Monday, March 23, 2020

SARS-CoV-2 and the Rush to Judgment

Why Is the World Being Quarantined, and Is That the Only Option?

by MARK GABRISH CONLAN

Copyright © 2020 by Mark Gabrish Conlan for Zenger’s Newsmagazine • All rights reserved

A note on nomenclature: Throughout this article, the virus causing the current pandemic will be referred to as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) and the disease associated with it as COVID-19. This is partly because those are the official designations from the U.S. Centers for Disease Control and Prevention (https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fsummary.html) and partly to stress the point that, though almost universally referred to as the “novel coronavirus,” it is “novel” only in the sense that the Apple iPhone 11 is “novel.” It has new features that make it more effective — and therefore more dangerous — than its predecessors, but it’s still an organism human immune systems can recognize and mount some sort of immunological defense against.

“The prospect of domination of the nation’s scholars by Federal employment, project allocations, and the power of money is ever present and is gravely to be regarded. Yet, in holding scientific research and discovery in respect, as we should, we must also be alert to the equal and opposite danger that public policy could itself become the captive of a scientific-technological elite.”
— President Dwight D. Eisenhower, January 17, 1961

The advent of the SARS-CoV-2 virus and the COVID-19 pandemic it is causing has hit the human race like a whirlwind. Less than two months after the World Health Organization (WHO) identified it as a global health threat (though they hung back from calling it a “pandemic” — a worldwide epidemic — for another month after that), nations, states and cities are taking drastic actions to stop it that countries usually don’t take unless they’ve been directly attacked in a war. I started writing this article about a week ago — March 16, 2020 — and already the state of California has taken actions I would have considered unthinkable then.
On Thursday, March 19 California Governor Gavin Newsom essentially declared public life illegal in this state. (Governors in New York, New Jersey, Connecticut and Illinois have since followed suit.) As reporter Taryn Luna wrote in the March 20 Los Angeles Times (https://www.latimes.com/california/story/2020-03-19/gavin-newsom-california-1-billion-federal-aid-coronavirus), “The mandatory order allows Californians to continue to visit gas stations, pharmacies, grocery stores, farmers markets, food banks, convenience stores, takeout and delivery restaurants, banks and laundromats. People can leave their homes to care for a relative or a friend or seek health care services. It exempts workers in 16 federal critical infrastructure sectors, including food and agriculture, health care, transportation, energy, financial services, emergency response and others.”
Other than those exceptions, Californians aren’t allowed to go outside their homes at all. Businesses that don’t fit the above-listed exceptions are supposed to close. Even before the full shutdown, Newsom had ordered all bars to close and all restaurants to limit themselves to to-go orders only. Ironically, liquor stores and marijuana dispensaries have both been declared “essential businesses” that are allowed to stay open. Someone in Newsom’s administration seemed to realize that if you’re going to tell people they have to stay indoors, one way to reconcile them to that is at least let them get drunk or high.
Exactly what this is supposed to accomplish is not clear. We’re being told it’s to stop transmission of SARS-CoV-2, but it’s an open question just how much even the most restrictive and well-enforced mass quarantine can do. The best health officials seem to think they can do is what they call “flattening the curve,” meaning reducing the numbers of new cases of COVID-19 disease to a level the current health care system can handle without being overwhelmed. Even this is going to be difficult, especially since this is one of those viruses that can be transmitted from someone who has the infection but is not showing any symptoms. (This is also true of flu viruses and the rhinovirus that causes the common cold, so it’s not that odd or unusual.)
Once it was established that asymptomatic carriers could transmit SARS-CoV-2, University of Minnesota director of epidemic research and policy Dr. Michael Osterholm told CNN March 17 that trying to stop that sort of transmission “is like trying to stop the wind. … Honestly, this kind of transmission, we’re never going to stop it. What we best are able to do is slow it down.”
A front-page headline in the March 18 Los Angeles Times (https://www.latimes.com/politics/story/2020-03-18/coronavirus-poses-dreadful-choice-for-global-leaders-wreck-your-economy-or-lose-millions-of-lives) summed up the choice for political and social leaders in the starkest terms imaginable: “Coronavirus poses dreadful choice for global leaders: Wreck your economy or lose millions of lives.”
“While some initially hesitated, leaders and legislators in the United States and worldwide increasingly have decided they have to accept the severe economic pain,” reporter David Lauter wrote. “U.S. officials know the worst-case scenarios could be extremely bad. The White House has based some of its new plans on a research model developed by doctors and scientists at Imperial College in London that suggests the [SARS-CoV-2] coronavirus epidemic in the United States could kill at least 2.2 million Americans over the next few months if left uncontrolled.”
That Imperial College report, available at https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf, differentiates between two strategies against the virus: “mitigation,” which as the report states “focuses on slowing but not necessarily stopping epidemic spread — reducing peak health care demand while protecting those most at risk of severe disease from infection”; and “suppression,” whose aim is “to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.” In the last week some state governments in the U.S. and national governments in other countries moved decisively from mitigation to suppression — even though, if Dr. Osterholm is right, suppression may not even be possible.
“In the U.K. and U.S. context, suppression will minimally require a combination of social distancing of the entire population” — i.e., keeping people at least six feet apart from each other at all times — “home isolation of cases and household quarantine of their family members,” the Imperial College report states. “This may need to be supplemented by school and university closures, though it should be recognized that such closures may have negative impacts on health systems due to increased absenteeism.
“The major challenge of suppression is that this type of intensive intervention package — or something equivalently effective at reducing transmission — will need to be maintained until a vaccine becomes available (potentially 18 months or more) — given that we predict that transmission will quickly rebound if interventions are relaxed. … [W]hile experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.”

