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The Eye of the Beholder

My Quaker Grandmother always advised us to remember that every person you see and know as you go through the day is secretly carrying an unknown cross and you have no idea what that burden may be, The crosses we bare come from the individual experiences in our lives and can be shaped from experiences in our families and communities, but today the media has become a real source of not only our burdens, but our fears and expectations.

The announcement of President Trump’s and the First Lay’s positive Covid-19 Test created much fear, generated in the media. I would like to put the situation into context. The information that helped me form my opinions comes from two sources: Dr. Marty Makary who is a Surgeon and Public Health Specialist at the John’s Hopkin’s Medical School and the author of many articles and a book entitled UNACCOUNTABLE Health Care Transparency, and former New York Times reporter Alex Berenson most recently the author of UNCOMMON TRUTH ABOUT COVID -19.

A recent frequently sited poll of everyday Americans demonstrated they believed that 30% of Americans have contracted Covid-19. They were unable to differentiate between cases with physical findings and asymptomatic patients. They felt that the chances of dying if one became infected was 50%. Using those numbers one would expect that 4.5million souls would have passed away from the virus instead of the 205,000. They overestimated the death rate by 95%. I am sure that if you or a love contracted the disease it would seem that the larger number would be possible. Or if you have a family member with a comorbid condition or a preexisting disease—my daughter in law for example has recently completed chemotherapy for Diffuse Histiocytic Lymphoma and is severely immune compromised so she has legitimate concerns (not fears). And we know that 80% of people dying from the disease are over the age of 60, but did you know that if you contract the disease and you are over 60 you have almost an 80% of surviving?

Finally, let’s look at the Trumps for a perspective. According to Public Health Specialists at the John Hopkins led by Dr. Makary, our 1st lady who is in excellent health and is several years younger than our President has a 99.9% chance of surviving her infection without any sequel. What about her older husband our President Mr. Trump who is 74 years old and overweight but not technically obese what are his chances of surviving his Covid-19 infection? 99%! Are you surprised? If you have had the disease yourself or know someone or have a loved one with the disease who has died you probably are. If you have been reading the mainstream media you probably are. The crosses we bare help determine our perspective.

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So almost 10 months into the pandemic where are we? WE have had 205,000 deaths nationwide with 7.3million positive tests for an IFR (Infection Fatality Rate) of 2.8. In Idaho, the numbers are 490 deaths with 42,915 testing positive for an (IFR) of 1.55. And one other point about Idaho—though I don’t have exact numbers, it appears that the elderly and nursing home patients are doing better in both not contracting the disease and with morbidity and mortality.

One final point of concern for me is the fact that we are now looking at the disease through the lens of a public health perspective. We are at the point in time where we need to deploy clinical strategies for taking care of sick patients that are more directed to the individual patient and pathology, and not toward demographics. The medical resources that will be leveraged to attend to our President and First Lady are for the most part the same resources that the majority of Covid-19 patients have had available to them—but not all. The shifting cadence from population medicine to individual patient care should have occurred in our country and State very early on in the game when the initial “curve was crushed”. This should have included switching mitigation strategies from type 2 to Type 3—isolating at risk patients.

I do need to discuss one final issue. In my opinion, the biggest threat to our community—especially those at risk, would be from the seasonal flue and not from Covid-19. Even if we have two “mini curves’ occurring at the same time this could be problematic—not catastrophic. Get your flu shot especially if you are at risk. Even if the flu vaccine is only 50% effective that would be a big step in preventing a double curve situation.

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