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 (Françoise 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?”
