Monkey see – Monkey Do ?

This is not a well-thought-out piece but a sort of rambling rant of thoughts in my mind for a year.  My previous writing on Covid is here and Ayurveda.

I have no medical/biology/medicine background nor am I am a scientist nor do I claim to understand statistics. Read this as some thoughts of a layman.

It’s been a year since India went hard into the lockdown. And after trying N things for over a year, we are back on the verge of lockdown in Maharashtra. (at least the CM keeps threatening a lockdown). Unlike initial predictions of respite from Covid in warm weather, it appears both Covid spikes in India have occurred in the considerably warmer weather while mysteriously getting low during the winter months. While I am yet to find a convincing argument that explains several strands associated with mechanisms of spread of Covid19, some aspects of the challenge, namely public reaction needs to be assessed as we get into the second year of the pandemic.

A question to ask here is – how different would the global reaction to covid19 have been without the world witnessing the Chinese state response in the first place? Did it act like a guess in an optimization algorithm – which eventually decides the outcome in some cases no matter it’s value? The European nations first chose to ignore and when they acted they acted in echoes of China. While totalitarian states like China or the gulf countries have been able to reign in the pandemic, no significantly sized country has. What would have been the Italian reaction had they First Guess been other than China? This is not to condone any herd immunity strategies – but at least in a country like India, the cost-benefit analysis needs to be done.

Additionally, should we ask if how much did lockdown work? Dr. Watve, a scientist based in Pune has some good blogs on the topic. While I am not convinced by Dr. Watve’s reasoning yet, its opposite doesn’t appear convincing too.

What else (if anything) could we have done differently? especially in India.  Critics of government often talk about the lack of testing as an issue in India. Personally, I feel once we get a critical mass of vectors, testing and tracing becomes merely a placebo exercise. Aping the WHO models on test, trace on Indian scale (at least with the resources we have).

Another thing that continues to bother me is the Fomite transmission theory. Going through the literature, I couldn’t find convincing research to believe it in the first place, let alone taking it to the insane level it was taken to – especially in India. Newspapers and milk delivery was turned off for months. Home deliveries of groceries were turned off initially. Shops were open only for small durations of the day. All these measures together meant that whatever essential services were available were often extremely crowded with people.  How much did these bizarre policies initially aid the transmission of covid?

I still remember vividly the most spectacularly stupid team meeting I have been part of. This meeting took place around 10-15 March 2020 to let the employees know that the company was doing everything they can to stop covid around the company premises (which was mostly a rain of sanitizers). In this meeting, the management called around 30-40 people in a closed room and talked without masks (that was early 2020, and even the scientists and WHO were maskophobic back then). Anthony Fauci who today, parades in “Rand Paul’s words” in two masks after getting two shots of vaccine, was saying a year back that masks are unnecessary (or even counterproductive). It’s perfectly acceptable for humans to make errors and correct those in the course of action – that’s something we should all try to do. But an analysis of what led us to make those mistakes in the first place ought to be done. Or was it just another example of the Sun revolves around the earth?

Local authorities (including society chairmen etc) have been on a different level of insane. After seeing city authorities sanitizing roads, pavements, trees, and even migrant laborers, whenever a patient is found in a building, the staircases, floors, and grounds continue to be sanitized. I am not even a novice on Bacterial evolution, but on my rudimentary understanding- this use of sanitizers scares the shit out of me. It is not that I am totally sure that fomites don’t spread covid, but the focus on fomites has also meant the possible aerosol spread was not focussed on. What’s worse, in my opinion – the focus on fomites and sanitization has lulled large swathes of people into the sense of false security. People wash their hands, sanitize groceries, but when talking to people often take down masks. Almost 95% of the cases I have heard have of contracting covid from a distant family member indoors or at some function. Yet people continue to focus on sanitization while attending public gatherings and religious ceremonies. At one point in my society, deliveries had to be collected at the society gate while members celebrated Diwali, New years, and Republic day inside without masks in large numbers. To this day, servants and handymen are treated with suspicions while friends and family (some of whom may have more exposure) arent. We have a separate lift for non-members – while members don’t mind traveling in lifts with unmasked members.

However, another question posed by this pandemic is, what should be the role of the state? and what should be its Aim?

  • Is the Aim to try and prevent every covid infection – at cost of the economy and livelihood?
  • Is the aim to avoid the overcrowding of medical facilities so as to avoid collateral damage?
  • Is the aim to keep pushing potential cases in the future – so as to reduce potential cases by vaccination?

When it comes to livelihoods, we need to separate two strands – the effect on the economy due to natural fear in people & and lockdown invoked economic downturn.

The mathematics of economic catastrophe is clear enough to follow – while the mechanism of spread seems to allude even the best of the minds. Every time someone comes up with reasons for why Covid stopped spreading rapidly around the end of 2020 in India and began afresh in 2021. The lockdown had ended in October and *new normal* activities had opened by November, but it appears this increased activity didn’t immediately accelerate the pandemic. Intuitively I would guess it takes time to gain a critical mass and a similar time for it to reduce. The momentum of the critical mass of vectors ought to carry on the spread (due to unavoidable contacts) in spite of overall contacts being low. Maybe once the first fuel was exhausted, it took time to gain a similar mass of vectors before it could truly explode. Add to this the new variants and reinfections (especially those who were asymptomatic the first time), then maybe the second wave starts making sense. Or maybe I am just pulling theories out of my ass which has no value – Either way I don’t mind as no one seems to have any deep insight into this.