How Long, O Lord, How Long?

The implementation of suppression in California has meant the closure of virtually all schools, from grade schools to universities. It has meant the shut-down of all businesses that aren’t on that “essential” list — and an explosion in claims for unemployment compensation. Nationally, it has led to millions of people suddenly finding themselves without jobs — and without income — in a society that has historically been unforgiving of people who can’t “earn their own way” in the economy, and very parsimonious and grudging when it comes to offering a social safety net. Indeed, SARS-CoV-2 hit when the U.S. Presidency and Senate are controlled by Republicans committed to a Libertarian agenda that calls for the ultimate end of all social safety-net programs.
Indeed, that’s one of the reasons we’re in this pickle in the first place. The Trump administration has sent budget after budget to Congress calling for drastic cuts in public assistance of all types. They want to make it harder for poor Americans to get health care, food stamps, housing subsidies and any other spending of public money to help them. Some of Trump’s public press events about SARS-CoV-2 have featured Seema Verma, Trump’s appointee to run Medicare and Medicaid — and when he hired her, he specifically told her to cut as many people as possible from access to those programs, Medicaid in particular, without starting a political backlash. Trump also wants a cut in the federal payroll tax that supports Social Security — helping people in the short run, maybe, but speeding up the economic collapse of Social Security Republicans have been warning about for generations and using as an argument for eliminating it altogether.
SARS-CoV-2 has at least temporarily interrupted the broad-based, ideologically driven Republican attack on the social safety net. Instead, it’s led to a debate in Congress over what the federal government can do to repay people for at least some of their economic losses. President Trump and Congressional Republicans want to give that aid to giant corporations, particularly airlines, hotel chains and cruise-ship companies, especially hard-hit by the collapse of the travel market in the face of SARS-CoV-2. Democrats want some sort of direct aid to individuals. Trump has floated the idea of a single $1,000 to $1,200 tax rebate to everyone in the U.S. — much like the $600 rebate the Republican Congress and President George W. Bush gave out in 2001 as part of a tax-cut bill that undid the Clinton administration’s success in actually balancing the federal budget in 1999 and 2000.
The Imperial College report’s authors (all 31 of them, which is why they aren’t named individually here) admit that “we do not consider the ethical or economic implications of either strategy here, except to note that there is no easy policy decision to be made. Suppression … carries with it enormous social and economic costs which may themselves have significant impact on health and well-being in the short and longer-term. Mitigation will never be able to completely protect those at risk from severe disease or death, and the resulting mortality may still be high.”
Much of the uncertainty surrounding the SARS-CoV-2 pandemic comes because nobody really knows just how long the interventions will need to be sustained. So far, most individuals have been willing to live with the restrictions, mainly because they’ve been presented as something we have to do to get through the crisis. ““[U]ltimately, it’s an easy choice,” Jason Furman, who chaired the Council of Economic Advisers for President Obama and currently teaches at Harvard’s Kennedy School of Government, told Los Angeles Times reporter David Lauter. “There’s no time to do careful cost-benefit analysis” of whether a particular restriction might cause more damage than it prevents.”
Instead, government officials have to “follow a simple rule,” Furman told Lauter. “Anything the health people want to do to save lives they should do,” then “the economic people can do what they can to mitigate the damage.”

Do We Really Have to Do All This?

The changes we are being asked to make as a society go far beyond individuals’ daily lives — as horrible as those are. The term “social distancing” means that we are expected to stay six feet apart from each other all the time, especially when we go outside the home. We’ve seen the rapid shutdown of one mass public event after another, from the Coachella and SWSX music festivals to the entire National Basketball Association (NBA) and the National Collegiate Athletic Association’s (NCAA) “Final Four” basketball tournament. We’ve seen Major League Baseball, which continued in the U.S. through two world wars, delay the opening of its season at least until July. We’ve seen all Broadway theatres go dark, though some live-theatre venues are trying to sustain themselves by staging their performances to empty halls and broadcasting to audiences in real time through online video streaming.
• The wholesale closure of restaurants, bars and other social venues, not to mention the shuttering of sports leagues and movie theatres as well as delays in film production and release caused by the virus;
• The loss of an entire education system, from grade school to college, as school after school closes down or goes to “online learning” in the face of the viral panic;
• The strain on grocery stores as panicky customers buy basic items like toilet paper in massive quantities, fearing there won’t be any more available for months;
• The massive unemployment rates as millions, perhaps billions, of people worldwide are turned out of their jobs;
• And the horrific disruptions in the elaborate global chains of production and distribution of everything — including food supplies as well as medicines and virtually every product we use —
— all threaten to sink the world’s economies into not just a recession but a major depression, comparable to the 1930’s, lasting years. They also threaten to turn our children of all ages into a “lost generation” of under-educated adults just as other social changes are increasing the need for ever-higher levels of education.
The potentially catastrophic effects of the shutdowns of whole sectors of the economy for months or even years, and the even more catastrophic psychological effects on people forced to live for months or even years with the ever-present sense of danger, would seem to call for a careful weighing of how to act and whether some of the proposed “cures” for stopping the COVID-19 pandemic are worse than the disease itself. Instead we’re getting both the bad ways society as a whole, or its leaders, can react to a new disease: denial and panic.
Denial is usually the first stage; the failure to act quickly when the disease is still relatively easy to contain leads to a widespread increase in both the number of cases and the level of fear among national leaders and their populations. Then the panic sets in: hysteria grips the body politic and public health officials institute “containment” measures that become more and more draconian as their ability to contain a virus, bacterium or other disease-causing factor becomes less and less possible.

