Primary Author: David Williams, MD
Revised April 23 with updates to section regarding COVID-19 deaths and the addendum.
This is being written on April 19, 2020. Although there is a central author, it is being written on behalf of multiple physicians in West Alabama and will be distributed through multiple medical offices. Between us we have well over a hundred years of practice and have treated hundreds of thousands of patients suffering infectious diseases. Including mission trips we have treated patients on five continents. We planned this date for several reasons. First, most of our patients now realize there is something “funny” about the coverage and handling of this disease. Secondly, if it wasn’t being handled differently by April 19, we knew it would take action from us and our patients to change that handling. Finally, we were told in March by our state officials that experts predicted New York, Florida, Texas, and Alabama were projected to have the median most fatalities from the COVID-19 outbreak with the peak in Alabama expected to be April 19. On this date, Alabama was supposed to be on pace for 5,516 deaths and be short over 21,000 hospital beds. The information just listed, and every piece of information discussed below, can be verified with a quick internet search. Many of the sources will be directly referenced. So here goes:
TRUTH: COVID-19 is an actual medical disease that will lead to tragic deaths. Although this seems obvious, it should be clear that no one involved wishes to express anything but sympathy to those affected and their families. Respiratory failure is a terrible way to die. That is true if that death is due to asthma, COPD, pneumonia, influenza, smoke inhalation, cystic fibrosis, ALS, or COVID-19.
LIE: We don’t know much about coronavirus. This is one of the media’s favorite lies. It is much scarier if it is unknown. We know that coronavirus is a zoonotic disease. In other words, it’s natural hosts are birds and animals as opposed to humans. We vaccinate domestic animals for them. We know that four forms cause colds every year. We know it mutates and evolves just like the flu. We know it sometimes becomes deadly as it has in SARS and MERS. We have done medical studies on coronavirus as a coexisting illness in patients in the past.
LIE: COVID-19 is more infectious than influenza. This is one of two lies most often quoted by the millions who call national radio programs or post on social media. It is amazing how many people with absolutely no medical training somehow feel qualified to comment on this disease. Now, we want to be more fair than the national media so we are obligated to report there will never be a study where 1,000 people eat after people with the flu and 1,000 others eat after people with COVID-19 to see which one is more infectious. But the evidence is overwhelming. COVID-19 was first identified late December/early January. A little over three and a half months in, we have slightly over 2 million confirmed cases globally. By comparison, according to the National Center for Biotechnology Information (Google Influenza Update- NCBI), influenza is responsible for up to a billion infections annually. Flu season is basically from the start of October until April. At the flu’s three and a half month mark, that works out to 583 million cases globally. Even accounting for the fact COVID-19 is underreported that is a HUGE difference.
However, there is even further evidence influenza is more infectious. Drawing from our own (meaning everyone reading this) experiences, when influenza gets started in a daycare or elementary school, they often have to be closed for a short time because otherwise everyone gets it. All the kids, workers, teachers, and parents. The most students in one class we could remember was 23 of 25 out at the same time with the flu. Certainly, daycare classes in both Tuscaloosa and Jefferson counties have been closed this year. Contrast that to what you know about coronavirus. The NBA tested hundreds of players, staff, and media to come up with 14 cases. The vast majority did not contract the virus at all. The most extreme case in terms of possible COVID-19 exposure we could find was the aircraft carrier USS Theodore Roosevelt. If you have never toured a military ship, space is at a premium. Very tight and crowded conditions. Secondary to this, hundreds of crew would become infected. So 4,800 men and women were exposed to multiple individuals with the virus several times a day, day after day. Despite that constant exposure, 4,140 (or over 86%) of those sailors would never even contract the disease.
To address the possible rebuttals, it is absolutely true we don’t know the true number of COVID-19 cases. It doesn’t make the average person under 60 sick so we will never account for all of those. However, it doesn’t even infect the average person with a healthy immune system who comes in contact with it, so the number can only be so high. It is true that testing has not been available everywhere the entire three and a half months but we are making up for that by testing generously now. Locally, DCH had tested 3,105 by April 17, 2,958 of which were negative.
LIE: COVID-19 is more dangerous than influenza. The second lie of the medically uninformed. Even among those who do contract COVID-19, most under 60, including virtually everyone under 21, will never know they had it. On the USS Theodore Roosevelt, 60% were asymptomatic. Of the 2 million people who have tested positive for COVID-19 globally, most have had mild to no symptoms. By the three and half month mark of flu season, the flu had resulted in over 2 million severe cases requiring hospitalization. Influenza results in 290,000 to 670,000 deaths annually. COVID-19 deaths will be discussed below.
