23 November 2020. Updated 24 November 2020.
Dr. Roger Hodkinson
Related: Hodkinson at Edmonton City Hall Meeting
The World Health Organization (WHO)
Statistically speaking, given the probable origin of SARS and COVID-19 in China, the next pandemic is likely to originate there also. That’s a problem. China was secretive about the start of its local COVID-19 epidemic (and still is), wasting valuable weeks before alerting the WHO of its existence which then downplayed its significance for the rest of the world. An early warning system is a vital starting point for effective international response to future pandemics. Clearly, the Chinese Communist Party (CCP) and the WHO cannot be trusted to act any differently in the future.
Furthermore, the (current) head of the WHO, Dr. Tedros Adhanom, is not a physician as have been all his predecessors, and has questionable credentials to effectively lead such a vital international resource at a critical moment in world history. He has, at times, acted as China’s apologist in this whole fiasco, compounding the problem by disseminating China’s misinformation under the imprimatur of the WHO early in the pandemic.
A senior WHO official responsible for the global response to this pandemic, Dr. Michael Ryan, has actually stated that “we may have to enter homes and remove family members” if they are COVID-19 positive – but in a “dignified manner”. It would seem he thinks COVID-19 is as lethal as ebola or smallpox, which it most emphatically is not. Do we want ‘officials’ knocking at our doors in the middle of the night taking away our kids to control future pandemics? I think not, and to attempt such an assault on personal liberty would cause civil revolt. But that was exactly what the WHO recommended!
I believe a personal anecdote is also relevant here. Right in the middle of the SARS epidemic in 2003, I met with the team of WHO officials ‘managing’ the outbreak right in their war room at WHO headquarters in Geneva. There wasn’t a virologist in the room, and of the eight or so people present about half were nurses from obscure African countries doing an obligatory WHO secondment. To say it was a gong show is an understatement. The world was left to its own devices, and so it was initially with COVID-19.
The most rational explanation for the origin of the epidemic in China is not the Wuhan wet food market as the WHO immediately and confidently stated, but rather one of the virology labs in Wuhan doing environmental surveillance of bat corona viruses. There was almost certainly an accidental escape due to poor compliance with laboratory bio-safety procedures for which there have been many examples in China in recent years. COVID-19 was not a genetically engineered virus for use in biological warfare – the corona virus isn’t anywhere near lethal enough for that nefarious use, judging from the number who’ve died in China, unless the entire Chinese population had already been vaccinated against it!
I believe I have made my case that the WHO cannot be trusted, is politically compromised, and is actually incompetent in the discharge of its expected leadership role. But more importantly, the WHO is advocating extreme containment policies that cut to the very heart of personal freedom.
First of all, by way of context and with respect to estimates of mortality from COVID-19, the table below from the website of the Centers for Disease Control (CDC) shows the estimated number of US deaths in previous influenza epidemics:
Clearly the current US mortality rate due to the COVID-19 is similar to many previous flu outbreaks. (We must ignore the 1918 Spanish flu as that was before the age of antibiotics which would have saved many lives had they been available.) But did we shut down the global economy in 1957 with the Asian Flu, or in 1968 with the Hong Kong Flu, or in 2017 with the H3N2 Flu? No! We did not. If we weren’t sick we went to work, and there was no attempt to shut down the economy. So exactly why is it so very different this time around?
Absent the WHO for reasons stated above, the world now relies for a heads-up on potentially severe public health matters from the ‘experts’ at the CDC, the FDA (Food and Drug Administration), and the NIAID (National Institute of Allergy and Infectious Diseases). Unfortunately, they have all failed us miserably. Let’s deal with them one at a time.
The CDC’s initial test kits for the molecular diagnostic test for the COVID-19 were found to be unreliable causing a delay in the manufacturing of reagents, wasting precious weeks for large scale testing. The reagents are still in short supply, two full months later. The FDA placed ridiculous bureaucratic impediments in the way of appropriately credentialed laboratories wishing to start the testing by their own methods, adding to the delay. Given the alleged urgency, the arrogance of the FDA was stupefying. And the NIAID, under the leadership of Dr. Anthony Fauci, was responsible for nightly predictions of the most extreme mortality, orders of magnitude higher than plausible, driving public fear and a hysterical media reaction. Furthermore, Dr. Fauci was initially insisting on a formal clinical trial before authorization of the use of hydroxychloroquine for which reasonable efficacy had been quickly demonstrated by a prominent French infectious disease expert, Dr. Didier Raoult. The drug has an excellent safety record with decades of use as an anti-malarial, so this was yet another example of fiddling while Rome burns. Dr. Fauci is an academic, totally out of his depth this time around.
