(posted on 2020/04/28, updated on 2020/04/29)

On April 22, 2020, a television station in Bakersfield, California reported on a press conference given by two doctors who argued that the scientific data on Covid-19 indicates that an end of confinement is necessary. The YouTube video had 4 million views within five days before it was taken down for “violating community guidelines.”

The key points made by the doctors were these:

Data from around the world indicate that in both policy choices–confinement of the healthy and non-confinement of the healthy–there is no resulting difference in rates of infection or rates of mortality.

The number of infections, both detected and undetected, is much higher than the number of reported cases. This leads to the calculation of a fatality rate of less than 1%, which is in the same range as previous pandemics during which there were no drastic measures taken.

The immune systems of millions of people are being weakened by confinement. People need to be outdoors, encountering pathogens, and keeping their immune systems strong. There is a high possibility that millions of people will get sick when they resume their normal routines because their immune systems will have been weakened.

Confinement and loss of jobs are causing severe distress and harms that will have effects over a lifetime. These will be greater than the harm caused by Covid-19.

Background of the two doctors:

Dr. Daniel Erickson is an emergency medicine specialist in Bakersfield, California and has been practicing for 16 years. He graduated from Western University of Health Sciences/College Of Osteopathic Medicine Of The Pacific, Western University of Health Sciences in 2004 and specializes in emergency medicine. Dr. Artin Massihi, is a board-certified emergency medicine physician in Bakersfield, California. He is currently licensed to practice medicine in California. He is affiliated with Mercy Hospitals of Bakersfield and Bakersfield Memorial Hospital. They are co-owners of Accelerated Urgent Care.

The press conference instigated a furious debate online. Some people found the argument convincing while others accused the doctors of being motivated by their financial interests and political support for President Trump. They were also accused of using anecdotal evidence and misinterpreting the global data on Covid-19. On April 27, the American College of Emergency Physicians (ACEP) and the American Academy of Emergency Medicine (AAEM), April 27, 2020 made this statement:

The American College of Emergency Physicians (ACEP) and the American Academy of Emergency Medicine (AAEM) jointly and emphatically condemn the recent opinions released by Dr. Daniel Erickson and Dr. Artin Messihi. These reckless and untested musings do not speak for medical societies and are inconsistent with current science and epidemiology regarding COVID-19. As owners of local urgent care clinics, it appears these two individuals are releasing biased, non-peer reviewed data to advance their personal financial interests without regard for the public’s health. COVID-19 misinformation is widespread and dangerous. Members of ACEP and AAEM are first-hand witnesses to the human toll that COVID-19 is taking on our communities. ACEP and AAEM strongly advise against using any statements of Drs. Erickson and Messihi as a basis for policy and decision making.

This is a harsh statement which itself contains unproven allegations—ones that might meet the legal definition of libelous defamation (for example, that the doctors have no regard for public health). Since when are two medical doctors not allowed to publicly express a medical opinion? The opposing arguments may be valid to some degree. We do not know if financial interests motivated these doctors to speak out, but it is more plausible that they have genuine concerns for what is happening to their patients, their employees and society in general. With their medical qualifications, they could be wiped out financially and still have prosperous careers as doctors, so selfish motives are not likely their prime concern.

Regardless of how much of their argument might later be proven erroneous, they have worthwhile things to say about the immune system and the long-term social effects of the confinement policy. Physicians are supposed to consider “first, do no harm,” and after two months of confinement, it is reasonable to be asking hard questions about what the least harmful path forward will be. It is appalling that contrarian views on this important matter are being censored and silenced. For the sake of promoting an informed public debate, I have posted excerpts from their press conference below.

Final comment: When these doctors say it is “like the flu” they are referring to the mortality rate, not the nature of the virus and its symptoms, the subjective experience of patients infected, or medical staff dealing with a critical shortage of medical facilities and trained personnel. Their interpretation does not need to be dismissed as cruel indifference to suffering.

Quotations from the press conference (April 22, 2020) of Dr. Daniel Erickson and Dr. Artin Massihi. The video was removed by YouTube on April 28, for “for violating community guidelines” after it had received over 4 million views and extensive media coverage.

erickson-massihi

Dr. Daniel Erickson and Dr. Artin Massihi:

“… as the data comes across, we say, now wait a second. We’ve never ever responded like this in the history of the country. Why are we doing this now?

“Why would you quarantine the healthy? If you’re young and healthy, why would you quarantine yourself? It doesn’t make any sense…”

“… the data is showing it’s time to lift [confinement]. So if we don’t lift, what is the reason?”

“This is not about science. This is not about Covid.”

“We both have had extensive classes in microbiology and biochemistry and immunology. We’ve studied this, each of us, for 20 years. And we take everything that we’re seeing today, and we put that against that backdrop and say, “Does this make sense? Are we following the science?”