LIE: The fact one doesn’t know he or she has COVID-19 makes it more dangerous. All viruses shed and are primarily spread while the infected host is asymptomatic. Repeat, all viruses do this. We use the term virulence to describe how dangerous a virus is. The more virulent, the more likely to cause infection or more severe symptoms. One’s chance of becoming infected with anything is multifactorial. In other words, lots of things come into play. The infectiousness and quantity of the pathogen comes into play. Your level of rest, nutrition, stress, age, and general health come into play as well. In the case of influenza, if you contract it you are going to get sick. There will never be a time where the NBA tests hundreds of players and staff to find 14 cases of influenza – two with mild symptoms and twelve with no symptoms. If you get influenza, even if you are Michael Jordan (who had perhaps the most famous flu game of all time), you are going to know. That is because the flu is so virulent that in 24 to 48 hours it overwhelms even the immune system of a healthy adult and you develop symptoms. But in that 24 hours it is multiplying, everyone around you is at risk. Depending on the exact exposure, the risk goes from high probability to certainty of contracting. For instance, if a high school student kisses their boyfriend or girlfriend during that day, they are getting the flu, period. But COVID-19 is so much less virulent it usually never overcomes the immune system of a healthy adult. Yes, they will shed this virus for up to 2 weeks, but most people around them still won’t get it. Since we are in West Alabama, let’s use a football example. Think of the healthy adult immune system as Alabama’s 2019 football team. Influenza is LSU’s 2019 football team. It only took one exposure to LSU to record a loss. COVID-19 is closer to Arkansas’ 2019 football team, maybe Ole Miss. Alabama could have played them 14 times and were less likely to lose than the one game with LSU. It is possible to record a loss, with some fumbles and a blocked punt, etc. but way less likely.
TRUTH: COVID-19 is more dangerous to the elderly and immunocompromised.
TRUTH: That doesn’t really mean anything in and of itself because everything is more dangerous to those unfortunate individuals. It does mean we should try to protect those individuals from infections in general.
TRUTH: It is now almost impossible for anyone in the general public or general medical community to know the actual number of deaths from COVID-19. That is because sometime in March US hospitals started testing all ER patients and every patient who died, regardless of cause of death, for COVID-19. Those patients are being included by the media in COVID-19 death tolls. Yes, a victim of a car accident brought to a US ER who passes away will be tested for COVID-19. Two of the most egregious examples of misrepresentation involve infants. One of the fascinating things about coronaviruses from a medical standpoint is children are almost universally immune to deleterious effects. A study from back in 2004-2005 was conducted in which swabs were done in both controls and children hospitalized for respiratory illness. The incidence of coronavirus was the same for controls and hospitalized children and the conclusion was HCoV (coronavirus) infection was not associated with hospitalization or with increased severity of illness in those hospitalized due to other infections. Search NIH if you want to review these findings. Obviously, COVID-19 is not included in that study since it was first identified recently. However, COVID-19 has not been associated with pediatric illness anywhere. Not China, South Korea, Italy, or Spain. So on March 29 when BuzzFeed.News and an Illinois paper, The Guardian, led with the headline “The First Infant Has Died In The US After Testing Positive For The Coronavirus,” it caught our attention. The article goes on to say the infant’s death was announced by Governor JB Pritzker and, depending on which article you read, either Pritzker, or Dr. Ngozi Ezike, director of the Illinois Department of Public Health, said: “If you haven’t been paying attention (to COVID-19), maybe this is your wake-up call.” On April 2, CBS News reported Connecticut Governor Ned Lamont had announced “It is with heartbreaking sadness today that we can confirm the first pediatric fatality in Connecticut linked to COVID-19.” He went on to say it was likely one of the youngest deaths from the disease “anywhere.” The problem is neither death has actually been attributed to COVID-19. On April 3, the Hartford Courant correctly clarified that all patients who die in Connecticut hospitals were being tested for the virus, regardless of manner of death, and that Connecticut’s Chief Medical Examiner had not ruled COVID-19 to be the infant’s cause of death. Just yesterday, April 18, NBC 5 Chicago reported Chicago Department of Public Health Commissioner Dr. Allison Arwady said it is preliminarily believed the infant in Illinois did not die from coronavirus.
