A Greater COVID-19 Danger: Misinformation

My people are destroyed for lack of knowledge.  – Prophet Hosea (710 BC) 

The financial firm, Franklin Templeton, has teamed up with Gallup to determine people’s behavioral responses to the COVID-19 pandemic.  Their hypothesis: What people know and don’t know about the pandemic will play a crucial role in shaping the economic recovery. 

Maybe you’d like to participate in part of the survey.   If so, write down your answer to three of the questions based on what you know about the COVID-19 pandemic.  Here you go:  What percentage of total COVID deaths have occurred among Americans…
(1)  …age 55 or older?
(2)  …age 44 and younger?
(3)  …age 24 and younger?

COVID-19 Risk:  Survey Results
Now, let’s compare your answers to the actual COVID-19 mortality statistics from US Centers for Disease Control and Prevention (CDC), and the National Center for Health Statistics (NCHS), as of July 22, 2020.  First, in order to make you feel better in case your answers are far from the actual percentages, here is part of the conclusion made by authors of the “Franklin Templeton–Gallup Economics of Recovery Study:”

These results are nothing short of stunning.  Six months into this pandemic, Americans still dramatically misunderstand the risk of dying from COVID-19.

Maybe you will be "stunned" as well.  To compare your responses with the responses of Americans included in the survey when the three questions were asked, here are the results:

Based on this sampling from the survey, can you see the stunning discrepancy between perceived health threat of COVID-19 and reality?  Amazingly, in spite of Americans having access the best health care system in the world and excellent access to information at our fingertips, we demonstrate a stunning misunderstanding of the risk of death from COVID-19.  

As the table below suggests, Americans 65 and older are much more aware of the heightened risk for their own age group.  On the other hand, the younger the age group polled the more misled Americans are about their risk of negative health consequences from the virus.  Shockingly, school- and college-age young people (age 24 and younger) overestimated the danger of COVID-19 by a factor of 40!!

What is even more unfortunate and even frightening is the way in which the misinformation causes fear among us.  The table below clearly shows the increasing fear of negative health consequences among the younger age groups in spite of the lowered risk of death from COVID-19.

The following statement from the Franklin Templeton report summarizes how misinformation can be used to generate fear and influence partisan outcomes (emphasis mine):

Fear and anger are the most reliable drivers of engagement; scary tales of young victims of the pandemic, intimating that we are all at risk of dying, quickly go viral; so do stories that blame everything on your political adversaries. Both social and traditional media have been churning out both types of narratives in order to generate more clicks and increase their audience.

Media and Partisanship Blamed
The more access we have to information about risks to our health and well being the greater the likelihood that we will make decisions that favor our safety and minimize our fears.  If this claim is true and the survey data is accurate, how can Americans make good decisions based on risk to personal health if they misunderstand the risk.  The same applies to making good policy decisions on the part of policymakers.

For instance, if the risk of death among school and college age young people is less than 0.2%, how can we justify closing classrooms and canceling sports?  If the survey results are accurate, the current debates about whether or not to open classrooms and schedule school or college sports this Fall are being made by poorly informed administrators, educators, students, athletes, parents, and policymakers.  But never mind the actual data.  If the media and political actors can create the “perception” of greater risk than reality, then they can use a falsely generated fear to manipulate us to follow unrealistic guidelines.

Proof of media involvement in creating a misinformed public is seen in the differences in responses between those who identify as Democrats and those identifying as Republicans.    “People who get their information predominantly from social media have the most erroneous and distorted perception of risk.  Those who identify as Democrats tend to mistakenly overstate the risk of death from COVID-19 for younger people much more than Republicans.”  Most cable news watchers are aware of the vast difference in messaging between CNN or MSNBC and FoxNews.

The Franklin Templeton/Gallup survey predicts that if “…those who can afford it are willing to pay significantly more for extra perceived safety, we might see a significant rise in inflation down the line.  Again, misinformation can lead to unwarranted fear which in turn makes a population vulnerable to manipulation in directions that fit partisan priorities and visions for a restructured American government and society.

It is becoming clear that misinformation and resultant unwarranted fear may be the greater threat from the COVID-19 pandemic.  Consider the following statement from the survey report:

From a public interest perspective, we believe the top priority should be better information and a less partisan, more fact-based public debate.  The fact that a large share of the population overestimates the COVID-19 danger to the young will make a targeted public health response more difficult to agree on. We think it is also likely to delay the recovery, causing a deeper and prolonged recession.

We Need to Be Informed
Maybe it is time we devote some extra time to becoming accurately informed by doing our own research and making decisions accordingly.  At the same time, we who are called to love our neighbor as ourselves (Mark 12: 31) need to deal graciously with those who are more fearful of negative health consequences whether or not their fear is warranted. 

Hopefully, readers who look in more detail at the Franklin Templeton and Gallup Survey will be better informed and able to articulate truth to neighbors who are misled or confused.  Otherwise, the greater risk may not be COVID-19.  Instead, we may experience very dire consequences to our culture and nation from those who seek to use the virus for selfish political motives.

Remember the words from the Prophet Hosea, My people are destroyed for lack of knowledge (Hosea 4: 6).  If you’d like to stay informed as the survey continues to expand over the coming months, you can receive ongoing updates on the project's findings by signing up here.  

What Do You Think?
Do you consider yourself well informed about the pandemic?  How well did you score on the opening three polling questions?  If you’d like to respond to this blog with comments or questions, just use the “Comments” link below, or contact me at silviusj@gmail.com   Thank you for reading, and may God honor your efforts to be informed, make good decisions, and inform others as we try to learn how best to respond to the pandemic and the politics surrounding it.

