Poison In The Bloodstream

From the right-wing bloodstream comes another misleading mail, designed to, well, keep them together and distrustful of their fellow Americans, regardless of the cost. It’s short, so I’ll just quote the whole thing, with minor changes to formatting to make it easier to read:

1/1/20 – 4/1/20
WWW.WORLDOMETERS.INFO/

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10,670,908 Deaths from Abortions
2,807,806 Deaths from Starvation
2,061,853 Deaths from Cancer
1,254,997 Deaths from Smoking
422,032 Deaths from HIV
338,886 Deaths from Traffic Accidents
269,209 Deaths from Suicide
246,250 Deaths from Malaria
211,416 Deaths from Unclean Drinking Water
122,062 Deaths from Seasonal flu
46,491 Deaths from Corona Virus

Readers who are paying attention will know the obvious response to this missive, but I think it’s important to go through this piece by piece, in order to understand how this is put together and its objective.

First, note the link to WorldOMeter, a reputable statistics source. This signals that this is a serious e-mail and validates that the group at which it is aimed is serious and a member of the intellectual community.

But, in order to tell the right-wing group that this should be taken seriously by them, the first statistic is … number of abortions. You can’t be a member of today’s conservatives without adhering to the ideology that abortion is equivalent to the death of a human. The position is easily disassembled intellectually, and my understanding is that it has no basis in Christian theology. But it’s one of those ties that bind. My willingness to dispute this as a valid death statistic marks me as outside of the conservative group, BUT as an American, I would hope and expect that my fellow Americans, who I think have received this email as part of a malicious anti-American scheme, will pause and complete reading this missive.

After that little bit of subtle political advertising, we get a bunch of causes-of-death and numbers. I will stipulate that the numbers were accurate when taken for my purposes, because I’m too lazy to actually check … and they seem likely.

So lets talk about categories. Categories help us define valid comparisons and assess risk and thus how seriously we should take threats. Are all these sources of morbidity in the same category?

No. This is the second clue that this is not a missive to take seriously. So let’s talk about why all these apples are actually oranges, chunks of rock, and monkey brains.

Smoking, Traffic Accidents, and Suicide

These are the results of human behavior, implying they are reducible, if we’re only willing to take certain actions, such as invest in better mental health services, stopping smoking, or drive more sensibly (or take the bus).

Importantly, these numbers are known and expected, and when one deviates upwards, steps can be taken to discover why and to fix it.

Cancer

For the most part, cancer is the result of shitty bad luck. Since Smoking is separately listed, we needn’t caveat about lung cancer, leaving only a few cancers known to be caused by pathogens, such as HPV. Most occur because of said bad luck or are heritable, which I’d argue is also bad luck, as one cannot pick one’s parents.

But many cancers are treatable, and treatments for more are under development. Most cancer death rates exhibit a downward trend. From the National Cancer Institute:

In the United States, the overall cancer death rate has declined since the early 1990s. The most recent SEER Cancer Statistics Review, released in April 2018, shows that cancer death rates decreased by:

• 1.8% per year among men from 2006 to 2015
• 1.4% per year among women from 2006 to 2015
• 1.4% per year among children ages 0–19 from 2011 to 2015

Malaria and Seasonal Flu

False-colored electron micrograph of a sporozoite, which causes malaria (Wikipedia)

These are diseases with high transmissibility. You get it, it’s dangerous, and it’s difficult, in the proper localities, to not get it. But what’s interesting is that we have extensive experience with these illnesses. There are preventive strategies available: annual vaccines for the flu, with fluctuating effectiveness, and treatments. Malaria has been developing resistance to the drugs used to treat it, but the keyword is developing. For prevention, night time netting is advocated on the personal level, and strategies to make the transmission vector, mosquitoes, unable to carry the parasite causing malaria are under development by the medical community.

HIV

I saved HIV (which names a virus; one can argue people suffer and die from AIDS, the illness HIV causes in humans, but it’s a semantic quibble) for its own category because it is an example of a disease in transition in the context of human society. When it first appeared, it swiftly caused utter panic in the homosexual community, because the death rate was high, it was as likely to kill the old as the young, it was an ugly way to die, and it spread disproportionately through homosexual sexual contact. (Update: Andrew Sullivan accidentally corrects me to note that the anal sex practices of male homosexuals in particular; female homosexuals, or lesbians, are less likely than heterosexuals to contract HIV.) Members of the community from that era speak of attending funerals weekly, or worse, for young friends and relatives. Survivors sometimes have PTSD.

Today? If you live in a Western country, it’s generally little more than a nuisance. From Wikipedia:

The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs. In many parts of the world, HIV has become a chronic condition in which progression to AIDS is increasingly rare.