New York is also a source of great misinformation. On March 22, Sky News ran footage of a hospital in Italy. On March 25, CBS This Morning ran the same footage. However, they claimed it was filmed in New York. Citizen reporters by the dozens have recorded empty testing tents and idle ambulance crews when the national media has reported hours long waits at the same testing sites and overstretched ambulance crews. You can find those videos on Youtube, although they don’t always make it easy. But there are enough people interested in getting the truth out there they are consistently reposted. At the time of publishing this link was successful https://youtu.be/MOBKyCY2esw. On April 14, the New York Times reported New York City officials at the Health Department had increased its death toll by 3,700 who NEVER TESTED POSITIVE for the virus. They were “presumed” to have died from it.
REVISED April 23, 2020. This is actually much worse than we thought. According to worldometers.info from January 1 to April 1, 2020 the worldwide deaths from COVID-19 were 46,438 as opposed to 121,993 for influenza. To recap, during the same three months, with the same social distancing, the same shelter in place, and even handicapped with a vaccine against it, the flu still killed more than two and a half times as many people as COVID-19. In terms of deciding to shut down the economy, there were 11 causes of death on the list. Influenza and COVID-19 were ranked a distant 10th and 11th. On March 23, 2020, a Vox.com article by Dylan Scott outlined COVID-19 risks by age group. CDC figures cited a death rate of 2.7 percent for those 65 to 74, 4.3 percent for those 75 to 84, and 10.4 percent for those 85 and over.
How does a virus that killed 46,438 globally in three months (and which about 96% of those 75 to 84, and 90% of those 85 and older survive) suddenly kill 143,984 in the next three weeks, according the same worldometers.info?
On April 2nd, 2020, the National Vitals Statistics System, which is part of the CDC, provided new guidance regarding the issuing of death certificates. COVID-19 was to be listed if it was assumed to cause or contribute to a death. For example, if someone dies from pneumonia, respiratory distress, or COPD, and has exhibited coronavirus symptoms, their certificate will list COVID-19 as a presumed contributing factor. Since shortness of breath, fever, and/or cough will be exhibited in all respiratory illnesses, every such death could potentially be recorded as a COVID-19 fatality. This certainly appears to be happening across the board. We have never seen any disease handled in this way. Any medical professional who can provide an example of similar protocol is encouraged to share such a case. It completely defies any scientific method to work based on assumption. Even doctors opposed to reopening the economy should be upset because we will never have accurate numbers concerning this disease. To complicate matters further, if your city attributes enough deaths to COVID-19, it can request billions of dollars of federal aid.
TRUTH: The current policies instituted by our local, state, and national governments are causing greater health problems than the virus ever will. According to the Wall Street Journal, 22 million Americans have filed for unemployment in just four weeks. When you consider spouses and children, it seems reasonable that up to 70 million Americans would be affected by that number. Staying at home is not without consequence. Those individuals are at significantly higher risk of depression, suicide, domestic abuse, and other mental health issues. The stress is making them more likely to become ill from all manner of disease. Many have lost their insurance. Some will become divorced. Hundreds of thousands of medical procedures have been cancelled or delayed.
There is another threat to our health. Rural hospitals have closed in large numbers is recent years. The situation with COVID-19 has placed many more community hospitals of all sizes at risk. Most are relatively empty and are bleeding cash.
TRUTH: The media as a whole has grossly misrepresented this disease. We felt if we used the word “deliberately” we may have to present this as an opinion, but it sure appears deliberate. A couple of national examples include the CBS This Morning story referenced above and yesterday’s CNN story. The headline read “Jacksonville beach packed as Florida coronavirus cases hit record” and they ran a photo taken in the past of a Los Angeles County beach to show the crowd. Locally, on April 14, local news outlets used the headline, “Mayor Walt Maddox to Pitch Plan to Re-open Tuscaloosa on April 28th.” While not technically untrue, that sounds like the plan is to re-open the city on April 28th. In reality, it should have read, “On April 28, Mayor Walt Maddox to Pitch Plan to Re-open Tuscaloosa,” because no plan is even to be presented until April 28. A Tuscaloosa News headline today read “Prison system reports COVID-19 death.” You had to read the article to find the 66 year-old victim was already terminally ill and had been hospitalized since April 4th in critical care for his preexisting conditions. He only tested positive on the last day of his life.
OPINION: The way in which the media has pushed fear nonstop amounts to psychological warfare against this country. If it hasn’t occurred to you that we have heard one story and essentially one story alone for literally two months, well, that should have aroused suspicion.
TRUTH: The media will continue to fight reopening of this country by stating “experts” predict a spike in deaths if we do so. We would assume those are the same experts who initially predicted 2.2 million US deaths, revised to 200,000, then 100,000, then 60,000, then ordered testing all US deaths just in case they had coronavirus because we weren’t on pace for even 30,000 prior to that change in policy.