“Playing Better Defense”-- Against COVID-19

Some have called planet Earth the “Blue Jewel” because of the way in which its lovely blue and white appearance from outer space sparkles in the midst of the blackness all around it.  Although there is some disagreement about how it occurred, planet Earth appears to be perfectly suited to support life as we know it.  The anthropic principle maintains that if Earth did not have its precise combination of physical, chemical, magnetic, and cosmic relationships, life as we know it could not exist.

In spite of its amazing, life-supporting, “Blue Jewel” status, planet Earth is also a very dangerous place to live.  Human mortality rate in the long haul is 100%.  Everyone eventually dies.  Each of us have known family members or friends whose lives were seemingly “prematurely” ended.  Pathogens like COVID-19 very often do not directly cause death but instead add stress to the body, mind, and spirit of those who are “at-risk” due to age, genetic, or health reasons.  Because of this, “cause of death” is often difficult to assign to one factor.

Thankfully, there is much more good news for us than bad during these uncertain days of the pandemic.  For people who understand the more enduring principles of human life, there is a good alternative to succumbing to confusion, worry, and fear of “the virus.”  The alternative is to “play better defense.”  We need to ask ourselves, “Are we ‘playing the best defense we can play’ against the COVID-19 threat?”

To me, “playing the best defense” begins with the understanding that our bodies are the amazing result of intelligent design.  According to the Bible, Jehovah God is the Intelligent Designer (See Creation’s Complexity Can Be Convicting).  God gave the first humans the moral authority to exercise dominion and stewardship over creation (Genesis 1: 27-28; 2: 15).  God’s assignment to Adam (Genesis 2: 16-20) is still ours.  Like Adam, we accomplish stewardship through the obedient exercise of our God-given gifts of reasoning, inquiry, and creativity.  This principle of stewardship features a complementary relationship, or con-service, between God’s creating and sustaining role and our responsible role as wise managers of what belongs to God, including our bodies (See Fundamentals of Conservation, Part 3 "Serving with Our Neighbor)."

Stewardship of Our Bodies
In the context of our stewardship of creation and our own health, let’s examine the basis for “playing the best defense” against the COVID-19 threat.  “Health” in its broad definition is best maintained through wise stewardship of the physical environment of Earth.  Then, within a healthy environment we enhance our own personal health by maintaining our daily rhythms of work and rest, eating of nutritious foods, and recreation through activities that promote physical, emotional, and spiritual well-being.  God’s part in this design and plan is evident when we consider three types of defense against viruses and other pathogens.  We’ll classify these as innate immunity, acquired (adaptive) immunity, and “spiritual defenses.”  All three categories function interdependently but we will consider each separately.  My discussion of these will be brief and certainly open to correction by readers who have much more knowledge of human anatomy and physiology, psychology, and theology than I.

Innate Immunity
Innate immunity is generally associated with physical barriers (e.g. skin, body openings and tracts into the interior of the body) and secretions (e.g. mucous, saliva, tears, sweat, oil, wax, and gastric acid) that provide protection both exterior and within passageways and internal organs of our bodies.

Our skin is an organ composed of three layers of tissue and provides the principal physical barrier against pathogens.  The epidermis provides the outer protective layer and determines skin color.  Beneath the epidermis is the dermis which contains sweat glands for evaporative cooling, oil glands for waterproofing, and hair follicles.  Finally, subcutaneous tissue consists of fat, connective tissue, and blood vessels.  Our part in maintaining our health is to keep our skin clean and to protect it from excessive dryness, burning, cuts and abrasions.  And, we must see that our skin is medically treated when it is damaged. 

Our skin covering is interrupted by specialized openings for visual, auditory, respiratory, digestive, and reproductive functions—i.e. eyes, mouth, nasal passage, ear canal, anus, and genitals.  Each of these openings have complex mechanisms to protect our bodies from entry of debris and pathogens.  For example, our nasal passages contain nasal hairs which collect dust particles and control moisture.  Our respiratory tract is lined with ciliated epithelium which physically directs particles away from our lungs.  In addition to its function in physical and enzymatic digestion of food, our saliva contains both antibacterial and antiviral agents, and promotes wound healing.  Our eyes produce secretions that have antiseptic and antibiotic properties.  For more details on the human eye, see “Tears for Good Reasons—At Least for Now.”  

Our innate immune system also includes various types of blood cells, including large white blood cells (lymphocytes) known as macrophages.  These cells circulate in the blood and “ingest” viruses, bacteria, worn out body cells, debris, and inflamed body cells that could go rogue and cause cancer.  Macrophages also secrete small protein molecules called cytokines which facilitate the entry of lymphocytes known as “natural killer cells” (NK cells) into tumor cells and viral infected cells, thus facilitating destruction. 

Unfortunately, when our innate immune system is compromised due to age or poor health, it may overreact to Coronavirus invasion, causing a so-called cytokine storm.  COVID-19 deaths often result when the virus causes a cytokine storm leading to widespread attacks by NK cells that inflame the respiratory system.  Again, as with our skin, it is our stewardship responsibility to maintain each of these components if we wish to “play a better external defense” against disease.

Innate Immunity and Masks
Masks or respirators with varying degrees of sophistication have been used for many years in a variety of settings to prevent entry of dust, pollen, pathogens, or toxic aerosols and gases.  There have been confusing signals from the Coronavirus Task Team and a general lack of clear evidence that wearing masks is effective in preventing the spread of COVID-19.  (See “COVID-19 Transmission – “Unmasking” Science.”

According to a WHO Guidance Report, “…the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets.”  However, according to a Nature Medicine report, “surgical masks can efficaciously reduce the emission of influenza virus particles into the environment in respiratory droplets, but not in aerosols.”  The report also stated that “Among the samples collected without a face mask, we found that the majority of participants with influenza virus and coronavirus infection did not shed detectable virus in respiratory droplets or aerosols…” An updated WHO Report this month (July) calls for further studies on “what role aerosols might play in transmission.”

