Sunday, October 30, 2022

Mistakes in Pandemic

 Reading "Uncontrolled Spread" by Scott Gottlieb on the US response to Covid19. So far (100pp in) it's good. Gottlieb was on the outside (former Trump FDA director for a couple years) but offering input via Twitter and close enough to people on the inside to be knowledgable. 

Those who attack the medical establishment often cite the confusing advice about masks in the early months of the pandemic.  Gottlieb says both CDC and FDA relied on their experience in dealing with flu epidemics, assuming that Covid-19 would be like the flu, SARS and MERs.  They were tracking respiratory cases using their "syndrome" system, which relied on reports filtering up from Medicare and hospitals, using statistical analysis to try to determine if there was a surge in cases which might mean a new virus.  The system had defects--it was after-the-fact--and not precise.

Dr. Birx made much of the failure to identify asymptomatic spread. Gottlieb also notes the problem, with an interesting consequence.  Some early cases, which we now recognize as resulting from asymptomatic spread which isn't usual in influencza, were instead explained by fomites--the idea that the virus was deposited on surfaces.  This meant the early emphasis on handwashing and cleaning surfaces, and the discouraging of masks. 

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