Video still from news report about what happens when you are admitted to a COVID-19 intensive care unit

Trumpism Fallacies About COVID-19 That Could Cost Your Life – “Asymptomatic”

by Richard Cameron


 

Trumpism Fallacies About COVID-19 That Could Cost Your Life – “Asymptomatic”

There are many misleading narratives about the COVID-19 pandemic, that if you base your lifestyle choices around them, you could wind up extremely ill, experience permanent damage to your respiratory and cardio-vascular system, or succumb to the symptoms and die.

That statement, it would seem, would not or should not, be news to many people or be controversial, but the evidence that it is –  is born out in both public behavior and in the attitudes of a significant segment of society that journalists and public health experts describe as denialists.

When the first surge in infections and deaths revealed itself around the third week of February, the response from the political right, from Trump down, was that what was being reported was a “manufactured crisis” or as Trump described it, a “new hoax”.

We saw the emergence of a class of media and science critics to join the ranks of such as Anti-Vaxxers, dubbed, “Floomers” – people who imagined the coronavirus as being nothing more significant than merely an iteration of the annual flu.

Much of the most prominent trafficking of COVID-19 denialism narratives took place on Fox News. Typical of this, was a diatribe in May, delivered by Laura Ingraham, who told her audience, “Social control over large populations is achieved through fear and intimidation and suppression of free thought. Conditioning the public through propaganda is also key. New dogmas replace good old common sense.”

Over the following five months, the number of infections have multiplied in the United States from several hundred and the deaths of a few dozen, to where we stand at the moment, with over 3 million infections and nearly 132,000 fatalities.

The denialism is insidious, crass, feckless, but most important – deadly.

What follows will be a brief look at the misconceptions inherent in COVID-19 denialism and then provide counter arguments based on scientific consensus. All of the fallacies we outline here are inter-related to one degree or another, but we will begin with the notions surrounding the status of being “asymptomatic”.

People who resist community mitigation (stay at home directives, the donning of PPE and social distancing), universally object on the basis of their belief, paraphrased as, “I’m not infected, I have no symptoms!”

This is the foundation for their rejection of state mandates prohibiting large gatherings and anger regarding the restrictions applied to gyms, movie theaters, bars, beaches, parks and parties. It also arises when retail establishments condition shopping to the wearing of protective face covering.

The logical fallacy of “asymptomatic = not infected” is pernicious. There is an expression that describes the problem well. It is often attributed to Mark Twain and although there is some dispute among literary scholars, whoever coined it describes a fundamental truth:                   

“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.”

And what many people, “know for sure, that just ain’t so”, is the assumption that because they don’t perceive any symptoms, ergo they are not infectious to others. It just ain’t so.

There is a counter-argument on this issue based on misrepresentations of news reports and we need to look at it for a moment. It stems from a comment made in a press conference of the World Health Organization on June 8th by Dr. Maria Van Kerkhove:

“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual. It’s very rare.”

It was both an ill considered statement and unfounded. Without apologizing for the misstatement or offering a credible explanation for having dispensed it, Van Kerkhove, issued a clarification the following day.

“Some estimates of around 40% of transmission may be due to asymptomatic, but those are from models, so I didn’t include that in my answer yesterday, but wanted to make sure that I covered that here,” “I was responding to a question at the press conference. I wasn’t stating a policy of WHO or anything like that. I was just trying to articulate what we know. And in that, I used the phrase ‘very rare.’ And I think that that’s a misunderstanding to state that asymptomatic transmission globally is very rare. What I was referring to was a subset of studies. I also referred to data that isn’t published.”

On the 10th, W.H.O. Director General Dr. Tedros Adhanom Ghebreyesus sought to further clarify the official position of the organization, telling reporters that the agency has said since early February that “asymptomatic people can transmit COVID-19, but that we need more research to establish the extent of asymptomatic transmission.” Notice that it was not a question of “if”, but rather a matter of precisely the degree.

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“We’re six months into a pandemic. There’s a huge amount of research that’s being done, but we don’t have that full picture yet.”

– Dr. Maria Van Kerkhove

It was too little, too late and too equivocal and the damage was done. Academicians in NGOs, in this case, the World Health Organization, fail to comprehend that in many countries, such as Brazil, India, Nigeria and indeed the U.S., the pandemic has been politically weaponized and any statements that don’t properly qualify the context are going to be seized upon immediately by those who cleave to junk science.

It has been established that the COVID-19 “truther” movement is an extension of the Anti-Vaxx and to a comparable extent, the Climate Change denialist movement.

The COVID-19 denialists in the right wing media, (Fox News, InfoWars, Breitbart, etc.) and in the GOP contingent in Congress, seized upon the misleading statement and it spread throughout the rank and file of Trump voters and consequentially, became a rallying cry for people who rebel against efforts to prevent further spread of the virus. It was an “aha!” moment for them.

This was a post on Facebook from June 8:

meme from June 8, 2020 posted on Facebook, claiming that asymptomatic transmission of COVID-19 is "hysteria" and fictional.

Alternately, the scientific community reacted strongly against the implications derived from Van Kerklove’s incompetent messaging. We’ll audit a few of the majority of dissenting voices.

