Overreaction

I have become concerned that dangers of the COVID pandemic have been overstated, perhaps deliberately. The containment measures adopted in most Western countries have had little effect on the spread of the virus, but they have been maximally disruptive of our economic and cultural lives, and have produced loneliness and isolation, while throwing millions of people living on the edge of their means into desperate poverty.

(graphic is my own, based on data from http://OurWorldInData.org/coronavirus )

Here is Dr John Ioannidis, professor of epidemiology at Stanford Medical School, speaking to this point.

The good news is that daily deaths from the virus have peaked worldwide, and begun their decline. Since death rates trail the rate of new infections by 2-3 weeks, we expect that spread of the virus peaked worldwide in mid-March and in the US 10-12 days ago.

Does it make sense to continue with policies of economic shutdown and social isolation now that COVID is declining? The answer depends on whether these policies have been responsible for the decline, or whether COVID is declining for other reasons. I tend to think “other reasons”, but I’ll try to present both sides. I recognize that there is no definitive proof, but only judgment in the face of diverse evidence. My bias is that in such situations I lean toward a contrarian view. 

There are three factors which I consider to be plausible reasons for the decline of COVID:

  1. Warmer weather is arriving
  2. Doctors are learning how to treat COVID from others’ experience
  3. Saturation / herd immunitymost people have already been exposed and have built up immunity

1. Respiratory illnesses tend to be seasonal. Reasons for this are not fully understood, and there may be several factors [ref, ref, ref]. Every year, there is a flu season, and deaths from flu are down almost 100-fold from winter to summer.

Is COVID19 likely to be an exception to this rule? We already see that cold countries have much higher incidence and much higher death rates from COVID than warm countries.

India may be the most striking example, a very hot country with weak central controls and a large population that is unreached by medical services. There has been no effective lockdown in India, yet COVID deaths per million population are comparable to the US.

The above leaves me very hopeful that, like SARS and MERS and countless strains of cold and flu that went before it, COVID is dying out as spring weather sets in.

In this week’s Science magazine, an article (summarized on ScienceBlog) argues that unlike these predecessors, COVID may not slow down with warm weather. As I read it, their basis for this claim is that these other seasonal illnesses spread sufficiently to engender herd immunity in the spring, but because of lockdown COVID has not crossed that threshold. Both these assumptions, in my view, are suspect. There is no scientific agreement why respiratory infections are so deeply seasonal, but it’s an empirical fact. If it were just about herd immunity, then we would see some waves of cold and flu that start in the spring or summer and die out by fall; but we rarely see this. And below I argue that if COVID is as contagious and as persistent as is claimed, then we (America and the world) may be acquiring herd immunity already.

2.  In just a few months, doctors have shared their successes, and there are now several promising treatments (though there has not been time for blinded, controlled clinical trials).

3.  It’s more difficult to know whether herd immunity is already being established around the world. We depend here on experts and on computer models. Here’s an expert (Professor Knut Wittkowski, head of Rockefeller University’s Department of Biostatics):

COVID is reputed to be extraordinarily contagious, and if that is so, I would argue that the kinds of half-measures used in the US and other Western countries are slowing but not preventing spread of the virus. People are still shopping in supermarkets and drug stores. Labs are claiming the virus remains active on surfaces we touch for 24 hours, but we are still freely sending and receiving mail and packages. 

If claims that non-symptomatic carriers can be contagious are credible, then surely a majority of people have been exposed by now, enough that our immune systems have generated the first few antibody-producing B cells, which can multiply rapidly (exponentially) when we are exposed to more virus.

If claims that non-symptomatic carriers can be contagious are not credible, then why are we locking ourselves away from people who look and feel perfectly healthy?

Herd immunity is the population’s usual way to stop an epidemic, and social distancing may have slowed the acquisition of herd immunity, but by now we have all touched someone who has touched someone who has touched someone who has been exposed.

Possibility number 4: Can we credit the lockdown for present decline of COVID?

There are many politicians and policymakers who will line up to take the credit for COVID’s decline. We would all like to think that the individual sacrifices we are making these months have achieved a collective purpose.

Empirically, we can never resolve the counter-factual, “what if we had not locked down?” The best we can do is to compare regions that have locked down to regions that have remained open. If we do this, then, subject to the caveat that all these numbers have been gamed in the reporting, we have to conclude that the evidence for effectiveness of lockdown is not strong.

The scale on the left is in deaths per million population. For comparison, the ten most recent flu seasons in the US have caused death rates ranging from 34 to 175 (according to CDC).

Rates of COVID deaths vary widely. But countries that have locked down do not appear to have an advantage over countries that have not.

