100,000 Deaths from COVID-19!

Last Tuesday as rumors of new guidelines asking everyone to wear facemasks spread, I decided to watch the Task Force briefing. There was no such guidance at that time, but I was impressed by how the reporters never seem to listen to the speakers. Are they distracted by the opportunity to ask their prepared questions and ability to get airtime? I spent a good deal of the time telling the TV, “They just said that!”

In any case the first question was about one of the graphs projecting 100,000 to 240,000 deaths, even with full mitigation. This was a modeling result and was in no way guaranteed. No one asked about confidence in the model or how it could change. They just focused on the numbers, because they are scary numbers. The primary reason for the question appeared to be to get the president to say the number, so they could pin it on him. He handed it off to Dr. Birx to show the chart again and repeat the projection.

The next day those scary numbers were all over the news. CBS said, "The White House projects 100,000 to 240,000 Americans will die from coronavirus if ‘full mitigation’ measures are taken.” NBC called it a “dire warning” and only used the upper limit of the projection. ABC chimed in with, “Grim Trump, doctors say prepare for potential 100K to 240K deaths.” That story emphasized the president “abruptly” changing his mind when given new information – I wonder what ABC does when they get new information. 

I cite the mainstream media here, because so many editorials like to pick only on “cable news” when criticizing incomplete or slanted coverage.

Now let’s do what neither the media nor the task force made an effort to do, put it in perspective.

First, are all these incremental deaths? – Probably not. Some of the people who die from the virus would likely have died anyway, especially those in nursing homes. In addition, with so many people staying home, traffic deaths and other accidental deaths may be avoided, but all deaths will be recorded as virus-related and extraordinary.

Second, America is a land of big numbers. The government just passed a law to spend a huge amount, over $2 trillion! Each year Americans drive over 3 trillion miles, personal and commercial, and 2.8 million babies are born. It wasn’t too long ago we were stressing over news like this, “more than 130 people in the United States die of an opioid overdose every day.” And today: “School closures due to coronavirus have impacted at least 124,000 U.S. public and private schools and affected at least 55.1 million students.” The CDC considers over 107 million American adults obese. In America, charities, activists and politicians wanting to raise money, awareness or votes easily find such big numbers to elicit support. 

The CDC estimates 24,000 to 62,000 deaths from the flu this last season, and that’s with a vaccine available. In 2018, the number was 55,672 from flu and pneumonia. If we had 100,000 deaths from coronavirus in 2018 (the last year with complete numbers), it would have ranked seventh among leading causes of death just ahead of Diabetes. 

In fact the total number of deaths in the US from all causes was 2,813,503. On average over 234,000 people die every month from other causes. It’s all counted in big numbers.

Relative to some of these numbers, 100,000 across the entire population is not that large; but taken by itself it can be scary. The task force uses it without perspective to motivate people, to shock them into doing the right thing. The media piles on by using it without perspective to attract viewers and to sell newspapers.

We should be able to cooperate in the containment effort without fear and be able to stay calm knowing the media agenda is to upset us enough to ensure we buy more of what they are selling. But that's not what's happening.

Is It False Advertising?

A couple of years ago plaintiffs brought a class action suit against Boiron Inc., the maker Oscillococcinum, a homeopathic cold and flu remedy claiming that it didn't work. What was unusual in this case is that it went to a jury trial. Most of the time, in fact twice in the past in other lawsuits against Boiron, these types of cases are settled before they go to trial. Apparently this time the company decided it was time to take a stand and risk the decision of a jury. Surprisingly, the company won in court. The jury simply felt that the plaintiff hadn’t presented sufficient evidence that the product did not work as advertised, that is, they had not shown that it did not relieve flu symptoms.

 The reason this is coming to light now is that the plaintiff appealed to the 9^th Circuit, but the court sided with the company. The court found that “the jury appeared to have believed Boiron’s expert, clinical studies, and anecdotal evidence more than it believed the plaintiff’s expert." According to the court, there was no legal reason to overturn the verdict.

 But what exactly is going on here? Is there a scientific reason to doubt the claims of the company?

More can be learned from the website Rxlist.com. “Homeopathic products are extreme dilutions of some active ingredient. They are often so diluted that they don't contain any active medicine.” Due to legislation passed in the 1930s this type of product can be sold in the U.S. but, like dietary supplements, are not held to the same safety and effectiveness standards as approved drugs.

Oscillococcinum claims to relieve flu symptoms, but not cure the flu. It’s effectiveness is based primarily on self-reporting. The website finds “no reliable evidence that taking Oscillococcinum can prevent the flu and evidence of any beneficial effect at all is questionable “due to flaws in the study design.”

It is made by highly diluting in water a compound extracted from the heart and liver of the Muscovy duck. Its dilution rate is coded in homeopathic terms as 200C. This means there is one part duck in a solution containing 1-followed-by-400-zeros parts water. That is an insanely huge number. There isn't even a name for this number. It is more than the estimated number of molecules in the entire universe! It is physically impossible for any part of any active ingredient to survive that level of dilution. But homeopaths explain this away by saying that the water retains the essence of the ingredient (even though there is none left). The remaining water is then combined with inactive ingredients of lactose and sucrose.

