COVID-19 Update #1


I have been asked by many people to comment on the recent Corona Virus epidemic. Schools are shutting down for the rest of the year, restaurants have been ordered to be closed, borders have been closed, store shelves are running bare, church services over 100 people have been banned. These things have never before been experienced in our nation in modern times, and on such a grand scale.

These dramatic interventions and closures are not meant for people to necessarily avoid becoming sick. When a sickness runs through a family, for example, one can take maximum protections with each other (touching, hand washing, covering mouths, etc.), but it seems as though inevitably, everyone will get sick anyway. The difference is that with maximum precautions, the sickness will take a longer time to run through the family. Is that a good thing? Maybe not for the family unit, but for a nation, it allows the health care system to avoid becoming overwhelmed all at once. Additionally, it “runs down the clock” to the end of the flu and cold season when most respiratory viruses find it difficult to survive in the warmer weather, thus hopefully actually reducing the total number of sick.

The question is this: is it all worth it? It is not an exaggeration to say there is a general spirit of alarm and/or panic. All this, from a virus called the Corona Virus - the second leading virus that causes the common cold, after the rhinovirus.

Reasons for Panic

1. Bad bug

First, the disease this particular strain of Corona Virus causes, is called COVID-19, which stands for the Corona Virus Disease of 2019. Why is it a bad bug?

First, The incubation time is 2-3 times longer than the flu. Theoretically, this means that it can be transmitted long before anyone realizes they are sick. That would delay people from taking proper precautions (mouth covering, intense hand washing, isolation, etc.). During this “ramp up” time, however, it is not clear how significant this is. Is the infectivity almost negligible until just before the symptoms strike, or is it more of an even but steady buildup?

Next, different viruses have different levels of aggressiveness: How “catchy” is it? This may be another reason why the average flu patient will infect 2 others, while the average COVID-19 patient will infect twice as many - four.1

Finally, it is more severe. As of today, according to the Johns Hopkins Center for Health Security, there have been 179k cases worldwide, leaving 7,400 dead - a 4% fatality rate. In China, where the outbreak started, there have been 81k cases with 3,200 dead - a 4% fatality rate. They are nearly through the cycle, as cases have dropped off dramatically. Italy has had the second most cases, at 28k, with 2,000 dead - a 7% fatality rate. Third is Iran with 6,000 cases and almost 1k dead - a 16% fatality rate. In the USA, there have been 4,200 cases with 75 dead - a 2% fatality rate.2

So there is a range from a low of 2% (USA) to a high of 16% (Iran), with China (4%) and Italy (7%) in between. There are a few reasons for this wide range. The most obvious reason is that in poorer countries with less resources, the population will not fare as well, such as in Iran. 

Second, is that in socialist countries, healthcare is Centrally Planned: Protocols are already in place to decide who gets full healthcare, and who gets only comfort care. In places like Italy (which has a very large geriatric population), the elderly with severe COVID-19 disease may be told to go home to die if adequate local resources are not available.On the other hand, a Centrally Planned government that has the will and resources, such as in China, can mobilize quickly. The world celebrated on February 8, 2020, when China opened two specialty hospitals in Wuhan, within 12 days of construction start.It just closed down March 15th, open only for 6 weeks, due to the rapidly dwindling number of sick patients.

Contrast these systems with the Patient Centered model in this country, where supply strives to meet demand. There is then, more built in elasticity to meet the needs of the patient. One nurse I work with reported that recruiters are currently offering $85/hr plus all expenses to work in California. No doubt, at least partially, this was to meet the demand for COVID care in that state. As this disease primarily threatens the elderly, it would not be unreasonable for a young healthy nurse to help out, while being compensated well.

2. History of Epidemics and Pandemics

The next reason that there is so much worry is the not too distant history of catastrophic diseases:

Measles killed 1/3 of the population of Fiji in 1875. As a medical missionary in Africa, I witnessed that measles still killed many children. Yet in modern countries when people occasionally do catch measles, the death rate is 0.1% Why is that? It’s because, primarily of sanitation and nutrition. People that are malnourished do not do well against disease, no matter the date in history. Similarly, Smallpox killed 90% of some Indian populations in this country. Despite romantic notions of Indian lore, near starvation, exposure to the elements and poor sanitation was a matter of everyday life in that time period.

