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.

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?”

COVID-19 News: “Batteries Not Included”

“Batteries Not Included.” 

We’ve all read these disappointing words on the package of a newly purchased product.  It is especially unsettling when the package contains a toy, and your child or grandchild has just unwrapped it excitedly on Christmas morning.

Friday, I “opened” a different kind of “package”—an article reporting new COVID-19 cases in Ashland County here in Northeast Ohio.  With all due respect to its author(s), I selected this article because it resembles many other articles I could have chosen to illustrate the points I hope to make here. 

Like a toy that comes with “batteries not included,” this Ashland Source article comes without an important “power source”—good journalism.  But there’s also a second “battery” missing— “good science.”  The third “battery” must be supplied by educated readers who can exercise sound critical reasoning.

Good Journalism

I’m not an expert in journalism.  However, I located a list seven qualities of a good news story provided by pivotcomm.com.   A well written story should include good sources (e.g. data from “good science”) and provide the necessary focus and context that enables well-educated readers to reach accurate conclusions.  With these criteria in mind, note that the headline of our “example article” reports the occurrence of 5 new positive results of COVID-19 infection in Ashland Co.  This heading would grab attention and maybe even elicit fear among those who think a second wave of the virus is likely.

The Ashland Source article goes on to explain that 4 of the 5 COVID-19 cases “were exposed to the virus at mass gatherings – a wedding, church service, and auction – where safety precautions were not observed.”  Can you identify at least one “red flag” here?  If so, you may be asking how the 4 individuals could have known the exact place and person responsible for infecting them.  (My record at doing this is dismal.)  And finally, who verified that safety precautions were not observed at each of the events--wedding, worship service, and auction?

In spite of limited information, the article includes a stern reprimand from Heather Reffett, Ashland Co. Health Department (ACHD) Commissioner:  “If safety precautions had been in place…at least four of these new infections could likely have been avoided.”  There is no mention of how individual #5 was infected. 

Clearly, the ACHD is faithfully conducting its civil duty.  But in so doing their message through this article suggests that the citizens of the Ashland area should remain isolated and locked down much as they were in April.  But does the larger context of the pandemic in Ashland Co. support this policy?

The article would have been more helpful if it had informed the readers that the 5 new cases bring the total number of cases in Ashland Co. to 27 as of June 12.  According to the last paragraph of the article, of these 27 cases, 22 have recovered and 5 are still recovering.  Although the article dutifully lists the dates, beginning March 18, when each COVID-19 positive case was reported, it does not mention that there have been no deaths in Ashland Co. to date.  No deaths in Ashland Co!  This statistic is quite striking considering that, according to my research at the Johns Hopkins Coronavirus Resource Center, neighboring counties ranged from 1 to 61 deaths (average = 21) attributed to COVID-19.  And what about death rates statewide in Ohio?

We would expect the number of COVID-19 cases in Ohio to increase now that increased testing is occurring.  But if the virus is posing a threat to Ohioans sufficient to justify a total lockdown for nearly two months, we would expect to see a significant rise in total deaths in 2020 compared to deaths in previous years.  But, according to Dr. Mary Kate Francis, interim medical director at the Ohio Department of Health, quoted in the Akron Beacon Journal, “Despite the climbing death toll, though, total deaths are up by 1.2%, or 680 people, in 2020 compared to the previous five-year average, according to state mortality data.  It’s “hard to guess as to what could be the case or the cause” for a lack of an overall surge, though several factors have probably contributed, Francis said.

One factor to account for the absence of the predicted increase in deaths this year is the fact that epidemiological models were very misleading.  Based on modeling data, in early April, Gov. DeWine had predicted as many as 60,000 new cases in Ohio per day!  However, at the COVID-19 peak in Ohio, around April 19, less than 1,300 new cases were reported per day.  It is hard to account for this discrepancy (prediction was off by a factor of 46-to-1) based entirely on good public compliance to social distancing that “flattened the curve.”  Here is where we need “good science.”

