Email followup about COVID-19

Good morning, Friend#6

Here is your morning musical interlude: 

First another Vienna Teng song, showcasing amazing technological prowess, with an introduction that we geeks-turned-activists can readily appreciate: 

Vienna Teng In Concert: Whatever You Want (w/intro):  https://www.youtube.com/watch?v=m4wzzLkwAog

And then a live Arlo Guthrie performance (You know perfectly well what’s coming, so I don’t have to warn you!): 

Arlo Guthrie – The Garden Song – 1987: https://www.youtube.com/watch?v=9QTj45cTB4U

There’s another thing I forgot to mention in my comments about your video advising low-risk populations how to manage the coronavirus pandemic. It’s based on this really brilliant article by Tomas Pueyo: “Coronavirus: Why You Must Act Now”: 

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

  • It’s not enough just for high-risk groups to practice social distancing. 
  • Even though younger people aren’t at as much risk, even their mortality is about 40 times higher if supportive medical care has to be rationed. 
  • Healthcare providers on the front lines are also especially vulnerable under rationing conditions, especially now, when personal protective equipment is scarce and can’t be discarded after every use. Exhausted healthcare providers cannot give the best care, thereby exacerbating the deleterious effects of rationing. 
  • Against the crush of exponential growth of a deadly disease, we can’t get behind the curve. Once the peak becomes obvious, it’s too late, and lots of people will have died. 
  • The nations that are doing worst in this epidemic — the United States, Russia, Brazil, and the United Kingdom — all have Trump-like leaders (Trump, Putin, Bolsanaro, and Johnson) who characteristically deny reality, sow divisions, and underemphasize planning. 
  • We should have stockpiled massive amounts of needed equipment and practiced a synchronized nationwide lockdown to “hammer down” the virus. We can start over with such an approach if people insist on it: “If the people lead, the leaders will follow.” 
  • Deaths will have much more impact on the economy than lost revenues. The loss of the expertise of irreplaceable people, especially healthcare providers, will create shortages and all sorts of “cultural amnesia”. 
  • Education might suffer by loss of face-to-face contact with teachers and other students, but then again, might benefit from creative development of new technologies that allow everybody access to really great teachers. 
  • I think, at a critical juncture in human history, God is showing us that virus-like leaders are worse than viral pandemics. Over most of history, pandemics inspired fear of God. God has put in power a cohort of dictators who show no such respect even in the face of nature’s most fearsome force — deadly pandemic disease — to humble them and all those who have empowered and followed them. 
  • I also think this course of events is a message that those in whom God has invested a lifetime of cultural interactions have more value to Him than the theoretical lives of unborn babies, for whom a manufactured theological doctrine has empowered dictator wannabes and undermined democracies throughout the world. What this pandemic could do, if we are not careful, is simulate the cruel practice of slaughtering elephant herds and leaving the surviving calves in confusion and grief to grow up as psychotic rogues. 

I thought you implied in your remarks that some people are trying to bully our country into a kind of sustained lockdown. I think, until we fully get our act together, it’s wise to put the economy into a kind of “medically-induced coma” so it can come out on the other side of our preparation with good medical results, the fewest possible deaths, and an intact world community. 

This discussion doesn’t consider what’s going to happen in developing countries. It’s so tragic that we prepared so badly for ourselves and cannot exert leadership helping them. International relationships after this pandemic are going to be far less favorable to our position, especially because developing nations will attain herd immunity the hard way, long before we do. We should be prepared to counter their anger at us by providing technological assistance, e.g., inexpensive “Raspberry Pi” computers for every person on earth, so they can pull the whole international community of this economic depression. The days of denying global dependency are over, contradicted by pandemic, global economic decline, and a thorough retrospective critique of Trump’s folly after his administration has safely crashed and burned. 

Ultimately, we can purge coronavirus from the human population by ending our encroachments that spawn zoonotic diseases, vaccination, and global synchronized lockdowns. We have to be patient, recognize what we’re up against, and ultimately preserve our values, not our carefree but now obsolete routines. 

Stay well and safe, 

Ray G

2020|5|20   continued — Friend#6’s response

From: Friend#6

Subject: Re: important points I forgot to make

How bout some push pull.  On a few items.

I’ll use //// for my thoughts since i don’t do fonts well.

There’s another thing I forgot to mention in my comments about your video advising low-risk populations how to manage the coronavirus pandemic. It’s based on this really brilliant article by Tomas Pueyo: “Coronavirus: Why You Must Act Now”:

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

·       It’s not enough just for high-risk groups to practice social distancing. 

//// high risk groups in my care have to do absolute avoidance , way more than social distancing . I had to get the national guard into my ALF when the HD balked , after a thoughtless hospitalist d/c a pt with pending viral status . I was not willing to wait 1 day.  Compare to some states gov’s who forced known infected pts into Sr living. Accounting for half the deaths. 

