K-9 Posted June 8, 2020 Posted June 8, 2020 28 minutes ago, Gray Beard said: I think people should watch this video from back in March. This doctor does an excellent job Maybe it’s been posted already and I missed it. ”But if we do this right, nothing happens. Yeah. A successful shelter in place means that you're going to feel like it was all for nothing. And you'd be right. Because nothing means that nothing happened to your family. And that's what we're going for here.” As prescient as it can get. 1
plenzmd1 Posted June 8, 2020 Posted June 8, 2020 16 hours ago, Bad Things said: We just heard the great news that New Zealand no longer has any active cases of Covid-19. There hasn't been any new cases in over 17 days and the last patient has recovered and was sent home. what is going to be travel policy? 4 hours ago, BillsFan4 said: For those now saying the lockdowns in the US were unnecessary: https://www.washingtonpost.com/health/2020/06/08/shutdowns-prevented-60-million-coronavirus-infections-us-study-finds/ “Shutdown prevented 60 million coronavirus infections, new study finds”. 2 different studies were published on the lockdowns in the US, UK, Europe and China. 1st one: the University of California at Berkeley researchers estimate stay at home orders, business closings and travel bans ended up preventing 285 million infections in China and 60 million cases in the US. https://www.nature.com/articles/s41586-020-2404-8_reference.pdf 2nd one: researchers at Imperial College in London estimated shutdowns saved more than three million lives in 11 European countries and dropped infection rates by more than 80-percent. https://www.nature.com/articles/s41586-020-2405-7 Hmm..lots of fishy science in there..good thread on it here. I was all for lockdowns when this thing hit..and believe they have had the desired impact. Curve was flattened 6 weeks ago though. This from the WHO today is interesting as well...as this was a main facet of the lockdowns Again, we learn and learn as this things moves on...maybe temp checks are valid...and you can bet your right testicle will be happeneng at sports events when fans are let in! https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html?__source=sharebar|twitter&par=sharebar
Hapless Bills Fan Posted June 8, 2020 Author Posted June 8, 2020 4 hours ago, K-9 said: Why am I not surprised? The logic seemed intuitive all along. Yet there are those that will still argue it was unnecessary, “Look at Sweden!” But that’s the convenience of analyzing the shutdown in retrospect; people can always say it just never got as bad as all the models predicted so it wasn’t necessary after all. I think when looking at Sweden, there are three things to keep in mind: 1) No national lockdown does not mean that no measures were taken. Universities and HS were closed. People were asked to work at home, avoid travel, and employ social distancing measures. A number of measures that were imposed in the US, were done on a voluntary basis in Sweden (such as ski resorts closing over a popular holiday weekend) 2) Even so, Sweden has had a covid-19 death rate of almost 40 per 100,000 people as compared to its near neighbors which did lock down who have had a death rate of 6 per 100,000 3) The epidemiologist who directed Sweden's response, Anders Tegnell, now says Sweden should have done more and there is mounting internal criticism 1
Bad Things Posted June 8, 2020 Posted June 8, 2020 25 minutes ago, plenzmd1 said: what is going to be travel policy? Although just about everything is back to normal here, our borders will remain closed for obvious reasons. One good thing is that sports are back on the menu again... with actual people watching in the stadiums! 3
