Friday Dec 27, 2024
Friday Dec 27, 2024
Wednesday, 9 December 2020 00:10 - - {{hitsCtrl.values.hits}}
Sri Lanka has ramped up testing on an unprecedented scale. When you test that much more, you will get more ‘positive test results.’ May I just remind everyone that 1% is considered an extremely low prevalence, and if Lanka ever hit even that, it would be 210,000 ‘positive tests’ not 28,000! We are far away from really even ‘being’ on any comparable global grid – Pic by Shehan Gunasekara
I am very concerned about the national narrative on COVID. Again, Asia and Lanka are ‘winning’ by any global metric you may wish to name. The real metric is mortality, and of the 7k+ that are ‘ascribed’ 
COVID one day mortality numbers globally on 6 December, about half come from Europe, just under 2k from North America, and from all of Asia, about 1.3k, mostly from India, Iran, Indonesia and Turkey (but even from those four, still less than 1k cumulatively).
But it’s getting worse!
No, it’s really not. We have to knock off this ‘positive test’ hypnosis.
Lanka has ramped up testing on an unprecedented scale. When you test that much more, you will get more ‘positive test results.’ May I just remind everyone that 1% is considered an extremely low prevalence, and if Lanka ever hit even that, it would be 210,000 ‘positive tests’ not 28,000! We are far away from really even ‘being’ on any comparable global grid.
And though we have Antigen tests (lateral flow, rapid tests), we don’t use them. Harvard and Yale stats are clear, those tests are more than 98% accurate in terms of ‘current contagiousness.’ PCR tests take longer, are riddled with false positives, and if set at higher than 30 Ct (amplification settings) are not necessarily detecting ‘live’ virus, but only fragments and strands.
Recent research out of Oxford indicates ‘strands’ cannot confirm infectiousness anyway (Carl Heneghan, Oxford Centre for Evidence Based Medicine). Michael Senger reports on a recent peer reviewed paper which compares the accuracy of various COVID-PCR test protocols recommended by WHO. Two of the major ones (E Charite or Drosten and N2 US CDC assays), were, I quote ‘positive for all specimens, including negative samples and negative controls (water).’
Therefore, our airport opening, and tourism welcoming regime may find it hard to manage if we are not going to use rapid Antigen tests which will soon inevitably be what is used worldwide, due to cost and as no one can wait seven days for results based on a manifestly uncertain test.
When said tests were applied in Austria recently, remember they are more accurate than PCR in terms of ‘current contagiousness’ not in terms of detecting any and all ‘fragments’ of the virus (dead or alive, which the far more ‘sensitive’ but not necessarily more helpful PCR test picks up), positive rate was .4%, only about .5% in teeming Vienna, a far cry from the PCR distortion (aggravated by the combination of low prevalence and inevitable false positives).
And if this sensible, cost-effective, and timely regime continues to take hold, I really worry (particularly with the very successful example of Maldives next door without any arrival quarantine) if we may trail unnecessarily behind.
Further misgivings
Business leaders who barely survived months of curfewing, were making a comeback, confidence was surging and then our ‘positive test-demic’ (symptoms and deaths are very tame, and so no cause for objective panic has been there around the island) came along, we opened and shut parts of the island, ignoring the impact to the economy of interconnected hubs, particularly flows in and out of Colombo.
Ships bypassed our closed port, materials weren’t received, and despite active demand, products could not be produced. And so no strategies could be forged as no basis for the ‘opening’ and ‘shutting’ on ‘test numbers’ was conveyed, until the very welcome transition now to highly targeted, zonal, street, or building ‘isolation.’
But it has shaken the confidence of the business sector. Many leaders convey to me as a trusted adviser that the Government is rightly calling on them for innovation and being daring. But they are barely solvent, some eking out a nominal profit, and the status quo serves them better than disruption, as they cannot count on the socio-economic playing field or the applicable ‘gates’ or normalisation ‘milestones’ being based on actual illness and mortality and not just ‘test numbers’ being flashed to terrify and petrify.