Finally, let’s look at the Spanish Flu pandemic of 1918. It was a strain of the Flu Virus, affecting up to 27% of the world’s population (500 Million), and causing up to 100 Million deaths! Curiously, because it began during World War I, censors in the UK, France, Germany, and the USA did not permit real reporting of the devastation. Since Spain, neutral in the War, did not have such censorship, a false impression that the disease was focused there was projected to the world.

3. Lack of transparency

Because of the perceived lack of openness, many are rightfully concerned about the full scope of the COVID-19 pandemic:

China has been accused of hiding the true number of people affected. A US Senator suggested that since China’s only Maximum Security Biolab was only 20 miles from the epicenter of the outbreak, that this may be the source of a human manufactured virus that somehow escaped from the lab. That China’s response was so quick and so forceful does not allay fears. “Fact Check” sites say there is no concrete evidence of this, yet they can not convincingly prove it is not.

In Iran, satellite pictures of football field sized “trench” graves, “visible from space” emerged in the media, along with individuals claiming there are over twice the number
of dead that officials are claiming. Incredibly, these were dug within 3 days of the outbreak announcement. Keep in mind that at the time when news of this broke out, there were about 400 deaths . . . in a population of 81 million. Are mass graves needed for this level of mortality? Still, Iranian researchers estimate 12,000 dead if radical measures, such as have been instituted in this country, are taken . . . and 3.5 Million if not.6

4. Political Influence

Finally, it would be difficult to underestimate the political component to this pandemic, especially in light of this being an election year. Though we are first Heavenly citizens, it should not blind us to the reality that this has been, to a certain degree, a politicized disease. How much is debatable, to be sure.

The president had been accused of not doing enough for an anticipated calamity, with some pundits openly opining (hoping?!) that this could be the President’s “Katrina,” referring to the mismanaged, and politically ruinous hurricane response that lacked compassion for the victims.(The verse “...he that is glad at calamities shall not be
unpunished.” (Proverbs 17:5) comes to mind in this situation.) His response was to outdo all expectations by shutting down international flights and borders, among a list of another 41 decisive actions.8

Not to be outdone, Governors in a number of states followed the lead, shutting down schools, businesses, and gatherings in a seeming back and forth contest of 1- upmanship. In NY, it has been proposed to bring back retired doctors and nurses, not thinking that these very individuals would be at the greatest risk. Convicts would be drafted to manufacture more antiseptic hand sanitizer.Perhaps allaying the fears of consumers hoarding sanitizer would be a quicker way to bring product back on the shelves. The Germans made up a word for this: “hamsterkauf” (literally “hamster shopping”), in reference to the panicked hoarding exhibited in the tiny creatures.

In reality, this politicization is a form of State Mandated Compassion. But it is an artificial form of compassion, since it is done by decree, rather from the personal concern, risk, and involvement that the Bible calls us to: The parable of the good Samaritan quickly comes to mind (Luke 10:25-37).

Proper Perspective

How should we respond to this pandemic? It helps to put things into the proper perspective:

1. Christian Witness History

One study of 1409 christian missionaries from Scotland from 1867-1929, reported that 151 died during their service term (an 11% Mortality rate), another 20% had to
abandon the mission field due to ill health. There were no stats on the remaining missionaries that suffered significant health difficulties, yet pressed on.10  I suspect it was no small number.  

Hudson Taylor, founder of the China Inland Mission, lived a life of self sacrifice. He survived 2 typhoons traveling to China. He fathered 11 children, 5 of whom died in their childhood. His wife died of cholera. He did not live a life of risk avoidance. He lived a life that glorified God.

