Author Topic: Coronavirus  (Read 801871 times)

Investor20

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Re: Coronavirus
« Reply #8030 on: October 29, 2020, 06:42:00 PM »
Very funny that you ask for evidence for masks (there is substantial evidence in the literature) but then claim that 90% of people are wearing masks (with no evidence).

Because some were very sure if only everyone wears masks, the covid 19 will disappear.
They say its our ""best defense" against Covid.
I am only pointing out that even after over 90% are wearing the mask, masks being mandated in Europe and Ontario, big spikes and lockdowns are still there.  I just hope masks are not in fact our best defense.
« Last Edit: October 29, 2020, 07:06:41 PM by Investor20 »


Cigarbutt

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Re: Coronavirus
« Reply #8031 on: October 29, 2020, 07:45:11 PM »
...
What we should demand from CDC is evidence, not pronouncements.
@Investor20
What's your opinion about the Association of American Physicians and Surgeons?
Are you a member?
...
-----
This whole discussion about masks as a potential variable among many variables is seeing parallel developments in severe Covid survival data. There have been recent works published (solid data, peer-reviewed etc) from the New York (Langone) and UK experiences.



If one accepts the three sub-waves definition, results from people reaching hospitals in the second wave were better (better survival) and it looks like this trend is continuing into the third wave although it is still too early to tell for this last one. This article covers the basics and i've looked at the underlying data:
https://www.msn.com/en-ca/health/medical/death-rates-have-dropped-for-seriously-ill-covid-patients/ar-BB1avfbY?ocid=msedgntp

The data shows that the improvement is only partially explained by the younger cohorts affected after the first phase. The data supports the hypothesis that there were no silver bullets. In the UK, the data reflects the introduction of 'new' treatments (as part of the Recovery Trial) and the NY data suggests a similar phenomenon but most of the improvement came from a better assembly of many small things (timely interventions, protocols based on sequential and shared learning, liberal use of steroids at the right stage (dexamethasone has been known for ages in the use against inflammatory respiratory distress), more dedicated use of blood thinners etc). Singling out how a specific aspect of the treatment improvements would be very difficult to delineate at this point and it may take a while to figure out but the improvement in survival has been impressive (clearly, we are on the right track). But the wheel has not been reinvented here, people have just learned to make it roll better. Some suggest (hypothesis) that people survive better because of the use of masks because a coherent link can be made between using masks and viral loads which have been clearly shown to be significant for disease severity. It's an interesting hypothesis and, frankly, wearing a mask is more comfortable than having a breathing tube down one's throat.

A relatively negative aspect of this development is that there are more people fighting harder and longer for survival and, in some centers, that is resulting in longer hospital and intensive care unit stays, with obvious consequences for those waiting for care unrelated to Covid and this can be an acute problem when hospital capacity becomes a limiting factor. It's been shown (for Covid and other ailments) that acute episodes of excessive hospital disease burden can result in poorer results for all involved. Somehow, the Graham concept of margin of safety applies elsewhere also.

Investor20

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Re: Coronavirus
« Reply #8032 on: October 30, 2020, 09:48:12 AM »
...
What we should demand from CDC is evidence, not pronouncements.
@Investor20
What's your opinion about the Association of American Physicians and Surgeons?
Are you a member?
...
-----
This whole discussion about masks as a potential variable among many variables is seeing parallel developments in severe Covid survival data. There have been recent works published (solid data, peer-reviewed etc) from the New York (Langone) and UK experiences.



