Global Pandemic Solutions : Gone Viral….
Regarding the Coronavirus Pandemic, I am reminded by the inspirational poem “IF” by Rudyard Kipling who once said: “ If you can keep your head, when all about you are losing theirs and blaming it on you. If you can trust yourself when all men doubt you, but make allowance for their doubting too. Yours is the earth and everything that’s in it and which is more, you will be a man, my son!” Ok, time to take a deep breath and explore more closely the Coronavirus Pandemic; offering a few solutions in the new, exciting and relevant book: Global Pandemic Solutions: Going Viral….
If we can first take a step back in trying to understand the epidemiologist’s initial predictions of the Coronavirus Pandemic: millions of deaths, high mortality rate and spread throughout the country. It is the job of the epidemiologist to understand how disease can spread from person to person within a population. While an epidemiologist can give advice about populations, they are not the expert in giving medical advice for the individual. As it turns out, the predictions (model and data) were wrong as was their intervention to shut down the economy, wear masks and social distance (because we do not know someone else’s possible pre-existing conditions and we want to protect them). Offering a 10th opinion (meaning if 9 people agree on a course of action, then the 10th person must disagree) about the Coronavirus Pandemic provides an obligation to disagree and present opposing views:
Do we have a Pandemic? I am not so sure. If we thoroughly evaluate the definition of infection, which means that a microbe like a virus is not only identified, but it must grow to sufficient numbers to cause disease or injury to the person. At no time have we demonstrated quantitative testing to differentiate colonization (identify a virus) versus infection (demonstrate increasing replication and numbers of virus that cause disease or injury). The epidemiologist are not tracking cases, disease or infection between persons in a population at all; as we are being asked to accept that a positive test for Coronavirus represents a case or infection. It does not. In effect, Coronavirus testing (positive or negative) is not something that we should be counting, never mind track or try and slow the spread and confuse us by saying flattening the curve. Curve of what? Positive or negative testing. The initial premise and fundamental question that positive testing for a Coronavirus represents disease or infection is flawed from the very beginning and so are the recommendations that follow: wash your hands with Purell, stay home and wear a mask everywhere and above all, stay off the beaches. What?? All over television and social media: Stay home, be safe, stop the spread. Stop the spread of what? Positive Coronavirus testing. Ridiculous!
Albert Einstein once said: Not everything that counts can be counted. And not everything that can be counted counts. Let’s take the last part of the statement first: Not everything that can be counted counts applies to testing for Coronavirus. A positive test does not count by itself and should not be counted. The result of a test is not disease or infection and therefore is not a case. Now let’s take the first part of what Albert Einstein said: Not everything that counts can be counted meaning what counts is severity of disease like severe pneumonia, ARDS (Acute Respiratory Distress Syndrome or death, which is not being counted or at least not counted correctly. What we need to establish is that the Coronavirus multiplied to sufficient quantities and caused severe disease or death. It is imperative to separate correlation from causation. If a patient has multiple medical problems, are we saying that a positive Coronavirus test is causation of death. Really?
The prevalence of disease in a population is supposed to represent how widespread the disease or infection is in a population; not how widespread is the exposure of a Coronavirus by measuring the presence or absence of Coronavirus on a test. Again, this is not a case, disease or Infection, but just possibly exposure to the virus. When a person receives a different test looking for antibodies in a relatively healthy person, it is still exposure to the virus with the body’s immune system response to it. It is still not disease or infection. But, what does the finding of antibodies to the Coronavirus in a relatively healthy person mean. In simple terms, it means the mortality rate from Coronavirus is no different or even less than the seasonal Influenza. In effect, the initial epidemiological prediction, model and data were wrong, therefore there is no justification for the set of events that followed and can immediately be reversed as we were and are safe, but what is really making us unsafe is stay at home (confined space with low humidity which makes you more prone to viruses including Influenza), restricted or no income from not working and social engineering by monitoring and restricting social interaction.
When it comes to analyzing interventions for the Coronavirus causing true disease or infection, everything hinges on the matter of evidence (Carl Sagan).