And we are not the only ones with numerical confusion. Take the US, of course currently buffeted and besieged. But in context, in the US, 8,000 die every day, three million a year, irrespective of C-19. COVID ascribed deaths ‘may’ approach 10% of that by year’s end, which is not an abnormal annual fluctuation and is still uncertain because the mere ‘presence’ of C-19 there leads to the recording of the mortality as a ‘COVID death’ no matter the comorbidities (which could include traffic accidents, poisoning and gunshot wounds, dementia based deaths, etc.).
In the US, 40,000 die in nursing homes each month. Half of COVID-19 deaths are in nursing homes. A large percentage of C-19 hospital fatalities had ‘DNR’ (do not resuscitate orders prior to admission). Average age of death is 80, higher than normal US life expectancy. So, while serious, not apocalyptic, and no basis at all to have destroyed large sectors of society, or to decimate livelihoods.
In fact, our current strategy seems ideally suited in places where ‘lockdown’ and its variants are practiced, to produce the following outcomes (here and globally):
This is not what we want for Lanka, so we must, must change this narrative now.
New narrative: It’s NOT getting worse; we just currently have lots of positive tests because we are manically testing the healthy for the first time in history on unsubstantiated hypotheses re the ‘asymptomatic.’ We have to focus on symptoms, use rapid testing, take special care of the elderly and vulnerable, trust nature over medical union pronouncements, as we have co-evolved with viruses for billions of years.
Let Lanka rebound and sustain that by being able to count on no more curfews, targeted interventions only, symptom and fact based, and keeping other priorities and medical and human needs in mind, not just one middling pathogen playing ‘lord of the rings.’
Every bloody, blooming thing has been farcically wrong!
So, what are we to make of mass absurdity, repeated so blatantly, so unrepentedly, as to seem ‘mainstream?’ Because virtually everything asserted from the outset of this tragicomedy has been wrong.
So ‘one size fits all.’ It took Professor John Ionnidis and Dr. David Katz to bring our attention to the fact that vulnerability re COVID-19 was overwhelmingly concentrated in those above 65 with pre-existing conditions. If this were repeatedly understood and focused on, then shutting down the planet at large, undermining our ability going forward to be economically viable enough to protect the vulnerable was simply insane. With the rest of the demographic profile having no more danger than we do with influenza or the flu, that being reaffirmed as it has been consistently, should have called off the mass panic and this whole vaccine pageant months ago.
Next, ‘Tremble before the asymptomatic.’ When deaths were not forthcoming and ‘symptomatic’ positive cases began to flounder, centuries of medical practice was uprooted in one fell swoop by asserting ‘asymptomatic contagiousness’ on scant to no evidence, which remains the case, outside of a few isolated, unverified lab studies today. So, on the basis of this superstition, bolstered by ‘positive tests’ detached from symptoms, the frameworks of society and civilisation as we knew it, have been devastatingly compromised.
‘We have a test,’ well actually we don’t. Peer review of the diagnostic application of a test (PCR) its inventor clearly said was never intended for diagnosis but for ‘detection’ was rushed through at an unprecedented pace. A retraction is now being sought by leading specialists on evident grounds that range from acute sensitivity and amplification levels, the inability of the test to detect the difference between ‘live’ virus and fragments or debris, and the inevitability of ‘false positives’ increasing as prevalence goes down.
And furthermore, as we started ‘proactively testing’ and detached that from symptoms, then the carnival was in full force. Because the mass testing of the symptom free, and basing the ‘results’ of that on a non-diagnostic test) as the basis for compromising everything else on the planet: all other medical care, the survival of businesses, education, poverty, is so gratuitous and so grotesque as to defy apt characterisation.
‘Look at all the deaths.’ And more legerdemain! First when seroprevalence studies make it clear many more have been ‘infected’ than we have ‘tested,’ we realise we need the ‘infection fatality rate’ not the ‘case fatality rate.’ And once you make that switch and run the analysis on the basis of antibodies and other markers, the IFR (infection fatality rate) plummets to median influenza levels. In some parts of the world, it goes below that.
Sixty million die each year in the world, at the ‘hyped’ COVID death numbers, 1.5 million if truly ‘excess’ would be about 2.5%. But we cannot assert it is ‘excess’ as deaths from other factors seem to have dropped off, either because they are not being counted, or they are being clustered as ‘COVID deaths’ in many regimes, where the mere ‘presence’ of C-19 as explained above makes it a ‘COVID death.’