The Backlash Begins

Indeed, sometimes public response to an epidemic becomes cyclical, bouncing around between denial and panic without ever settling into that “sweet spot” of reasoned concern. Reasoned concern over SARS-CoV-2 would mean taking actions to stop, or at least slow down, viral transmission without going overboard. It would mean accepting a rising rate of infections and death while trying to minimize that as much as possible. It would mean giving a SARS-CoV-2 test to anyone who wants one while also acknowledging the limits of the test (as discussed below), particularly the fact that neither of the two existing tests (the throat swab and the blood draw) actually detects live, infectious SARS-CoV-2 in the body.
The far-reaching quarantine/isolation/lockdown measures being pushed by public health officials and adopted through much of Europe as well as in California, New York and other U.S. states are already sparking acts of defiance. Over the March 21-22 weekend so many people in San Diego flocked to the city’s parks and beaches — and came a good deal closer to each other than the six-foot “social distancing” mandated by the guidelines — that on March 23 San Diego Mayor Kevin Faulconer ordered them all closed.
The March 23 Los Angeles Times reported that certain bars in Southern California, New Orleans and Boston are remaining open despite orders from state and local governments to close under the quarantine. The local bar the Times was reporting on, the Griffins of Kinsale Irish pub on Mission Street in South Pasadena (https://www.latimes.com/california/story/2020-03-23/businesses-open-coronavirus-shutdown-orders-quarantine-shaming), hosted its traditional party on St. Patrick’s Day, March 17, despite Governor Newsom’s statewide order that all bars close.
Times reporter Andrew J. Campa interviewed the pub’s owner, Joseph Griffin, and reported that Griffin had said he’d told his customers not to eat food on the premises and make all their orders take-out. But not only did some customers eat on site, Griffin hosted a live band. Angry residents posted what Campa called “shaming” messages on social media and eventually tipped off the South Pasadena Police Department. At 7 p.m. — after giving Griffin two warnings — the police ordered Griffin to shut down. “The way attitudes have changed just in the last couple of days has been amazing,” Griffin told Campa. “I was open Saturday and Sunday and nobody said anything. Nobody said anything on Monday. Then Tuesday rolls around, and all of a sudden I’m this horrible person.”
The South Pasadena bar owner isn’t the only one chafing at the restrictions imposed by state and local governments at the behest of public health officials in an attempt to stop the spread of SARS-CoV-2. Campa’s article also cited a CBS Evening News segment on spring-break partiers in Miami Beach getting drunk, hanging out on beaches and laying out considerably closer than the six-foot “social distance” mandated by the guidelines. One participant put up a tweet that drew 900,000 hits and quite a number of comments critiquing it as “selfish” and “stupid.” “If I get corona, I get corona,” the tweet said. “At the end of the day, I’m not going to let it stop me from partying,”
Resistance to the anti-SARS-CoV-2 measures is growing among politicians, media people and commentators too, especially those on the Right end of the political spectrum. A March 19 op-ed from John P. A. Ioannidis, professor of medicine, epidemiology and population health at Stanford Woods Institute for the Environment (https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/), questioned not only the science behind the dire estimates of COVID-19 disease and death rates in reports like the Imperial College study but also the assumption that stopping (suppression) or slowing down (mitigation) the spread of SARS-CoV-2 is so important harsh measures are necessary whatever their short- or long-term economic impact.
“[W]e don’t know how long social distancing measures and lockdowns can be maintained without major consequences to the economy, society, and mental health,” Ioannidis wrote. “Unpredictable evolutions may ensue, including financial crisis, unrest, civil strife, war, and a meltdown of the social fabric. At a minimum, we need unbiased prevalence and incidence data for the evolving infectious load to guide decision-making.”
Ioannidis’ article apparently made an impression on President Donald Trump, who announced on March 23 that he’s considering easing the restrictions announced by the federal government last week. “At some point, we’re going to open up our country, and it’s going to be fairly soon,” Trump told a White House press conference. “I’m not looking at months, I can tell you right now. … If it were up to the doctors, they may say, ‘Let’s keep it shut down for a couple of years. Let’s shut down the entire world.’ And you can’t do that with a country, especially with the number one economy anywhere in the world, by far.”
Trump’s press conference was reported by Noah Bierman, Chris Megerian and Eli Stokols in the March 23 Los Angeles Times (https://www.latimes.com/politics/story/2020-03-23/the-war-against-coronavirus-becomes-a-battle-for-trumps-ear#nt=1col-7030col1-main). They also got comments critical of Trump’s attitude, including one from Jeffrey Levi, public health expert at George Washington University in Washington, D.C. “The worst thing for the economy would be to go back to work and see an upsurge in cases again,” Levi told the Times. “That’s the balancing act that policymakers need to perform.”
