I am putting my public health hat back on so this will be less politics and more disease control. Let me first say what disease control is NOT – it is NOT medicine. Public health, when it’s doing it’s job properly, works with doctors, but we aren’t deluded enough to believe that makes us doctors, let alone that we should dictate to doctors. Disease control deals with preventing the spread of infectious disease – it does not deal with making people well.
Of course, reality is messier than that – treatment is integral to disease control. The distinction is that your doctor cares about you getting well; disease control cares about you not giving your infection to others.
We have over eighty years experience in successfully reducing the spread of disease. We know how to do it and how to do it well. All of that knowledge and experience was tossed out the window during the panicdemic. I was proud of my work and my profession so this infuriates me.
Let’s deal with the big one: China. They end the lockdowns and all heck breaks loose. Lockdowns worked, right? No.
Not only did they not work, they probably made everything MUCH worse.
How do I know? I’m assessing based on both my experience and expertise in disease control. Like I said, disease control isn’t medicine but they are intimately interconnected. You cannot effectively intervene in the course of a disease without understanding how the thing works.
The first and foremost step in effective disease control is TREATMENT. Not prevention, not vaccination – TREATMENT. Why? Simply because treatment is the fastest way to reduce infectiousness either by making the person well faster or by curing the disease. It simply doesn’t matter which – both work just fine.
Treatment bats first. Prevention bats second. Prevention isn’t a great batter – we’re lucky if it gets on base initially. Prevention depends on the disease behavior – using condoms doesn’t help against the common cold. Prevention has to be tailored to how the disease actually behaves. With a novel disease, that’s extremely difficult because we don’t have enough information. I’ll come back to prevention in a moment.
Batting clean up is vaccination. Vaccination stinks at intervention – it takes WAY too long in most cases. By the time the vaccination is effective, the patient has already gotten well. What that means is that the person has already been infectious as long as normal for that disease – we haven’t stopped it from spreading at all. Vaccination is great for preventing the next outbreak but it cannot usually slow down a current one.
Fancy term is intervention – just means we got in the way of the disease’s continued spread. Vaccination intervenes in the long term progress of a disease but it’s just not fast enough to do so in the short term. Treatment can. So treatment will definitely get on base. Prevention may. Vaccination bats clean up – hopefully with a grand slam!
None of that happened like it should have anywhere that I know of. But China took ‘let’s make this up as we go along’ to new heights of insane stupidity. Masks, quarantines and lockdowns are prevention. Testing is nothing at all – testing is just what we do to figure out what will work best with a particular person; it’s not an intervention itself. But boy howdy, China did enough of it.
Let me be clear – China’s statistics are creative fiction. China never got near ‘zero’ and its caseload was grossly underreported. I know that for two reasons: China has been caught lying on its statistics in every area so many times that it’s a meme and nothing they did should have caused a significant reduction in prevalence (number of cases in relation to the number of people). The fact that they built MASSIVE quarantine facilities and used them kinda eliminates the notion that China only had a handful of cases until they opened up.
So, why the explosion after China ended the lockdowns? Well, first off, creative fiction – the ending of the lockdown might have just been a way of covering for how out of control things already were. I suspect this is partially true at least. But there’s another reason, or set of them, why ending the lockdowns failed so miserably. Lockdowns, especially extended ones, almost certainly impair even healthy immune systems.
Stress – which lockdowns cause in spades – is known to adversely affect the immune system if it goes on for long periods. Check. Sunshine – being outside – is known to improve immune systems and being confined is proven to weaken the immune system. Check. Lack of exercise is known to weaken the immune system. Check. Then we get to the really bad stuff.
China had multiple instances of people not being given access to food to the point of cases of literal starvation. Malnourishment is known to impair and degrade the immune system. Triple check.
Cherry on top: lack of socialization also adversely affects the immune system. Lockdowns couldn’t be worse for the human immune system if we designed them to be!