“Most experts believe that it will have no beneficial effect and also no negative side effects.” How could it not be safe when it’s primarily sugar water, unless the sugar was somehow contaminated? The company relies on the placebo effect to influence customers and then uses endorsements and personal accounts in their advertising and in this court case.

In my opinion this is nothing but snake oil and that people are basically throwing money away. However, I agree with the jury and the court that they did not advertise falsely. People who are willing to pay about a dollar per dose and take three doses per day really believe in its power to reduce flu symptoms. That belief alone is often enough to make them think they feel better and to report a reduction of symptoms. (Note: Some people take it to prevent the flu, a benefit the manufacturer doesn’t even claim.)

 We each get to decide how to wisely spend our dollars. (Annual sales of Oscillococcinumin in the U.S. were $20 million in 2013, and they probably only had to use one duck!) Information on homeopathic medicines is so easy to find, but the ability to overcome most people’s longstanding beliefs is so difficult to sway.  And suppose those people who still have the flu, but strongly believe they feel better, decide to come to work or school and spread it around. What then?

Oops on the Flu Shots

It is interesting how, when people don’t agree with advice they receive, even very sound advice, they look for excuses to ignore that advice and do what they want.  A common example is the person who doesn’t want to quit smoking and ignores all the scientific evidence while citing as an example the 90-year-old grandmother who smoked all her life and is still going strong.

Now we get news from the Centers for Disease Control and Prevention (CDC) that this year’s flu vaccine may not be as effective as expected.  The flu virus has mutated to a new and unanticipated strain that the vaccination doesn’t cover. 

This sometimes happens, but individuals and organizations like Natural News are quick to jump in with both feet to say, “See we told you so!”  The Natural News website flashes headlines saying:  "CDC issues flu vaccine apology: this year's vaccine doesn't work!”  They go further:  “For the first time we can remember, the Centers for Disease Control and Prevention are going on the record, saying the flu vaccine won't work this year.”  This is followed by an attack on the CDC accusing them of foolishly continuing to promote vaccination for this season, being in bed with Big Pharma, and renewing the same old anti-vaccine, mercury-scare story.

A more balanced report comes from Forbes with the headline:  “Your Flu Shot Might Not Work -- But Go Get One Anyway.”  In it they talk about the warning from the CDC that the development of the vaccine in the spring to try to anticipate the flu strains in the winter resulted in a poorer than usual match.  “As a result, just half of current flu cases match the available vaccine.”  It’s a long way from “won’t work this year” to just half.  In fact, the flu shots are never promoted as being 100% effective.  Many studies show the average to be between 60% and 75% depending on the year and the population tested.  One study in the New England Journal of Medicine concluded that, regardless of this inability to be 100% effective, “[v]accination against influenza has substantial health-related and economic benefits for healthy, working adults.”

In addition, the CDC never attempted to paint a different picture.  They were honest in a posting back in May of this year and renewed that honest approach by admitting their miscalculation.  That May posting is clear.  “During years when the flu vaccine is not well matched to circulating viruses, it’s possible that no benefit from flu vaccination may be observed. During years when there is a good match between the flu vaccine and circulating viruses, it’s possible to measure substantial benefits from vaccination in terms of preventing flu illness. However, even during years when the vaccine match is very good, the benefits of vaccination will vary across the population, depending on characteristics of the person being vaccinated and even, potentially, which vaccine was used.” 

Finally, the flu can be deadly.  "Over a period of 31 seasons between 1976 and 2007, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people.”  Vaccines are generally effective as well as safe.  “For more than 50 years, seasonal flu vaccines have had very good safety track records. Over the years, hundreds of millions of Americans have received seasonal flu vaccines. The most common side effects following flu vaccinations are mild.”

Of course, both those pieces of information about the danger of the flu and the safety of the vaccine come from the CDC, and some believe they are part of a big conspiracy to make pharmaceutical companies rich by selling shady products to citizens and insurance companies while adding to their already obscene profits.  Those of us who are not paranoid, though, will continue to get our flu shots even if they are not 100% guaranteed.  The minor inconvenience and cost (often zero) are worth it to be 50% sure.  Although they may be unpredictable at times, behavior really does have consequences.

What Are You Afraid Of?

A couple of weeks ago USA Today ran a summary of the results of a Chapman University survey asking people what they were afraid of on a personal level.  The top 5 were:  walking alone at night, becoming the victim of identity theft, safety on the Internet, being the victim of a mass/random shooting and public speaking.  They went on to point out that “crime was rated at the high levels of fear, despite the fact that violent crime has been on the decline in the past 20 years.”  When it comes to fear we are often not rational.

Take Ebola as an example.  This article from one day later tells of the Ebola panic spreading across the nation.  This based on just four cases and one death, but driven by the “increased media spotlight."  The scientific term for this is Baader-Meinhof Phenomenon referring to “how once we learn about something new, we start thinking that we see or hear it everywhere.”  People are more fearful of Ebola than they are of the more common diseases like the annual flu that kills about 30,000 Americans per year and leads to untold amounts of economic loss as adults miss work and children miss school. 

