Today, I wanted to talk about the evidence for social distancing, especially in regards to COVID 19. Now, just so you know I am NOT being paid to talk about this. What I’m going to say is just my personal opinion as a medical doctor. However, you are entitled to your own opinion and I would strongly encourage you to do your own research on this topic.
So that you can make up your own mind. I will link the references that I’ve used in the description below. Now I don’t know what your personal situation is, in regards to being in lock down, as everyone is under a lot of strain. But let me tell you about what is going on in my home country New Zealand.
We have to remain at home in our social “bubbles”. We can leave our house if we need to go to the supermarket, pharmacy, if you are an essential worker or to exercise. You cannot go swimming, hunting, tramping or do anything that may put extra strain on emergency services.
You cannot talk to anyone outside of your social bubble at a distance of less than 2 meters, which includes family, friends and co-workers. And lately, when I’ve gone for a walk or run I notice people don’t even want to make eye contact. And they often cross the street or act panicked and move away from you like you have leprosy.
The first time I went to the supermarket, after we went into lock down, three weeks ago. I saw someone wearing a gas mask. Now why would someone want to wear a gas mask at a supermarket? I’d presume that it’s either a practical joke or it’s because they are scared and think that they might die from an infection that is hanging around in the air. I don’t blame that person for feeling scared as most people don’t understand what the medical risks are to them.
As we’re bombarded every day by the media about how dangerous it is when people don’t practice social distancing. So I decided to look into this myself as I wanted to understand what scientific literature is behind social distancing. Before I get into the interesting stuff I thought I’d quickly recap on how infectious diseases used to be dealt with. When there was no treatment available for a disease.
One word. Quarantine. The practice of separating the diseased from the healthy has been around for a very long time. In the Old Testament, for instance, rules existed for isolating lepers or people who have leprosy. It wasn’t until the Black Death of the 14th century where Venice established the first formal system of quarantine. Where they made ships lay at anchor for 40 days before landing.
Should we quarantine people with COVID-19? One of the problems with Covid-19 is the fact that seemingly there are many, many people who have tested positive for it, but are completely asymptomatic. Meaning they have no symptoms and don’t go on to develop symptoms. Apparently, up to 30 percent of people with coronavirus are asymptomatic and never show symptoms.
This figure may be much higher, even as high as 80%. As there have never been any studies comparing rates of positive tests in a control population. Therefore, it’s not as easy to quarantine individuals with COVID, as many are completely well. And unlike leprosy, where people mostly have symptoms. On the flip side, there are no lasting disfigurements or health concerns with coronavirus for the average person. Once you are recovered, you are back to normal.
I made another video on how lethal COVID-19 actually is. If you’re interested, please check it out in the description up there. So, what’s the science behind social distancing? There’s one systematic review article that looked at how effective social distancing is in reducing the spread of influenza. It looked at 12 modeling and three epidemiological studies.
Unfortunately, all three epidemiological studies were highly biased and therefore the results are not usable. And if you have any familiarity with computer modeling, you’ll understand how highly unreliable these results can be. As you have to plug in hundreds, if not thousands of variables.
And the end result can be manipulated, by changing the variables that are included in the study. Examples of recent computer modeling gone wrong, is from the Imperial College of London. Who estimated the risk of infection and death from Coronavirus to be a hundred and thirty-one times greater than it actually has turned out to be.
In this systematic review, the modeling studies support social distancing in non healthcare workplaces. But I am highly dubious that these models play out in reality. There have been no observational studies in real human beings, to determine if social distancing works. Please let me emphasize that I am NOT talking about the evidence for quarantine or self quarantine which is different to social distancing and physical distancing.
Prior to COVID-19, social distancing was a term that was hardly used or advised by doctors and now everyone seems to be an expert on this. The definition of what constitutes a safe distance changes by the day. What is the evidence for wearing facial masks? To summarize, all the studies have only looked at health care workers and mask use.
Specifically, if health care workers wear masks does it prevent them getting sick from an infectious disease? Despite widespread use of masks in health care workers, there is very little clinical evidence that these prevent infection with airborne infectious diseases.
What was quite disappointing, is there was a really good study called the respect study, that was originally going to answer : How well do respirators, AKA masks prevent airborne infectious diseases? But then, they changed the outcomes when it was published and only compared two different types of masks and asked which one was better.
Unfortunately, we don’t have one study looking at whether wearing masks and gloves in the community does anything to prevent catching respiratory infections. What I personally believe is far more troubling is social isolation and the generalized suspicion we have for our neighbors, our friends, co-workers and strangers in the street.
Many studies have been done on social isolation and long-term it increases the risk of premature death. While short periods of isolation can cause increased anxiety or depression that start within days. We are social creatures that have evolved over millennia to be in family structures and groups. We rely on that interaction with other human beings. I believe more is needed than just social media. Which can never replace a cup of coffee in person with a friend.
Now, I’m not asking you to break the law in regards to social distancing and wearing masks. But please think about what the emotional cost of these measures are as a society. I believe there is no evidence for social distancing and in time we will be able to compare real world infection rates and deaths in countries like Sweden and Denmark, who have very different policies in place on social distancing.
Like I said in my original COVID video, I still believe the death rates from coronavirus will be similar to the ordinary flu. Most countries have overreacted, so that their cures are much worse than the disease.
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