“And at the same time our volumes [of patients] have dropped significantly. The hospitals, the ICUs, are empty, essentially. And they’re shutting down floors. They’re furloughing patients. They’re furloughing doctors. So the health system has been evacuated in certain places. In New York, the health system is working at maximum capacity. In California we’re really at a minimal capacity, getting rid of our doctors and nurses, because we just don’t have the volume. The hospitals don’t—as I’ve met with their CEOs twice in the last week—and we don’t as well.”

“We’ve never seen [a situation in which] we quarantine the healthy, where you take those without disease and without symptoms and lock them in their homes. So some of these things from what we have studied from immunology and microbiology aren’t really meshing with what we know as people of scientific minds that read this stuff every day.”

“We’re going to go over the numbers a little bit, to kind of help you see how widespread Covid is, and see how we should be responding to it based on its prevalence throughout society, or its the existence of the cases that we already know about.”

“The initial models were woefully inaccurate. They predicted millions of cases of death, not of prevalence or incidence, but death. That is not materializing, but what is materializing in the state of California is 12% positive. We have 39.5 million people, so if we just take a basic calculation and extrapolate that out, that equates to about 4.7 million cases throughout the state of California, which means this thing is widespread. That’s the good news. We’ve seen 1,227 deaths in the state of California, with a possible incidence or prevalence of 4.7 million. That means you have a 0.03% chance of dying from Covid-19 in the state of California. That does that necessitate sheltering in place. That does not necessitate shutting down medical systems, does that necessitate people being out of work.”

“So that’s California, and I also wanted to mention that 96% of people in California who get Covid would recover with almost no significant sequelae, or no significant continuing medical problems. So those are important statistics for the state of California. Two months ago we didn’t know this. So I’m going to bring it to light now because we’ve shared our own data. This isn’t data filtered through someone. This is our own data. We found 6.5% percent, and then California has found 12%, so the more you test the more positives you get. The prevalence number goes up and the death rate [number of deaths] stays the same, so it [the rate of death] gets smaller and smaller and smaller. As we move through this data, what I want you to see is millions of cases; small amount of death. Millions of cases; small amount of death. And you will see that in every state.”

“And since we’re talking about following the science, we’re going to follow the statistics and follow the science, so I want to look at New York State. They’ve been in the news a lot, and their numbers are critical. Let’s go over their numbers. Cases of Covid as of yesterday: 256,272 cases in New York State, not in New York City. In New York, the entire state, they did a total of 649,325 tests. 39% of New Yorkers tested positive for Covid 19. That’s their ratios. This is public data online. You can all look it up. 39% of people were tested, which means it is likely they have 7.5 million cases, if we extrapolate the data [to cover the total population of NY state]. We extrapolate data. We test people, and then we extrapolate for the entire community based on the numbers. The initial models were so inaccurate that they’re not even correct… They tested 649,000 people. That’s a massive test. That’s accurate data, [with] 39% [testing positive], so if they tested the whole state, would we indeed have 7.5 million cases. We don’t know [with certainty]. We will never test the entire state, so we extrapolate out. We use the data we have because it’s the most we have versus a predictive model that has been nowhere in the ballpark of being accurate. So how many deaths do they have [in NY state]? 19,410 out of 19 million people, which is a 0.1% chance of dying from Covid in the state of New York. And they have a 92% recovery rate. If you are indeed diagnosed with Covid 19, 92% of you will recover, so we’re seeing millions of cases; small amount of death.”

“If you study the numbers in 2017 and 2018, we had 50 to 60 million with the flu [in the US]. And we had a similar death rate. The deaths the United States were 43,545, similar to the flu of 2017-2018. We have always been between 37,000 and 60,000 deaths in the United States every single year. No pandemic talk. No shelter-in-place. No shutting down of businesses.”

“The next thing I wanted to talk about is the effects of Covid-19. The secondary effects of Covid-19 is one aspect of our health sector. What has it caused to have us be involved in social isolation? What does it cause that we are seeing the community respond to? Child molestation is increasing at a severe rate. We could go over multiple cases of children who have been molested due to angry family members who are intoxicated, who are home, who have no paycheck. These things last a lifetime. This doesn’t happen a lot with seasonal flu. These are things that will follow these people and affect them in a negative fashion for their lives. And these are secondary effects from Covid. And these [conclusions] are from me talking to ERs, talking to my doctors, and talking to people across the country, and finding out what they’re seeing. Spousal abuse: we see people coming in here with black eyes and cuts on their faces. It’s an obvious case of abuse. These are things that will affect them for a lifetime, not for a season—alcoholism, anxiety, depression, suicide.”

