Coronavirus

[Investor20]

https://www.hsgac.senate.gov/hearings/early-outpatient-treatment-an-essential-part-of-a-covid-19-solution

 

Early Outpatient Treatment: An Essential Part of a COVID-19 Solution

Full Committee Hearing

November 19, 2020 09:00 AM

 

Location: SD-342, Dirksen Senate Office Building and via Videoconference

Witnesses

 

    Peter A. McCullough, M.D., M.P.H.

    Vice Chief of Internal Medicine

    Baylor University Medical Center

 

    Harvey Risch, M.D., PH.D.

    Professor of Epidemiology

    Yale University

 

    George C. Fareed, M.D.

    Medical Director and Family Medicine Specialist

    Pioneers Medical Center

 

    Ashish K. Jha, M.D., M.P.H.

    Dean of the School of Public Health

    Brown University

[Gregmal]

Theres few moments in ones life where you get a chance to showcase your skillset as the world watches. These are the kind of things they make movies about. Weirdo with an arcane talent gets opportunity of a lifetime and not only is the girl of his dreams captivated by his talent, but the entire universe gets drawn in, and usually it ends with said person being a hero and getting the girl. These scientists just had that moment, and not only made total fools of themselves, but did a great disservice to the credibility of science in the eyes of every day people. What a disaster this whole thing was for them.

 

Scientists are very much like analysts. An analyst is good for compiling data and doing research, but should not be trusted to make and form final conclusions and take action. Because any analyst who is any good at it, would be managing money and not writing book reports if that were actually true.

[Investor20]

I'm sorry to tell you this. But even if the 24% number is correct, that is way, way short of even heard protection let alone heard immunity.

 

I agree with rb.

 

Furthermore, Investor20 posted a link to an empirical study, where antibodies appeared to fade away within about a few months.

 

The head of the Swedish Health Authority, Mr. Tegnell, yesterday publicly expressed concerns & second thoughts about the Swedish pandemic strategy, btw. [Ref. the Swedish situation has been touched recently in this topic.]

 

Personally, I'm very happy today, that my ticket in the ovarial lottery turned out to be Danish.

 

- - - o 0 o - - -

 

In short : Don't challenge your own fate by trying to mess around with this sucker. [Also, I think that this is what Greg all the time has been expressing in his posts.]

 

Dont overlook cellular immunity which is the better way to look at immunity. Just looking at antibodies gives an incomplete picture and if not all the great majority of people should have long term immunity regardless of IgM, IgG antibody counts.

 

https://www.nytimes.com/2020/11/17/health/coronavirus-immunity.html

 

Wow we went from immunity may not last more then a couple months and you can get covid twice!!! to now immunity may last for decades. Wow things are coming around. 2 vaccines with >90% efficacy and all of sudden we have discovered this virus follows normal cellular immunity patterns. Rejoice! What a difference 3-4 weeks makes in the media and perception!!!

 

This truely is an exceptional time as we coalesce post election. Who would have thought. Now we just need some more evidence that people who bitch about covid symptoms for months afterwards are babies and we will be on the home stretch!!!!

 

CDC Director Dr. Redfield in senate hearing Sep 17 (words to remember for decades).

            "I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine,"

            "Because the immunogenicity may be 70 percent and if I don't get an immune response, the vaccine's not going to protect me. This face mask will."

 

Now NEJM study...two weeks after supervised mask wearing.. along with other mitigation efforts such as distancing... 2% infections in two weeks.

95% efficacious vaccine that will provide immunity for years.

These guys are really good (sarcasm alert!).

 

 

[clutch]

Theres few moments in ones life where you get a chance to showcase your skillset as the world watches. These are the kind of things they make movies about. Weirdo with an arcane talent gets opportunity of a lifetime and not only is the girl of his dreams captivated by his talent, but the entire universe gets drawn in, and usually it ends with said person being a hero and getting the girl. These scientists just had that moment, and not only made total fools of themselves, but did a great disservice to the credibility of science in the eyes of every day people. What a disaster this whole thing was for them.

 

Scientists are very much like analysts. An analyst is good for compiling data and doing research, but should not be trusted to make and form final conclusions and take action. Because any analyst who is any good at it, would be managing money and not writing book reports if that were actually true.

 

Scientists are supposed to formulate falsifiable hypotheses, run experiments to validate them, report the findings, and align future research based on these findings. Scientists are not supposed to make predictions and decisions based on incomplete and descriptive data.  At least this was what I was told to do when I earned my PhD in applied science.

