Covid-19 Coronavirus Outbreak: Is the United States Government Covering Up the Spread of the Disease?
Edit: Thanks for all the responses I’ve already gotten with this piece. Find a quick FAQ regarding risks and common misconceptions here, and the WHO’s report on the virus here.
Recently making the rounds online, an article from the CDC website entitled “Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease 2019 (COVID-19)” is upsetting healthcare workers everywhere. The simple explanation: “They’re throwing doctors and nurses under the bus.”
The fact of the matter is that the coronavirus is about half again as deadly as the most recent plague on the books by current estimates (about 3.4% mortality as opposed to 2.5% mortality associated with the Spanish Flu of 1918) and doctors and nurses are among the highest-risk populations in the US, as the patients who will soon be flooding into the hospitals and doctors’ offices of this nation will expose each and every one of them to a variety of hostile pathogens, including multiple strains of the rapidly mutating coronavirus.
To understand how unbelievably stupid it is to allow healthcare workers to go to work sick if they choose to and to remove basic protections from the recommendations such as masks (or to recommend basic dust masks, which won’t work the same as an N95), which seems downright criminal once you’ve got a grasp of just why this disease is so terrifying, let’s think through the situation from the beginning. If we take into account the various strains of Covid-19, the question isn’t simply how quickly the virus will spread, but rather what we can do to keep different strains from spreading through populations of people we love.
It is not the goal of this piece to be overwrought or alarmist. Some of the pieces I have seen on Medium accuse the government of covering up the disease (or at least masking its severity) outright. Frankly, the authors of these pieces have a point. We need to consider the present situation, in which the nation is being exposed to a once-in-a-century level emergency under the management of a corrupt government in which reality must be brought into line with the expectations of the President, and not the other way around.
An Alarming Failure of the United States Government in the Making
There have been myriad gaffes during the Trump presidency, but I’ll refrain from using the sort of coarse language which so suits my emotional response to the situation. Instead, I will offer an explanation of certain current states of affairs which will attempt to shine some light on the situation and what we, the people, can do about it — as it is clear that our government is unlikely to be of much assistance, whether by design or by accident.
The tenure of Donald Trump as the forty-fifth President of the USA has been marred by countless scandals and continuous farces. Advisors have come and gone rapidly, and entire government departments have seen dramatic funding cuts as well as a certain reluctance to replace anyone who leaves (voluntarily or otherwise). This article is not the place to re-hash these events, or to debate the fact of rampant corruption in the US government. In 2018, the Trump administration fired the U.S. Pandemic Response Team, which did a number of things that would have helped ensure that the nation was organized and prepared to do things like develop testing kits that worked properly and ensure that proper protocols were observed in patient care facilities around the country (i.e., the article which opened this piece would have a lot more substance to it and involve a lot more resolve to protect healthcare workers).
However, among the qualified professionals who were willing to speak out against the shortsightedness of the administration, few remain in government posts. Instead, the President has willfully surrounded himself with loyal followers who are willing to do what he says, which is why guidance memos from the CDC are suddenly a hotbed of political controversy.
Can We Still Trust the CDC?
Reddit and Twitter are full of rants against the CDC’s (mis)handling of the present situation, which has been caused by an overabundance of yes-men and too few strong souls willing to face the consequences of standing up to the injustice of the Trump administration. These oft-times dramatic interpretations of events range from speculative to downright nonsensical, but each one carries in it a kernel of the truth, which is that people are very upset about the situation we suddenly find ourselves in.
I’ve been actively observing the progress of the Covid-19 Coronavirus for about seven weeks at this point. I’ve gone from hoping it would blow over to hoping that the mortality rate was miscalculated to thinking the virus is probably everywhere.
The scariest part of the epidemic is not the flu-like symptoms or the severe immune response which eventually accompanies death in all too many cases of Covid-19. Instead, doctors are losing their wits because they see a very high level of risk entering the workplace they inhabit. Before I enumerate the specific virology that could make Covid-19 the deadliest disease facing humanity at present, I’ll save the less technically-inclined among us a bit of legwork: The government has no idea how to mobilize to handle this problem. It’s one of the most severe threats we’ve ever see in infectious disease and neither the money nor the people to deal with it in time to prevent a major catastrophe seem forthcoming.
In a previous article, I explained why the slow initial response from the U.S. Government was problematic (cliff notes: the disease spreads very rapidly, and can spread before symptoms appear. This means all of our estimates regarding the number of cases are probably very, very low, even if you don’t take into account the argument I explain in the second half of this piece.) and gave a few suggestions as to how to help minimize your chances of contracting a severe case yourself.
