By Bhaswati Bhattacharya
We are repeatedly reminded to trust experts, who understand technical language. After all, that is why we respect credentials of scientists and doctors, economists and electricians, plumbers and engineers…. epidemiologists and statisticians.
Who is Sick? In March when the world finally admitted that a viral contagion was leading to an epidemic, the first task was to know who was sick. The medical hegemony took charge, using emergency acts and legal rights to prevent others from interfering with systematic, sound and scientific assessment and implementation of the protection of the health of the public.
The Source. Biomedical science, the dominant legal system of medicine in the USA, in which we have invested trillions and trillions of dollars, identified the cause of disease. This virus, albeit common and found in soil and animals and air, appeared as a changed and empowered being now able to penetrate man’s defenses.
Once identified, scientists searched how it penetrates the body, assuming this miniscule virus caused the disease without providing evidence-based medicine. Physical objective methods of evidence were created through laboratory tests that look for the body’s antibodies against the virus.
The Test. Was the test able to pick up the antibodies? The technical terms are sensitivity and specificity. If the test has good sensitivity, it will pick up any antibody if it is there. Tests are usually 90-98% sensitive. If the test has good specificity, it will correctly tell whether the person truly has NO antibody.
What Positive Means. In the current scenario, saying someone is “positive” does not reveal three important details: what molecule of DNA antibody type they were testing for and how long it stays in the body to be detected, the name of the test with its sensitivity and specificity with how it was assessed for accuracy, and the method by which the cutoff of +/- is established.
That means the test you took was wrong 25%-60% of the time. In addition, by the time you got out of the clinic where you took your test, how do you know you were not exposed to the virus? So, by the time you get the results of your test saying you are negative, what does it mean? It often means very little.
Yet the news reports daily tallies of people testing positive. Authorities and experts worldwide base the utilization of resources and human efforts on these tallies. Still the rationale of the interventions being used and the conclusions being made are not providing clear scientific answers.
Tools. Ventilators are now purchased and available. PPE is there, shields, masks, gloves, gowns, covers. But are we discussing the overwhelming Fact that competent people are lacking to work the ventilators with all the parameters that need to breathe for the ill patient. Qualifications are there, but competence is not. Thus, recovery from a ventilator is around 20%. Nurses and doctors are legally prohibited from discussing the reality, as it can create a bad reputation for the hospital or clinic.
When a patient goes in desperation to the hospital assuming it will help them, most have no idea that the professional and qualified providers do not know…how to competently provide for them with the tools they know.
Human Competence. Secret chat groups have popped up for nurses, doctors, and hospital workers signaling mental health collapse. They shared in the trauma and comforted each other, not only about the overwhelm of watching people die but also with quiet hushed admissions that doctors did not know how to work the machines. Doctors were scared working without the necessary PPE, which was kept locked away by administrators for their personal needs and until commissions were paid. Doctors were unable to see past the fog in the mask and made mistakes, could not see the numbers, could not see others’ faces. Sheer volume of patients overwhelmed their ability to make life-saving decisions. Hush clauses and peer pressure from colleagues who made mistakes in a highly punitive system kept them quiet. Over time and long hours and bad cafeteria fast food, they got sick and succumbed. Many are experiencing post-viral symptoms.
The Environment. Most have forgotten about their concerns for the environment, as each healthcare worker today dumps environmental waste 100x greater than they did one year ago.
Clean. If we visit the homes of most but not all health professionals, they are not tidy homemakers. They are a mess. We should assume that the way they clean at home is the way they clean at work. Hygiene habits are not strong. Bedsheets are not changed. Handles are not wiped. People lick and touch and exhale in the American culture without thinking twice. They wipe their stool with paper and walk around for a day without rinsing the perianal region. They eat and do not rinse their mouths afterward or wash their hands. We doctors know how our colleagues conduct their handling and we see the nurses. The ego-laden war between different health professionals wages a quiet battlefield between vectors who themselves propagate the virus to would-be patients, EMT workers, food servers, and delivery persons who come in and out of the infectious setting. Many standards are not in place because the authorities themselves are simply sloppy in their own lives. They are not ensuring that each and every person knows how to clean.
Masks. We are not unified in our commitment to the science of mask-wearing. We are not sure about the vaccine, recombinant technology for an injected vaccine from people who fully acknowledge that our DNA makes us differently susceptible.
Antibodies. Modern immunology until 2020 asserted that once a person had antibodies to a viral disease, the antibodies would provide immunity protection for life or at least a long period of years. It is the basis of vaccines, in which we give microparticles of a virus or bacteria to stimulate our own immune system into making its own antibodies to protect the immune system. If the vaccine fails to produce antibodies, it is not a good vaccine. Yet, what we have today is a disease in which a large portion of the people do not have antibodies even after having the disease. How will the vaccine then offer protection?
The highest policy experts, scientists, public health specialists and expert immunologists worldwide have not mapped all the variables, because they have no overarching science that sees the big picture.
Ayurveda whispers that diseases must be detected by their symptoms and should be diagnosed in people, not in cell cultures or animal studies or computer modeling. Over 10,000 years of observation by millions of physicians who discussed and then captured their wisdom into books, Ayurveda has seen innumerable diseases. It describes the patterns robustly and says we must perceptively watch the patients and look for signs, symptoms, and treatments that work, staying clear of interventions that harm the patient now or later.
Early Signs. These early predisposing symptoms do not mean definitively that you have the disease. They warn you that you should be careful and engage in strong preventive measures to ensure you do not get the full-blown manifestations of disease. Watch for a scratchy throat and sense of unusual dryness in the nose and throat, a painful sore throat such as you may feel at the first signs of the flu or a cold, a cough that is worse than a usual cough if you have chronic cough or if you smoke, a runny nose that persists for days, symptoms of chills or a fever, a thermometer-based temperature taken in your armpit, rectum, or under the tongue of 100.4 degree F, muscle aches (worse than usual), nausea, vomiting or diarrhea, shortness of breath, inability to taste of smell, or red or painful eyes. Paying attention to symptoms early not only avoids an ambulance ride, but also may mean life or death on a ventilator. These symptoms are the current gold standard being used in clinical studies today for understanding predictors for the viral scourge.
Ayurveda says the best intervention is early prevention. 1. Daily exercise, such as a morning walk at sunrise, and daily time in fresh air around nature is needed. 2. Holding a full breath each morning for 20+ seconds proves that the lungs are working. 3. If the breath is tight or short, or if the nose or throat feel full or dry, steam inhalation for 2-5 minutes for 3 days is recommended. Adding bitter herbs to the water is advised. 4. Put attention toward clearing your bowels daily. Light foods or fasting 2 non-consecutive days every other week clears the gut and keeps toxins from building up. 5. Lower obesity strategically. 6. Increase your mental and emotional strength. 7. Clean the air regularly. Dhoopana of your indoor space and perimeter is a must. 8. Make sure everyone knows how to clean house.
We are hopefully learning to stop depending on doctors to take care of our every issue. Your body and mind and prevention of disease are YOUR responsibility. We must stop depending on the healthcare system to take care of our bodies when we pay no attention until an emergency happens. Our choices during these next months will determine the health of our families, whether they lose us, gain a chronic patient and burden, or whether we lift those we love through our own awareness and good health.
Dr. Bhattacharya is a columnist at The South Asian Times, Fulbright Specialist 2018‐2022 in Public Health, and Clinical Asst Professor of Medicine, Weill Cornell Medical College, New York.Read More