If we look to the history of the 1918 Influenza Pandemic, which affected younger (age 20-40) persons who were immunocompetent; death occurred as quickly as 24 hours after exposure to the virus. In effect, it is likely their overactive innate immune system killed these patients as their lungs were damaged by their own inflammatory response injured normal lung tissue while trying to kill the virus as their lungs filled up with fluid resulting in “ suffocation similar to a drowning death.” The initial emphasis in treating severe cases of Coronavirus (or in any viral infection) has to address the body’s initial inflammatory response to the virus. Hydroxychloroquine (anti-malarial drug) does just that; it blocks interferon gamma which recruits macrophages in the initial inflammatory response, so at the very least the drug should not be so quickly dismissed as the idea is correct. However, if you want to learn more about other options regarding solutions for severe illness to Coronavirus read on: Global Pandemic Solutions: Going Viral…..
However, here is a sample of what you need to know about viruses (including Coronavirus).
*If we look at bats and understand why they harbor viruses like Coronavirus and even more lethal ones like Ebola Virus, why do the bats live with these deadly viruses and not die from them. The answer or solution lies in the initial inflammatory response as the bats dampened immune system reaction to the virus means the bats immune system is not destroying itself, consequently the bat initially lives with viruses, but is not dying from them.
*Vaccines do not treat infection or disease. Vaccines can only prevent disease or infection. The vaccines do not kill or destroy viruses. As a technical point, a virus is not a living organism so you cannot kill it, but you can prevent it from being produced or from allowing it to replicate. However, vaccines take time to develop ( normally take 10 years, but if you fast track it possibly less than 2 years) as a result much of the potential damage is already done by the virus that has already occurred before a vaccine ever becomes available.
* Vaccines work better in immunocompetent persons; moreover, when some people are exposed to the Coronavirus the presence of antibodies (essentially vaccinated by their own humoral adaptive immune system) means their body was exposed to the Coronavirus and their body fought it off, thus preventing disease or infection. On the other hand, high risk patients may be immunocompromised and may not respond to a vaccine even when one becomes available.
*When it comes to vaccines, ‘ nothing is so firmly believed as that which is least known’. Viruses (Coronavirus) are intracellular pathogens, meaning once inside the cell a vaccine (which makes antibodies) does not affect or kill intracellular pathogens. In fact, the body’s last line of defense is based on the adaptive cellular immune system, which is not affected by vaccines, but relies more on the integrity of a person’s own competent immune system. It is worth mentioning again, vaccines can prevent disease or infection, but they do not treat disease or infection once they have occurred. Having said that, passive immunity with blood transfusions (someone else’s antibodies) does not treat disease or infection with Coronavirus.
* Antivirals like Remdesivir are used to treat disease or infection once it has occurred, while vaccines try and prevent disease or infection. The issue with both vaccines and antivirals is that they are implemented late in the game and so their true value, importance and benefit are overstated as much of the damage is already done.
* Ventilators are not a form of oxygen therapy. Ventilators are primarily for controlling ventilation, which has more to do with carbon dioxide and acidosis. Oxygen can be beneficial, but it an also be harmful as oxygen can be a potent vasoconstrictor. Additionally, the often misunderstood concept oxygen in the setting of infection, sepsis and uncontrolled inflammation is that too much oxygen is harmful to cells by creating increased oxidative species, oxidative stress and free radicals that can damage the virus, but also health tissues. There are 2 parts to the equation regarding oxygen. Oxygen delivery and oxygen utilization. Often the focus is on oxygen delivery improving respiration at the lung level; when the real solution must address respiration at the cellular level, which is the more important problem to overcome. When it comes to ventilators, “nothing is so firmly believed that which is least known’.
* We do not do as much for a patient by giving them a diagnosis and putting them in a hospital room and if we are calling a positive Coronavirus test a case or infection (which we should not) then why introduce Coronavirus positive patients into a high risk populations like nursing homes. Really?
Rudyard Kipling’s advice applies to the Coronavirus Pandemic: be open to another person’s ideas, respect diversity, be humble and ty and be part of a solution and not part of the problem. Lastly, what I attempted to do with Global Pandemic Solutions: Gone Viral is to tell a story implementing knowledge from history, apply a systems approach depicting biology of disease and be open minded to try and apply a unique understanding of other living things ie. animals that may provide insight into the human condition regarding both disease and health.
Global Pandemic Solutions: Gone viral is the beginning of a discussion that needs to be viewed by considering many points of view, not just stamping out disease, but defining and improving health as a way to move forward and adapt just like the animals featured in the book namely bats and sea turtles.
Enjoy for better solutions, health and world.
Paul M Willette MD
Global Health Science Solutions LLC