If one accepts the three sub-waves definition, results from people reaching hospitals in the second wave were better (better survival) and it looks like this trend is continuing into the third wave although it is still too early to tell for this last one. This article covers the basics and i've looked at the underlying data:
https://www.msn.com/en-ca/health/medical/death-rates-have-dropped-for-seriously-ill-covid-patients/ar-BB1avfbY?ocid=msedgntp

The data shows that the improvement is only partially explained by the younger cohorts affected after the first phase. The data supports the hypothesis that there were no silver bullets. In the UK, the data reflects the introduction of 'new' treatments (as part of the Recovery Trial) and the NY data suggests a similar phenomenon but most of the improvement came from a better assembly of many small things (timely interventions, protocols based on sequential and shared learning, liberal use of steroids at the right stage (dexamethasone has been known for ages in the use against inflammatory respiratory distress), more dedicated use of blood thinners etc). Singling out how a specific aspect of the treatment improvements would be very difficult to delineate at this point and it may take a while to figure out but the improvement in survival has been impressive (clearly, we are on the right track). But the wheel has not been reinvented here, people have just learned to make it roll better. Some suggest (hypothesis) that people survive better because of the use of masks because a coherent link can be made between using masks and viral loads which have been clearly shown to be significant for disease severity. It's an interesting hypothesis and, frankly, wearing a mask is more comfortable than having a breathing tube down one's throat.

A relatively negative aspect of this development is that there are more people fighting harder and longer for survival and, in some centers, that is resulting in longer hospital and intensive care unit stays, with obvious consequences for those waiting for care unrelated to Covid and this can be an acute problem when hospital capacity becomes a limiting factor. It's been shown (for Covid and other ailments) that acute episodes of excessive hospital disease burden can result in poorer results for all involved. Somehow, the Graham concept of margin of safety applies elsewhere also.

Yes CFR has gone down.  That could be because of virus itself attenuating.  I dont have citation but the concept I read is the virus mutation that causes less severe disease spreads more than the virus mutation that causes more severe disease since the person who has more severe symptoms would quarantine irrespective of any mandates and it is the asymptomatic person who would go around more spreading the virus.

Yes it may be because of better treatments except not many clinical studies I am aware showing positive results of treatment of hospitalized patients (except Dexamethasone may be). 

Regarding the inoculation level, I posted an article by several doctors from many top medical schools across US and world saying it works other way round.  That the masks increase inoculation of infection at early stages.  This is disputed area of research.

Please see below

Reduction of Self-Reinoculation
It is well-recognized that COVID-19 exists outside the human body in a bioaerosol of airborne particles and droplets. Because exhaled air in an infected person is considered to be “loaded” with inoculum, each exhalation and inhalation is effectively reinoculation.15
In patients who are hospitalized, negative pressure is applied to the room air largely to reduce spread outside of the room. We propose that fresh air could reduce reinoculation and potentially reduce the severity of illness and possibly reduce household spread during quarantine. This calls for open windows, fans for aeration, or spending long periods of time outdoors away from others with no face covering to disperse and not reinhale the viral bioaerosol.
https://www.amjmed.com/article/S0002-9343(20)30673-2/fulltext#seccesectitle0005

frank87

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Re: Coronavirus
« Reply #8033 on: October 30, 2020, 12:05:03 PM »
I think anti-masking has become ideological just like how much of this debate has evolved. I think it's rather silly to object too much - it's a fairly small inconvenience with some possible benefits (if not reducing transmission then maybe reducing viral load) and none of the massive collateral damage that comes with lockdowns. I think the consensus gradually focusing on masking and moving away from lockdowns is a good thing on balance.

It is not objecting to masks Frank.  But pro-maskers were saying if only every one wears masks Covid disappears.  Even CDC director said that - masks are more important than vaccine. CDC director said "masks are our best defence".  If masks are our best defence and are better than vaccine, we are doomed.  Because mask mandates have been tried in many places and masks are worn by above 90% people and yet there are big spikes in infections.  The best defense is not working.

Coming back to whether masks are better than not wearing, not everyone agrees on this.  For example as per this article
Reduction of Self-Reinoculation
It is well-recognized that COVID-19 exists outside the human body in a bioaerosol of airborne particles and droplets. Because exhaled air in an infected person is considered to be “loaded” with inoculum, each exhalation and inhalation is effectively reinoculation.....