The so-called ‘super spreader events’ aren’t significant. If they were, Walmart would have been the leading source of spread in the US and all those stupid testing centers would have been spreading the disease like wildfire in China. No, large crowds aren’t the problem – but what happens next is. People desperately need social contact. So immediately after those protests, don’t imagine most people went straight home. They visited. They went anywhere they could to be with people for a while longer.
C19, like many respiratory infections, appears to need two things to spread quickly: long exposure and a vulnerable immune system. China’s lockdowns provided that second one and human nature did the rest the instant people had the chance to be with others again.
Had they all had strong immune systems, being exposed for longer periods probably wouldn’t have mattered much. Healthy immune systems fight off a lot of stuff – even novel diseases sometimes – and speed up recovery from the stuff the immune system can’t fight off. Sure, overexposure will eventually overcome even a healthy immune system, but those are the kinds of exposure you get from living with a patient, not from being in a restaurant a bit too long.
A nation full of folks with compromised immune systems – most experts believe that the outbreak had already started before the lockdowns ended. Compromised immune systems plus infectious disease, yep, this was probably already out of control. The next few weeks will be horrible.
I’m praying this doesn’t translate into higher death tolls and it might not. A compromised immune system is far more likely to contract an infection than a healthy one but what happens next depends on just how compromised that person’s immune system is. Folks that were vulnerable before the lockdowns – this is not going to be good for them. But folks who started out healthy may well be healthy enough to recover without serious complications. They probably wouldn’t have contracted the disease or if they did, have it be as severe as it will be post-lockdowns, but they are hopefully still well enough to fight off the worst of the disease.
The overall prevalence will be insane. It’s not that the Chinese people haven’t been exposed at all as some commenters keep saying but that they are much more vulnerable than they were before the lockdowns.
You know from your own experience. When you have just gotten over an illness, the last thing you want is to get near someone infectious with something else. As you’re recovering your immune system is a bit busy and you are far more susceptible than you would be when you are well. Same exact thing only add lots of malnourishment and cortisol levels through the roof. Little wonder the case numbers are exploding.
Quarantine sounds like a good idea but it’s not. Yes, we isolate really, really vulnerable people but preventing all exposure of everyone isn’t possible. The attempt subverts the natural systems that let species deal with infectious disease. Oddly enough, we NEED the healthy folks to be exposed. Their healthy immune systems will figure out how to handle that pathogen long before a guy with a test tube can even figure out which pathogen it is.
Even without intervention, those healthy people interfere with the spread simply by becoming immune. Slowing down the rate of spread lets others develop immunity as well while making it less likely that those who are vulnerable will be exposed. It’s the natural version of disease control – you probably know it as herd immunity. But if all the healthy people hide from exposure, the process of creating herd immunity is slowed down instead.
Yes, this probably also plays a role in what is happening in China. I seriously doubt that they have no herd immunity at all but they probably don’t have the levels they should by now.
Unfortunately, C19 isn’t prevented long term by vaccination. At best, vaccines are creating a temporary immunity. That means the vaccines won’t be hitting that grand slam we’d hoped for. It’s too late for China anyway. None of the vaccines work anywhere near fast enough to stop the epidemic China is experiencing.
What could? Truthfully, probably nothing now. HOWEVER, it may still be possible to blunt some of the spread. IF China does what everyone else should have done back in 2020 – TREATMENT. Treat as many as possible with whatever is most effective and safe for that person. If the doctors say it’s safe enough, treat even the healthy people who live or work with the sick. But either way, treat every person you can.
With what? Ask the doctors! They haven’t been idle this whole time – they’ve been censored in the public square here in the West but they haven’t been idle! THIS is what we rely on doctors for in disease control – let THEM figure out what to use and who to use it on and when. CDC writes it all up in a pretty chart and GO! Wanna help China? Send them treatment protocols and if necessary, the drugs!
Batting first: TREATMENT!