Please don’t get me wrong, the leaders of these three organizations in more normal times have done credible work, particularly Dr. Fauci with the AIDS epidemic. But during this crisis they have all been caught with their pants down.
If we are indeed “at war” with COVID-19 (with which I profoundly disagree as dangerous hyperbole), the FDA should have loosened the reins and allowed accredited laboratories to ‘get to it’, and develop their own validated tests which they were perfectly capable of doing within a couple of weeks of the need being established. And Dr. Fauci should have approved the use of hydroxychloroquine much earlier.
There isn’t a single reliable statistic except that a lot of people are dying, and that the vast majority of deaths are occurring in vulnerable age groups with significant co-morbidities. That’s about it. We don’t even know if some of the deaths could be co-mingled with other viral infections such as the ordinary seasonal flu, as that is not being tested.
The best of the worst statistics is mortality per million population, but even that is flawed as the numerator is totally unreliable for country to country comparison. That’s because the way death is recorded on death certificates varies greatly in different countries – Germany in particular. Did a person die ‘with’ the corona virus or ‘due to’ the corona virus is the issue, as the majority of the deaths have occurred in elderly people with severe co-morbidities (particularly severe lung and heart disease and diabetes) which could well have been the principal cause of death.
And deaths per million positive cases is also flawed as there is no data on what percentage of the population have asymptomatic infections. The current guess is around 15% of all people are infected, which would translate into a significant reduction in the mortality per million population.
The number of people tested is also a factor with many variables – how sick were they to present for testing, availability of testing, concern about the cost, fear of personal economic consequences if found to be positive, etc. We do know that as of the time of writing, now two+ months into the pandemic, there are still hundreds of thousands of samples waiting to be tested in the USA.
As statistically there’s not much to go on for an assessment of what’s happening in real time as a basis for political decision making, comparative sources become quite valuable:
Computerized modelling has been totally misleading for a very simple reason: nonsense in, nonsense out! (I first heard that from a brilliant cardiologist under whom I had the privilege to train 50 years ago as a house officer, and it’s as true today as it was then). The modelling has been catastrophically wrong and has fed the media frenzy. At the time of writing the predictions are being constantly downgraded, but in my opinion still seem inflated.
The media gorges on crises (“never let a good crisis go to waste!”) as that drives ratings and therefore advertising revenue. Crises are good for the media’s bottom line, so they have hyped COVID-19 mercilessly, to the point that people have been driven into a state of panic and paranoia by the nightly parade of ‘experts’ and exaggerated statistics. We certainly didn’t hear all this media hysteria during similar past flu epidemics even though some of them killed more. It was just life as usual then, and should be now.
We hear we must “flatten the curve” by “social distancing” and “self-isolation” to reduce the possibility of hospitals being overloaded – only to find them actually underutilized! And, piling fear upon fear, we must be wary of the “guaranteed second wave” without any evidence whatsoever that it will happen. A second wave has happened with past flu epidemics, but COVID-19 is a virus unrelated to influenza – in fact the last related viral epidemic, SARS (or Covid-1), apparently died out completely and has not returned (except for well documented escapes of SARS from other Chinese virology labs that were well contained).
Let’s take a careful look at the different types of testing currently being performed to assess the presence of COVID-19 infection.
This method (technically called RealTime PCR) is also well known to have false negatives and false positives, although not to the same degree as Point-of-Care methods. Think of the ‘lock and key’ method this way: the wrong key (the test reagent) can sometimes open your front door lock (false positive), and the right key might not open your front door if the lock had been changed (mutated) without your knowledge (false negative). False negatives potentially encourage unintended additional spread of the virus, and false positives could overload hospital facilities and accentuate anxiety.