Our brief summary of innate immune defenses ought to impress upon you just how complicated, overlapping, and potentially effective these defenses are.  While there is much attention and controversy focused on the social implications of wearing a mask and social distancing, let us not forget our individual stewardship responsibility to maintain our innate immune system through proper hygiene, nutrition, rest, and outdoor exposures.   The same principle applies to our acquired or adaptive immune system.

VIDEO CLIPS:
Nutrition and Your Immune System

How Coronavirus Confuses the Immune System

Acquired Immunity
Our acquired immune system is fully integrated with our innate immunity, especially since both systems rely on lymphocytes within the bloodstream.  But while all of us are born with the components of the innate immune system, lymphocytes of the acquired immune system are designed to respond in specific ways towart specific pathogen we encounter during our life.  The response involves white blood cells known as B Cells and T-cells.  The B Cells secrete antibodies when triggered by the presence of an antigen, a foreign protein of a pathogen; whereas, T cells produce and “wear” antibodies on their surfaces to bind the antigens of pathogens.   

If we are exposed to Coronavirus, a healthy defense response would involve production of antibodies that should be able to defeat the virus.  The hope is that we can develop a vaccine which would contain a weakened form of the Coronavirus antigen(s) to trigger antibody production and thus “acquired immunity.” The Life Science website gives additional details on B and T cell immunity and how they relate to acquiring natural immunity and also, the chances of manufacturing an effective vaccine.

Our brief introduction to acquired immunity again reveals the importance of maintaining our health.  Among factors that can weaken our immune system are prolonged grief, stress, alcohol, and smoking.  Nutritional deficiencies include low vitamin D and insufficient intake of fruits and vegetables.  Lack of sleep, exercise, and exposure to the outdoors also weaken immunity.  The result of poor health habits are health conditions that weaken our immune system.  Besides aging, these include obesity, diabetes, high blood pressure, coronary heart disease, respiratory condition, and cerebrovascular disease.  Given the high frequency of people who practice poor health habits and who experience emotional as well as physical problems, is it possible that our third and final type of defense against pathogens and disease has been underestimated?

“Spiritual Defense” against Disease
It is scientifically established that emotional stress weakens the human immune system and can lead to greater susceptibility to infections and disease.  According to a publication of the American Psychological Association, “Stress Weakens the Immune System.”  We have already discussed the role of a healthy spiritual life in helping us to “play a better defense” against viruses and other pathogens.  In the article, “Coronavirus Resistance: Biological and Spiritual,” we presented evidence from Scripture and from science to support the belief that a person of strong, practicing faith in God can find joy and peace emotionally and spiritually in place of fear, hopelessness, and despair.

COVID-19 Meets the Human Immune System
This article has outlined the amazing design and function of the human body’s defenses against pathogen infections.  We have only scratched the surface of subject of how the human immune system defends against viruses.  However, if our immune systems are as effective as they are claimed to be, then the proof should be in how well humans can resist infection, disease, and death from pathogens like COVID-19.   Let’s test this hypothesis against the current mortality and percentage of recovery from virus infection.

The data table represents total population in selected states, number of tests, positive tests, deaths, mortality, and percent recovery.  Of particular interest to demonstrate effectiveness of the human immune system against COVID-19 is the relatively small number of positive cases compared to the number of tests; the relatively small number of deaths compared to the number of positive cases; and, the relatively small percentage if infected people who died compared to the percent recovering.  In each of these pairings, the degree to which first number (or percentage) is smaller than the second is a testimony not only to our health care system and access to generally good nutrition, sanitation, and living conditions but also to a generally very effective immune system. 

In many states, especially where elderly people with COVID-19 were not moved into crowded nursing homes, percent recovery is up to 99%!  These data suggest that we have an amazing immune system which is largely effective in providing resistance to COVID-19 infection, and where infection does occur, effective in overcoming the infection and resulting in a high percentage of recovery.  The upshot is that our most certain and ultimate protection from COVID-19 resides in making good choices to maintain our health in body, mind, and spirit.

What Are Your Thoughts and Questions?
There are many “invitations” in this article for you to respond with your comments and questions.  I’m especially interested in what you are doing to maintain your nutritional and spiritual health. Please use the “Comment” link below.  Also, may I encourage you to “Subscribe to Oikonomia” by responding to my invitation in the right sidebar above?   Thank you!

COVID-19 Transmission: “Unmasking” Science

I’d like to think that most Americans still believe that truth exists, that truth can be known, and that we make the best decisions when we have truthful information.  Science, especially “good science,” is one way of finding and publishing correct truth claims.  However, in the era of COVID-19, it seems there are many “middle people” operating between what science discovers and what the average person reads or hears in the news.  For example, there are scientific studies of the efficacy of masks in preventing spread of viruses.  Then, there are news reports recommending whether or not we ought to wear masks.  What is the truth about masks?  

You are no doubt aware of the mixed signals regarding whether or not we should wear masks that have come from the Coronavirus Task Team members, especially Dr. Anthony Fauci.  This confusion could be an indication that political bias and efforts to influence policy may be creating static in the signals between the actual scientific findings on mask wearing and the recommendations we receive through media sources.

The purpose of this article is not to convince you of whether or not to wear a mask. Instead, as I tried to do with an April article, (See COVID-19 Policies & Outcomes: Learning Online), my purpose here is to simply reference several scientific studies to show how researchers report their findings, make conclusions, and offer recommendations based on their results.  In other words, I want to take us back to the primary sources, the journal articles from the scientific laboratories.  These are the sources of information from which newspaper and TV journalists obtain their information.  Resultant newsprint or media newscasts which most of us receive are considered secondary sources, and perhaps tertiary sources, any of which are subject to accidental or deliberate errors.

