By Mary O’Brien, M.D.
Quick. What’s the clinical definition of a “spike”? You’re not sure, are you. Don’t feel bad. No one knows what the clinical definition of a “spike” is. But the all-knowing bureaucrats and media types toss the word around with abandon. It serves their purpose, which is to keep as many people as possible afraid and, therefore, controlled, especially in the age of COVID-19.
If you were fortunate enough to have had a good education and some training in critical thinking, you know you must define your terms. It’s the essential starting point for any serious discussion or debate. You cannot make up terms or definitions on a whim. This, of course, is distressing to those who worship their notions and emotions. Today, that means millions of people. Reality (or a “spike,”) is whatever people say it is.
Announcing that “the country is seeing a worrisome spike in COVID-19 cases” is misleading. Defining the terms is not only critical for any measure of professional or intellectual integrity, it is essential for a prudent response. Sadly, in far too many cases, a lack of intellectual integrity can be easily used to promote paranoia. Today, nearly anyone can create scary graphics splashed with “worrywart red” ink. This is done routinely to exaggerate the threat of anything from a virus to a thunderstorm. Be afraid. Be very, very afraid.
No. Do not be afraid. Understand what is happening:
- There is exponentially more testing being done now compared with six weeks ago (as of late June 2020).
- The criteria for COVID-19 testing have evolved tremendously over the past three months.In March, elderly people with obvious respiratory symptoms were told to stay at home and avoid the emergency room. They were advised they did not need to be tested. Today, in much of the country, many people can be tested on demand.
- Greater numbers of young people are being tested.Naturally, more positive tests will be reported. Most of these individuals are asymptomatic and will remain so. Consider this — no one could walk into a clinic or makeshift roadside testing site and simply demand a test for flu, strep, hepatitis, or mono because he or she felt like it. Medically speaking, what’s going on now is odd.
- Deaths from COVID-19 have declined by 40% across the U.S. over the last two weeks.This is crucial for understanding what is really happening. The mortality rate for COVID-19 here is around 0.05% (and probably lower). Contrast this with what we were told initially. Italy had a mortality rate around 10-11% and in the U.S. we expected a mortality rate between 3-4%. That’s quite a difference.
- Our focus should not be on the number of positive tests, but on hospitalization and mortality rates.There will be regional fluctuations in both.
COVID-19 is new. Patterns of transmission, virulence, and regional penetrance will change gradually. Our understanding of the best ways to treat seriously ill patients will change. This has happened throughout history. For now, don’t overreact to “worrywart red” on TV graphics. Steady as she goes, America. Steady as she goes.