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Posted

Tomas Pueyo thread on masks and decisions under uncertainty:

 

 

Also, how someone way over their heads sounds BS’ing their way through everything:

 

Posted

So you tell me what criteria you used in picking three out of a lot of European countries to compare?

 

https://en.wikipedia.org/wiki/Scandinavia

 

https://www.worldatlas.com/webimage/countrys/eu.htm

 

You dont mind comparing US with Korea on other side of globe or US with Germany across atlantic but dont want to compare Sweden which is close to UK and Netherlands.

 

New York to Seoul : 6867.74 miles

New York to Berlin: 3977 miles

Stockholm to Amsterdam: 700 miles

https://www.mapdevelopers.com/distance_from_to.php

 

If New york to Seoul or New York to Berlin comparisons are O.K., then Stockholm to Amsterdam comparision is just fine.

 

No. He said there was a reason to compare to those and you said you didn’t see it. I pointed it out. You can still also compare to everything else including the moon, but Scandinavia is a thing.

Posted

The thing about Sweden...they readily admitted that their death count per capita will be higher than Scandinavian neighbors as a result of their strategy because of a higher rate of infections. But they're also going to see a steeper rise and steeper drop off (like NYC is now). Hard to come to firm conclusions that their deaths per capita will be far worse than their neighbors when it's all said and done. Sweden also has more large nursing homes than other Scandinavian countries and higher population density in its major city, which will figure into the stats as well.

Posted

Here is another controversial take. Remdesivir May be worthless. Don‘t have an opinion either way, but it looks the poster may have some valid points. For various reasons (intravenous applications in 10? Doses ) it is unlikely a game changer anyways.

https://twitter.com/markhoofnagle/status/1256242036015063042?s=21

 

3 trial results came out the same day:

NIH ACTT trial - discharge in 11 days vs 15, mortality 8% vs 11.6% in Remdesivir vs control arms ( so reduced morbidity, second order effects on reducing overburdened health care systems)

https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

 

SIMPLE trial - 5 days and 10 days use showed no significant differences (so can be used in shorter course). IDK why they did not release any data about the control arm in this one, I thought it had it...

https://www.gilead.com/news-and-press/press-room/press-releases/2020/4/gilead-announces-results-from-phase-3-trial-of-investigational-antiviral-remdesivir-in-patients-with-severe-covid-19

 

China Remdesivir trial 237 patients data - no significant mortality benefit

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

 

As far as the twitter poster goes, one point well taken is that the next population to study in trials would be earlier start of treatment (now that we have same day per testing) and high risk non-hospitalized patients (somehow delivering at home maybe).

 

Sarilumab phase 2 data also came out, with phase 2 outcome met and phase 3 trial focusing on critically ill patients only where potential to reduce mortality is being seen.

 

Thirdly a lot of attention is going towards the prothrombotic effects of the virus as well as proning early.

 

Stacking all of them and what we know about the virus after all this time, I think mortality will be lower in the future, although a little bit lower not a lot lower (just my opinion).

 

Posted

Here is another controversial take. Remdesivir May be worthless. Don‘t have an opinion either way, but it looks the poster may have some valid points. For various reasons (intravenous applications in 10? Doses ) it is unlikely a game changer anyways.

https://twitter.com/markhoofnagle/status/1256242036015063042?s=21

 

3 trial results came out the same day:

NIH ACTT trial - discharge in 11 days vs 15, mortality 8% vs 11.6% in Remdesivir vs control arms ( so reduced morbidity, second order effects on reducing overburdened health care systems)

https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

 

SIMPLE trial - 5 days and 10 days use showed no significant differences (so can be used in shorter course). IDK why they did not release any data about the control arm in this one, I thought it had it...

https://www.gilead.com/news-and-press/press-room/press-releases/2020/4/gilead-announces-results-from-phase-3-trial-of-investigational-antiviral-remdesivir-in-patients-with-severe-covid-19

 

China Remdesivir trial 237 patients data - no significant mortality benefit

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

 

As far as the twitter poster goes, one point well taken is that the next population to study in trials would be earlier start of treatment (now that we have same day per testing) and high risk non-hospitalized patients (somehow delivering at home maybe).

 

Sarilumab phase 2 data also came out, with phase 2 outcome met and phase 3 trial focusing on critically ill patients only where potential to reduce mortality is being seen.

 

Thirdly a lot of attention is going towards the prothrombotic effects of the virus as well as proning early.

 

Stacking all of them and what we know about the virus after all this time, I think mortality will be lower in the future, although a little bit lower not a lot lower (just my opinion).

Thanks for the comments. I agree that treatment is improving (and has already) and mortality will be lower. Even though we go down the path of herd immunity , I think there is a huge benefit of getting the perhaps inevitable infection later rather than sooner.

Posted

Here is another controversial take. Remdesivir May be worthless. Don‘t have an opinion either way, but it looks the poster may have some valid points. For various reasons (intravenous applications in 10? Doses ) it is unlikely a game changer anyways.

https://twitter.com/markhoofnagle/status/1256242036015063042?s=21

 

3 trial results came out the same day:

NIH ACTT trial - discharge in 11 days vs 15, mortality 8% vs 11.6% in Remdesivir vs control arms ( so reduced morbidity, second order effects on reducing overburdened health care systems)

https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

 

SIMPLE trial - 5 days and 10 days use showed no significant differences (so can be used in shorter course). IDK why they did not release any data about the control arm in this one, I thought it had it...

https://www.gilead.com/news-and-press/press-room/press-releases/2020/4/gilead-announces-results-from-phase-3-trial-of-investigational-antiviral-remdesivir-in-patients-with-severe-covid-19

 

China Remdesivir trial 237 patients data - no significant mortality benefit

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

 

As far as the twitter poster goes, one point well taken is that the next population to study in trials would be earlier start of treatment (now that we have same day per testing) and high risk non-hospitalized patients (somehow delivering at home maybe).