As of this writing, there are 8 US states that have not locked down by executive order: Arkansas, Iowa, North and South Dakota, Oklahoma, Nebraska, Utah and Wyoming. Their death rates per million are, respectively, 11, 15, 7, 12, 27, 9, 6, and 3, all well below the national average of 77.

Looking at the state and country data, it appears to me that lockdown has been a response to high COVID mortality, rather than a preventer in advance of mortality. Perhaps this is the nature of political humans, to respond only after a threat becomes serious. But as policy, it is (to use the technical term) bass ackwards. Quarantine measures are very effective in early stages of an epidemic, but of limited usefulness once the epidemic has gotten its toehold in the population. 

China locked up quickly, cutting off all travel out of Wuhan in late January. Rules were liberalized and commerce resumed 2 months later. This makes sense. The US waited too long to lock down, and now, at a time when isolation measures are least useful, they are being intensified. I fear that the economic, psychological, and cultural consequences of this new wave of restrictions will be severe, while the epidemiological benefit will be marginal.

Greece locked down promptly and probably saved the whole country an ordeal. (I’m grateful to Zisos in the comment below.)

Theoretically, is there reason to believe that limited social contact and economic activity slows the spread of the disease. Yes, without a doubt. But is there reason to believe that it can affect the number of people who will eventually be exposed? Much less clear. I would say, only if the disease is truly wiped out in its early stage, before it becomes widespread and engenders herd immunity.

Costs

Heaven knows we all could use a few weeks of vacation. But we wouldn’t choose to spend it indoors, apart from our friends, deprived of cultural events and social supports, church, Kiwanis and AA meetings and yoga classes and folk dancing and community theater. 

Congress has appropriated $2.3 trillion for the Covid Relief Act (CARES), but some claim the true cost is $6 trillion. On Wall St, the S&P lost $10 trillion in March. If we were willing to spend any tiny fraction of this money on a rationally-designed program of public health, the number of lives saved would be far greater than the highest estimate of COVID’s potential toll. Diabetes is an eminently preventable disease that causes more deaths every year than COVID will cause over its entire lifetime, and NIH spends $0.0002 trillion to prevent it. 

Millions of small businesses are bankrupt. Tens of millions of people are unemployed. Depression and isolation have major impacts on health, much more so if they are prolonged as some are proposing.

Politics

I am all too aware of the potential for scientific opinion to be swayed by money and political influence. In the shadow of these unimaginable economic costs, there are a few who are profiting handsomely. Why did so much of the CARES money go to banks? Why is so much of the reporting promoting a vaccine to rescue us from COVID, when many past attempts to develop a coronavirus vaccine have been halted because test animals died. Vaccines are the most profitable segment of the pharmaceutical market, and drug companies are spared by law the costs of safety tests and are indemnified from legal liability.

The thing that keeps me up at night is not fear that I might catch the disease, but fear that Constitutional liberties in America are being systematically erased. “Hate speech” laws are being used to censor inconvenient political truths. The US government is barred by the First Amendment from direct censorship, but Google and Facebook and Twitter are immune because they are private companies, and they collectively have enormous influence on what we can find out and what we can discuss. They are doing the government’s bidding, suppressing dissent.

Dear readers, this is how fascists take power. They don’t say “Ha ha ha HA…now I’ve got you where I want you.” Rather, they get everyone scared, declare an emergency, and they offer to save us all from danger.

Read Naomi and Naomi. Remember the Reichstag fire. Discover, if you have not already, the shocking history of Operation Northwoods. Read Sinclair Lewis, It Can’t Happen Here (1936). 

Eternal vigilance is the price of liberty has been attributed to Thomas Jefferson so often that he might as well have said it.

52 thoughts on “Overreaction

  1. I have kept a spreadsheet of the CDC’s daily Corona virus reported infections since March. As of 2/10/20 CDC reported 8 cases. As of 4/14/20 CDC reported 579,005. The first deaths I tracked was on 3/30/20 was 2,405. As of 4/14/20, CDC reported 22,252 total deaths. The daily percentage increase of cases has declined in the last several days – but the increase in deaths has declined. However from 4/13 to 4/14 went from 554,849 to 579,005. Today’s total reported by CDC (released at 4pm each day) was 605,390 – so the total continues to go up.
    Total deaths as of today is 24,582 deaths. So a 10 fold increase in deaths from 3/30/20 to 4/15/20 – 2 weeks. CDC website address: https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
    Sobering. I have not left the house in the last 3 weeks – will make a food run maybe in the next week. I have 2 N-99 masks I bought 6 weeks ago. Oh, another issue, I am assuming the N-99 which states that it filters out 99% of all particulate matter provides some level of safety. I have read that masks only prevent you from spreading the virus. I question that assertion. I acknowledge that the N99 lets 1% of particulate matter through – so if all of the virus falls within that 1% I am in trouble. Oh, there are also 3m Masks that are N100 – but I have not been able to find them. I don’t know what the likely particulate size is for the virus attached to a cough is, don’t know. Also, I bought and am waiting for a UV bulb to arrive. Articles suggest that UV light for 3 minutes will kill a virus. So that is my strategy to deal with all of this. I am only trying to help add to the overall level of community knowledge. Best advice/conclusion, stay home, stay save. Thanks.

