Pittsboro, NC – We held an online livestream video interview with Kevin Roche on October. We discussed the fact that COVID is here to stay and we must learn to live with it. For example, if you observe basic cautions, there’s absolutely no reason why people shouldn’t be getting together for Thanksgiving and Christmas this year.
Below is the YouTube video as well as an AI generated transcript of the discussion we had. (A one hundred percent accuracy of the transcript is not guaranteed.)
Gene Galin
Kevin Roche runs a blog; has a long history in in the medical field. I love his blog, he’s given us permission to reprint some of his articles in the Chatham Journal, and you’ve been able to read those on site. The reason we’ve got him on this morning is to just talk about COVID. And taking a look at it from a data perspective. What do we need to be doing? What’s the situation now that we have vaccines? What are considerations that you need to take into mind when you’re dealing with vaccines?
But I think in the last few weeks, actually, in the last few months, the big deal that I’ve got away from Kevin’s blog is the fact that COVID is here to stay. And we need to deal with it. So starting from that premise, Kevin, can you kind of elaborate on, hey, it’s been 18 months, where at this point, we’ve got this and that, and here’s what we need to do to be able to deal with COVID, since it’s here to stay?
Kevin Roche
I think if you kind of read even a little bit about respiratory virus epidemics, one of the things you observe is that they really can’t be suppressed, that you can’t get to what some people refer to in this epidemic is COVID. Zero. You know, that just doesn’t happen. And that’s true, whether it’s flu, we have seasonal coronaviruses, we have rhinoviruses, we have a dino viruses, we have RSV, which is actually quite dangerous to children. And all of those pathogens have been around forever, and they’re going to be around in one form or another. So the notion, which was somewhat unique, and this epidemic that we ought to try to completely suppress it, I think was few times number one, and number two, has resulted in a lot of damage both to the public health and to the economic situation of many people, the educational situation, I think we’re seeing in some parts of the world recognition and acceptance of this, the Scandinavian countries, which I think have been more enlightened in general, have all basically said, we’re done with the epidemic. You know, it’s gonna be here at some background level, we’ll just deal with that. But we’re not kind of putting restrictions on what people do. other European countries are moving that way. I think we have states here, Florida might be an example that are moving in that direction. And, and it’s an attitudinal kind of thing. As much as anything, we need to recognize that we’ve done what we can pretty much to mitigate the effects of the virus, the virus is not going away, people just need to understand that these things don’t magically disappear or all get killed, they have reservoirs, they have ways of persisting that we don’t even understand. So it’s going to be here, we’ve adapted pretty well, frankly, to its presence. And I think at this point, we need to just return to letting people make their own decisions about what actions they do or don’t take.
Gene Galin
I think one of the things I’ve also enjoyed about reading your content is you pulled in, there seems to be a few folks on Twitter that actually put the data into the graphics forms, that allows you to understand if you’re willing to pay attention to it as to who COVID affects the most. So once you let folks know, again, who who’s most affected by COVID, age group, health conditions, all sorts of different variables. I think there’s enough data out there after 18 months that you do a good job on your site, letting folks know hey, here’s here’s the here’s the group that are most affected by it.
Kevin Roche
Obviously, I’m most familiar with and I have a collaborator. I am not a technical Excel genius. So I have a collaborator who helps me actually put things into charts and I think one of the most enlightening sets of charts that we put out regularly is what we call kind of the age structure, which kind of shows the level of testing of cases of hospitalizations And of deaths for each age group. But it’s actually been apparent since the very start of this epidemic, you may recall, there was a cruise ship in Japan, on which one of the early kind of extensive outbreaks occurred. And if you look at the data from that cruise ship, you could tell even then that this was going to predominantly be a source of serious disease in the in the older population, and in particular, in the frail elderly. And that continues to be born out. The risk of death for people over 80 is literally several 1000 times what it is for people in younger age groups. So both hospitalizations, and especially deaths are concentrated in the very old, especially the frail elderly, often in nursing homes. And in the rest of the population, it’s concentrated in people with serious health conditions, you know, including the cluster of diseases that are typically associated with obesity. Interestingly, and you see this very clearly in the Minnesota data, we just did another set of charts that will be published today. After vaccination in the first three months or so, after vaccination, when vaccination started here, with the elderly obviously being prioritized, we had sort of a case wave in the spring. In that case, wave, the proportion of deaths among the elderly was actually very suppressed. We had a recent kind of case wave, about the same size as the April one, it looks like it’s just rolled over in the last couple of weeks here. In that wave, we have returned to the earlier age structure where a lot of the deaths are in the very old, and I attract these are vaccinated people, the vaccines just lose their effectiveness. And and that’s not unexpected, especially in old people. So it’s, it’s what I have referred to from the start is this incredibly bifurcated epidemic with the serious disease and bad outcomes, concentrated in the very elderly.
