I’ve tried to resist the urge to write more about the COVID-19 epidemic. Afterall, there are only so many ways to say that we’ve done just about everything wrong that’s possible. Turning politicians and journalists loose on the disease was certain to make a hash out of a serious, but not world ending, problem. Even simple issues like measuring the severity of the epidemic using readily available data are beyond their ken.
More than half a year into the infection, we know who’s at high risk and who has a very low risk of death. We are at the point in the evolution of this disease where the number of new cases is no longer a very important statistic. It’s obvious that many cases are asymptomatic and perhaps not even infectious. What is of most concern is how many affected patients become ill, how many are hospitalized, and how many die as a direct result of infection rather than as a add on to a serious underlying illness.
Also of great concern is the coming flu season which will interact with the coronavirus in uncertain ways. Equally uncertain is the immune status of the population which has yet to contract the virus. What’s certain is that the virus will be with us for at least a year or two. If a vaccine is developed it will take considerable time to convince a large segment of the population that it’s safe and will consume more time for its widespread distribution and administration. Luckily, the election will soon be over and the vaccine will cease to be an issue 1 second after the result is certified, probably sooner.
Even the most optimistic view sees the bug with us for at least another year. Thus, we’d better learn to live with it as new or sustained lockdowns will destroy society, education, and the economy. The governor who seems to have the best handle on the epidemic, its consequences, and how to manage it is DeSantis of Florida.
As coronavirus infection in the young and healthy is no more severe than the flu and possibly less so, we should let them go about their business much the same as before. We seem to have gone crazy testing for the virus. To what end? If a young person tests negative, five minutes later he could catch the virus. If he tests positive we can’t be sure that he really has the disease or even if he can spread the disease. To protect his grandparents, he should stay away regardless of his test status until the epidemic subsides. The large number of athletes who have tested positive while remaining asymptomatic illustrates the problem of testing. I think is confuses and disturbs more than it enlightens.
Then there’s the problem of how many of the population is susceptible to this infection. Consider that no epidemic, no matter how severe, infects the entire population. In fact, even the worst virtually never hits more than 50% of a cohort. For whatever reason, a large segment of the population is resistant to whatever new infection appears. The issue of preexisting immunity to COVID-19 is discussed in a recent paper in the British Medical Journal – Covid-19: Do many people have pre-existing immunity? It discusses T cell mediated immunity which may protect against the virus in the absence of detectable antibodies. It also presents the view that herd immunity against the virus may not take 50-60% of a population to be immune, rather it is possible to achieve protection with just 10-15% immunity.
This possibility may explain why the epidemic is declining in Sweden, which never locked down. The disease does not seem to have have recurred in anything like its initial from in London and New York which did lock down. London has only 15% seropositivity.
Look at the case incidence and the mortality rate in the UK . Both are shown below. [Figures from Johns Hopkins COVID tracker] The daily cases are rising while mortality is close to zero. Why? There are two possibilities which are not mutually exclusive. Either there are a lot of false positive tests and/or the disease is now afliciting a healthy population in which the infection is easily resisted. If you looked at the caseload without considering mortality, you might panic and be tempted to rash action.
The message is the same as has been since the start of the pandemic, even if few have read it. Our approach should be targeted. Protect the old and the vulnerable. Let the young and healthy lead their lives as they see fit. Do not lock down society as such a course is worse than anything the virus can mete out. One could fill reams with the bad consequences of our blunderbuss attack on the virus. Here’s just one. A study shows a decline in awareness, treatment and control of high blood pressure. People are so afraid of getting sick that they’re letting themselves get sick – just from something other than the virus.
As the study in the BMJ linked above is not behind a paywall, I’ve appended it below as a pdf.