By Dr. Anthony Policastro

It is interesting watching the current TV ads. If the Democrats win our nation will crumble. If the Republicans win our nation will crumble. The QAnon group has a theory about pedophiles and Satan worshippers. Abundant other theories are proposed.

Actually, this is not a real surprise. Conspiracy theories are part of the human psychological makeup. As far back as JFK’s assassination there have been multiple conspiracy theories that popped up related to that.

These theories are a psychological defense mechanism. They help people deal with uncertain times. They are not a lot different than things like denial and rationalization. They are just a different approach to deal with unpleasant events.

Interestingly, psychologists have found that there is a personality type that tends to believe conspiracy theories. That should not come as a real surprise.

The first characteristic of these individuals is that they in general are not very cooperative with others. They tend to do their own thing. That creates a kind of isolation. As a result they need to prove that it is everyone else that is wrong. It can’t be them.

Another characteristic is a focus on their own interests to the exclusion of society as a whole. This is a form of narcissism. They feel that they can manipulate others. They feel that it is appropriate to deceive others. They feel that they can exploit others. All of these are necessary to attain their personal goals. Those goals are more important than society’s goals in general.

A third characteristic is a natural distrust of others. This makes the individual somewhat paranoid. The result is coming up with explanations that fit their paranoid way of thinking.

The result is that their critical thinking skills are impaired. They are likely to attribute random events to a pattern that does not exist. They are likely to attribute things being done intentionally when that is not really the case. They tend to under analyze things and just go with their gut reaction.

The result is that they see themselves as special. They have secret knowledge of things that no one else has. That is why no one has the same beliefs. It is important that they think that because the real underlying subconscious issue is poor self-esteem.

The arrival of social media has increased this behavior. The individuals who believe these theories can continue being isolated from real people. The computer stands in the way of that. Thus, conspiracy theorists have a new outlet that was not present before.

We also know that conspiracy theories thrive in times of uncertainty or trauma. The COVID-19 epidemic creates fertile ground for that.

There is an old saying that if it sounds too good to be true it probably isn’t. For conspiracy theories a similar thought can be if it sounds too far fetched to be true, it probably isn’t.

I need to end at this point so I can go back and watch TV and see what the newest ways there are for the nation to crumble.

COVID-19 Update

There was a clear increase in the overall number of new cases nationally in the last week. For the 7-day period there were just over 500,000 new cases. In July at the peak of the surge, there were just under 500,000 new cases in a 7-day period. Therefore, we are at about the same level of new cases that we were in July.

In Sussex County we have had about 300 cases over the same seven-day period. Thus we are not currently one of the hot spots in the country. But we do still have some areas of the country where medical resources are overwhelmed. Failure to have a centralized system for moving resources to those areas is one of the  glaring weaknesses in our response to the virus.

Last week we once again doubled the total number of cases nationally. However, it took 88 days to do so.

Previous doublings were in 45 days and then 41 days. If you remember, it took Delaware 87 days to the last doubling so the numbers are not a lot different. The curve continues to remain flatter than it originally was.

Vaccines are currently in Phase III testing. They have been given to one group of people and another group received placebos instead of vaccines. Only the researchers know who received which one.

Now the goal is to see how many people with the placebo get infected naturally with COVID-19 compared to how many people with the vaccine get COVID-19. That will tell how effective they are.

The expectation is that 30,000 individuals will be enrolled. Half will get the vaccine. Half will get the placebo. Then 53 individuals will need to become infected naturally with COVID.

Of those 53, at least 40 must be in the placebo group. That would make the vaccine 70 percent effective and meet the pre-determined standard for effectiveness.

On October 20th a report was released from the Butantan Institute in Brazil. The institute is a vaccine research center. The report indicated that Coronavac was the safest of the vaccines in terms of side effects that they were testing. Other vaccines being tested there included those from Pfizer, Johnson and Johnson and AstraZeneca. There have not yet been comments about effectiveness compared to other vaccines.

One issue that has changed over time is related to fomites (viral particles on inanimate surfaces). Early on there was evidence that the virus could maintain its infectivity on surfaces for a period of time in laboratory studies. Therefore directions were to wipe everything down that could contain the virus. However, laboratory conditions are not the same as what we face in real life.

You clearly can catch the virus from inanimate surfaces. However, the process is complicated. First an infected person needs to leave virus on the surface in the form of droplets. That usually occurs with coughing or sneezing. Then an unaffected individual has to come along and touch that surface while the droplet it still fresh. The final step is that the second individual needs to touch his/her nose, mouth or eyes while the virus is still on the hands.

The approach is relatively simple. If you are touching surfaces that might have been recently contaminated, wash your hands before you touch your face. For example, I use alcohol wipes on my hands when I pump gas. I do it when I touch packaging for take out food. I wash my hands after handling the mailbox (metal is more likely to maintain droplets than paper mail). However, most other surfaces are ones that I know have not been exposed to infected individuals. Therefore, the need for caution is diminished. It is never 100 percent but comes pretty close to that.

I have had a reader raise a question to me by e-mail about hydroxychloroquine. Hydroxychloroquine has been an excellent drug over the years for patients with lupus and rheumatoid arthritis. It is not tolerated by a significant group of them. Therefore, it cannot be used in everyone. However, it is very beneficial for the group that can tolerate it.

I mentioned a few weeks ago that a study in Minnesota had looked at the drug after screening out anyone with cardiac risk factors. They showed some benefit. Another study has been done in France with similar results. The problem with hydroxychloroquine all along has been its cardiac side effects.

The benefits to be gained were not significant enough to risk cardiac deaths from it. It was a classic case of the cure being worse than the disease. Hydroxychloroquine does have some positive effects when used in the right populations. Even then the effects are not that huge. It is certainly not a cure all.

It works to reduce inflammation. That is similar to what steroids do. That is why steroids are first-line drugs for lupus and rheumatoid arthritis patients. It appears to this point that for COVID-19 patients steroids actually perform better than hydroxychloroquine in accomplishing this particular task. In addition, they have less severe side effects. So the steroid route appears to be the better way to go.