How to create a pandemic
In March 2020, the World Health Organization (WHO) declared that there was a “pandemic” of a new disease called ‘COVID-19’. However, there was a critical problem from the start. On 7 July that year, the historically well-respected Cochrane group published a systematic review to determine how doctors were supposed diagnose the “new” disease in either the office or hospital setting. The conclusion of the review was staggering because it stated that:
“based on currently available data, neither absence nor presence of signs or symptoms are accurate enough to rule in or rule out disease.”
This meant that the traditional diagnostic techniques – taking a careful history and examining the patient – were useless in determining whether a person had the alleged new disease. Perhaps not surprisingly, something very odd was seen the following month when the WHO published its official COVID-19 case definition stating that a confirmed case was:
“a person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms.”
In other words, a loop of circular reasoning was created in which a case was defined by a test and this test defined a case. It was a monumental sleight of hand that disconnected the concept of disease from the case definition.
Indeed, during the COVID-19 era, many aspects of time-honoured medical practice were flipped on their head. When I was a medical student 20 years ago, a large part of our training was dedicated to the art of making a diagnosis. We were cautioned that while there was an ever-increasing number of “diagnostic” tests available, the most important part was listening to the person in front of you and carefully examining them. After that, the doctor may elect to perform tests to provide confirmatory evidence for the suspected diagnosis or at least use a test to help differentiate between competing “differential” diagnoses.