 

Sarilumab phase 2 data also came out, with phase 2 outcome met and phase 3 trial focusing on critically ill patients only where potential to reduce mortality is being seen.

 

Thirdly a lot of attention is going towards the prothrombotic effects of the virus as well as proning early.

 

Stacking all of them and what we know about the virus after all this time, I think mortality will be lower in the future, although a little bit lower not a lot lower (just my opinion).

 

The problem with early therapy using Remdesivir is that it's very hard to manufacture. If you are opening up Remdesivir to not just severe cases, but mild/moderate and earlier stages in infection when symptoms are not that bad, that potentially opens up millions of potential patients as candidates for therapy. As we know, ~80% of people don't get to severe. You would now be treating a lot of those 80% with the drug instead of reserving it to just the severe patient group (because you have little idea which patients will end up with severe manifestations and which ones will not early in the course of covid).

 

Meanwhile, Gilead is only going to have achieved 140,000 courses manufactured by the end of May. They are hoping for ~1 million # of courses manufactured by end of yr I believe...

 

https://www.wsj.com/articles/gilead-to-expand-manufacturing-of-covid-19-drug-remdesivir-11588281598

Posted

Pence is just doing his job -- we're not talking about injecting people with disinfectants at present.

 

The man is too bland to be a predictable distraction. But floating rumors about the US defaulting on its debt to China or Remdesivir or whatever...

 

Or...

 

Donald Trump speaks out on bombshell UFO Pentagon footage

 

https://www.express.co.uk/news/world/1276235/Donald-Trump-pentagon-UFO-video-alien-footage

 

How could I forget that one. And wasn’t Kudlow talking about the China trade deal (phase 1, ha!) too? Anything to change focus...

 

Remember when they teased that one every other day like it was Groundhog Day last year?

Posted

Singapore continues to have exceptionally low mortality (1/1000 of confirmed cases). This could be due to:

 

1) Recent rise in infections (deaths could surge in the coming weeks)

 

2) Aggressive testing (leading to large # of confirmed cases), contact tracing (limiting spread to vulnerable groups)

 

Or, more optimistically:

 

3) Protection in the host in humid/warm (tropical) climates due to factors such as enhanced innate immune protection of lung--which has been shown with Influenza:

https://www.pnas.org/content/116/22/10905

 

If #3 is true, one would hope for a drop in mortality during the summer months in the Northern Hemisphere. Also if true, perhaps this would be the ideal time to catch it and (hopefully) develop immunity. This is all speculation at this point.

IMG_8118.thumb.jpg.d5c27deed886af52572c16055ed919eb.jpg

Posted

Singapore continues to have exceptionally low mortality (1/1000 of confirmed cases). This could be due to:

 

1) Recent rise in infections (deaths could surge in the coming weeks)

 

2) Aggressive testing (leading to large # of confirmed cases), contact tracing (limiting spread to vulnerable groups)

 

Or, more optimistically:

 

3) Protection in the host in humid/warm (tropical) climates due to factors such as enhanced innate immune protection of lung--which has been shown with Influenza:

https://www.pnas.org/content/116/22/10905

 

If #3 is true, one would hope for a drop in mortality during the summer months in the Northern Hemisphere. Also if true, perhaps this would be the ideal time to catch it and (hopefully) develop immunity. This is all speculation at this point.

 

What does the demographic distribution of Singapore's confirmed cases look like?

Posted

I'm pretty sure that large scale nursing homes are less common in East/Southeast Asian countries. It's customary for sons/daughters to live together with elderly parents and take care of them. Might explain the lower death rates in Singapore, Japan, and South Korea.

Posted

I'm pretty sure that large scale nursing homes are less common in East/Southeast Asian countries. It's customary for sons/daughters to live together with elderly parents and take care of them. Might explain the lower death rates in Singapore, Japan, and South Korea.

 

Sons/daughters living with elders could make things worse. This was one of the theories as to why Italy had such a bad outbreak--elderly in frequent, close contact with younger relatives.

Posted

I'm pretty sure that large scale nursing homes are less common in East/Southeast Asian countries. It's customary for sons/daughters to live together with elderly parents and take care of them. Might explain the lower death rates in Singapore, Japan, and South Korea.

 

Sons/daughters living with elders could make things worse. This was one of the theories as to why Italy had such a bad outbreak--elderly in frequent, close contact with younger relatives.

 

Massive outbreaks at nursing homes are less likely, though. In many countries, the majority of deaths occurred in nursing homes and long-term care facilities.

Posted

Also maybe, the disease doesn't spread at homes because while they live together, they never hug or kiss the elderly in Asian countries.  ;D

Posted

According to some articles, the migrant workers who live together in Singapore got high infection rate, who are young and healthy.

 

The government was able to protect old and vulnerable and low infection rates in older people.

 

Together they had high infection rate with low deaths - low fatality rate.

 

This argues against closing colleges and sending college students back home from dorms.

 

It will be interesting to see the antibody tests in SE asian country by age vs Europe/US.

Posted

The video's amusing, but clearly propaganda. Both the CCP and Trump screwed up, and spinning it as entirely a USA problem is pretty ridiculous.

 

The thing is, because of polarized politics in the USA, a significant number of Americans may support this propaganda.

 

Putin certainly got his money's worth.

Posted

The video's amusing, but clearly propaganda. Both the CCP and Trump screwed up, and spinning it as entirely a USA problem is pretty ridiculous.

 

The thing is, because of polarized politics in the USA, a significant number of Americans may support this propaganda.

 

Putin certainly got his money's worth.

 

Spot on RG.

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