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Another Look at the Big Picture

By December 6, 2020Commentary

Minnesota appears to have officially passed Sweden in deaths per million.  We are right at 700, Sweden is at 698.  I use 5,690,000 as Minnesota’s population, which is a little higher than some people use, but that number comes from the Minnesota modeling paper, so I assume it is accurate.  So my per capita number is a little lower than some people’s.  And Sweden sometimes is lagged in reporting deaths, but their level is pretty low right now, so I don’t think it will make much difference.

I will ask the same question I always ask of those who want to make it look Sweden did something wrong–would you rather get to that rate of deaths the way we did or the way Sweden did?  The people who are determined to make Sweden seem bad generally ignore any thoughtful analysis, for example, Sweden has a major metropolitan area, as densely populated as any city in Europe, and it has a large migrant population.  So comparing it to Norway and Finland makes little sense.  Comparing it to other major European countries is more logical.  And my favorite is the way critics cherrypick economic statistics to try to make it look Sweden isn’t doing better than most of Europe.  Despite having a very export dependent economy, by any well-regarded set of measures they have incurred less economic harm.  And they have avoided excess deaths caused by locking down and terrorizing their population, in fact for much of the year their deaths have been at or near average.  Their children in particular have fared far better.  So there isn’t really any meaningful comparison, and anyone who is being objective would rather have lived through this period in Sweden than Minnesota.

One other quick note, active cases in Minnesota are dropping like a stone in Lake Superior and are well under half the peak, according to my  analysis.  I have a new analysis on this coming shortly.

On to the big picture, which I do every now and then because there are new readers and there are occasional developments.