  2. I think there is a lot of wishful thinking in your post. Addressing each of the four points:
    1) Regading the warm temperature the virus has been found to survive shorter on surfaces in warmer temperatures and this will slow down spread somewhat but this will not likely have a major effect on spread between two individuals in close proximity to each other which is a major route of spread. Also I think all the warmer countries you mentioned have in common that they have universal BCG vaccination and such vaccination is less common in colder richer northen European countries. A strong inverse correlation has been found between BCG vaccination and disease spread and severity and it is suspected that BCG vaccination protects against the virus.
    2) The success of doctors is certainly improving but we are still nowhere close to being able to cure hard cases with confidence. Deaths are certainly not peaking because of this factor. They are peaking mostly because of lock downs.
    3) The herd immunity theory is not reasonable. To reach herd immunity for such a contagious virus you would need somewhere around 60% of the population to have the virus. There is no country in the world with even remotely close to that high rate of infection. Some people are hoping that there are far more asymptomatic people infected than reported or measured and while that is true the difference isn’t that high. Just look at Iceland the country that has tested 10% of it’s population including mass tested a ton of random people that had no symptoms. Btw Iceland before putting on lock down had fast early spread of the virus because of massive tourism industry. Despite these tests they estimated that only 0.8% of the population there is infected according to the most recent numbers (I’m from Iceland and this number was reported today in a news report by deCODE the company that is doing private mass testing there). The spread and the number of cases has reduced a lot recently in Iceland but the figure you posted (showing lock down countries versus no lock down countries) incorrectly lists Iceland under countries that do not have lock down. Matter of fact is Iceland has been under lockdown for weeks now. This is what is slowing down the spread of the virus there.
    4) As for point number 4, yes lock down is usually only put in place after things get very serious, that’s why there is a big correlation between lockdown and number of cases. Countries that didn’t have lockdown, like Sweden, are now catching up and experiencing a massive increase in cases while those that started lockdown weeks ago (such as Iceland) are experiencing a major slow down in the number of reported cases.

    I don’t have time to dig up the references for the above, I’m sorry. But these are my opinions based on researching the virus and closely following the development of the situation in the past several weeks.

    • Good reply!

      I’m surprised Josh is so far off the Mark with this.

      It seems everyone thinks they have relevant expertise to make quite inaccurate commentary.

      David Wyatt PhD Immunology & Virology

    • I’m also not sure why Josh wrote:

      Quote
      “Saturation / herd immunity—most people have already been exposed and have built up immunity”

      Quote
      “If claims that non-symptomatic carriers can be contagious are credible, then surely a majority of people have been exposed by now, enough that our immune systems have generated the first few antibody-producing B cells”

      Sorry but this is complete nonsense. Even in New York City where some random testing has been done, only 15% are showing antibodies (https://www.nejm.org/doi/full/10.1056/NEJMc2009316 ), and that’s in the worst hit city in the country. We are NO WHERE NEAR “most people having immunity”.

      Then Josh goes on to include a video of Knut Wittkowski predicting there should only be 10,000 total US deaths with NO MITIGATION efforts at all, it will just come and go in 4 weeks and we are done. And yet, we now have 35,000 deaths (US) right now, with lockdowns, social distancing, masks, school closures, and lots of mitigation efforts. I’m not sure he is “winning” this argument (even if grand total deaths at the end of the year pretty much match a bad flu season). But I guess we still have “no lockdowns” Sweden to look to right? Ironically, Josh’s article includes the following chart (with NO commentary about this specific situation as if he completely missed it!):

      https://joshmitteldorf.scienceblog.com/files/2020/04/covid-and-temperature-1.png

      • Thanks for the challenge, Gordo. In self-defense, I’d say I did give myself an out “IF non-symptomatic carriers are contagious…”
        I am doubtful this is true. I think the evidence for it is weak, but that’s a topic for a different day.

        >> Only 15% of New York has antibodies.
        Remember the counter-intuitive way that exponential expansion behaves. 15% is just 2-1/2 doublings away from herd immunity, which is a matter of a week or so. The 15% number you cited is based on a sample taken from March 22 to April 4.

