At the Edge of Covid Truths

We are like a herd of wildebeests at the edge of a river that we must cross as part of our annual migration.  We crowd together, pushing the weaker or more naïve animals into a crocodile-infested waterway. The crocodiles may let a few of us across, just to fool the thousands behind them that it is safe to wade in and risk the swim.  Even if a few dozen get killed, we are indifferent because thousands will cross, and the likelihood that any of us will get eaten is small. And so, we push and shove and ignore those who are timid or experienced who are calling for caution. We are over 300 million strong.  Who cares if a few hundred thousand in the herd die? Who cares if there is a safer crossing?

Herd Immunity? 

This metaphor came to mind as I watched Senator Rand Paul, a physician who trained and worked as an ophthalmologist before entering Congress,  explain “herd immunity” to Dr. Anthony Fauci, the director of the National Institute for Allergy and Infectious Diseases. The ophthalmologist [eye doctor] told the director of the nation’s agency dealing with infectious diseases that New York had reduced its level of Covid-19 infections by virtue of this alleged “herd immunity.”

In effect, he insisted that the most vulnerable had died off, and the remaining population was at little risk because most of the population was resistant to the virus. In other words, the crocodiles had eaten all the wildebeests they could stomach, and the waterway was perfectly safe. The measures taken to protect the population were pointless and ineffective. Dr. Fauci’s learned response can be summarized with one word: Bull.

Rand Paul’s attack on Dr. Fauci and the thousands of New Yorkers who struggled through the horror in March, April, May and June obviously has wide appeal.  His claim that we have achieved herd immunity, a situation defined by infectious disease specialists, not by ophthalmologists, anywhere in our country is absurd. Most of the target population affected by the virus must be resistant before so few people are vulnerable that the virus cannot get a foothold in the community and continue its spread.  That the Covid-19 virus is still sickening thousands of Americans every week refutes the claim that we have achieved herd immunity anywhere in our country.

I believe we all want this plague to end. The governor of Florida has decided that it is over, and we can go back to normal life, version 2019. I spoke to a lawyer in Florida who told me that she was convinced that the pandemic was a fiction concocted by the ‘media” to make us more malleable. She explained that the “media” was just trying to scare us. I assured her that the refrigerator trucks outside New York hospitals stuffed with corpses and the stench of rotting bodies near overwhelmed funeral homes in Brooklyn were real and quite scary without press coverage.  The last time the city smelled of cadaverine and putrescine, those chemicals that give corpses their distinctive odor,  was the week after the 9/11 attack on the World Trade Center towers when more than 2,000 bodies were being reclaimed from the rubble.

Herd Mentality

I can understand why many Americans believe it cannot be all that bad. We do not have herd immunity, but we do have a herd mentality.  Most of us are comfortable sticking by the assurances of those we trust. If they say the river is safe, we jump in. Terms like “excess mortality of more than 200,000” and “asymptomatic carrier spread” mean nothing to the majority of Americans and might as well be menu items in a remote country. But Rand Paul is a physician. I believe he knows better than to push the nonsense he is serving up. I also believe he knows what Americans want to hear: “It’s safe. It’s over. Go outside and enjoy yourself. Take your children to the rallies and houses of worship.” Unfortunately, the death has not stopped in the United States, but it appears it has stopped in countries that took aggressive steps, including mask-wearing, quarantines, massive testing, group restrictions, contact tracing, etc., at the first sign of the virus.

The “media” has distributed photos of packed bars, crowded swimming pools, maskless worshippers in over-capacity houses of worship, and, of course, excited minions at mass gatherings for political candidates. The pandemic deniers grant that this is not fake news, that people are packing themselves into crowded spaces without masks or any other precautions. After all, you cannot drink beer or effectively flirt or express your enthusiasm with a mask on. 

The truth be told, we need crowds.  We need to be a part of crowds, audiences, mass gatherings, mobs, etc.  It is in our genes, as surely as it is for the wildebeest, even if it means the death of us. Most of us are so uncomfortable with limiting our contact with our fellow humans that we apparently are willing to not only risk our own lives, but are even willing to risk the lives of others, including our own flesh and blood, by spreading the virus to the more vulnerable. This is the trait that allows for pandemics.  We certainly can survive for a few weeks without social gatherings, but we will not. We simply refuse. If the bars and bowling alleys, the churches and synagogues, the sports stadiums and fitness venues are open, we shall swarm to them. If you send the police, we shall offer them drinks and free seating.  Our need to gather shall not be denied.

The Prognosis

Of course, the solution is the vaccine, the elixir of life that will allow us to be us. One or two injections will stop this plague, maybe. The trials being conducted are not actually testing resistance to infection. They are tracking antibody production, on the assumption that people producing antibodies to some elements of Covid-19 when given the vaccine will be protected against infection. Antibodies are materials produced by the body to protect us against infections. The level of antibody production is what is called a surrogate marker. It is something we can measure without actually exposing anybody to Covid-19.  We hope that a vaccine that elicits a robust production of this surrogate marker will protect us against the virus. We shall see.

The United States Constitution guarantees “the People” the right to assemble, and we embrace that right with enthusiasm, regardless of the prevailing conditions. We choose to ignore the declaration by Supreme Court Justice Arthur Goldberg that, “The Constitution is not a suicide pact.” We shall cross the river at the same point, adopting the same strategy, year after year, regardless of how many of our herd are killed. Our herd is slow to learn.

Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan.  He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the USA, as well as in England, Germany, and France.

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