“Good Science” Needed
I have been particularly interested in how the scientific data on COVID-19 is obtained and interpreted.  See “Pandemic—or Policy without “Good Science?” Our example article from Ashland Source refers to the basic reproduction number (or reproductive ratio, R_o) of a virus.  Please don’t panic here when you see the symbol, R_o. What follows is not beyond your ability to understand if you read slowly and stay with me.

In simply terms, R_o is the number of people that one infected person will infect in a population.  So, if one person develops the infection and passes it on to two others, the R₀ is 2.  The “0,” or naught, indicates a reproductive number (R) for a new virus in a population with zero immunity. Jeffrey K. Aronson, et al. of the Centre for Evidence-Based Medicine , University of Oxford, explain in more detailed terms that R_o is “the number of cases that are expected to occur on average in a homogeneous population as a result of infection by a single individual, when the population is susceptible at the start of an epidemic, before widespread immunity starts to develop and before any attempt has been made at immunization.”

The article refers to estimates of R_o reported by Ohio Governor Mike DeWine.  According to the governor, “Ohio’s R₀ number was as high as 1.9 in March but as of June 1, it was slightly lower than 1.”  Gov. DeWine has attributed the decrease to the interventions implemented by his administration to “flatten the curve.”  Ohio’s Region 5, which includes Ashland currently has an R₀ of 0.72.

By this time, you may realize that, by definition, R_o applies only at the start of viral infection of a population.  In contrast, the  effective reproductive number, is the number of people that can be infected at a given time during the progression of the virus in a given population.
The R_e “changes as the population becomes increasingly immunized, either by individual acquired immunity following infection or by vaccination, and also as people die.”  Gov. DeWine and the ACHD seem to be misusing the R_o value (applies only at the start of viral infection of a population).  As noted in the previous paragraph, where Gov. DeWine reports changes in R_o, in all likelihood he is referring to R_e.

The estimated R_o for COVID-19 (or SARS-CoV-2) is given in the adjacent figure from CEBM.  Note that COVID-19 to date is not significantly more deadly than several prior influenza viruses.  Yet, because we adopted the policy of broad separation and economic lockdown, this pandemic may end up being much more devastating because of economic disruption, deaths from delayed health procedures, suicides, and drug abuse.

We should note that estimates of R_o, are based on complex mathematical modeling which incorporates estimates of susceptibility, infectivity, and rate of removal of individuals by either recovery through acquired immunity or through death.  As I have already stated, considerable variability has occurred among the epidemiological models largely because they are predictive and based on limited data.  Some of the modeling error may be attributed to the unexpected compliance of our culture to social distancing guidelines.  But there is still reason to doubt their accuracy.  George Box, the noted British statistician, has quipped: “Models, of course, are never true, but fortunately it is only necessary that they be useful. For this it is usually needful only that they not be grossly wrong.”  See “Pandemic—or Policy without “Good Science?”

In conclusion, I have noted the importance of good journalism, good science, and an educated population that can think critically to read and analyze articles such as the one from Ashland Source on the topic of the COVID-19 pandemic in Ashland Co., Ohio.  So far in Ashland Co., there have been no deaths and only 27 reported cases as compared to over 5,000 cases and 303 deaths in Cuyahoga Co. (Cleveland).  Obviously, reported cases and deaths vary greatly among different Ohio counties depending on population density.  However, in no case did number of cases and deaths reach those predicted by the models used to justify the total lockdown. Today, a more recent report in Ashland Source hints that the county's low number of cases (28 as of today) and their very well executed Continuity of Operation Plan (COOP).

Nationwide, it remains to be seen whether broad isolation instead of protection of vulnerable individuals was worth the great cost of economic disruption, unemployment, interruption of routine health care, and termination of most social and cultural events, classroom education, and spiritual gatherings. 

It is not uncommon that both toys and news stories come with “batteries not included.” But let us pray that our nation doesn’t suffer from news reporting that is poorly communicated, lacking in “good science,” and even biased to serve dishonest political or economic gain.

