Hysteria and the Coronavirus: Part 3
This has been a very difficult and very confusing period in the course of the pandemic. Every day, there is an armageddon-like announcement on the morning news that Texas, Florida, Alabama, South Carolina, etc. has identified a record number of new cases. That hospitalizations are up, deaths are surprisingly down, and the end of the world must be near...near, that is, unless we wear masks, social distance and, above all, test until the cows come home. If we do, we can "reduce the spread" or "flatten the curve" . How exactly, testing accomplishes any of this continues to escape me but everyone knows that if we only tested more, then surely the virus would disappear. As of this writing, we are approaching or have surpassed four million identified cases in the US. Last week, the head of the CDC was on the morning news to announce that the actual number of cases was likely ten times the identified cases. For about a day, the media paid some attention to this fact, which was based upon nationwide antibody testing, and then went back to focusing exclusively on new, identified cases. I think it is important to discuss the real world ramifications of this fact.
For every identified case, there are nine cases that are not identified. That means that nine people out of ten are interacting with family members and perhaps friends with no knowledge that they are infected and are therefore likely infecting all those they are coming into contact with. Health officials are unaware of these newly infected and probably unidentified cases. If symptomatic, some would get tested and perhaps be counted in the identified cases but only after they too interacted with family and/or friends. The real situation is like an iceberg with the identified cases above the waterline but the much, much larger number of cases below the waterline. Even in the best of all worlds, attention is paid to the identified cases in terms of quarantine and tracing, but nine (9) times that number have no such focus of activity. So when the morning headline trumpets two thousand (2,000) new cases in x locality and three thousand (3,000) would surely mean that we are doomed, the actual number of new cases is twenty thousand (20,000).
In Europe, there is a movement to achieve herd immunity called the Avalanche. Its proponents want large numbers of people between 20 and 50 to purposely become infected so that the antibody protection will significantly limit the spread of the virus. They believe that, in the long run, it will save lives. There would be an expected number of severe cases and there would be death. Europeans seem to look at these things differently than we do in the United States. In the 80's, an anti-psychotic wonder drug, Clozapine, was marketed worldwide. Due to a life-threatening side effect, regular and very costly blood testing was required for prescription in the US. As the drug was aimed at resistant schizophrenia, the primary purchasers were state hospitals and the cost was deemed prohibitive and so it was not used as often as it might have been. In Europe, blood testing was not as rigorous and the risk of death from the side effect was accepted as the price for the benefit. Unless in the womb, life in the US, both human and animal, is considered sacred enough to do everything possible and to pay any price to save or prolong. Witness the $100,000 rescue of a kitten in a well or the fact that 50% of the healthcare dollar is spent on patients who won't be alive in ten months.
The idea of herd immunity is resisted, especially in the United States, but failing a vaccine, herd immunity is our best bet. Shutting down or restricting activity actually prolongs the course of the virus. The reality, though it is regularly denied by the media and by public health officials, is that we are in the midst of developing herd immunity because we only focus on identified cases. As of this writing, there are approximately four million (4,000,000) identified cases in the United States. The CDC says there are really forty million (40,000,000). Where are the other 36,000,000 people? One of them is probably at your breakfast table. And the others are everywhere. "Reducing the spread" or "flattening the curve" by counting the identified cases is like weather-proofing your house by caulking around a bathroom window while the front door, sliders and other windows are wide open. As long as the healthcare system is not overwhelmed, the more cases the better, the more cases the safer.