COVID19 SHUTDOWN & its COSTS

In all post-war aftermaths, a reckoning is inevitable. Even though we are still in the midst of this pandemic, there are certain corollaries that seem to fill in some of the blanks. These are the blanks that wake us up in the dark of night with a thought that cannot be easily reconciled; A scratch that cannot be itched. 

Before we go hunting for the culprit of this current pandemic, let us visit the age-old annual irritant to our existence. The Influenza virus. There is something quite sinister in this micro-beast. The Influenza virus rears its ugly head every year to raise Cain among the young and the old. The virus has developed an art form in its sneaky attacks. Winter brings with it the cold. With the cold, everyone cordons themselves to the indoors. The virus starts the breeding process in schools where young children congregate. From there it gains access to the parents and thence to the commercial tracks across the world. 

INFLUENZA...

Influenza is a very contagious illness. It affects approximately 9% of the population infecting roughly 1 billion people annually. Of those around 30%-50% develop fairly significant illness requiring some form of therapy and management. And of those around 10% die as a result of the illness. The Case Fatality Rate is 0.15% for the Influenza illness. The numbers are staggering and this happens every year, but no specter of “the world is coming to an end” is in the daily news broadcast. If we are to look strictly at the United States population, 15-20% of the population is affected each year or 50 million people in all are infected by the Flu virus. Of those 250,000 are hospitalized and around 10-20% succumb to the illness. The variations in the severity of the illness and the fatality rate depend on the mutational features in the Hemagglutinin and Neuraminidase surface antigens of the virus and the efficacy of the vaccine. If the antigenic drift (Antigenic drift results from the accumulation of point mutations in the Hemagglutinin (HA) and Neuraminidase (NA) genes) is significant (and not anticipated by the vaccine producers) then the infection rate and the fatality rate is fairly extensive as evidenced by the H1N1 viral infection of 2008-2009 period. According to CDC estimates, between 43 million and 89 million cases of novel influenza A (H1N1) occurred from April 2009 to April 2010. Between 195,000 and 403,000 individuals were hospitalized, and between 8,870 and 18,300 people died. Of those patients who died, 90% had underlying medical conditions. Given the vulnerability of the elderly population with multiple comorbidities such as Diabetes, Hypertension, COPD, Kidney disease and Heart Disease, the elderly makeup almost 15% of the U.S. population but represent 65% of the hospitalizations and 90% of the deaths associated with influenza. (1,2,3)

ECONOMIC BURDEN OF INFLUENZA

In regards, the economic burden of the Influenza infections specifically in 2003 alone was the estimated economic burden of influenza totaled $87.1 billion, with $10.4 billion spent in direct medical costs. Most of the costs were directly related to the care of the 65 years and older patients. (10,12)

FATALITY RISKS FROM INFLUENZA

The mortality from the Influenza virus is enhanced by comorbid states such as COPD after making adjustments for age, sex and risk status. Any person with a history of hospital admission three years prior, or a chronic condition such as cirrhosis, Heart disease, pulmonary disease, kidney disease, Immuno-deficiency, HIV infection, and long-term residence in an Extended Care Facility (Nursing Home) were considered high risk for the Influenza. (4,5)

COVID-19, SARS COV-2, CHINESE CORONAVIRUS

Now let us turn our attention to the current miscreant; the SARS Cov-2 or COVID-19 or the Chinese Corona virus. The current data on this virus as of this writing today suggests that a total of 1.48 million people across the world have been infected and 87,444 people have succumbed to the disease. In the United States the estimates are that 1 in 994 people are infected with different regions showing different penetrance. In February 12, 2020, 4,226 COVID-19 cases were reported in the United States; 31% of cases, 45% of hospitalizations, 53% of ICU admissions, and 80% of deaths occurred among adults aged ≥65 years with the highest percentage of severe outcomes among persons aged ≥85 years. (6). The incubation period of 2-14 days makes the exact number infected (diagnosed) difficult unless testing for IgG and IgM antibodies is done. Although the number prevalent in this discourse, based on China data, is that an estimated 81% of the population is asymptomatic, this number is probably much higher (86-90%) given the nature of illness in asymptomatic people. The difference of the severity of infection in the Hubei Province and other parts of the world is discussed in this article at length.

