Here's a collection of some of my LinkedIn Posts on the Coronavirus Pandemic. I don't claim to be an expert - but do try to think logically as a doctor, and use my common sense to reason !

1. Contrarian Views on Coronavirus - Dr. Aniruddha
Malpani
~Collection of all LinkedIn posts
Opinions
The Coronavirus Pandemic has brought into sharp focus how intolerant we are of people whose opinion is
different from ours!
Many of my friends wonder why I stick my neck out by expressing contrarian views about the Coronavirus
Pandemic, which are unpopular, and attract trolls. Do I enjoy raising controversy?
Fortunately for me, I do not have to worry about being politically correct or toeing the party line, so I am
happy to share what is on my mind on a public platform. I don't pretend to have all the answers, and am happy
to be proven wrong if this done logically and politely!
I am happy when people don't agree with me about the Coronavirus Pandemic - this reassures me that I am on
the right track!
Madness is rare in individuals - but in groups, parties, nations, and ages it is the rule. - Friedrich Nietzsche'
The madness of the crowds has destroyed the wisdom of the crowd in the Coronavirus Pandemic. The one
thing which has spread exponentially during this Coronavirus epidemic is negativity, doom, and gloom, thanks
to the media and social media! Why have we lost our ability to think rationally? Think!!!
There's a lot of confusion about the Coronavirus Pandemic. There is a lot of uncertainty, and it's hard to know
who to trust. This is why critical thinking skills are so valuable. Whenever you read an article, always ask your
self - What is missing? What did the author leave out? And why? Sadly, most stories aren't balanced or honest.
The public prefers listening to people who project confidence, even if they are ignorant. This is why the voice
of thoughtful experts is never heard - they have the intelligence and humility to qualify their statements
because they don't pretend to be omniscient! The slippery slope fallacy has hijacked our ability to think clearly
about the Coronavirus.
Berkson's bias is one of the reasons why we are over-reacting to the Coronavirus Pandemic
The way we have mishandled the Coronavirus Pandemic is a great example of
● How the media misleads us
● How unreliable social media is
● Why we can't always trust the self-important talking heads
● How we behave like a mindless mob when we are scared
● Why we need to learn to respect doctors and nurses!

2. Can we please stop treating Coronavirus Positive cases as pariahs or lepers, please? They aren't ticking time
bombs which are going to kill all of us! The one thing which the Coronavirus Pandemic seems to have
damaged is our Common sense. We need to learn from the doctors and nurses who are routinely taking care of
sick patients with COVID-19, that as long as we follow Universal Precautions, we are safe! If none of the
health care workers who treated patients with COVID-19 got infected, doesn't this mean that the chances of
acquiring infection because of casual contact in the community must be very low?
I understand the natural tendency on everyone's part to overreact during the Coronavirus Pandemic. After all,
death is scary, and no one wants to take any chances with the lives of their loved ones. However, over-reacting,
over-testing and over-treating is not a risk-free course of action either!
Complex adaptive systems such as the Coronavirus Pandemic are full of unknown unknowns, and the sooner
we acknowledge this, the better! Rather than look for oversimplified answers, we need to learn to ask
thoughtful questions!
Is it possible to acquire herd immunity against Coronavirus, even without direct exposure to the virus? Yes,
thanks to evolution, our immune system has adapted intelligently over thousands of millennia, so that most
healthy people can fight off completely new pathogens successfully on their own. Read more about innate
immunity at https://lnkd.in/fNNKS2F
Our mucosal immune system protects us from invaders. And don't forget we have protective antibodies against
tons of microbes, and most of these infections are silent and asymptomatic.
Healthcare Workers
The reason doctors make irrational decisions during the Coronavirus Pandemic
● Sometimes, clinical ritualism is “de rigueur”.
● Sometimes, decisions are dictated by the defensive practice of medicine. Physicians may wish to
avoid lawsuits. They may also “over- immunize"
● Something must be done often rules. There is the art of doing nothing and the art of waiting. An old
surgical saying holds that “it takes two years to get into the abdomen and twenty years to learn to stay
out.”
● Sometimes decisions are made without taking into account epidemiological information and methods.
● Politically motivated decisions leave them helpless, and they are forced to toe the line
● Some decisions are dictated by extraneous power and/or justified socially, historically, culturally, or
by faith.
● Simple blind willingness to please decisions are still made. Anything that pleases the patient, the
physician, and/or the onlookers or any parties connected to the patient may take precedence over
rational decision making.
From the book, 'A Primer on Clinical Experience in Medicine' by Milos Jenicek
Coronavirus Paranoia! Refusing to allow doctors to get back to their homes after their hospital duty!
Mismanaging doctors and hospitals during this Coronavirus Pandemic.

