8/6/2020 COVID disease modeling taking precedence over current data and research

The word “specious” is an adjective that is defined as superficially plausible, but wrong. My recent proposal for a more targeted public health approach was labeled as such by one individual who disagreed. I do not accept this characterization. There is ample encouraging data that allows another way to respond to this virus, without the crippling consequences of current policies. I have provided a slide show summarizing important CDC and Oregon Health Authority data below. The slide show addresses the disconnect between the highly publicized case counts and disease severity.


Recently, the Oregon Health Authority provided the circumstances in which school could resume in the fall. They cite that their policy rationale is derived from the Institute of Disease Modeling in Bellevue, Washington. Although there are exceptions to the following points made in the guidelines for small schools and rural districts, the Oregon Health Authority has provided the following county metrics that will guide school reopening in the fall:


1. Less than 10 new cases per 100,000 in the population in the previous 7 days

2. Test positivity rates of less than 5% in the preceding 7 days

3. Maintaining the above parameters for 3 weeks in a row.


The Institute for Disease Modeling entitled their modeling research; “Schools are not islands: we must mitigate community transmission to reopen schools”. The Institute details key inputs, assumptions and limitations of their modeling approach that are too extensive to detail here. Some of the uncertainties included but are not limited to; susceptibility, symptom expression/severity and infectivity of COVID-19 in children. There is the assumption that all individuals must reduce their daily infectivity by 70% for home contacts, 90% for community contacts and 100% for school and work contacts. Not included in their modeling is after school care; which many working parents depend upon to cover the gap between school hours and working hours.


In their modeling, all mitigation measures would need to maintain a virus reproductive number below one. However, they add that if workplace and community returned to 80% of baseline pre-COVID mobility, perfect follow up testing and tracing of screen and test positive individuals would not be enough to bring the effective reproductive number below one.


What happens when a county has 2 straight weeks that meet OHA criteria but then there are 11 positive cases in a county of 100K in the 3rd week. Do we interrupt school for this? There are so many other situations that would cause havoc on the lives of children and their families based upon these arbitrary numbers built on faulty assumptions. The modeling does not incorporate the most recent research and data about this virus. I am concerned that we are allowing predictive modeling such as this to take precedence over more solid data and research.


The result of our current public health policy is dividing citizens, when unity should be our goal. We are weaponizing regulatory authorities and misallocating valuable medical resources.


“Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. . . Those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience.”


C.S. Lewis


In addition to the link to the Evergreen website above, I have found the article links below to be valuable. The latter 2 links are preprint studies which means that they have not been peer reviewed. I am concerned about delayed time frames to move some very important studies to publication. Meanwhile, weak observational studies are rushed to print in medical journals and then amplified by the general media if they confirm existing bias.


I have included a WSJ opinion article from Dr. Joseph Ladapo, a professor at UCLA School of Medicine, writing about our country’s political, public health and media response during this pandemic.


https://www.wsj.com/articles/fear-and-loathing-in-covid-america-11596470084?mod=opinion_lead_pos5


The following link represents a preprint research article about the much more favorable Covid19 infection fatality rates based upon serology data across many countries.


https://www.medrxiv.org/content/10.1101/2020.05.13.20101253v3


A research article from the United Kingdom about pre-existing and de novo humoral immunity to SARS-CoV-2 in humans. This is a very technical article but suggests that other “common cold” coronaviruses provide a level of protection against the COVID-19 virus -especially in children.


https://www.biorxiv.org/content/10.1101/2020.05.14.095414v2


I will continue to share perspectives that are evidenced based and data driven. I believe there is a more rational path forward if we choose to take it.


Live well,


John Powell M.D.

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