Why we will not learn anything from the crisis-year of 2020.

Occam’s razor requires of me that I sidestep all the many swirling conspiracy theories and, instead, favor the simplest explanation, which is generally stupidity. In politics it was often more important to pass the blame than to take effective action, which clouded the picture, but we will try not to let that bother us here. Other issues were mixing up the levels of solutions and not keeping a clear analytical focus.

It seems that one way or another, the so-called novel Coronavirus was quite the story for 2020, playing against a background of epic political dysfunction in the USA, as the Trumpian demolition derby raged on. By all appearances, a hysteria broke out that has little rational justification. Throughout, there was little or no rigorous assessment of the real risks, and ridiculous measures that assumed the absolutely worst possibilities, resulting in the gratuitous destruction of the economy, but yet the same politicians could not get it together to provide the safety net under the crisis they had just created. What is sad is that there is no indication that a swing to the Democratic party will bring anything new either. The trend seems be towards an effort of resuming business as usual, which is clearly not an option. Change will have to happen in spite of politics, not because of it.

In the following, I simply want to highlight some of the major issues of change, which might be real opportunities, but are in the process of being missed by the atavistic drive of returning to old approaches that have already failed and are certain to continue to disappoint. There are some signs of hope, but not enough to make me hopeful about this part of the process. My favorite Congress woman and former neighbor, #AOC has a knack for raising the quality of the dialogue, for getting necessary things on the agenda, even if they’re not popular, but the solutions she proffers are too often returns to failed policies of the past, like Medicare for All, and the Green New Deal, which looks like a hand-me-down re-wrapped Christmas present to me.

The Covid-19 Debacle

For some reason, the apocalyptic forecast of the Imperial College in London got all the press early on and the medical industrial complex with Fauci and Gates in the lead, smelled an opportunity to sell us another vaccine. Serious attempts at data analysis, as by Stanford’s Biophysics Prof. Michael Levitt, Stanford’s Prof. John P.A. Ioannidis, and Dr. Scott Atlas were initially ignored, at least until, long after the horse was out of the barn, Trump appointed Dr. Atlas to the Coronavirus Task Force as more and more countries were showing signs of herd immunity, with Sweden in the lead. Lockdown regimes such as New York and, even more draconian, Peru, seem to have fared substantially worse, and some of this was predicted by some of these keen researchers, who weren’t buying into the panic. The emerging view now is that the lockdowns made things worse not better, Sweden spiked earlier, but then excess deaths quickly fell to below seasonal levels. The press continued to ignore the obvious relationship of reporting more and more cases, but fewer and fewer deaths. Clearly, the collective immune system is making a vaccine moot, and might help us avoid another bad medical risk — with certain damage from side effects for uncertain benefits.

Clearly, the multiple levels of failure have also upset a lot of the medical profession on multiple levels, one of the more categorical objections is formulated very well in the following video. Clearly, the typical medical posture of treat first and ask questions later will no longer do, and the impulse of the vaccine salesmen of the world, who told us to just go home until they have a vaccine, was self-serving and plain wrong. The lockdown cure was clearly worse than the disease. Public health is a mixture of biology, sociology, nutrition, economics and statistics and medicine is merely an optional instrument, but it should not be driving the bus. We still don’t understand the issue of conflicts of interest.

Amidst the increasing reports of herd immunity arriving, and sooner than anticipated by most, has made the vaccine solution moot, and should make it clear why putting the vaccine salesmen in charge of public health is an example of having the fox guard the hen house. The HCQ question is a fascinating one, but beyond me to judge, I cannot make much sense of it. Possibly it seems it could work early in the process, if indeed it slows replication of the virus, but again that is hard to judge as the overwhelming majority of cases are asymptomatic or nearly so and purely retrospective claims of effectiveness are unconvincing without appropriate, well-constructed and large enough studies. What is clear is that the pharmaceutical industry always tries to prove that the newest products, that are patent protected, are better, so they can charge a lot of money — evidence be damned.

In this video a forensic pathologist from Hamburg reports that of the 100 coronavirus deaths he autopsied, not one of them actually died from Covid-19. The average age was about 80, and all had one or multiple serious comorbidities, which were the primary causes of death in all cases. Let me repeat that: of 100 “Covid-19” deaths, not one of them actually died from Covid-19. This pattern has been repeated throughout the world. In short, we actually have a nutritional and lifestyle problem, which just got complicated by this virus, that’s all. What we need to do is change our diet and lifestyle and our immune system will take care of the rest, which is not to say there aren’t times when you need some meds, but about 90% less often than we now assume.

