That viral season!

When we moved to ‘elimination’ we extended draconian measures that have infiltrated people’s lives, their sense of autonomy and well-being, and the shockwaves will be felt for years to come in terms of poverty of populations, other crucial deferred medical treatments, destruction of educational prospects on a mass scale, further indebtedness of already besieged economies and more – Pic by Shehan Gunasekara

Everything has been eclipsed by COVID this last year. All politics, economics, commerce, foreign policy, family life and more seem to have become understudies of ‘pandemic management.’

There has been progress, more alarm bells and more voices being heard, though the implications and impact of our choices will be years in fully fathoming. As Santayana warned, those who don’t study history are doomed to repeat it. So, to conclude our challenging of hysterical misinformation this year, here is an inventory of questions that needed to be asked, and we can fairly reliably answer.

Perhaps before waving ‘adieu’ or ‘good riddance’ to large aspects of 2020, it may behoove us to ensure this is understood and its implications, taken on. To waste this crisis, with so much grief and anguish, and get no ‘return on crisis’ in terms of understanding or resolve, would be truly lamentable. 

What is COVID-19?

It is a coronavirus; we’ve experienced many before as common colds and flu. This is a relative of ‘SARS’, hence it’s called SARS-CoV-2. SARS-CoV-2 is the genetic material, COVID-19 is what we call the disease it can give rise to (symptoms largely are high fever, dry cough, loss of taste and smell, not unique to this illness). 

There is controversy as to how long this has been around, strains have been found as far back as 2019, and one of the arguments as to why it has been far less lethal than modellers predicted, is that it had circulated, and there was far more antibody protection than anticipated. 

Globally, this came into focus in 2020 as emerging from a wet market in Wuhan China, though there are claims it ‘escaped’ from an experimental lab where research was being done. 

How did we get from an outbreak in China  to a global shutdown?

The Chinese first denied the issue and were slow to shut down. Borders stayed open, and the global conduit was primarily via Iran and Italy, where large Chinese populations and production facilities were present. That it would ripple out from there, as well as spread more directly, isn’t hard to conceive. The initial trajectory of infection extrapolated by modellers gave rise to global panic.

China, too late but decisively, ‘locked down’ Wuhan (the epicentre) hard. People were allowed out for essentials, but businesses were shut, as well as all travel in or out. It should be noted though, this ‘hard’ lockdown was maintained for only 38 days, and the rest of the country was unaffected. China has always engaged in lockdown regionally, not nationally, which makes sense. 

At 38 days businesses and lives within the area were allowed to normalise (Sri Lanka, for example, was curfewed longer than Wuhan was ‘locked down’). Just over two months from the outset, travel was allowed to resume. China’s COVID numbers since, have been extremely nominal, despite its population.

How did Sri Lanka’s ‘lockdown’ differ from others?

Most countries ‘locked down’ when they saw a spike in cases and a linked spike in seeming excess mortality. Lanka is to be lauded for an early border closing when we didn’t know what we didn’t know. However, there was no spike in cases or mortality then, and so a 24/7 ‘curfew’, the most extreme varietal of ‘lockdown’ was unlike anything practiced anywhere else, and we had the least reason to subject ourselves to it, much less for a protracted period, extending over two months. There was no curve to flatten! 

And each time the curfew was to be relaxed, a new ‘cluster’ would emerge, once from overseas and then from the Navy. After opening there was a rehab centre, and then the current garment factory/fish market cluster which officially kicked off a ‘second wave.’ However, to the credit of our leaders, seeing the devastating impact on daily wage earners and SMEs (which extended far too long for far too little), the current ‘isolation’ approach which is zonal, or by street, or building or neighbourhood was adopted and is far more effective and allows the country to operate and for people to live.

What was the much-touted ‘Hammer and Dance’ theory?

Essentially as China demonstrated, premised on shutting societies down hard, but briefly, to interrupt transmission, and to ensure health services and ICUs weren’t overrun. It was to then ‘relax’ measures and while protecting the vulnerable, let the virus circulate and be dealt with by medical treatment and our immune systems. If again, there is a surge, you again ‘tighten’ (not completely shut) where you need to and exercise your best cost/benefit judgment between allowing for a solvent society and a manageable pandemic. 

Unfortunately, our global zeitgeist found this too nuanced. And somehow, tragically, we segued to ‘eradication’ of a virus as a plausible aim, which it isn’t. Of all the illnesses that have made a host of the human body, only smallpox has been fully eradicated. The others are now milder, or have treatments, or our immunity is better. Truly, that IS the dance! 

When we moved to ‘elimination’ we extended draconian measures that have infiltrated people’s lives, their sense of autonomy and well-being, and the shockwaves will be felt for years to come in terms of poverty of populations, other crucial deferred medical treatments, destruction of educational prospects on a mass scale, further indebtedness of already besieged economies and more.

Have all parts of the world been equally hit?