“One of the most perplexing questions regarding the current COVID-19 coronavirus epidemic is the discrepancy between the severity of cases observed in the Hubei province of China and those occurring elsewhere in the world. One possible answer is an antibody-dependent enhancement (ADE) of SARS-CoV-2 due to prior exposure to other coronaviruses. ADE modulates the immune response and can elicit sustained inflammation, lymphopenia, and/or cytokine storm, one or all of which have been documented in severe cases and deaths. ADE also requires prior exposure to similar antigenic epitopes, presumably circulating in local viruses, making it a possible explanation for the observed geographic limitation of severe cases and deaths.”

Furthermore, data from Wuhan presented in the journal Science, “This estimate reveals a very high rate of undocumented infections: 86%. This finding is independently corroborated by the infection rate among foreign nationals evacuated from Wuhan.

Additionally, Michael Farzan, co‐chair of the Department of Immunology and Microbiology at Scripps Research, states, “once a vaccine for COVID-19 is developed, it would not need regular updates, unlike seasonal influenza vaccines” Those infected and recovered have active immunity and are firewalled against future infections as well. The British Medical Journal states that the COVID appears less mutable than expected. The Case Fatality Rate for the COVID-19 is between 0.15%-1% with an average of 0.6% based on results from across the world vs. SARS or MERS, which have had case fatality rates of 9 to 10% and 36%. 

Most countries are already showing a “flattening of the curve.” (By “flattening” we mean that the rate of infection and recovery equalizes and then as the rate of infection falls, the curve turns downwards) In some of the countries, the flattening of the curve has occurred spontaneously preceding the Social Distancing, while in others it has followed. Several questions arise as a consequence of this finding and need further elucidation. Remember the estimates of infection rates and death rates are based on an arbitrary multiplier as done for the Swine Flu previously and was grossly overestimated. “We estimate that the total number of pandemic (H1N1) 2009 cases in the United States during April–July 2009 may have been up to 140× greater than the reported number of laboratory-confirmed cases.” The worst aspect of all this “estimated scientific data” is what most Journalists sensationalize to get their ratings and cause fear and panic among the laity for the sake of viewership and some busy experts feed off the journalists to get more exposure on television as well. Experts like journalists are, after all, human. The R0 or Reproducible Rate of the virus has also become an issue. The common flu R0 is 1.28 while the COVID-19 was estimated at 2.2. The difference is of significance because the +0.92 difference is the difference between an epidemic and a pandemic. Hence the deployment of the “Shelter in Place” mandates. However, if one considers this a bit further, a conundrum becomes evident. The advocated “Social Distancing” does limit exposure but might it prevent the youth from getting the asymptomatic infections and thus restrict enlarging the herd immunity pool and thereby because of this prevention might inadvertently later be exposing the risk to the vulnerable elderly and thereby cause a secondary peak?

OBFUSCATION

The management of the present COVID19 virus has been of serious concern from the beginning. In China, the real data from the Communist country remains hidden. The issues related to suppressing information and delaying the transmission of pertinent information from the Chinese Authorities and the World Health Organization are in discussion presently. Both are being questioned for disinforming the virulence of COVID19, the actual number of cases and its easy transmissibility between humans. Why this obfuscation was attempted, will need to be reconciled in the near future.

LIES, DAMNED LIES, AND STATISTICS

Another more interesting but likely dubious statistical modeling data done by the Imperial College of London by Neal Ferguson suggested that the deaths from this virus would amount in the millions globally. That initial model became the benchmark for all countries and threw everyone into a tailspin. No one, no leader or otherwise would ever want such a debacle on their hands. Experts clogged the television and Radio waves to highlight the Armageddon that was upon us. “Shut everything down,” they cried, and the leaders listened. The initial impact of the virus on humans was a cause for concern, accented with the statistical modeling. The dye was cast. The world would pay a huge price if it did not listen to these sages of science. The initial event can be traced down to the Hubei Province and Wuhan in particular on Chinese soil. Images of the shutdown of the Province from the rest of China, while simultaneously allowing world travel by millions of the Wuhan citizens came to pass. Images of Street spraying and lock-down and citizens forcefully separated from their families played out on the Western media daily. At the same time, the virus was being carried to points far and wide, WHO Director Tedros Adhanom maintained that the virus only was transmitted from animal to human and there was no evidence of human to human transmission. Simultaneously WHO’s Tedros and some other politicians suggested that any restriction on incoming travel from China would be considered xenophobic. The rest of the world let their guard down because of these assurances and collectively with political correctness the journalists cast the net of confusion. The influx of the infected Wuhan citizens into the world community gathered steam and intensity without a question. 

