COVID Chronicles: Alas Poor Pandemic, I Knew Him
We continue our COVID Chronicles series. In this episode, my friend and medical colleague Vince will be enriching the series with a few posts. So, here we go…
Ever since the current SARS-CoV-2 pandemic began, I’ve wanted to have my say about the various issues surrounding the pandemic controversies. Fortunately, my good friend and physician colleague Dr Chaim has done a fantastic job in outlining many of the points I’ve raised in person with friends, students I precept, and many of my patients. I’m going to add to this conversation with my own observations. For those who know me well, I just don’t know how to write things briefly (!) so I’ll try to keep things simple and break down into a few posts what otherwise would take a few novel-length chapters to go through.
Controversy
Rarely in medical history, and certainly in American society, has a virus or bacterium caused so much uproar in an already fractured society, as has the SARS-CoV-2 virus. The current controversy surrounding the vaccines intended to provide protection against infection, has been clouded in massive amounts of misinformation and controversy, particularly on social media, where too much misinformation about the virus, the disease, and the protective measure guidelines has already been spewed like so much vomit.
Let me back up just a second regarding the reference to the SARS-CoV-2 vaccines, which are commonly called “COVID vaccines”. It’s always irked me how society and the media have gotten used to being lazy by referring to vaccines not by the virus or bacterium they’re intended to provide protection against, but by the disease that they end up preventing.
Sometimes they’re the same, such as measles virus (MV) that causes measles or influenza viruses that cause influenza (“flu”). Others are different, such as whooping cough, caused by the Bordetella pertussis bacterium, or shingles, caused by the varicella zoster virus. In the case of COVID-19 (doesn’t that just sound like it was named by someone coming down off a crack high?), it’s caused by the SARS-CoV-2 virus.
Looking Back
Before getting into controversies surrounding the SARS-CoV-2 pandemic, I think it would pay us well to look back to the past couple of big pandemics – SARS in 2002-2004, and H1N1 influenza in 2009-2010 – and how they were handled, in order to provide a better backdrop for the problems with the current pandemic.
The SARS outbreak in late 2002 and finally eradicating around mid-2004, was very minor in comparison with other pandemics (and certainly SARS-CoV-2). According to official records from the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC), China was reportedly the hardest hit, with a little over 5,300 infections and around 350 deaths reported (but we know China’s penchant for telling the truth!), Hong Kong and Taiwan were also hard-hit, and Canada came in number 4 with a whopping 250-some cases. Only 29 infections – and 0 deaths – were reported in the US.
But do some research on this one yourself – no vaccines, respiratory/droplet transmission. The pandemic was eradicated by the use of isolation of the sick (local lock-downs and quarantines, particularly in China, Hong Kong, and Taiwan, as well as standard infection control measures. We can give some partial credit to the CDC and the WHO for comparatively rapidly issuing travel warnings and restrictions for the areas affected, which further helped minimize the impact of SARS-CoV-1, particularly in the US.
Doing It Right
We can credit the CDC again for their nationwide actions during the influenza H1N1 outbreak in 2009. Technically, this strain of H1N1 was different, referred to as “influenza A (H1N1)pdm09”, for which many children and young adults had no common immunity (though many middle-age and older people are believed to have better protection due to likely exposure to prior H1N1 strains earlier in their lives). In the US, it’s estimated to have infected about 60 million people, with about 12,500 deaths.
The routine annual multi-valent influenza vaccines gave little protection against this particular strain, and a monovalent vaccine was created and distributed in the latter part of 2009 with the coordination of the CDC, which certainly helped effectively close out that pandemic around the first half of 2010.
The CDC estimates that the (H1N1)pdm09 strain continues to circulate, but due to some alterations in annual influenza vaccines, as well as exposure to the strain from the 2009-2010 pandemic, it’s unlikely to cause another pandemic in the near future. And with that pandemic, the CDC did things right – early detection of the vulnerable populations, nationwide control directly from the CDC (not the states) with infection control and treatment measures, helped keep the (H1N1)pdm09 virus from killing more people than it had in the US.
Doing It All Wrong
Now contrast all that with all we know and have experienced thus far during the SARS-CoV-2 pandemic, and it should be easy to see what I mean when I say that with SARS-CoV-2, we did everything WRONG. Maybe it’s not “all” our fault in the US, since China played the same ridiculous “it’s not us” game that they played with the 2002 SARS pandemic.
Personally, I’d have no problem staring the Chinese Communist party officials in the face physically (distancing 6 ft of course) and pointing my finger accusingly at them, because if there’s anyone who started this mess, it’s clearly the responsibility of the officials of the Chinese Communist party for playing their deceptive crap for a second time this century, and pretending it wasn’t them, and (to this day) obfuscating the facts (wouldn’t it be nice if someone in the Federal government can arrange my personal interaction with the Chinese leaders? We could film it and put it on YouTube!).
Properly Blaming the Government
In my view, the Communist party officials in China should have cared less about saving face, and more about being human and telling the truth that would have helped us minimize the spread of this virus before it became a truly worldwide pandemic on par with the severity of the 1918 influenza pandemic.
Oh, and for the record, anyone ignorantly blaming “the Chinese” in general for this pandemic and playing the “Asian hate” game, I’ll shove my accusing finger in your faces, too – this isn’t the fault of the Chinese people, the blame has to be pointed at the Chinese government.
Comedy of Errors
Our major errors in the country began when then-CDC Director Robert Redfield took no significant initial action on the emerging infection that was still only in the Far East but had every appearance of easily spreading beyond the Far East thanks to the obfuscation of the Chinese government and their failure to initiate containment measures fast enough.
“No Big Thing”
He was even the one who advised then-president Donald Trump very early on, that the virus was no big thing. I’d especially like all the rather rabid Trump-haters to re-read that. Mr Trump did not come up with the “this is no big thing” dismissal of this virus himself – he got that impression, and parroted it to the public, after discussions with Redfield. This information is confirmed by sources within the CDC who have first-hand knowledge of Redfield’s actions and statements (their identities are being held because Chaim and I, who are friends with some of these people, don’t want them being retaliated against for exposing Redfield’s incompetence).
Not Sealing the Borders
Recall too, that Redfield compounded his errors by deliberately refusing to seal the US borders to all travel early on, when it became clear that the virus was rapidly spreading out of China. Then-Vice President Pence used his emergency powers to take that action, even though the CDC Director has statutory authority to take such actions in the interest of public health. It’s worth noting that since that time, the media have painted Pence’s actions as an excuse to “expel migrants” from the US, when in fact the clear motive was an attempt to prevent the spread of the virus from other countries to the US, which was in line with what other countries were doing at the time.
Wear a Cloth Mask
The comedy of errors continued on the CDC Director’s part when, relying on (then) insufficient and incomplete data on this virus, he told the public (through a White House press briefing) “wear a cloth mask, and you’ll be safe“, and later at a Senate hearing, he claimed that the mask was “guaranteed” to protect “me” more than a vaccine.
Decentralizing the Response
As if all that shouldn’t have been enough for Trump to fire Redfield right then – had Trump actually had any intelligence – Redfield’s worst action was his deliberate refusal to allow the CDC to take the same nationwide control measures that it took in 2009 with the H1N1 outbreak. Redfield pulled the CDC back from controlling the situation, and insisted that he will “let the states handle this” (again, this is absolutely verified by CDC sources with first-hand knowledge). This is arguably the worst mistake any CDC Director could ever make, and is one of the main reasons why we’re still in this mess almost 2 years later.
Controversies Coming Up
Now that I’ve provided that backdrop, next time I want to delve into some of the big treatment and infection control controversies.