  3. I thought the whole point was to “flatten the curve” to prevent the health system from being totally overwhelmed. It also allows some time for learning more effective ways to treat the disease and it gets us closer to spring/summer.
    As far as economic impact, yes, it’s severe, but it didn’t have to be. People could have received much more in terms of benefits, that’s the real scandal. Just like with the last major financial crisis, the bias is to keep large businesses operating and ordinary people are ignored.
    Who will pay for it? Who paid for it the last time? The FED created 300 trillion dollars out of thin air and nobody said a word.

  4. I agree that skepticism and vigilance over erosion of liberties is needed. But You need to consider Australia and NZ in your analysis. They are both warm countries on a parabolic curve of infections that were brought under control by distancing. The thing that reassures me is that no one really benefits from lockdown (apart from big tech) so I hope this means we are not see a slide into a permanent police state.

  5. As of today, the death rates per million for some Mediterranean countries are:
    France: 253
    Spain: 400
    Italy: 350
    Greece: 10
    All four countries have a similar climate and a similar diet. Since all are under lockdown, someone might conclude that the difference between the first three and the fourth is not related to the lockdown, and there must be another reason that explains the difference between Greece and the rest of them.
    The only difference between the first three and the four is WHEN they applied the lockdown. Greece acted swiftly after the appearance of the first case. The first three were acted several weeks after the first case. Their death rate is x30 to x40 of the death rate in Greece, even though the health care system in Greece is not as good as the first three. My conclusion is that the lockdown is extremely effective only if applied early enough. The later it is applied, the less effective it is. It does not help to close the barn door after the horse ran away!

    I also tend to think that the reason the new cases are dropping is not due to “herd immunity”. Based on the death rates above, the herd immunity would be very low in Greece, and therefore, the number of new cases should be increasing, until we reach a similar death rate. Yet it is the opposite. The peak was reached in Greece a bit before the other countries.

    As far as effect on freedoms, it is a valid concern in some cases. Again, not in all. The leaders in countries like Hungary, Russia, Turkey, and China, will take advantage of the situation to tighten their grip. But I do not see any evidence that in democratic countries like the UK, Germany, France, Spain, Greece, etc there is such a problem.

    • @Zisos,

      that’s the point. The differences in death rate are dictated by how fast or slow have been the governments taking action, not for physical reasons.

      The thing is much simpler than it looks.

    • I apologize for not commenting on the coronavirus and not being politically neutral but I was very upset when I read about such misconceptions. Although it is amusing, how informed the people in western countries think they are regarding the state of democracy in Hungary, just because what they see/hear/read in the media. You know, when in a post-communist country the people of The Party are not excluded in time from public life entirely, but they and their descendants get into opposition, they try everything they can to get back in power. As they are well embedded in the Western press as well, it is also a tool in the campaign, so don’t believe everything. For example, our press is still more free than yours, and (maybe unfortunately) everyone can write/read what one wants despite what the “silenced” are rumoring….

      If my post is incompatible with the purpose of the blog, I would still like my message to reach at least the person concerned. Thanks.

      • It was a mistake of mine to mention countries that I consider undemocratic. First, because I might be wrong (as you indicate), and second because this blog is not a place to judge countries for their democratic values. I do apologize. I wish I could erase that part of my post.

  6. I just want to make two comments:

    I. Countries with, let’s say, concerned governments have been very successful against the virus by taking quick action, via masks or lockdown. Three great examples: Portugal, Check Republic (masks), Greece. Put them in any graph related to warm temperature would make little sense because their results come from the management of the epidemic, not from physical reasons.

    II. The government of my country has managed to produce the highest death rate per million of the whole world. After that, they are more worried about the control of mass media, social networks, and straight authoritarian (proto-communist) measurements. So yes, the virus is killing lifes and later will kill liberties.

  7. Please everyone, look into the fact that the CDC told hospitals to write down Corona as the cause of death, even when the person was not even tested. It was to be ASSUMED the death was caused by corona.
    This is a fact. You can find the actual documents that the CDC sent out to hospitals.
    They’re skewing the numbers.

    Dr Scott Jensen, a Minnesota State Senator and doctor, has confirmed this. I’ll try to post a video of him below.

    Also, flu and pneumonia deaths have, coincidentally, sharply declined just as corona went up. And no, flu and pneumonia deaths don’t normally decline this way during these months. It was an unusual decline.

    This is all about the vaccine. They want to institute a mandatory vax. They want us all to be so scared that we’ll rush out to get the vaccine.

    Look into Bill Gates and his depopulation agenda (don’t be fooled by his claim that it’s in the name of “climate change.” It’s not. I won’t get into it but this certain group of people are pure evil. Actual, real evil.
    Henry Kissinger is also into depopulation. It’s easy to find that info.)