3. A thoughtful article by Dr. Zarir Udwadia. 'Casually exposed medical staff should not be self-quarantined: A
paper from Singapore is informative: 41 health care workers were exposed for 4 days to a critically ill patient
before he was eventually diagnosed with COVID-19 infection. Despite the high-risk nature of the exposures,
including intubation, ventilation, and regular intensive care, none of the workers became infected. 85% of
these exposed workers had used only surgical masks (not N-95). All had however adhered to proper hand
hygiene. Medical staff who have had a brief, incidental contact should only be asked to monitor themselves for
symptoms.
Contrast this with the recent panic in Mumbai when a large hospital was shut down after it was detected that an
asymptomatic doctor and another out-patient who had a CT scan in the radiology department of the hospital
had both tested positive. If health care workers are quarantined after even casual exposure and hospitals shut
down, there will be no one left to treat patients!' In times of crisis, we want certainty and confidence that the
authorities are in control. Sadly, it's exactly at these times, that life is going to be full of risk and uncertainty.
A doctor's dilemma during the Coronavirus Pandemic -
'As an ordinary private medical practitioner with my own small set up, I feel the most lost out in the present
scenario. It's not that I don't want to rise to the occasion but is there someone who will unambiguously guide
me with dos and don't, what I am left with is only Farmans being issued every few hours by govt or the
association who consider the entire fraternity as having the same resources as a big hospital. I am told to which
mask to wear when but no one tells me where to get it from and the one which I got is indeed the standardized
or just a remake by some scrupulous manufacturers who don't want to miss an opportunity to make hay while
this sun is shining. There are posts after posts on PPE and everyone displaying their skills in innovating
another without anyone assuring which is the best scientifically suited for the present condition. There are
guidelines on prophylaxis which do not say that all healthcare personnel irrespective should take it .what does
ICMR mean when it writes if you have come in contact with a suspect. Can someone tell me who is not a
suspect? '
Lockdown
When is the risk of continuing with the lockdown going to exceed the reward? And how do we monitor this
tipping point?
I hope we don't end up creating a man-made famine in our efforts to contain the Coronavirus epidemic through
a Lockdown! Supply chains have got disrupted and restoring them can be a monumental task if we fail to
prioritize this. The one thing which is going to grow exponentially about the Coronavirus Pandemic is the
harm the lockdown will cause!
Effective vs Efficient. Yes, the Lockdown is effective in reducing the spread of the Coronavirus. The problem
is that it is not efficient. The cost of implementation is far more than the benefit. Most people don't seem to
understand the difference. Are Lockdowns are the best way to implement social distancing to control the
Coronavirus Pandemic in all areas? This is a reasonable hypothesis but should have been tested. Yes, it
sounds logical, like most conjectures do, but this doesn't mean that it is right. Sadly, it has now become an
unfalsifiable proposition we can no longer even express doubt in

4. The reason we are stuck with this Lockdown is because of the 'sunk cost' fallacy! I hope the Lockdown doesn't
end up becoming a Chakravyuha!
The Coronavirus quandary. We need to weigh all the following, and there will always be a trade-off. We need
to acknowledge the pros and cons explicitly, rather than naively assume that we are doing our best!
● Personal safety
● Personal harm
● Social safety
● Social harm
The risk-benefit curves of both the Coronavirus epidemic and the Lockdown are changing all the time and we
need to be willing to calibrate our actions accordingly. We think that staying at home is staying safe, but this,
not a cost-free option. It may provide personal safety, but can cause social harm for the poor and unemployed.
The lockdown is an irrational kind of rationality because it underestimates the impact of everything which can't
be measured easily, such as the long-term costs of disrupting the economy. We are trading the high risk of
long-term pain by instituting unproven measures to achieve possible short-term gains.
The standard justification for every extreme measure the Government takes during the Coronavirus Pandemic
is - ' Desperate times call for desperate measures'. But are we responsible for creating this aura of desperation
by highlighting all the negatives and amplifying the fear and panic?
The Coronavirus is not going to be the last Pandemic we will see. The good news is that just like viruses
evolve, so does our immune system, and it's this co-evolutionary balance that will ensure human survival - not
curfews and lockdowns!
Media
How the media creates fear and panic about the Coronavirus. Images like this trigger a fight or flight response,
and logical thinking go for a toss

5. Finagle’s laws of information, as applied to the Coronavirus Pandemic
● the information you have is not what you want.
● the information you want is not what you need.
● the information you need is not what you can obtain.
● the information you can obtain costs more than you want to pay.
Please remember this the next time you read an article on COVID-19!
The Coronavirus Pandemic has made the Us vs Them divide very clear propagated by media. We are happy to
assume that poor people are illiterate and ignorant, and will spread the virus because they are too stupid to take
appropriate precautions! Isn't this the height of arrogance? They are much street smarter than we are!
The problem with the news channels is that they will never express any doubts, or offer an alternative
perspective because Doom and Gloom sell far more than rational logic!
We can't even agree on the definition of a Coronavirus case! In China, people who test positive for the virus
but don’t have any symptoms are not classified as confirmed cases. This runs counter to the practice in
countries like South Korea, Japan, and Singapore, where all patients who test positive are included in official
tallies of total cases, regardless of whether they have symptoms such as a fever or cough
The reason we are panicking about the Coronavirus Pandemic is that the media has dumbed us down. Most
people just want to watch videos, read the gory headlines, or listen to talking heads. They need someone to
explain the gist of an article to them, because they don't want to take the time and trouble to read the original,
or understand the raw data, and how this has been analyzed. They first make up their mind, depending upon
which story appeals the most to them, and then close their brain to alternative perspectives.