 

What I'm worried about is that we will witness even worse snafu than the current situation when comes to handling climate change. Scientists will continue to push descriptive statistics and their consensus opinions as the  "scientific evidence/truth" and make predictions/decisions based on them. Scientists are the High Priests of our age.

[KCLarkin]

Scientists are very much like analysts. An analyst is good for compiling data and doing research, but should not be trusted to make and form final conclusions and take action. Because any analyst who is any good at it, would be managing money and not writing book reports if that were actually true.

 

Greg, you can't even get your tortured analogies right:

 

Scientists -> Quants

Bureaucrats > PM/Analysts

Politicians -> DIY investors

[Investor20]

https://www.nytimes.com/2020/11/18/health/coronavirus-masks-denmark.html

 

Danish Study Questions Use of Masks to Protect Wearers

 

Masks prevent people from transmitting the coronavirus to others, scientists now agree. But a new trial failed to document protection from the virus among the wearers.

 

https://www.acpjournals.org/doi/10.7326/M20-6817

Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers;    A Randomized Controlled Trial

 

"Remaining participants (group 2; n = 3029) were randomly assigned on 24 April 2020 and were followed from 2 to 4 May through 2 June 2020."

 

Study recruiting done in June, and published in November 18.  Similar time line to NEJM study.

 

We should not forget this by CDC Radfield "I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine," Sep 16, 2020.

[Liberty]

Sorry if already posted, haven't been following this thread lately:

 

https://nationalpost.com/news/world/lockdown-u-turn-in-sweden-as-covid-19-cases-soar-and-herd-immunity-hopes-falter

 

Lockdown U-turn in Sweden as COVID-19 cases soar and herd immunity hopes falter

 

The strict measures come after chief epidemiologist Anders Tegnell conceded a first wave of coronavirus cases did not prevent a second

[KCLarkin]

Masks prevent people from transmitting the coronavirus to others, scientists now agree. But a new trial failed to document protection from the virus among the wearers.

 

Shows a 20% reduction in transmission but the study wasn't large enough to get a significant result.

[Investor20]

Masks prevent people from transmitting the coronavirus to others, scientists now agree. But a new trial failed to document protection from the virus among the wearers.

 

Shows a 20% reduction in transmission but the study wasn't large enough to get a significant result.

 

Large enough sample : "4862 completed the study."

 

 

[KCLarkin]

Large enough sample : "4862 completed the study."

 

Yes, but most of them didn't get infected over this short period.

 

Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.

 

So, a mask likely reduces your risk of infection by -46% to +23%. We'd need more data to reduce that range. Matches the general consensus that masks are primarily source control but provide some protective benefit.

 

NOTE:

 

There are important caveats to this study. For example, this study started during the first lockdown, so most of the transmission is likely within households.

 

[patience_and_focus]

Large enough sample : "4862 completed the study."

 

First off I want to say I am of the view that there isn't currently conclusive evidence that masks are effective. There is also not conclusive evidence that masks are not effective. In this regard we may be in agreement (at least partially).

 

Now for the sample size. It is not large.

 

This is clear from the confidence intervals (potential range of possible outcomes in 95% confidence interval is very large). Typically you get large intervals when sample size is small. There is another very important reason why I say this. Look at the sample size of Pfizer/BioNtech or Morderna trials. They are 10X the size of this trial. Pfizer trial had ~44000 participants. The goal was very similar, to assess whether an intervention (in this case a vaccine as opposed to masks) is effective in preventing future infections.

 

The reason why this large sample size (~44000) is needed is to be able to power the study enough to convincingly make a call one way or another in this infectious disease setting. Same is true for any other intervention study (vaccine, therapeutic or non pharmaceutical interventions such as masks).

[Liberty]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355084/

 

“Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors...”

[Jurgis]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355084/

 

“Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors...”

 

They already tested Donnie?  :o

[Gregmal]

Assclown in NY giving people one more chance to exit the WFH trade...

[Viking]

Large enough sample : "4862 completed the study."

 

First off I want to say I am of the view that there isn't currently conclusive evidence that masks are effective. There is also not conclusive evidence that masks are not effective. In this regard we may be in agreement (at least partially).

 

Now for the sample size. It is not large.

