Following the Science: COVID19

 

Saving people from the virus while sending one fourth to one third of our citizens into poverty is not winning the war against the virus. Saving people by sheltering in place and then losing them to heart attacks, cancer, and other diseases, which they needed to monitor, to have procedures for, and to control, is not winning the war against the virus. Saving people by sheltering in place while the food supply is disrupted and people are sent into bread lines is not winning the war against the virus.

Nor is it following the science.  Unknown to the alchemists in the press, the science moves with the data. The goal of shelter in place has been achieved, even in New York and had been achieved for most parts of the country BEFORE the shelter in place order was given.  It is time to allow a rationally implemented opening of the country, the returning to work for the great majority of citizens who NEVER were at risk.

When this all began, we faced a new, scary, and relatively unknown virus. We saw parts of Asia gear up with rapidity to contain it. At first our expert scientists, relying on historical pandemics, said we had plenty of testing capacity and furthermore Americans didn’t need to worry about it. Next we saw it jump to Europe. We watched it devastate northern Italy. Then it hit New York and New York was heading at lightning speed to be as bad as Italy. Then the experts changed their course. Suddenly, EVERY American needed to worry; EVERY American needed to shelter in place. Even at this point in time they knew better. Six weeks ago, the scientists already knew that certain people were vulnerable and others not. To give them credit, it took awhile to realize that the greater portion of those who had the virus were so weakly impacted that they did not even know that they had had it. So, unnecessarily, they herded EVERYONE into a massive lock down, as if Earth had been hit by a meteor. While I would not condemn this early response to the unknown virus, still we can’t act like we are the last two dozen people on the earth, who, when hungry can conveniently gather canned goods from a deserted grocery store. If you rationally follow the science, you see that we are likely not to end up in a post apocalyptic movie with two dozen movie stars, but will most surely end up where Sweden is (here) now. 

When hell rained down on Italy, Fauci did the only thing he could, called for reducing the channels for the transmission of the disease by sheltering in place, but now the hospitals have stabilized and we have some new and important data so we must change our strategy.

Now, six weeks later, they have reams of data, all describing the same thing, and it tells us who is vulnerable and that most people are not. It is time to reassess our strategy by applying science to the data that has been developed from the experience in Europe and the United States. Continuing to follow the strategy that was dictated in the absence of data is not following the science. It is following superstition, and it is what the media, the progressive press, people who never met a science curriculum that they could not fail, are advocating.

Science applies knowledge to data to assess a problem and develop a strategy, or strategies, to resolve the problem in the most efficacious way possible. It does not guarantee an absolute resolution. In some circumstances an absolute solution is impossible, and accepting a relatively good solution is necessary. Our current situation is one of those.

What has science learned about the virus and our health during the last six weeks?

Most importantly, the virus is not equally deadly to all people. In fact, prior to an outbreak in any community, it can be determined just who in that community is likely to die, and just who in that community will hardly be affected by it. Indeed, the doctors in each community can go through their patient records and tag those who are most likely to be seriously ill or who may die from the virus, and also tag those who are most likely to have mild or no symptoms. So we can determine, if we have the will and commitment to work at it,  exactly who is at risk. Even a fool can look at community demographics and with 90% accuracy predict who will be seriously ill and who will hardly be bothered. Simply, divide the population by age: Those under 65 will hardly be bothered; and, by the way, they make up 95% or more of the work force. Those over 65 will have a very high death rate; and, by the way, they are hardly involved in the workforce.  A scientist or doctor can make an even more accurate division of the population by consulting the individual patient records. In short, if any state governor is “following the science” then the first step he or she would take would be to “harden” the nursing homes, elder centers, and hospitals against the virus, unlike Governor Cuomo who injected the virus into nursing homes where he successfully murdered thousand of elders. By hardening these centers a governor could immediately reduce the death rate by 20-40%. If Pelosi were really concerned about restarting the economy and saving lives then the first line of her HEROES bill would say that a state needs to harden their elder centers and hospitals first before receiving any stimulus dollars. The rest of the dollars they receive need to be spent making businesses safe to open. Now that would be an economic stimulus, but Pelosi has Mad Cow Disease, and she thinks you do too. 

That is important science fact number one. If we are following the science, shouldn’t we use that data in our plan?

Shelter in place was instituted to slow down the spread of the virus. It was never thought that shelter in place would completely defeat the virus. It was only hoped that shelter in place would reduce the load of critically ill that was overwhelming and breaking hospitals. Somehow, we have lost sight of that objective and have begun to believe that shelter in place can be an ongoing solution not just to protect our hospitals, but to also lower the death rate to zero. After six weeks we have seen that most hospitals in the USA were not overwhelmed, indeed they have been underwhelmed, leading to layoffs of hospital staff and delays in critical medical procedures which are needed by people in the community.