6. Technology
We are seeing an epidemic of Coronavirus chatbots and apps. Most of these are copies of each other. Is this
our idea of creativity and innovation?
Self-isolation works for everyone. If you are sick, it stops you from infecting others. If you are healthy, it stops
others from infecting you. Common sense � Why do we need to waste money on tests and apps to implement
this?
Big Brother is watching you - the ultimate dystopian nightmare is coming true! The privacy as we know is
changing and will have a permanent effect on our lives post this pandemic.
In our rush to battle the Coronavirus Pandemic, we are going to end up wasting lots of resources on useless
tests, unreliable ventilators, ineffective masks, and pointless apps. Should we stop and take stock and then use
it in the most optimum way?
Myth Busters
Masks and the Coronavirus. They have a powerfulplacebo effect in making people feel protected, even though
this is an illusion!
The oversimplified story is - If you get the virus, you are doomed to die! Fortunately, this false! The question
we should be asking about the Coronavirus epidemic. How many healthy people would we need to quarantine
and for how long, in order to prevent one death because of COVID-19? We need to differentiate mortality vs
lethality when discussing Coronavirus Deaths!
The problem with the Coronavirus epidemic is that people confuse risk with prognosis! The risk of getting the
infection is high, as is true of most viral infections. However, much more importantly, the prognosis is
excellent, and the chances of a full recovery without any treatment are very high as well!
Before assuming that 'tests, tests and more tests' is the best way to tackle this Coronavirus Pandemic, please try
to understand the limits of medical tests. And if you can't, then please don't mindlessly ask for tests!

7. Why mass Coronavirus testing is a bad idea. It's much cheaper and easier to advise people to self-isolate!
Testing is expensive, consumes resources, and increases the risk of disease transmission because many people
need to go to a lab to get tested, and crowding can be dangerous!
To add insult to injury, the RT PCR tests are untested because their clinical significance has not been
validated! Who decides what the right LOD (Limit of Detection) should be? And has this been correlated with
the gold standard - viral culture? In times of crisis, most people are happy to follow the crowd. Being part of
the herd seems to be a much safer bet, rather than trying to think independently or reason from first principles
The real-life problems with Coronavirus testing! Manufacturers and labs are cutting corners in their rush to go
to the market and make money!
The problem with the Coronavirus Pandemic is that we are confusing screening tests with diagnostic tests!
Pointless testing causes more harm than good - especially when people don't know how to interpret the results
intelligently! Why is everyone panicking about this? We are all going to test positive for some virus or the
other! A positive test does not mean that you are going to get ill!
Some Coronavirus Basics
● Positive test = Case only!
● Case ≠ Patient
● Patient ≠ Death!
Interestingly, the Chinese don't count someone who has tested positive but is asymptomatic in their statistics.
Labeling someone a patient on the basis of a positive test result, even though he is hale and hearty, is
something which only modern medicine does!

8. Extrapolating from the Italy experience with Coronavirus to India is flawed. We can't compare apples and
oranges when discussing disease transmission in a population that is so different from ours!
Coronavirus - Biology vs Chemistry
The infectivity of the virus is a function of the amount of viral load you are exposed to. This is why casual
contact - community transmission - is very rare because our bodies can fight off small loads. The Coronavirus
RT PCR tests, on the other hand, will be positive, even if there are a few molecules of the viral RNA in the test
sample! We are worried that we may get infected by an asymptomatic carrier of the Coronavirus. Common
sense will tell us that the risk is much less because someone who is asymptomatic is likely to have a much
smaller viral load, which means he is shedding much less virus and is not going to be as infective as it is
someone who is ill!
Why the Coronavirus death rates are misleading?
Let's take a critically ill patient in the ICU who is on a ventilator because of a stroke, with a high chance of
dying because of severe brain damage.
Now suppose he dies, and his Coronavirus test comes back positive. Because of the media coverage, his death
will be considered to be a COVID-19 death, but the truth is that he did not die because of the virus - he did
with it.
It's quite possible that his respiratory tract was colonized with many other bugs as well, but because these were
not tested for, these were undocumented, and therefore were not reported as a cause of death on the death
certificate!