More Questions to Consider:
1.  Can you see how important it is that we exercise caution and think critically, especially when the journalism sometimes lacks sufficient accuracy, context, and helpful assistance to critical reasoning on the part its readers. 
2.  Ohio residents, how many COVID-19 cases have currently been recorded for your county.  You can go to various sources such as Akron Beacon Journal.  Here, scroll down to the Ohio map and click on your county for statistics.  Readers from outside Ohio can find similar data at the Coronavirus Resource Center under your state.
3.  How do deaths from COVID-19 compare to other causes of death?  You can look up a listing of DEATHS BY DIFFERENT CAUSES IN YOUR STATE.  Then, observe how the average deaths from each cause for the past few years compares to the deaths in 2020 (adjusted for the fact that we are only about six months into 2020).  Particularly, how do COVID-19 deaths compare to deaths from other influenza viruses?

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.  

COVID-19 Policy Ignores “Good Science”

Since my last article on the COVID-19 pandemic and policy entitled, “Growing and Groaning into the ‘New Normal’,” we are beginning to see various degrees of progress in opening up more of the essential services of our economy.  Our elected leaders are realizing the great cost and resultant damage that is resulting from having chosen a policy of locking down and socially distancing the human population.   Many now believe that we were wrong to isolate entire populations as opposed to isolating the vulnerable and the infected as was done in past successful handlings of outbreaks.

Still, there is much controversy.  We have taken different sides on whether the policies of the current administration and respective state governors are too lenient or too restrictive.  When evidence that contradicts a person’s belief is presented, the frequent response is, “It depends on who you listen to.”  And, this is certainly a good point.  So, I’ve been looking carefully at the credentials of those who are vocal and influencing policy.

In view of the ongoing uncertainties and controversy over policies to “open up the economy,” this article simply directs the reader to some points of evidence that ought to have been considered three months ago.  The evidence comes from an informative YouTube video, produced by Dave Cullen on Computing Forever, entitled “MUST WATCH: Debunking the Narrative (With Prof. Dolores Cahill).  I have anticipated that many readers will not which to take the time to view all of this long video.  Therefore, I have selected some important segmentsof the video and provided links where readers can "jump in" to hear specific points on COVID-19 science and  policy.  At each "jump in point," you will hear the jist of a key point within 3 minutes at which time, you can stop viewing.  

I present these key points as an example of what we all ought to be looking for as we listen to “authorities, then consider carefully in a spirit of prayer how we ought to think about the issue, and then decide whether or not to contact our elected officials.

Credentials and Connections of the Speaker
Dave Cullen's valuable interview is with Dr. Dolores Cahill, an Irish scientist with degrees in molecular genetics and immunology.  She also has decades of global scale experience in antibody research.  Dr. Cahill is also chairperson of the Irish Freedom Party which advocates separation of Ireland from the European Union.  Political connections?  Certainly, but who among major scientific voices doesn’t?  Please listen HERE to her background and then we’ll address her scientific integrity.

Are We Using “Good Science?”
["Good science" has been defined elsewhere.] Dr. Cahill’s research on antibodies worldwide has been scientifically validated, in part because of her own effort to establish standards of research integrity.  She explains that research fraud is regarded as a criminal offense in Germany, where it is reported to the police, the fraudulent scientist’s name is published, and then he or she loses funding for 10 years.  In the process of her discussion, we learn some of the basics of how the rampant rise in scientific fraud can be controlled.  Also, Dr. Cahill addresses how the lockdown policy was “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.  Listen HERE to her comments on the efforts to assure global progress, accountability, and valid publications of results in antibody research and research in general.

Will the Authority Take Responsibility?
Science naturally refutes false hypotheses as part of progress in pursuit of a true understanding of phenomena.  So, the claims of science can change.  However, scientists who speak through the media ought to “own up” when new research refutes their previous claims.  Of particular concern to many is the amount of seemingly unquestioned authority that has been granted to Dr. Anthony Fauci.  But recent media reports like this one by Tucker Carlson this evening point out how Dr. Fauci has changed his recommendations several times in ways that seem untethered to epidemiology and immunology.  In view of this point, you will be encouraged to hear Dr. Cahill place her scientific reputation on the line to make three statements about the COVID-19 virus.