    Bill Gates claims to believe that man-made climate change is killing our planet, yet he owns 4 or 5 mansions, a private jet, many luxury automobiles, etc. He claims to believe that the world is overpopulated and promotes abortion and vaccines as a way to combat overpopulation. Yet he has 3 kids of his own. His kids are fine and dandy, but YOU should not have kids and if you do get pregnant, have an abortion. Wake up, people.

    Fauci is connected to Gates. Look into that connection.
    And there’s a woman named Birx on the Gates Foundation. Not a common name. Same name as the woman who’s been right beside Fauci with all this corona crap.

    And, for the love of God, don’t use any mainstream sources. They are ALL (including “fact-checking” sites) owned by the same group. Youtube is also owned by that same group. So is Google. Dig deep. I find Bitchute (it’s like youtube) and Swiss Cows (search engine) to be better. Bitchute’s algorithms aren’t the best, which can make it hard to find things sometimes, because they don’t have the money that youtube has. But Bitchute doesn’t censor.

    CBS aired footage of a NY hospital where people were supposedly being treated for corona. Only is WASN’T a hospital in NY. It was footage from Italy.
    When caught, CBS apologized for their “mistake” but it was not a mistake. They are trying to fool people into thinking corona is bigger than it is.

    Look for videos of Dr Sherri Tenpenny speaking about it.
    I’ll try to post some links at the end of this.

    Please look at Robert F Kennedy’s Instagram or his Twitter page. He posts info about Gates and vaccines. PLEASE, everyone go look at that info.

    The polio vaccine created by Jonas Salk (1955?)…Up to 30% of the vaccines had simian virus in them. That virus was injected into people. Simian virus is known to cause cancer.

    Vaccine Ingredient SV40….Polio vaccines used in the late 1950s and early 1960s were contaminated with a virus called simian virus 40 (SV40) present in monkey kidney cells used to grow the vaccine. Subsequently, investigators found SV40 DNA in biopsy specimens obtained from patients with cancers such as mesothelioma (lung), osteosarcoma (bone), and non-Hodgkins lymphoma. It was traced back to the vaccines.

    Do you think they’re not still doing this to us today? There are carcinogens in today’s vaccines (you can research that). Cancer via vaccines.
    The difference is that NOW investigators won’t discover it because the evil group of people have infiltrated aspects of our society, and our government, more now than ever before.

    And don’t buy that the cancer by polio vaccine was done by mistake. Once you know their depopulation agenda, you’ll realize nothing is done by mistake.

    I’ll now post some links. If the links don’t show up here, please research all the info yourselves.
    The depopulation agenda is real. And vaccines are a big part of that.
    Don’t be scared of corona virus. Be scared of what they implement because of it.

    I apologize for any typos. I’m too tired to edit. 🙂

    https://www.bitchute.com/video/LAXIrizogU9v/

    https://www.bitchute.com/video/4CPpZPSRMbCh/

    https://www.valleynewslive.com/content/misc/Sen-Dr-Jensens-Shocking-Admission-About-Coronavirus-569458361.html?jwsource=cl

  8. I forgot to mention another data point that complicates comparisons between countries. In my country roughly half of deaths are of elderlys in residences. Of course any decent government can take measurements to avoid this, and decrease a lot the damage of the virus.

    So again, with the exception of Italy, where they had no true info from China and time to react, the number of deaths per million is basically an statistics of the negligence of the government of each country. In my country the government was promoting huge political demonstrations in March that were biological bombs.

  9. There is no real evidence of a lasting loss of liberties due to pandemic containment measures. We do see various political groups blaming each other for deaths and for economic harm and also trying to distract from mistakes in pandemic management. The “loss of liberty” line just an attempt by one group to blame another for the economic disruption. The usual political BS, nothing more.

    Regarding how long the various lock-downs should last… most countries have a variation on the same plan, which is to use the lock-down to gain a breathing space for research, organization and learning in healthcare systems, manufacture and stockpile of protective gear and testing kits, etc. Most plan to gradually relax their lock-downs once we are better prepared. If herd immunity has been developing faster than thought or if summer weather helps, so much the better, but nobody was seriously planning to maintain a strict lock-down long-term (even if they have been reluctant to say so).

    In other words, other than hot air, there is not really all that much difference between the policies of the various bickering political factions.

    • No. To give one example, there is constant talk of requiring people to show evidence of antibodies or vaccination. This is a huge loss of liberty and it establishes a precedent of punishing people who did the right things, specifically like reading this site (and other related sources) and educating themselves about how to improve immune function and overall health, while further validating approaches that solve nothing in the longer-term like isolation and vaccines.

  10. Josh, after the many many years of following your important blogs I am dismayed to see you have drawn the antivax crowd and other weirdos to your site.
    One remark then: it is not logical to distinguish between lockdown and no lockdown. The lockdowns in various countries are not at all similar. Even de basic rule of social distancing varies: some countries demand 2 meters, others 1.5…

  11. No offense, but shouldn’t we leave this discussion to educated virologists. It seems that everyone has got a masters degree in virology, just overnight.