Gene Galin
You mentioned that the elderly, the vaccination wears off, is that true of pretty much any vaccine for any type of virus?
Kevin Roche
Yeah, it’s an immune system. It’s just an immune system. It’s the nature of the immune system. And it isn’t just vaccines, if you are very old and not in great health, and you get a cold, the adaptive immune response, you have to that cold isn’t going to be as strong as it would be in a 30 year old. So it’s it’s a very well established phenomenon in the research that old people and again, especially those who aren’t very healthy, have poor adaptive immune responses to any kind of challenge, including from vaccines. And those responses that they do have not only are very strong, but they don’t last as long so I you know, I think the public messaging around vaccines has been really been pretty bad bad in the sense of setting expectations that just weren’t supported by what we know about how vaccines work, and people should have been told, you know, vaccine doesn’t stop exposure to the virus, it doesn’t stop some level of infection. And in old people, it’s probably not going to prevent a lot of deaths that that occur.
Gene Galin
Here in North Carolina, the governor, mask mandates are not required on a state level. However, certain municipalities and here in Chatham County, one of our towns Pittsboro, the Pittsboro mayor, who falls in that over 65 category, has passed a mask mandate, which quite honestly is kind of adhered to and not adhered to. Like you mentioned the older folks let’s talk about masks. And we have a sizable elderly population here in Chatham County over 65. And our number of deaths in DeKalb. County overnight, over 18 months has been 90 and most of those that’s happened within the first few months and to nursing homes. As you mentioned, the elderly are super successful. And we’ll do it. I think there are other local people chatting us and record did a search to the to the death records and found that the youngest death of someone a Chatham County resident was like 55. So what’s your feeling? Should elderly people be wearing masks when they’re going out? And what’s the efficiency of masked? Is it? No mask? Yes, mask? What’s the benefits? I mean, you put out a lot of content as to masking. You know, what’s your feeling on masking? When does it help? When doesn’t it help. And, you know, on an ongoing case, if we’re living with COVID, for it’s here, and it’s here to stay, are masking mandates even? I recall, I mean, is it really not necessary to have those
Kevin Roche
I’m not going to encourage people not to wear masks. I think people should do whatever they want. I don’t. I would be concerned that people get a false sense of security, because the reality is, they don’t work very well. In an isolated instance, they might prevent transmission, either from aware or to someone who’s wearing a mask. over a large number of transmission opportunities, they don’t work very well. And you can see that in any data or chart that you look at. And I don’t pay as much attention to the whether or not there’s a mandate as to data about how often people are actually wearing masks. And you know, here in Minnesota, we had a statewide mask mandate for a very extended period of time, we had 90% plus mask wearing adherents. during most of that time, and last fall, we had a horrific wave of, of cases, hospitalizations, and deaths. And masks, obviously had zero impact on that. And I try to explain to people, you always look at stuff on a micro level and a macro level at a micro individual level. When you look at what’s happening, you know, masks don’t stop transmission. Because virus and virus particles and aerosol particles that the virus is on are very small. The whole purpose of a mask is to collect those particles. So they’re on the mass, there was a study in England that looked at how long the virus persisted in a viable form on various surfaces. And the second longest persistence was actually on mask surfaces. So you know, you’re collecting virus, if you are exposed on the mask, there are gaps, it can eventually be pushed or pulled through the mask. The best kind of modeling studies that look at the wearing of masks over long periods of time, and what happens to various particles around the mask show that masks in some ways actually concentrate, opportunity opportunities for the virus to be either inhaled or exhaled. So from a physical perspective, most masks that people are using just, you know, don’t really have the capability to stop transmission. And as I said, then you look at the macro level. And what you observe in any well done kind of data or research study is that there’s not an impact on on transmission. But again, I don’t care if people wear them. I don’t think they should be mandated, because there isn’t evidence to support any beneficial effect, but people who are concerned and who think it’s going to help them should wear them. I would if you’re that worried, I think the better advice is stay out of high risk situations than assume you’re going to protect it because be protected because you’re wearing a mask and then
Gene Galin
Staying with the older population. And before we get to that, what’s your definition of a high risk situation?