First, the Coronavirus is not as dangerous as it is claimed to be.  Second, once a person has had the virus their immune system clears it after 10 days and they are immune for life and should be able to function in the world without isolation.  And third, Dr. Cahill is offering her recommendation to the Irish minister of health that the lockdown in Ireland be stopped within the next 10 days with appropriate provisions for protection of vulnerable individuals and instructions for all others as they return to their normal activities.  Listen HERE to her confident recommendations.

“Good Science” Refutes Lockdown Policy
Finally, the main point of much of Dave Cullen’s video interview with Dr. Cahill is her reasoned interpretation of the epidemiological data on COVID-19.  In this segment, you will see a chart of U.S. Center for Disease Control (CDC) showing the percentage of hospital visits due to influenza-like illnesses during the past thirty weeks dating back into late autumn, 2019.  You will want to hear Dr. Cahill explain how these CDC data support her claim and the claim of an increasing number of epidemiologists that the lockdown was not necessary. 

Specific points Dr. Cahill makes are as follows:  First, our bodies house hundreds of thousands of different viruses and it is necessary for the well being of our “micro-biome” within our bodies that we naturally come into contact with viruses and bacteria.  Second, during the flu season this year, from December until April, there were three major viruses circulating the globe; and the third was COVID-19.  Third, COVID-19 had its peak in the US on March 22 and people were at peak infection ten days before.  Then, most of the population in America cleared the virus within 10 days and then the threat was essentially gone.  In Dr. Cahill’s words, “there was absolutely no need for lockdown,” even in the early weeks of the pandemic.  Listen HERE for a discussion of these data and the implications for policy decisions in the days ahead.

Thank you for reading, and I thank Brian, one of my former students at Cedarville University, for referring me to this video.  As always, I invite “Comments” as we continue to seek to be informed and share information and opinion in a reasoned and polite manner.

Coronavirus Resistance: Biological and Spiritual

Someone has said, “When FEAR knocks on our door, and FAITH answers, there is no one there.”  Admittedly, the current Coronavirus pandemic sometimes causes me to “hear fear knocking on our door.”  But then, I realize that my fear won’t solve anything.  When I make a conscious choice to anchor my emotions in solid faith, I am able to rationally respond in two major ways.

Responding to the Pandemic
First, I must take advantage of day-to-day news reports concerning the Coronavirus pandemic.  Then, as an informed American, I must willingly choose to follow instructions from federal, state, and local authorities to reduce the spread of the virus (e.g. wash my hands frequently, cover my sneezes, keep safe distances from others, and stay away from large gatherings).  Beyond these basic responsibilities, I must resign to the fact that what happens is beyond my control.  I must continually choose to cast my concerns and anxieties into God’s hands.

The second discipline I must choose is to maintain my personal nutrition and hygiene, both physically and spiritually.  Physically, I try to maintain my discipline of getting proper nutrition and rest.  My regular food intake favors fresh fruit and vegetables, eggs, meat (fish, poultry, or grass-fed beef), cereal, wheat bread, nuts, milk, and hot teas.  Since 2014, I have supplemented my food intake with a nutritional formulation called Reliv NOW wiith LunaRichX capsules which containing a naturally occurring soy peptide, the first ingredient identified to promote optimal health at the epigenetic level.  Thankfully, I have avoided colds and flu during these years.

Spiritually and emotionally, I follow the advice of those who recommend maintaining a consistent schedule and routine each day.  I am blessed to greet my Heavenly Father in the early mornings through prayer; and, try to hear from Him through reading and study of His Word recorded in the Scriptures of the Bible.  I maintain a daily journal of major events, and on some days, I record insights and helpful applications to my life from this time in the Word.  When trials come, and frequently they do, my physical and spiritual disciplines often but not always help me to respond in ways that I hope are pleasing to God and to those involved.  Finally, I try to regularly encourage and assist Abby, and we maintain contact with family and friends, and provide assistance to those who need help.