Meanwhile they shun the flu vaccine for reasons based on rumors and personal beliefs rather than on any real science.  Many just refuse to be vaccinated:  “Flu vaccine coverage in the 18- to 64-year-old group in November 2013 was estimated at about 34%, compared with about 41% in children and 62% in those 65 and older.”  In 2013 it was found to be 61% effective and this year’s estimate is 70% to 90%.  A shot that people skip for various reasons, many unfounded, can keep most of us healthy.

But the media attention (along with Twitter and Facebook) focuses on Ebola (just as it did on ISIS in September, unaccompanied minors from Central America in July, and Russia invading the Crimea before that – remember the Crimea?).  When are we going to stop trusting the media, and rightly expect them to over-hype each crisis as it comes along?  They’ve got news to sell; balanced information is just a rare byproduct.  When are we going to stop making medical decisions based on undocumented evidence and opinions on social media?  They have no more expertise than we do, often just a friend or relative who tried a weird cure and got better – sometimes it just happens, but it’s not science and it may not even be safe.

We must start thinking for ourselves, doing the research and being skeptical.  I couldn’t look for a better endorsement of this than one from John McWhorter, Professor of Linguistics at Columbia University, as he writes about what languages do and don’t tell us about the people who use them.  “(Skepticism) is certainly a keystone to sophisticated thought.  It would not be inappropriate to even state, for general purposes, that skepticism – that is applying one’s mind to taking the measure of things before coming to judgment – is the heart of intelligence.”  (Source: The Language Hoax, p. 41.)

If we do the homework we will find not only what we should be scared of and what are figments of our own or other people’s imaginations, but also what we should be doing to avoid the real dangers.  The CDC lists below the top five causes of death in the US and what behaviors will help us reduce the risk of each.

"Modifiable risk factors are largely responsible for each of the leading causes of death:

• ·      Heart disease risks include tobacco use, high blood pressure, high cholesterol, type 2 diabetes, poor diet, overweight, and lack of physical activity.
• ·      Cancer risks include tobacco use, poor diet, lack of physical activity, overweight, sun exposure, certain hormones, alcohol, some viruses and bacteria, ionizing radiation, and certain chemicals and other substances.
• ·      Chronic respiratory disease risks include tobacco smoke, second-hand smoke exposure, other indoor air pollutants, outdoor air pollutants, allergens, and exposure to occupational agents.
• ·      Stroke risks include high blood pressure, high cholesterol, heart disease, diabetes, overweight, previous stroke, tobacco use, alcohol use, and lack of physical activity.
• ·      Unintentional injury risks include lack of seatbelt use, lack of motorcycle helmet use, unsafe consumer products, drug and alcohol use (including prescription drug misuse), exposure to occupational hazards, and unsafe home and community environments."

Fear is a powerful emotion.  It can affect our health and overall wellbeing.  It can lead to foolish decisions.  As technology and communication get more sophisticated, they can either work for us or against us.  Not trusting everything you read is much safer than marching in step to the drumbeat of the news or social media.  What a waste it is to be afraid of the wrong things because we fail to do the research and to think for ourselves.

Secret to Good Health

As I read this information from John’s Hopkins on how to maintain good eyesight, it occurred to me that products advertised as the secret to good health must be a scam.

This article from a group of medical experts tells that other than regular checkups, to maintain good eyesight “many lifestyle factors that protect our heart health may also help keep our eyes healthy, including being active; getting enough sleep; controlling blood pressure and diabetes; not smoking; maintaining a healthy weight; and eating a diet rich in fish and leafy, green vegetables like spinach and kale.  Wow, that’s almost the same advice for every other health concern, not only heart health, but also improving the effects of arthritis, preventing chronic illness  and promoting memory and general mental health.

The real secret to good health is that there is no secret.  Health authorities have not been trying to hide anything from us.  There is no big secret "doctors don't want you to know."  In fact they have been shouting from the rooftops at every opportunity.  We are told over and over on a number of issues that if we want to avoid problems and just generally feel better we should:  get enough sleep, eat healthy, drink alcohol in moderation, stop smoking, get plenty of exercise, get enough liquids, use sunscreen, wear work gloves or protective eyewear as appropriate, learn relaxation techniques to reduce stress, brush and floss, wash your hands and get a flu shot.  This should come as a surprise to no one.  We have heard all this advice or subsets of it many times for many years.

The problem with advice like this is that no one wants to hear it.  Americans are looking for the easy way, one that requires little discipline.  So every time a new diet book is published or the doctors on TV tell us about a miracle cure or another health secret, people want to sign up for the program (and send in their money).  They can’t hold an audience by saying the same things over and over, especially when we are so desperate for secrets, so the authors and television personalities must give us secrets.

The real secret is the boring truth – that there is no secret.  Like every other endeavor in life, staying healthy requires a little luck and a lot of discipline to stick to the best course of action.  The rest is distraction.