Kevin Roche
Well, obviously, if you’re around people who appear to be sick, I hide you know, my guidance for keeping myself healthy aside from getting vaccinated which I’ve which I’ve done has been to avoid kind of crowded situations with people I don’t know. Because you just don’t know if there’s a person there. transmission in this epidemic, as in many epidemics appears to be primarily from people who are often referred to as Super spreaders or relatively Small percent of the population appears to have pretty high viral loads to be expelling pretty high amounts of virus. And those people are probably accounting for a very high percent of all transmission, that may actually be one factor that accounts for the shape of waves that we see. So I, I, you know, I tend to I go to restaurants and stuff, but I, I tend not to go to very crowded bars with a lot of people I don’t know. So I think you just kind of use common sense. But I pretty much lived a normal life through the whole epidemic. I think it’s really just kind of common sense.
Gene Galin
Well, that’s a good piece of advice there. What other advice and I know there are folks that are genuinely concerned our communities, especially over 65 years old, that you know, some of them have stopped seeing their grandkids. They’ve stopped interacting with family members. It sounds like what some of the suggestions you’re saying is, you can interact safely with folks that you know. If they happen to be sick, maybe they need to stay home and not eat come into contact with you. But what other what other advice could you give to somebody that’s over 65 years of age?
Kevin Roche
Yeah. I mean, unless you’re really severely immunocompromised, you are taking some medicine that just really suppresses your immune system or have a disease that does that. My my advice to anyone is keep living your life as much as you can, I can’t imagine not seeing my grandchildren or family. And I did throughout this. And I do think that’s relatively low risk, because you’re trusting them to tell you if they’ve either been exposed or are feeling sick. And there have been a couple of examples of situations where a member of my family has thought that works both and one case actually did get infected. And we kind of all stayed apart for a while. So I, I think being cautious like that, but I hate to see people give up what’s important in life, I wouldn’t do that. The other thing I would encourage people to do is get themselves in as good a health as they can, you know, eat healthy exercise. You know, if you’ve got unknown, you know, bad health condition, do your best to keep it under control, because it is pretty clear that that people who are healthy don’t tend to get seriously seriously ill. So as with everything, maintaining good general health probably helps you as much as anything, wouldn’t be obsessive about cleaning the, the research shows that it you know, wiping stuff down all the time doesn’t seem to make much difference. Those plastic barriers don’t seem to make much difference. Social distancing, doesn’t seem to make much distance primarily because it appears that the virus has capability to kind of persist in the air and travel a lot further than then we think so. You know, a lot of stuff that people recommend doesn’t necessarily work.
Gene Galin
What’s the data that you see on being indoors and being outdoors? Differences? My wife’s a nurse, and she says, “Hey, outdoors is probably one of the best environments to be.”
Kevin Roche
I think that’s probably true. And I think the data pretty much shows there’s very limited examples of outdoor transmission. And that that would likely be partly because sunlight, frankly kills the virus. So if you’re out in the sunlight, there, you know, even if the virus is around, it may not last long airflow will probably disperse the virus more quickly. So yeah, I think you’re a lot safer outdoors than you are indoors in in general, I would say.
Gene Galin
We’ve touched on the elderly. It seems that right now there’s a vaccine that’s going to be close to being approved if it hasn’t been approved for the five to 12 year old age group. You’ve written quite a bit on the healthy skeptic about how this has affected kids not just from a health perspective, but from a learning perspective. Child abuse them off. There’s all sorts of negatives because it’s That our leadership in local counties and states in the nation have overreacted to certain extent. What are you seeing from a? How does how does COVID affect kids? I know they they mentioned that cases have gone up. But that doesn’t necessarily mean there’s more deaths and also kids are more asymptomatic. I mean, you’ve got loads of information on your website to get a concise then let the folks in Chatham County know about how COVID affects kids and what you see as a healthy perspective to COVID and kids. Can you give us something a little bit concise?
Kevin Roche
Yeah. So I mean, it’s very clear, I don’t think anybody disputes children are at extremely low risk of any kind of serious illness from Coronavirus. And that’s partly because they constantly are suffering seasonal Coronavirus, and infections. And it appears that those prior seasonal Coronavirus infections actually help with the immune response to the current strain. So that there is basically to a healthy child, there really is zero risk of any kind of serious disease. Obviously, children who have serious health, health issues can can be at risk. So you start there for kids themselves, there’s very little risk.
Doing things like keeping kids out of school or having virtual school, the research all shows that’s just very damaging to children, not just from a an educational perspective, where we’re just seeing kids both drop out of school, especially minorities, but also lose the years of of learning. But it also hinders their social development. And some of the stuff we’ve imposed on children in the name of safety is actually damaging them. So it’s not actually very safe. In terms of vaccines and children, I think we need to be super cautious because of the low risk. If there’s any number of serious adverse events in children from the vaccine, then it’s more dangerous to them than the virus itself. So I personally think we need some really large significant studies to be sure we understand the safety risk to children. And then, you know, I would be very unhappy to see mandates about vaccinating children, you know, parents, I think can make an assessment of the risk to their the comparative risk to their child from disease and from vaccination. And, you know, in schools, for example, if teachers are worried they can all get vaccinated to protect themselves. And I don’t think we should be imposing measures on children to protect other populations, when those measures might be harmful to the children themselves.
