Fake Epidemics

 

We are bombarded with messages about epidemics. The latest organism that will destroy life as we know it.   This can be very confusing and anxiety – provoking.

Further, there is the issue of false alarms.   Testing a population that does not have even 1 case of a disease, disrupting people’s lives, having people take dangerous medications and be subject to isolation for a disease they do not have. This is the earmark of a false epidemic.

This situation is illustrated by an article in the   New York Times on January 22, 2007. The article is entitled, “The Epidemic That Wasn’t.” This article tells the story of a highly trained physician who developed a dry cough in midwinter that persisted for several weeks. Another Physician observed this and thought it could be pertussis. As the director of infectious diseases, the second physician exercised her authority and tested the first physician using the screening test for pertussis. The result was positive, indicating the presence of a pertussis infection. The Expert Physician, an Infectious Disease Specialist, then decided to have all hospital workers tested for this disease. 1,000 workers were sent home until the test results were available, 1,445 took antibiotics, 4,524 were immunized against pertussis and 142 were told they had the disease – pertussis. The hospital had to close beds because staff were home awaiting test results. All this in a matter of days.

The outbreak was of such great magnitude that epidemiologists at the hospital and the state of Vermont and New Hampshire decided to take extra steps to confirm the pertussis infections. A more specific test was done.   The results of the more specific test became available months later and indicated that the initial test results were false; no one had pertussis.

Initially, one might be struck by the humiliation of expending such resources on the basis of an inaccurate test. The real lesson here is that this is an all too frequent occurrence in medicine. Initial screening tests are designed to have many false positives. This means that the test indicates people have a disease when they actually do not.

This raises 2 questions. The first question is the value of screening tests. This is hotly debated in Medical circles. Although, you would never know it from the media. Many screening tests such as stress tests yield many false positives that lead to uncomfortable and even dangerous tests to evaluate the initial false result. Another such screening test is prenatal screening tests. The perception is that 2 lives are at stake so the range of abnormal results is set so broad that most abnormal results are false alarms. This has resulted in a situation where many tests lead to mothers being advised to abort healthy babies. The outcome is actually worse than had the test never been done.

 

How do you recognize a false epidemic?

  1. The test NEVER tests directly for the infecting agent itself. The test becomes a ritual that randomly generates positive results in healthy people. Antibody tests are an example of this.
  1. The consequences of the disease are believed to be dire but the death rate from this organism in the year prior to the epidemic was less than the death rate for healthy adults.
  1. People who do not have symptoms are tested.
  1. The symptoms of the disease are similar to many harmless conditions.
  1. There is no cure.
  1. Social isolation of some kind is offered as a remedy when person to person spread is not scientifically proven.

Zika is an example of this. The antibody test indicating infection takes 4 weeks to turn positive. So the person spreading the disease and the person who was believed to have been contaminated, would both have needed to be tested prior to contact and again 1 month after contact. The test shows positive in people who do not have Zika but had yellow fever, yellow fever vaccine, dengue, west nile and many other virus exposures. In other words, it is not reliable.

The second question raised by this story in the New York Times is how should a cough that comes each year and lasts several weeks be treated? Does one have to suffer or is there a holistic approach to this?    

Well, I will tackle the first question first. The situation with the pertussis screening test is similar to that of most screening tests. If you get every screening test available and follow through with all of the additional testing necessary to indicate that the screening test was false, you will spend a lot of time and a lot of money “Just to make sure everything is OK.” Your doctor will frequently say things to you like, “Aren’t you glad we checked?”, “It was nothing.”, “The test was negative.”, “There is no sign of disease but let’s recheck in a year.”  

One could refuse all screening tests. While advisable, this may not be practical. As in the pertussis example above, the test was presented as necessary due to symptoms. The recipients who had symptoms did not know they were getting a screening test. The other alternative is to refuse tests for any condition that is not life threatening and will go away by itself. In the example above, the cough went away every year by itself. So, when you are presented with the opportunity to take a screening test,   ask, “What will happen if we do nothing?” If the answer is something that you can live with, you may want to skip the test. The next option, is asking how long it would be safe to wait before reconsidering the necessity of the test. Most medical tests become unnecessary over time. In this example, the cough that made the test necessary went away on its own. One important strategy when dealing with screening tests is never worry. The result is likely a false result; why? Because it’s designed that way. Screening tests are designed to cast a broad net and have many false positives. In this case there were 100 percent false positives. In other words, the test is nothing more than a random number generator that randomly assigns disease to healthy people. All tests are designed to register positive results even if no disease exists. This should make you wary of submitting to any test.

The final option, is search for a holistic approach to handling your symptom, risk factor or lifestyle so that you no longer fall into the category of people who should take the test.

This brings us to the second question; what are the holistic options for dealing with an annoying, dry cough in the middle of winter that comes every year and goes away on its own in a few weeks. Any tests the doctor has done are negative and you have been sent home to endure the situation.

Having practiced family medicine for 10 years I have seen many such coughs and even experienced it myself. The x-rays are negative, the cough is so dry there isn’t enough sputum to send to the lab and cough drops just don’t do the trick. There are 2 things at work here. Dehydration is the most important cause. The dry winter indoor environment combined with reduced water drinking lead to a depletion of mucous; much like a public speaker coughing and finding relief with a glass of water.

The first move is to change all beverages to distilled water. The only exceptions are alcohol and coffee. Suddenly stopping either can be unpleasant. Then, drink a total volume of water daily that is equal to 1 quart per 50 pounds of body weight or 1 gallon per day whichever is less. This usually resolves the cough in 2 days. If you would like quicker results or the cough is so severe that the water merely improves it, use vicks vapor rub. Apply under your nose, around your neck and on your chest. This should be done 2 or 3 times a day. Once a day is not effective. If you object to vicks for any reason, tiger balm red can be applied in the same manner with good results. Although results are dramatic and visible within 24 hours, it may be necessary to continue this for one week for complete resolution.

What if you do not like smelly gooey stuff? There are many things that one can use orally. While continuing to drink the water, one can buy some dried peppermint leaves and place them in a 4 ounce cup. Tip the cup so that 1 tsp or more of leaves goes into your mouth. Chew thoroughly and swallow the juices. Once the flavor is gone from the leaves, you can swallow them. Repeat as desired. One can also make a tea using 1/3 cup peppermint leaves per quart of boiling water. Steep 5 minutes. Strain off leaves and sip. Another oral remedy is vitamin C.   Take one rounded teaspoon of Ascorbic Acid (the pharmaceutical name for vitamin C) powder and stir into a glass of water. Drink one or 2 times a day. Once the cough is gone, reduce to once a day then stop. Loose stools may result while you are taking the vitamin C. Just think of this as the cold leaving your body.   Some people prefer capsules. If you are using 500mg capsules, the equivalent is 20 capsules once or twice a day. If you are using 1g (gram) capsules, it would be 10 capsules once or twice a day That sounds like a lot of vitamin C and it is – but it works. Just as a point of information, the minimum useful dose of Vit C appears to be 3g or 6 capsules of 500mg.

On can use these holistic options alone or in combination for that pesky midwinter cough. For educational materials and programs on natural healing,

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Dedicated to Your Healing,

Dr Jennifer Daniels, MD/MBA

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