  1. The Pathogen.   It is really hard to figure out how dangerous this virus is.  Yes it has “infected” a lot of people, but an astonishing number develop no “illness” and even those who are “ill” have very mild illness for the most part.  It is understandable that the frail elderly are easily overwhelmed; their immune systems tend to be weak and CV-19 may have specific immune evasion capabilities.  One thing that is clear, but maybe all coronaviruses are like this, just haven’t been studied that much til now despite the original SARS and MERS,  this is a very transmissible and infectious pathogen, but really in what appears to be a limited set of environmental conditions.  As best I can tell from the research, this is most likely due to characteristics of the lipid envelope around the virus.  That envelope may be easily destroyed in most temperature, humidity and sunlight combinations.
  2. What it means to be “infected” and “infectious”.  These are two critical concepts that I find people have trouble grasping.  You really have to understand the micro level of when virus meets human tissue.  To be infected means to me that the virus has succeeded in entering into a number of the infected person’s cells and is actively replicating and emerging from cells.  And a person is only infectious if they are emitting sufficient numbers of viable virus particles to cause an infection in another person.  Emitting fragments does nothing.  Emitting small numbers does nothing in most situations, although some people, especially the frail elderly, may be capable of being infected by a very  small number of virions or virus particles.  What we care about most from an epidemiological perspective is the number of people who are infectious at any one time and the trend in that number.  Many people are exposed, and could even test positive if their upper respiratory tract is swabbed at the right time, but are never infected by this definition, and never infectious.  This is largely due to immune defenses that clear the virus before it gets going.  And it is a weakness of PCR testing.
  3. Adaptive immunity.  Another hard to grasp concept.  Again, think of a rapid reaction force.  You  are exposed to a pathogen again, and your body very quickly recognizes it and responds by killing the virus before any infection gets going.  And again, it is possible that a person could test positive if they are swabbed at the right time, but as above, would never be truly infected or infectious.  The vast majority of the research is finding that almost everyone, and I really mean with very rare exceptions, after being infected develops a strong and lasting B cell and/or T cell defense.  Antibody assessment isn’t the critical item, presence of memory B and T cells is.  If this weren’t true, it is unlikely that a vaccine would perform very well.
  4. Vaccines and vaccination.  I assume the vaccines will work to some extent to promote or enhance adaptive immunity.  I am cautious because my work in drug development taught me that clinical trials are done in a manner to maximize apparent effectiveness and minimize adverse events.  Real world use can be and often is different.  Respiratory viruses, including coronaviruses, tend to have a large number of mutations and variations, and some of these can assist in avoiding antibodies and T cell responses prompted by vaccine-aided immune defenses.  So I worry that the vaccines won’t appear to be as effective as people are imagining, but are as effective as they realistically could be, which should make a big difference in transmission and seriousness of illness.  And it would be foolish not to be very watchful about adverse events.  I am a big believer in vaccines, they are one of the examples of human intelligence and ingenuity at work to truly improve quality of life.  Before vaccines, infectious diseases routinely killed very large numbers of people.  But see above, about adaptive immunity; they aren’t going to make the virus disappear.  We have to have the will to accept this and adapt to the presence of the virus without changing “normal” life patterns.  The cost of doing otherwise is too high.
  5. Government response.  This is the item that drives me.  We really have indulged in coronamonomania.  We have ignored the consequences of the response as it has attempted to mitigate spread.  Governments have collected and reported data in ways that exaggerates the spread and risk posed by CV-19.  Governments have failed to collect and analyze or have hidden data that is extremely important to understand the actual risk, and the actual shape of the epidemic.  Governments have almost completely failed to acknowledge the extreme harms caused by the various mitigation of spread orders.  These are serious, widespread, long-lasting, in many cases irreparable, and far more harmful to society than CV-19.
  6. Population Response.  At least in America, we have revealed ourselves to be a nation of meek followers, incapable of looking for, analyzing and coming to logical conclusions based on real data and science, blindly following the pap fed to us by governments without question, submitting to all manner of totalitarian orders and allowing ourselves to be whipped into a hysterical terror by the media.  Our democracy has been revealed to be far more fragile than I would have imagined possible if people are this willing to give up freedom and to see democratic processes subverted for an extended period of time when normal legislative action was available.
  7. The actual epidemic.  Lots of apparent “infections”.  Not that much serious illness.  Over-attribution of deaths, generally to very frail elderly persons.  Excessive hospitalizations, many not actually due to CV-19, and many solely for remdesivir treatment.  Inability to find an effective solution to the issue of the frail elderly.  Terrorization of the population despite extremely low risk to the general population.  The latest wave will subside, just as the others have, and is already subsiding in many places.  In a year or so, when the data is assessed accurately and over a sufficient period of time, we will find that there were no excess deaths to CV-19, just a lot of pull-forward deaths, but there were a lot of excess deaths due to the government responses, and ironically, many of those deaths will also be among the frail elderly.

 

Join the discussion 12 Comments

  • Darin Kragenbring says:

    I really enjoy your “Big Picture” observations. If more leaders took your cue and admitted that humanity cannot immediately cure all diseases, the pandemic could have been dealt with more evenhandedly.

    Do you think Florida’s directive for labs to report Ct values for PCR tests will mark a turning point in getting more reliable data out to the public? If in fact cases are overstated, it would make other aspects of the pandemic make more sense to me.

    Thank for keeping us informed!

  • Peggy A Lewis says:

    ” In a year or so, when the data is assessed accurately and over a sufficient period of the, we will find that there were no excess deaths to CV-19, just a lot of pull-forward deaths, but there were a lot of excess deaths due to the government responses, and ironically, many of those deaths will also be among the frail elderly.”

    To me, that statement is the big fat elephant in the room and one that seems to ignite my sense of fairness and leaves me wondering if, at a later time, will justice ever be served.

    Today I spent far too many hours scouring the internet, reading and looking for even a GLIMMER of hope that professional/scientific dissenting voices might be finally, bravely emerging. I found this on Daniel Horowitz: The Blaze

    theblaze.com/op-ed/horowitz-hopkins-analysis-showing-covid-19-has-relatively-no-effect-on-deaths-in-us-retracted

    “Nobody made this point better than Kamran Abbasi, executive editor of the British Medical Journal, in a recent editorial in which he accuses scientists and politicians of “suppressing science” for political gain.