That’s the current state of COVID-19 testing: relatively unavailable, inaccurate and slow. But hope is around the corner! A COVID-19 test is being developed in the USA that has virtually no false negatives or false positives, and may become available in Canada very shortly (see PART TWO).
Well, actually, there is no good evidence for any of them except self-isolation for those with symptoms or increased vulnerability, protective gear for front-line health care workers, hand washing and vaccination.
We have no data to confirm that any of the following measures, that seem at first blush to be intuitively worthwhile, are actually effective: masks for everyone, travel bans, assembly bans, school/daycare closures, ‘social distancing’ in public areas, business closures, etc. Why should they be? The virus has already spread everywhere due to people flying while infectious; either during the incubation period or as asymptomatic spreaders. The genie almost certainly got out of the bottle months ago and hitchhiked internationally, and will probably do the same with the next viral pandemic.
Isn’t it odd that we can still visit grocery stores where we lick our fingers to open the collapsed plastic bags in the fresh produce section, and then squeeze the lemons for firmness? Yet we’re not allowed to go to work where the risk is undefined and likely very, very low if symptomatic workers were to simply stay home (or ‘self-isolate’ in the new obligatory jargon) as we normally do during a flu season. In my opinion, there’s probably a fine patina of virus already on every lemon in every grocery store, waiting opportunistically for the next squeeze (not to mention sneeze).
There just isn’t sufficiently documented support for most of these profoundly disruptive and intrusive measures.
The media, aided and abetted by the ‘experts’, have created such a tsunami of hysteria that politicians have been forced to act – to do SOMETHING, ANYTHING – commensurate with the assumed gargantuan threat. The price tag amounts to trillions of dollars internationally, and has been sold on the basis that COVID-19 is an almost existential threat to humanity. Excuse me for injecting a moment of sanity: It’s not!
Following the SARS crisis why weren’t aggressive surveillance systems implemented? Why weren’t medical resources and facilities being equipped to handle something similar to or larger than SARS? Many governments reduce funding for research and investment in preparedness until there is outright panic, but by then it’s often too late. Prevention of any type has always been a low government priority.
A ludicrous analogy would illustrate why the reaction to the COVID-19 pandemic was massively disproportionate: has anyone ever suggested quarantining the entire population to prevent drug abusers and smokers from accessing their drugs and killing themselves? No, obviously, despite the fact that mortality from those activities exceeds deaths from pandemics like this one by orders of magnitude. US deaths directly attributable to smoking are estimated to be around 450,000 per year, and annual deaths from even second-hand smoke exceed 40,000 according to the CDC! Drug overdoses kill around another 70,000 per year in the USA. Those numbers occur year in and year out, and are accepted as the unfortunate ‘norm’.
Remember, the main reason anyone does anything is because someone else is doing it! Evidence is the very last thing required. Being politically correct – woke – is now the essential element for political survival and re-election. And, as that only requires using other people’s money, politicians have dutifully fallen in line and written the big cheques; deficit be damned.
Part one summary
So it’s the unknown we had to handle, with very few reliable guideposts for what should have been done. What we can say with certainty is that all the actors in ‘the system’ failed miserably, causing politicians to make highly flawed decisions with disastrous consequences for the economy. This simply can’t be allowed to recur with future pandemics. Once a malevolent genie has escaped next time around there must be a better way to respond, and that will be the topic of Part two: How to Prepare for ‘The Next Big One’.
source: Lockdown Skeptics
In Part One, good grounds were presented to describe how perverted the COVID-19 experience has been to date. Just about every resource expected to help define and support an effective public health response proved to be suspect: the WHO, CDC, FDA, NIAID, laboratory testing, statistics and computerised modelling, assessment of treatment options and the media. Those serious deficiencies plus the lack of preparedness were made painfully obvious, with a devastating number of unnecessary deaths and a severe interruption of the global economy. We must seriously re-examine how to minimise deaths while not killing commerce. The cure must not be worse than the disease!
Eight major failures created a perfect storm:
But the most important lesson was that Common Sense was singularly ignored!
So let’s review what must be done before ‘The Next Big One’.
To be blunt, heads should roll. In particular Drs. Adhanom and Ryan for reasons set out in Part One, and they should be replaced by competent people recommended by the new head of the CDC (see below). Otherwise, the USA, as the principal funder of the WHO, should withhold any future financial support.
