sufficient hundreds of case reports—usual corona cold progression for about 7-10 days. But then there is a bifurcation. 75-80% of patients start improving. In 20-25%, they begin a rapid decline into lower respiratory pneumonia. It is a subset of these where the deaths occur with or without ICU intervention. And as whistleblower Dr. Li’s death in Wuhan proves, ICU intervention is no panacea. He was an otherwise healthy 34 years old doctor.

We also now know from a JAMA report Friday 2/7/2020 analyzing spread of Wuhan coronavirus inside a Wuhan hospital, that 41% of patients were infected within the hospital—meaning the ubiquitous surgical masks DO NOT work as prevention. The shortage of masks is symptomatic of panic, not efficacy.

Scientists last week also traced the source. There are two clues. Wuhan is now known to be 96% genetically similar to an endemic Asian bat corona. Like SARS and ‘Spanish flu’, it jumped to humans via an intermediate mammal species. No bats were sold in the Huanan wet market in Wuhan. But pangolins were, and as of Friday there is a 99% genetic match between pangolin corona and Wuhan human corona. Trade in wild pangolins is illegal, but the meat is considered a delicacy in China and Vietnam and pangolins WERE sold in the Wuhan wet market. This is is similar to SARS in 2003. A bat corona jumped to humans via live civets in another Chinese wet market. Xi’s ‘simple’ permanent SARS/Wuhan coronavirus solution is to ban Chinese wet markets.


Should the world be concerned? Perhaps.

Will there be a terrible Wuhan pandemic? Probably not.

Again, the analogy to climate change alarm is striking. Alarm based on lack of underlying scientific knowledge plus unfounded worst case projections.

Proven human to human transmissibility and the likely (since proven) ineffectiveness of surgical masks were real early concerns. But the Wuhan virus will probably not become pandemic, or even endemic.

We know it can be isolated and transmission stopped with 14-day quarantine followed by symptomatic clinical isolation and ICU treatment if needed.

We know from infectivity duration on surfaces that it cannot be spread from China via ship cargo. And cargo ship crews can simply not be given shore leave until their symptomless ocean transit time plus port time passes 14 days.

Eliminating Chinese wet markets and the illegal trade in pangolins prevents another outbreak ever emerging from the wild, unfortunately unlike Ebola.

Footnote:  This is of particular interest to me since my wife and I are presently on a cruise in the Indian Ocean ending in Singapore.  We were supposed to fly from there to Shanghai connecting to Air Canada back to Montreal.  Those AC flights were cancelled for February and unlikely to be available for our transit.