Thursday, April 30, 2020

Did I Already Have COVID-19?

Did I Already Have COVID-19? 


Did I Already Have COVID-19?

It is an increasingly common statement, in comments sections, in social media posts and from callers on talk radio programs, “I think I had COVID-19 back in [name your month].”  This is an important phenomenon for public policy.  If they believed the experts, if they trusted what their governments had told them, then would people make that statement?  Governments around the world saw COVID-19 start in early March and shuttered their economies, claiming it necessary to stop its spread.  To ponder if one had COVID-19 before March is to doubt that narrative, and that pondering is amplified by those who tested positive for COVID-19 antibodies. 
Is it a good idea to proclaim indefinite tyranny, such as Illinois’s Governor Pritzker has, when the narrative upon which that tyranny is based is taking on water?  Consider that some of those forums normally talk about hot loads, suppressors and double taps.  To those pondering, before cooking a goose, let’s make sure you’re not chasing a wild one.
These doubts have a strong foundation.  Data from sailing vessels showed COVID-19 infecting 13.8% to 19% of the population.  Terrestrial randomized serological testing shows that COVID-19 has already infected between 14% and 30% of the population, with an infection fatality rate (IFR) lower than influenza and in some studies, approaching that of common colds, 0.04%.  Moreover, the numbers mesh together, suggesting that somewhere around 80% of people are completely immune to COVID-19.  Not antibody immune, but zoonotic virus immune.  Wrong species.  COVID-19 is 96% genetically identical to a known SARS-like coronavirus collected from bats.
COVID-19 also has uncertain origins.  COVID-19 was first discovered in Wuhan, Hubei, China when a doctor familiar with SARS diagnosed a patient with SARS in mid-December.  The virus was genetically sequenced and confirmed as a SARS-like coronavirus originating in bats.  Other patients were soon identified and tested positive for SARS-CoV-2.  Consumed with the memory of SARS, the Chinese immediately assumed that it came from an intermediate animal sold in wet markets.  It helped that all of the known infected had connections to the Huanan Seafood Wholesale Market (HSWM).  The Chinese descended on the HSWM and shut it down, but the animals had been removed.  By the writing of the final report for the WHO-China Joint Mission on Coronavirus Disease 2019, not a single animal had been found to test.  There were plenty of surfaces to swab, and the Chinese found COVID-19 in several locations.
Firmly focused on SARS, the Chinese thought the problem was over.  SARS was only transmitted from animal to human and the animals were gone, but then more cases showed up.  The Chinese began tailing and isolating the infected, but cases appeared without any contact to the known infected.  Did COVID-19 travel through sewers?  By the writing of the WHO-China report in mid-February, the Chinese had no idea how COVID-19 was spreading.  Their zero-contact and extreme distancing policies were acts of desperation in an epidemic that made no sense.
In search of SARS, the Chinese ignored colds.  Their testing protocol only tested those with the most severe symptoms and contact with the HSWM or the known infected.   Real scientists would have tested all they could, to get a handle on the situation.  If there were 100 times more infections than they thought, and they were only looking at the worst of the worst, then the epidemic makes perfect sense.  It also pushes the start of the epidemic back.  The earliest confirmed case is now November, 17th, and if that was a community acquired infection, then COVID-19 was spreading around China in October.  By Christmas, every city in China, not just Wuhan, likely had tens of thousands of active infections.  The positive samples in the HSWM might not have been from infected animals, but infected humans.  The consumption of bats is not particularly prevalent in Wuhan, but it is in the south, around Hong Kong.  Wuhan might not even be the origin, just the place where it was first noticed, and the Chinese never knew it because they slapped on the blinders.
Because the owners of the HSWM were so obviously tipped off, we are unlikely to know for certain, unless the Chinese start widespread testing throughout China.
If China had millions of cases by Christmas, it was certainly spreading around the US by January.  As recently recognized by the CDC, the first COVID-19 deaths were in California, in early February, and likely acquired from communal infection in mid-January.  COVID-19 must have been spreading by early January.  If COVID-19 had infected even 10 people by January 1st, then nearly a third of Americans, 110 million people, could have had COVID-19 by the time we started distancing.
The dates of the first cases fit with the large numbers of infected people determined by serological testing.  Looking at graphs from Johns Hopkins, you see that around the world, COVID-19 grew linearly with time, not exponentially, as would be expected.  This is due to limited testing.  Once testing went beyond those with known contact to the known infected, testing capacity was exceeded, everywhere in the World.  If COVID-19 started in March, or even mid-February, that shouldn’t have happened.
But that could be wrong.
The CDC has added more cold-like symptoms to the list for COVID-19.  A reminder that the bug you had could have been something else.
COVID-19 is a bat virus, and with 80% of people completely immune, COVID-19 might spread far slower than we think.  Much of the above is based on a 5.8 day serial interval, but if COVID-19 has a serial interval of 10.0 days, cases are back down into the thousands.  With a very modest, undetected, asymptomatic population, it is possible for the interval to appear shorter than it actually is.
The serological tests could be in error.  There are many coronaviruses spread among humans and animals, and cross-species infections are known.  The coronaviruses have also been observed to produce serological cross-reactivity (antibodies to one coronavirus attack another).  Human natural antibodies (monoclonal antibodies normally present without a specific adaptation) can react to SARS-CoV-2, just as they do to SARS-CoV, yielding false positives.
While millions of unseen cases are a good explanation for mysterious transmission, COVID-19 can, as many coronaviruses, transfer via the fecal-oral and oral-oral routes.  The Chinese handwavingly dismissed these, but never completely discounted them.  Many viruses can transfer via these routes, noroviruses, the bane of many cruise ships, being a well-known example.  Many of the most serious diseases among pets and livestock are enteric coronaviruses transferred via saliva or feces.
The testing insufficiency is difficult to explain with a slowly spreading virus that infected few.  Most likely, COVID-19 got around well before distancing began.
Whether COVID-19 is a moderately spreading cold that infects many or a slowly spreading death that infects few, the extreme of “distancing” lacks justification.  Even if COVID-19 was a fast spreading death, the behavior of quasi-tyrants who restricted our lives and then flaunted their superiority was inexcusable.  At this point, people are realizing that COVID-19 was nothing like it was promoted to be, and continuing restrictions and sending out experts to tell them not to believe their lying eyes is just going to anger them.  Sometimes, you just have to eat crow.

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