Friday, March 26, 2021

The Great Coronavirus Pandemic of 2020--7 Critical Lessons

As of January 28, 2020 there were more than 4500 confirmed cases (98% in China) of a new virus that originated in the City of Wuhan, China and more than 100 deaths according to Lawrence O. Gostin, J.D., global health expert at Georgetown University (and now an advisor to Biden). On January 30, 2020, when the U.S. had not yet reported a single death, President Trump closed travel into the U.S. from China. Powerful Democrats like Biden, Pelosi, and DeBlasio predictably called him racist and xenophobic. Since Trump is not a doctor, lawyer, or experienced in public health, he created a team and listened to advice from well established experts, with credentials just as good as Dr. Gostin. For weeks he was on TV with his advisers, but because he was hopeful and positive, the Democrat run media stomped their feet and insisted on gloom and doom (which we still get with the nightly news).
In JAMA Forum article Nov. 10, 2020 (v. 324, no. 18) Dr. Gostin published "The Great Coronavirus Pandemic of 2020--7 Critical Lessons." He's a lawyer who advises organizations like UN, WHO, and now Biden, and holds multiple international academic professorial appointments. If I were to criticize his lessons, I would be waved away like a gnat.

With distain he refers to "populist political leadership" right after acknowledging the remarkable development of clinical trials for a vaccine within 6 months of the virus being sequenced. He credits personal hygiene, physical distancing and masks to control virus particles so tiny that so far, no mask has been able to stop. Still, lesson 2 is a nation needs great leadership and public trust to beat such a challenge. Imagine public trust when 95% of the media report negatively or lie about dear "leader." Gostin seems to mean, any leader other than Trump could raise the public trust. Like someone who says, "Hey man, I'm here for ya."

And no article could be complete these days without a mea culpa for health inequities. When this article was in a first draft in the fall he knew, we all knew, old age and comorbidities were factors in death rates. Now I think the figure is about 50% elderly and 80% overweight or obese. Blacks and Hispanics have a higher rate of overweight and obesity than whites, who are obese, but less so. Life style strongly influences health--smoking, drinking, drugs, poor nutrition/too many calories, lack of exercise and sexual promiscuity. Dr. Michael Rosen of the Cleveland Clinic says 75% of chronic illnesses can be improved or cured by changing our lifestyles. The medical profession has not yet found a way to control our lifestyles, despite all the articles, TV ads, billboards, organizations and lectures. It's easier to just blame societal inequities.

In lesson 6 he mentions the horrifying disaster of the uneven lockdowns through the sweeping powers of local and state governments. He warns of usurpation of power under the pretext of a health crisis which threatens to erode democratic freedoms. Yet his only solution seems to be "the rule of law," by which I think he means federal, or even global. If you're a hammer, everything looks like a nail, and his area of expertise is global law and institutions. So he really was unhappy when President Trump thought WHO mishandled or mislead other countries.

So his recommendations are choose "science," the rule of law, and equity. That would be transformational, he says.

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