What follows are references to two primary (scientific journal) sources which report recent studies of the effectiveness of masks in intercepting COVID-19 and other viruses.  I am also including one secondary source compiled by the World Health Organization (WHO) based primary sources.  Each title is accompanied with the link so you can obtain the article in PDF format to read for yourself.  I have given each source a handy label which I can use to refer to each article as follows:

1)  Vietnam Study (2015)
MacIntyre CR, Seale H, Dung TC, et al.  A cluster randomised trial of cloth masks compared with medical masks in healthcare workers. BMJ Open 2015;5: e006577. doi:10.1136/bmjopen-2014-006577
Locate Article:  HERE

2)  WHO Guidance Report
Advice on the use of masks in the context of COVID-19  -- WHO in April, 2020

Locate Article (automatic download of PDF): HERE

3)  Nature Medicine study:
Leung, N.H.L., D. K. W. Chu, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks.  Nature Medicine 26: 676–680, May 2020
Locate Article:  HERE

Vietnam Study
The “Vietnam study” involved 1,607 hospital health care workers (age 18 or older) employed full-time in selected high-risk wards among 14 different hospitals.  The objective of this study was “to compare the efficacy of cotton cloth masks to medical masks in hospital healthcare workers.”  Their conclusions are as follows:

Caution against Cloth Masks:  “This study is the first randomized critical trial of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally.  However, as a precautionary measure, cloth masks should not be recommended for health care workers, particularly in high-risk situations, and guidelines need to be updated.”

The results of the “Vietnam study” were summarized in the adjacent graphic presented by the Laura Ingraham Angle on Fox News.  This news channel is a secondary source that is seen by millions of viewers.  The Fox News summary accurately presents the conclusions of the study.  However, reading the journal article reveals several complicating factors that are typically missed in news reporting.  The following excerpt from the journal article addresses some of the limitations of the study:

A limitation of this study is that we did not measure compliance with hand hygiene, and the results reflect self-reported compliance, which may be subject to recall or other types of bias. Another limitation of this study is the lack of a no-mask control group and the high use of masks in the controls, which makes interpretation of the results more difficult. In addition, the quality of paper and cloth masks varies widely around the world, so the results may not be generalisable to all settings (MacIntyre C.R. et al, p. 7).

What can we take away from the “Vietnam Study?”  First, the “Vietnam Study” appears to demonstrate “good science.”  The researchers were objective, conducted experiments and analyzed data with care, tried to avoid bias, were careful not to overstate conclusions, and invited scrutiny and critical analysis by peers and readers.

Second, primary journal sources often contain admissions of limitations that may or may not affect the conclusions; and, usually suggest the need for additional scientific research.  However, news reporting based on these primary sources often do not include these details.  Therefore, I encourage readers to check out the “Vietnam Study” article itself to gain more of a sense of how science is conducted and reported. 

Finally, the “Vietnam Study” provides much reason for us to question the efficacy of cotton cloth masks in preventing transmission of virus, and suggests that “moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection.”  We ought to be asking, “Is it possible that by wearing a mask I am increasing my risk of infection?”  How will this scientific study affect your choices, and the current policies of our state governors regarding masks?

WHO Guidance Report
Unlike the “Vietnam Study,” the “WHO Interim Guidance Report” is a secondary source with recommendations based on primary research reports.  This secondary source by definition represents interpretations and recommendations made by at least some people who were not directly involved in primary research and reporting.  However, if the interpretations and recommendations are accurate, the secondary source can reveal patterns and trends based on multiple research results including the “Vietnam Study” by MacIntyre CR, Seale H, Dung TC, et al.  cited above. 

The “WHO Guidance Report” offers the following summation concerning the efficacy of wearing masks to prevent spread of COVID-19:
When infected people wear masks:  “Studies of influenza, influenza-like illness, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets.”

When uninfected people wear masks:  “There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure. However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19 (WHO Interim Guidance Report, p. 1).”

This April, 2020 recommendation by WHO was consistent with the recommendation at the time from Dr. Anthony Fauci who informed Americans that “There’s no reason to be walking around with a mask.  When you’re are in the middle of an outbreak, wearing a mask might make people feel a bit better, and it might even block a droplet, but it’s not providing the perfect protection that people think that it is.” 

Facebook now flags the April interview with Dr. Fauci as “false information.  Dr. Fauci later recommended wearing of masks and explained that his turn-around was based on his concern that if everyone wore a mask, healthcare workers would be left in short supply.  However, another April study, this one published in Nature Medicine, seems to confirm Dr. Fauci’s original recommendation against the need for wearing masks.  Is it possible that Dr. Fauci was scientifically correct in his April recommendation?  Let’s have a closer look at the “Nature Medicine Study.”

Nature Medicine Study
This report, published online April 3, 2020, is a primary source from a reputable journal.  The study was conducted from March, 2013 through May, 2016 in a general outpatient clinic of a private hospital in Hong Kong.  Researchers “screened 3,363 individuals in two study phases, ultimately enrolling 246 individuals who provided exhaled breath samples.  Among these 246 participants, 122 (50%) participants were randomized to not wearing a face mask during the first exhaled breath collection and 124 (50%) participants were randomized to wearing a face mask. Overall, 49 (20%) voluntarily provided a second exhaled breath collection of the alternate type.”

Results of the “Nature Medicine Study” were summarized as follows:
Virus Transmission in Air:  “Our results indicate that aerosol transmission is a potential mode of transmission for coronaviruses as well as influenza viruses and rhinoviruses.”
Efficacy of Masks:  “Our findings indicate that surgical masks can efficaciously reduce the emission of influenza virus particles into the environment in respiratory droplets, but not in aerosols.”
Very Little Virus Shedding:  “Among the samples collected without a face mask, we found that the majority of participants with influenza virus and coronavirus infection did not shed detectable virus in respiratory droplets or aerosols…”

The “Nature Medicine Study” affirms that coronaviruses can be transmitted in respiratory droplets (size greater than 5 micrometers) and in aerosols (size = less than 5 micrometers).  Surgical face masks (# 62356, Kimberly-Clark) reduced transmission of virus in respiratory droplets but not virus transmission in the smaller aerosols.  This result should be unsettling to infected people who depend on mask wearing to reduce transmission to others, and even to noninfected people who depend on masks to avoid infection.  However, there is some good news from this study; namely, the indication that the majority of those infected with coronavirus did not shed virus in either droplets or aerosols!

