What happened the moment after you tested positive for Covid?

When you tested positive for Covid-19, what happened right after that moment? Try to think back and imagine the day. I’ll help to set the scene. 

You were in the middle of a global pandemic when you got your result, you had just been informed of the news by a very clever hand-held gizmo. It had been manufactured in record time and in massive quantities, it was now inside nearly every household in the country. Inside was an immunoassay designed to be triggered precisely by the presence of this very novel virus. Helpfully, it told you, “you’re Covid-19 positive”. Then what happened?

In most of Europe, absolutely no treatment at all was offered to you at the moment you tested positive. We could tell you that you were sick, but we didn’t offer a single medical intervention to give you the best chance of beating the virus. It didn’t matter if you were 18 or 80, the advice was the same: stay at home, cough as effectively as you can, take ibuprofen if you feel uncomfortable, and only go to A&E if “you're so breathless that you're unable to say short sentences when resting.”

As far as the public knew, there was absolutely nothing that could be done if you had Covid-19.  You’d either get better, or you’d end up on a ventilator and die. Understandably, people were scared. Now that the dust has settled on the pandemic, does that strike you as unusual?

Whilst our experiences of the pandemic are powerful and personal, we may confuse them for being universal. Didn’t every country respond in the same way?

The responses were anything but identical. As early as August 2020 in El Salvador, a country with less than 1% of the GDP of the UK, evidence-based treatment kits were being given out all across the country. If you tested positive for Covid-19, they wanted a medical intervention right at that very moment. Given the emergency we were in, such a policy surely seems logical?

It had already been established that Covid-19 was associated with blood clotting and inflammation, so including aspirin in the treatment kits was rational. Evidence was emerging that cytokine storms, overactive immune responses that attack the body, were causing severe illness in Covid patients. So it was logical that antihistamines might be a viable treatment for that, and evidence was emerging they were effective. So, the inclusion of antihistamines in the treatment kit also made good sense. Previous studies of avian-flu suggested Vitamin D played a role in viral immune response, and some evidence showed those suffering the worst outcomes from Covid-19 were vitamin D deficient, so vitamin D was put into the treatment kits. There was a wealth of information on the correlation between zinc depletion and worse outcomes in Covid-19, so zinc was placed into the treatment kits. All reasonable, ‘best current advice’ additions to the kit, which found its way to the citizens who’d just tested positive for Covid-19.

The El Salvador COVID-19 kit contains acetaminophen, aspirin, loratadine, ivermectin, azithromycin, vitamin C, vitamin D, and zinc.

El Savador wasn’t the only country that adopted this strategy of treating people early. Similar kits were handed out in Guatemala, Bolivia, Mexico, Honduras, India, Bangladesh, and Panama. Broadly, there were countries that aimed to treat Covid-19 patients at the very moment they tested positive for the virus, and countries that waited until breathing became problematic before an intervention was made. How is it that countries with fewer resources managed to mobilize a rapid treatment response, whilst advanced health economies all over the world drew a blank?

In order to accommodate the west’s ‘dropping the ball’ on early treatment, we must believe that every single country that treated early must have been mistaken because had the treatments really been effective, advanced western health care would have ensured they were on offer in the west. Building on this explanation, we must also believe that the first and only treatment that works ‘at home’ for Covid-19 patients is Paxlovid, Pfizer’s brand new drug with a $500 price tag. No home treatments existed or worked until Pfizer brought their product to market.

But we can actually test that theory because there are two years of Covid-19 data available to compare outcomes. We can look at Covid-19 deaths per million amongst the countries that treated citizens early and compare it with the countries where no such interventions were made. If the advanced health economies were ‘correct’, there shouldn’t be a difference between the two outcomes. And yet…

In the graph above, the blue line shows the cumulative deaths per million amongst the entire populations of Argentina, Bangladesh, Belize, Bolivia, Botswana, Brazil, Cambodia, Columbia, Dominican Republic, Egypt, El Salvador, Honduras, Lebanon, Nicaragua, Nigeria, Panama and Venezuela. All of these countries had a policy of early intervention during Covid-19. The red line represents the deaths per million in the United States, United Kingdom, Italy, Canada, France and Australia, where no such interventions were made. All the data was acquired from here.

The data tells a clear story, the countries that treated early had massively different outcomes to the countries that didn’t. How did Western nations miss the opportunity to treat you the moment you caught the virus? How did so many nations end up with a policy of only treating people when they struggled to breathe? How is it that El Salvador managed to make a medical intervention in Covid-19 patients sooner than the UK did? For regular readers of The Digger, the answer is perhaps clear, but it’s a sprawling story. As best I can, I’ll be condensing one potential explanation into something readable within the week.