#Covid19 Corona Chronicles: A Post Truth Pandemic

14 October 2020

One of the key elements that sort of put people off was all the models that initially estimated that our known world would get overwhelmed by the pandemic. What most people who now pooh poohed these models then and now, do not understand is that with whatever little understanding they had of the novel corona virus strain and an assumption that we as a scientific community and as a society would not come up with responses. So when the earliest rumour came, Taiwan sent researchers to Wuhan- Ground Zero, as did Vietnam, Korea,Singapore and Japan. These were in any case countries too close to China and had battled the SARS outbreak, so they were more than clear that any rumour emerging about a novel flu from a Chinese source must be handled with absolute respect and certainty. Of course, the conversion of SARS CoV virus in the form of a mutation very early led to the disappearance of the clinical disease, so SARS remained a contained outbreak, which the rest of the world had little direct exposure to. What happened with SARS CoV2 our novel corona virus of 2019 is it checked all the boxes as we kept listing them, as-
It proved to be no seasonal flu, it didn’t vanish in summer
It proved to be both virulent and prevalent as anticipated
It had both asymptomatic and symptomatic spreaders
It has symptomatic super spreaders
It has varied clinical course
It has documented cases of reinfection
It affects all age groups, only severity is more with advancing age and co-morbid conditions
It has great ability to be carried by fomite transmission ( articles touched by infected)
It created an open season for ‘repurposing’ for ‘expertise’ and sullied the ‘research credentials’ of venerable medical journals like NEJM and Lancet because of how it became the singular focus of the global community across fields and subject expertise

What we have observed is that there is really no evidence that while the virus sticks to surfaces well, it actually infects people that way, which could be more a compliment to humans adopting to hand hygiene too! Dr Fauci and other experts are on record to say that the chance of such an infection is as rare as being struck by lightning twice! Vegetables and other food items have been initially subjected to bleaching, peroxidising and Ultraviolet, but now it is clear that contamination is not possible by merely handling and processing by way of cooking or boiling does take away the risk. It could also very well be that after handling of such items, hand washing ensured it any ways. Anecdotally fresh vegetable and meat markets are functioning and reasons for them becoming hotspots like Greater Mumbai’s APMC and Chennai’s Koyambedu in the first six months of the pandemic are more to do with lack of ‘social distancing’ and other measures, than any contamination of produce…So transmission is now acknowledged as largely human to human transmission.

Still, medical experts have yet to advise us to get off this ‘sanitisation’ of common areas, the cleaning of pavements and railings and seats and so on…Likewise for strange reasons, the CDC and US Federal Health authorities refused to recommend universal mask wearing in the initial phase of the Pandemic. I still remember feeling let down back then, when Dr Fauci in a briefing advised that people wear masks if they were symptomatic only. By that time, the model of Taiwan was already there, with that island entity prescribing its residents medical masks, rationing them so that one mask was meant for 10 days, then it became weekly before now when masks can be exchanged daily. This wearing of masks in a compulsory manner along with some physical distancing guidelines for restaurants and monitoring for symptoms and contact tracing helped Taiwan remain perhaps as one truly safe country for people to live in Corona Times. The others are Japan, Korea, Vietnam and Singapore. For 500 cases Taiwan saw 7 deaths so far, which means that the disease spectrum remained true to initial prediction with fatality at 1.54% ( the range is 0.8-2.4 in ideal modelling)

We don’t know much about China, though Chinese medical experts have published lots of papers that have enhanced the understanding of Covid19 disease pathology, clinical course and spectrum of organ involvement as sequelae. We could never imagine that Chinese would be transparent with their disease burden data, and sure enough, China stopped her Covid19 bean counter, it would seem, once it declared it had contained the pandemic in Wuhan and Hubei, which it declared were the most badly affected areas. It is clear when you watch ‘China in Focus’ on NTD that outbreaks happen in other parts of China and perhaps the Chinese are able to quickly trace and isolate and contain the pandemic, but we have no official confirmation. We know that PLA were administered experimental vaccines in Phase II clinical trials, now Chinese students going abroad to study are going to be likewise inoculated as per reports. We also know that China has indicated to Bangladesh that she may not be able to offer her the Sinovac and herself signed up for the WHO Covac programme.

There is an army out there who seek to send the same message that President Trump has been doing in public- downplay the disease.

One of the reasons they have such salience is because, globally individuals are desperate to get on with their lives. The key contentions of nay sayers is-
Covid19 and our lockdown responses cannot be separated from each other in the increase in crude mortality globally
Covid19 mortality itself is because of initial mismanagement, including sending elderly patients to nursing homes to create hospital capacity as it happened in Sweden, UK, USA amongst others
Deaths in hospital could be due to invasive management, use of Hydroxy Chloroquine, Nosocomial and also because of co morbidities

So for this lobby and their faithful, Covid19 is just another flu and instead of learning to get on with it and learn to live with it, we are allowing our lives, our very societies and our countries to be bogged down by it!