The alarming fact of the matter, however, is that multiple infections in the same person are being reported. Also problematic, a new strain of Covid-19 has already been found. Multiple strains at the same time would explain the troubling “cytokine storm” observed in early reports — the body wouldn’t be able to produce enough antibodies to defeat two (or more!) different severe infections at once without collapsing its own circulatory system.
The core problematic here, if you’re in the CDC’s position, is that you have far too small of a budget and far too few people to effectively address the crisis. So you downplay it, tell the politicians what they want to hear, and do what you’re told, hoping for the best. If you don’t cause a nationwide panic, everyone will be more or less able to deal with the disease on their own terms.
The unfortunate fact of the matter here is that the United States was caught off-guard by the disease and will now be forced to pay the consequences. Nobody will be more affected than the medical doctors and staff who will deal with the patients. In my view, the CDC has behaved more or less honestly and rationally in the situation, but the message they’re overwhelmingly sending to everyone paying any sort of attention is that we’re on our own in dealing with this thing.
At the end of the day, incompetence and dishonesty yield precisely the same sort of situation for the rest of us to deal with, which may in fact be quite bad. I’ll now turn to the virus and the scenarios doctors and nurses throughout the world are likely mulling over right now.
Why is the Virus so Deadly?
Chinese doctor Li Wenliang was killed by the coronavirus after receiving reprimands from the Chinese government for attempting to sound the alarm. The doctor was in his mid-30’s and by all accounts appeared to be in good health, and yet he died of Covid-19 only a few weeks after being exposed to it and becoming one of the first people to recognize the threat it represented. In general, it is uncommon for a flu to kill a healthy, young person with the knowledge and personal hygiene of a doctor. As you will quickly see, Covid-19 is far, far worse than a flu, despite the commonalities the two diseases share.
Covid-19 is not bioengineered, but it does share one common feature with AIDS: rapid, rapid mutation. In fact, as stated above, researchers have now identified a mutated version of the disease. This level of speed in mutation is the single most dangerous attribute of the disease — it could lead to multiple, varied infections (and has), and it could also lead to seasonal recurrences (as we see with the flu).
Let’s run through two quick scenarios to really get through the logic here so everybody can understand what they’re up against.
- A doctor sees dozens of patients per day. Each patient has the potential to be infected not only with the Covid-19 strain that is currently famous, but also every other permutation of the disease in his or her area. Any one version of the disease is likely to be quite unpleasant, but if the information slowly leaking through the grapevine is to be believed, you can catch more than one variety. Only this level of deadliness could explain the response deemed necessary by the Chinese government (which seems to have been reasonably effective, as evidenced by the decline in new cases, assuming honest reporting).
Our hypothetical hospital staff will be comprised mainly of fit, healthy people with good hygiene — people who see most of the diseases that come through their towns, and in general are not terribly susceptible to them. However, they do get sick from time to time, and a disease as virulent as Covid-19 is likely to be one of the ones people will pick up. An entirely plausible scenario is that the same honorable public servant will be exposed to at least two different strains of Covid-19 coronavirus variants during the normal 14–30 day incubation period.
In perhaps Li Wenliang’s case and other fatalities involving healthy adults, the first variant of the virus will onset and the host becomes ill. Cytokines (chemical signaling proteins) will be released from affected cells, calling for immune system attention and triggering the symptoms we experience as illness. The body has a certain capacity for dealing with this sort of situation: fevers, chills, thirst, and the lymphocyte-mediated immune response are each responsible for a different part of this response.
The crummy feeling of being sick (aches and pains, even nausea and diarrhea) is caused by the various components of the blood all beginning to stick together. Caused by the excessive number of proteins (cytokines, among others) in circulation, a state known as hypercoagulability develops in the blood and fairly soon our even, viscous liquid is separating out into chunks and plasma.
The biophysics can get rather tedious, but suffice it to say that the endothelial glycocalyx which lines the insides of all blood vessels and is structurally similar to the extracellular matrix that holds our cells together ends up being degraded. This is bad because the glycocalyx layer helps our cells feed themselves, get rid of waste, and it takes awhile to grow back.
All of these conditions add up to feeling bad, but the reason why it feels bad is what’s important here. Oxygen and nutrients no longer flow freely throughout the body in this ill state. Waste does not leave the area it is created in. Organ failures ensure, then death via heart attack, stroke, or pulmonary embolism.