    • Yep, that brilliant community that, after an in-depth look into statistics, concluded that the coronavirus would be like the flu in the worst of the cases. Few of them realized that the numbers they were using to calculate the rates were cooked by the Chinese government.

      Basic logic and robust arguments go much further than any degree.

    • Hi Ole:

      IMO, there is knowledge to be gained from the “Wisdom of the crowd”

      Sometimes a non-virologist may be able to think outside the box in a way a virologist with tunnel vision can not.

  12. I will mention one thing that is wrong in the article. The slow down of the virus because of higher temperatures seem to be not much. If you look at Africa, it took some time before the virus arrived, but now the virus is spreading. See the excellent source for comprehensible data:
    https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Africa

    And of course the African countries do not have the equipment and everything else that we do, so they have no chance to fight this.

  13. According to Knut Wittkowski, in the above posted video, social distancing/lockdowns prolong the virus, and will cause another wave of it as soon as they end. To Professor Wittkowski, “If we had herd immunity now there couldn’t be a second wave.”

    Could, you, Josh, or anyone here, please comment on that?

    • The key part of this is the “IF”. We don;t have herd immunity yet and the argument over how to cause the least amount of damage and death while we get there. Herd immunity doesn’t do much of anything till 60% of the population has it and you really need over 80% for it to be very effective. This is all about how do we not overwhelm the hospital system and keep the death rate as low as possible while we get to that 60 to 80% range.

      If you do it over 2 months, you get millions of deaths, if you do it over 2 years, you can hopefully limit it to tens or maybe a few hundred thousand.

      • Douglas, the problem with your logic is that you assume that the population’s health and immunity stay static. We (at least in the anti-aging community) have an opportunity to dramatically improve our resistance to diseases such as CV and if that was properly rolled out to the broader population, especially high-risk people, it would likely have a much greater benefit, now and for future pathogens, than fear, dependency and helplessness which is what the current strategy features

  14. I am from Spain but living in Vietnam during the last year and I am deeply convinced most of the differences between countries come from the huge difference between the way different government’s awareness and actions regarding Sars-cov-2. Most of the countries that went through SARS before knew what to do and were prepared for it. Vietnam, being a country limiting to China implemented controls as early as January 2020 such as canceling flights from affected countries and aggressive tracking of closed contacts to confirmed cases. My kids stop attending school after TET holiday on January 29th and did not resume yet even though during March Vietnam got their only 16 cases to full recovery and manage to keep it like that for two weeks. Unfortunately, as with many countries, tourists from Europe brought the virus back which led to a fast implementation of an enforced 2-week quarantine for all arriving passengers. As of today, Vietnam has a total cumulative of 268 cases and at the peak got more than 72,000 people quarantined. The country has NO DEATHS as the medical system was never overwhelmed by this and the entire society is aware and adopting coherently the required safety protocols.

    More opinions from Vietnam here but I think it is a remarkable case
    https://www.testermanadvisory.com/post/coronavirus-the-view-from-vietnam

    In Spain, contrary, with more than 600 cases declared the government was authorizing demonstrations in Madrid. Lockdowns were poorly implemented, with announces in advanced which make many infected people leaving to other cities to avoid it and therefore spreading the virus. The medical system is overwhelmed in some places and therefore people are dying of coronavirus and also of many other conditions requiring intensive care. There is not enough personal protection equipment for the medical staff which exposes them to get sick and the testing acquired for rapid screening was not reliable enough. Doctors are making decisions on who qualifies for getting a ventilator with people as young as 60 and covid positive dead bodies are accumulating to the point several ice-skating parks are being used as morgues. Cases have started to drop after three weeks of a total lockdown and the government has now reverted the decision, hopefully, this will not lead to another outbreak in two weeks, but I am dubious.

    As mention by someone else here, things are simpler: death per million is, in most cases, an excellent indicator for government preparedness, awareness, and efficiency to handling a pandemic.

    This makes me really dubious from indexes always declaring developed countries as better prepared for anything………
    https://www.ghsindex.org/
    https://www.visualcapitalist.com/global-pandemic-preparedness-ranked/

    • Thank you, Guillermo. The stories of Vietnam and Greece are dramatic, and they show that early action is crucial. Whether social isolation is effective after there are already thousands of dispersed cases throughout the country is still unclear to me.

    • Guillermo,

      official figures of deaths in Spain are grossly under-reported. The worst of all is that the government is more worried about propaganda and control of mass media than anything else. They have even forbidden to the companies to do private tests of coranovirus for their workers.