Gene Galin
So it sounds like your advice to parents is don’t rush into it. Hold off. How much how much information? How much time? Should parents take into consideration if it’s that low of a risk? I mean, I guess, what you’re saying it’s an individual parent’s decision, and it shouldn’t necessarily be a mandate, is that correct?
Kevin Roche
If it were up to me, I would leave it up to parents. And I would give them as much information as possible. You know, right now, you can’t vaccinate kids under 12. If you’re the parent of a boy who’s in the 12 to 17 range based on the incidence of myocarditis in that group. I would be extremely cautious about getting my son vaccinated because the risk of myocarditis, while it’s not often serious, is not insignificant. So I just, I think you got to give parents lots of information and let parents make the decision because from an epidemic management perspective, it’s not gonna make much difference. Very high percentages of kids have already been infected. And so they’ve got adaptive immunity. And frankly, the research is showing that that immunity from infection is probably at least as strong if not stronger than people are getting from the vaccines. So I just, you know, I have nothing against vaccines. I’m vaccinated. I just got my booster. This weekend spent a couple of days of not feeling great from the from the booster and I generally encourage people of any risk to you know they they should talk to their doctor but I generally think there’s nothing wrong with getting vaccinated kids is a different story because the risk benefit calculation is different and I I don’t like the idea of forcing kids to get vaccinated I just view it as probably unnecessary.
Gene Galin
You mentioned boys between the ages of 12 and 17 getting myocarditis. I’m going to ask because I don’t know what myocarditis is and I’m sure people who are going to listen to this are going to ask the same question. What is that?
Kevin Roche
It’s a heart inflammation and it’s occurred in adults too. They’re not sure why it happens frankly with coronavirus disease somewhat frequently, typically mild. Some cases are a little more serious and and require hospitalization. Something about the vaccine, you know, the spike protein itself that’s in the vaccines. Something’s triggering inflammation, triggers inflammation and other tissues too. But obviously, anything that’s affecting your heart is a particular concern. And I don’t want to unduly alarm people. But again, the risk to children is so small from the disease that I just think, you know, you got to weight what the benefits are versus what the risks may be.
Gene Galin
Early on, you brought up the fact that certain states are doing better than other states when it comes to coronavirus cases. And that there been any noticeable trends or similarities between the states that are doing better and worse? And also, I think you’ve mentioned that the reporting from a lot of state health agencies hasn’t been the best either. So there’s a lot of states seem to be doing things differently. And it doesn’t all seem to quite add up.
Kevin Roche
Yeah. So on the data side, I think it’s generally true, most states have done a pretty poor job of giving people really good useful information, some states, my State of Minnesota is definitely one of them have been far more interesting in using the data. What data is presented, how it’s presented to support their messaging than to just give people full and accurate data and let people understand what’s going on. So yeah, I’m not overly impressed with the data. In terms of overall response. I think some states have had a little more balanced than other states, you know, we’ve just had this obsession with epidemic as though it’s the only thing that matters. And I do think some states and I’ll point to Florida, and some countries, and you can look at Sweden, as a great example of this, have had more of an appreciation that look some of these measures we take, have bad health implications for people, we scare people into not going to the doctor who really need to go and now we’re seeing heart attack, deaths increase or diabetes. Deaths increase because people missed health care that they needed. I mentioned, the educational deficits that were that we’re creating. So I think there are states that had a little more of an attitude of Look, I’m supposed to be looking out for the overall public health and the overall welfare of the people who live in my state. And I I think that’s commendable because it wasn’t easy to do that if you did that. You got beat up by the press, and you got beat up by other people. But in my judgment, you were doing the right thing, because you were trying to do what was in the best interest of all of the people you’re responsible for.
Gene Galin
So what what should we as the public be demanding of our leaders, whether it’s political or health, health department leaders? What What should we be demanding from them, being able to handle COVID from which as you say, is here and is staying from this point on?