TRUTH: Not every country has shut down their economy, and none of those countries have suffered higher rates of death because they have kept their economy going. One of the searches done prior to putting this together related to countries who kept their businesses open. One of the lowest mortality rates in the entire world is Japan, who fits that description. Looking for the country with the highest mortality rate and an open economy, we came across an article with a very liberal bent that described two Scandinavian countries. It described how uncaring Sweden was as it conducted business as usual while Denmark cared for its’ people and shut down. The expected mortality rate for Sweden was 69 per million whereas Denmark was 39 per million. If you take 69 and multiply it by 340 (for 340 million people in the United States) it comes out to 23,640, or about 15,000 fewer people than we are expected to lose to the flu this year.
OPINION: Medical organizations have failed this country. Literally every doctor in America should know everything listed above. So why haven’t organizations like the AMA and AAFP, as well as state organizations, presented this information to their governors and the President?
TRUTH: China is involved, but not how you think. We can not tell you how many times people have expressed consternation about not knowing what China is hiding. Generally, they feel it is horrific death numbers or the genesis story of the virus. China withheld information about the virulence of COVID-19. They knew they had cases of asymptomatic individuals, possibly hundreds of thousands such patients. By not including this data it changed the mortality rate greatly. Initial terror regarding COVID-19 was a 4% mortality rate in China. Most would now concede the mortality rate is less than 0.2% given the high number of asymptomatic patients. Meanwhile, the Chinese are buying property in affected areas, particularly Italy, and likely not unhappy with what is happening in America given their trade battles with President Trump.
TRUTH: The NBA cancelled their season voluntarily, with no external domestic pressures, and China is a huge market for them. Their financial interests in China were threatened after a single tweet from Houston GM Daryl Morey in October supporting Hong Kong protestors. After literally a single runny nose, the NBA cancelled their season and proceeded to test hundreds of healthy individuals looking for COVID-19. We find it fascinating no one in the media, and certainly no one at ESPN, has asked questions about that behavior.
TRUTH: People are lazy, or they have an agenda. Not only did the media not ask pertinent questions about the NBA, they have not reached out to knowledgeable health professionals even when they were provided the names and contacts of such individuals. If the narrative did not fit COVID-19 terror, it was ignored. We know this has happened both locally and nationally. Local, state, and national politicians have done the same thing. All of the information here is readily available. So if any elected official has said anything along the lines of “as a leader, I feel a responsibility to keep people safe,” to support restrictions on you or local businesses, ask that official what research he or she was basing his or her decision on. The general public is lazy. They read headlines. Grossly misleading headlines. So when you pass this on, you will have to insist people actually read the whole thing.
TRUTH: Amazon founder Jeff Bezos is making a fortune, and he wants you to stay home. In addition to owning Amazon, he owns the Washington Post. Just read any headline or article it has ever written regarding a plan to reopen the economy. Do with that information what you will, but we hope it means you stop ordering from Amazon and support local businesses instead.
TRUTH: COVID-19 has been treated like a world-ender; it’s not even remotely close. As mentioned earlier, it has infected just over 2 million people in the world. Not killed 2 million people. Actually, not even made 2 million sick. Just infected. So it is 76 million short of infecting 1% of the world’s population. It is 998 million short of infecting as many as influenza has this year, the vast majority of which are sicker than the average coronavirus patient. The world has never shut down for any disease before. And it chose this one to do so?
TRUTH: Quarantine is a period or place of isolation in which people who have been exposed or infected with a contagious disease are placed. The government has used it to impose shelter in place on healthy individuals and close businesses. There are words for that, but quarantine is not one of those words.
TRUTH: This is not a medical crisis, but a political crisis. There is a saying in politics, “never waste a crisis,” and this is apparently true even if the crisis is fabricated. We briefly debated leaving out politics, but the reality is most have already figured this out and there is no explaining the phenomenon that is COVID-19 hysteria without talking politics. In short, Democrats attempted to impeach Trump late in 2019 and failed. Shortly after a State of the Union address in which he touted considerable economic success, COVID-19 was made front and center by the media. Most probably feel both parties have failed us but there is no debating which party is most responsible for pushing the fear. Every time President Trump argues for reopening, the press and the Democrats gnash their teeth and talk higher death tolls. The governors of Illinois and Connecticut who incorrectly reported infant deaths are Democrat. Michigan governor Gretchen Whitmer, who has gone so far as to restrict her state’s residents from mowing their lawns and planting flowers, is a Democrat. Louisiana governor John Bel Edwards, who threatened to permanently take licenses from open businesses and organize a special police task force to arrest anyone in groups of more than ten, is a Democrat.