      TVs here are amazing, like a science fiction movie. Do you know that the only coffins (after near 20k official deaths) that apper on the Spanish TVs are coffins of NY?.

  15. Interesting post
    There are still a great many questions and it will take time to sort this all out.

    Iceland did not lock down the country. Stores and schools remained open but they were extremely good at mass testing and isolation/ tracking techniques. They’ve tested a remarkable 13% of their population and most of that was random . They were then able to conclude that 50% of positives were asymptomatic. Their tracking of contacts was thorough.

    Asian countries immediately mandated wearing of masks for everyone. No exceptions. There is ample data that masks+ gloves+ hand washing can reduce transmission by over 90%. The Czech Republic did the same thing and their total number of deaths was in single digits.

    Humidity matters more than temperature. Cilia don’t operate efficiently to clear pathogens at either extreme of humidity. The ideal is between 50% to 60%. Africa may be protected to a degree from widespread prophylaxis for malaria.

    It’s difficult to get a grip on efficacy and safety of hydroxychloroquine since it’s now highly politicized. I’m afraid that even large, controlled studies won’t be definitive and will be conflicting due to such a large number of variables that won’t be adequately controlled for.

    Sara Gilbert of Oxford may well have a vaccine tested and ready to go in 6 to 9 months. Let’s hope so.

    Have we overreacted? Impossible to know for sure. I do know that many of my patients are suffering from anxiety, sleeplessness, depression, and loss of livelihood. All,of those things also take a great toll. If there is a second wave this fall, hopefully the world will be better prepared and a treatment will be available to bridge us to a vaccine.

    • I always thought it was odd that Fauci and Birx, did not advise everyone to wear face masks of some type, early on.

      What was that all about?

  16. For some reason my earlier comment/question was not included.
    My question (to Josh) is this: do you have a view on whether or not the virus emanated from the Wuhan Institute of Virology?

    • I’m writing about this, and will post something tomorrow. Teaser: There is genetic evidence, suggestive though not conclusive, that the virus is man-made. Where did it come from? There are plausible scenarios for the Wuhan bioweapons lab, and there are equally plausible scenarios for the American lab at Fort Detrick. I’ve even seen suggestions that the American and Chinese bioweapons facilities are working together, and I don’t know what to make of that.
      For the record, I’m against bioweapons research, no matter who is doing it.

  17. interview w Dr David Katz
    Here’s the moderate voice of a credentialed expert. He talks about comparing the risk of harm from isolation and shutdown of economic activity to the risk of dying of COVID. He emphasizes that one way or another, we’re going to have to establish herd immunity, and that means either staying locked down for years while we wait for development and testing of a vaccine or else exposing the population to the risk. He suggests that healthy, young people should be going out, being the first to expose themselves — maybe even deliberately — and that after a few weeks they will have antibodies, and it will be time for people at slightly higher risk to begin to emerge.
    The whole thing is informative and original and well worth listening to.
    – Josh

    • We will not need to stay locked down for years for a vaccine. That might be the case with business as usual, but, with a crash program, probably nine to twelve months is possible.

      So the effort needs to focus on testing, tracking, and stepped up vaccine development.

      • I disagree. “The effort” needs to focus on promoting strong immune function and a reserve of good health, especially for older people. Testing, tracking and vaccines solve nothing for an individual, and lack of focus on underlying health and maintaining youthful function is the root cause of this problem. Infections will always be an issue and we (especially we in the anti-aging community) need to be able to fend them off and to need to lead by example.

    • All of this depends on just how deadly this disease really is and no one has a handle on that number. Here’s the first round of antibody tests done in the UShttps://abcnews.go.com/Health/antibody-research-coronavirus-widespread/story?id=70206121
      If that’s true then the case fatality rate is 32,000/ 45,000,000 which is less than the flu. In that case it may have made sense to expose those at low risk so that we developed a herd immunity.
      But of course, if the case fatality is 1% to 4% in those inder 65, that would be an alarming number of deaths.

    • To date, it appears that most of whom have died from Covid 19 had some other type of underlying disease or disorder.

      Also, a large percentage had diabetes. Perhaps the virus thrives and replicates faster under conditions of high blood sugars.

      Or, perhaps those with Diabetes, already have weakened hearts, kidneys, liver as well as damaged blood vessels.

      I have heard of at least one 94 year old man and one 104 year old woman that survived Covid 19.

      That appears to indicate that even the hearty elderly can survive.

  18. For once not much to add. Brilliant essay.

    I could ramble on about NAD+ levels, nicotinamide riboside, and PARP in virus infections (and I will as soon as Brenner’s paper is out on BioRxiv), but I think you’ve made all the main points about the damage from the governmental response.