Scientific fact number two: Regionals with high population densities have been hardest hit by the virus and have been in danger of having their hospitals overwhelmed. Regions of low density, have not been in danger of being overwhelmed, indeed they have been endangered by the disruption of services caused by the shelter in place order. The science shows that different regions are affected differently and the scientific implication is that each region should be managed according to its characteristics. I would say that each region is best managed by the local medical community, not the governor, nor state authorities. So why are governors demanding that everyone, regardless of their region adhere to the same standards? The answer is that politicians are superstitious, non-scientific and ideologues. One stupid doctrine that progressives believe in is: All share equally. If there is a fire in Paradise, do we go burn down Los Angeles to keep everything uniform across the state?

Scientific fact number three: The shelter in place has caused unintended consequences, among which the disruption of the food supply chain is one of the most important. Remember when our favorite governor, Cuomo, said, “We’ll figure out how to get the food to you.” Well they didn’t.

Texas has managed the pandemic better than almost any place on Earth. 1100 deaths versus over 22,000 recoveries and the hospitals have never been threatened. They have over 500,000 test stations. It is questionable whether Texas ever needed to close, and Governor Abbott is opening the state up in a rational and thoughtful manner. The rest of the country should follow.

From the above, we can see that science is screaming at us to change policies, the most important of which would be to address the virus on a more granular basis, letting natural regions, defined by their regional hospitals, monitor their status and manage themselves accordingly. States can best serve their intrinsic regions by channeling resources to where they are needed, much as Trump has been doing for the states. We will not bring the virus to zero infections; that is not scientifically possible. We will not bring the deaths to zero; that is not statistically possible. The best we can hope for is to be as responsive as possible while maintaining as robust a community as possible. Only our local leaders and local scientists who have accessed to the details of our local situations can determine what is a reasonable course of action for each locality.

Clearly from the above, we know that we must reopen while minimizing death and critical cases in the hospitals. Any plan for reopening needs just a few key components:

Individuals: We have heard ad infinitum what individuals should do: Wash your hands, don’t touch your face, cover your sneeze, wear a mask, stay six feet away, if you feel sick stay home, if you have any of the symptoms then get tested, etc. I cannot remember all of them, but they are out there all day long and every day. They amount to: Avoid receiving the virus, take the precaution to wash off the virus with soap and water just in case you have received it, take extreme precaution to not infect someone who is vulnerable, and if you have an indication that you have gotten the virus stay home, call your doctor, keep track of yourself, and go to the hospital if you are becoming critical.

Doctors: Review your records and inform your patients whether they are vulnerable or not. Form local boards to establish recommendations for your region’s response to the changing virus situation in your community (probably based on a regional hospital or groups of hospitals). Establish or adopt guidelines for limiting the exposure to the virus in elder facilities. These may have to be draconian with daily testing of staff, confining staff to the facility or a facility nearby in order to keep staff “clean” and other measures. Assess your regional supply needs for managing the virus in your region. Meet with local political leaders to present your case for self governance to your state government. 

Businesses and trade unions: Develop standards to be instituted by your trade which would allow you to operate in a reasonably safe fashion. Present your standards to your members, to your political bodies, and to your partner businesses. 

Local Politicians: Enlist doctors, businesses, and trade groups to help you make your case for local governance.

Newsom was quick on his feet in reacting to the threat of the virus, impressing the voters of California, but he has become entrenched in the inflexibility his position without recognizing the differences between various regions within his state. Will the eastern part of the state choose to join Nevada or Texas to escape his dogmatic irrational rule?

State and Federal Government: Allow regions to operate independently provided they present a reasonable plan for doing so, establish methods for channeling resources to regions, support regional reopening rather than resisting it, monitor regions and channel information between regions to help them improve their performance, establish practical and reasonable standards of success. If you want to toss money at the people, toss it at the working people who are vulnerable and who have been told by their doctors that it is unsafe for them to return to work. Tell everyone else that there is no government gravy train and they need to get back to work. Don’t pass foolish bills to create government gravy trains. Printing money does not create wealth; it only increases inflation. Making things creates wealth; people need to work to create the things we need. 

Zero infections, or zero deaths is not a reasonable standard. Such flies in the face of science. There will be deaths with this virus as there have been deaths with viruses and diseases since the beginning of biological life. Because we have science and we are smart, we will eventually have a vaccine, but our society needs to be working in order to keep the infrastructure in place so that the vaccine can be developed.

NOTE (May 16th): Today I had standard blood test at a local hospital. Local hospitals probably conduct dozens to hundreds of these tests daily, each. What if included in your regular test was a test for the COVID19 titer? If it were possible to include that test with the others that everyone has to take, we could build a mountain of data about what portion of the population now has antibodies for the disease. Possibly it is worth looking into building the necessary test procedure into standard blood tests.

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