Now, in this damaged and depleted state, even a healthy body has its hands full. If another pathogen for which no antibodies had yet been developed were to suddenly appear, it could pretty well wreak havoc among the damaged and starving cells left in the body. So if you’re a healthcare worker and you end up being exposed to two or three of these things during a single busy shift two or three weeks ago and you fall ill, then get sent home from work, there is an excellent chance you’ll end up back at the hospital on your own ventilator — if you’re lucky.
Let me make it absolutely clear: doctors aren’t afraid of one Covid-19. It’s the variety of different infections that is likely driving the body count. Even relatively minor variations could keep the body’s natural defenses from being able to effectively halt the spread of the virus. Keep in mind that infected, unmasked healthcare workers could effectively spread the disease back into the patient population as well, and you’ve ultimately got a perfect storm ready to go.
- In China, the government acted swiftly and on a massive scale to keep people from being around each other.
Now, the Chinese being the circumspect bastards that they are, we haven’t heard much justification for this unusual behavior. Videos of the authorities welding people into their homes made the rounds, and the Reddit page for Covid-19 is still full of outrageous eyewitness accounts of various terrifying goings-on.
Yet, cases reported seem to be going down. In the case of Wuhan in particular, there was a sudden and massive flare-up and subsequent government crackdown, but the death rate seems to be lower than in countries such as Iran, where the entire government seems to have been infected depending upon which news source you read. China is even working to restrict travel back home from places around the globe where Chinese citizens have been, in the cases where local flare-ups in places such as Iran have the potential to infect returning travelers.
One seemingly-plausible explanation for this state of affairs is that the Iranians didn’t know they were infected until they had all been incubating the virus for weeks — if it is mutating as rapidly as it seems to be, we have a possible explanation for why they’re all so ill as to be increasing the mortality rate of the disease at the global scale: they all incubated different versions for weeks and then passed it around to one another, and each of them has the main pathogen, true, but if the disease is capable of rapidly mutating into slightly different forms (follow mutation research here), it’d take a lab team in every house in the world to keep up with all of the various permutations that will appear.
Seven versions are currently being tracked, but I am not virologist enough to know 1) how many there are likely to be in each geographic region or 2) which changes affect the body’s natural defenses enough to team up against an unfortunate host. I do know that no one’s immune system is likely to be up to the task of addressing multiple severe infections at once, and if the general family of variants have much at all in common we would expect them to target the same areas of the body, again causing an overload of natural defenses.
Now, when I first heard about the government’s behavior in China, I assumed that Xi Jinping was simply using the Covid-19 outbreak as an opportunity to exercise his government’s emergency machinery as a way of dealing with some of the political opposition he has faced from protesters in Hong Kong and Taiwan. However, if political skullduggery is not what is animating the Chinese state and instead it has calculated that the best way to prevent the spread of N mutated forms of the disease is to keep people away from each other to whatever extent that is possible, then the rest of the world needs to get a move on and figure out how best to make effective quarantines before things get further out of hand.
There are no sure things here, yet. However, it is very easy to miss a detail you’re not looking for. The ELISA kits used to test for the virus look for a specific pattern on its surface, which, if the virus is mutating rapidly, could change. For all we know, a substantial portion of the population known to be infected with Covid-19 could have been infected with multiple strains at the same time.
I might even go so far as to hypothesize that the massive disparity in the severity of the disease from person to person is related to the mutations, and not the simple infectious properties of one virus or the other. However, even if I did speculate that this were the case, I would have little evidence to prove the assertion — and I must confess that the evidence seems to point to successful tracking of many varieties of the virus; in a perfect world, this would mean that cross-strain infections would be in all over the media and we should thus be able to infer from their absence that this was not the case.
However, information about Covid-19 has not flowed freely and this has left almost everyone paying attention with a very bad feeling and a general propensity to distrust everyone from the Chinese government to the CDC to the WHO. Keep in mind, I’m simply explaining the possibilities going through the heads of the people who will soon be tasked with treating cases of Covid-19 both domestically and abroad. I hope, as we all should, that this inference-from-ignorance is soon proven incorrect and instead of a mutating super-chimaera all we have to deal with is a particularly successful virus that does not behave too terribly differently from other viruses.
The most pressing issue of the day regarding Covid-19 is learning everything we possibly can about the disease. Researchers around the world are working around the clock to put the brakes on this pandemic, but authoritarian governments are slow and prone to failure during any sort of extenuating circumstance. The world’s political scene’s rightward slide has hamstrung a variety of different countermeasures which, had they been implemented properly, may have helped to slow or even stop the spread of the disease.
