• dennisformt

Where viruses and politics meet

Our home is in the midst of the worst pandemic in over a hundred years. When a discussion about epidemic response is on a political web page that is not generally a good thing. Given my background and current events, I feel compelled to speak on this issue.

Please diligently follow recommendations from the County and State public health resources.

Epidemics depend on the interactions of three principle actors: the agent (virus in this instance), the host (us), and the environment( our homes, businesses, etc.). The goals of epidemiology are to understand the characteristics and interactions of these three factors, identify the “weakest link” in the “change of causation” and then take action to break that link.

Many corona virus types circulate in the world, but this virus mutated in a way that promoted person to person spread by a respiratory route. Since humans have not experienced this virus before, we have little or no immunity. I have heard say that this "just like" the seasonal flu but it is not. We have some immunity to the seasonal flu both as individuals and as populations. So as bad as it is, it kills “only” one in thousand that it infects and only infects a small portion of the population each year. Theoretically, this corona virus could infect the entire human population although this seems unlikely. I have heard said that this virus will kill ten in a thousand people infected but in the countries with more advanced epidemics then ours it is killing forty to ninety of every thousand it infects. Since we don’t know how this may play out, we must engage in a maximum response.

What is a maximum response?

We must act on what we know. 1) Social distancing seems to be effective in stopping disease transmission. 2) Modern medical care can reduce the death rate of those infected but does not stop the epidemic. 3) In communities with sporadic cases, aggressive testing, contact tracing, and isolation of infected individuals reduces the epidemic.

We must gain more knowledge and rely less on opinion.

Understanding the molecular and biologic characteristics of the virus are essential but not sufficient to break the epidemic - you need to also understand host and environment issues.

We need to understand host response to the virus ASAP. If you are infected but not sick, how much of the virus can you transmit? During the incubation period, the virus multiplies exponentially so it may be detectable for several days but in insufficient quantities to transmit to others until illness begins. If we understand this we can change our social distancing recommendations. If you have been infected and recovered, are you immune? This is of immense importance on returning to normal activities and how the epidemic may progress.

People hope and pray for a vaccine or a treatment to help. Vaccines change the host and are often very beneficial but many epidemics have been stopped without vaccines. Treatment does not stop the epidemic and as the old saying goes “prevention is worth a pound of cure”.

Understanding and acting on these and other questions is really the only way we can save potentially millions of people and potentially trillions of dollars. Guessing, hoping, etc will not solve the problem.

We need to hear from our leaders what they are doing to answer these and a myriad of other questions. If we do not, we need new leaders.

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