In my opinion the role of the WHO in future pandemics should be restricted to the following:
The current heads of the CDC, FDA, and NIAID should also be removed from office and replaced by non-partisan experts approved by the US Congress. Pragmatism should be the prime quality for the appointments, and there is still lots of that around. Academic/medical credentials are required of course, but should not be the only factor in the search.
Dr. Fauci in particular has vacillated on matters of substance with his nightly hand-wringing in the media. He also insisted on a formal double-blind trial for hydroxychloroquine (a drug with initial successes in France and an outstanding safety record) while thousands of people were dying! That opinion was classic for an academic, but in this crisis he was totally out of his league – or gone “wobbly” as Maggie Thatcher would have said. He also dressed up absurd modelling predictions by saying that they “could happen”, which of course the general public read as likely to happen – significantly ratcheting up public anxiety.
The FDA was similarly culpable for denying immediate use of hydroxychloroquine, actually intimidating very capable infectious disease specialists until they boldly decided to ignore the edict en masse.
As described below, the CDC would not need to scramble to design a high-volume test method for a novel outbreak of a pathogen likely genetically related to COVID-19 and influenza, as once a new method has been approved for general use with standardized generic reagents (see below) it would be available for instant use world-wide.
A radically different high-volume method for testing COVID-19 and related viruses
A US company is commercializing a COVID-19 test method that will potentially revolutionize the field. This method claims to have virtually no false negatives or false positives, can be run at high-throughput on existing instrumentation, and is price competitive with current centralized methods. But more importantly, it has a menu that includes other viruses in the same test that have similar presenting symptoms as the seasonal flu (which is a much more likely cause of presentation), as well as other historically relevant pathogens such as SARS and MERS. Remember that the vast majority of tests for COVID-19 are negative; but worried people don’t just want to know what they don’t have, they also want to know what they do have – giving additional confidence that the test is reliable.
This method is intentionally designed to not only simultaneously identify and confirm the specific genetic sequences of all the viruses in the panel, but also novel related viruses that could cause a new pandemic. It is a modification of the method used for the Genome Project (Sanger sequencing, the recognised Gold Standard). Therefore, it will be unnecessary to undertake immediate genomic sequencing of a genetically related novel virus before testing commences. The test itself would document the unique novel genetic sequence, and more complete sequencing could be performed later.
Although in my opinion containment is likely to fail at the site of origin, immediate awareness of a new potential pandemic would be of huge value for the implementation of global mitigation efforts if they were proven to be effective in studies yet to be undertaken (see on), as well as the ramping up of pre-existing stockpiles by the WHO and individual countries with that capability.
That being said, the prime issue in my opinion would be to simultaneously protect the vulnerable and the economy. If early reporting of mortality demographics again indicates that death is occurring primarily in the elderly and those with co-morbidities, then that should be where the major protection is focused using proven methods, and with possible use of prophylactics. There would be no need to try and contain the infection within the rest of the general population at low risk of death, as it would inevitably be ineffective and would devastate the economy yet again.
People outside the vulnerable group would be encouraged to go to work normally – just as they did in prior ‘flu epidemics that killed substantially more people! If they were to get sick, they would not go to work, would stay home, not visit Grannie, take Tylenol and chicken noodle soup – just as they have before! They could test themselves with mailed out, easy-to-use, cheap point-of-care devices to see if they are negative for the novel virus or have immune status, so as to allow a reasonably safe return to work (despite the acknowledged poor accuracy of these types of tests). That way they would not have to leave the home to be tested and potentially spread the virus to others.
Medications shown to be effective for treatment and/or prophylaxsis (see on) could be obtained by family members or delivered to the home.
There is an urgent need to conduct numerous studies if this utterly disastrous train of events is to avoided in the future:
When the studies listed above are completed there will be a much better sense of what worked and what didn’t. My suspicion is that nothing really works beyond:
Paradoxically, the WHO and both the Governor and Mayor of New York (none of whom I particularly admire) may have been absolutely correct to say initially “Relax, it’s just another flu”! Only further studies will reveal how a more balanced approach could protect both the vulnerable and the economy.