We propose that fresh air could reduce reinoculation and potentially reduce the severity of illness and possibly reduce household spread during quarantine. This calls for open windows, fans for aeration, or spending long periods of time outdoors away from others with no face covering to disperse and not reinhale the viral bioaerosol.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410805/

This article is written by some of the top doctors including Baylor, Johns Hopkins, Emory, Yale....and many more....

There is one randomized study that is cited by anti-maskers which is
https://bmjopen.bmj.com/content/5/4/e006577.short
This study does not have an arm of not wearing mask and it is not with Covid 19.
It compares "Hospital wards were randomised to: medical masks, cloth masks or a control group (usual practice, which included mask wearing). Participants used the mask on every shift for 4 consecutive weeks."

What we need are proper studies which are lacking.  That is why I keep asking what is your evidence?  There is no evidence.  Only arguments and pronouncements.

Now I am not going to tell you whether CDC director is correct (Masks are our best defence in which case we already lost because our best defence has been tried many places) or all these doctors are correct that re-innoculation of virus is bad and will lead to more severe disease.

What we should demand from CDC is evidence, not pronouncements.

Yes, I'm aware that the clinical evidence of mask effectiveness has not been particularly strong yet. But practically speaking, it's a minor inconvenience with low trade-offs - which is one reason why I think the public health messaging has shifted from lockdowns to masking. I don't think it's particularly helpful to get into the righteousness of all this stuff when people's lives have been upended to such a degree - we should be focusing on practicality.

Spekulatius

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Re: Coronavirus
« Reply #8034 on: October 30, 2020, 07:31:52 PM »
Pretty typical microcosm of what is happening:
https://www.boston.com/news/coronavirus/2020/10/28/why-did-massachusetts-shut-down-ice-rinks-charlie-baker-says-blame-the-adults
Quote
Massachusetts announced last Thursday that it was shutting down indoor ice rinks for two weeks, after more than 30 coronavirus clusters across the state were linked to hockey leagues.

Other states, including Maine, New Hampshire, and Vermont, have taken similar action following their own hockey-related COVID-19 outbreaks.

But according to Gov. Charlie Baker, hockey itself isn’t necessarily the threat. Rather, the transmission of the virus is “likely coming from all the activity around hockey and some irresponsible behavior from parents and coaches,”
Life is too short for cheap beer and wine.

Investor20

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Re: Coronavirus
« Reply #8035 on: October 30, 2020, 08:23:05 PM »
Quote
Yes, I'm aware that the clinical evidence of mask effectiveness has not been particularly strong yet. But practically speaking, it's a minor inconvenience with low trade-offs - which is one reason why I think the public health messaging has shifted from lockdowns to masking. I don't think it's particularly helpful to get into the righteousness of all this stuff when people's lives have been upended to such a degree - we should be focusing on practicality.

Frank, I agree with the sentiment here.  If we are aware that many of these dont have good research to back up and we are cautious about it, we are better off IMO.  Personally I like the below Korean guidelines, but dont want to say I  ask anyone else to do the same.  I feel ventilation and distancing has better research so, the way they put it I like it better.  One addition is (Koreans when they use a mask, they mostly use K95 mask), when I go to a shop or indoors with little ventilation, I use K95 mask because I dont believe that cloth masks do the job with small particles in the air indoors. But K95 masks are difficult to wear all the time, so I do that mostly indoors only such as shops and minimize my time there. Also, I feel indoor clusters are more important as discussed earlier in this thread.

https://www.weforum.org/agenda/2020/05/south-korea-office-coronavirus-covid19-work-enviroment/

Provide a well-ventilated, spacious area for the meeting and be sure to ventilate before the meeting.

Take a break every hour to ventilate the space by opening doors and windows. Maintain a distance of two meters between every attendee (minimum one meter).
             If this cannot be met, refrain from meeting in person. If the meeting is still necessary, ensure every attendee wears a mask, even when speaking.