Hapless Bills Fan Posted June 8, 2020 Author Posted June 8, 2020 37 minutes ago, plenzmd1 said: This from the WHO today is interesting as well...as this was a main facet of the lockdowns Again, we learn and learn as this things moves on...maybe temp checks are valid...and you can bet your right testicle will be happeneng at sports events when fans are let in! https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html?__source=sharebar|twitter&par=sharebar I would like to see and understand the data to which Van Kerkhove is alluding which leads her to believe that asymptomatic or presymptomatic transmission are rare, because there are bunches of case studies of which I'm aware that speak to the contrary. Now of course case studies are just that - they aren't the overall picture. But when something has as far reaching an impact on public health strategy, I think we all ought to be seeing the data. And here's the thing - so far I can find quotations of her remarks all over the freakin' place, I guess because the implications would be. But I can't find one single solitary reference to the data upon which she based them. I'm fairly good at data sleuthing, so that's not Good News. Here's some science: patients tested at a Washington nursing home who were asymptomatic, presymptomatic, or symptomatic had similar levels of virus titre, in the presymptomatic people 1-6 days before they developed symptoms: Quantitative SARS-CoV-2 viral loads were similarly high in the four symptom groups (residents with typical symptoms, those with atypical symptoms, those who were presymptomatic, and those who remained asymptomatic). It is notable that 17 of 24 specimens (71%) from presymptomatic persons had viable virus by culture 1 to 6 days before the development of symptoms. If asymptomatic, presymptomatic, and symptomatic people have the same levels of viral titer, Why on earth would one believe all three groups would not transmit it? It reminds me of early days of the AIDS epidemic, which emerged in the US initially as an infection of male homosexuals and blood-product users but had a different pattern of heterosexual spread in Africa. One could find straight-faced physicians and scientists who would insist that all the heterosexuals in Africa were totally back-dooring and the virus couldn't spread from PIV sex. As one frustrated physician virologist said, throwing up his hands "What is Wrong with these People? If a virus will spread from a penis to an anus, why wouldn't you believe it will spread from a penis to a *****? They're lined with the same damned cells!" And of course with time, he was proven right. But I digress. Back in mid-March, Van Kerkhove was telling us asymptomatic covid-19 infection was "very rare", how did that work out? Now it turns out that maybe 40%, maybe more, of covid-19 infected people are asymptomatic. Next up, mid-April, Van Kerkhove was telling us no evidence people with antibody tests are protected from re-infection - while technically true at the time, the implications were pretty widely critiqued - immunity may not last lifelong, this has been seen with other coronaviruses, but 1-2 years immunity is common. I want to see the data. Maybe she's right, that would be FANTASTIC news, actually. But it's critical to how we approach the virus, Show Your Work!
K-9 Posted June 8, 2020 Posted June 8, 2020 1 hour ago, Hapless Bills Fan said: I think when looking at Sweden, there are three things to keep in mind: 1) No national lockdown does not mean that no measures were taken. Universities and HS were closed. People were asked to work at home, avoid travel, and employ social distancing measures. A number of measures that were imposed in the US, were done on a voluntary basis in Sweden (such as ski resorts closing over a popular holiday weekend) 2) Even so, Sweden has had a covid-19 death rate of almost 40 per 100,000 people as compared to its near neighbors which did lock down who have had a death rate of 6 per 100,000 3) The epidemiologist who directed Sweden's response, Anders Tegnell, now says Sweden should have done more and there is mounting internal criticism You know that, I know that, and most rational people know that. And yet, “But Sweden...” is a common refrain from those who’ve convinced themselves shutting down and brining the economy to a crawl was never a necessity. As if we can compare our response to an entire country with 8 million less people than the NYC metro area alone. That is a very telling number about their death rate. No wonder the internal criticism is growing.
