CR is due to speak again soon- I had heard it was planned to be this evening, but I haven't had confirmation yet- about the level 3 lockdown restrictions and freedoms. I can't help thinking back to his last speech, for which we all waited with eager anticipation, only to be left feeling moderately deflated and disappointed (even angry in some cases). To be honest, I felt incredibly sorry for the guy. There's not a chance in hell that I'd ever want his job because the truth is, whatever he does and whatever decisions he makes, he will be criticised. The other truth is that there is no right answer. So basically the poor guy is doomed to be vilified. If he had not made the decision to impose lockdown, he would be hated for all the deaths that would inevitably be overwhelming our hospitals. Having made the decision to lock the economy down, he is hated for the economic implications that have resulted from that decision. It is very easy to judge him in hindsight. The retroscope is a wonderful instrument that gives us many of the answers. Unfortunately it's also an imaginary instrument. Not a single person can presume to know what the reality of the situation would have been without the insight of hindsight and even then, the view is relatively murky. It really irritates me- actually, let me not sugar-coat things here- it completely pisses me off when people presume that because they have read three articles on epidemiology the equivalent of a degree in epidemiology has magically been conferred upon them. The same principle applies for people who watch a few YouTube videos on COVID and suddenly think that they are experts in virology. Seriously? Don't start your Facebook post with 'I've read up a lot about this'. Have you read up four year's worth (at a minimum) of detailed and objectively written research on your preferred topic? Have you read the opposing views and research, or just those articles that support your views? Be honest in your answer. Also, since I'm having a rant, can I just throw it out there that the correct terminology is 'herd immunity' (as in a herd of animals), not 'heard immunity' (as in the past tense of hear).
Here is a comprehensive list of what I know about the COVID-19 virus and the epidemiology of the pandemic:
1) Nothing
2) Zilch
3) Nada
4)Zero
5)F**k all
That's it. I have a medical degree, but (or maybe because I do) I would not presume to know all the properties of the the novel coronavirus and I definitely would never have the arrogance to make broad statements about what the correct way to be managing the pandemic situation would be.
The truth is that we, the medical community, know very little about the novel coronavirus. This is a hard thing to acknowledge, on a personal level and on a global level. We are still learning about the various ways that the virus presents; we are gathering information, more and more each day, about how it is transmitted and what the course of the disease looks like; we are unsure why it affects some people in one way and others in another way; we are scrambling for ways to best manage, prevent and treat the infection. We do not have all the answers and that is difficult. It's difficult for doctors and it's difficult for those to whom we answer: you. It is much easier to have answers than not to, even if the answers don't bear down to proper scrutiny. I think that that is why there is an abundance of conspiracy theories populating the pages of social media at the moment. It is easier to believe that the virus was artificially generated in a lab than that it was a novel mutation because if it was a mutation, there is the chance that it could happen again at any time. An artificially generated virus is less random; it gives us some sense of control. In the same vein, it's easier to believe that the pandemic is the manifestation of an evil plan by Big Pharma or some other stinking rich, elite master-minds looking to make a fortune than to believe that it is simply a result of Darwinian selection, because the former implies that if we act, we can end or prevent it. The latter option, that it is a product of natural selection or evolution, negates any illusion of control that we have over it. I have seen again and again in practice that it is easier to have a reason for something, even if it is an incorrect reason, than to accept the random or unknown (just think about the vaccine-autism argument: it's easier to blame one's child's autism on a vaccine, despite ample evidence to negate any link, than to accept that it was arbitrary or multi-factorial). It's the basic premise upon which charlatans make an income.
Since I am baring my ignorance to public scrutiny, now would also be a good time to admit that I have no idea about the epidemiology of COVID. I don't know a)whether the impact of the pandemic has been inflated by social media and over-reporting or not (I'm torn between worrying reports I'm hearing from colleagues in Cape Town, pictures of mass graves being dug outside Sao Paulo and horrific stories emanating from New York, and articles claiming that the mortality rate is less than that of seasonal flu), b)whether the pay-off of closing down the economy is worth the cost, remembering too that this will be different for first and third world countries, c) whether reopening the schools is a good or bad thing and even whether I will send my sons to school in a week, d) whether lockdown has become a tool for draconian political agendas or whether it's preventing mass deaths and e) whether we are even doing the right thing in trying to slow down the progression of the disease. The altruistic answer would be to let the pandemic run its course without medical intervention (as pandemics have done throughout history) and effectively cull off a whole lot of people- mostly the old, weak, sick and healthcare workers- thereby sorting out the overpopulation problem and restoring balance to nature. Great in theory. Not so great in reality when it's your mother, husband or child who dies. The answer is that there is no simple answer and to presume that there is is nothing short of complete arrogance.
Here is a list of things that I believe (which is very different to knowing; opinion, not fact):
1) I believe that our president is doing the best that he can in a very shitty situation. I believe that he is human and, as such, is fallible and should be forgiven for making mistakes. I believe that he is a good man and that his intentions are good (not sure if I believe this for the whole cabinet).
2) Perhaps I am naive, but I find it difficult to believe that there are people who would withhold a vaccine or treatment for this devastating virus simply to make money. Likewise, I find it very difficult to believe that there is some international collaboration of evil people willing to watch the destruction of the world as we know it, purely for profit. Again, perhaps I am naive, but I would rather believe in the innate goodness of humanity than the alternative.
3) I do not believe that there is simple solution, or even a solution, to the pandemic, but I do believe that there are very many, very good people working very hard to try to make some sense of the unknown.
4) I believe that all of our lives will be affected by this virus and by the consequences of the lockdown. We may lose loved ones, our jobs, our homes, our security. Our lives as we knew them may be torn from us. But I also believe that we can chose to embrace the unknown, as difficult as that is. We can use the uncertainty surrounding us to strengthen our faith. We can take this opportunity to recognise the humanity in those around us, and within ourselves. Because the way that we will get through this pandemic is not by arguing figures and statistics or by pointing fingers and attributing blame; it will be by acknowledging our individual and collective vulnerability and by facing it with persistent compassion and kindness. That is how we will survive.
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