The plot sickens

The ‘experts’ are in a modelling muddle. My response to this is one of empathy. You see, the ‘experts’ in medical science are for the most part entirely affiliated to the mechanistic bio-medical model – they know no better. This is the model which has attempted to equate the human and other organisms to machines. The narrative goes that we are comprised of ingenious individual cells which form into tissues and organs and the whole organism is co-ordinated by systems and their related electro-chemistry. This is true. But... the heart in bed number three is actually in the body of Betty Smith who has a nurture history and subsequent unique life narrative. She also engages with her environment and develops further emotionally and cognitively, which all contributes to her subjective world view. We now know that Betty’s entire subjective reality which necessarily incorporates her cognitive and emotional memories impacts in a very profound way upon her body physiology (in bed three!), most notably upon her immune function. But this input has not been factored into the bio-medical model in any real way.

And so the mechanistic experts review the data and propose models. The rationale in the context of this Covid pandemic is to profile the population, quarantine them and thereby ‘flatten the curve’ of infection rates to prevent the afflicted from swamping the available healthcare facilities. Bear in mind that this approach also prolongs the time taken for ‘herd immunity’ to become effective which contributes to sustaining the vulnerability of the said population to ongoing infection. Regarding the configuration of the illness that individuals may suffer, this is more a reflection of the individuals than of the virus. Those that have a predisposition to a severe illness as a result of a genetic heritage, life narrative, habits, diet and psycho-social circumstances – will experience a similar illness along the trajectory of the virus in our midst, whether it be pre-, peri- or post-lockdown.

Before starting my working day I generally review current articles pertaining to my own speciality and of late, articles relating to the Covid pandemic. It becomes apparent that approximately 80 – 85% of individuals experience no or minor symptoms; 10 -15% experience severe and/or life threatening symptoms and require hospitalization. Of those requiring hospitalization, 14% may require admission to ICU and of these, 4% may require ventilation. The mortality rate on ventilation based on the Italian and UK experience is 88%! (Why the obsession then with ventilators? Just a thought.) But there are also controversies relating to the very fundamentals of the data used by the ‘experts’. Firstly, the screening test does not for the most part indicate if the individual is carrying the virus. It tests the genetic footprint of the virus. The individual therefore may never have harboured the virus but was merely exposed to degenerating fragments of the organism. This equates to a whole lot of potential false positives. Secondly, attributing the cause of death to Covid in every case that was found to be positive on screening, flies in the face of Koch’s postulates: The organism has to be shown to be causative of the illness and not just present in the context of other potentially lethal co-morbidities. Of relevance is that 70% of alleged Covid cases admitted in the Bronx district of New York had severe co-morbidities.

In the context of the current viral pandemic we need to ask what conventional healthcare facilities can provide? This question is critical because the benefits of healthcare provision need to mitigate against the significant healthcare and socio-economic disruption of the lockdown situation. Firstly, there is no cure for the corona virus. If it is indeed the cause of the illness and not merely an innocent bystander, the treatment is based upon the monitoring of body physiology and correcting the basics such as fluids, oxygen and other essentials. In rare cases (14% of 15% of admissions = approximately 2% of the total afflicted) organ function may become an issue in which case ICU management becomes a necessity. For the most part however, treatment is symptomatic with ongoing monitoring of function. This is easily managed in a general ward and in milder cases, at home. The question I ask here and one that I’ve asked several times before is whether it was justified then to severely curtail and compromise the treatment programs of many individuals who require ongoing non-Covid intervention in the face of a pandemic which has been sufficiently managed with adequate facilities to spare? Over-subscribed facilities have occurred but these have been relatively few and over short periods of time. Therefore as I have stated in previous articles, it is my contention that there was no justification for mass lockdown and the exclusion of those in need of medical intervention for non-Covid pathology. Quarantining of the elderly and the infirm together with appropriate social distancing would have sufficed.

I invite you now to share in three case studies which I believe illustrate both the short-comings of the bio-medical model together with its experts and devotees as well as the insufficiencies in the prevailing models in the context of the current Covid environment. The names of the individuals have been changed for obvious reasons.

