In response to my proposal to change course in how we deal with COVID, and my expressed willingness to adhere to policies based on scientific evidence, Dr. Carson invites me to do just that, based on the evidence he presents.
First, let me correct his statement that the offer for the State Health Officer was made in jest. Acknowledging that I don’t “want” the job, but am willing if Gov. Burgum is willing to change course, does not make the offer a joke.
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Next he claims I could find only one study showing asymptomatic spread, which is not a true statement. He then lays out his evidence for the significance of asymptomatic spread, however, what he is actually offering is evidence of presymptomatic spread; a faulty premise with which to counter my statements. The CDC gives the definitions: “A pre-symptomatic case of COVID-19 is an individual infected with SARS-CoV-2, who has not exhibited symptoms at the time of testing, but who later exhibits symptoms during the course of the infection. An asymptomatic case is an individual infected with SARS-CoV-2, who does not exhibit symptoms during the course of infection.”
The World Health Organization stated that asymptomatic spread is a rare occurrence. They later walked back that statement, because people tend to confuse “asymptomatic” with “presymptomatic”; the very error Carson makes in his letter. To be sure, presymptomatic people can readily spread COVID, but that has dramatically different ramifications on policies regarding contact tracing, isolation and quarantine when compared to asymptomatic people.
Asymptomatic people have viral clearance much earlier than symptomatic people (Lee et al, JAMA), and their viral loads, or transmissibility, may be 60 times less! (Liu et al, Lancet Infect Dis.) Further, a study by Byambasuren, et al states, “Our estimates of the prevalence of asymptomatic COVID-19 cases and asymptomatic transmission rates are lower than many highly publicized studies”.
With regard to effectiveness of health interventions, Carson refers to several very weak and limited “modeling” studies done in Wuhan, China. They have very little application to real-life interventions in North Dakota. Alternatively, we do have an abundance of data from the various countries, states and cities that have done differing interventions. What we find is that there is no policy in which we see consistency from one place to another. That lack of consistency itself gives evidence to the theory that these policies have no substantial direct effect. For a policy to have scientific validity, it must be reproducible. That level of proof is clearly lacking in all of the data thus far.
Using a type of logical fallacy known as an emotional plea, Carson references the 109 children who have died with COVID as further “evidence.” The problem is that these children died “with“ COVID, not “from“ COVID. The actual number of children who have died from COVID could be as high as 109, or as low as zero. Neither Carson nor I know the answer. What we do know is that the CDC has estimated that 600 children died “from“ the flu in each of the 2017/2018 and 2019/2020 flu seasons. Carson should explain why he does not consistently apply his plea for government intervention and mask mandates to influenza, given the tremendously higher death rate in children.
What we all should know is that the jury is still out. There is some evidence to support Carson‘s claims, however, there is at least as much evidence to counter his claims. Because of the impact government interventions regarding COVID have on depression, suicide, domestic violence, job loss, bankruptcy, and the overall health of both our economy and our morale, the burden of proof is on those who want to implement these policies. Until such evidence is given, we must refrain.
I would be happy to continue the scholarly debate with Dr. Carson, however, he may want to consider doing so via direct correspondence, rather than letters to the editor.
Becker, R-Bismarck, is a plastic surgeon who represents Bismarck's District 7 in the North Dakota House of Representatives.
This letter does not necessarily reflect the opinion of The Forum's editorial board nor Forum ownership.