 

This is clear from the confidence intervals (potential range of possible outcomes in 95% confidence interval is very large). Typically you get large intervals when sample size is small. There is another very important reason why I say this. Look at the sample size of Pfizer/BioNtech or Morderna trials. They are 10X the size of this trial. Pfizer trial had ~44000 participants. The goal was very similar, to assess whether an intervention (in this case a vaccine as opposed to masks) is effective in preventing future infections.

 

The reason why this large sample size (~44000) is needed is to be able to power the study enough to convincingly make a call one way or another in this infectious disease setting. Same is true for any other intervention study (vaccine, therapeutic or non pharmaceutical interventions such as masks).

 

Every country that has brought the virus under control has a couple of common factors. One is widespread mask wearing. It is obvious wearing a mask helps. Now exactly how effective? We will know much more in a few years. (But i think that will be a little too late to help us today :-)

 

Social distancing is a second. Effective contact tracing is a third (this lets you know where the clusters are breaking out and why which is super important to know).

 

Now we could wait a few more years and wait for irrefutable scientific evidence before implementing any of these measures. Kind of like what happened back in February and March in South Korea, Iran and Northern Italy. The virus loves stupidity.

 

Now is wearing a mask a silver bullet? No, of course not. Managing the virus well is your classic example of a multivariable event. You need to get a bunch of things right at the same time for an extended period of time. And the trade offs are difficult and of huge impact. And there will be a need for constant course corrections (as new information becomes available).

 

It totally cracks me up how people completely miss the forest for the trees.

 

——————————-

miss the forest for the trees: to not understand or appreciate a larger situation, problem, etc., because one is considering only a few parts of it

[Gregmal]

The only way not to catch covid with a near certain success rate is to avoid being around people. If you are going to be around people, wearing a mask helps to a certain degree, but your risks increase greatly. Why is this such a hot button topic for people? Seems really freakin simple. The more people you are around, the greater your chance of catching a cold, whether you have a mask or not...

[Viking]

The only way not to catch covid with a near certain success rate is to avoid being around people. If you are going to be around people, wearing a mask helps to a certain degree, but your risks increase greatly. Why is this such a hot button topic for people? Seems really freakin simple. The more people you are around, the greater your chance of catching a cold, whether you have a mask or not...

 

Effectively managing the virus is complex. There are many layers involved. .

 

As i have been saying since March, the virus is in control (until a vaccine is available). Do stupid things and the virus will love it. Develop a fatalistic mind set and the virus wins. It is pretty straight forward.

 

It is not black and white. Not go out or stay home. Not open up or lock down.

[Gregmal]

The only way not to catch covid with a near certain success rate is to avoid being around people. If you are going to be around people, wearing a mask helps to a certain degree, but your risks increase greatly. Why is this such a hot button topic for people? Seems really freakin simple. The more people you are around, the greater your chance of catching a cold, whether you have a mask or not...

 

I love it when i encounter this type of thinking when it comes to investing. It is like taking candy from a baby. Not so great when in the middle of a pandemic and the health consequences can be extreme.

 

Effectively managing the virus is just a tad more complex than you are suggesting (my uneducated opinion).

 

As i have been saying since March, the virus is in control (until a vaccine is available). Do stupid things and the virus will love it. Develop a fatalistic mind set and the virus wins. It is pretty straight forward.

 

It is not black and white. Not go out or stay home. Not open up or lock down. Not left or right. Not Democrat or Republican. But just like thumb sucking when young i guess this is the easiest most comforting way for most people to think about the virus. Just like trying to play checkers when you are in the middle of a game of chess.

 

Well in regards to both investing during this manufactured "crisis", and handling the virus, I am pretty certain I'm doing quite well in both categories....much better than most I would imagine.

 

It isn't totally black and white, but in many aspects it is. If you run around chicken shit scared or impair your life, well, that sucks. If you choose not to, well, thats your choice. And then even in the worst case, despite the liberal loveliest for headlines like "he dismissed the virus and then he got it!"...most people, even who fall into the later category, end up just fine.

 

Bottom line is if you're so damn scared of this thing, your only surefire way to avoid it is to sit in your house and avoid any contact with people. If you do that, you'll never get it. For the rest of us, its pretty reasonable to just go about living our lives to the extent that the corrupt and power-hungry politicians dont interfere. Not much more to it.

[Viking]

The only way not to catch covid with a near certain success rate is to avoid being around people. If you are going to be around people, wearing a mask helps to a certain degree, but your risks increase greatly. Why is this such a hot button topic for people? Seems really freakin simple. The more people you are around, the greater your chance of catching a cold, whether you have a mask or not...