Bad Things Posted June 8, 2020 Posted June 8, 2020 I don't understand why some of you are pointing to Sweden as being a success. http://www.stuff.co.nz/national/health/coronavirus/300027183/coronavirus-swedish-disease-expert-admits-covid19-mistakes?cid=app-android 1
BringBackFergy Posted June 8, 2020 Posted June 8, 2020 (edited) Asymptomatic spread of coronavirus is 'very rare,' WHO says Interesting. https://amp.cnn.com/cnn/2020/06/08/health/coronavirus-asymptomatic-spread-who-bn/index.html Edited June 8, 2020 by BringBackFergy Link
Hapless Bills Fan Posted June 9, 2020 Author Posted June 9, 2020 5 hours ago, plenzmd1 said: Hmm..lots of fishy science in there..good thread on it here. When you have a former NYT reporter who has written a book on finance filings and 3 thrillers referring to a publication from Imperial College, UK and one of their professers as a "joke", that might be a clue that the Dunnings-Krueger is strong in the vicinity Not that a layperson can't educate themselves and have meaningful critique of a scientific study - they can Not that professors at Imperial College who publish in Nature can't be mistaken - they can But when you refer to just the presence of one as a coauthor as "dispositive" and the paper is a "joke", I think that's ......dispositive I don't have energy to dig into the science myself right now, sorry - but a bunch of the things he leads off poking at are not what he says they are
plenzmd1 Posted June 9, 2020 Posted June 9, 2020 12 minutes ago, Hapless Bills Fan said: When you have a former NYT reporter who has written a book on finance filings and 3 thrillers referring to a publication from Imperial College, UK and one of their professers as a "joke", that might be a clue that the Dunnings-Krueger is strong in the vicinity Not that a layperson can't educate themselves and have meaningful critique of a scientific study - they can Not that professors at Imperial College who publish in Nature can't be mistaken - they can But when you refer to just the presence of one as a coauthor as "dispositive" and the paper is a "joke", I think that's ......dispositive I don't have energy to dig into the science myself right now, sorry - but a bunch of the things he leads off poking at are not what he says they are i will refrain from making this political, but he has been right, and not wavered, unlike the "experts".
Hapless Bills Fan Posted June 9, 2020 Author Posted June 9, 2020 1 minute ago, plenzmd1 said: i will refrain from making this political, but he has been right, and not wavered, unlike the "experts". Educate: What has he been right about where experts have been wrong? The paper he is critiquing is a model. That's what Imperial College is known for. I've said this before: models are based on assumptions. If the assumptions are wrong, then the models will be wrong. I don't mean to diss it off by saying I don't have energy to dig into the Nature paper myself (or his assessment, which I caught as off on a couple points right off the bat). I'm digging hard to try to find the actual data on which American epidemiologist Maria Van Kerkhove (based at WHO) has made her statements about asymptomatic spread being rare, masks only necessary in the presence of symptomatic people etc. So far I'm coming up bupkis.
spartacus Posted June 9, 2020 Posted June 9, 2020 On 6/5/2020 at 9:07 PM, Hapless Bills Fan said: Hydroxychloroquine works in test tubes! lots of things work in test tubes. https://med.umn.edu/news-events/university-minnesota-trial-shows-hydroxychloroquine-has-no-benefit-over-placebo-preventing-covid-19 University of Minnesota Trial Shows Hydroxychloroquine Has No Benefit Over Placebo in Preventing COVID-19 Author: Kelly Glynn, Media Relations Coordinator | June 3, 2020 looks like another nail in the coffin
plenzmd1 Posted June 9, 2020 Posted June 9, 2020 Just now, Hapless Bills Fan said: Educate: What has he been right about where experts have been wrong? Berenson right 1) Virus hits folks with age and comorbidities much harder that the general popultion. 2) Morbidity rates amogst those without high risk factors is not greater than other viruses 3) it was an absolute mistake to force nursing homes to intake people that were still positive 4) No need to close schools, proven to not hit young people at any kind of rate that justifies all the negative affect that clsoing schoolls has caused. Experts !) No need to worry, this is not an issue 2) Come party in Chinatown, show your suppprt agasint racism 3) masks are ony for the sick, there is not proven science that masks help suppress transmisson of the virus 4) Asympatamatic people are super spreaders, 5)do you need more?
