Pandemia run amok

There are critical confusions that desperately need attention. I fear for the health, wealth and perhaps solvency of the nation.

Let me highlight these as clearly and as carefully as possible.

 

Doctor vs. other expertise

I am not a doctor or scientist, but a researcher and a consultant. However, having advised global shipping lines on how to reverse decades of negative growth and turn that around, or FMCG companies on how to take market leadership from their toughest rival, or guiding financial institutions in profitably and sustainably re-engaging their customers after a global financial meltdown, or working with pharmaceutical companies to create a successful national partnership with the Chinese Government, I can tell you the basis for all such value addition, has been a deep dive into wells of expertise, and humbly combing what key practitioners are saying, and then seeking to “connect the dots”.

Everything that follows can be stress tested on the basis of logic, or easily referenced research or data.

Doctors should provide medical insight not policy conclusions

We had a strange outpouring of quasi-hysteria last week with medical groups and doctors virtually “demanding” a two-week lockdown, and asserting only this could stave off COVID catastrophe, and further claiming this was based on “medical” reasoning. And we have catastrophically capitulated with no rationale given, and in contradiction to all the best current medical insights and practice.

If Minister Cabraal was right in forecasting about a Rs. 200 billion impact from two such weeks (having already endured he says a Rs. 60 billion+ impact from the initial four days), then having issued such a “demand” without the remotest idea of how to survive this economic tsunami, on top of an already desperate economy is a prescription we cannot rationally just “order” to be filled. 

“Focus on the people not the economy” is mindless babble. I’ll say it again, economic suicide is not a medical strategy! And hunger and poverty will kill you as decisively and far more assuredly than a viral strain, which even if you take each “ascribed” COVID death as literal despite all the overarching comorbidities, the percentage is about 0.005% of total Lanka population and 0.76% of Lanka annual deaths (and even that is 14 months). 

Skyrocketing impact on child and maternal health, deferred vaccinations, business destruction, how are these “demanded” with such imperious abandon?

Even our 32 deaths reported on 24 May, we are told are an aggregate of deaths from 23 April to 22 May! Only five passed on the 23rd itself. All tragic, all to be mourned, but we will not mourn them by blowing up the survival prospects of the survivors.

All leadership is about cost-benefit. This is as elementary and as inescapable as it gets. If I told you I could get rid of your headache by shooting you in the head, we would realise it is a mad recommendation. On its merits, this isn’t much better, unless we have a magic grove of money trees, or wish to continue to raise levels of indebtedness to degrees that make “sovereignty” less and less tenable. 

And when we open borders, or keep inciting new variants by vaccines or lock up, can these gentle folk promise they will never again ask for a further two-week economic and social kamikaze remedy? That then we will live with this with grace, and believe our immune system can deal with a disease with a global 99% recovery rate for those below 70 without serious comorbidities? If not, then they are just confessing this is not a “cure”, it is a desperate gamble, for a self-defeating strategy.

The seminal error

The key issue is not in fact medical. Leaders receive cost-benefit inputs, should balance the scales, and hopefully decide what is in the best interest of their citizens. The seminal error is to assume that it is settled that C-19 towers over all other considerations. Why? Explain why it’s more important. 

The tallies are in. Excess global mortality in 2020 was 0.12%. 80 million people have passed of all-cause mortality since this began, with three million from C-19 with potentially skewed death certificates and comorbidities distorting all past precedent of how death certificates were filled out. But even so, let’s take that number. Clearly, it far from makes the case.

Every two minutes in India a child dies from diarrhoea or TB/influenza. Every day, 365 days a year. Why is that not the real crisis? 

On what basis has it been asserted, that this one coronavirus, without the need to justify, debate or discuss, should take primacy over every other health, social, economic, or national consideration? Doctors cannot possibly decide that.

So, if we do not start with the assumption that every indignity, hardship, invasion of rights, including the right to make a living and be educated, is secondary to chasing “positive tests” that aren’t even reliably definitive for diagnosis, as per WHO itself, then we perhaps return to sanity and can review the evidence soberly.

Lockdown is a dud

So, why do we assume it is demonstrated (when it is not) that this failed recipe is somehow “proven science?” Sweden has better COVID results than Germany, despite largely voluntary “distancing,” no real masking, schools open, even despite a nursing home disaster. You cannot blow up your economy without explaining that. And it is unavoidably true in terms of mortality which is the only thing that counts.

Texas open for 10 weeks, no masks, no lockdowns, 50,000 in sports stadia, nothing, no spike, plummeting death numbers, empty ICUs. Florida despite the winter surge, outperforms all the masked locked down states of the two coasts, and is fully open. When such living data points exist, you cannot just keep parroting “lockdown” as some self-evident fact.

WHO itself until 2020, updated in a 2019 report, said quarantining the asymptomatic, and such pervasive “locking down” should “not be done under any circumstances.” They flagged the humanitarian issues with migrant workers and more. No new research has emerged to say otherwise. On the contrary, and all over the world, the masked locked down jurisdictions, are trapped in wave after wave. 