David Lauter’s March 18 Los Angeles Times article on the trade-off between public-health measures to control SARS-CoV-2 transmission and their potentially devastating economic impacts (https://www.latimes.com/politics/story/2020-03-18/coronavirus-poses-dreadful-choice-for-global-leaders-wreck-your-economy-or-lose-millions-of-lives) dropped a hint of an alternative strategy that commentators on Right-wing Web sites have started to run with.
“Public health officials expect the virus will spread until about 80% of all Americans have caught it or until a vaccine comes on line, whichever comes first,” Lauter wrote. “At that point, enough people will be immune — what doctors refer to as herd immunity — that the spread will stop.” Though Lauter stated that the estimates of how long it will take for either a vaccine or an 80 percent infection rate are 18 months to two years, some Right-wing commentators have suggested we should stop trying to control the infection rate. Instead, they argue, we should allow the virus to run its course, and accept that quite a few people are going to die along the way, until it infects 80 percent of the population and “herd immunity” is achieved.
Douglas MacKinnon made this case in a March 22 post on the FreeRepublic.com Web site (though I accessed it at https://townhall.com/columnists/douglasmackinnon/2020/03/22/should-america-vote-on-letting-covid19-run-its-course-n2565441?utm_source=thdaily&utm_medium=email&utm_campaign=nl&newsletterad=03/22/2020&bcid=7211a88f055bd17bdb282abe13bcaec5&recip=26438269). Like Ioannidis, he argued that the estimates that 2.4 to 3.4 percent of all people who contract SARS-CoV-2 will die from it are inflated and based on poor-quality data.
“As I write this, the total number of cases of the COVID-19 is still a minute fraction of the Swine flu pandemic which hit our nation and the world in 2009 and 2010,” MacKinnon wrote. “Back then, when it ran its course, the Swine flu was in 70 countries, infected approximately 1.5 billion people, and killed anywhere between 300,000 to 700,000. Here in the United States, over 60 million were infected, approximately 300,000 hospitalized, and upwards of 18,000 Americans lost their lives. And yet, life went on as normal.”
MacKinnon argues that it should be the American people, in a national referendum, who decide whether or not to follow the draconian recommendations of the public health officials to mitigate or suppress SARS-CoV-2 transmission. “More and more Americans are articulating the fear that shutting down our nation, destroying millions of jobs, and wiping out billions in life savings is exponentially worse than letting the virus run its course,” he wrote. “Without the immediate introduction of a vaccine to protect us from the COVID-19, does the strategy of ‘Herd Immunity’ make the most sense? That being to let the virus run its course with the proven theory being that once enough people have been exposed, they will develop antibodies and create a natural ‘herd’ immunity that dramatically reduces the threat of the virus.”
Texas Lieutenant Governor Dan Patrick made a blunter and nastier argument along the same lines as MacKinnon’s in a March 23 interview with Tucker Carlson of Fox News (https://www.mediaite.com/tv/texas-lt-gov-says-we-cant-sacrifice-the-country-to-combat-coronavirus-older-people-like-me-will-take-care-of-ourselves/). Pointing out that he himself is an older person with other chronic health condtions — and therefore part of the group most at risk for disease and death from COVID-19 — Patrick told Carlson, ““I’m not living in fear of COVID-19, I’m living in fear of what’s happening to this country.”
Patrick added, “No one reached out to me and said as a senior citizen, are you willing to take a chance on your survival in exchange for keeping the America that all America loves for your children and grandchildren? And if that’s the exchange, I’m all in. … Let’s get back to work, let’s get back to living, let’s be smart about it, and those of us who are 70-plus, we’ll take care of ourselves but don’t sacrifice the country. Don’t do that. … [If] this goes on another several months, there won’t be any jobs to come back to for many people.”

Assumptions Behind the Crackdowns

Many of the courses of action we have been essentially ordered to take have been based on assumptions that are either unspoken, untested or untrue. Among them:

The virus is “novel.” That’s true only to the limited extent that its particular combination of nucleic acids and proteins hasn’t been seen before. But it isn’t really new: as the U.S. Centers for Disease Control and Prevention (CDC) acknowledges on its Web site, it’s really just a mutant version of an older virus, SARS-CoV. As the CDC Web site explains:

Coronaviruses are a large family of viruses that are common in people and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-CoV, SARS-CoV, and now with this new virus (named SARS-CoV-2).

The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The sequences from U.S. patients are similar to the one that China initially posted, suggesting a likely single, recent emergence of this virus from an animal reservoir.