Hapless Bills Fan Posted June 9, 2020 Author Posted June 9, 2020 9 minutes ago, spartacus said: https://med.umn.edu/news-events/university-minnesota-trial-shows-hydroxychloroquine-has-no-benefit-over-placebo-preventing-covid-19 University of Minnesota Trial Shows Hydroxychloroquine Has No Benefit Over Placebo in Preventing COVID-19 Author: Kelly Glynn, Media Relations Coordinator | June 3, 2020 looks like another nail in the coffin Dammit. I had high hopes...something that could clear prevent infection in exposed vulnerable people would be SUCH a boon
Hapless Bills Fan Posted June 9, 2020 Author Posted June 9, 2020 5 minutes ago, plenzmd1 said: Berenson right 1) Virus hits folks with age and comorbidities much harder that the general popultion. 2) Morbidity rates amogst those without high risk factors is not greater than other viruses 3) it was an absolute mistake to force nursing homes to intake people that were still positive 4) No need to close schools, proven to not hit young people at any kind of rate that justifies all the negative affect that clsoing schoolls has caused. Experts !) No need to worry, this is not an issue 2) Come party in Chinatown, show your suppprt agasint racism 3) masks are ony for the sick, there is not proven science that masks help suppress transmisson of the virus 4) Asympatamatic people are super spreaders, 5)do you need more? No, I do not need more of that because it's pretty much baloney, Plenzmid. And some of this we've discussed before, with references and stuff, which might mean you're in the boat of dissing off experts "because". Your Berenson list: 1) Nope, not something he got right that experts got wrong. Experts knew that covid-19 kills primarily older people and people with comorbidities from the start of the epidemic. The WHO-China joint report released 28 Feb lays it all out. The points that people with an agenda "therefore this means we need not shut down the country" gloss over is that a) a significant number of younger people (20-49) who contract covid-19 also become severely ill, require prolonged hospital care, and suffer damage that may take months to recover (lung damage, damage from clots) - the hospitals were slammed b) The comorbidities in question are present in a LARGE number of people in the US, including younger people - obesity, high blood pressure, heart disease, diabetes. (42% obese, 46% high blood pressure, 13% diabetes, 6.7% of those 20 or older have heart disease) So No, this is not something Berenson got right that experts got wrong. NFW. 2) We've discussed that before and it's quite simply not a FACT at this point what the morbidity rates are by ages. There simply hasn't been enough time to sort that. Every clinician I know who is treating patients says they are seeing a lot of healthy, young people walk into hospital. Now most of them recover, but it's serious for them. As for As for "people without risk factors", keep in mind that almost HALF the US population has relevant risk factors (again: 42% obese, 46% high blood pressure, 13% diabetes, 6.7% heart disease and no it's not all the same people) Woo hoo let's dismiss the seriousness of a disease that might seriously impact half of us. No, can't pass that as "right", sorry. 3) I will grant you and him that in full: It was a mistake to force nursing homes to readmit covid-19 patients that were still positive. True. It was also a mistake to have covid-19 infected people who were not critically ill, quarantine at home where they inevitably infected family members, sometimes vulnerable people who then became critically ill or died. I don't think there were any infectious disease experts or epidemiologist who thought that was a good idea. It was done because NY and NJ were desperate to preserve hospital capacity. It's tragic; at the end there were overflow hospitals that wound up being unused, but they weren't available to covid-19 patients (or willing to do long-term-care?) when needed. Many of those nursing homes had covid-19 in the facility before those positive people were returned to them, either via an infected caregiver or a patient who was hospitalized and discharged before covid-19 testing was sufficiently widespread to know they were positive. Still a mistake to bring more infected people in. 4) Schools are traditionally disease amplifiers, even of diseases that aren't severe in young children. The point of closing schools is that young people may contract the disease and spread it to adults who may be more vulnerable. The role of children in transmission of covid-19 is still unclear because they are typically asymptomatic or mildly symptomatic. The transmission risk seems small, but there are now some very scary apparent complications of covid-19 showing up in children - MIS-C. I'm glad you know Berenson can tell us for sure we wouldn't be seeing more MIS-C if the schools had remained open. Your "Experts" column: 1) False. The CDC epidemiology experts behind the scenes in January-February were BEGGING people to take the disease