Author Topic: Coronavirus  (Read 811585 times)

Investor20

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Re: Coronavirus
« Reply #8330 on: December 04, 2020, 06:00:46 AM »
^ big surprise if you live in crowded quarters m use the same bathrooms (that was one way infections were found in the study) and have roommates bunking together (I bet they do t wear mask when they sleep, how could they).

My only conclusion for a civilian setting is that I wouldn’t  rely on mask preventing infections in a setting like a cruise ship (the closes equivalent). As for the general conclusion of the reference (not the study ) that mask don’t work, I would agree.

If you refer to the often cot d danish mask study, check out Taleb’s posts on Twitter. He concluded that the design and even the math of the study is incorrect and that the results actually infer that mask cohort did show lower infection rates.

All recruits wore double-layered cloth masks at all times indoors and outdoors, except when sleeping or eating; practiced social distancing of at least 6 feet;

They slept in double-occupancy rooms with sinks, ate in shared dining facilities, and used shared bathrooms.

All recruits cleaned their rooms daily, sanitized bathrooms after each use with bleach wipes, and ate preplated meals in a dining hall that was cleaned with bleach after each platoon had eaten.

And Spekulatius, there is unusually high number of unasymptomatic in this study (46/51) may be because they are young and healthy.
Isnt it that asymptomatic transmit less?

"The viral load at diagnosis, estimated on the basis of the qPCR cycle threshold, was on average approximately 4 times as high in the 5 symptomatic participants as in the 46 participants who were asymptomatic"
« Last Edit: December 04, 2020, 06:22:20 AM by Investor20 »


Cigarbutt

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Re: Coronavirus
« Reply #8331 on: December 04, 2020, 06:25:29 AM »
Two days ago, I participated in an online interactive review which is relevant for this military recruits study and its interpretation. The 60-minute review was health related and the word virus was not mentioned once which may be a sign that focus may have to go back to the host at some point. The review was a discussion about tools to assess studies and include in an evidence-based framework. The discussion was made necessary and relevant due to the fact that, for that specific field in question, in North America, there is an explosion of data, an incredibly high number of unnecessary procedures (waste) and an incredibly high number of poor outcomes (harm) and people are starting to notice (trust issue). One of the underlying messages was that one can ‘massage’ the data, the analysis and the interpretation (depending on incentives). But there are ways to help sort this out. This was relevant also to the analysis of various healthcare stocks I’m following as it seems to me a natural outcome of all this will mean, eventually, a very significant downsizing of sales and a shrinking market. It is also coming down on me that the polarized approach to the virus (great aspects, ie vaccine development and inefficient policy due to failure to coordinate and collaborate) closely parallels the growing issues for US healthcare overall (great aspects combined with a growing divide in the unusual hybrid approach) explaining the overall high costs and the overall low outcomes. More to come on that front for sure.

There are two major problems with the interpretation of the military recruits study. First, extrapolating on the ‘intent’ of the study and second, the issue of generalization from a sample (unusual sample). 1st The questions (2) asked upon initiation of the study are: Under a standardized approach (and ideal in some ways), can spread be reduced to zero? and can asymptomatic transmission occur? These questions were reasonably answered and the answers were offered for peer review. Starting the process of retrospectively asking questions (and providing answers) after the study is complete is associated with very real and significant analytical risks. Asking questions is fine but providing answers then requires more work. That’s how blockbuster drugs for hair loss and erectile dysfunction were discovered. Companies did not start marketing a drug because they noticed unusual side effects while doing studies for a different question, they reframed the issue by asking a new question and by doing further studies and going through a systematic process. This example hides the fact that this exercise is a clear example of a survival bias as most unusual side effects and related hypothesis generation do not resist the test of time (analysis) after. To affirm that mitigation efforts for this virus “don’t work” because of this study, with some recruits coming in positive after a quarantine to start with, is a very weak assertion. 2nd The more the sample is different from a population, the more one has to be careful about generalization of specific findings.