We have a ‘cure.’ Our cure, by destroying the livelihood and commercial vitality of the planet for a virus based on ‘modelling,’ is a penal infusion never used since the Middle Ages, trumpeted in a college paper based on extrapolations by those with zero public health experience. Our ‘cure’ was not in any prior public health playbook, had been conceptually rejected by the WHO, all through 2019. And then Wuhan, the optics of Lombardy, and panic begat panic. However, now we see, lockdown regimes did no better, and in fact quite a bit worse in many instances, than jurisdictions that either had no ‘lockdown’ or a mild version, with targeted restrictions for very limited periods of time.
‘Masks can mitigate.’ Some physical distancing is clearly needed, being outdoors more often where transmissibility is virtually nil is even better. The aerosols and droplets by which an infected person infects someone else are too small to be seen, and cloth masks, particularly with a gap between mask and face, offer virtually no defence. This is easily verified in the medical literature by anyone interested.
Surgical masks are better, but again infectious disease specialists and surgeons are in accord: they catch at most 50% of such particles, and that is a generous assessment. And these are ‘fitted.’ To really stop these minute viral particles, you need a respirator, fully fitted, and sealed. These are usually worn at most for a few hours at a time. The cloth mask regime is essentially a well-meaning but ineffectual cult foisted upon us. Essentially, we touch the masks, infecting them, they catch God knows what on them, and become a potential breeding ground if not frequently sanitised. Eyes are still exposed.
And as we breathe out CO2, the quality of our oxygen supply is undermined, to dangerous levels according to many experts who point out that the resulting quality of oxygen would be outlawed in European workplaces, and we are then essentially breathing our own waste. Numerous studies show such masks make no difference re influenza and viral transmission. The studies may not be perfect, but they seem ‘almost’ unanimous, including from Hong Kong, Vietnam (focused on cloth masks) and now Denmark (focused more on surgical masks).
And don’t ever, ever ask this bloody obvious question. What do we do next time? Does even the most ardent zealot think we can possibly afford this self-destructive playbook ever again? So if we learn nothing, emerge with no better public health wisdom or knowledge but to have included ineffectual masks and Middle Age penal prescriptions, while detonating the equivalent of a civilisational neutron bomb, do we truly feel confident we are ready for whatever may come next?
One of the reasons the ‘modellers’ were so incorrect about death toll we are being told is they assumed immunological ‘naiveté’ relative to C-19 (no prior immunity). As we now know, exposure to other coronaviruses, the possibility C-19 has been circulating for much longer, clearly provided some in-built immunity that has tempered its impact. But now, as we are seeking to cordon off our immune systems, one has to fear that future varietals may not find us similarly ‘gifted’ and the current vaccines may or may not provide requisite protection (as we see from needing cold vaccines each year).
The failure to think
We don’t like to think about implications, of how the pandemic is viscerally different for those with guaranteed paychecks who can work from home and those who have customer-facing businesses and their literal existence mortgaged to them. We don’t consider how ‘positive test’ numbers masquerade as ‘cases’ and somehow ‘imply’ impending deaths, we don’t seem to ‘mind’ when it all shifts. Someone somewhere, the perennial ‘they’ (as in ‘they are now saying,’) has our back.
Well, it’s all there if we wish to sieve it, review it, respond to it, and exercise the rights autonomous individuals in a democratic society have had others die and suffer to bequeath to them. Our leaders are dedicated to Lanka and Lankans, but they need our voice and our collaborative views and our thinking partnership, not just our mulish compliance.
In a different vein, arguing for the right to teach Darwin in schools, Jerome Lawrence and Robert E. Lee have their protagonist (loosely modelled after Clarence Darrow) say in exasperation, ‘Then, why did God plague us with the ability to think?’ He argues we have few other merits, when the butterfly is more beautiful, the mosquito more prolific, and even a simple sponge more durable. Other animals are faster and stronger. This ‘plague’ is our defining, distinguishing characteristic, and allows us also to ponder, to wonder, and thereby build a bridge to our emotions and spirit as well, if we allow for flow rather than dogmatic fortifications.
So, we are endowed with the privilege and the capacity to be able to think, and thereby equipped to sanely opine, and also to meaningfully feel. What ‘plagues’ do we unleash when we refuse to do so?
