COVID has made everybody a medical expert. Politicians, investment advisors, journalists, TV newsreaders all are full of analysis and advice about the virus now comfortably settled in throughout most of the world. In general our leaders and opinion setters seem unable to deal rationally with an epidemic that has been with us for two years. President Biden is obsessed with vaccinating the world, a strategy that seems to be having little effect on the virus, at least as measured by positive tests for it. UK Prime Minister Boris Johnson seems to have become totally unhinged over the omicron variant of the virus which appears to be the least virulent strain yet to emerge from the mutant population of the bug.
The routine and frequent testing for the virus of athletes has, as predicted here, resulted in an enormous number of positive tests. Many professional athletes are testing positive, though as far as I know, none has become seriously ill with the disease. If you test these athletes several times a week eventually they will all test positive. The professional sports leagues are in danger of testing themselves out of existence.
What is the purpose of such testing? Many people who harbor the virus are asymptomatic. Most are not being tested routinely. The virus is widespread among the population, it’s also widely present in animal reservoirs. It is found in large numbers of deer in Texas and other states.
Thus, the virus is ubiquitous. Routine testing of asymptomatic patients serves no discernible medical purpose as such testing is only applied to a very small and specialized subset of the population. The only effect of regularly testing athletes is to disrupt sporting events without protecting the athletes or any one else. Remember that these athletes are at almost zero risk from the ill effects of the coronavirus. They are virtually all vaccinated, in good health, and young. When they leave their sports facilities they enter a population full of people carrying the virus who are not routinely tested. Then there is the problem with false positive tests. Conspicuously lacking from reports of an increase in cases is whether these cases are associated with illness or just positive lab results of little or no clinical significance.
We are not going to test our way out of this epidemic. It also appears more and more likely with each passage of the weeks that we are not going to vaccinate our way out of it as well. We have no long term data as to the the delayed side effects of the currently available vaccines. We also don’t know the effect of repeated doses of these vaccines. The Israelis appear to be ready to give a fourth dose. Can a fifth be far behind? Vaccinated people can still be infected by the virus. They appear to get milder illness when such infection strikes. Humoral immunity induced by the vaccines unlike inflation is transitory. Such evanescence doesn’t necessarily mean protection wanes as cell mediated immunity may persist. Thus, the need for a booster is not clear as a meaningful risk benefit ratio cannot yet be calculated. The absence of such calculations has been a demerit on virtually all approaches to the management of this epidemic.
We probably have placed too much emphasis on vaccines, Therapeutics, should be studied and developed. New drugs that are being developed may successfully treat the virus, especially if given as soon as symptoms appear. Another mitigating factor against the virus is natural immunity.
A study that will appear in the Journal of the American Medical Association shows that breakthrough infections greatly enhance immune response to variants of the virus that cause COVID-19. If this is generally true then immunization combined with a subsequent infection may provide robust protection. A caveat is that this is just a lab observation. Clinical studies are needed to determine if there is a real protection from disease secondary to an encounter with the virus in the subjects described above.
Especially notable is that the home of the brave has become the abode of the meek. We’ve got to stop perpetuating the penumbra of fear that has gripped a large portion of the population. Encouraging is that many Americans, and residents of other countries, are showing increased resistance to the various mandates imposed on them by governments which seem to relish increased control over their populations.
Covid likely has entered an endemic phase and may well be with us for a long time, perhaps indefinitely. We will have to place it alongside many of life’s hazards that we accommodate without succumbing to desolation. Our current crazy quilt approach to prevention, diagnosis, and treatment makes as much sense as modern monetary theory. There is no reason to test any asymptomatic subject for this disease under ordinary circumstances.