The military recruits’ situation was not a ‘lockdown’, it was a situation associated with some restrictions which, fundamentally, did not change their fundamental training. Basic tools such as safe distance, masks, self-quarantine when sick or exposed etc are not “lockdowns”. These tools are like the standard practice of giving oxygen to someone coming in with what looks like a heart attack. AFAIK, there is no definitive evidence showing that it ‘works’ but it’s done because it connects a lot of dots (easy, standard, low cost, makes sense scientifically and from a common sense point of view). If somebody doubts that, they can do or support doing studies to disprove that but that somebody should be careful before suggesting to stop oxygen use while the person is having a heart attack, especially if the motivation is that a mask is a threat to his or her freedom.

In this thread, I’ve spent some time trying to disprove a fair amount of assertions of various levels of quality. So I’ll ask the following question:
Fact: When including countries of a certain size (population large enough) and with a large enough GDP per capita, you end up with about 20 countries. In this group, since last May, by far, the US has reported the highest Covid-19 death per capita (even higher that the “high mortality” countries) and trends indicate that it will remain a clear leader for the foreseeable future.
Question: Why is that? Is it because masks don’t work?
The following answers will not be accepted: the virus was here in 2015, it’s China’s fault, it is what it is, we are turning the corner, Cuomo is dumb, so and so who is ugly had a hamburger yesterday, people don’t take enough zirconium, have no access to hydroxyfuckinqueen or to Bolivia’s health-minister-approved toxic bleach.

My area is only a province and not a country but, if it were, it would take the #1 spot from the US for worst performer on the death per capita competition. Just a few days ago and a few kilometers (1 mile = 2.2km) from where we live, in a shopping center, there was a “demonstration” of a group (an anti-mask group) who “occupied” key walking space at the center of the shopping mall, dancing and singing unusual slogans. Why would you belong to an anti-mask group (waste of time)? Why would you participate in such a demonstration (waste of time, counter-intuitive and counter-productive)? Why would you put such a demonstration in the middle of an enclosed space at a time when it is most crowded during a period of rampant community spread in a “red zone” (dangerous on top of all the other reasons)? The most ironic part of all this was that there was this lady wearing a mask and doing her usual shopping who thought people had formed a group to show support for healthcare workers, so she entered the dance only to be told that she didn’t ‘belong’ and she was kicked out for fear of ideological contamination.

Apologies for the length of the post and the ranty aspect but, yesterday, I ‘visited’ the huge tent beside my regional hospital and I still have (mental) nausea. Even if nobody reads this, writing it was therapeutic. It's not the ignorants that worry me.


KCLarkin

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Re: Coronavirus
« Reply #8332 on: December 04, 2020, 07:31:38 AM »
Actually it is a 4 week study
2 weeks of home quarantine
zero day: test and remove positives
Enforce supervised quarantine procedures
seventh day: test and remove positives
Enforce supervised quarantine procedures
Test on 14 day which still gave 0.6% positives.

The result as given by authors

"At the time of enrollment, after 2 weeks of home quarantine, approximately 1% of study participants had positive qPCR results, and approximately 2% subsequently became infected during the 2-week supervised quarantine period."

The incubation period is 14 days. The false negative rate is extremely high in the first 4 days of infection. So it is not possible to say how many people became infected during the quarantine period. Many of those who tested positive on Day 7 were likely infected on or before Day 0.

Only ~half the recruits were tested on Day 0 and Day 7. Untested and tested recruits were intermixed. So a recruit could be sharing a room with an untested roommate.

But the main reason why your assertions are wrong is the lack of a control arm. This is an infectious disease with a doubling time of ~3 days in a general population. Doubling time is even worse in congregate settings like military camps. If you start with 16 infected people and no controls, you'd expect more than 500 infected marines by the end of two weeks. So these interventions stopped ~90% of the expected infections.

Investor20

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Re: Coronavirus
« Reply #8333 on: December 04, 2020, 08:15:32 AM »
Actually it is a 4 week study
2 weeks of home quarantine
zero day: test and remove positives
Enforce supervised quarantine procedures
seventh day: test and remove positives
Enforce supervised quarantine procedures
Test on 14 day which still gave 0.6% positives.

The result as given by authors

"At the time of enrollment, after 2 weeks of home quarantine, approximately 1% of study participants had positive qPCR results, and approximately 2% subsequently became infected during the 2-week supervised quarantine period."

The incubation period is 14 days. The false negative rate is extremely high in the first 4 days of infection. So it is not possible to say how many people became infected during the quarantine period. Many of those who tested positive on Day 7 were likely infected on or before Day 0.

