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OpEdNews Op Eds    H3'ed 5/22/20

Infectious Disease Science and D.J. Trump, Part 2

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"Either this nation shall kill racism, or racism shall kill this nation." (S. Jonas, August, 2018)

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"To announce that there must be no criticism of the President . . . is not only unpatriotic and servile, but is morally treasonable to the American public. Nothing but the truth should be spoken about him or anyone else. But it is even more important to tell the truth, pleasant or unpleasant, about him than about anyone else."

Theodore Roosevelt, Editorial in The Kansas City Star May 7, 1918

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Note to the reader: This column is the second of a two-part series that began with longer versions of these two paragraphs:

Trump's Way of Thinking About the Pandemic --- And its True Clinical Expression To get an idea of how Trump thinks, and doesn't, about the pandemic (which I call the Trumpidemic2020©) let us first refer to his famous statement that: "When you test, you have a case. When you test, you find something is wrong with people. If we didn't do any testing, we would have very few cases." There is no indication, nor to my knowledge has there ever been one, that these three sentences are not an entirely accurate representation of how Trump thinks --- about the pandemic and about many other issues as well.

There are two trains of thought/non-thought in D. J. Trump's brain that drive his responses to the COVID-19 pandemic and in turn drive the policies that his Administration is carrying out in its dealing with it. One is that from statements of his like that on testing, he simply does not understand the simplest science about the disease [see just below]. Of course, many people do know these basic facts about COVID-19. It is tragic that Trump is not one of them.

SARS-CoV-2. All too familiar.
SARS-CoV-2. All too familiar.
(Image by (From Wikimedia) CDC/ Alissa Eckert, MS; Dan Higgins, MAM, Author: CDC/ Alissa Eckert, MS; Dan Higgins, MAM)
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OK. As to the virus we are dealing with this one comes from a family of viruses known as "coronaviruses," the "crown viruses" (presumably because of what at least one observer saw when looking at one of them under suitable magnification). This particular one is now known as the "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic.

We do know certain characteristics of this virus and the disease-responses it can cause in humans. First, there is a very wide range of responses it can cause, ranging from none clinically (that is detectable-as-an-illness-of-some-sort in a person) to very severe clinically, leading to death. The primary disease the virus causes involves the respiratory system, which can range from a "cold" to severe pulmonary involvement. This range is well-known in viral diseases. For example, in polio-myelitis, which became very well-known because President Franklin Delano Roosevelt had been afflicted with it, the vast majority of infected people got a cold. "Paralytic poliomyelitis" occurred in relatively few infected people.

Second, SARA-CoV-2 is transmitted from person-to-person through the air, in mucous droplets containing the virus. A very small number of virus particles (around a thousand), can cause a person to get sick. An infected person can expel as many as 200,000,000 virus particles in one cough or sneeze. So, this disease is highly (to say the least) contagious. But again, we don't know why one person inhaling the output of another's sneeze can go on to have a fatal illness while another gets a cold, or nothing.

And so, with modern epidemiology (which is the science of the study of the distribution and expression of diseases in populations) it must be possible to figure out all of this stuff (and I just scratch the surface of the "stuff" we need to know to really control the transmission and distribution of the disease), no? Well, yes, in theory. Over the centuries going back to the Black Death epidemiology at various levels of science has been done to bring a wide variety of infectious diseases under control, ranging from malaria (a parasitic disease, dealt with by mosquito control) to cholera (a bacterial disease dealt with by purifying the water supply) to smallpox (a viral disease that has been wiped out through vaccination).

So why, you might ask, are we not further along already with this one, at least in this country. (They are likely further along with it in other countries, and hopefully the published papers will be coming along soon.) Two words: Donald Trump. In order to effectively determine the details of the epidemiology of the COVID-19 disease (as well as of course effective disease-management), effective and very wide-spread viral and anti-body testing, contact-tracing, and isolation of infected persons must be done.

As is well known, covered extensively by myself and many other observers, Donald Trump has stood firmly in the way of developing and implementing a well-planned, well-coordinated, and fully funded national testing program. I and an increasing number of others have attributed that resistance to, on the one hand, Trump's thinking pattern described as "magical" and on the other his being told by the U.S. Chamber of Commerce and others in no uncertain terms that, for a variety of politico-economic reasons he is not to invoke the Defense Production Act, which invocation would be necessary for such a national program to be developed.

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Steven Jonas, MD, MPH, MS is a Professor Emeritus of Preventive Medicine at StonyBrookMedicine (NY) and author/co-author/editor/co-editor of over 35 books. In addition to his position on OpEdNews as a "Trusted Author," he is a Senior Editor, (more...)
 
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