Remember SARS (Severe Acute Respiratory Syndrome), the disease caused by the first SARS-CoV virus? Almost nobody else does, either, but in 2003 it was considered as much of a potential heavy-duty threat to human existence as COVID-19 is today. But it didn’t engender the kind of worldwide panic we’ve seen over its successor. Instead, it was quietly contained after about 8,000 reported cases and 800 deaths.
SARS CoV-2 has already claimed quite a bit more than that — 378,848 cases, 16,514 deaths and 102,069 recoveries worldwide as of March 23, according to https://www.worldometers.info/coronavirus/, including 15,209 cases and 201 deaths in the U.S. as of March 20 (https://www.statista.com/statistics/1101932/coronavirus-covid19-cases-and-deaths-number-us-americans/e). But if we were able to contain the original SARS-CoV without draconian measures like quarantines and mass business closures, why can’t we do that with its successor?
One possible answer from the Canadian National Post Web site, https://nationalpost.com/news/world/new-study-suggests-coronavirus-can-live-in-patients-for-five-weeks-after-contagion, cites a new study from China that suggests the virus can live inside the body’s respiratory tract for 37 days after exposure, whereas the original SARS-CoV didn’t survive for longer than four weeks. That study also suggests that SARS-CoV-2 is “likely more highly transmissible but not as deadly” as the earlier SARS-Co-V or related MERS-Co-V viruses.
Just as the Zika pandemic threat seemed less serious when it was revealed that the organism was transmitted by mosquitoes — a threat we have experience dealing with — the revelation that the feared “coronavirus pandemic” is caused by a mutant version of a virus we already know about should make it less fearful. And if that Chinese study is correct that SARS-CoV-2 is easier to transmit but not as lethal as SARS-CoV, that says it’s following the usual evolution of viruses.
The horrific 1918-1919 “Spanish” flu pandemic — the closest we’ve actually experienced to what the scientists are predicting for SARS-CoV-2 — ended not because humans got particularly good at fighting it. The pandemic ended a year after World War I did — thereby taking away its most effective transmission vector — and evolution favored those strains of flu virus that didn’t kill their hosts because they could find new hosts more easily and quickly than the lethal strains.

The virus is almost uniformly fatal. No, it isn’t. Estimates so far of how many people infected with SARS-CoV-2 will die from COVID-19 disease are between 2 to 4 percent. The World Health Organization came up with a 3.4 percent death-rate estimate (https://www.nytimes.com/interactive/2020/03/07/upshot/how-deadly-is-coronavirus-what-we-know.html), while China’s Center for Disease Control and Prevention reported a study of 72,000 COVID-19 patients that produced a death rate of 2.3 percent (http://www.cidrap.umn.edu/news-perspective/2020/02/study-72000-covid-19-patients-finds-23-death-rate). That means 96 to 98 percent of all people infected with this virus will survive it. I’ve seen a report that 15 percent of all people exposed to SARS-CoV-2 will get “serious illnesses” from it — but that also means 85 percent won’t.
All the studies conducted on the rates of death or serious illness from SARS-CoV-2 infection indicate that the people at greatest risk of dying or getting seriously ill from it are older (over 65) people or others with chronic health conditions like diabetes, heart disease and lung disease (the ones the CDC mentions on its Web site) or compromised immune systems. However, after I wrote that in the first draft of this article I learned that younger, healthier people are not only encountering SARS-CoV-2 but getting seriously ill. One person I’ve known for years and consider a friend is now in an intensive care unit. He’s in his early 30’s and, as far as I knew, was in good health until he got COVID-19. Nothing focuses your attention more on a new disease than personally knowing someone who has it.