Though now facing minor recent flare ups, South Korea never fully locked down, so it is untrue that no country on earth was able to contain exponentially rising cases otherwise. Taiwan never did. Vietnam did very targeted lockdowns. Japan despite “national emergency” status never fully locked down; it’s constitutionally banned there. Despite flare ups now, compared with the West, numbers remain tame. Dhaka claims a “quasi lockdown” but the roads are packed day and night. So, if they have one in more than name, it’s highly surgical, and COVID numbers have been falling past peak for some time now. 

We can’t just ignore Sweden and Belarus, Finland and Norway, 20+ US States and instead benchmark places with the worst COVID stats.

Any thinking, rational person, can simply click on this link and see over 30 published papers from around the world, based on actual data (not modeling), that clearly demonstrate that “lockdowns” are dubious if not outright useless (as most of the transmission has taken place indoors), and certainly far from self-evident insofar as our screeching to a halt once more. https://inproportion2.talkigy.com/do_lockdowns_work_2021-01-15.html.

As has been said, we are all entitled to our own opinions, but not our own “facts.” So please click away and arm yourself with what has been so painstakingly learned.

The transmission fiasco

After more than a year after the beginning of the pandemic, WHO, after being written to by a collection of over 200 doctors and scientists, has finally acknowledged that “aerosols are the primary mode of transmission of SARS- CoV-2”. We can’t keep ignoring this published update, restated also by MIT, and reported in the Lanka press. We can’t call it “medicine” to have an outright immunity to updated data.

Leading aerosol researcher and professor at the University of Colorado, Jose-Luis Jimenez says his research shows that aerosol transmission is likely 99% of such transmission! That means poorly-ventilated indoor spaces are a disaster. It means outdoors where, as he says, any exhaled pathogens, or wafting viral strains will be readily dispersed, is close to zero concern, masked or unmasked. 

Indoor transmission is more than 99%. Since larger respiratory drops are not primary, masks get even dicier and as MIT says social distancing becomes secondary at best. Therefore, hospital infections were so widespread (up to 30%), protecting nursing homes once people were congregated was so hard (about 50% of global deaths), the seasonality of infections (dependency on latitude). Hence as MIT urges, focus on ventilation, less indoor crowding, and let sunshine and fresh air infuse us with fresh life. 

The asymptomatic fiasco

We cannot find any credible instance. I’ve explained that, and this pretension is rebuffed by leading experts including former Chief Science Officer of Pfizer, Michael Yeadon and leading COVID treatment specialist (published the only two peer-reviewed papers on COVID treatment globally), Dr. Peter McCullough (one of the most credentialed and published doctors in the world).

To illustrate, glandular fever, as a leading researcher points out, is caused by the virtually ubiquitous (everyone has it) Epstein-Barr virus or EBV. If infected early in life, it takes up residence in your B cells (the cells in your immune system that create antibodies), where it quietly persists for much of your life. Occasionally it does some viral replication, copies itself, and this gets shed into your mouth – all of us blissfully unaware of this viral frolic. If you get infected later in life though, you can develop “infectious mononucleosis” says this researcher, or glandular fever.

Let’s apply our asymptomatic orthodoxy here. If we were to define having a disease simply by the presence of a viral genome, virtually everyone in the world would be identified as having “asymptomatic glandular fever” and should not be kissed! Millions of “cases” on this basis…

But this is nonsense because you need more than “presence” you need “infection”. The same applies to COVID. So there is no disease concern if you are asymptomatic, and the viral load if any is touted to be so low as to be not worth attending to. Transmissibility is yet to even be proven.

In terms of public policy, we then focus on the symptomatic as these specialists suggest, and focused diagnostic testing capacity for the minority rather than dubious industrial-scale screening. Restrictions would focus on sick people, and we know there are treatments, demonstrated again by India, Mexico, Zimbabwe, Bangladesh, in many parts of the US, and we’ll come to that next. Ergo, locking up everyone is beyond unaffordable, it’s patently unnecessary.

The treatment fiasco

I will not expend more energy making a case that Dr. McCullough in his interviews and testimony I’ve linked to makes so compellingly. And we have but to look at the Indian states using some of these protocols like Ivermectin, despite the WHO “slow walk” to approval, demanding of cheap drugs that have been used for decades, randomised trials that only pharmaceutical giants can afford.

Look at Delhi, Goa (where every adult is being given Ivermectin), to Uttar Pradesh and compare it to Brazil, and then look at Tamil Nadu as it stopped Ivermectin and switched to one of the “protocol” treatments…not a pretty sight! Even WHO has congratulated Uttar Pradesh, though sidestepping mention of the protocol, the State itself credits with the remarkable drop in cases and deaths.

Much here inspired by Dr. Paul Marik, legendary professor, and the second most published critical care doctor in history, with more than 500 peer-reviewed papers. If we are to swat away such expertise and call that a “medical opinion,” that would be unfortunate, especially when a look next door at both Bangladesh and India beckon.