    As far as US governmental response goes, FDA banned all commercial PCR test kits here for the critical months, CDC forced its dysfunctional kits on hospitals that could have made better ones themselves, and then CDC told everyone not to wear PPE. Oh, and the government turned out not to have restocked the FEMA PPE since the H1NI flu in Obama’s time… no government response would have been FAR better than what we actually got here. Of course most countries did a better job.

  19. Hello Josh,
    Article 2004.07224v1 on arxiv.org suggests that blood pressure drugs are associated with weakness for covid-19 .
    Could one make a world map of covid-19 deaths versus use of these drugs?
    Peter

    • I think the evidence is very mixed for that and one drug, losartan, is in trials to see if it might be of benefit. At any rate, nobody has suggested changing hypertension treatment because of risks.

  20. Here we see the culmination of the “updated” scientific world view you espoused in your last post. I’m surprised you haven’t suggested psychic healers or shaman epidemiologists to rid us of the plague.

    This is conspiracy theories and pseudo-science – shark jumping at its finest.

  21. Annual mortality in the US is about 0.72% of the population. Death from COVID-19 also is about 0.7%. Doubling the annual mortality by Infecting the entire population will not overwhelm hospitals if distributed over 12 months, but will be a disaster if it occurs too quickly.

    • That’s a good point. I like David Katz’s strategy of exposing the population in waves, with the young, healthy population going first. Eventually a lot of old and vulnerable people are going to end up exposed, but maybe we can protect them longer than the rest of us.

    • makes no sense to me. That type of calculations are obviously wrong because when faced with reality, they don’t match.

      My country is full of nursing homes with tens of deaths. Collecting the data from the few regional governments that have released them, there are more than 10k deaths in these places (which btw have not been included in the ridiculous figure of official deaths).

      The funeral homes here are having about 40% more burials than a normal year.

      No flu produces this type of mortality in nursing homes or burials, distributing the data along any period.

      • How do you know those deaths are due to covid-19? Here in the UK access to doctors is severely restricted under lock down. No one is going to hospital unless severely ill. Nursing homes will have a high requirement for doctors and medicine. It may well be that this is a contributing factor to the excess mortality and attributable to the lock down rather than directly to covid-19. It might be possible to tease this out looking at non-lock down countries,

  22. Josh, Thanks for a great post. I think you make any points that have not received enough attention and highlight important context.

    This episode should make clear to anyone with an interest in health and anti-aging that there is no substitute for a strong immune system and a reserve of good health, especially related to heart and lung health. The lack of any attention from mainstream “authorities” on immune health and data which could guide us (such as a simple correlation between disease progression and easily controllable immune factors such as peptides, minerals, vitamins, hormones, micro-biome, sleep, cholesterol and activity) has been appalling, however non-mainstream sources have come through pretty well with a lot of great information that should make as all much more resilient now and in the future.

    Whatever one thinks of the safety of vaccines, this episode should make clear that they are not a solution to anything on an individual level since they are not there when you need them, they might not work at all, the pathogen can mutate and there will be plenty of other infections that are small scale and which will never have a vaccine. The other health benefits of immune-related health for anti-aging are not addressed by vaccines.

    Anti-aging approaches should have IMO been the first-line defense against infection starting many years ago, however many things which decline with age and which are directly related to immune function (e.g. melatonin, vitamin D conversion, thymus gland outputs such as Thymosin alpha one) are cheap and readily available.

    Regarding the regional differences, I don’t think Vitamin D status has been given nearly enough attention. The outbreaks have been more severe in the northern hemisphere where it has been late winter and vitamin D levels (a key aspect of immune function) are at their lowest in people who don’t supplement.

    I agree complete with your point about loss of freedoms and suppressing dissent. The cultural damage from “social distancing” is huge when people learn to fear each other. Also, it is appalling how many people believe that the “slow the spread” strategy is ironclad truth instead of what I think the evidence suggests it is which is a wild guess with costs that likely outweigh the benefits, especially in comparison the alternative of promoting strong immune function among the vulnerable.

    I also think of your post on NAC frequently since that is one of my many immunity/anti-viral supplements

  23. Very interesting discussion started by Josh -there is no doubt that some countries have dropped the ball and others have flattened the curve. Here in Australia we have a population of 25million and only 61 deaths so far- almost all of them of people over 75. It could have been a disaster because of the large numbers of university students returning from Whuhan. Our university system has been badly funded by governments and now reliant on Chinese students. However, massive free testing (now for anyone with a sniffle and some random testing of people without symptoms) contact tracing and physical distancing has saved the day. Everyone returning from to Australia now has a compulsory two week stay in a hotel funded by the government. Vietnam and South Korea have done even better than us whereas the US- the richest country in the world, now has the most deaths. Sadly, you seem to have a moron for a President.

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