The thing that stands out the most is that world wide 95% of Covid-19 deaths involved circa 95% comorbidities, with obesity in the lead, and for the longest time this was not talked about. Today however, even health experts admit that an eventual vaccine would be less effective in obese people, which are the most at risk. At the same time the debate was raging about the US nutritional guidelines, with AMA finally coming out in favor of removing meat and dairy from the recommended list, to become “ optional.” Clearly, they can no longer get around the mounting evidence of the damage these foods do to our health. The racial part of this dialog is particularly important these days, two thirds of the US population and the world-wide population are lactose intolerant to begin with. It is insidious how a white dominated medical profession has treated lactose intolerant as a medical condition to be treated, to the delight of the drug companies. The comorbidities for Covid-19, with obesity in the lead, are all diet related, and this belongs in public health policy, more so than treating medically what is merely a warning sign of unhealthy foods.

CDC graphic of age distribution of Covid-19

The Healthcare Debate

Some facts first:

• The US has declining life expectancy, currently rating #37 in the world for health outcomes overall, and the trend is down.
• US healthcare expenditures are running at close to 20% of GDP, roughly double of what most industrialized countries spend, many of which are ahead of us in health outcomes.
• With 5% of the world’s population, we consume 50% of the world’s drugs, and pharmaceuticals are the 3rd leading cause of death, or arguably even the first, since the first two, heart disease and cancer, are strongly diet related, so diet is the the first leading cause of death, as the Global Burden of Disease also analyses it, and pharmaceuticals are number two. We are one of only two jurisdictions where direct to consumer marketing of prescription drugs is even allowed, and the results are great for stockholders of pharmaceutical companies but not for public health.
• The huge racial disparities in health outcomes are not genetic, but all public health issues, starting with bad diet, as Dr. Kim Williams has demonstrated at Rush in Chicago (NB.: He is African American himself!). So again, public health policy is at issue. Williams’ study showed that, corrected for the comorbidities, African Americans actually had better SARS CoV2 outcomes. One more finding to reconfirm we did not have a virus pandemic, we do have a nutritional pandemic that was momentarily aggravated by a virus.
• To expand this same insanity to a larger number of people by means of healthcare for all, will, if it is done without serious healthcare reform, mostly just help the country go bankrupt faster. It certainly won’t make anybody any healthier. The problem is diet and lifestyle — Lifestyle Medicine, and not healthcare — disease treatment. The Covid crisis made this clear all over again.
• Note also that with the shift to prevention and true healthcare, which is an emergent specialty called Lifestyle Medicine, diet is coming central and this will entail a change in the food system. We will be eliminating animal agriculture, and shifting to foodcrops, the hospitality industry and packaged food sectors will see a lot of change as a result.

Healthcare is probably the single most important issue facing the country, and the tendency to revert to old approaches is the most painful. Still, the complete failure of the premature medicalization of the coronavirus pandemic is a massive warning sign that it is a mistake to reach for the medicine cabinet first, before you have figured out what is going on. As it is, herd immunity is making the vaccine moot. The example of the treatment of lactose intolerance is another. It is not a disease condition to be treated, but we need to change our diet. As a white person, nobody ever told me I was lactose-intolerant (it affects “ only” 33% of Caucasians), yet in the 80’s a doctor tried to put me on antihistamines for “allergies,” which I refused, but it took me only another 30 years to figure out conclusively that the problem disappeared once I got all the dairy out of my diet. Fortunately for me, I managed it with nutritional supplements during those 30 years, but cutting out the dairy was easier and cheaper. Doctors don’t know, unless they are educated in nutrition and Lifestyle Medicine.

The American College of Lifestyle Medicine concludes that about 86% of all healthcare expenditure relates to medical care for diet and lifestyle-related chronic illness. In other words, reversing this trend by shifting towards a healthier whole foods, plant-based nutrition, could dramatically improve our health picture, and if we pay more attention to all the lifestyle medicine categories, diet, exercise, relaxation, meditation, loving relationships and sleep hygiene, we would all be a lot healthier, and we’d gradually cut down that 86% of health care costs. The simply fact is that any country that puts two and two together, and seriously commits to lifestyle medicine, will soon find out they can have world-leading healthcare for 5% of GDP instead of deteriorating health outcomes and spiraling healthcare inflation, like the US, at 20% of GDP. This will alter economic competitiveness rapidly.

Should America come to its senses on this issue, that will dramatically improve our economic outlook. Meanwhile, a long list of over the counter remedies would also become moot overnight, from fiber supplements, like Metamucil and ant-acids, most cold medicines are useless, and yes, you guessed right, even deodorant. Body odor is a non-issue once you are on a whole foods, plant-based diet. In terms of prescription medicine, probably 80–90% of statin prescriptions might become unnecessary with a whole foods, plant-based diet, and the same goes for most blood pressure medication. We can get rid of the infamous tapeworm in the economy. If we’re spending $3.5 trillion on healthcare over all, even 50% of the 86% is still about $1.5 trillion of direct savings, which could be realized fairly quickly, probably 5–10 years.