Marik, by the way is world famous for creating the “Marik Cocktail,” a revolutionary combination of cheap, safe, generic, FDA approved drugs that dramatically reduce deaths from sepsis by 20 to 50% whether in Zurich or Zimbabwe, Chengdu or Chicago. And if given soon after people appear at hospitals, the death rate plummets to almost zero (sepsis last year passed cancer and heart disease as the world’s number one killer).

Marik put together an exceptional team, including the father of noninvasive intubation and a world authority on steroid treatment Dr. Gianfranco Meduri, and his own protégé, Pierre Kory, with deep expertise in trauma and life support and critical care. They realised this coronavirus is not what kills. In the second week, all the infiltrating coronaviruses die, and they draw massive “friendly fire” of a hyper-immune response causing multi-organ inflammation and massive clotting. But these pulmonary critical care doctors knew how to treat inflammation and clotting: corticosteroids and anticoagulants. As Marik calls it, “first grade science”.

The hospitals they led had astonishing survival rates. Their first steroid “cocktail” was recommended against by all the national and international agencies. Subsequent studies then established it as the “gold standard” in hospital care.

Their subsequent early treatment protocol involves the aforesaid Ivermectin. I state the background to establish that despite media evasion, you cannot sanely ignore the depth of experience and the remarkable results produced. 

Ivermectin is an over-the-counter medicine that won the Nobel Prize for its discoverer, microbiologist Satoshi Omura for nearly eradicating two of the most debilitating diseases in history, river blindness and elephantiasis, saving millions in Africa. It is safer than Tylenol, and the journal Antiviral Research in Australia reported it blocks other RNA viruses like dengue, yellow fever, Zika, West Nile, influenza, Asian flu and more. And claims that more randomized trials are needed are silly. Off label uses of otherwise approved drugs that are used by doctors at their discretion drawing on their experience and judgment are a mainstay of treatment as all these doctors point out. Penicillin never was randomized, it just obviously worked.

A cheap, readily available, anti-viral, anti-inflammatory medicine has no reason to be controversial…except insofar as it threatens the vaccine profiteering by stopping the disease in its tracks and being a far safer bet than yet to be authorised experimental treatments.

Ivermectin was originally criminalised in South Africa. Activists campaigned and got permission from the Ministry of Health on 27 January. Case fatalities dropped in one month from 70 a day to two a day, and South Africa, with virtually no vaccination, has done atleast as well as Israel. 

I advise anyone interested to visit the website of Front Line Covid-19 Critical Care (FLCCC) for more. 

The point is there are clearly credible treatments for a disease that has a viral, an inflammation, and thrombosis component. And that these were inspired by one of the most globally esteemed pulmonary care specialists should be reassuring. Lungs are the most common organ that fails in the ICU in the context of many diseases. Pulmonary critical care physicians are the most widely skilled and the most knowledgeable and experienced in all facets of disease and all levels of severity. No other specialisation comes close.

I would urge our doctors here to get Sri Lanka at the forefront of these trials and achievements. Putting energy there rather than “medically advising” national shutdown would be such a boon to the country they clearly love and seek to serve.

Moving on

So panic won over data. Our weird habit of aggregating death numbers (imagine petitioning for a two week shutdown telling the literal truth, “well we had five deaths yesterday”), being infatuated counting “positive tests” posing as cases without ever admitting that numbers have jumped as our testing has jumped or ever confirming whether the amplification settings are per WHO guidelines, and instead of sticking to the symptomatic, and focusing on treatment not penal lock-ups, we have inflicted a further body blow to the functioning of an economy needed so desperately by everyone.

This economy can never recover if we follow this insane playbook, of repeated panic shutdowns. No one will plan, no one will trust us, no one will sanely invest. If for every pathogen, unlike all of history until 2020, the best we can manage is intemperate panic, we have no way forward.

Have we the courage to say, we will never inflict another lockdown again? Doing what doesn’t work over and over is silly. And for an airborne virus with tourism resuming and business travel, it’s coming back. It has to get endemic. 

We are told we have to develop natural immunity plus perhaps targeted vaccination for the vulnerable. 

And let’s commit to being at the forefront of home treatment, early treatment and hospital treatment using these globally demonstrated treatment protocols. Hey, it’s been 14 months. A disease so mildly lethal and so clearly treatable should not be our undoing.

Let us compare all harms and all risks and trust that if Sweden and Texas can do it, so can we. Our mortality numbers are a fraction of virtually anywhere else, so our immune system has already been serving us well. 

Why ignore the obvious sunshine and fresh air prescription any virologist would give us before ordering mass meltdown?  

We simply cannot assert a fact free basis for further destroying society on the basis that only one cause of harm matters when it’s not even a blip in the mortality numbers here, frankly in India too. To do so, ignoring the new emerging playbook, is actually mania, not medicine.