Disease has historically been regarded as divine judgement - is it still not so? The shelves are empty, yet there have been only 75 deaths in a nation of 330,000,000? Toilet paper is gone yet COVID-19 is primarily a respiratory virus (only 5% have diarrhea) - this defies reason. Is this reality not a judgement on a self absorbed people? If our mission in America is to be a light unto the world, how can we do so by being hidden under the bushel of self quarantine? Still, this does not mean being reckless with our health, and those of our brothers and sisters.

2. Christian Witness Today

Let’s also look at the example of our Chinese Christian brethren today to help put things into the proper perspective:

Reports of Christians in Wuhan province witnessing during the epidemic, while passing out face masks and tracts were noted in the media. Even the police, some of whom may have been persecuting them just months prior, accepted the gifts.11 The Christians were so successful in their ministry, that they were ordered to stop by authorities.12  I suspect they obeyed the highest authority.

Contrast this with the voluminous numbers of our churches cancelling services. What wild beasts could not do in the first century, what the sword could not do in the sixteenth century, is being accomplished in our society, by an organism only 100 nanometers in size, in the twenty first century. There is no word on how virtual communion and foot washing will be conducted.

3. The Faith of Science

Next, to put things in the proper perspective, we need to face the fact that Christians should have a different world view, and basis for being.

To the secular world, that does not believe in an afterlife - this life on Earth is all that there is. Science is their savior, and nothing else matters. Thus, when they say, “this is scientific” and that all debate ends, it is as if they are quoting from their own version scripture, since they see their understanding of science as everlasting Truth.

In order to bolster this, they negate all other factors in their decision making. Close the Nursing Homes down to visitors. (Yet ignore the social adverse effects of the need for touch and companionship.) Close down businesses. (Yet ignore the adverse economic effects, potentially bankrupting families, individuals, and businesses.) Close down churches. (Yet ignore the spiritual effect it will have on the body of believers, by forsaking the assembly (Heb 10:25).) Genuine fellowship can not be had by virtual telecommunications, as much as genuine friendships can be found and maintained exclusively through Facebook.

“Scientifically,” we could chart a course to eradicate this disease tomorrow. If we closed everything down and barricaded all people in their homes, COVID-19 would, in the matter of a few weeks, quickly die off. But what good would it do if we all starved in our homes? Science alone can be cold and sterile - people are not.

4. Relative Mortality

The problem is that “science” is a fickle “god” and the devil is in the details.

Remember how I mentioned that the fatality rate varied from 2% in the USA to 16% in Iran? Well, this is not a very accurate number. While we do know the number of people who died from COVID-19, in order to determine the fatality rate, we need to know the actual total number of people who are infected - not just those that are sick that show up at hospitals and clinics. In order to determine the number of people infected, we need to sample the number of people, both with symptoms, and without symptoms, since many people who are infected have only mild, or even NO symptoms. This is hard to do, since there is a shortage of tests. Until this testing is done, NO organization can claim to have accurate numbers.

The numbers quoted are actually the Mortality Rate from Identified Cases. But not everyone is identified. In fact, one study stated that 86% of the cases are not documented. If this is true, then we have a better idea of how many were truly infected. So out of 7,400 dead worldwide, there were 1.3 million actually infected (not just the 179,000 identified), giving a 0.6% Fatality rate.13

In 1999, the West Nile Virus hit the United states. Annually since then there have been about 2,000 cases here, with a fatality rate of 5% (of Identified Cases.) However, one study showed that 61% of adults in Egypt, where the virus originated, had antibodies to the virus,. This would mean that they had the virus at some time in their lives, but most had not known it.14

The flu has a fatality rate of 0.1%. Over the last 8 years, there have been anywhere from 9.3 - 45 Million cases annually in the USA, with 12,000 - 61,000 deaths in a single year.15 Coming on the tail of the flu season this year, we are at about 22,000 deaths. So theoretically, with COVID-19 potentially having 6 times the fatality rate, perhaps 240,000 deaths, without the radical intervention that has taken place, would be more
realistic. The CDC projects anywhere from 200,000 to 1.7 million dead Americans within a year.16 The New York Times says up to 2.2 million.17