Here’s what’s involved in realigning healthcare to public health:

• The pharmaceutical industry would be scaled way down.
• The agricultural industry would have to realign to growing food crops and abandon animal agriculture.
• The fast food industry in particular, but restaurants in general, would have to learn to offer healthy options or perish.
• The packaged food business would have to learn to abandon sacrificing public health to convenience, and evolve away from nutritionally worthless but convenient foods. There are plenty of options to help making healthy foods more available.
• Undoubtedly, there should be independent research on pharmaceuticals, the current FDA is controlled by industry, this should be absolutely independent academic research and it should include the issue of cost. Too many times new drugs offer no improved results, but always higher cost and they get approved anyway.
• Direct to consumer advertising of drugs and diseases should be outlawed. Today the selling of disease is funded by big pharma and helps their bottom line, but not public health. We are the sickest, most over-medicated country on earth. The opioid crisis was merely an extreme case, but the same issues happen all the time.
• The lifestyle medicine shift towards primary care and disease prevention or reversal with nutrition and lifestyle needs to rule the day. Medications should not even be a topic of conversation until those elements are taken care of. The primary care doctor needs to become your health coach, and your subject matter expert for any use of medical services. A Direct Primary Care model should be funded primarily with an $2,500 tax credit that is awarded to anyone who subscribes to a Direct Primary Care Lifestyle Medicine program. Achieving good biomarkers with lifestyle, not medications should be the mission.
• What we now call health plans should cover the second tier, reinsurance really, any medical treatment over and beyond the primary health needs of the patient. Health insurance should not even begin except by referral from primary care and premiums should be rated based on personal biomarkers, without penalizing people for things that are beyond their control. In the area of personal health management the structure needs to incentivize healthy living. Even with employer-based healthcare, the individual should have zero deductible based on a level of their biomarkers, and a growing contribution if they simply choose an unhealthy lifestyle.
• It is clear that there is a valid public health concern with natural disasters, including potential epidemics, where ensuring healthcare for all is important. In the area of large scale healthcare needs the public interest needs to be the driver. Likewise, employers should remain liable for any unhealthy working conditions. This issue has been in the news again with evidence of employers failing to provide safe working conditions, and in fact skimping on care by having in house nurses send people back to work without adequate medical care.

The Green New Fraud

Technology is not the problem. In fact what is the problem is the market distortions of endless green programs which have trained people to chase subsidies instead of making smart financial and engineering decisions. Meanwhile the technology has changed so fast that vastly better options are often the most economical solution. What people need to learn is how to make proper financial decisions, but in many businesses the returns on this are higher than on their basic business, and in residential applications these retrofits will always improve property values.

The ongoing market distortions of the last fifty years in energy have simply trained generations of mindless people to follow the pied piper and do what the government tells them to do. Never mind every property is different and what is best for one property may not be best for the others, but the sales strategy of the industry is to sell the latest subsidy or tax incentive, etc. regardless if it is to the benefit of consumers or business owners.

The largest contribution to mitigating climate change is the one thing nobody is talking about except on the intergovernmental level — abandoning animal agriculture and meat, dairy and fishing, will do more for the environment than anything else, those developments alone would mean massive progress to sustainability. Eliminating meat, dairy and fishing is the one area where we can reduce entropy in a meaningful way, for we are eliminating the middle men — the animals that pre-chew the protein for us, which we then consume second hand with the dubious benefit of cholesterol and fat. Cutting this out saves resources by an order of magnitude. All the rest is tinkering in the margin by comparison.

The knee-jerk reaction of more funding for energy technology development should be used very sparingly for the most part, just leveraging the technologies we have can make a huge difference. 70–80% reductions in GHG emissions are within easy reach in many buildings.

Conclusion

In Covid-19 early politicization of the threat of this latest coronavirus, left to a massive hysteria that is out of all proportion. We now simply know that 64% of deaths were in people over 85 many with multiple comorbidities, and another 22% were in the 75 and 85 bracket. Sick people already. So it was a nursing home epidemic and the resulting economic setbacks will likely be more costly than we care to admit. A clear focus on what public health really means, and competent staff really could have made a difference. Sweden was able to figure it out.

The funding problem for healthcare for all is completely solvable, given long overdue healthcare reforms. The proof of these concepts is abundantly available. Lastly, the Green New Deal is too much of a return to failed energy policies of the past, far better is possible by rigorously pursuing efficient capital allocation in respect of energy. But the real opportunity is in the shift from animal agriculture to foodcrops, not least because the shift in the diet will also solve the health crisis and world hunger at the same time (humans will not be competing with livestock for food any longer). That will do more for GHG emissions than hare-brained ideas like battery electric vehicles which hardly make a difference. May we wisen up in 2021.