Summary Considerations
In summary, I have reviewed two primary literature sources and one secondary source.  All of them provide significant findings that should be taken into consideration when policy makers and we as individuals decide on whether or not to wear a mask; and, for what purpose, or what kind of mask, or how to avoid increasing risk of infection as a mask-wearer.  Perhaps most telling to us is whether we have been surprised by any of the results reported in these three studies.  I suggest that the degree to which we are surprised reflects the degree to which we have depended solely on broadcast media (secondary sources) as most Americans do.  

Unless we have a media source that does the hard work of extracting results from primary scientific sources, and reports it objectively without political bias, we will not be able to do as many say we should do-- “just follow the science.”  In the case of mask wearing, as I have discussed here, there appears to be “good science” and at least some good journalism, suggesting that we do well not to put too much trust in cotton cloth masks even if there are dozens of websites that tell us how to make cloth masks.  Furthermore, depending how we use the mask we could even increase our risk of infection.  Nor is there clear evidence that masks are stopping aerosol transmission of virus as much as the fact that virus shedding by infected individuals may be much less than we imagine.

What Do You Think About It?

As always, I welcome your opinions, corrections, questions.  Just use the “Comments” link below.  And, if you would like another COVID-19 related topic to research “back into the science,” consider hydroxychloroquine which as been shown to be efficacious against COVID-19 if prescribed appropriately but which has been opposed vehemently by many in the liberal media.   See Hydroxychloroquine: “Good Science” Challenges Politicized Science and a recent interview with Dr. Harvey Risch, Yale epidemiologist.  Why aren’t we following the science?”

If We Had Only Known: But Why Didn’t We?

After nearly three months of social distancing and economic shutdowns aimed at preventing the spread of COVID-19, what do we have to show for the policies aimed at preventing the spread of the virus?  Answer:  Tens of millions of Americans out of work, thousands of businesses destroyed, our health care system disrupted, schools and colleges across the land shuttered, and over 40,000 at-risk senior citizens who were exposed to virus infection and caused to die.  The actual virulence of the disease and the number of lives saved by all of this remains unknown.

What a staggering price to pay in order to defeat a virus!  But was all of this really necessary?
According to The Blaze, "A U.S. Centers for Disease Control and Prevention report published April 1 cited the ‘potential for presymptomatic transmission’ as a reason for the importance of social distancing, the network said.”  However, there was significant dissension within science and medicine.  Now, heads are wagging and many are regretting not having listened to the dissenters; or, regretting that many dissenting voices of science were marginalized or silenced.

The World Health Organization (WHO), according to CNBC, now claims that asymptomatic carriers of COVID-19 rarely spread the virus!  According to a CNN report yesterday, Dr. Maria Van Kerkhove, head of WHO's emerging diseases and zoonosis unit has stated, "We have a number of reports from countries who are doing very detailed contact tracing. They're following asymptomatic cases. They're following contacts. And they're not finding secondary transmission onward.  It's very rare."

Based on an article this morning in BBC News, the Van Kerkhove statements may be a bit too emphatic given the size of the study she referenced.  The article stated that, “While people without symptoms do seem to be capable of infecting others, current evidence still suggests people with symptoms are the highest risk” of transmitting the disease. The article adds that a positive test doesn’t tell us the “viral load” (how much virus in a person’s system).  However, Dr. Van Kerkove still maintains that secondary transmission requires high viral load which are passed mainly through infectious droplets from coughing and sneezing.  She adds, “If we actually followed all of the symptomatic cases, isolated those cases, followed the contacts and quarantined those cases, we would drastically reduce (Parenthetically, she inserted:  I would love to be able to give a proportion of how much transmission we would actually stop.) but it would be a drastic reduction in transmission."

WHO:  Accountability and Admission of Error
Are you shocked?   Many are not.  If Dr. Van Kerkhove’s assessments are true, then prior suspicions toward the WHO are only being further confirmed.  While some still question how much virus transmission can occur just prior to expression of symptoms, it is looking more and more like the WHO is either incompetent or complicit in an effort to distort the truth.  At very best, it appears that the measures that resulted from WHO and CDC recommendations were much too drastic to be justified by the limited data and associated predictive models.

Although somewhat haltingly, the WHO is basically admitting that the decision to institute social distancing and business shutdowns, supposedly “following the science," was misguided.  If, instead of recommending the widespread social isolation and lock down of all but essential services, health officials had simply recommended tracking, tracing, and isolating symptomatic cases, the COVID-19 pandemic may have had no greater impact than annual influenza viruses that come and go.

If these recent claims of WHO officials are confirmed in the days ahead, history may record the “COVID-19 pandemic” as one of its greatest fiascos.  Of major concern already is not only the disruption of our economy, health care, education, family, social interactions, and worship, but the avoidable deaths of 40,000 of our senior citizens who were left vulnerable and then moved in large numbers into close quarters where COVID-19 infection and death were largely unavoidable.  But I believe we will be adding insult to injury if millions of Americans and billions worldwide do not raise some serious questions that justify a major investigation of exactly who and what led us down this costly and deadly path.  

