Fauci and the vindication of science

irresponsibility, the danger of non-transparency, and China's plague

Wishing all a peaceful and healthy Christmas regardless where you are or whether you celebrate its meaning. Many of us have annoyances, to include massive snow drifts and cold, but we all know this is occurring because of news circulating among people, on the internet, or on clunky old traditional news outlets.

China has no such luxury. The internet is closely monitored to prevent aggregations of angry folks. Reliable transmission of news is often by word of mouth but that is problematic around the People’s Republic because many obstacles and distance preclude those facts from circulating. Instead, distrust and half-truths abound.

28 days ago today we saw protests proliferation across the country as people demanded revision to the ‘Zero-Covid’ policy limiting their movements for long stretches of time and leading to a tragic fire in Urumqi killing an undetermined number of Uyghurs earlier that month. Most analysts expected the Communist Party to crack down on the demonstrators rather revise a policy so closely associated with General Secretary Xi Jinping. Xi had shown no willingness to bend on the policy, regardless of the cost to the economy, personal lifestyles, or much else.

No doubt increased public security surveillance did intimidate many Chinese immediately following the protests but shockingly the government scaled back the Zero Covid rules. They did so with no obvious planning or attention to how the Chinese health care system would cope with the inevitable cataclysmic explosion of Covid cases.

China’s history of state-driven quashing of protests is ugly so I was relieved to see the restrictions reversed as I do not relish violence carried out against anyone. The Tainanmen massacre in 1989 alone left probably three thousand dead at the hands of the People’s Liberation Army, an arm of the Communist Party. I feared the Party would crack down so the shift on Covid ended that likelihood.

At the same time, I was vaguely uncomfortable that it seemed both sudden and poorly planned as a major shift in government policy. I have no medical training but am a consumer of science through a number of reviewed publications and I choose to believe that our government operates with public accountability, thus policy statements issued to us are overwhelmingly reliable. I personally have never understood the hubris of assuming I can have the same level of knowledge or conduct reasonable inquiry on medical questions through conducting my own internet searches versus relying on referreed research. This has always seemed folly to me but I realise it appeals to many. Yes, there are spectacular ‘failures’ in referreed publications but I think the conspiracy theories far outnumber serious cases of fraud. Give me evidence to the contrary and I will revise my thinking.

My vague discomfort resulted from not hearing them discuss Covid mitigation approaches that the United States and other accountable governments had taken almost three years ago. I am not interested in rehashing some of the public policy advice that surfaced from the White House in 2020. We received policy advice to limit exposure to others by staying home or wearing quality masks, receive innoculations when they became available, and to test for the virus. In the worst case, and it was pretty bad in March, April, May and into June of that year, those infected went to hospitals where our robust system struggled to meet the challenge of Covid. Tens of thousands died that year but the investigators—whether public or governmental—traced some of our policy advice to help us improve our national response. Millions took shots and survived. Millions of others chose not to take the advice recommended and many of them died but the advice. The virus, as a living entity, mutated to continue challenging us but that is a Darwinian reality of viruses. The health options gradually helped to stabilize a system in crisis. According to statistics this morning, 102,211,153 cases in the United States have so far led to 1,115, 933 deaths and 99,173,973 recoveries. Worldometer, Covid Cases U.S.A., 25 December 2022

The same website shows China with 400,178 cases total, 5,000+ deaths, and 2983 new cases. Worldometer, COVID Cases by Country, 25 December 2022 The problem is that these are figures supplied by Beijing. And thus the problems for the PRC.

The Chinese government numbers are notoriously non-transparent. This is true of all numbers on all subjects in China. Without accountability, there are no incentives for officials to report bad news to their superiors or to the public. Zilch. None. Instead, as happened in the 1950s with economic data for the Great Leap Forward under Mao Zedong’s leadership, the local officials revise numbers to fit a particular narrative about competency, in line with goals stated by the Party, or because they simply do not like delivering bad news. No one generally likes giving bad news but without someone to check back on your work, the seduction of massaging the bad into better, if not flat out good news is real. Xi Jinping, in his decade-long campaign to return the Party to a position of unquestioned dominance has dismantled, if not incarcerated, those voices demanding accountability. The people who are willing to admit mistakes are viewed as threats to the Party’s decisions. Virtually none of them exist in a systematic way today. There were simply no voices asking a month ago how the system would guarantee the fidelity of tracking Covid cases in the PRC.

