Popping pills with Joe Rogan

Much of the COVID discourse has moved on from hysterical bean counting to more nuanced discussion of “excess mortality.” That is a very good thing.

Short note:

Suppose that, at the age of 101, I suffer a heart attack and die.  What would the experts say? “He should have had more oatmeal”?

Suppose, I did maintain an expert-approved diet.  Suppose I assiduously conformed to prevailing orthodoxy, and suppose I still died from a heart attack.  Should I have consumed even more oatmeal, notwithstanding the fact that I would have consumed the ostensibly optimal volume of oatmeal?

The point is, of course, that death is an “absorbing state.”  There’s no escaping it.  But the bean counters charged with assigning fatalities to causes would check some cardiovascular condition, and that would be that.  But, would such data mean anything?  Would it inform public policy relating to health?  Or, would it have made as much sense to label the cause of death as “old age”?

In 2019, Yasuhiro Nakasone died at the age of 101.  He served in the Japanese Imperial Navy during the Pacific War and recounted performing Shinto rites on a beach in the Dutch East Indies (Indonesia) for comrades who had fallen in the taking of those same East Indies from the Dutch.  He went on to be prime minister during the Reagan-Thatcher years.  In 1983 he set the Western press into a tizzy with the abundantly plain proposition that “Japan had caught up with the West.”

The reported cause of Nakasone’s death was “congestive heart failure.”  Should he have consumed more tofu? … Oat meal?

He seemed fine a week before his death.  But, then he fell ill and was bed-ridden.  The week passed.  He faded away.

Is that not the way to do it?: Operate at a high level of functionality and enjoy a high-quality life before gently fading away over the course of a few days.

Well done. Perhaps he did eat his oat meal.

I bring this up in response to Joe Rogan’s standard proposition that the expert class has denied the efficacy of affordable remedies to COVID such as vitamin D and ivermectin.  Joe observes that the COVID toll numbered well more than a million in the United States and then quite reasonably speculates that the COVID toll could very well have been lower had the medical establishment afforded access to ivermectin or encouraged people to avail themselves of vitamin D supplements.

I get this from some number of clips, such as this one, of Russell Brand’s appearance on The Joe Rogan Experience on March 2.

Joe might be right.  Getting people, who had been infected with COVID, on ivermectin or vitamin D supplements might have reduced the COVID death toll.  Getting uninfected people on vitamin D supplements might have enabled them to shake off incipient COVID infections.  But, would these COVID remedies have made any difference in the ultimate accounting of total mortality? That is, would some of the people who had succumbed to COVID have succumbed to something else in the absence of COVID?

I would suggest that such remedies may very well have contained total mortality had COVID been a scourge concentrated on the young and healthy.  This is an important point.  Even the CDC guesses that the median age of fatalities attributed to the Spanish Flu (1918-20) was 28; much of its toll was concentrated on young, healthy people… many of whom were ensconced in the rat-infested trenches of the First World War.  Potent remedies to the Spanish Flu would have preserved a lot years, per young person, that each such person did not yet get to enjoy.  In contrast, COVID concentrated its toll on the immuno-compromised, who tend to be the very elderly.

So, would vitamin D and ivermectin have saved the one-million-plus who had purportedly succumbed to COVID?  No.  Most of these people would have died anyway.  Many of them would have succumbed to some other respiratory virus or to some other condition. But, these remedies might have given some measure of people a marginally longer lease on life.  That would be consistent with the fact that COVID really did seem to induce some measure of excess mortality among (mostly) older people.  It was not the case that COVID fatalities amounted to fatalities that would not have otherwise occurred, but COVID did take away some measure of people who would have lived see another year or two.

What about ivermectin?  I don’t know much about it, except that it has demonstrable and demonstrated anti-parasitic properties and anti-viral properties.  It has been used, for example, to save otherwise healthy people, both young and old, from the ravages of “River Blindness” and other parasitic maladies.

https://www.nature.com/articles/ja201711

“Otherwise healthy” is an important qualifier.  Saving otherwise healthy people amounts to granting them not a marginally longer lease on life but to granting them a affirmatively longer lease on a higher quality life.  Big difference. 

Metrics like “excess mortality” respect the big difference whereas mere counts of fatalities disrespect the big difference.  Counts of fatalities amount to bean counting, but bean counting makes no accommodation for the distribution of fatalities across ages and degree of immuno-suppression.  For that reason, I wish Joe Rogan would stop opining about bean counts and talk more about the nuances and limitations of pill-popping solutions. It’s not obvious that getting everyone on vitamin D supplements or ivermectin would have made more than a marginal difference in the COVID toll. Surely the public policy response has been criminally poor, but COVID was going to burn through the population no matter what and was going to take its toll. We should count it as a blessing that that toll was, unlike Spanish Flu, not concentrated on the young and healthy. That would have made for a great tragedy. Are there no adults anywhere to impose some perspective?