The Testing Quandary

Mass testing is necessary. “Lack of widespread testing makes everyone, including the asymptomatic, a threat; the only way to reduce exposure is through total distancing,” wrote American Prospect contributor David Dayen in the March 16 edition of his daily COVID-19 e-mail. “And at the root, these cities and states mean to preserve the local health systems, which will verge on collapse under the current trajectory.”
Certainly, the public fear of COVID-19 will go down as more people get tested. In fact, one optimistic scenario would be that as more tests are given, the percentage of people reported as being infected with SARS-CoV-2 will go up — and the estimated toll of the virus in terms of death or serious illness will go down. If that happens, the fear level associated with this virus will also go down — and maybe, just maybe, that will hasten the day when life on earth, especially in the largest cities of the most advanced countries, can return to normal.
But the whole question of SARS-CoV-2 testing is intimately bound up with what the tests actually measure. According to a March 8 post on the LiveScience Web site (https://www.livescience.com/how-coronavirus-tests-work.html), neither the currently existing tests — the ones they give you by sticking a sterile swab down your throat and then bagging the results and sending them to a lab — nor the “serology” (i.e., blood-based) tests currently under development actually test for live, infectious SARS-CoV-2.
As Laura Geggel explains in the above-cited LiveScience article, “If you’re in the United States, chances are a health care worker will use a long Q-tip to swab the back of your throat and then send that sample off for testing. If you’re in a country that has developed an antibody test, such as China, you may get blood drawn. What happens next to these samples is very different. The throat swab is well suited for polymerase chain reaction testing, also known as PCR, while the blood sample will be mined for antibodies specific to the new disease, known as COVID-19.”
The reason for that, Geggel writes, is time. The current tests take a few days to produce results — and the test manufacturers are working to shave that down to a few hours or less — while the more elaborate process of actually culturing the virus out of the blood of an infected person can take weeks. But the limitations of both antibody and PCR tests are bound up with yet another controversy: the sweeping changes (and, I would argue, perversions) of the basic rules of virology ever since April 23, 1984, the day the so-called “Human Immunodeficiency Virus,” or HIV, was politically proclaimed to be the “probable cause” of AIDS.
As the syndrome first identified in Gay men in 1981 got its name changed from “GRID” (“Gay-Related Immune Deficiency”) to AIDS (“Acquired Immune Deficiency Syndrome”) to “HIV/AIDS” to “HIV Disease” and now just “HIV,” testing “HIV positive” was presented first as an infallible harbinger that you would get the disease, and now a positive test is considered the disease itself. This is ass-backwards virology. Historically, having an antibody response to a virus — which is what the standard so-called “HIV tests” measure — did not mean you would get the disease associated with that virus, but quite the opposite.
Through most of the history of virology, having antibodies to a virus meant you were immune. Antibodies are created by the immune system, and their very existence usually means you will not get the disease that virus causes. Indeed, the whole purpose of vaccination is to give you something similar to the virus you’re vaccinating against, but weaker, so your immune system will develop antibodies that will protect you.
There are well-established partial exceptions to the rule that antibodies mean immunity. Certain viruses, such as hepatitis or herpes, produce antibodies that are able to neutralize the virus but not to clear it from your system completely. That means that as age or stress weakens the immune system, those diseases can become symptomatic again. The commercials for shingles vaccines say, “If you had chickenpox, the shingles virus is already inside you” — and that’s true because they’re the same virus (a herpes-class virus, by the way) . But never — until HIV was proclaimed as the cause of AIDS — did medical science ever say that a positive test for viral antibodies meant you would get the disease associated wth that virus and would, without treatment, inevitably die from it.
The reason this is relevant to COVID-19 is that the technologies being used to test for SARS-CoV-2 are virtually identical to those used for HIV. The blood tests (which are available in some countries but not yet in the U.S.) test for antibodies to SARS-CoV-2, not the virus itself — and historically, except for HIV antibody tests, doctors and scientists have regarded an antibody response as evidence that you were exposed to the virus but your immune system figured out how to deal with it, so you are immune. The throat swabs are based on PCR, which measures pieces of the virus in your system rather than the virus itself. They do not prove that you have live, infectious virus inside you!
Certainly it’s important to make more tests for SARS-CoV-2 available, despite their limitations. For one thing, they’re needed to get accurate information on how many people exposed to the virus get infected, how many infected people get sick, and how many sick people die. For another thing, the tests are important psychologically. In terms of the mental health of the people taking them, the current test regime — in which SARS-CoV-2 tests may be administered only after doctors have ruled out common flus or any other viruses that may be making that patient sick — is ass-backwards. It would seem to make more sense if doctors could give the SARS-CoV-2 test first, and then if it’s negative they could send the patient home with the reassuring words, “It’s not COVID-19. It’s just the flu. Stay home, rest and don’t panic.”