Masks are up to personal discretion if ventilation and distancing can be followed.
« Last Edit: October 30, 2020, 08:59:34 PM by Investor20 »

Gregmal

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Re: Coronavirus
« Reply #8036 on: October 30, 2020, 10:10:29 PM »
Pretty typical microcosm of what is happening:
https://www.boston.com/news/coronavirus/2020/10/28/why-did-massachusetts-shut-down-ice-rinks-charlie-baker-says-blame-the-adults
Quote
Massachusetts announced last Thursday that it was shutting down indoor ice rinks for two weeks, after more than 30 coronavirus clusters across the state were linked to hockey leagues.

Other states, including Maine, New Hampshire, and Vermont, have taken similar action following their own hockey-related COVID-19 outbreaks.

But according to Gov. Charlie Baker, hockey itself isn’t necessarily the threat. Rather, the transmission of the virus is “likely coming from all the activity around hockey and some irresponsible behavior from parents and coaches,”

Again, the fallacy of CASES! OMG!

What a disaster...these people are total idiots.

As I posted earlier...UF GAME CANCELLED BECAUSE OF COVID OUTBREAK......(tiny print) All 21 players are either asymptotic or show minor symptoms...

Can we please create some place where a certain percentage of the population lives where there are high taxes, shutdowns every time one catches the flu. and absurd rules around things like soda, plastic bags and police officers doing their jobs...and another where there are no taxes, and people just live their lives??

RichardGibbons

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Re: Coronavirus
« Reply #8037 on: October 31, 2020, 01:10:00 AM »
Can we please create some place where a certain percentage of the population lives where there are high taxes, shutdowns every time one catches the flu. and absurd rules around things like soda, plastic bags and police officers doing their jobs...and another where there are no taxes, and people just live their lives??

This would be a neat experiment to run. I think for now, the countries that would best meet your criteria are probably Denmark for the former and Somalia for the latter.

Gregmal

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Re: Coronavirus
« Reply #8038 on: October 31, 2020, 05:46:30 AM »
I guess we've come full circle. America was established by a bunch of folks tired of outrageous taxes, constant persecution for their beliefs, and overreaching governments....self governing I believe was the major theme. Now look at us!

Spekulatius

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Re: Coronavirus
« Reply #8039 on: October 31, 2020, 05:47:38 AM »
Pretty typical microcosm of what is happening:
https://www.boston.com/news/coronavirus/2020/10/28/why-did-massachusetts-shut-down-ice-rinks-charlie-baker-says-blame-the-adults
Quote
Massachusetts announced last Thursday that it was shutting down indoor ice rinks for two weeks, after more than 30 coronavirus clusters across the state were linked to hockey leagues.

Other states, including Maine, New Hampshire, and Vermont, have taken similar action following their own hockey-related COVID-19 outbreaks.

But according to Gov. Charlie Baker, hockey itself isn’t necessarily the threat. Rather, the transmission of the virus is “likely coming from all the activity around hockey and some irresponsible behavior from parents and coaches,”

Again, the fallacy of CASES! OMG!

What a disaster...these people are total idiots.

As I posted earlier...UF GAME CANCELLED BECAUSE OF COVID OUTBREAK......(tiny print) All 21 players are either asymptotic or show minor symptoms...

Can we please create some place where a certain percentage of the population lives where there are high taxes, shutdowns every time one catches the flu. and absurd rules around things like soda, plastic bags and police officers doing their jobs...and another where there are no taxes, and people just live their lives??

If you read the article - one of the main reason for the shutdown is that the coaches fail to cooperate with the contact tracers and even went to so far to told the team to ignore calls from contact tracers. So it is likely that more clusters were created by these activities that we don’t know about.

Our governor Charlie Baker is Republican.
« Last Edit: October 31, 2020, 10:26:21 AM by Spekulatius »
Life is too short for cheap beer and wine.