Liam Smeeth, Professor of Clinical Epidemiology, London School of Hygiene and Tropical Medicine, said:

“I was quite surprised by the WHO statement, and I have not seen the data the statement is based on.  It goes against my impressions from the science so far that suggest asymptomatic (people who never get symptoms) and pre-symptomatic people are an important source of infection to others.

This is the main basis for steps such as self-isolation and lockdown – steps we know, from yesterday’s two Nature papers have massively reduced the numbers of people infected and have prevented millions of deaths globally. There remains scientific uncertainty, but asymptomatic infection could be around 30% to 50% of cases. The best scientific studies to date suggest that up to half of cases became infected from asymptomatic or pre-symptomatic people.”

Babak Javid, Principal Investigator, Tsinghua University School of Medicine, Beijing, and Consultant in Infectious Diseases at Cambridge University Hospitals, said:

“Without having access to the data Dr van Kerkhove refers to, it is difficult to make any other assessment. I’m sure those data will become publicly available in due course. In the meantime, other data available, from studies in several continents confirming that presymptomatic transmission does occur would suggest that being well does not necessarily mean one cannot transmit SARS-CoV-2.

However, the important point is made that some even very mild symptoms that are not ‘typical’ of Covid (i.e. not having a fever or cough) may still represent someone who can be contagious. 

“There is, unequivocally, asymptomatic spread,” Dr. Barbara Ferrer, the Los Angeles Public Health Director, told ABC news. “I don’t want anyone to get confused that people who are asymptomatic may not be capable of spreading. They are, in fact, capable of spreading and we all need to keep that in mind.”

And finally, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and prominent member of Trump’s COVID-19 Task Force also weighed in, responding adamantly that:

“There’s no evidence to indicate that’s the case. And in fact, the evidence that we have, given the percentage of people — which is about 25% to 45% — of the totality of infected people, likely are without symptoms. And we know from epidemiological studies they can transmit to someone who is uninfected even when they’re without symptoms.”

A major aspect of the confusion resulting from Van Kerkhove’s comments, has to do with the dichotomy between what some scientists mean when they use the term, “asymptomatic” and what the general public understands when they hear it.

“Asymptomatic” in the parlance of epidemiologists, usually means that it is a class of those infected, who never display symptoms from the onset of the infection, to the point where they pass beyond the infectious stage. This is distinguished by them, from those which are “pre-symptomatic” – persons who are infected and who do eventually display symptoms during the span of time they are actively infected and test positive.

Such individuals in the category of asymptomatic, it has been established, can transmit the disease without awareness of symptoms (“silent transmission”), and estimates of spread from persons in this category of status, range from one in six, to as many as four out of ten.

The practical implications of that are that if you are standing or sitting in a confined space, such as a Trump rally, three people among the ten that are inside your social distance zone (in this example, non-existent) that are not displaying obvious symptoms, are capable of infecting you.

It’s important to understand that COVID-19 is a new member of the family of respiratory diseases that emerge with a host of unknown characteristics. That is precisely why the coronavirus that originated in Wuhan, China was classified as “novel” – meaning essentially that it is a unique strain of virus and consequently, in a practical sense, there is an extended learning curve for scientists.

That learning curve regarding contagion, symptoms, health effects, morbidity and treatment, extends to our present moment.  Novel viruses also mutate in unpredictable ways.

And to illustrate this, some new findings reported just a month out from the misinterpreted W.H.O. comments, strongly reinforce the predominant view among scientists and public health officials that asymptomatic people do in fact, spread the coronavirus at a significant rate.

The conclusion was the result of a model compiled by American and Canadian researchers and published in PNAS (Proceedings of The National Academy of Sciences), applying data collected internationally within two separate epidemiological studies examining asymptomatic and presymptomatic transmission. The statistics demonstrate that more than 50% of infections were attributable to people not exhibiting symptoms.

From the summary of the published study:

We evaluate the contribution of presymptomatic and asymptomatic transmission based on recent individual-level data regarding infectiousness prior to symptom onset and the asymptomatic proportion among all infections. We found that the majority of incidences may be attributable to silent transmission from a combination of the presymptomatic stage and asymptomatic infections. Consequently, even if all symptomatic cases are isolated, a vast outbreak may nonetheless unfold.

In the second report in this series, we will deal with other aspects of COVID-19 denialism and associated fallacies surrounding this pandemic, including the mask controversy.

Trump supporters and COVID-19 "Truthers" crowded together on a boat with no social distancing or protective face covering during a 4th of July boat parade

Stay tuned for that, but in the meantime, I will let Amanda Marcotte, writing in Salon, sum up the mentality that is prone to these misconceptions and the almost futile level of effort required to disabuse them of their notions, if in fact that is even possible:

Unfortunately, as we’ve seen with climate-change conspiracy theories, once they take hold, it’s very hard to pry people free from their delusional beliefs. If you confront them with the evidence that the threat is real, they simply move to claiming it’s overblown.

George Soros will probably be blamed. Or they’ll come up with excuses for why they personally won’t be affected and so shouldn’t care. Or they’ll just shift to casting aspersions on the motives of people who do care, whether that’s Greta Thunberg or Dr. Anthony Fauci, accusing them of being tools or power-hungry schemers.

They’ll embrace any view, really, except admitting that the problem we’re all facing is real and that yes, we have to do something about it. 

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