Far from it, but in terms of psychological irrationality, they seem to be competing with each other. More than 50% of the deaths (which is the only sane metric of interest in terms of public health) come from Europe and the US. Three factors have to considered and will doubtless be studied in the years ahead: age of populations, enfeebled immune systems from too much ‘medication’, mislabelling deaths where someone has a positive COVID test result though clearly did not die from a respiratory disease but from say a gunshot wound or a brain aneurysm. This last is true certainly in the US and UK, across much of Europe, and in some jurisdictions financial incentives were provided for such categorisation.

Some countries have done better, taking a different approach. Sweden had the lightest restrictions, most of which were voluntary, and while modellers predicted 90,000 deaths plus, it has about 8,000 deaths to date (despite autumnal surge and 70% of the total came from nursing homes where like other countries and regions from Lombardy to NYC they made a tragic error of clustering the elderly ill together, creating a superspreader environment). 

Taiwan closed borders early, did some limited testing, asked for symptom monitoring, and has been scrupulous in not ascribing ‘COVID’ as a cause of death if the progression from C-19 to pneumonia to respiratory distress syndrome to death wasn’t clear (seven deaths total). Vietnam did targeted, limited zonal shutdowns. Singapore as well. Belarus has just stayed open and has one of the lowest death rates in Europe, with large events also being allowed.

Outside of islands like New Zealand and Australia, quaking at every stray addition to the C-19 roster, none of these relative successes went the route of extended, heavy restrictions.  Short, sharp at times, yes. Maldives has been welcoming tourists with no quarantine required for months. Total COVID ascribed deaths? 48!

Given size and density, Japan has been a success while keeping economy open. But a whisper of a ‘mutant’ and they shut their borders to all travel? How will that be sustainable for the planet going forward? We have to flip a psychological switch. Thailand with very tame statistics, are terrified to let travellers in, though it was a hub of sex tourism in the midst of the AIDS epidemic, and there is no way this is anywhere near as lethal.  So some existential alarm bell has been set off, even for hardy cultures (Japan weathers earthquakes gracefully and with resilient calm by comparison, most of Asia did likewise with the tsunami). 

Which countries or regions have done the best?

Overall, Asia, with 60% of the world’s population, having only 19% of the ‘ascribed’ COVID deaths, and Africa where there has been barely a ripple, show what hardy immunology and coping with ravaging illnesses and lack of ‘hygiene’ can do in the positive (crippling as those factors can be otherwise). 

How lethal is C-19? 

Virtually all who die globally from C-19 are over 65 with serious pre-existing conditions. Average age of death is 74, virtually at life expectancy everywhere. There is a 99.9% recovery rate for those below 60 without serious comorbidities. Children are virtually not at risk, and we have yet to have a record of a child transmitting the virus to a teacher anywhere. Again, Sweden kept schools for children 1-15 open throughout, not one death in that 1.8 million child population. 

Taking infections not ‘cases’ based on seroprevalence studies conducted by Stanford Professor John Ioannidis, show .05% lethality. If we take WHO’s numbers of 10% of the world population likely already having been infected, it would be .14% roughly. SARS was far less contagious mercifully but has a lethality of around 7-9%.

Another key difference, the lethality of C-19 follows the normal course of life and primarily afflicts the very elderly who are at risk from a multitude of factors seasonally. Past pandemics (Hong Kong Flu, Asian Flu, the epochal Spanish Flu of 1918) targeted the young, and so tended to take their lives more so than the elderly, leading not only to more deaths in a far less populous world, but also exponentially more ‘life years lost’ on that basis.

 How do we ‘stop the spread?’

We have a ‘case-demic’ or a ‘test-demic’ not a pandemic. Originally, we only tested those with symptoms. And those with positive tests were corroborated by symptoms, and so one tracked the other. 

Now, most testing positive are ‘asymptomatic’, about 80% or so here in Lanka from what I’ve been told by informed authorities. In that case, then the ‘positive tests’ are not ‘cases’ (people with symptoms requiring medical attention) and if not translating to excess ‘mortality’ we are driving ourselves insane for nothing. 

We are detonating a neutron bomb under our society and educational infrastructure for a sheer phantom. Let’s stop the ‘testing industrial complex’ that has irrationally and unproductively taken over our lives, as it manufactures only further pointless panic.

We are also assessing ‘cases’ from a PCR test, which was never, as per its founder Kary Mullis, designed for diagnosis. It is prone to be set at amplification (Ct) settings that detect stray viral shards or debris and not ‘live virus.’ At those settings, we cannot get any indication of contagiousness. 

Every lab doing these tests should publish their ‘False Positive Ratio’ (FPR) and as is now endorsed by WHO (finally!) and being insisted upon increasingly across the US, also confirm the Ct (Cycle Threshold) value when reporting a result. Otherwise, it is deceptive and as per the former Chief Science Officer of Pfizer, ‘clinically useless.’

What has been most challenging re our national response?

The lack of consistency in messaging. We know our death statistics relative to COVID are inflated (even though the ascribed ‘192’ COVID deaths are still extremely modest and do not dent the monthly mortality numbers in Sri Lanka which are roughly 12,000 per month). Most of the deaths come from diabetes, heart attacks, brain bleeds, multiple chronic conditions, and yet we don’t address this disconnect.