Only ~half the recruits were tested on Day 0 and Day 7. Untested and tested recruits were intermixed. So a recruit could be sharing a room with an untested roommate.

But the main reason why your assertions are wrong is the lack of a control arm. This is an infectious disease with a doubling time of ~3 days in a general population. Doubling time is even worse in congregate settings like military camps. If you start with 16 infected people and no controls, you'd expect more than 500 infected marines by the end of two weeks. So these interventions stopped ~90% of the expected infections.

This type of quarantine is very disruptive to the society and Dr. Bhattacharya laid out the downside of such disruption. Its very difficult for everyone to be 6 feet away from each other for example.

For example, less vaccination for children is bad for their health.  And many other health care activities have taken back seat because of these restrictions.  The burden that these restrictions work is on the people who propose them because of the economic and health care downsides.

On other hand proof required for Hydroxychloroquine or Ivermectin is really high. For example a peer reviewed article below gives all the early administration HCQ studies are successful.

https://pubmed.ncbi.nlm.nih.gov/33042552/
Hydroxychloroquine is effective, and consistently so when provided early, for COVID-19: a systematic review

Another peer reviewed article written by many doctors from many well known hospitals argues about early intervention and this includes use of HCQ.

https://www.sciencedirect.com/science/article/pii/S0002934320306732
Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection

Written by doctors from following medical schools/hospitals:
a  Baylor University Medical Center, Dallas, Tex

b   Baylor Heart and Vascular Institute, Dallas, Tex

c  Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Tex

d  Cardiology Division, Regina Montis Regalis Hospital, Mondově, Cuneo, Italy

e   Christ Advocate Medical Center, Chicago, Ill

f  Emory University School of Medicine, Atlanta, Ga

g  Johns Hopkins School of Medicine, Baltimore, Md

h   Cedars Sinai Medical Center, Los Angeles, Calif

i   Abrazo Arizona Heart Hospital, Abrazo Health System, Phoenix, Ariz

j  Carter Eye Center, Dallas, Tex

k Cardiorenal Society of America, Phoenix, Ariz

l University of Texas McGovern Medical School, Houston, Tex

m  Bakersfield Heart Hospital, Bakersfield, Calif

n  University of Siena, Le Scotte Hospital Viale Bracci, Siena, Italy

o  University of Torino, Torino, Italy

p  Henry Ford Hospital, Detroit, Mich

q    Yale University School of Public Health, New Haven, Conn

I earlier posted a meta analysis of 8 RCTs all of them showed improvement for Ivermectin.  But all this is discounted.
I posted earlier that Bangladesh has high infection rate based on seroprevalence but low death rate.  They use HCQ. But that cannot be spoken about.

Not a suggestion for treatment. Please consult your doctor regarding treatment.  For discussion only.

RichardGibbons

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Re: Coronavirus
« Reply #8334 on: Today at 02:13:57 PM »

And, I've got to say, Trump deserves some credit for the fast vaccine. By minimizing the impact of the disease, discouraging people from wearing masks and other preventative measures, and generally helping the virus along, he's helped the number of cases to explode. Without that massive number of new infections, Phase 3 trials would've taken far longer-- to determine whether a vaccine is working, you need people to catch the disease, and he did his part to achieve that. So, credit where credit is due.

Lol wut. That’s the most ridiculous thing I’ve heard in a long time. Trump should be praised because his policy allowed more people to be infected and die so more studies could be done? Seriously? If ten times more people died would that be ten times better?

Don’t you think we could have come to the same conclusion had only half or a quarter of the people got infected and died? By your logic, Mao should be praised for reducing the population in China so there’s be enough food to eat after the cultural revolution and famines? Have a famine, millions die. Now the little food we have is enough for the smaller population. Thanks Mao! /s

Please tell me you’re being sarcastic? or I simply don’t know enough about vaccine development...

Yep, it was tongue in cheek. It's atrocious that so many people have become infected and dead in the USA as a result of this pandemic.

But I do get a kick out of the perverseness of the situation because it is actually true. The more people get infected, the faster you can do the Phase 3 trial, so to the extent that Trump has helped this contagion spread, he's also helped speed up the testing of a vaccine as an unintended side-effect.