First World Problems
There is much we can learn from the developing world, starting with how best to react to Omicron but even more importantly how governments must retain trust with their people.
Being a dad (and not all that hip these days), it was only recently that I heard the phrase “First World Problems.” This term refers to minor annoyances such as a weak cell phone coverage or misplacing your AirPods that only those of us in highly developed countries complain about. We have the luxury of complaining about these issues because generally we don’t face concerns of those in Third World countries do: food, shelter, basic medicines, and safety. We ought not think they lack happiness or wisdom.
One of my last pre-pandemic trips took me and a few of my kids deep into the undeveloped countryside of Uganda. Many in the area had never seen a doctor in their lives. We accompanied doctors and nurses, providing the legwork so the medical staff could practice their craft and the preachers could provide the Gospel. The gratitude of the Ugandans we met made the simple tasks of logistics and paperwork so rewarding. My daughter remarked on the plane flight home how the people of Africa had real problems but, by and large, they were happier than many of the people we knew back home.
Those folks down on the southern-most tip of the continent are teaching us many things about COVID. As they said it would, Omicron is spreading like wildfire but symptoms are mild and deaths infrequent compared to prior waves. Panicking about it may very well turn out to be a First World Problem. Africa, South Africa at least, appears to be over Omicron already, largely because they can’t afford to be obsessing about it. There is work to do. There are mouths to feed.
In America, we could learn a lot from our neighbors in Africa. It starts by getting a handle on what the most pressing health problems are and it ends with trust. History has taught us that the most important thing for national leaders to do in a pandemic is to be honest with its citizens.
What goes up must come down
South African COVID cases truly did skyrocket for the three weeks following the American Thanksgiving. New cases were averaging less than 1,000 per day prior to African scientists schooling the developed world on a new variant about to sweep the world. They were right. The spread has been swift. Less than three weeks later, cases were nearly 40 times that level. For a short time, cases were doubling every two days … but only for a short time. Since the middle of the month cases have steadily declined.
It turns out something can’t double every two days for very long. Fun fact: if the number of new cases doubled every two days from where they are today (~500,000 globally), we would be at 8 billion daily cases before a month is up. The virus would run out of places to go long before that.
So, when you hear the media say, “Omicron is doubling every other day” in the UK or elsewhere, this might be true … for a week or so. The progression appears to be that Omicron replaces Delta (which is a good thing) followed by a further spike for another day or two before the number of new daily cases hits a plateau.
The city of London may have already peaked. Daily new cases in the UK, while quite high, appear to be nearing a plateau. Something similar is taking place in Denmark. New York state is now in that upward swoosh. That too shall peak.
Don’t misunderstand my comments as callous ones. COVID is a deadly disease. There will be deaths. But for parts of the world in the throws of a Delta wave, having cases be displaced by the less-lethal Omicron is a blessing, not a curse. We shall see if this holds but, for now, hospitalization and deaths in the UK are quite muted. They not really heading up much, let alone doubling.
Mass hospitalizations and deaths from Omicron never materialized in South Africa. In fact, their case fatality rate (percentage of each positive COVID case that results in death) has plunged to just 0.2%, a tenth of what it was during their Delta wave. Currently, there are just 244 people on ventilators in the country of sixty million people. Just 611 people are in an ICU as Omicron is subsiding. These figures are substantially less as compared to this past summer’s Delta surge.
South African doctors and experts are now recommending a halt to pandemic containment measures. They are not just talking about the Omicron variety they so bravely told the world about. They mean COVID altogether. The country’s Ministerial Advisory Committee (MAC) recommended a stop to quarantining and contact tracing. People need to work. The MAC which advises the country’s Ministry of Health considered quarantine, “no longer viable in the current social and economic climate.” In other words, there are mouths to feed. Most of the country’s workforce are day laborers who don’t get paid if they are in quarantine. With the risk of hospitalization and death vastly reduced, it is best to let people to go about their lives. Protracted mandates, it turns out, are a First World issue.
In the First World (United States), we do have serious medical issues but depending on the age we are talking about, COVID deaths is not the biggest concern. We have made much progress in protecting the elderly. As the fear of grandma getting COVID and dying has subsided, it has been replaced by the narrative, “kids and young adults are getting sick at a much higher rate.” There is a hint of truth to this, but it is largely misleading.
The overwhelming majority of COVID deaths in the US still occur in people over 50. During this past month (November) that percentage was 91%, down from 97% the same time last year. Correspondingly the percentage of deaths for the rest (49 and younger) were 9%, up from 3%. Older people dying from COVID were more than cut thanks to vaccinations and better treatments. The percentage shifted not so much because those younger than 50 are dying more (up 630, year over year) but because COVID deaths in those 50 and older decreased (down 27,000).
For our younger generations, the deadliest issues are being ignored
I applaud the concern for our youth and young adults. If that is our goal, we need to focus on the right areas which are mental health issues such as suicide as well as drug overdoses.
This past summer, Dr. Monica Gandhi, COVID expert and professor of medicine at the University of California, San Francisco, wrote an OpEd in the Wall Street Journal criticizing the government’s response to public health. Our youth are far, far more at risk of visiting the hospital Emergency Room (ER) due to suicide or other mental health reasons than they are from COVID.
Dr. Gandhi and co-author Jeanne Noble chronicled how COVID and our response to it drove a 75% rise in mental health related ER visits by teens in 2020. It is not just ER facilities. Mental health programs and outpatient therapists have been overwhelmed since lockdowns began in the spring of 2020. The waiting time for access to such resources is now measured in months.
Our media tells us that Omicron has mutated into something more deadly. The facts dispute this. Yet, there are a set of facts about an epidemic which has morphed into something more deadly.