Once the virus had taken hold in a country, the images of the Wuhan lock-down and street spraying, social distancing, shelter in the home became the call from the experts. Focusing on the population needs based on the IHME modeling and other such experts, estimates of the devices, including ventilators, hospital beds, and PPEs appeared grossly below the needs. Calls for the government to take action rose in unison by the political crowd. “We need more!” Yet in a mere period of 2 weeks, they needed less!

THE ECONOMIC DEBACLE

Meanwhile, the economic engine of the world, the economy of the United States was brought to a standstill by a select few individuals. The economy that produced $21 Trillion a year shut down. The US government was forced to pay the companies and individuals a total of $2.5 Trillion (at last count). The money was shepherded to keep the economic engine on life support and workers on the payroll. From an $80 billion loss for the Flu to a staggering $2.5 Trillion and counting loss for the COVID-19. But there were some dishonest and shameful politicians who wanted to secure a fiefdom by giving freebies to their constituents and wanted more. Together, the damage was done across the world and especially to the most productive nation on the globe. But the experts were not done yet. They promised that this virus was going to be rearing its ugly head annually, (contrary to known information that this particular RNA virus’s virulence via the spike was immutable and that a potential vaccine would mitigate that risk entirely), therefore we must get used to “social distancing” as a way of life and just to add fuel to their rhetoric they advocated the need for “Contact Tracing” as a means to contain the spread. The fix was in and the population could be controlled easily under the guise of “public good.” Meanwhile, the technocrats at Google, Facebook, Apple, and others were busy working overtime to make this happen. These technocrats already know what your next desire is, why not know where you are or where you are going to be every second of the day. 

Liberty seems to be on a ventilator these days.

But getting back to the illness-related loss of human life from the COVID19, seemed to mimic that of the annual Influenza but the death rate was higher by a factor of 6-10 of an average Flu season but similar to a highly evolved Flu virus with a larger antigenic drift. The Economic loss however as a consequence of the shutdown is and will be astronomical. It might contract the greatest economy into a Recession. The experts continue their rant to keep everything shut down. One such “expert” wants the shut-down to last for 18 months. Perhaps these fanatics believe their rhetoric, perhaps their need for self-importance exceeds their capacity to understand or tell the truth, but there is a willingness to obfuscate reality in the United States equal to that what happened in China. Only in the US that obfuscation comes from biased modeling, fear-mongering, while in China it comes from Authoritarianism and Control. An important study  from John Ionnadis, MD., “People less than 65 years old have very small risks of COVID-19 death even in the hotbeds of the pandemic and deaths for people less than 65 years without underlying predisposing conditions are remarkably uncommon. Strategies focusing specifically on protecting high-risk elderly individuals should be considered in managing the pandemic.” The study suggests that selective high-risk group distancing is the more appropriate measure.

Meanwhile, did I mention that the “Wet Market” where supposedly the virus originated is now open for business? The previously safety-breached Wuhan Level IV Biosafety Lab (the other possible source) remains shut down for the present as far as the world knows.

WHAT IS THE VIRUS TO DO?

All of this begs the question, “What is this virus going to do?” In answer, one can only say with the most humility that it will do what viruses do. It will infect humans as many as it can to propagate itself. When a certain number are infected and attain a degree of immunity to it, one of three things will happen: 

1. The Selection pressures from the immunity will slow the virus down both as the temperature rises and people start to stay outdoors with pockets of infection scattered intermittently. 

2. The virus mutates, and that antigenic drift creates a more benign version that behaves like the common flu. 

3. The virus mutates with a significant drift that creates another monster. 

The current Social Distancing has had an impact. Perhaps only selective distancing measures for the vulnerable with comorbidities going forward might be appropriate and not the entire country. The economy needs to rev up again so a further loss of life from starvation, depression, and suicide does not engulf us in the future. 

Vaccine innovation against the COVID19 is in full bloom( 13). Meanwhile, mitigation strategies including the cheapest therapeutic version of Hydroxychloroquine and Azithromycin plus Zinc are being used with some success, but simultaneously being derided by the experts. Newer drugs probably at much higher prices are being touted as potentials, including Remdesivir (anti-viral agent) and EIDD-2801 as a prophylactic. Time exposes everything from the antisepsis of the sun. 

This time too, it will tell a tale, worthy to learn from.

 References:

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13. Wang CS, Wang ST, Lai CT, et al. Impact of influenza vaccination on major cause-specific mortality. Vaccine. 2007;25:1196–1203