seriously. https://www.theguardian.com/world/2020/apr/07/donald-trump-coronavirus-memos-warning-peter-navarrohttps://khn.org/news/red-dawn-breaking-bad-officials-warned-about-safety-gear-shortfall-early-on-emails-show/https://www.nytimes.com/2020/04/11/us/politics/coronavirus-red-dawn-emails-trump.html https://www.nytimes.com/2020/04/11/us/politics/coronavirus-trump-response.html 2) That wasn't an expert saying "Party in Chinatown", that was Bill DiBlasio (unless you think he's an expert) Again - his EIS-trained public health doctors were tearing their hair out, begging him to shut down the show. Show me the expert. Who was the expert who said that? "Show your support against Racism" - Fauci has clearly said he considers the BLM protests a "perfect setup" for further spread of Covid-19 (I linked several articles quoting him elsewhere - I'll go back and find it but if you search my content you'll find it. 3) The initial CDC advice to not wear masks was based viewing masks as a means to effectively prevent infection, something only respirator-type masks (N95) do, and early information from the Chinese epidemic (few asymptomatic people, droplet transmission) that suggested the best strategy was "wash hands to remove droplets, don't touch face, stay home if you feel ill". When new information arose (aerosol transmission may be occurring, many people are infectious while they don't have symptoms, countries with high mask wearing are doing much better at shutting this down) the CDC started looking at masks from the other side - preventing TRANSMISSION - and changed advice according to new information. That's actually one way to tell the difference between a scientific expert and someone pushing dogma - the scientific expert will look at new data and say "OK, based on this, we were incorrect before, and we need to change" 4) I'd like to see the source of an expert claim that asymptomatic people are "superspreaders". I haven't ever seen that. Several "superspreading" events have been catalyzed by people who were mildly ill with respiratory symptoms similar to a mild cold or seasonal allergies: the Skagit County Chorus; fever: a woman attending the Sheonji church in S Korea who infected at least 3 dozen people, The question currently is, what data is there, or is there not, about the potential of asymptomatic (or presymptomatic) people to spread the disease? There are several case studies pretty clearly showing asymptomatic transmission https://pubmed.ncbi.nlm.nih.gov/32083643/?from_term=covid-19+asymptomatic&from_pos=1 or presymtomatic (asymptomatic at the time) transmission in Singapore dormitories https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e1.htm The most aligned thing I can find is people saying "this needs more study". Dr. Isaac Bogoch and Dr. Allan Detsky of the University of Toronto previously pointing out the misuse of the term "asymptomatic" when referring to "presymptomatic" patients. Dr. Ashish K. Jha, director at the Harvard Global Health Institute, tweeted out the distinction and noted that the agency "should be clearer in communication, also noting that some models "suggest 40-60% of spread is from people when they didn't have symptoms." I just want to see the data. 1
plenzmd1 Posted June 9, 2020 Posted June 9, 2020 Her is my point @Hapless Bills Fan, the messanging from "experts"..be they CDC, Fauci, WHO, Imperial College et al..the folks who are quoated most often have evolved like this No need to be concerned about this...to epic pandemic No need for masks... to masks are mandatory Spreads on surfaces... to little evidence of contact spreading Close all schools down...little evidence children spread the virus So dangerous based on asymptomatic spread..to little evidence that is the case Now there can be clear reasons for all of those changes.. but these major themes have all switched over time, public decisions that affect millions upon millions upon millions are based on them, and our fundamental way of life has been altered, maybe permanetly. Count me crazy if i think the " experts" will continue to make changes and revisions to things we "must do today"..that will than change in a few months time
spartacus Posted June 9, 2020 Posted June 9, 2020 (edited) 10 hours ago, Hapless Bills Fan said: Dammit. I had high hopes...something that could clear prevent infection in exposed vulnerable people would be SUCH a boon well, you are in luck then. https://med.umn.edu/news-events/university-minnesota-trial-shows-hydroxychloroquine-has-no-benefit-over-placebo-preventing-covid-19 fortunately, the UM study did nothing to "prove" the lack of a viable covid treatment. Studies on SARS and others, back when medicine was actually looking for treatments, clearly show that zinc severely limits the replication of a virus. To be effective, however, zinc needs a transport assist to cross into a cell to fight the virus. Hydroxychloroquine is one of the items that zinc can use as a transport vehicle. you would think a better study might want to measure how effective zinc stops the covid virus. The MN study only evaluates the transport vehicle- not for its effectiveness in transporting zinc - but to cure the disease -= which seems to be a pretty badly designed study. It would be like doing a study to evaluate the success rate of heart surgeons doing heart transplants. The MN study designed their test to study the taxi cab that transported the surgeon to the hospital and concluded that taxi's did not improve the transplant success rate. Somehow their study failed to address the efficiency of the surgeon (zinc) that was actually the active element in the success of the procedure. Edited June 9, 2020 by spartacus
