Asymptomatic Spread Revisited

asymptomatic-spread-revisited

29-11-20 08:27:00,

– November 22, 2020 Reading Time: 6 minutes

The phrase “fog of war” is attributed to Carl von Clausewitz. It has come to refer to the confusion and uncertainty felt by everyone in the midst of conflict. It is often unclear who is making decisions and why, and what the relationships are between the strategies and the goals. Even the rationale can become elusive as frustration and disorientation displace clarity and rationality. 

In 2020, we’ve experienced the fog of disease mitigation.

The initial round of lockdowns was not about suppressing the virus but slowing it for one reason: to preserve hospital capacity. Whether and to what extent the “curve” was actually flattened will probably be debated for years but back then there was no question of extinguishing the virus. The volume of the curves, tall and quick or short and long, was the same either way. People were going to get the bug until the bug burns out (herd immunity).

Gradually, and sometimes almost imperceptibly, the rationale for the lockdowns changed. Curve flattening became an end in itself, apart from hospital capacity. Perhaps this was because the hospital crowding issue was extremely localized in two New York boroughs while hospitals around the country emptied out for patients who didn’t show up: 350 hospitals furloughed workers. 

That failure was embarrassing enough, given the overwhelming costs. Schools closed, commercial rights were vanquished, shelter-in-place orders from wartime were imposed, travel nearly stopped, all large events were cancelled, and so on. Clearly there needed to be a good, solid, science-based reason for why the politicians and their advisers had, on their own, decided to take away much of what we once regarded as human rights. 

Talk about this began in March but faded. Sometime in summer, the idea of asymptomatic spread started to trend, bit by bit. It finally went to an explosion of interest in the first week of June. It trailed off again until very recently.

Asymptomatic spread was the answer given to the great question: I’m not sick so why should I have to be locked down? Why are we quarantining the healthy? And what possibly could it mean, in any case, to be sick without symptoms? Why are half the PCR-positive tests assigned to people who otherwise seem to be perfectly fine? 

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