Pre-COVID, our society was coming to terms with an opioid epidemic that had hit people from all walks of life. The emergence of fentanyl has transformed our country’s drug overdose problem into the leading cause of death for adults aged 18 to 45.
A nonprofit group Families Against Fentanyl analyzed data from the Centers for Disease Control (CDC) in the US. According to this data, 64% of all drug fatalities involve fentanyl which is now put in cocaine, heroin, opioids, and marijuana. This makes them all the more additive and more deadly. They put out a great factsheet on this.
We do have First World problems that are deadly serious. Making progress on these problems require a trust between people and their government. That trust is increasingly in short supply.
What is the harm in shading the truth if your intentions are good? A lot actually.
For two years now, government leaders in the First World have cherry-picked their facts and told the public what they thought we needed to hear so we might behave in the way they thought was necessary. Let’s assume for the moment, their intensions are entirely noble – ‘the means justify the ends’ as they say. Yet, when they lie about one thing, the public has the right to question every future government pronouncement. People in developing countries like South Africa have vivid memories of public uprisings and government downfalls. As a result, they can’t take public trust lightly the way First World countries often do. Here are just two examples this month of US government leaders spinning a narrative in direct contradiction to the science.
Example 1: In the past week, executives from all the major airlines in the United States testified before the US Senate. Senators raised the issue of how necessary masks were on planes in reducing virus spread. It turns out, each of the airlines enlisted research universities to conduct scientific studies on this topic. They all found the same thing. In the words of one CEO, “Masks don’t add much, if anything.” Air filtration systems are so good, you are safer unmasked on planes than any other indoor space. The airlines have the scientific data to back it up. In fact, the air on planes is safer than is found in an Intensive Care Unit (ICU) of a hospital.
Shortly afterwards, Dr. Fauci was asked to respond. He countered that he “believed” masks were still necessary despite acknowledging how great air filtration systems on planes are. I can’t seem to find the scientific data to back up his beliefs. So, which is it? Are we going to follow the science or the narrative based on how a person in power feels?
Example 2: Long before COVID-19, the US government set up a database to log all “adverse events” that might be a result of a vaccination. The Vaccine Adverse Event Reporting System (VAERS) has catalogued deaths and other events from vaccines since 1990. The VAERS database typically gets 500 or less reports of death each year. In 2021, more than 20,000 reported vaccine-induced deaths were logged, virtually all of them related to COVID vaccines. It is highly unlikely these are bogus or over estimated. The vast majority of the cases are logged physicians and are attested to under penalty of perjury. Research studies suggest that, if anything, cases are underreported by a factor of five at least.
Throughout all of 2021, the CDC has been looking the other way as reports of adverse events including hospitalizations, paralysis, heart problems, and anaphylactic shock have piled up. Here is the latest dashboard:
I give credit to the CDC for finally doing their job in monitoring vaccine safety. This month they convened a committee meeting to question the safety of the Johnson & Johnson vaccine given all the blood clot issues in adults. In that same meeting they reviewed the safety data in VAERS as it pertains to the Pfizer COVID vaccine in young kids (ages 5-11) now that jabs have started for them.
CDC Director Dr. Rochelle Walensky was interviewed Friday, December 10th on this very subject of vaccine safety in kids. When asked about what safety concerns were being seen, she said, “We haven’t seen anything yet.” She was specifically asked about myocarditis because it is a known threat for teenagers to which she confirmed there were no concerns. You can see her reported comments in the left side of the graphic below:
The true facts of the situation were revealed in that committee meeting the following week (right side of graphic). CDC scientists presented how two deaths and 14 cases of myocarditis are being investigated. Eight of those 14 cases had already been validated. Sounds like something every parent would like to know about.
I am not saying that two vaccine deaths and 14 kids hospitalized with heart issues is too high. It may be or it may not be. My point is that leaders are telling us what they want us to hear despite what the facts say. This erodes trust.
Vaccines in young kids appears to be just a First World Problem. South African kids ages 5-11 aren’t being vaccinated. In fact, vaccine uptake in that country sits at 31% with little upward momentum. This is despite being one of the few African countries that can afford to vaccinate their population. People don’t want it. The government recently told drug companies to halt shipments because they can’t give away the doses they have.
South Africans have moved on. They have moved on from COVID, from Omicron, from quarantines, and from vaccines to some extent. The country’s working class have more pressing problems to face. Their ruling elite realize that they have a fragile democracy that could break if too much is accomplished through coercion.
In Conclusion
I am just finishing my read of John M. Barry’s landmark book on the Spanish Flu called The Great Influenza. His book was first published in 2004, making him somewhat of an expert ahead of this SARS-CoV-2 outbreak. The outbreaks of SARS, MERS, and H1N1 between 2002 and 2009 had governments seeking Barry’s consultation on how to prepare for the next pandemic. One nugget of wisdom our governments were told: lockdowns and travel bans are ineffective. Viruses are going to spread despite them.
Barry provided his advice to multiple US administrations (Republican and Democratic) in the last two decades. His number one piece of advice to governments handling a pandemic is, “the biggest problem lies between the governments and the truth.” The most important thing governments can do is level with the public, for better or for worse.
Despite some media narratives, COVID is not deadlier than the Spanish Flu. According to the best estimates, that 1918 influenza outbreak killed between 50 million and 100 million people worldwide, more than ten times our currently reported figures for COVID. It came at a time when the world population was a quarter of what it is today. COVID would have to get 40 times more deadly from here to be on par with that pandemic. History can teach valuable lessons to those willing to learn.
In Barry’s words, “Those in authority must retain the public’s trust. The best way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one.” It seems, at least one country on the southern tip of Africa is paying attention.
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