Kevin Roche
Well, something you’re never gonna see from a politician which is courage and integrity, right. You You know, I think the willingness to make decisions and take heat not be afraid of people saying, oh, you’re letting people get sick and blah, blah, blah, when there are other things to be reconsidered. As I just mentioned, I think, you know, the public has a right to full information, your your in media business, you know, the function of that, it’s not so much people being free to say whatever they want people have a right to hear the truth. And especially when the government is involved, they have a right to the truth. And so we ought to get every scrap of data that governments have, and be able to analyze it on our own. And to then, like I do, say, Hey, here’s what I see. So I think that would be critical. But as I said before, if we’re going to get out of this, there needs to be an attitude shift, we need to stop obsessing about it. And thinking it’s the only thing that matters if it isn’t, and it’s not that threatening. At this point, I think we’ve done pretty much what we can, and it’s pretty much under control. And so frankly, we need to move on.
Gene Galin
We’re getting close to wrapping it up here. Two questions. I, my wife and I, my son had COVID last Christmas and I had to spend a zoom Christmas away from family members and quite honestly, it sucks. So what are your recommendations for the general public coming into Thanksgiving and into Christmas? Because I’ve already seen the reports out there from certain experts that say, hey, you just need to stay home and not go out. I’m not planning to do that. But again, want to be aware of I’ve got relatives are over 65 over 70 over 80 years of age. What precautions do we need to do to have a happy family gatherings both Thanksgiving and Christmas over the holidays?
Kevin Roche
Well, I think the most obvious thing is what you did if you’re sick or have been sick recently, then the right thing to do is isolate yourself from people just in case you’re infectious. Absent that, as I said earlier, I encourage people to live your life. You know, you don’t live forever no matter what. You need to enjoy what makes it worth being alive. So I’m, you know, here in Minnesota last Thanksgiving and Christmas, they were telling people “Oh, don’t get together”. And I thought that was horrific advice. If you observe basic cautions, there’s absolutely no reason why people shouldn’t be getting together and and so I tell people don’t pay any attention to the so called experts who tell you that you shouldn’t get together with your family at Christmas. Somebody’s sick, they should be careful. But other than that, I say enjoy your life.
Gene Galin
Alright folks, we’re getting ready to wrap this up. We’re here with Mr. Kevin Roche. He’s got the healthy skeptic website healthyskeptic.com. Kevin, let’s just wrap this up with asking, you know, why you start the blog? Why you start posting the stuff you’ve done? What have you been able to accomplish with it? What have you been happiest? And what it’s been able to do? A and you know, what things would you like to see and be able to do? Or what other things would you like to be able to see the message go out. And again, I would recommend folks, we do read reprint some of this stuff on the Chatham Journal website, but also feel free to go on there. And you pretty much put something out just about every day on that site. And there’s lots of good content and you go to the sources for some of those medical studies with a capsule explanation of here’s why this study is important. I actually asked you a question about some of the stats about hospitalizations versus deaths and everything else like that and and you’ve got that content on your website.
Kevin Roche
Yeah, so actually, you know, the blogs been around for 15 years. It’s just a sleepy little Healthcare Research and Policy blog. And when the epidemic started, I didn’t have any intention of writing about Coronavirus until we started doing lockdowns and school closings, and I was like well, wait a minute. We’ve never done anything. like this before, for flu epidemics that were frankly just as as bad. And why are we doing this now, and it’s going to cause enormous kind of collateral damage. So I started writing primarily because of that. And then I realized, as I looked around for sources of information that in Minnesota in particular, there was no place that people could go to, to kind of just get basic data about what a case curves look like, what a hospitalization rates look like, what’s the age structure, all kinds of interesting data. And so I started putting together charts and, and information like that. And I also realized that people probably weren’t aware there’s this immense body of research that’s being conducted about the epidemic. And that, you know, to have some of that knowledge summarise might be helpful for people. As far as the future goes, I just didn’t stop writing about this. And I intend to as soon as, as I can, because I again, I, you know, I’m happy to go back to what life was kind of like before, but in the meantime, you know, I think I’ve I’ve acquired an audience of people who do appreciate having access to data and science that helps them make up their own minds about what they think the appropriate policy is.
Gene Galin
Well, folks, that’s Mr. Kevin Roche. I appreciate him being on. Feel free to reach out and take a look at his website. Again, we do run stories on the challenge journal website that we do read reprint that, again, the Minnesota stuff that’s Minnesota specifically, I think, oh, stay away from but I think the stuff that you’ve recently been putting out on kids and how it affects them so much more. It seems like the lockdowns and the masks and everything else has had more of a negative effect than COVID has on that that age group is. Is that kind of a good way to wrap things up.
Kevin Roche
Yes, I think that’s true.
Gene Galin
Alright folks, thank you very much for watching. We’ll also have a follow up story on the Chatham Journal and Mr. Kevin, thank you very much.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.