A Personal Note

I come to the SARS-CoV-2 controversy with, to say the least, a very jaundiced view of medical “experts” and their recommendations for social policy — especially when they deliver them in apocalyptic language that demand we as a society do whatever they say, or else. I got that attitude largely through my experience of the AIDS epidemic, which “broke” in the early 1980’s just as I was first coming out as a Gay man and realizing that the “Gay lifestyle” I would be entering was going to be quite different from the one I’d been led to expect by knowing other Gay people and reading about the Gay male community as it stood when AIDS hit.
When I first started reading and hearing about AIDS in 1982 I was immediately convinced that “Acquired Immune Deficiency Syndrome,” which is what the initials stood for, was just that: a syndrome, a multiplicity of diseases that occurred in people. I was convinced from the get-go that, like pneumonia, AIDS had to have multiple causes. The symptoms various patients reported, their clinical histories and their life expectancies after diagnosis — some died within a few days, others lasted for months — were too different for the syndrome to have a single cause.
Alas, the people the federal government — and particularly Margaret Heckler, secretary of health and human services under Ronald Reagan in the early 1980’s — made the exact opposite assumption. On April 23, 1984 she held a joint press conference with virologist Robert Gallo in which they announced that “the probable cause of AIDS has been found.” Their “probable cause” was a virus Gallo claimed he had discovered — though later evidence showed he had stolen it from a sample sent him by French virologist Luc Montagnier — and it later turned out both Montagnier and Gallo had taken credit for research actually done by their lab assistants (Fran├žoise Barre-Sinoussi in Montagnier’s case and Milo Popovic in Gallo’s).
Gallo called the virus Human T-Cell Lymphotrophic Virus III (HTLV-III), and he and Heckler claimed it was “a variant of a known cancer virus” — one Gallo had announced called Human T-Cell Lymphotrophic Virus I, which it turned out did not cause cancer. Montagnier called it “Lymphodenopathy-Associated Virus” (LAV), and the governments of the U.S. and France eventually had to negotiate a settlement between the contending researchers. Among its terms was that the French and American teams would split the royalties from the tests for antibodies to the virus, and the virus itself was given a new name: Human Immunodeficiency Virus (HIV).
Though Heckler had called HIV only the “probable cause” of AIDS in her press conference, from then on the U.S. and most other countries refused to fund any research on AIDS that did not assume HIV was its one and only cause. Dr. Anthony Fauci, who assumed the chair of the National Institute of Allergy and Infectious Diseases (NIAID) in 1984 — and, amazingly, still holds that job — explained why in an April 4, 1994 episode of the ABC-TV news show Nightline. “There has been an extensive effort, looking not only at HIV but earlier on, when we were trying to find out what the underlying microbe was that was causing AIDS, that in fact there was no evidence at all that there’s anything but that.”
What struck me about Fauci’s statement, then and now, is that from the get-go the government’s anti-AIDS response was based on the assumption that there was one “underlying microbe” responsible for the myriad symptoms, epidemiologies and case histories of AIDS. That never made sense to me, and beginning in 1987 — when UC Berkeley virologist Peter Duesberg published a paper in the journal Cancer Research arguing that retroviruses like HIV could never cause cancer, AIDS or any other human disease — I finally encountered credentialed scientists who agreed with me.
I became an activist in the movement challenging the conventional wisdom that HIV caused AIDS. I co-founded a local organization in San Diego, the Association to Re-Evaluate AIDS (ATRA), and later affiliated it with a national network of AIDS-reappraising groups based in New York called H.E.A.L. (Health, Education, AIDS Liaison). H.E.A.L.-San Diego continued regular meetings from 1994 to 2012, and during that time I also published a local Queer-community paper, Zenger’s Newsmagazine. Though Zenger’s was never specifically an AIDS-reappraisal journal, I made a point of covering AIDS from a reappraisal point of view and interviewing Duesberg, David Rasnick, Stefan Lanka, Charles Geshekter, Rebecca Culshaw and other scientists challenging the HIV/AIDS model.
Among the logical inconsistencies in that model that caused me to reject it were its extensive redefinitions of virology. The scientists who argued that HIV did cause AIDS fundamentally redefined virology and epidemiology to keep HIV at the center of the AIDS universe. As I explained above, until HIV was politically proclaimed as the cause of AIDS, a positive antibody response to a virus meant you had been exposed to the virus but your immune system had successfully fought it off and therefore you were immune to it. There are partial exceptions to this, but only with HIV and AIDS is a positive antibody response to a virus considered not only infallible evidence that you will get the disease associated with that virus but, more recently, the positive antibody test is the disease.
The reason all this history is relevant to SARS-CoV-2 is that the top scientists in charge of the federal government’s response to it, Anthony Fauci and Deborah Birx, came from the “HIV/AIDS” world and made their scientific, bureaucratic and political “bones” with it. When I heard the hosts on MS-NBC speak of Fauci as if he were some sort of virological and epidemiological oracle whose word should not be questioned and whose recommendations should be obeyed without question, I wanted to puke. As far as I’m concerned, the man who so totally screwed up America’s response to AIDS should never be allowed to work again, much less be put in charge of the fight against SARS-CoV-2, a genuinely infectious disease.
My heart sank further when I started reading information on what the so-called “coronavirus tests” actually measure. The HIV antibody tests were based on two wildly unselective technologies, the ELISA (Enzyme-Linked Immunosorbent Assay) and the Western Blot, which produced so many false-positives that alternative AIDS activist Christine Johnson assembled a list of 63 potential causes for a positive “HIV test,” including such common infections as hepatitis, herpes, malaria and flu.
So you can imagine my shock when I read a February 28 report from Johns Hopkins University’s Center for Health Security (http://www.centerforhealthsecurity.org/resources/COVID-19/200228-Serology-testing-COVID.pdf) that said the technologies being used to develop a blood test for SARS-CoV-2 were, you guessed it, the ELISA and Western Blot, which are not only wildly inaccurate but, even when they’re right, measure only an antibody response to the virus, not the virus itself. Indeed, another report from Johns Hopkins on March 13 (https://www.jhsph.edu/news/news-releases/2020/infectious-disease-experts-recommend-using-antibodies-from-covid-19-survivors-as-stopgap-measure.html) argues for using SARS-CoV-2 antibodies isolated from living patients as at least a stopgap treatment for COVID-19!
I’ve taken a long time writing this article, and my attitude towards the SARS-CoV-2 pandemic and the measures being pushed to control it have shifted back and forth like the pendulum on an old-style clock. On the one hand, COVID-19 is consistent with other viral diseases — the symptoms are basically the same from patient to patient and the epidemiology makes sense. On the other hand, I fear that the draconian measures being taken against it — including the shutdown of whole sectors of the economy — may do more harm, long-term, than good.
At the same time, as a health-care worker myself (an in-home caregiver for four clients, all of whom are senior citizens with underlying health conditions and therefore prime targets for this virus and the disease it causes) I’m trying to abide by the restrictions as much as I can. I’m still going to work and maintaining a surprisingly normal life — especially by the standards of most of my friends, who have been furloughed and told to stay at home until such time (weeks, months or maybe years) as the public-health experts tell us we have to.
My husband Charles, a grocery-store checker, is also considered part of an “essential industry” and thus still has a job. In fact, tonight Charles showed me what amounts to an internal passport, like the infamous “yellow tickets” that controlled mobility in both Czarist Russia and the Soviet Union, where you weren’t allowed to travel from one part of the country to another without showing your papers to prove you had a government-recognized right to do so. Charles’ “yellow ticket” is a piece of paper from his employer and his union he can show if anyone questions his right to be on the streets or on the buses, saying that as part of an “essential industry” he’s not restricted by Governor Newsom’s emergency order like most Californians are.
In a future article for this blog I intend to explore the long-term effects — political, economic, cultural, social and, above all, psychological — of the SARS-CoV-2 quarantines. I’ll just state here that in a society already trending towards too much social isolation, too much separation between individuals and also between social groups, and too much reliance on electronic communications, particularly the Internet, to substitute for real face-to-face interactions, the SARS-CoV-2 emergency and the official response to it are speeding up already worrisome trends and adding to the growing social alienation between people in ways that may be as destructive to people’s mental health as the virus itself is to their physical health.
I’ll leave you with one memory — again — I have from the early days of AIDS. I remember reading in the New York Native and other Queer papers that in the early 1980’s Gay men were still meeting each other and going home together for casual sex, but when they did that they often had the thought, “Is this the one that is going to kill me?”  Now we’re being told to have that same fear of people with whom we interact far less intimately than having sex. We’re being told to eye the stranger who gets too close to you on the street, or inside one of the few businesses that are still open, and — especially if he coughs, sneezes or even breathes in your direction — think, “Is this the one that is going to kill me?”

