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The Final Big Picture Assessment for 2020 and First of 2021

By January 3, 2021Commentary

One thing I hope this epidemic has taught everyone is that things are generally complex and simplistic notions or explanations aren’t good enough for understanding a situation thoroughly and devising sound public policy.  This is particularly true when thinking about concepts like “infected”, “infectious”, “population immunity” and “adaptive immunity”, and the vaccine-aided subset of adaptive immunity.  Nothing is magic, absolute or bulletproof; it is all shades and subtlety.

The virus itself is highly infectious, which may be due to low dose needed to cause infection, strong binding affinity to the receptor and some capability to down-regulate the immune system.  The apparent high infectiousness may also reflect very high testing levels which pick up “infections” that would be ignored in regard to any other pathogen.  Like any virus, CV-19 mutates frequently.  Notwithstanding the hysteria, there is no evidence yet that any of these mutations are making the virus more lethal or dangerous.

The epidemic has been occurring for over a year. In several areas, multiple case waves have been experienced.  Those waves suggest that there is a narrow set of environmental conditions which favor transmission.  When those conditions are right, spread occurs almost without regard to mitigation efforts.  I believe it is fair to say we don’t yet fully understand the reasons for the acceleration and deceleration of spread.  We can say with some assurance a few things that aren’t likely in regard to transmission.  Surface transmission doesn’t occur often at all.  Outdoor transmission is pretty much non-existent.  Transmission by infected but asymptomatic persons is unusual.  Transmission by aerosolized virus does appear to occur with some frequency.

Exposure alone doesn’t make a person “infected”, even though they might test positive if they happen to be swabbed at the right time.  Infection occurs when the virus is inside cells and replicating.  A person is infectious when they are expelling viable virus that could be transmitted to another person and cause an infection in that person.  A person who becomes exposed typically shows signs  of infection within 5 days or less.  An infected person is infectious on average for no more than a week or so of developing symptoms.  A most critical aspect of tracking the course of the epidemic is to identify how many persons may be actively infectious at any one time and what the trend in that number is.

Testing for CV-19 has been poorly designed and executed.  Both PCR and antigen testing appear to have significant accuracy issues.  PCR testing has led to identification of large numbers of false and low positives. Antigen testing appears to be wildly inaccurate, especially in a low-prevalence environment.  The testing policies have also overwhelmed contact tracing efforts.

In addition to defective testing and resulting unreliable data, information on other aspects of the epidemic has been untrustworthy.  Hospitalizations and deaths have both been extensively over-attributed to CV-19.  This feeds media and political panic programs.  At no point have hospitals been overwhelmed, or indeed, even beyond normal capacity utilization.  Most people said to have died from CV-19 had multiple conditions or frailty which made them vulnerable to any additional health issue.

The epidemic has been extremely bifurcated, with far higher rates of serious illness and deaths occurring among the elderly than the young.  The bifurcation is even more extreme when considering residents of long-term care facilities versus the general population.  The epidemic may also be front-loaded, in terms of attacking the most vulnerable first, which can give an appearance of higher fatality rates than would be true in the population as a whole.  Due to this factor as well as improved treatment, fatality rates have steadily declined and if all infections were known, and deaths attributed in a rational manner, would be in the range of a serious flu year.

The political response has been abysmal at best.  Reliance on bad models and data, herd mentality, obsession with lowering cases due to CV-19 regardless of effects on other health issues, and generally ignoring the overall welfare of the population have characterized that response.  Children in particular have been devastated by the response, losing educational opportunity and enduring social deprivation and resulting mental health issues.

How does this epidemic end?  The virus is not going to disappear.  At some point enough of the population has some form of immunity to limit transmission opportunities and drop cases to a background level.  It currently appears that adaptive immunity from seasonal coronavirus infections or even general immune defenses may limit infections.  According to the CDC, 91 million Americans have been infected.  That is over a fourth of the population, and much higher in some areas.  That number is sufficient to begin slowing transmission opportunities.  Infected persons almost universally have been shown to develop memory B and T cell responses that would prevent or limit subsequent infections.  These adaptive immune responses seem to be lasting and durable.  In addition, we now have vaccines that should create adaptive immunity.  At this point, in most places we are unlikely to see another serious wave of cases.

But politicians and public health “experts” love their power, so will they stop the damage they are imposing or will they milk the situation as long as they can to exert their totalitarian will?  I would bet on the latter, exacerbated by a new administration full of people who think they all know better than the rest of us what is good for the citizenry.

Join the discussion 5 Comments

  • M. McRae says:

    Excellent analysis, Kevin!

  • Douglas Kraus says:

    Thanks for the sanity. Is there any data to support or contradict Fauci’s assertion that the vaccine does not prevent the virus, but lessens the severity?

    • Kevin Roche says:

      In general, vaccines against respiratory viruses have a substantial effect in preventing “infection” and “infectiousness”, that is eliminating the virus before it begins replicating and being expelled in a viable form. It also would therefore lessen any illness. I suspect what that clearly over-rated charlatan was attempting to say is similar to the analogy I have often used, or mixed, adaptive immunity, from infection, or vaccination, is not a physical barrier preventing exposure, it is a rapid reaction force that can quickly eliminate the pathogen.

  • DuluthGuy says:

    The best defense against COVID-19 and most other illnesses is take a vitamin D3 pill (5,000 iu) every day and live a healthy lifestyle (eat veggies and meat, avoid sugar, and get a reasonable amount of exercise). That’s especially true in northern climates during the winter. If the government was actually encouraging people to do that rather than stay in their homes, close down schools, not talking to anyone in person, hope and pray for the vaccine but still wear masks once you get a vaccine, and lots of other insane advice, we’d have been over this a long time ago. The scariest things from the last 10 months have been how easily the population has been scared out of their minds.

    I hope I’m wrong, but I don’t see things changing anytime soon. Walz and his ilk are going to keep this going as long as he possibly can. It’s in the DNA of every Democratic politician and many Republican politicians to want to control people. If I didn’t have family in Minnesota, I’d have probably moved elsewhere already.

  • Harley says:

    I had to chuckle and roll my eyes the other day when I heard Fauci proclaim that the vaccines are effective on the new variant/ strain of Covid. It took how many months, cooperative research, and $ billion to develop and test a vaccine, but took Fauci about four days, a handful of cases, no data, no research, and no testing to CONCLUDE AND DECLARE the vaccine would still be effective.

    This clown has no credibility. Given his previous history of lying, is this the truth or more poppycock? And how would we know?

    But with his financial interest in the vaccine, don’t stop, don’t pause, just keep administering. More volume, more $.

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