In the past we’ve said there will be no shutdowns, and then on the eve of liberation, extended a crippling shutdown for a further week to 10 days, devastating businesses that have painstakingly restaffed to open, or painfully impacting hotels who were barely scraping by with local tourism. And the ‘proclamations’ when there is no net mortality rise, and even ‘positive tests’ have not reached even half of 1% prevalence (1% prevalence globally is considered low, and for us would be 210,000 positive tests), have been baffling.

Has there been global collateral damage?

Devastating impact on whole industries, travel and hospitality in particular, but others too. Small and medium sized businesses wiped out in droves. Masses of children being pushed back towards hunger, populations towards poverty, gains against other crippling illnesses like malaria and TB retarded, commercial and cultural centres like New York City and London potentially no longer feasible for the foreseeable future (something that World Wars and 9/11 and everything in between were unable to achieve, but our own misguided panic has wrought).

And much has been gratuitous. Governor Cuomo in NYC has shut indoor dining when only 1.4% of the spread of C-19 as per their own contact tracing came from indoor dining and 74% roughly has come from ‘household transmission!’ So how is it remotely sane to drive everyone indoors, especially in the winter, in New York size apartments? So, these antics aren’t even data driven.

We are told by numerous jurisdictions that the UK ‘mutant’ is no more dangerous and possibly not even more infectious but being used by the British PM to justify mass closures and the panicked obfuscation of their ‘tiers.’ Think of trips cancelled, people isolated, destinations and businesses unable to welcome people, and then look at net mortality on the Euro Momo website and you will see how shocking this silliness is. 

Is there asymptomatic spread?

This has justified everything else and is a pure hobgoblin. WHO said there wasn’t in June. A day later they had to ‘retract’ to the extent of saying it was extremely ‘rare.’ Well, just recently we have a 10-million-person strong study from Wuhan unable to locate any asymptomatic transmission. Then a JAMA meta-analysis of 77,000 people, finding 18% household transmission rate among the symptomatic and .7% from the asymptomatic, which the study says is within the margin of error, inclining towards zero.  Just in, researchers from the University of Florida conducted a significant study, finding yet again no evidence of asymptomatic transmission, and the British Medical Journal concludes there is inadequate evidence of same to justify any mass testing. It’s a hoax. Some studies purport to have found examples, when contact traced, none could be actually located.

Do masks make a difference?

No, the particles are too small. You need a sealed ventilator to protect against viral aerosols and droplets. A study in Vietnam in 2015, a Hong Kong study early 2020, the recent peer reviewed Danish study, and a recent study across US states finding lower spread in states without mask mandates. 

If in close quarters, as there can be macro particles, err towards caution. Otherwise, the quality of oxygen flow is compromised, and we breathe in our own waste for nothing when clearly eyes are exposed and there is a gap between mask and face besides.

Have lockdowns worked?

No. I cited nine studies in my last article providing references showing no statistical connection between lockdowns or their severity and any positive gains re mortality or virus eradication. Being outdoors in Vitamin D enriched sunshine is better than being locked up. ‘Lock down’ is a penal concept, never a part of any public health recommendation before 2020. We survived all these other pandemics without this self-destructive prescription.

What role should the corporate sector play?

To be the voice of practical prudence. They sat mum for too long. They watched as the economy unravelled, and lone voices from the sidelines, often august past captains of industry, pointed out that you cannot have medical services if you have no economy.

Economy or lives is silly, economy is lives too. Economic bankruptcy once more, is not a medical strategy. We need business leaders to help implement the health guidelines where they are needed and advise our leaders towards navigating to a real rebound.

Is there a mental and emotional health dimension to this?

Everything has a mental and emotional dimension, and we must address the surging depression, suicidal tendencies, overdoses and more, here and globally. We must provide some basis for mutual trust and a conviction that our liberties and ability to make a living will not be suddenly yanked away once more. 

We must do all we can to support businesses and livelihoods, and crucially get children back to being educated, and mentored and coached – their lives literally depend on this, and one day the nation’s life will depend on them.

Do we have any reason to be concerned with vaccines?

Let’s go warily, animal testing was bypassed, safety protocols were deferred, and this is a new technology, some call it ‘genetic tinkering’. You owe it to yourself to read extensively and not just from those with a financial investment in the supporting orthodoxy.

I do not find vaccination credible if it doesn’t go overwhelmingly to the vulnerable. The rest of us don’t need it. If no worse side effects emerge, let elders and those with pre-existing conditions make an informed choice. Mass vaccination would be a highly suspect, pernicious hoax for an illness most people don’t know they had, and 99% recover from.

How is Sri Lanka doing today overall?

We have some of the best stats in the world. If we can stop gorging on ‘case counts’, remove ourselves from PCR test tyranny, record deaths ‘from’ versus ‘with’ COVID, and help everyone emotionally and mentally ‘flip a switch’; if we can trust MoH guidelines, so if someone is infected, we can still operate without exposing anyone else to risk; if we can moderate the mask fetish; and refocus our imagination and resilience into reviving the economy and the growth prospects of our citizens, armed with above clarity, then 2021 can be a year of true flourishing!