Entry of the Coronavirus (COVID19) pandemic this winter has seen me striving to maintain my physical and spiritual disciplines and to gain proper perspective toward this global threat.  To date, I have been attempting to understand the virus pandemic from a biological and spiritual perspective. 

A Biological Perspective
Biologically speaking, I’ve been comparing the threat of a virus to that of a lion or a wolf.  Lions and wolves are predators who gain their nutrition by attacking and devouring other animal species who become their prey.  Predators must often expend considerable energy in hunting, pursuing, and overpowering their prey.  Predators like wolves and lions must also contend with protective behavior of their prey such as almost equally fast running speed and traveling in herds for protection.  Sheep and other grazing animals often find protection in herds.  Worldwide, most humans no longer fear lions, wolves, and other large predators as they once did.

Smaller animals like wasps and spiders are no less predatory than large carnivores.  And these smaller predatory invertebrates must contend with even smaller animals like mites.  British mathematician and logician, Augustus de Morgan (1806-1871) highlighted the amazing size range the exists among predator-prey relationships of the Animal Kingdom in a humorous poem:

Great fleas have little fleas upon their backs to bite 'em,
And little fleas have lesser fleas, and so ad infinitum.
And the great fleas themselves, in turn, have greater fleas to go on;
While these again have greater still, and greater still, and so on.

But when we consider “little fleas” and “lesser fleas,” the biological terms change from predator to parasite.   Both predators and parasites depend upon another animal of a different species for their nutrition, except that parasites are generally smaller than their prey; and their prey is referred to as their host.  Some parasites, called ectoparasties, gain their nutrition by attaching to the host animal and extracting nutrition with special mouthparts or other adaptations.  On the other hand, parasitic bacteria have adaptations that enable them to enter the bloodstream and body fluids of their hosts, reproduce, and eventually escape in great numbers to infect other hosts.

Animal and bacterial predators and parasites spend considerable resources to obtain their food, grow, and reproduce.  Viruses are a very different sort of parasite.  They attack the cells of a host organism while investing almost nothing of their own making.  A viral attack, unlike a predator overpowering its prey, is more like a thief coming to your home with the right “key” to fit the “lock” on your front door.

COVID19 or SARS-CoV-2 (SARS = Severe Acute Respiratory Syndrome) is the parasite now causing the current global pandemic.  It is classified as a coronavirus because each virus particle has numerous spike proteins (S-proteins) that project from the surface to create the appearance of a crown.  It is believed that these viruses have hopped from animal hosts like bats to intermediate animals and then to humans.  The COVID19 virus originated in Wuhan, China where it apparently started infecting people who visited a wet market where both live and dead animals were being sold.

In order for a SARS-CoV-2 infection to occur, this viral “thief’s” S-protein (the “key”) must exactly “fit” into a receptor protein (“door lock”) of the host cell.  The host cells are human respiratory cells.  When a S-protein binds to a respiratory cell receptor protein, the respiratory cell membrane “opens” by a process called endocytosis which engulfs the viral particle and ushers it into the host cell cytoplasm.  Here, each coronavirus particle takes control of the host cell genetic and protein synthesis machinery and directs the manufacture (replication) of new S-proteins, other membrane components, and the genetic code for making more S-proteins and other viral parts. These parts are then reassembled into new coronavirus particles which eventually escape by exocytosis to infect other respiratory cells.

Viruses are perhaps the most efficient parasites known.  They have nothing to give the host and come only to take control of the host cells and force the host to replicate all viral components needed to multiply themselves.  If a vaccine or other medication now being sought or developed is to successfully combat COVID19, it must either interrupt viral replication in the host cytoplasm or stop the binding of S-protein “keys” to the receptor “door locks.”

