Jim’s Take

An Employer’s Current COVID-19 Status Report

We’ve been “at” COVID for ten months.  We know a lot more about it now than at the beginning.  However, little of the truth is getting out to the public.

Employers – and that’s who I’m trying to focus on here – are rightly worried about the impact the virus will have on their operations.  There are multiple considerations, which I’ll try to cover as best I can.

Please also remember that COVID is a politicized subject, and any report – certainly including this one – represent the author’s interpretation of results.  Anyone’s interpretation will always reflect their “world view.”  The sidebar included identifies parties at interest – and everyone is somehow a party at interest.

“Infected”, “Infectious”, and “Testing Positive”

This is a critical set of definitions to understand. We test for the virus by “PCR testing” (see text box for discussion). If a person has some virus in their nasal passages when tested, they may well “test positive”. But are they infected?

What is PCR testing? PCR stands for “polymerase chain reaction.” Certain portions of the virus – portions different from most other viruses so as to assure we’re measuring the correct virus – are repeatedly duplicated (each duplication is called called a “cycle”) until there are enough particles to measure. This is often one billion times the number originally present. The more cycles if duplication, the more sensitive the test is, and the more likely it is to give a false positive.

COVID Parties of Interest

Politicians – Their power and authority are enhanced by the level of public panic.

Media – Their readership, influence, and profits are enhanced by the level of public panic.

Medical – Health providers are well-informed. Their natural desire to heal might make them more inclined to see risks, not rewards.

Health Facilities – Facilities, particularly hospitals are hurt by too much panic because the public will avoid treatment due to fear of the virus.  But hospitals are paid an “inducement” for COVID diagnoses, which may cause over-reporting of deaths.

Liberals – Read the mainstream media, were/are untrusting of anyone affiliated with Trump and the GOP, but more trusting of liberal/Democrat politicians.

Conservatives – the exact opposite of liberals: Trump, GOP – good; Liberals, Democrats – bad.

Not necessarily. Lots of people get the viruses in our systems, but they’re only infected when the virus penetrates a cell and begins replicating.

While this is happening, the body is fighting back. Our immune systems have had thousands of years to develop the ability to fight off infections. So, you could be “infected” because the virus is in cells and is replicating, but your body may be successful in destroying the infection.

Despite our immune systems being resilient, the ability to overcome diseases like COVID tapers off with age, dramatically seen with COVID and its impact on those over 70. People from the very young through the end of the effective working age successfully fight it off – often not even realizing that they have the virus, i.e. they mistake it for “a cold” or “the flu.”

The question for those of your employees who are currently healthy but worried about becoming ill is how many “infected” people are “infectious?” A person is only “infectious” if they are emitting (called “shedding”) enough viable virus particles to cause an infection in another person. The person may be shedding virus fractional particles instead of entire viruses, or the number may be too small to infect another person.

What Does This Have to Do with the Number of Reported Cases?

Unfortunately, PCR testing only tests artificially multiplied amounts of the virus. It may be multiplying only fractions of viruses, in which case the person isn’t really “infectious,” i.e. not a problem.

Moreover, remember the concept of “cycles” explained above? There is general agreement that if a sample has only gone through 30 or fewer cycles of reproduction, a positive test is very probably correct, that is, the patient is infected.

However, in the US, some states are allowing tests to go to 38 cycles or more. To put this in perspective,

  • if we can detect “X” number of virus particles, and
  • if in a particular sample at 30 cycles there is a quantity of X particles, and
  • if we instead replicate the sample for 38 cycles
  • then there will be 250X particles.

In other words, letting it run to 38 cycles is a prescription for over-reporting the number of infections. It is likely, even probable, that in those states or localities the number of cases means nothing.

That – over-replication in testing – is effectively Reason #1 why I’m less worried about the disease than many – over-reporting of cases that aren’t really infectious.

Reason #2 is the fact that the medical establishment is “incentivized” to report ANY illness with associated COVID diagnosis as a “COVID-caused medical necessity”. Even if it’s a heart attack, if the person has a COVID diagnosis, either upon entering the hospital or acquired in the hospital, it is labeled a “COVID” case. If the person dies, even if it’s from the heart attach, it’s listed as a “COVID death.”