Mayor Walt Maddox is a Democrat. He told us in March that if he did nothing Tuscaloosa County would experience 3,686 deaths due to COVID-19. Think about that for just a second. It was first identified in Wuhan, China, a city of over 11 million people. China has a population of 1.4 billion and at the time of his presentation, COVID-19 had killed a little over 3,200 in the entire country. Tuscaloosa County has a population of just under 184,000 and is considerably less densely populated than Wuhan, China. That number is not only meant to do nothing except incite fear but indicates a serious lack of insight and judgement.
TRUTH: The Alabama coronavirus numbers presented in the opening paragraph appear to be way off. We are nowhere near 5,000 deaths. In fact, we currently have only 4,700 total cases and 113 deaths. Tuscaloosa County has yet to experience a single death. DCH reports five or fewer inpatients in the ICU (they will only report units of five to protect privacy) being treated for COVID-19 with five or fewer on ventilators. Again, every such patient is significant, but we are thankful the numbers are so small. While we recognize some may feel those numbers are smaller due to social distancing and/or shelter in place orders, COVID-19 numbers have not been affected by those behaviors when compared to countries where they were not employed.
TRUTH: If you love your children, enjoy sports, or know anyone who owns or is employed by a small business you should be angry. Very angry. We can absolutely take steps to protect the elderly and vulnerable, but everything should reopen immediately. Millions of high school seniors have been deprived graduations and proms. Millions of high school athletes have lost their spring season. Thousands of NCAA athletes have lost the same. Some will permanently lose their programs altogether due to financial issues associated with the coronavirus response. Your kids are at home when they should be with their teachers and classmates. Your neighbors have been prevented from working and businesses built over decades or generations have been lost or threatened. Absolutely NONE of it was or is necessary.
TRUTH: Nothing will change unless it is demanded. Seriously, take this, repost it, and act on it. It will have to happen nationwide. Call mayors, governors, representatives, senators. Call back the next day. Email them. Email these facts. Verify for yourself which facts you are comfortable utilizing. DO NOT BE LAZY. Call radio stations, TV stations, national news outlets. Send it to medical organizations like the AMA and AAFP. It needs to happen by the thousands. They clearly aren’t paying attention. Or they assume you aren’t.
ADDENDUM: I would like to address a few of the concerns and criticisms this document has received. I am changing from we to I because I am speaking only for myself. Primary criticism has been either 1) how do we know this is true/qualification issues or 2) it is a political piece.
The first criticism simply validates one of the main points of the document. This information can be verified and was valid at the time of publication. Most of the time, you were told exactly where you could find it. The complete lack of effort the public has shown to educate themselves about this virus has contributed to the terror it has created. It really shouldn’t matter who wrote it if the information is valid. I am not an epidemiologist, but, for the record, it was reviewed by one and he agreed.
The second criticism I can at least understand. The objective of the paper was not to be political but to recognize the role it plays in behaviors related to the virus. Frankly, I have never been able to successfully explain why we are hearing so much about a virus that doesn’t make most people sick without involving the politics (and I have tried, and that information is also available). However, I may not have done as well as I could have in conveying that. I am not happy with either party’s handling of the issue. I have had political discussions with patients of every race and persuasion and said the same. Both parties have failed us. I haven’t voted for somebody in way too long. I have voted against somebody else. I have told everyone that has to change if we are going to make it. My primary political concerns are reduced health care premiums, lower deductibles, less expensive drugs, lower taxes, taking care of the environment, and smaller government. We should take care of ourselves and each other. It is my opinion, though, that the media and the Democratic party are most responsible for pushing the fear and trying to keep us from reopening the economy. The point of the paper is to suppress fear, dispense information, and reopen the economy. Yesterday (April 21), Texas’ Governor and Lt. Governor called for reopening their state and the country. The article in The Hill goes on to say Texas has nearly 29 million people with 19,458 having tested positive for coronavirus and 495 fatalities. The response of Texas Democratic Party Chair Gilberto Hinojosa was that they “would put Texans at-risk to enrich themselves and their stock portfolios.” “They would see our family members die to bail out Wall Street,” Hinojosa said. “The lives of our families, our friends, and our communities have no dollar amount. Texas Republicans can no longer claim to be the pro-life party anymore.” You can draw your own conclusions. I based mine on statements such as those.
REVISED April 23, 2020. For those who question whether I am truly anti-fear, as opposed to having another agenda, President Trump disagreed “strongly” with Georgia Governor Brian Kemp’s decisions to reopen certain businesses in his state. I strongly agree with Governor Kemp.
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