Over at Powerline there's a new post up that is rather interesting. What it is--after a brief intro--is an email from a highly credentialed ("expert") medical professor and researcher. This is the author of the email:
Holding both M.D. and Ph.D. degrees, Dr. [Matthew] Meyerson is professor of genetics and medicine at Harvard Medical School. He is also Director of the Center for Cancer Genomics at the Dana-Farber Cancer Institute.
Meyerson takes exception to recent posts at Powerline which in his view "understimat[e] the seriousness of this epidemic.”
What I'm going to do is summarize the five points that Meyerson makes--you can read his full argument at Matthew Meyerson: Five COVID-19 theses. Then I'll provide some additional excerpts from an article I read early this morning. That article is by a professor of biology at Texas A&M (Texarkana) and sheds some light on why a virus like SARS-Cov-2 on the loose is an epidemiologist's nightmare. I believe the article lends support to Meyerson's Five Theses.
Here we go, and remember that my summaries are really just thumbnails--Five Theses re Covid-19:
1. COVID-19 is very highly transmissible. ...
2. COVID-19 causes severe illness in medical professionals and otherwise healthy young people. There are numerous examples of previously healthy young people, especially physicians, who are becoming severely ill or dying from COVID-19 infections. This almost never happens in other diseases. ...
3. It is hard to compare deaths from COVID-19 to deaths from influenza. ...
4. I do not believe that we are overreacting to COVID-19. We are seeing a highly transmissible disease ... That would suggest the possibility of [millions of] deaths in the US if we got to 300 million infections, and we could. We will likely have far fewer deaths than this ...
5. Until we have treatments and vaccines, preventing transmission is the only way to go. ...
Being a non-scientist, I'm in no position to endorse Meyerson's theses per se. However, the article I referenced above (What the coronavirus does to your body that makes it so deadly, by Benjamin Neuman) provides some specifics on SARS-CoV-2 that help explain why allowing this virus to become endemic within the US could lead to catastrophic consequences. As we've learned in the last few days, the people who are vulnerable to this virus span a large cross section of our population--one that is not limited to "old people." Smokers, fat people, diabetics, people with high blood pressure or other heart related diseases--we can't quarantine them all indefinitely. Moreover, even among those who "recover," there is the real possibility of serious damage to the lungs and possible other organs. Neuman's article--and I urge you to follow the link for the entire piece--provides facts that help explain all this. Here's my brief summary:
SARS-CoV-2 is highly transmissible and--by the standards that we're used to in infectious diseases, like seasonal flu--highly deadly. Since there is no immunity to the virus, if left unchecked it could spread to many millions of people due to its highly transmissible nature. The more it spreads, the more likely it will be to find those who are most vulnerable, and the more deaths we will have--deaths on a scale to dwarf all war deaths in our history. The virus' ability to block the immune system will help see to that. Even among those who "recover," there could be long term, serious health consequences. This explains the drastic action that Trump has taken. Excerpts:
A coronavirus infection usually plays out one of two ways: as an infection in the lungs that includes some cases of what people would call the common cold, or as an infection in the gut that causes diarrhea. COVID-19 starts out in the lungs like the common cold coronaviruses, but then causes havoc with the immune system that can lead to long-term lung damage or death.
SARS-CoV-2 is genetically very similar to other human respiratory coronaviruses, including SARS-CoV and MERS-CoV. However, the subtle genetic differences translate to significant differences in how readily a coronavirus infects people and how it makes them sick.
...
... SARS-CoV-2 has a totally different set of genes called accessories, which give this new virus a little advantage in specific situations.
...
The cells that SARS-CoV-2 prefers to infect have a protein called ACE2 on the outside that is important for regulating blood pressure.
...
SARS-CoV-2 grows in type II lung cells, ... As with SARS, most of the damage in COVID-19, the illness caused by the new coronavirus, is caused by the immune system carrying out a scorched earth defense to stop the virus from spreading. Millions of cells from the immune system invade the infected lung tissue and cause massive amounts of damage in the process of cleaning out the virus and any infected cells.
...
The ACE2 protein that SARS-CoV-2 uses as a door to enter cells is also important for regulating blood pressure, and it does not do its job when the virus gets there first. This is one reason COVID-19 is more severe in people with high blood pressure.