Reason #3 – and this sounds irrational – is that there are – according to the CDC – probably 91 million cases, not the 21 million that were reported as of January 6, 2021. So, why is it a “good thing” that the number of cases is higher than reported?

Simple. All those unreported cases have NEVER reported their symptoms to a medical professional. In other words, they never got sick enough to feel any need for treatment.
If the CDC is correct, that means that

  • 91 million Americans have already had and survived the virus
  • Which means their bodies fought it off
  • Which means their bodies have developed COVID antigens
    • Which is just like getting a vaccination, at least in terms of how your body reacts
  • Which means they can’t easily get reinfected.

“But wait!” you cry! “The media tells me that people have been reinfected.” To which I say, “Go back and read the definition of the word ‘infected’ given above.”

The question is simple – are these people the media and the medical establishment talking about infected (i.e. the virus is replicating within their body cells)? Or did they merely “test positive?”

The medical community have been studying the antigens, B Cells and T Cells that victims develop, and to date – that’s nine month’s observation – there has been little or no lowering of the body’s defense mechanism. Therefore, if you get the disease once and survive, you are much more likely to be able to fight it again – more easily this time.

Here’s what a researcher told me [conversationally, not in formal “report” language (emphasis added)]:

“Adaptive immunity. Another hard to grasp concept. Again, think of a rapid reaction force. You are exposed to a pathogen again, and your body very quickly recognizes it and responds by killing the virus before any infection gets going. And it is possible that a person could test positive if they are swabbed at the right time, but as above, would never be truly infected or infectious. The vast majority of the research is finding that almost everyone, and I really mean with very rare exceptions, after being infected develops a strong and lasting B cell and/or T cell defense. Antibody assessment isn’t the critical item, presence of memory B and T cells is. If this weren’t true, it is unlikely that a vaccine would perform very well.”

(Courtesy of Kevin Roche, Healthy Skeptic, Roche Consulting, LLC khroche@healthy-skeptic.com)

What Does This Mean to the Business Owner?

This means two simple things. First, if you are fully insured: Your carrier is worrying about the costs of the deferred treatment from 2020, the complications from ignored/avoided care of existing diseases and conditions, and the increased seriousness of identified-too-late conditions also do to 2020 care avoidance. Second, your carrier will have to pay the COVID-incentive costs of claims for everyone who does contract the disease, so they’re adding that cost to your premium.

What the business owner with, say, 10 or more employees on his/her health plan should ask is, “How generally healthy do I think my employees are?” You typically know the answers to these kinds of questions:

1. Is my workforce younger or older than the average?
2. Are more than a quarter of my employees obese? (probably the most dangerous condition from a COVID perspective)
3. DO I know offhand of any serious conditions – COPD, cardiac problems, pulmonary (lung) problems, etc.?

If the answer to the questions above are 1) younger, 2) no, and 3) no, then you ought to do a serious evaluation of your ability to save money by “sharing risk” with an insurer.

Another term for that risk sharing is “partial self-funding,” and it is a proven practice that too few businesses take advantage of. Particularly in Massachusetts, where we have primarily non-profit carriers of high quality competing for your business.

Depending on your size, you can have a plan that is no more difficult to administer than a traditional fully insured plan (that is, you get a flat bill every month).

The only functional difference between a risk sharing plan and a traditional fully insured plan is that

  • if you incur more claims than you funded, no problem. The carrier eats it.
  • If you incur lower claims than you funded, good news – some or all of it is returned to you in the following plan year.

While I/we have immense respect for the carriers we work with, the fact is that they, like you, are more concerned about their bottom line than they are about your bottom line. By sharing in the risk you help to reduce the amount of money the carrier removes from your business.

It’s easy to evaluate, a more accurate evaluation of your possible risk than previously used, and the process of implementation is far simpler than it ever has been.

Given the overpayment for the COVID risk that EVERY fully insured employer faces, deciding to NOT INVESTIGATE this possible solution is about the same as shredding your money.