Tuesday, March 03, 2020

Harold Meyerson on the Geezer-ocracy

I just received this e-mail from political commentator Harold Meyerson, a man I met in the San Francisco Bay Area in the late 1970's when we were both young political activists and wanna-be journalists. He noted that with the withdrawals of Amy Klobuchar and Pete Buttigieg, ALL the remaining major-party Presidential candidates are over 70 years old.

I was born in 1953, and when Barack Obama (born in 1961) was elected President I thought that was going to be a significant age marker for me: the first time the President of the United States was someone younger than I. Now it's beginning to look like Obama may be the ONLY President younger than I who will serve in my lifetime. That makes me sad, especially for the potential talents members of the younger generations may have to offer and the voices that won't be heard as people my age or older clog the political system and cling to power until everyone in my generation croaks.

But of all the Presidential candidates in the field at the moment, the one I'm most afraid of in terms of his age is Joe Biden. Bernie Sanders, Michael Bloomberg and even Donald Trump have aged without any apparent ill effects to their mental acuity. (Everything awful and apparently crazy we know about the current-day Donald Trump was readily apparent to people who knew him 20, 30 or 40 years ago.) In putting their bizarrely misplaced faith in Joe Biden, the Democratic Party establishment and all too many Democratic voters are locking themselves into the candidacy of a man who is simply not up to the mental strain of the job and who four years from now may not even be capable of functioning, much less governing.

If the Democrats nominate Joe Biden -- if the party elites rig the process for him the way they did for the equally unelectable (but for different reasons) Hillary Clinton in 2016 -- they will present American voters a choice between two crazies: a narcissistic egomaniac and a dementia patient. — Mark Gabrish Conlan


MARCH 3, 2020
Meyerson on TAP
The Septuagenarian Sweepstakes. Yesterday, I turned 70.
Aging, of course, is both anticipatable and nonetheless surprising. Seventy? How the hell can I be 70?

Even more surprising, however, is this: With Amy Klobuchar’s withdrawal from the presidential contest yesterday, exquisitely timed to my birthday, I enter my eighth decade still younger than any of the serious candidates for president who remain in the running. Bernie Sanders and Mike Bloomberg are both 78. Joe Biden is 77. Spring chicken Elizabeth Warren is 70 (she’s about half a year older than I). Donald Trump is 73.

This is a field that lends itself to age-specific critiques. Some Biden backers point out that Bernie is a heart attack survivor (and presumably, a heart attack risk), while some Bernie backers note that Biden doesn’t seem as sharp as he once was (however sharp that may have been). Many assert that Trump is a dangerous lunatic, though most believe that’s not a function of his age.

Never before in our history has the nation been confronted with a choice of leaders all of whom were 70 or more. In the 19th century, people didn’t live that long, but it wasn’t until 1960—Eisenhower’s last year in office—that a president reached the big seven-o, and that was when Ike was outward bound. The only incoming president who’d surpassed the 70 threshold before he moved into the White House was Reagan, but years of Hollywood makeup had made him look younger, shinier, and better coiffed, and he’d had to fend off rival candidates all of whom were a good deal younger, if not so well coiffed.


In all my now 70 years, it never once occurred to me that by the time I would age out of my sixties, I’d still be younger than an entire presidential field. Should this make me feel better as an individual? (The possibilities before me are still limitless!) Or worse as a citizen? (Prepare for Geezer-ocracy!) Years of experience tell me to bet on Geezer-ocracy. ~ HAROLD MEYERSON