Nonetheless, standard international testing capability at all three levels is essential to better measure and track future pandemics, particularly if ‘The Next Big One’ is significantly more lethal. After the lessons with SARS, MERS, and now COVID-19 we should prepare for worst case scenarios, but not over-react. China cannot be trusted to improve its biosafety operating procedures in virology labs to accepted international standards.
Serious stockpiling by the WHO for undeveloped nations should certainly be undertaken, as well as contingency plans for ramping up production of essential supplies and medications in developed countries.
The central issue is: how to control a beast that’s more virulent than any virus? Can that ever be achieved without trampling on the freedom of the press as the watchdog for political incompetence and over-reach? The temptation to be partisan and drive ratings is probably irresistible, especially in a crisis. It’s really all about that indescribable thing called the ethical exercise of responsibility. You have it or you don’t. It can’t be demanded.
The best antidote is probably on-point political messaging based on better advice and analysis from non-experts who can inject that missing vital quality of common sense!
To highlight this conundrum, I’m torn between using a quote, the original version of which is inaccurately attributed to Churchill, and a famous obituary, so I’ll use both!
Fear gets halfway around the world before common sense has a chance to get its pants on.
And there’s that famous alleged obituary in the Times of London on the death of Common Sense.
I believe the principal laudable objective of politicians in the COVID-19 pandemic was to reduce death. But whose death? The vulnerable, or those who will assuredly die because of unintended damage to the economy?
Politicians traditionally tend to err on the side of caution to avoid the wrath of the electorate for causing more pain than gain. So pity the poor politicians handling the COVID-19 pandemic when the ‘experts’, statisticians and computer modellers were all initially singing the same tune. How could they have been reasonably resisted? As we now know they were all dead wrong, but that’s 20/20 hindsight.
Common sense should have been sought to add a counter balance to the collective hysteria, but even that might not have successfully injected wisdom. This whole episode is a florid example of a 4 letter word known to everyone – LIFE! Get used to it. It’s inherently risky and we all roll the dice every day driving our cars. Not even the Nanny State can totally protect everyone from every imaginable risk.
As a pathologist I can attest to the Grim Reaper being always around the corner, with pneumonia still called the “Old Man’s Friend” for good reason. And death certificates often use the term “Old Age” as the cause of death, which can be just as accurate as anything scientific. Although COVID-19 sadly took away prematurely many of those destined to die soon from their severe co-morbidities, it is not to say we couldn’t have saved many of those souls with very focused protection from contact with COVID-19 and possibly prophylaxis, and also done more to protect exposed front-line health care workers. We could have but didn’t, and in my opinion that should have been the principal objective, not over-reacting in the impossible hope of protecting everyone and thereby stopping the economy in its tracks.
What was lacking was balance between the unavoidable imminent death of the vulnerable vs. the life of the economy vs. personal liberty. In fact, putting a value on life itself! Not an easy task by any means, but a better attempt should have been made.
Politicians need to control the messaging, and not by default permit that role to be assumed by the media. I would suggest that next time our leaders focus on regular ‘fire-side chats’ to calmly put things into perspective, specifically countering media hyperbole, identifying the variables they are trying to weigh for the common good, and remembering: “A leader is someone who keeps his head while everyone around is losing theirs”.
The Law of Unintended Consequences
The COVID-19 pandemic has highlighted a number of unforeseen consequences for individuals, the country and the world:
So, without wishing to put too fine a point on it all, the up-side could be yet another example of the Butterfly Effect: just one pair of dirty shoes in Wuhan bringing down the last bastion of Communism!
The COVID-19 pandemic has caused utterly unpredictable harm, way beyond the deaths in its wake. It should be a salutary wake-up call for our politicians to learn once and for all the vital importance of major investments in prevention, preparedness and strategic thinking. The cost of having done so before this pandemic would have been a minute fraction of today’s reality.
On reflection, given the extreme current degree of hysteria, a good case could be made for calling this pandemic the Corona Pandemonium! But ‘The Next Big One’ could be equivalent to a direct hit by an asteroid – and we all know what happened to the dinosaurs.
This article was originally written for the University of Regina School of Public Policy on April 20th. The author was told it would be published if he toned it down. He refused.
We will not share your info and will seldom email you.
the struggle is real, the time is short