Of course, one country that backs them directly is India, which has been focusing on recovery rates, which has been persistent in not just undercounting, but also restrictively assigning Covid19 to mortality in India. So when India with as many cases as USA reports mere 50% of the deaths USA does, it queers the narrative of science. USA itself altered its stance on mortality attribution by reducing the count of comorbid cases, which happened from August, so we saw the US mortality climb slower that it did in the initial phase when the broad attribution of death as Covid19 death for any individual who died with Covid19 infection. Further in India, a person could be tested negative after 10 days of Covid19 infection and death later due to the disease sequelae makes this a non Covid19 death solely because of the negative test result which scientifically is just a marker of viral load/presence in the body. Even with tightening classification of deaths, Dr Fauci has issued an advisory that over next 3-6 months, USA will suffer a further 200000 deaths from Covid19. When Spanish Flu Pandemic occurred a century back, there was no test-no Nucleic Acid, RNA eluting, no markers, antibodies, nothing! So health workers labelled any fever during that Pandemic as The Flu. I can tell you now, that doctors still order a panel of infectious diseases screening and they are justified as one often sees a Typhoid/Enteric Fever or Dengue in patients with fever and flu like symptoms who test negative for Covid19. So when now the documented cases as nearly 40 million with a million deaths, we must not deny these numbers. It makes for a infection specific mortality of almost 3% globally.

The full effects of Covid19 cannot be assessed now, for many countries supply data selectively. In routine course, any disease would be tracked by demographics, by ethnicities, by many other parameters to enable us to understand how it affects us better. For some reason countries are reluctant to share such data. Even in EU, countries have different testing policies, while in India the RT PCR which is the best test so far is shrinking in usage compared to Rapid Antigen Test,(RAT) where even Kerala tested a mere 20% of tests using this benchmark and remainder was done with RAT. Further India has from mid September curbed her testing levels and now these hover around a million a day, and if Kerala is any yardstick a test which can throw up a near equal number of false negatives is our mainstay since! So we shouldn’t be surprised at our current trends.

So a lot of bad science is operating world over in this Covid19 Pandemic. It is primarily because of politics. Few countries like Australia, New Zealand, Germany, Czech Republic, Korea, Singapore, Sweden, Taiwan, Vietnam and Japan exist where the handling of the disease is entirely left to medical professional experts. In our neighbourhood, Bhutan and Sri Lanka can be added though this leadership is not as visible and upfront as in these other countries. I am not suggesting that professionals don’t make mistakes, because there is a whole host of them who are muddying the waters due to their prejudice and lack of critical thinking.

If one used the same yardstick as what the world used a century back, this Covid19 would be at par or worse with Spanish Flu. Only it is unlike then not seasonal, though experts predict an uptick in infections during Northern Hemisphere’s approaching flu season. Just taking USA as a case, excess mortality of all causes was almost an equal of those attributed to Covid19 for the period from 01 March to 30 May 2020, at 1,22,000 deaths https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767980. This was in a country where the testing is free, more widely available and largely accurate. So for countries across the world, the true picture of Covid19 would be globally closer to 70 million cases and about 4 million deaths for the period from 01 March to 30 September 2020. Again, China with her non-diclosure and opacity, India with her dubious number crunching and 1 in 5 Medical certification of mortality while accounting for nearly 50% of the global population are dragging the rest of the world in the efforts to obtain a truer picture of this Pandemichttps://www.indiaspend.com/how-india-could-fill-in-the-blanks-on-excess-mortality/. Yet, I can say that the Financial Times tracker of 20 countries is good enough a guide to say that Covid19 has delivered an additional 30% to 40 % excess mortality this year globally for countries with very good medical infrastructure ( OECD Standards. In India only TN has OECD standards as a state, Metros offer OECD standards for those who can afford OOP Expenses) so for those other countries this mortality could be as high as 50-60%.https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938

Researchers have used science to deflate the naysayers and anti maskers. Author of Black Swan Nissim Taleb has lent his authorship to counter narratives about early models as well models current, as have many doctors and experts. I offer you one link on Twitter which is Health Nerd @GidMK https://twitter.com/threadreaderapp/status/1315463957159665666?s=20 who has been debunking these fancy footloose who are derailing the science of Covid19 and creating confusion amongst the general public. As Taleb says, this is a war between scientism and science. Between make belief and fact. The failure of political leadership is what has brought this about in the first place. It will be won only by us, global citizens, applying our minds and engaging with the facts, and going with science and common sense.

Wear A Mask! Spanish expert has advised that Spaniards be ready to mask up for at least another two years! https://www.dailymail.co.uk/health/article-8821083/Brace-TWO-YEARS-mask-wearing-warns-Spanish-virologist.html?ito=social-twitter_mailonline

Is there really a toss up here? Even if no vaccines were forthcoming, Vietnam and Taiwan are well situated to weather this Covid19 storm, because they faced Covid19 with universal mask policy.

( Concluded)