All well-meaning people have been trying to shield the elderly for over a year. I have myself spent hours convincing older people to stay secure. But at what point does this become unbearable for a 75-year-old? Would it be wrong for an older person to be to think that they might not survive the pandemic (dying naturally amidst it) to live the end of the pandemic? Can they decide to take the risk of living a few months dangerously ahead of being condemned to a year in lockdown. (This equation has changed now with vaccines but the question still carries some weight I reckon)

Maybe this time next year we would have more answers than we have at this point. And hopefully, we would devise better strategies in countering such events in the future than acting like imitating monkeys in an experiment.

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Ancient and Modern Medicine

My friend Dr Joishy is a very well respected physician (an oncologist by training, with a special interest in palliative medicine). He also comes from a family of Ayurvedic practitioners and a long time ago he wrote a small article about ancient medical systems and modern medicine. He shared it with me, I liked it, one thing led to another, and here is his note about that article (unfortunately not available in etext form, only as a scan, see link in the following note).. I hope to do a podcast with Dr Joishy one day by the way..

ANCIENT MEDICAL SYSTEMS VS. MODERN MEDICINE:

BOTH CAN THRIVE TOGETHER IN THE EAST OR THE WEST

 By Suresh K. Joishy, M.D., F.A.C.h.P.M.

                 My good neighbor Dr. Omar Ali and myself were having a mutually interesting conversation on ancient medical systems and modern medicine.  I had published a paper on this topic titled “Towards Ideal Medicine: What Can Traditional Medicine Teach Us?”   This paper can be accessed by copying and pasting the following link onto an internet browser:

https://drive.google.com/file/d/1zDhnS11SFkhEKUomFVpLuPY1n4wNhEyD/view?usp=sharing

After reading it, Dr. Ali suggested I submit it to “Brown Pundits” but we did not have an electronic copy. The scan is attached above.

My paper was written in 1981, when I was practicing Hematology and Oncology  in the U.S., after a research assignment in Malaysia.    Since I am a medical graduate from India, my grandfather was a physician in Ayurveda, and as I lived in several states of India, I was able to closely observe the ancient medical systems still in practice and thriving.

I am a practitioner of modern medicine.  I believe in science and evidence-based medicine.  Then why write about ancient medical systems?  My paper addressed this very question as to why Ayurveda, Unani and Traditional Chinese Medicine were thriving despite the success of modern medicine in curing infections with antibiotics and no limits to what a surgery can accomplish to repair, replace, or transplant organs.  I have described the science of modern medicine and compared it to Ayurveda,Unani  and Traditional Chinese Medicine (TCM).

Rather than dwell on the past again, here I will give my views on what has transpired since 1981,  after which I was teaching and conducting research abroad in Malaysia, Saudi Arabia, England, Japan, and New Zealand.  I also observed ancient medical systems were still thriving over there. Continue reading “Ancient and Modern Medicine”

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Razib Khan corona-casting in the time of coronavirus

I recently talked about coronavirus with our old friend Kushal Mehra. I decided this is probably a time where I can post all the different coronavirus related podcasts I’ve done. I started on February 17th, on my podcast with Spencer Wells. You can see all the podcasts in rough order of date recorded…

It’s not live yet, but I’m going to have an episode on Two for Tea soon (it was recorded before the two below, so I put it here).

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Browncast episode 88: Phillipe Lemoine, covid-19 “optimism”

Another BP Podcast is up. You can listen on LibsynAppleSpotify,  and Stitcher (and a variety of other platforms). Probably the easiest way to keep up the podcast since we don’t have a regular schedule is to subscribe to one of the links above!

You can also support the podcast as a patron. The primary benefit now is that you get the podcasts considerably earlier than everyone else. This website isn’t about shaking the cup, but I have noticed that the number of patrons plateaued a long time ago. This month has been our biggest traffic month ever, and I think our corona-casts have been popular (patrons also get access to one that you can’t find on the public feed).

I would though appreciate more positive reviews! Alton Brown’s “Browncast” has 30 reviews on Stitcher alone! Help make us the biggest browncast! At least at some point.

This week I talked to Phillipe Lemoine about his blog post Are we headed toward an unprecedented public health disaster? A philosopher by training, Phillipe is now working as a data scientist, and he has been looking a the patterns of fatality in Europe for the past several weeks.

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The Weather, South Asia, and coronavirus

I have a post where I analyze the idea that weather has an effect on the spread of coronavirus. One thing to note is that the best models focus on absolute humidity. This means that coastal Karachi is much better placed than inland Lahore, because Lahore often has low humidity. Mumbai shouldn’t be well suited for the spread of coronavirus at any time of the year (absolute humidity too high).

The major confound here: air conditioning. This creates a bubble of low absolute humidity, so coronavirus could spread very well in these environments. If you believe these results, one might want to turn off air conditioning in offices.

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The Consequences of Coronavirus

A couple years back, I spent my down time playing a video game called Plague Inc. The game starts off with you playing as a bacteria, parasite, fungus, or of course as a virus. Your objective is to spread yourself across the globe infecting as many humans as possible, eventually leading to the culling of all of humanity. To win, you must silently evolve and spread, careful to not alert too many humans nor remain too isolated. On the way, you cause travel bans, mass hysteria, political clashes, etc… Sound familiar?

Screenshot of Plague Inc – A Popular Disease Simulator Game

Now, we are seeing an eerily recognizable reality to the fantasy of that game. Coronavirus-19 has become the modern plague of our times. And while it is no where near the level of Plague Inc’s apocalyptic end game, COVID-19 threatens to upend many of our society’s given structures and force the world down a new path.

Continue reading “The Consequences of Coronavirus”

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