All’s Well That Ends Well
I began the piece here with the disclaimer that it was not meant to be overwrought or alarmist, and then proceeded to lay out two terrifying worst-case scenarios which we currently lack the information to confirm or deny. I apologize if you’re scared after reading that, but I believe it is important to get the word out about just how deadly this disease could potentially be, if we aren’t careful, starting right now.
It may turn out that the mutations are slower than this article might lead you to expect. If that is the case, please accept my apology in advance. As stated above, I am doing the best I can with limited information. I feel empathy toward the healthcare workers who are still going to work even though they understand the potential gravity of the situation, and I also feel empathy for their comrades in the CDC, working with limited resources to figure out what triggered the massive Chinese response to Covid-19 and do whatever the right thing to do about it happens to be.
However, it is imperative that the population of the United States is as prepared as possible to face the Covid-19 outbreak, and unfortunately, there is so much misinformation and speculation that it is very difficult to develop an accurate view of the situation. As more outbreaks crop up near you and me, it is difficult to predict what will happen next. Feel free to follow mutation research here, and by all means WASH YOUR HANDS (here is a tutorial about how to do it like a microbiologist) and avoid crowds if you can.
The government response has not only been lackluster, but, thanks to an incompetent executive branch, also downright dishonest. The current President has called Covid-19 a “liberal hoax” which ostensibly exists only to expedite his removal from office. From the CDC’s apparent resignation to defeat to the complete and utter failure of the US to implement even the most basic testing regimen even many weeks after the first signs that a pandemic was afoot, the vast majority of American citizens seem to have essentially no idea what is coming their way and unfortunately they have elected a leader who has managed to underperform time after time when they needed him.
As California escalates its response by declaring a state-wide state of emergency along with Washington and Florida, more and more hospital webpages will put up disclaimers to discourage the deluge of hypochondriacs that a threat of this magnitude can bring.
Everyone should be hoping for the best and planning for the worst. Don’t hoard all of the food or gas. Don’t go out as much. Save some money, keep an eye on the news (preferably from multiple sources), and do everything in your power to prevent yourself from becoming infected with this disease. Again, I wrote a different article that has a few helpful tips in it — check it out here.
Edit: Please see the WHO’s full report here. I want to stress that this article is about the need to test for Covid-19 and protect healthcare workers from a potentially terrible threat about which, little is known at present. From the WHO Report:
“For countries with imported cases and/or outbreaks of COVID-19
- Immediately activate the highest level of national Response Management protocols to ensure the all-of-government and all-of-society approach needed to contain COVID-19 with non-pharmaceutical public health measures;
- Prioritize active, exhaustive case finding and immediate testing and isolation, painstaking contact tracing and rigorous quarantine of close contacts;
- Fully educate the general public on the seriousness of COVID-19 and their role in preventing its spread;
- Immediately expand surveillance to detect COVID-19 transmission chains, by testing all patients with atypical pneumonias, conducting screening in some patients with upper respiratory illnesses and/or recent COVID-19 exposure, and adding testing for the COVID-19 virus to existing surveillance systems (e.g. systems for influenza-like-illness and SARI); and 22
- Conduct multi-sector scenario planning and simulations for the deployment of even more stringent measures to interrupt transmission chains as needed (e.g. the suspension of large-scale gatherings and the closure of schools and workplaces).”
In my next article, I’ll explain a few insights I’ve picked up over the years that may help you prepare your body for a fight. I’ll explain where to find certain molecules, why these compounds are likely to be beneficial, and kick along the latest. Stay safe, stay healthy, and think for yourself. Don’t get wrapped up in worry, but spend a few minutes thinking about ways to prepare yourself, your community, and your loved ones for all of the fallout that may be headed your way. Ideally, things could still blow over. The math could be wrong, or the virus could mutate into a less-deadly form. But be prepared in case the experts are exactly right and a pandemic is getting ready to roll through your city or town.
Second Revision: The purpose of this article is to explain the various different concerning aspects of the state of the information economy and the unknown quantities facing healthcare workers as a result of either closed lips or incompetence. This is no small cause for concern, and while it is entirely likely that containment measures could still succeed, the takeaway that this article is intended to facilitate is that we need to continue to increase our dedication to resource availability, testing, and monitoring as we continue to respond to this situation. An overreaction can be problematic, just as an insufficient reaction can — the question I intend to attempt to discuss is, as a layperson, how do I make sense of the flurry of news articles and, beyond that, how can I best prepare myself, given the potential severity of Covid-19. I am, of course, happy to see any links or read any comments anyone has after reading this article, and I intend to continue writing as events continue to unfold. Thank you.