Estimates, because absolutely no numbers circulating in China are authoritative or accurate, are that at least a million people contracted the virus daily in the past three weeks as Zero-Covid rules disappeared.'China Stops Publishing daily covid figures amid an explosion in cases', The Guardian.com, 25 December 2022 Indeed, the government announced it would not longer put out numbers on cases at all, a step taken not long after it narrowed the overall definition of a Covid death.

China has a terrible health case system, especially for its size. Primary care too often must be done in poorly funded local hospitals ill-equpped to address a pandemic featuring a virus that has been morphing for three years. Many Chinese still rely on versions of ancient Chinese medicine with spiritual and cultural norms but not scientifically-replicable and evidence-based. People don’t have the financial resources to do otherwise. Coupling the poor conditions in most local facilities with the lack of either Covid-resistent steps like N-95 masks or ability to separate from other potentially ill citizens creates an absolute public health disaster being highlighted repeatedly by those intrepid investigators going from place to place in the interior of the country. Associated Press correspondent Dake Kang, memorialised on Twitter frantic scenes and absolutely calamatous volumes of patients confronting hospitals inside the PRC. But few journalists are venturing into the interior to examine what is developing, for fear of their own health and because the situations are happening so rapidly. And China does have a population of somewhere nearing 1.4 billion people so the epidemic likely is a ways from running its course, especially with probable variants cropping up.

Beijing, Guangzhou, and Shanghai are not most of China. The facilities there are not even available to most of the tens of millions who live in those cities but the health care system in the most outwardly facing parts of the country do have more sophisticated facilities. According to these acknowledged anecdotes, the system appears in free fall.

China’s attempt to preclude people from Covid infections meant little immunity developed across the country. China’s vaccines, widely touted in Southeast Asia and in other portions of the world where the Belt & Road Initiative has expanded China’s influence, have proven less effective than those developed and used in the west. China would probably be effective at implementing a mandatory vaccination policy if they had enough vaccine supply. But that probably would require a level of cooperation between the Washington and Beijing that currently appears unimaginable. China cannot do it on their own.

This brings us to Dr. Anthony Fauci, head of the National Institute of Allergy & Infectuous Diseases who retires this week following a decades-long distinguished career. I am well aware Dr. Fauci has become a polarising figure for many in the United States. What I find far more remarkable is how accurately he predicted almost 33 months ago how the Covid problems would unfold. He noted the illness would not disappear through wishful thinking. He discussed why replicable studies, the basis of scientific inquiry, were required to prevent us from jumping off cliffs for unvalidated anecdotal solutions to curbing the problem. His work, while hated by so many, is a measure of both that transparency and validation essential to science and to health policy globally, not merely in the United States.

In one of his final interviews, Fauci warned us, much as the late Dr. Carl Sagan of Cornell University did in the 1980s and 90s, that one of our greatest poverties in the future is lack of scientific educaiton. Melissa Healy, 'Fauci's warning to America: We are living in a progressively anti-science era and that is a very dangerous thing', MSN.com, 22 December 2022 Science led us to revise our guidelines on Covid as it has led us to stop relying on leeches, for the overwhelming majority of the world, to cure some basic illnesses. Science is a progressive study rather than a one-and-done, and it relies on individuals presenting results that others can verify through the same method.

Science also gives us some parameters to expect. Some questions took time to answer such as how the virus was transmitted but the mathematical process of how numbers would proceed did in fact happen. Scientists methodically took the data they had to start answering questions about this mystery. We knew, based on other comparable illnesses, it had a somewhat predictable trajectory—one that would lead to many deaths but one that we could try options to ameliorate.

We are not China as we have the luxury of repeated examination of data and hypotheses in our system. The danger of discarding that process, however, and the doubts about the motives of those who engage in scientific research can lead us far backwards from where we are today. I, for one, do not want to go back to things without testing and validation. Science provides a methodical development of a hypothesis, rigourous testing of that hypothesis, and study of that process by replicating the process to assure its accuracy; this is based on the scientific method. It is absolutely incumbent, however, on us as citizens to be involved and attentive to rigourous thought rather than merely preferring our preconceived preferences. Those preferences, like actions, can have long-ranging consequences. FIN