Coronavirus

For the record, I’m not on either side of the mask debate. I wear one regularly (though like everyone I’d rather not).

It seems obvious that wearing a mask helps prevent you from infecting someone else by containing your droplets. But then there is recent evidence that says asymptomatic spreaders may not be a thing. And then the recent study that showed no material difference in mask vs no-mask infection rates.

So, do we do the seemingly obvious thing and keep wearing masks, or do we “follow the science” that suggests the presumption / common beliefs are wrong? (I’d argue that, lacking a better solution, masks are still the smart move.)

I believe the locales that have been the most effective in squashing the bug have done so with aggressive contact tracing and quarantine. Which is a very effective “we don’t know what it is or how it spreads, but we know we can wall it off and burn it out” technique. It’s the universal sledge hammer.

In the US, this authoritarian approach flies in the face of individual freedom, which is a core tenet of the country’s very existence. It’s not that people won’t rally (a la WW-II), but the government tracking citizens and who they contact (while technically easy by a multitude of methods) is a scary thought in American culture. We have an acute awareness that privacy (such that it is) is an essential element of freedom, and “the road to hell is paved with good intentions” - measures deployed / enabled / approved / proven for one use-case become supremely easy to abuse later.

There is an expectation that after 9 months, we ought to have a better quality of knowledge - scalpel or at least pocket-knife grade, yet the facts at those levels are still contradicting. Unfortunately that ambiguity leaves room for interpretation and polarization, which is where the US finds itself.


Back at the topic of treatment... there is no preemptive treatment being done here. If you have symptoms and go to the ER, they test you for Covid, send you home, and tell you not to come back until you have advanced symptoms. There’s no attempt to head off the progression before it gets severe. Is it any wonder they’re swamped with severe cases? Yet options that show positive results in early-stage symptoms are discarded - why? Because they aren’t making the dramatic diving catch? It defies common sense.


Revisiting the topic of vitamin D... 5000 IU was just my example, not recommended advice. It happens to be what I take in a single caplet daily, since long before Covid. But it’s a sturdy dose, and you probably could make such a generalized recommendation because there’s no risk of overdose, certainly not at that level. It would be cheap, easy, and risk-free - most people need it anyway.


Lacking a surgical-quality approach to prevention, and lacking contact tracing, signs are that we’re heading toward a national lockdown as an even more blunt sledgehammer...

You seem to take an interesting stance that contrarian views are disinformation. That’s actually a huge point of contention in US culture right now. Is it appropriate to suppress factual data that’s contrary to the official narrative?

Science has a long history of disproving widely-held beliefs. Skepticism of the status quo is a healthy attitude for science as well as politics. It should be encouraged, not squashed, in my opinion.

I believe NZ’s approach went beyond the science into contact tracing and quarantine, no? And geographically / population density, isolation and quarantine were easier to achieve. Certainly, keeping the load down on healthcare leads to better care and outcomes for those who are infected. Plus, if you’re doing early-stage treatment of symptoms that could be another huge differentiator. No arguing that NZ has done well, but it was likely due to more than just agreeing on one medical narrative.

From a public health point of view you are comparing apples and pears here. Containing an infection within an island nation of 5 million with few huge urban areas is an awful lot easier to achieve than borders to mange and the complexities of large and densely populated areas. 

I imagine your biggest advantage was leadership. You know, quick acting, decisive, non narcissistic, non re-election focused sort which involves listening and recognising where the boundaries of your expertise lie. 

Excess deaths has crossed my radar in recent months, though I’m sure the concept isn’t new. I rather like that approach to looking at the impact of the pandemic because it factors in causes that would otherwise be overlooked. It also gets out of the weeds of detail about how diagnostic tests are being applied, or even whether deaths were classified appropriately.

In the US, for example, it’s estimated that excess deaths are at least 20% higher than the death count publicly attributed to Covid. While causes like auto accidents have plummeted, there’s been a sharp increase in suicides, heart disease, and drug overdoses. Which suggests that, as a “medicine”, lockdown has it’s own set of impacts.

At the same time, some interesting analysis has been done on the EU stats, particularly around the Nordic countries. A curious pattern was found there, where countries with a spike in excess deaths had also seen a deficit of deaths the prior season, of nearly the same magnitude. Conversely, countries with few excess deaths due to Covid had seen normal death rates the prior season.

Conclusion being that, at least in those countries, Covid hadn’t contributed greatly to the annual death rates (though the infection period was very sharp and overwhelming). Rather, in countries where the prior year had been soft, Covid seemed to be “catching things up” by taking victims who statistically should have succumbed the prior season. (i.e., in isolation, 2020 would look higher than typical, but a simple moving average across several prior years shows that it’s closer to linear.) I’ll try to find the video and update here.

A comparison of apples and pears again. Nordic countries are sparsely populated with few if any densely populated areas. So their approach may be spot on for them, but cannot be applied to other demographics. However tempting this may be for Joe Six Pack to interpret and see room for conspiracy. 

I am all for leaving the epidemiology to the epidemiologists. 

Freedom stops when we interfere with the right for an other person to live. Thank god, very few people think that way here.

The professor Dr. Shultz in the MedCram videos pulls the science from all over the world. Even if they are small studies from different countries. USA is very embarrassing even though we don't all think that way. Those conspiracy theories will always be around the Darwin award types. I am really impressed with some of the doctors who followed some small studies out of Italy, Korea and China. They have a lot of success stories.