“Now I’m going to talk about the immune system. Dr. Massihi used to teach immunology. We both had years of microbiology, biochemistry and virology studies. We’ve made it our life’s work to understand this stuff. I’d like to go over some basic things about how the immune system functions. So people have a good understanding. The immune system is built by exposure to antigens—viruses and bacteria. When you’re a little child crawling on the ground, putting stuff in your mouth, viruses and bacteria come in, you form an antigen-antibody complex, you form IgG and IgM antibodies. This is how your immune system is built. You don’t take a small child, put them in bubble wrap in a room and say, ‘Go have a healthy immune system.’ This is immunology and microbiology 101. This is the basis of what we’ve known for years. So what I’m saying is when you take human beings and you say, ‘Go into your house clean all your counters, Lysol them down,’ you’re going to kill 99% of viruses and bacteria. ‘Wear a mask. Don’t go outside.’ What does it do to our immune system? Our immune system is used to touching. We share bacteria—staphylococcus, streptococcal bacteria, viruses. We develop an immune response daily to this stuff. When you take that away from me, my immune system drops. As I shelter in place, my immune system drops. If you keep me there for months, it drops more. And now I’m at home hand-washing vigorously, washing the counters, worried about things that are indeed what I need to survive. Let’s follow the science. This is immunology folks. This is microbiology.”

“I am telling them sheltering in place decreases your immune system. And then as we all come out of shelter-in-place with a lower immune system and start trading viruses bacteria, what do you think is going to happen? Disease is going to spike, and then you’ve a got disease spike amongst a hospital system with furloughed doctors and nurses. This is not the combination we want to set up for a healthy society. It doesn’t make any sense. Initially, maybe that was true, but again, I’m going through the numbers.”

“Nobody talks about the fact that coronavirus lives on plastics for three days. We’re all sheltering in place where did you get your water bottles? From Costco? Where did you get that plastic shovel from? Home Depot? Those are fomites and carriers of disease. So you have your family sheltering in place. You think it’s safe and you’re taking fomites with this disease [into your home]—that they’ve shown that lasts three days. Are you really protecting yourself from Covid? … If I swabbed things in your home, I would likely find Covid-19. So you think you’re protected, but you’ve got fomites coming from Home Depot and Lowe’s, and it’s okay for us to be mingling in those situations, but we have to not go to work. It’s okay for us to go to Costco, but not to church. Do you see the lack of consistency here from a microbiological, immunological standpoint?”

“Covid was part of it [the cause of death], but it is not the reason they died, folks. It is one of many reasons. So to be so simplistic and say, ‘That’s a Covid death because they have Covid’ … Do you know how many people died with pneumonia? Or people that died from flu, with flu, I should say. It’s not from flu. Their lungs were compromised by COPD [chronic obstructive pulmonary disease]. They had a heart attack two years ago. They have a weakened body. We aren’t pressured to test for flu. But ER doctors now—my friends that I talk to—say, ‘You know, it’s interesting. When I’m writing up my death report, I’m being pressured to add Covid.’ Why is that? Why are we being pressured to add Covid? To maybe increase the numbers and make it look a little bit worse than it is? I think so. So this is what I’m hearing from physicians I talk to in Wisconsin, New York and everywhere. They’re being pressured to add it to their diagnostic list.”

“Isolating the healthy just doesn’t make sense in our opinion. There are two ways to get rid of this virus. Either it burns itself out, or herd immunity. For hundreds of years we relied on herd immunity. Viruses kill people; end of story. The flu kills people. Covid kills people, but for the rest of us, we develop herd immunity. We developed the ability to take this virus in and defeat it. And for the vast majority, 95% of those around the globe, this is true. And when we look at people that have locked down, and people that have been locked down, we have massive data. It is not statistically significant whether you lock down or not. So why are we doing it?”

“We want to make sure we understand that quarantining the sick is what we do. Not quarantine the healthy. We need to make sure if you’re going to dance on someone’s constitutional rights, you had better have a good reason. You had better have a really good scientific reason and not just a theory.”

“One of the most important things is we need is our hospitals back up. We need our furloughed doctors back. We need our nurses back. As when we lift this thing, we’re going to need all hands on deck.”

Notes

Tamiyasu Shimamiya et al., “Effects of 10-Day Confinement on the Immune System and Psychological Aspects in Humans,” Journal of Applied Physiology 97, no. 3 (September 1, 2004): 920–24, https://doi.org/10.1152/japplphysiol.00043.2004.

Both IgM and IgG refer to a class of immunoglobulin. Antibodies are produced by the immune system to fight antigens like bacteria and viruses. IgM refers to those antibodies that are produced immediately after an exposure to the disease, while IgG refers to a later response.

Fomite: Any inanimate object that, when contaminated with or exposed to infectious agents (such as pathogenic bacteria, viruses or fungi), can transfer disease to a new host.