BillsFan4 Posted June 9, 2020 Posted June 9, 2020 On 6/7/2020 at 2:10 PM, Hapless Bills Fan said: Positive things about the protests: -they take place out-of-doors, where ventilation is typically excellent and UV exposure from sunlight may have an impact in reducing viral titer -in news coverage I have seen, many people are wearing masks or other facial coverage, at least over their mouths -people may not be spending huge amounts of time with the exact same people in the exact same configuration as when seated or kneeling at a religious service or in a restaurant, or standing at assigned stations in a meat packing plant. BUT, I have never participated in an actual protest demonstration so I don't know. -It appears a large majority of the protestors are relatively young, HS or college age or in their 20s-30s so they may be less likely to overwhelm the hospital system themselves Negative things about the protests: -No one knows the effect of inhaling crowd-control chemicals on covid-19 susceptibility -Likewise of just the stress of being in a crowd for hours, not to mention some people being beaten -Certainly being detained and incarcerated would place people in a high-risk situation for covid-19 spread with hours of close contact in vehicles or cells with limited ventilation -Because they are young, protestors who do develop covid-19 may become asymptomatic or presymptomatic spreaders (it seems young healthy people may take 14 days to show symptoms), thus they may be more likely to spread the disease unwittingly to older relatives, mentors, and friends if they don't observe social distancing outside the protests At a guess, in each city where there are protests, it's probably going to take 4-8 weeks to see whether or not there will be a protest-induced spike. I can try to run through the math behind that guess if anyone is interested Yes, I am. Thanks.
BillsFan4 Posted June 9, 2020 Posted June 9, 2020 (edited) https://www.axios.com/who-asymptomatic-coronavirus-69c56ce3-41e0-4ea7-ab2a-de866713b4cf.html Quote The World Health Organization clarified comments an official made on Monday that called asymptomatic transmission of the coronavirus "very rare," saying in a press conference that these carriers do take part in spreading the virus but that more information is needed to know by how much. What they're saying: WHO official Marisa Van Kerkhove clarified Tuesday that patients sometimes confuse not having any symptoms with only exhibiting mild symptoms. In addition, some patients transmit the virus before developing symptoms. Contact tracers classify this group as "presymptomatic," rather than asymptomatic. Quote Van Kerkhov said the WHO estimates 16% of people are asymptomatic and can transmit the virus. Some models suggest up to 40% of coronavirus transmission might be due to asymptomatic spread, she added, but much more information is needed. Van Kerkhove stressed that her comments on Monday were specific to particular studies and did not represent a new policy or direction. The WHO said it regrets saying that asymptomatic spread is "very rare." Edited June 9, 2020 by BillsFan4
Hapless Bills Fan Posted June 9, 2020 Author Posted June 9, 2020 Best source material I could find. https://wwwnc.cdc.gov/eid/article/26/7/20-1595_article Key points: Article summarizes epidemiological evidence, virological evidence, and modeling. Key points: -There are a number of case studies which strongly imply that virus transmission from people without symptoms at the time is occurring. -Titer measurements of people without symptoms at the time overlap titer measurements of people with symptoms (if you have as high viral titer in your upper respiratory system as someone with symptoms, what magic would render you unable to spread virus?) -Modeling (which of course depends upon assumptions) of different situations: "Although models are highly dependent on the assumptions built into them, these models suggest that the speed and extent of SARS-CoV-2 transmission cannot be accounted for solely by transmission from symptomatic persons" Conclusion: "Each of the epidemiologic, virologic, and modeling studies described has limitations. However, in the aggregate, these diverse studies suggest that SARS-CoV-2 can be transmitted by persons with presymptomatic or asymptomatic infection, which may meaningfully contribute to the propagation of the COVID-19 pandemic."
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