Important Questions:  Answers Please?
Here are some questions for starters:
1.  What was the origin of the COVID-19 (SARS-CoV-2) virus?
2.  Why did the Chinese Communists silence several of their prominent scientists?
3.  Why did these Chinese leaders claim the virus was not contagious while they were restricting travel from Wuhan and grabbing up related health care equipment?
4.  Did the Chinese Communist regime conspire with the WHO to control information flow?
5.  Why was doctor-prescribed use of Hydroxychloroquine so strongly opposed by many?
6.  Who are those responsible for decisions that led to the deaths of over 40,000 residents of nursing homes and long-term care facilities, representing 40% of the COVID-19 deaths in the US.
7.  Why have the WHO and CDC now begun to admit to recommending measures that were unprecedented and apparently too drastic? 
8.  In what particular ways did the media fail America and other nations by essentially censoring dissenting voices?  See Hydroxychloroquine: “Good Science” Challenges Politicized Science.
9.  Were there instances in which scientists deliberately acted unethically by withholding data and assessments that might have led to an end of the lockdown much earlier.   See Bring a Speedy End to the Pandemic Shutdown
10.  Is it time for a national discussion to heighten our awareness of how important good journalism and honest reporting by the media is to maintaining our democratic republic?
11.  What changes need to be made to assure that our national leaders receive broader-based, expert scientific and epidemiological input and can make good decisions to protect American people?
12.  How can Christians strengthen their faith in God and sharpen their discernment of the issues of our time, and then position themselves to be able to represent Christ to people mired in confusion, anxiety, depression, addiction, and fear?

With Question #12 in mind, I am finding Luke 21, particularly verses 7-19, very relevant to the events of our day.  While careful study is needed to place the future events Jesus is describing into context, He makes two statements that should be very encouraging (New Living Translation): 
Luke 21: 9 -- And when you hear of wars and insurrections, don’t panic.
Luke 21: 13 -- But this will be your opportunity to tell them about me.

I do not want to pretend to have all of the answers to the COVID-19 pandemic, nor even all of the questions.  I realize that there are many dedicated, honest professionals that were and are involved in some aspect of the pandemic; and, I don’t want to impugn well-meaning, honest people, nor deny the fact that hindsight sometimes prompts great criticism of decisionmakers.  Yet, the questions I have raised are among those that we would do well to answer in the days ahead.

How About You?
Are there particular questions you have about how the pandemic was handled, or about factors that influenced policy to move in such an unwise direction?  How have these events influenced your trust in “science,” the media, our leadership in Washington, and health care professionals?  How has the pandemic influenced your faith in God?

Hydroxychloroquine: “Good Science” Challenges Politicized Science

Hydroxychloroquine (HCQ), for over 60 years a familiar antimalarial drug, has fast become one of the most popular subjects in daily news surrounding the COVID-19 virus pandemic  allegedly caused by Chinese Communist mismanagement of a lab in Wuhan, China.  Like any drug, the safety and efficacy of HCQ as a treatment for a new disease, ought to be thoroughly investigated.  However, in spite of numerous favorable reports of the life-saving benefit of doctor-prescribed HCQ, many influential people including Dr. Anthony Fauci continue to oppose its use.  Are there legitimate reasons for this opposition to a potentially life-saving drug?   Or are we about to see just how many lives will be lost simply because “good science” is being ignored or silenced by selfish political and economic agendas? 

So-called “good science” has been a frequent subject of my blog writing in Oikonomia (Greek = “household management; or, stewardship”).  To me, “good science” is an inquiry into the workings of the “household of creation” by those who recognize the necessity of and abide by a faith-based ethical foundation for their pursuit of truth [See “The Conscience of Science: Part 1 Ethics & Accountability.”]  A faith-based ethic enables the scientist to see that his or her pursuit of truth is good stewardship of his or her God-given intellectual gifts.  Scientists who view their science as a stewardship are more likely to contribute in ways that promote the flourishing of God’s creation.  In so doing, they bring benefit to all mankind.  Above all, “good science” ought to be guided by honesty in its inquiry and in reporting of conclusions.

We can only hope that current debate over the safety and efficacy of hydroxychloroquine (HCQ) will be governed by “good science” and later remembered by the thousands of lives it saved.  Therefore, I am encouraged by an article authored by Dr. Harvey Risch, a Yale epidemiologist, published May 27 in the Journal of Epidemiology.  In it, Dr. Risch refutes an earlier article published in The Lancet which had caused the World Health Organization to halt trials of HCQ as a treatment for COVID-19 infections.  Dr. Risch’s critique is a classic lesson in careful scientific analysis of published results.  It also illustrates the importance of peer review in verifying scientific methodology and correct application of results.  I encourage you to read the article.

In order to provide context for this stage of the COVID-19 pandemic, Dr. Risch estimates that over 1.6 million Americans have been infected and up to 10 to 50-fold larger numbers of people carry antibodies to the virus.  In spite of “flattening the curve” through mask-wearing, social distancing, etc., Dr. Risch believes that over time

…very large numbers of people in the US may eventually get the infection.  The great majority of infected people are at low risk for progression or will manifest the infection asymptomatically. For the rest, outpatient treatment is required that prevents disease progression and hospitalization.  Exposures will occur as isolation policies are lifted and people begin to mix, even with various degrees of public isolation such as mask usage and physical separation still in place.

Dr. Risch also recognizes that, while we are averaging an estimated 10,000 COVID-19 deaths per week in the US, we are facing a greater risk of deaths due to policies that have created an unsustainable economic and social condition with over 36 million Americans out of work and disruptions in many essential services necessary to maintain our physical, emotional, and spiritual well-being.  He concludes: “We are rapidly reaching a breaking point in the ability to maintain the status quo; states have begun the process of lifting their restrictions, and we thus need to evaluate what evidence we do have for promising outpatient treatments.” 

Dr. Risch’s COVID-19 treatment recommendation may be summarized as follows (emphasis mine):

… the key to returning society toward normal functioning and to preventing huge loss of life, especially among older individuals, people with comorbidities, African Americans and Hispanics and Latinos, is a safe, effective and proactive outpatient treatment that prevents hospitalization in the first place.