A Spiritual Perspective
So far we have compared predators like the lion and wolf with highly specialized “predators” (i.e. parasites) like the COVID19 Coronavirus.  Regardless of size, from the lion down to the submicroscopic virus, all of them can incite fear in us.  In fact, the tiny virus can incite fear by the very fact of its submicroscopic size, making it an “invisible enemy.”  So, what spiritual lessons can we learn from the biology of these organisms by analogy? 

In 1 Samuel 17:34-36, young David, who later became King of Israel, defended his ability to defeat the Philistine giant, Goliath, by explaining the fearless actions he had taken as a shepherd to protect his flock by killing vicious lions and bears.  With God’s help, David had won his victory over fear long before he had chosen to face the giant Goliath. 

Centuries later, Jesus, the long-promised Son of David, presented himself as the Good Shepherd of all who will come to Him with their fears and failures. In fact, the reason God, the Creator of mankind, sent His Son Jesus down to Earth was because all mankind like sheep had gone astray (Isaiah 53:6) and were in need of a Shepherd to rescue them.  In John 10: 11-13, Jesus reveals His role as the Good Shepherd who gives His life for the sheep to protect us against wolves in contrast to the selfish and careless shepherding of the “hired servant.”  Here, the predatory wolf symbolizes a spiritual threat to our spiritual lives.

One of the safest disciplines of a grazing animal like a sheep is to avoid wandering away from the protection of the flock.  God’s Word compares us to sheep who are safest when we actively seek to belong within a human community.  In His Great Commission, Jesus Christ declared His plan that believers in His death and resurrection should repent, be baptized, and become members of a local church where they can be discipled in the Word of God (Matthew 28: 18-20; Acts 2: 41-42). 

Christians are also commanded not to forsake our own assembling together, as is the habit of some, but encouraging one another; and all the more as you see the day drawing near (Hebrews 10: 25).  Throughout the history of Christianity, the basic discipline of gathering on the first day of the week to worship God has been a stabilizing force in the life of the individual, the family, and the nation.  Today, we face the threat of the “invisible enemy” that has led to a cessation of church gatherings.  We must find creative ways to maintain connections within our churches and to give special help to those who are at risk physically and emotionally.

Jesus was also concerned about the “infection” of churches with false teaching and worldliness.  He said, Beware of false prophets, who come to you in sheep's clothing, but inwardly they are ravenous wolves (Matthew 7: 15).  Later, the Apostle Paul warned the leaders of the Ephesian church that savage wolves will come in among you, not sparing the flock…speaking perverse things, to draw away the disciples after them (Acts 20: 29-30; 1 Timothy 1: 3-7).  The Apostle Peter urges church leaders to shepherd their flocks without giving in to greed or sensuality (1 Peter 5: 2; 2 Peter 2: 1-3).  Today’s news frequently details the apostasy among Protestant church denominations whose leadership now questions the authority of Scripture.  Consequently, many churches deny the importance of repentance for salvation by faith, the sanctity of each human life, and marriage only between a man and a woman.

What Should We Fear Most?
Living in the midst of a global pandemic can be a fearful time for us as individuals.  Like me, you may be learning about the biology of viral transmission and following suggestions to minimize your chances of Coronavirus infection.  But our enemy is not simply physical and biological.  There is a spiritual element that involves our emotional well-being.  So, we must also prepare spiritually and emotionally.

Some have likened a Coronavirus infection to the attack of spiritual forces.  Not a bad analogy.  The Apostle Paul taught us that our struggle is not against flesh and blood, but against the rulers, against the powers, against the world forces of this darkness, against the spiritual forces of wickedness in the heavenly places (Ephesians 6: 12).  Just as the virus comes with a “key” to unlock the “doors” of host cells, so spiritual forces of wickedness are continually testing the “locks” of our doors seeking entry where they seek to control our lives.  The appeal may be to our pride and desire for pleasure, power, or prestige (1 John 2: 16).  When we succumb to spiritual attack and temptation, instead of the benefits we sought, we face havoc, fear, hopelessness, and despair.  This is not a very encouraging message during a viral pandemic, is it?

