Is it possible to live the epidemic differently?

Published in Expansión

Every July and August some 65,000 people die in Spain, of which approximately 20,000 die from cardiovascular diseases, 18,000 from cancer, 6,500 from respiratory diseases and 3,500 from diseases of the digestive system. Some 600 people commit suicide, 200 die in car accidents and a similar number drown on beaches or in swimming pools. Nobody talks about them, but instead each of 1,300 people estimated to have died this summer from Covid, almost all of them elderly or with concomitant pathologies, have been counted one by one by the media. According to these data, the case fatality rate on positives (CFR) would be 0.4%, so the infection fatality ratio (IFR), including undetected cases, may have been similar to that of a virulent flu. On the other hand, those hospitalized and admitted to ICU with Covid at the end of the summer were 90% less than at the peak, and although the increasing trend is worrying, the smooth growth curve has nothing to do with April’s. However, politicians have taken several extreme and rather extravagant measures in an atmosphere of collective paranoia. Why? Are they justified? Do they serve any purpose?

Politics has perverse incentive systems that often corrupt the decision-making process, so it is common for politicians not to be so concerned with solving a problem in light of the truth as with analyzing the risks of “what they might say” and identifying whom to blame if necessary (the well-known “blame game”). In this sense, many measures have the sole objective of making it easier for the politician to avoid the accusation of inaction and, if necessary, shift the blame to citizens, businesses or schools. Moreover, political power tends to despotism, that is, to “absolute authority unconstrained by laws, to the abuse of power or force,” so we are faced with very oppressive measures that violate fundamental rights.

This regulatory overactivity, feverish and impulsive, is linked to the panic created by the terror campaign of the media, unparalleled in Europe, which receives with joy the most eccentric measures. Perhaps they believe that it is necessary to “maintain the tension”, or just obey the slogans of political correctness or their own economic interests (sensationalism sells), or maybe it is just simple well-intentioned ignorance, but the damage begins to be irreparable. From time to time, this campaign of terror is peppered with alarmist statements by some doctors who, to the astonishment of colleagues who do their valuable job in silence, make statements that are contrary to scientific evidence or even logic that belong more to rumorology than to the Lancet, the BMJ or the NEJM. Nor do the inquisitorial communiqués of some medical associations help by threatening to burn at the stake any heretic doctor who questions these political measures, however unscientific they may be. Epidemiologists are a case apart: as their colleagues in other specialties know so well, if it were up to them they would lock us up for months in NBC suits in 47 million, negative pressure individual cells, only to realize that they have not left anyone out to feed the others.

But the real problem is that many of the brutal public health measures imposed in Spain, which seem to be aimed at reassuring (in vain) the most distressed, are not based on scientific evidence. Epidemiologically useless, they nevertheless provoke an unbreathable atmosphere that is destroying our country in the face of general impassivity. For example, although the evidence for and against the use of masks is weak[1], it is advisable to use them in closed, crowded and badly ventilated public places (where there may be contagions), but to force their use where it is extremely difficult or impossible to be infected (outdoors or alone in the street) is an unscientific farce unique in Europe (a fact that is unanimously silenced by the Spanish media) which, as is becoming clear, serves no purpose whatsoever except to create paranoia and destroy jobs. Non-medical masks are allowed for political reasons: the efficiency of their filters “is very low”[2], according to the ECDC (European Center for Disease Prevention and Control) itself; also, cotton masks may “be associated with a greater risk of penetration by microorganisms compared to not wearing a mask” and “incorrectly removing the mask could increase the risk of transmission”. Except for surgeons and some health care providers, no one wears a mask properly, so there you go. Another scientifically questionable measure (and, in my opinion, inhumane) is to force children and youngsters to wear masks eight hours a day. Aside from the physical, psychological and academic damage it can do to them, the mortality from Covid in children is virtually zero, lower than any flu, and transmission from children to adults is unusual[3]. In Sweden, where schools have not closed, there has not been a single death in a school population of nearly two million children. According to the ECDC, children are mostly infected at home[4] although they are rarely the first case in family clusters[5]. In addition, “available evidence suggests that transmission of SARS-CoV-2 among children in schools is uncommon, lower than that of influenza,” and there is “no greater risk to teachers in schools than there is in their homes or communities … since children are not primary causes of transmission to adults in schools”[6]. This is the evidence; the rest is (bad) politics.

We must demand that health measures be based on scientific evidence, not on the interest of politicians, that they be selective, not indiscriminate (local, not regional or national) and focused on protecting the elderly and the sick and not the majority of the population for whom Covid is a statistically mild disease. Finally, the health, social and economic consequences of every measure must be carefully analyzed, taking into account physical health but also mental health, Covid patients but also those with heart disease or cancer, with a global perspective and not with epidemiologist’s myopia.

Psychiatrist Viktor Frankl, a survivor of the concentration camps, recalled that in the camps an opportunity was offered on a daily basis to decide “whether one was going to submit and be a plaything of circumstances, renouncing freedom and dignity, or not”, and concluded: “Man can be deprived of everything except one thing, the last of human freedoms: the choice of one’s attitude in the face of a set of circumstances”.

We have had to live the circumstance of an epidemic and it is in our hands to decide how we are going to deal with it: with freedom and dignity or without them, with normality not exempt from logical prudence and responsibility (especially towards the elderly and the sick) or by getting obsessed and making the epidemic the center of our lives. The virus does not care and will wander around in any case (as is painfully obvious), but the consequences of taking one path or another will be very different. What example and what legacy do we want to leave our children? That of a generation that faced this unexpected ordeal with serenity, or that of a terrified generation that devastated its country unnecessarily? The question is certainly an uncomfortable one, but previous generations endured much harsher and more uncertain circumstances with wars, famine and the daily death of children and young people and did not hide in their den. Courage. We can live the epidemic differently, but how can we do it in the midst of political, eccentric and useless measures that help make collective hysteria chronic?

 

Fernando del Pino Calvo-Sotelo

www.fpcs.es

 

[1] https://www.telegraph.co.uk/news/2020/08/28/evidence-masks-not-strong-either-direction-says-deputy-chief/

[2]https://www.ecdc.europa.eu/sites/default/files/documents/Use%20of%20face%20masks%20in%20the%20community_ES.pdf

[3] https://www.wsj.com/articles/the-case-against-covid-tests-for-the-young-and-healthy-11599151722

[4] https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-schools-transmission-August%202020.pdf

[5] https://www.nature.com/articles/d41586-020-01354-0  and https://adc.bmj.com/content/archdischild/early/2020/08/06/archdischild-2020-319910.full.pdf

[6] https://www.ecdc.europa.eu/en/covid-19/latest-evidence/transmission

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