Based on Dr. Risch’s analysis of the results of numerous treatments in which COVID-19 patients were given HCQ in combination with the antibiotic azithromycin (i.e. HCQ+AZ), his recommendation is as follows (emphasis mine):

HCQ+AZ has been directly studied in actual early high-risk outpatient use with all of its temporal considerations and found empirically to have sufficient epidemiologic evidence for its effective and safe employment that way, and that requiring delay of such general use until availability of additional RCT (randomized controlled trial) evidence is untenable because of the ongoing and projected continuing mortality. No studies of Covid-19 outpatient HCQ+AZ use have shown higher mortality with such use than without, cardiac arrhythmias included, thus there is no empirical downside to this combined medication use.

The strong support for the use of HCQ+AZ from Dr. Risch was accompanied by two other endorsements of its therapeutic value.  Last week, President Trump announced that he has been using a prescription of HCQ, demonstrating that he is willing to put his health on the line to support his belief in the safety and efficacy of HCQ.  Then, this week, Breitbart reported that HCQ will be administered by Britain’s National Health Service (NHS) to as many as 10,000 health workers representing up to 20 hospitals as part of a clinical trial.

In conclusion, the debate continues between those who favor and those who oppose the use of hydroxychloroquine plus azithromycin (HCQ+AZ) for early treatment of high-risk COVID-19 patients.  However, the May 27 publication of Dr. Harvey Risch’s thorough analysis as summarized here ought to make the prescription of these drugs the centerpiece of our COVID-19 treatment strategy.  

It remains to be seen which voices will have the most influence on policy makers and medical health professionals--the voices of "good science" or the voices of those with political agendas that seem to care little about either “following the science” or protecting individual lives.   Meanwhile, I am siding with the voice of “good science” and can only hope HCQ+AZ will be available to me in the event that I am infected with COVID-19 and require medical intervention.  

Bring a Speedy End to the Pandemic Shutdown

Some baby-boomers like me remember a stressful part of our childhood:  having to get a penicillin shot, or waiting in line for “the needle” for vaccinations.  I’m not sure which was worse, the anticipation or the needle prick itself.  But afterwards, my fear and pain were eased by a warm feeling that I was protected from becoming ill.  Today, the results affirm the success of antibiotics and vaccines.  The anxiety and pain were a small price for a good outcome.

But what if, in order to protect us and our nation from a mortal enemy, we were required to surrender freedoms that we hold dear?  Such a request or demand would have a much more pervasive affect on our lives than the requirement to stand in line for a vaccination? 

Our COVID-19 Conundrum – Looking Back
As you know, my “what if” became a reality on March 15 of this year—the day that 65 Coronavirus deaths were reported in the US.  On that date, Dr. Anthony Fauci and the White House Task Force instituted a 14-day “national shutdown” with “social distancing” and limitations on our coming and going.  The purpose was to “flatten the curve” of daily hospitalizations and viral infections so that hospitals would not be driven beyond capacity.  But 14 days of shutdown was gradually extended to 1 month.  By that time, many voices in the medical and epidemiological fields were questioning the wisdom of this policy.

With all due regard for any loss of life due to the Coronavirus, many of us asked whether the national shutdown was actually saving lives.  Or, was it simply flattening the curve of infections and hospitalizations and delaying inevitable exposures and infections with uncertain future consequences?   By mid-April it had caused thousands of small businesses to close, millions of people to be unemployed, delays in scheduling of medical procedures, disruption of church worship and other human social interactions, and resultant mental stresses and suicides due to social isolation. 

Because of my own personal skepticism, I began to research the science and statistics related to the COVID-19 pandemic and shutdown.  At the same time, I wanted to assess my own attitude and faith in response to the pandemic threat on my life and family.  About this time (April 17), after one month of national shutdown, the US was approaching 40,000 deaths almost half of which originated in New York state.  I wrote a blog article entitled “Considerations for Our COVID-19 Conundrum” which outlines how I was personally responding to the pandemic and shutdown.  [I believe this article still contains valuable recommendations for readers who want to maintain their “health” in body, mind, and spirit.]

One week later (April 24), I had posted another article on COVID-19, entitled  “COVID-19 Policies &  Outcomes: Learning Online.”  Here, I cited experts who were concerned that the indirect effects of social distancing and the economic shutdown were having more devastating long-term effects than the COVID-19 virus itself.  The primary goal of “flattening the curve” had been reached in most parts of the US.  So, the rationale for remaining locked down shifted to a seemingly trumped up fear based on questionable predictive models and a philosophy that we ought to remain shut down until a vaccination is developed.  Fortunately, in spite of these dire warnings, several state governors began to aggressively follow the phase-in plan offered by President Trump and the White House task force. 

It’s Time to End the Shutdown
During the next two weeks, it became more and more obvious to those who followed objective media sources that the economic, social, and even medical costs of prolonged partial lockdown were exceeding the benefits in saving of lives.  Everywhere, hospital capacity and equipment to treat COVID-19 patients were all much in excess of demand.  As I wrote in “COVID-19 Policy Ignores ‘Good Science’,” “some experts such as Dr. Dolores Cahill called the lockdown policy “anti-scientific” and “anti-nature” because it has ignored the importance of the human immune system and how we need to beef up our immunity through good nutrition and vitamins.”  [Dr. Cahill’s informed logic is featured in a video interview accessible in my article, “COVID-19 Policy Ignores ‘Good Science’.”]

Today, opposition to the lockdown from professionals is being joined by an increasing chorus of Americans who want to get back to work.  Dr. Scott Atlas, MD. and senior fellow and experienced policymaker of the Hoover Institute, argues that there is no reason not to move more quickly to reopen our society with proper precautions for the elderly and other at-risk individuals.  In his op ed article published May 18, in The Hill, Dr. Atlas wrote,

The total lockdown may have been justified at the start of this pandemic, but it must now end — smartly, without irrational, unnecessary requirements contrary to medical science, common sense and logic. The goal of the strict isolation was accomplished in the overwhelming majority of places. We have direct data on risk and extensive experience, individually and as a nation, with managing it, even as new cases arise. We know that gradually relaxing total isolation will lead to more infections, but that’s acceptable, given that we know whom to protect and this disease is not harmful to the vast majority of infected people.