    “Politicians often claim to follow the science, but that is a misleading oversimplification,” charged Abbasi. “Science is rarely absolute. It rarely applies to every setting or every population. It doesn’t make sense to slavishly follow science or evidence. A better approach is for politicians, the publicly appointed decision makers, to be informed and guided by science when they decide policy for their public. But even that approach retains public and professional trust only if science is available for scrutiny and free of political interference, and if the system is transparent and not compromised by conflicts of interest.”

    In other words, “shut up and mask up” is not science and certainly does not exude transparency that will give the public confidence in the decision-making process. And as Abassi warns, “When good science is suppressed, people die.”

  • I love America, but I don’t think I’ve ever been more disappointed in my fellow Americans than during this “coronamonomania” casedemic. I’m sick of seeing these sheeple parade around in their (mostly) useless masks! I’m sick of stores, churches, schools, and the like being closed or requiring the (mostly) useless masks! I’m sick of the cancellations–especially my kids (ages 12, 14, 16, and 18) sporting/music/church events! I call on all freedom-loving, right-minded Americans to do their part (speak out, refuse to comply to nonsense, etc.) and END THIS WICKEDNESS!!!

  • Kevin Roche says:

    excellent points

  • Kevin Roche says:

    Well Florida has tried to be more transparent in a number of ways and others don’t seem to be following. Lack of journalistic pressure, actually it is a misnomer to call it journalism. But if people keep banging on it, and if Florida publishes the distribution, maybe it will create some change. That PCR test cycle number distribution is critical for people to understand what is really going on

  • Peggy A Lewis says:

    Kevin…

    Dr. Michael Mina has a genius idea regarding the at home covid antigen test:

    https://youtu.be/CjphzlV5DYo

    I say this only because I know you have a little push with the ST and other publications. If this reached even ONE brave journalist who had the nads to print it, it solves all the bickering, finger pointing and even the concerns from the anti vax crowd.

  • My favorite quote about statistics and politics:

    “Most people use statistics like a drunk man uses a lamppost; more for support than illumination”
    ― Andrew Lang

  • Dan Collins says:

    Just saw that Sweden has finally succumbed to outside pressure. I’ve marked there cases and deaths per one million as of today. Will be interesting to see if their measures going forward make any difference….

  • jbspry says:

    There are too many unique factors affecting each population to make direct apples-to-apples comparisons, which politicians love to do for dramatic effect.
    That being said, Sweden is a great model for what happens when voluntary, commonsense steps are taken to control a viral episode. Minnesota is a great model for what happens when severe, mandatory steps are taken. The results are similar enough to draw the inference that political directives and desultory prophylaxis measures are no match for a determined virus.
    If mankind had never faced a virus before, one could chalk it all up to a lesson learned. But viral contagions are as common as the blossoming of flowers in Spring. It has happened to our species countless hundreds of thousands of times and, within given latitudes, always plays out the same. We KNOW how viruses behave; we know that many will die each viral season, mostly the old and the sick.
    The lockdowns and quarantines, the business and school closures, the controlled movements, the general taking of control of the citizenry’s daily life activities by the government, all have been conducted by petty tyrants working under a common command for purposes of accustoming people to being treated like herd animals by their governments.

    “Euromerica is at war with Eastasiavirus; Euromerica has always been at war with Eastasiavirus.”

  • Gregory Fink says:

    Thanks for your continuing calm and rational discussion of all things COVID. Like one of the other commenters, I look forward especially to your big picture summaries.

  • Frank says:

    I am new to your website and don’t know my way around. Where can I find a replay of the talk you gave last Tuesday to the Rotary Club? A commenter left a link on your post referring to the talk, but I could not get from the Rotary Club site to a tape of your presentation.

  • Kevin Roche says:

    There wasn’t time to finish the entire presentation. I am finishing it tomorrow and then the entire presentation will be narrated and will be available and I will link to it.

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