·       Even though younger people aren’t at as much risk, even their mortality is about 40 times higher if supportive medical care has to be rationed. 

//// I just have not seen this in practice

·       Healthcare providers on the front lines are also especially vulnerable under rationing conditions, especially now, when personal protective equipment is scarce and can’t be discarded after every use. Exhausted healthcare providers cannot give the best care, thereby exacerbating the deleterious effects of rationing. 

//// agree , but in an early antibody screen in NYC , county residents had 16% + rate, of them health care workers had 6%+ . Indicating nurses and Drs understand how to defend better, or social distancing in practice fails, or both. 

·       Against the crush of exponential growth of a deadly disease, we can’t get behind the curve. Once the peak becomes obvious, it’s too late, and lots of people will have died. 

·       The nations that are doing worst in this epidemic — the United States, Russia, Brazil, and the United Kingdom — all have Trump-like leaders (Trump, Putin, Bolsanaro, and Johnson) who characteristically deny reality, sow divisions, and underemphasize planning. 

//// take out the Sr living deaths , USA has very good numbers. 

·       We should have stockpiled massive amounts of needed equipment and practiced a synchronized nationwide lockdown to “hammer down” the virus. We can start over with such an approach if people insist on it: “If the people lead, the leaders will follow.” 

//// agree and Bush , gave a speech recommending , neither he nor Obama prepared for.  And this is not that hard. GT IE is the top ranked program in the world and made a name for itself on just in time inventory . I’m impressed current task force stepped up to muster those methods.  

·       Deaths will have much more impact on the economy than lost revenues. The loss of the expertise of irreplaceable people, especially healthcare providers, will create shortages and all sorts of “cultural amnesia”. 

//// we disagree , respectfully . I have to consider all treatment side effects, including economic when I write an Rx. If the pt can’t afford it , they will not Benifit , if they try and it bankrupts them I have lost the pt. Their are superior  drugs my pts can not afford . I am on 2 such. I have 7 stints and an ablation , glad I can afford , and angry my ins co , does all it can to NOT pay.

·       Education might suffer by loss of face-to-face contact with teachers and other students, but then again, might benefit from creative development of new technologies that allow everybody access to really great teachers. 

//// agree , and this is to the risk of those colleges teaching underwater basket weaving and grievance studies. We as a country need to weed out these extended summer camps with their massive indebtedness and useless degrees. We are a bit biased having gone to a serious Institute . Did you know 10 years ago Forbes business , did a study of graduate earnings and GT was the #1 of all universities for future earnings / cost of degree. 

·       I think, at a critical juncture in human history, God is showing us that virus-like leaders are worse than viral pandemics. Over most of history, pandemics inspired fear of God. God has put in power a cohort of dictators who show no such respect even in the face of nature’s most fearsome force — deadly pandemic disease — to humble them and all those who have empowered and followed them. 

//// I agree , and rethought after your last email. I should not consider an act of nature as evil. If one steps off a cliff , gravity will have its way. I should reflect more on how the “church” of believers can find communion and worship in the natural world , as more dangers arrive. I remind my pts we live on a beautiful but deadly planet . I see my job as more how to help them navigate danger. 

·       I also think this course of events is a message that those whom God has invested a lifetime of cultural interactions have more value to Him than the theoretical lives of unborn babies, for whom a manufactured theological doctrine has empowered dictator wannabes and undermined democracies throughout the world. What this pandemic could do, if we are not careful, is simulate the cruel practice of slaughtering elephant herds and leaving the surviving calves in confusion and grief to grow up as psychotic rogues. 

I thought you implied in your remarks that some people are trying to bully our country into a kind of sustained lockdown. I think, until we fully get our act together, it’s wise to put the economy into a kind of “medically-induced coma” so it can come out on the other side of our preparation with good medical results, the fewest possible deaths, and an intact world community. 

//// I’m seeing increase calls to suicide hot lines, delayed diagnosis of Ca, unmanaged diabetes …. these effects will take a year to , look back on.

This discussion doesn’t consider what’s going to happen in developing countries. It’s so tragic that we prepared so badly for ourselves and cannot exert leadership helping them. International relationships after this pandemic are going to be far less favorable to our position, especially because developing nations will attain herd immunity the hard way, long before we do. We should be prepared to counter their anger at us by providing technological assistance, e.g., inexpensive “Raspberry Pi” computers for every person on earth, so they can pull the whole international community of this economic depression. The days of denying global dependency are over, contradicted by pandemic, global economic decline, and a thorough retrospective critique of Trump’s folly after his administration has safely crashed and burned. 

//// one thing Trump has done is crush the notion of relying on a country founded on Communism . I was lulled into thinking  they would grow out of that unfree state with time. Now I see a hundred thousand chinise  students a year here , have no chance to change dictators ruling over a billion souls. And I have no heart with our trillions of debt. Going on as the worlds policeman. 