However, looking at some more real numbers, the flu, in 1 typical year in the USA, takes more lives (about 37,000 on average) than 5 times the entire world’s cases of COVID-19 cases to date. China, which has 4 times the population of the USA is near the end of it’s COVID-19 disease cycle, as the number of new such cases is rapidly tapering off. In the last 24 hours of the writing of this article there have been NO new cases in Wuhan, China, where this epidemic started (though there have been 8 deaths from residual cases).18 It is hard to imagine that, with 1/4 the population of China, US fatalities will come to much more than in China (which had NO forewarning or preparation), with their 3,200 fatalities.  (This is nowhere close to the 1.7 - 2.2 million American dead worst case scenario.) COVID-19 cases will undoubtedly greatly increase, but it remains to be seen by how much.

That is one problem with what some claim to be “Science.” Sometimes the projections don’t match the actual numbers, because it is based on poor assumptions. So for the USA, will it be more like the number of Chinese fatalities (3,200), or less - best case - or will it be worst case (1.7 Million)? Will the laws of unintended consequences bear out a classic case study of the overburdening costs of mass panic, or will it point towards wise judgement calls?

Conclusions


The bottom line is that COVID-19 is a serious disease, yet we are led by the light, and not fear. (“For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.” (2 Tim 1:7))

Science, which is a very important tool the Lord gave us, is also subject to abuse and manipulation. Reasonable precautions are wise, but our decision making as a church can not be based on fear.

As with most contagious diseases, the elderly and immune compromised are affected the hardest, especially those over 80 and those with lung, heart, kidney disease, and diabetics. (Children are much less likely affected, though premies, and children with chronic illnesses are also at risk.)

Ministry and the brethren must decide the best course to take for their congregations and families. It would not be unwise to ask at-risk members to listen in on sermons, and to self isolate. It would also be wise to ask anyone who is sick to not attend church functions until they show marked improvement. All this, as individual consciences allow and the Spirit leads.

The rest, we put in the hands of the Lord - let “Thy will be done.” (Mat 6:10)



https://www.vox.com/science-and-health/2020/3/13/21176735/covid-19-coronavirus-worse- than-flu-comparison
https://myemail.constantcontact.com/COVID-19-Updates---March-18.html? soid=1107826135286&aid=o7v6B0qstl4
https://www.telegraph.co.uk/news/2020/03/14/italians-80-will-left-die-country-overwhelmed- coronavirus/?li_source=LI&li_medium=liftignit
https://www.businessinsider.com/wuhan-coronavirus-hospitals-not-filling-beds-data-2020-2
https://www.independent.co.uk/news/world/asia/coronavirus-wuhan-masks-video-doctors- nurses-hospital-a9402631.html
https://www.dw.com/en/iran-faces-catastrophic-death-toll-from-coronavirus/a-52811895 
https://www.cnn.com/2020/03/08/politics/2020-election-week-ahead/index.html
https://www.washingtonexaminer.com/washington-secrets/list-trumps-43-virus-moves-aims- for-south-koreas-99-3-recovery-rate
https://www.businessinsider.com/new-york-state-made-hand-sanitizer-produced-by- prisoners-announced-2020-3
10 https://www.ncbi.nlm.nih.gov/pubmed/9815303
11 https://onenewsnow.com/missions/2020/02/10/god-using-coronavirus-to-soften-hearts-in- china
12 https://www.nytimes.com/2020/02/23/world/asia/china-religion-coronavirus-donations.html 
13 https://science.sciencemag.org/content/early/2020/03/13/science.abb3221?rss=114 https://www.sciencedirect.com/science/article/pii/S187603411000022515 https://www.cdc.gov/flu/about/burden/index.html
16 https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coronavirus-model-210m- infected-1-7m-dead.html
17 https://www.nytimes.com/2020/03/16/us/coronavirus-fatality-rate-white-house.html 
18 https://www.foxnews.com/world/wuhan-hubei-report-zero-new-coronavirus-cases
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