What Do COVID-19 Data-by-State Suggest?
Yesterday, I devoted many hours to pouring over data from multiple sources.  I chose 15 states that represent 62% of the US population but which are responsible for approximately 85% of the COVID-19 deaths in the US to date (see Table).  The data by state is ranked according to “% Recovery” from lowest (top) to highest—i.e. the percentage of individuals who were “Reported Cases” who recovered and were not tallied in “Deaths.”  Note that Michigan currently has the lowest percent recovery at 90.5%.  All other states range above this percentage and reach as high as 98.3% recovery in Tennessee.

The 7 states that make up the upper-half of the table account for just over half (51%) of the total reported COVID-19 cases in the US to date but account for 67% of the total US deaths.   It is also noteworthy that nearly all of the 7 states in the upper half of the table have governors who have been slower in opening up their state than most of the 8 states in the lower half.  This suggests that governors who have been more aggressive in opening their state have not been unwise.  Both % recovery and mortality rates are lower in these more aggressive states.  More comments on my Data Table will come below as they relate to several claims by Dr. Atlas.

Supportive Data But Poor Communication
Dr. Atlas argues that neither policymakers nor the public have received several key messages that are both critical in alleviating public fear and valuable as a guide to safe reopening of society.  In his article Monday, in The Hill, Dr. Atlas lists four policy failures at the state level, each with scientific data from the CDC and other sources to support his claims.  The four policy failures he lists are as follows (emphasis mine):

1.  There has been a failure to remind everyone that the stated goal of the policy — total lockdown and whole-population isolation — has been accomplished in most of the United States, including the epicenter of New York.

2.  There has been a failure to reassure everyone that we fully anticipate more cases will occur, whether we test or not, with continuing relaxation of today’s isolation.

Many Americans are gripped in fear when they hear that more reported cases of COVID-19 are appearing daily with even more cases reported in some areas.   But remember, we are doing more testing—more testing means more reported cases!  But notice from my Data Table above that 90 to 98% of reported cases recover. 

3.  There has been a failure to educate the public that the overall fatality rate is not only far lower than previously thought but is extremely low in almost everyone other than the elderly.

Allow me to elaborate on failure #3 as it relates to the relatively large percentage of COVID-19 deaths among the elderly.  According a New York Times article, May 11, one-third of all US deaths to Coronavirus (est. 26,000, May 18) are from nursing home residents and workers.  Notice from my Data Table that nursing home deaths vary widely in percentage of total deaths by state.  

It is now believed that the large number of deaths of nursing home residents and workers in several states including NY, MA, and PA was due at least in part to the negligence or incompetence of state government officials and nursing home administrators.  The unfortunate higher number of nursing home deaths in some of these states is reflected in their higher “Mortality” rates (#Deaths/100K) (see Data Table).  The clear implication is that we dropped the ball in protecting our high-risk seniors while focusing instead on social isolation of the rest of us who are at low-risk.

4.  There has been a failure to clarify to parents the truth about the extremely low risk to children, and that has accompanied a gross failure to offer a rational medical perspective regarding schools reopening.

The #4 failure on Dr. Atlas’s list is the unfortunate lack of clear information provided to parents of young children—information which might have relieved much anxiety, and hopefully still can.  According to a Journal of the American Medical Association article cited by Dr. Atlas, “Of the critically ill children with COVID-19, more than 80% had significant long-term underlying medical conditions. Overall survival and outcomes from critical illness in infants and children with COVID-19 in this series was far better than reported for adult patients.  At the present time, our data indicate that children are at far greater risk of critical illness from influenza than from COVID-19.” 

Lack of good information and its dilution with misinformation threatens to drive school and college administrators to consider delaying reopening of classrooms in the fall of this year.  Dr. Robert Hamilton, pediatrician and founder Pacific Ocean Pediatrics, stated in an interview on The Ingraham Angle that only around 1.7% of people infected with Coronavirus are children up to age 18.  The majority of these are asymptomatic and don’t even realize they have a virus.  Meanwhile, we are learning about the negative impacts of school shutdown on adolescents and on their parents as they adjust to online courses while being deprived of spring sports and traditional commencement observances. 

Conclusion
Every human life is of great value to our Creator.  Therefore, policies dealing with the pandemic should be designed to do the greatest amount of good for the greatest number of people.  However, given that we live in a culture where the definition of “good” is so often rigorously debated, policymakers have a difficult time.  This is especially true when we allow our definition of “good” to selfishly dominate our political agendas to the point where we allow biased interpretation of data and media reporting to create an unreal world that is far from the truth.

While I have not escaped the world of pride, selfishness, error in computations, and bias, I have tried to deal accurately and honestly in compiling my Data Table and in presenting the arguments of notable scientists and policymakers.   Based on what I have gleaned from my study, I cast my small vote with those who recommend opening our culture as speedily as possible. 

Returning to my analogy of the anxiety I felt while waiting in line for my vaccination as a boy, I gladly remember that painful experience with no regrets.  However, I believe we will all have great regrets after our current painful pandemic if we don’t soon make it a priority to reopen and restore our economy, health services, family togetherness (especially with our beloved elderly), worship opportunities, education, and recreation.  Death from disease is a reality, but life and health depend on many aspects of our culture that have been restricted or ignored all too long.  As always, I welcome your “Comments.”

Acknowledgement:
This article is a joint effort between my wife, Alvadell ("Abby"), and I.  I thank her for her patience, helpful research, and critical suggestions in the writing.