Ultimately, we can purge coronavirus from the human population by ending our encroachments that spawn zoonotic diseases, vaccination, and global synchronized lockdowns. We have to be patient, recognize what we’re up against, and ultimately preserve our values, not our carefree but now obsolete routines.

Stay well and safe, 

//// you two. And let your brethren breath free. 

Ray G

From: Ray Gangarosa

Hi again, Friend#6

Good comments. I see you points and agree, at least in part, with some, maybe even all of them. We don’t need to go back and forth debating these issues. But you understand, Don’t you, that my remarks are directed primarily to protect physicians like you who, unlike me, are working on the front lines? 

And, as I said in the previous response, if we keep raising animals for meat on a massive scale in squalid factory farms, if Africans keep eating monkeys, and if Chinese keep eating bats and civets and pangolins (or whatever else), then it’s just a matter of time before some completely unmanageable RNA virus comes to get us, economic depression, mental depression, suicide hot lines, and all. 

COVID-19 was a merciful shot across our bow. God is telling us, by signaling through nature’s tools, that we’re the ones acting like a virus, technology can’t protect us from natural selection pressures, and if we don’t start behaving like a good citizen in the biosphere, He — and ever more virulent RNA viruses — will cull our ranks to a size the planet can manage. And that process, of intensifying pandemic diseases, would wreak havoc with human culture, society, and civilization, turning us even more tribalistically against each other. 

You have been doing the right thing all your adult life with your vegetarian diet, and I’ve always admired you for that. What concerns me is that you’re sending a message to those who are healthy that puts your own life at risk, because they will interpret that to mean, “It won’t affect me or the pandemic if I go back to (nearly) normal”. People will naturally let precautions slip, as you noted about advice not to touch your face. 

It’s interesting that you used the term “push-pull”, because if a “push” of relieved “low risk people” become a crush of an unmanageable outbreak that swamps rural Georgia clinics and hospitals, the virus will exert a “pull” that will first take the elderly patients through rationing, who can no longer be protected. And then it will come for the healthcare providers. 

Pandemics are a force of nature. Throughout history, they’ve been rightly feared. We don’t yet have that fear, even though we know this virus is comparable to the 1918 pathogen that spawned one of the worst pandemics in history. Our technologies are not protective. We have epidemiological tools that work well, but we’re not using them. Instead some people are disseminating really dangerous conspiracy theories.

And your life, my good lifelong friend, is at as much risk as anybody’s. One patient’s cough or sneeze, even through a mask, could end your life in a week or so, if — or should I say when? — a crush of COVID patients hits your corner of Georgia. 

Pandemics are a force of nature, and historically, people who lived through them found that out too late, with deep regret. What we think early, before the virus adapts to local conditions and hits in force, will tend to lull us into complacency. By the time exponential growth and doubling times of 2-3 days hits, those on the front lines will be overwhelmed and everyone will be filled with regret, but the virus will keep on coming until we change our behavior. And this virus, or one that follows, will get worse. Lacking any genetic machinery for error checking its own genome, it mutates on a daily schedule. 

As an epidemiologist who has studied these things in great detail, I can say with considerable authority that our anthropocentrism is a danger to us, especially now, in the midst of a pandemic. Cultures that did really well in purging the virus from island nations were like Taiwan, who had experience with SARS, didn’t trust the Chinese, and had cultural and economic barriers in place; and New Zealand, which has a truly enlightened female president who was willing to take on the small synchronized lockdown for enough incubation periods required to purge the virus from all their residents at the outset before many deaths occurred. 

You don’t have to respond again; I’ve said everything I need to unless conditions change. My longtime friend, Friend#3, reinforced the positions I already had as an epidemiologist. Tomorrow I’ll send another article by Tomas Pueyo that Friend#3 recommended (which I already had), entitled “The hammer and the dance”, which outlines, practically and thoroughly, how to manage pandemics, even those that might be more intractable than coronavirus currently is. Pueyo is a young engineer who has made himself an expert on epidemiology through conscientious self-study. [In the Dr. Lassie Adventures, my own alter ego makes a cameo appearance as the author of the self-help book, “How to finally quit always trying to keep improving yourself all the damn time!!!!!!!”] Whatever your viewpoint is on this pandemic, I think you’ll find Pueyo’s article (if not my unwritten book!) useful, instructive, and well-written. 

Of course, I’d welcome further responses to that article, but you’re off the hook to convince me that I‘ve influenced your opinions. Unless your response to that article compels me to respond again, I’d be happy to let you have the last word and leave it at that. I’m not trying to nag, just to warn. Just think about what I’ve said. 

Starting tomorrow, I’ll go back to my blogs. I hope to cover the mathematics of life. I think you’ll like that! 

By the way, Arlo Guthrie reminds me of you, especially in his audience participation mode. Any comments about the songs I’ve sent? As you can see from the numbers of views, those are very rare performances! 

Your (concerned) friend,

Ray

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