SARS-CoV-2 is more severe than seasonal influenza in part because it has many more ways to stop cells from calling out to the immune system for help. For example, one way that cells try to respond to infection is by making interferon, the alarm signaling protein. SARS-CoV-2 blocks this ...
...
At present, the transmission rate of SARS-CoV-2 is a little higher than that of the pandemic 2009 H1N1 influenza virus, but SARS-CoV-2 is at least 10 times as deadly. From the data that is available now, COVID-19 seems a lot like severe acute respiratory syndrome (SARS), though it’s less likely than SARS to be severe.
...
It may well be, that all of the above is true, but that the price we're paying from this lockdown will still destroy us before the virus does, esp. seeing as we *know* nothing about a lockdown's downstream effects.
ReplyDeleteSee https://www.eurasiareview.com/03042020-what-questions-should-we-be-asking-about-the-coronavirus-analysis/ :
" We need better data, and we need to test specific standardised communities, to assess the true nature of the medical risk we face. Only then we can move beyond empty MODELS to hard-headed decisions, about just what level of geopolitical defenestration and societal impoverishment we are prepared to accept, in order to maximise our efforts to stem this pandemic. We need to change course, and we need to do it quickly….
... we do NOT yet know, how many additional people may die or be at risk of dying, beyond those who would die anyway, as a result of contracting the virus.
... [As] Coronavirus, and its symptoms are not significantly distinguishable, in many cases (particularly milder forms of the infection) from the symptoms of various other viruses, we have very FEW reliable figures. We have NO useful figures for infection rates.
The figure of a 100% eventual infection rate is not available to us, but it a good working assumption, given what we know about the ease of transmission. All the other figures we do NOT know, and we CANNOT know, until there is widespread testing.
Therefore we do NOT now actually know, the optimal number of H+V’s (hospital bed plus ventilator) a society needs to minimise deaths, and we will not do so, until we have a comprehensive system of testing. With testing, we will be able to tell, how quickly the virus spreads under different circumstances.
... If values must be placed, upon the healthcare system changes the Coronavirus pandemic has engendered, then likewise efforts must be made, to evaluate the long-term COSTS of lockdown, using a comparable metric.
It is imperative, that we make efforts to measure the world’s economic, social and psychological losses. A model that takes account of the fact, that the societal damage done may extend indefinitely far into the future, is imperative.
Yet we have not even BEGUN to think, about how we might do this. Therefore we cannot currently weigh, the harm we are aiming to alleviate, against the *damage* we are inflicting against ourselves.
Moreover nobody has yet even thought, about assessing the potential geopolitical consequences of different nations, undertaking these sorts of balancing exercises in different ways. Each country may come out of this global crisis, at a different geopolitical level from that it began at...."
By M. Parish, an international lawyer based in Geneva, Switzerland and an Honorary Professor at the University of Leicester in the United Kingdom. He has been elected as a Young Global Leader of the World Economic Forum, and named as one of the three hundred most influential people in Switzerland.
The article is too long for me to respond in detail. Let me just point out that most of it is based on two premises:
Delete1. Governments instructing people not to socialise is not going to reduce the infection rate naturally below 100%. ... So we are all going to contract this virus.
2. The proper goal of the lockdown is to slow the spread of the virus while we have time to build hospitals and equip them appropriately. It is not to decrease infection rates.
Neither of these are true.
"Governments instructing people not to socialise is not going to reduce the infection rate...."
DeleteI can imagine that, eventually, they may reduce that rate for a while.
But, they won't be able to keep that rate down, w/o draconian measures which will send us to a Dark Ages standard of living.
To me, his main points are, that such a possibility isn't even getting any consideration at all, and that the current policies are assuming "medical" knowledge (models), that are nowhere near being scientifically established.
It's a problem that he's making his argument with assumptions that are no more established than the ones he criticizes.
DeleteIndeed, that's true. His top point is, that we're imposing Diocletian-like restrictions, with virtually no weighing of risks vs. bennies.
DeleteMy guess is, the most likely outcome of the current policy trajectory is, a series of lockdowns/ reprieves, and a series of bailouts, each of which goes mostly to the well-connected, these leaving most small businesses as, at best, totally hooked on the Federal tit (and probably at the mercy of Federal micro-management).