So why is it even listed by WorldOMeter? Not all parts of the world have supplies of the necessary drugs, or the medical personnel qualified to test, diagnose, and prescribe for it. This will change over time, and at some point, assuming progress is not interrupted by a world-wide catastrophe, the initial HIV years will be an historical event, still highly disturbing for those survivors, but for those who didn’t experience it, just another dry chapter in a history book.

COVID-19 (listed here as Corona Virus)

How does COVID-19, aka the Wuhan virus, differ from the above?

• How does it kill us? We don’t know, although we’re making progress.
• How transmissible is it? We know it’s at least high; it may be ultra-high.
• What is the infection rate in a normal human society? We don’t know.
• Who is more vulnerable? We know there’s evidence that people with health problems may be more vulnerable, but what then of the stories of extremely old people surviving, while apparently healthy younger people don’t make it? We don’t know.
• What percentage of those infected will require hospitalization in order to survive? Technically, we don’t know; medical personnel know the answer, in combination with the unknown infection rate of the previous point, is “way too high.” If you are or were a member of the law enforcement community, insert the profane adjective of your choice in the previous sentence, and then say it with conviction.
• What is the death rate “in the wild” (i.e., without support in a hospital)? We don’t know.
• Do survivors have immunity? We don’t know. (There have been reports out of South Korea of survivors suddenly showing symptoms again, but the meaning of this is not yet clear.)
• Are there negative consequences for survivors, like that suffered by measles survivors (damaged immune systems)? We don’t know. (We also don’t know if there are positive consequences.)
• Can a safe treatment be found for it? Despite the babblings – and that’s what they are – of President Trump concerning various anti-malarial medications, yes, the answer is “we don’t know.”
• Can a safe vaccine for it be developed? We don’t know.
• Suppose we can develop a safe vaccine, will it give us life long immunity? We don’t know. Maybe it’ll be an annual injection, like the flu.

See, that’s the difference between COVID-19 and all those other illnesses. We don’t know. But here’s one we do know:

• Given the high transmissibility and infection rates, and the apparently high rate of people needing strong support in a hospital, do we have sufficient Intensive Care Beds available? No, not in a normally functioning American society. We know that. That leads to medical personnel deciding who should die – these ten Covid-19 infected people, the car accident victim in the corner, the kid who fell out of a 4th story window and fractured his skull, the four gunshot victims, and our colleagues the five nurses and two doctors who have become desperately ill with COVID-19. This is why shelter in place orders are required in most American settings – because then we have a better chance of not overrunning our hospitals with desperately ill people.

Returning to the beginning of this post, when I said some readers will know the perfect rejoinder to this email, I will now add that. Recall that the time period on the email is January to end of March of this year. Victims of COVID-19 numbered 46,491, world wide.

Today is April 18. WorldOMeter now lists 156,338 deaths. NOT infections, which is listed at 2,280,490. Another source, Johns Hopkins University in Maryland, has comparable numbers.

In the last 18 days, that’s a 200% jump, and that’s with some significant changes to human society in an attempt to forestall the worst – so that when you become ill, there’s a hospital bed and a reasonable chance of you surviving.

So at some point I mentioned the missive to which I’m responding was malicious. Listen, folks, whoever the joker was who wrote that mail, they deliberately eliminated all context that might have clued you, the conservative reader, in to the seriousness of this disease. They could have shown you a graph of how the infection and death rates have been increasing as the infection spreads. They could have discussed important factors, likely victim trends, I mean an entire host of important things.

Instead, they stripped out the variable of time and presented you with a snapshot. Whoever this person is, they wormed their way into your community with the abortion flag, they invoked what has become the traditional conservative skepticism of any news not coming from Fox News, and they lowered the hammer of presenting incomplete information.

Look, readers, count up the unknowns I listed above. Look at how the deaths around the world continue to increase. I’ve been watching since Jan 21, and I’ve been horrified at the numbers jumping upwards at higher and higher rates, first in China, then Italy, now the United States. This missive to which I’m responding is designed to keep you skeptical of the American mainstream, to deepen the schisms that keep America from achieving its potential, to keep us distrusting “the other side”. It does it by presenting numbers, generally considered ideologically neutral, without mentioning that the numbers, no doubt accurate on the day they were taken, only matter in the context that’s been stripped. It plays on the ideas of Gee, this is just common sense, without every acknowledging that humanity’s common sense, unless trained academically, doesn’t understand infection and death rates trending up like we’re seeing.

This is a serious situation. Stay American. The comment that accompanied that email, received just a day or two ago by me, indicated the sender hadn’t even checked the numbers. Get smart. Or watch your friends and family die.