Luigi Caruso was seventy five years old. He suffered from type 2 diabetes which was under control. He also had hypertension – also controlled. He had previously been a heavy smoker and suffered from moderate chronic bronchitis (COPD). But Luigi was retired and content in his comfort zone. His family was an integral part of his life and he loved and took pride in his children and grandchildren. Luigi watched TV several time a day. Some time in early February the news bulletins  began describing a virulent virus in China which was resulting in much sickness and death. It appeared to have originated from a live food market. Luigi secretly felt that they deserved their virus if that is what they ate (bats apparently). The TV then began to show more and more scenes of people battling for their lives and being nursed by personnel in space suits. Within days the word was out that the virus had arrived in his neighbourhood. Suddenly the people battling for their lives were at the nearby hospital. Of even more concern was the information that all Luigi’s illnesses as well as his age were risk factors in becoming infected with the virus. Luigi became very fearful. With the fear came changes in his body chemistry – raised adrenaline and cortisol caused his inflammatory activity to increase and resulted also in an impairment of his immunity. Within days he was coughing and had a fever. The family insisted that he go to the hospital. On admission he was tested and found to be Covid negative, to everyone’s relief. He was sent to a back ward and received antibiotics. He responded well, but just prior to discharge he was required to undergo another Covid test. This time he tested positive. As a result he was immediately transferred to a Covid ward for isolation. His family were prevented from having any contact with Luigi and in fact had to go into 14 days of quarantine themselves. Fear welled up again in Luigi but he was helpless to do anything about it – even self-quarantine at home was denied. Very soon Luigi developed a pneumonia which progressed to an ARDS (wet lung syndrome probably due to an outpouring of inflammatory mediators). His condition began to deteriorate and Luigi was subsequently intubated and ventilated. He died 5 days later – alone in the cold environment of an ICU manned by strange de-humanised forms in space suits.

In the building next to Luigi lived Marco Corleone. Marco was sixty five and was a retired businessman. He had been retired for two years. Over the ensuing year Marco had begun to experience boredom in his day. He had some hobbies but these were not sufficient to compensate for the loss of structure and the challenge of his work life of yore. Gradually he began to lose interest in his life, to the point that he saw no further purpose in getting out of bed in the morning. He reckoned that his life’s work was done and saw no real further meaning and purpose. The absence of meaning and purpose activated a series of chemical events in his body, resulting in chronic inflammation and a suppression of immune function. It was established that Marco was inoculated with the corona virus after transporting a friend from the airport. Within seven days he had lost his sense of smell, had general body pains and a persistent cough. On arrival at the hospital he tested positive for Covid and was admitted. His condition rapidly deteriorated, developing severe respiratory problems, kidney dysfunction and marked abnormalities in his blood profile. He was diagnosed with an ARDS related to a cytokine storm. He died 7 days later with evidence of multiple clots in several vital blood vessels.

On the other side of the world Chuck Smith was locked down with his family due to Covid-19 for the second month. Theirs was a small apartment for the family of four. Chuck was the breadwinner, working in a hotel. He had recently been promoted to manager and with that came a substantially bigger paycheck. The Smiths had every reason to splurge a little and so they had purchased a new car (on a loan-lease). Chuck’s wife had a temporary job doing clerical work at a local company. With the crashing of the hospitality industry Chuck became very anxious about the future of his job. Up until that time he was receiving his full salary. It was towards the end of the second month of lockdown that Chuck received the fateful communication – the hotel had closed its doors and he was permanently laid off. Before him he saw a family without an income. Their savings were minimal and loans plentiful. Chuck opened his personal file and perused the small print of his life policy. He was relieved to note that in the event of suicide the policy would still pay out to his beneficiaries. The family had a great last breakfast together. Chuck had left an envelope with relevant details for his wife on their bed and while his wife cleared up after breakfast, Chuck went into the garden shed where he tragically ended his young life.

The ‘experts’ are muddling through the data because they’re working off a narrow, mechanistic base – their data has conspicuously excluded the psycho-social variables which contribute significantly to wellness versus illness and possible death. Factoring in human cognitive and emotional elements and their influences upon immunity and other physiological functions would result in far more authentic models. From these models would emerge applications and protocols more respectful of the human being as a dynamic, sensitive and creative being. Perhaps we had to collectively experience the suffering of the Covid-19 pandemic to birth a new and more inclusive perspective of life and its challenges.