If the bulk of wheels, bureaucrats, etc. here were like DJT, I would have hope, that our system could pull this off, as per your expectations.
Alas, I suspect, for every DJT, there’s at least one Gretchen Whitmer, one Jim Acosta, and one Mitt Romney.
I style my position here to be analogous, to Bork’s vs. Scalia’s on FISA, esp. in that Bork probably intuited, the likelihood that G-men would be tempted to abuse their power, more than Scalia was able to face.
You're so cynical! But then, you do have history on your side.
DeleteLike the Framers were.
DeleteThat's why we got checks and balances, and a Bill of Rights (esp. the 1st & 2nd Amendments).
It's not what you Expect, it's what you Inspect.
So much hinges, on Barr/ Durham making enough key heads roll, that slews of moderate liberals see the sort of light, that has hit guys like Dersh.
Interesting historical article:
ReplyDeletehttps://www.theamericanconservative.com/articles/how-generals-fueled-1918-flu-pandemic-to-win-their-world-war/
The disastrous character of the U.S. elite running the First World War is clearly revealed with the astonishing fact that more American soldiers were killed and hospitalized by influenza (63,114) than in combat (53,402). And an estimated 340,00 American troops were hospitalized with influenza/pneumonia, compared with 227,000 hospitalized by Germans attacks.
Why? Simple. He is our leader. He has to juggle not totally crashing our economy and being strong against the Chinese virus.
ReplyDeleteNot an easy task.
If he completely follows Fauci, nevermind his revisions, we will be in a economic depression that will be like the Great Depression.
If he doesn't follow, who knows how many more might die.
Hobson's Choice.
However, it appears that may not be.
Make no mistake, no matter what Trump does or does not do, the Dems and media will automatically excoriate him.
My entire take on this is twofold, we temporarily hurt ourselves as we doing with some lasting effects, and then ... life goes on.
It's time for a more targeted approach. What works or doesn't work in filthy, overpopulated New York, where people live stacked up like crated chickens, is not what's called for in Butte, MT.
ReplyDeleteWhen all is said and done, what will we have accomplished with this shut down?
Correct me if I'm wrong, but 99%--or better, we don't yet know--of the people who get this virus survive.
For this we destroyed an economy.
You are wrong, but I don't have time and space to correct you here. For the time being I direct you to:
Deletehttps://amgreatness.com/2020/04/03/why-the-shutdown-is-necessary/
https://amgreatness.com/2020/04/03/dont-downplay-the-wuhan-virus-the-real-story-is-china/
Butte and similar cities will not carry this economy on their backs. I'm all for a targeted approach, but that's still risky at this point. The best hope for the present is Chloroquine+, which would make such a targeted approach feasible if it works and if/when it can be widely disseminated.
I read the first article, the one where his worst case USA scenario is 6 million dead. Models, models, models. Attack rate?
DeleteI never had much use for models (I used to be an electrical engineer). The climate change lunacy pretty much put me off models forever.
I agree with much of article two, especially his belief that we stop the lock down end of April (I'm for sooner), but do question his certitude on the effect of the "lock down" on the Diamond Princess.
The air filtration system on that ship would not stop a virus, but ship owner claims the way the air moves through ducts and into and out of cabins would make it difficult for a virus to spread.
We don't know, do we?
But the argument that you and others are making amounts to a contradiction: we don't know the extent of the problem, so we should act as if there isn't a problem. But that means you really think that you do and base your recommendations on that presumed knowledge. You frame your argument in modest terms, yet are offering very absolute recommendations that dismiss contrary evidence.
DeleteYou dismiss the first article as "modeling." But the author is dealing not just with modeling but with real world numbers and real world practical experience. These numbers are not informed solely by theoretical constructs but by historical experience of infectious disease outbreaks of varying degrees of seriousness. We know the potential of Covid19 from scientific study of the virus that causes the disease since the 2003 SARS outbreak.
Best hopes:
ReplyDelete1. Quinine
2. More testing, and faster. It’s increasing about 10% per day in the us, with the exception of Ca
3. Everyone Wear masks
4. Get medical types equipment to stop cycle of spreading