The Apostle Peter was no stranger to fear.  Remember how he cursed and denied three times that he even knew Jesus whom he had grown to love for three years (Luke 22: 54-62).  But when Peter was restored by a loving encounter with Jesus and then filled with the Holy Spirit, he became a fearless defender of his faith.  Later in his life, Peter warned us against underestimating the power of Satan and spiritual forces: Stay alert! Watch out for your great enemy, the devil. He prowls around like a roaring lion, looking for someone to devour (1 Peter 5: 8). 

The Apostle Paul expands upon Peter’s warning with the Scripture quoted above that our struggle is…against…spiritual forces (Ephesians 6: 12).  Based on his experience watching Roman soldiers putting on their armor, Paul urge Christ-followers to “armor up” for spiritual battle (Ephesians 6: 10-18) because we are more than conquerors through Him who loved us (Romans 8: 37).

Spiritual Health Affects Physical Health
You may be saying, “I understand what you are saying about avoiding viral infection.  But I’m a down-to-earth person and I’m just not into so-called “spiritual warfare.”  Certainly, it is your choice to dismiss the spiritual dimension.  But you should know that your choices affect both your physical and your spiritual health—the two are inseparable.  According to God’s Word in Deuteronomy 30: 19, we have been created to make choices and God urges us to “choose life:”

I call heaven and earth to witness against you today, that I have set before you life and death, the blessing and the curse.  So, choose life in order that you may live, you and your descendants…

Dr. Caroline Leaf, a communications neuroscientist, explains that how we think causes “physical effects” on our brain.  Each thought has impact on our genes (DNA code) which in turn, initiate protein synthesis.  Dr. Leaf’s book, Switch on Your Brain (Baker Books, 2013), explains how repeated thought patterns, whether positive or negative, will establish patterns rooted in physical changes in our brain resulting in effects on our biological, emotional, and spiritual health.  Let’s consider some research results that link our thinking with how effective our immune system is in combatting viral infection.

Dr. Leaf cites research by Dr. Gail Ironson, professor of psychology and psychiatry at University of Miami, which suggested that the single most significant factor affecting the healing in patients infected “with HIV (Human Immunodeficiency Virus) was their choice to believe in a benevolent and loving God.”  Her conclusions were based on a significant 4-year decrease in HIV levels in the patients’ bloodstreams which was accompanied by a steady increase in levels of Helper-T cells.  Dr. Ironson concluded that patients who had a strong faith in God also had a more effective immune system as evidenced by greater T-cell destruction of the HIV (virus).

What About You?
If your desire is to live a healthy biological life but have little concern about a healthy spiritual life even though we have made a strong case for the interwovenness of the two, there is a reason to believe you are what the Apostle John described as one “walking in darkness” (1 John 1: 6), and what the Apostle Paul called spiritually “dead in your trespasses and sin”(Ephesians 2: 1)…  You may even be ”hostile toward God [and do] not subject [your mind] to the law of God, for [you] are not even able to do so” (Romans 8: 7).   That’s right, you may be “spiritually dead.” 

If the above description fits your life; then, according to the Bible, physical death may be your greatest fear but it is not your greatest enemy.  Jesus said, Do not fear those who kill the body but are unable to kill the soul; but rather fear Him who is able to destroy both soul and body in hell (Matthew 10: 28).   God is actually our “Enemy” until we are reconciled with him through the blood of Christ.  Hebrews 9: 27 states that it is appointed unto men once to die, but after this the judgment…  If you sense God’s Spirit prodding you to consider your eternal future, I would be glad to correspond with you and to open the Scripture further with you about how you can know and respond to the Gospel, God’s good news of salvation through Christ.   You may contact me at silviusj@cedarville.edu or enter your questions or responses using "Post a Comment" below.  You may also find a resource called Steps to Peace with God to be helpful. 

Reference:
Gail Ironson, G., R. Stuetzle, and M.A. Fletcher. 2006. An increase in religiousness/spirituality occurs after HIV diagnosis and predicts slower disease progression over 4 years in people with HIV.  Journal of General Internal Medicine 21: 62-68