 

I love it when i encounter this type of thinking when it comes to investing. It is like taking candy from a baby. Not so great when in the middle of a pandemic and the health consequences can be extreme.

 

Effectively managing the virus is just a tad more complex than you are suggesting (my uneducated opinion).

 

As i have been saying since March, the virus is in control (until a vaccine is available). Do stupid things and the virus will love it. Develop a fatalistic mind set and the virus wins. It is pretty straight forward.

 

It is not black and white. Not go out or stay home. Not open up or lock down. Not left or right. Not Democrat or Republican. But just like thumb sucking when young i guess this is the easiest most comforting way for most people to think about the virus. Just like trying to play checkers when you are in the middle of a game of chess.

 

Well in regards to both investing during this manufactured "crisis", and handling the virus, I am pretty certain I'm doing quite well in both categories....much better than most I would imagine.

 

It isn't totally black and white, but in many aspects it is. If you run around chicken shit scared or impair your life, well, that sucks. If you choose not to, well, thats your choice. And then even in the worst case, despite the liberal loveliest for headlines like "he dismissed the virus and then he got it!"...most people, even who fall into the later category, end up just fine.

 

Bottom line is if you're so damn scared of this thing, your only surefire way to avoid it is to sit in your house and avoid any contact with people. If you do that, you'll never get it. For the rest of us, its pretty reasonable to just go about living our lives to the extent that the corrupt and power-hungry politicians dont interfere. Not much more to it.

 

Greg, as you can see above, I did change my initial response. Too cranky.

 

As we have been learning for the past 10 months dealing with the pandemic is complicated.... :-) 

[cwericb]

For those who think wearing a mask is ineffective, next time you go in for a surgery tell the doctors & nurses not to bother wearing masks as they slice you open.

 

Covid is like any other serious risk. You take common sense steps to avoid becoming a victim. But if your number comes up, your number comes up.

[Spekulatius]

Interesting comparison of the two mRNA vaccine front runners (Moderna, Pfizer-BioNtech):

https://twitter.com/biohazard3737/status/1329131035540516865?s=21

 

FWIW, that @biohazard3737 fellow is worth a follow.

[patience_and_focus]

For those who think wearing a mask is ineffective, next time you go in for a surgery tell the doctors & nurses not to bother wearing masks as they slice you open.

 

Covid is like any other serious risk. You take common sense steps to avoid becoming a victim. But if your number comes up, your number comes up.

 

I think my comment is being taken out of context and this issue is becoming unnecessarily emotional as opposed to invoking rational thought. So let me clarify. My comment of masks not being shown to be effective so far was in the context of multiple previous posts specifically on covid studies that are being cited to argue in favor of or against effectiveness of masks to prevent infection for the wearer (not source control). I am not making any general claims about masks, especially for source control.

 

Also I was clear that so far there is absence of evidence that is coming from gold standard randomized controlled trials that unequivocally show effectiveness in that context. I am fully aware that absence of evidence is not evidence of absence. However, given what we know so far, wearing masks just by themselves is unlikely to show very high effectiveness to prevent getting infected in such studies. This may be partly due to difficulty in getting a large enough study going for something that is behavioral or masks may be more effective when combined with other non pharmaceutical interventions. But such trials have not been conducted.

 

By the way, I do wear mask in public. It has more to do with lack of harm doing it and potential for source control (in the unlikely situation of source being myself) than proof of preventative intervention.

[mattee2264]

 

Re mask wearing and social distancing I think there is an analogy with the effectiveness of condoms with perfect use as opposed to typical use. I'd imagine in Asian countries you get a lot closer to perfect use than you would in the West. So while part of the solution the best way to achieve reduce transmission is by ruining peoples' social lives through lockdowns.

 

Moderna had much worse side effects in the Phase 2 trials. So it could be dose dependent. I think most people if given a choice would prefer the Pfizer vaccine and especially if they aren't a high risk demographic would probably wait for it. So that could slow the roll-out.

 

I think now it is clear all the vaccines work there will be a much greater focus on safety and speed of roll-out and that uncertainty is going to result in a lot of volatility especially while you have the virus raging in the background. Could end up being a replay of the summer where recovery plays got ahead of themselves before pulling back.

[Investor20]

For those who think wearing a mask is ineffective, next time you go in for a surgery tell the doctors & nurses not to bother wearing masks as they slice you open.

 

Covid is like any other serious risk. You take common sense steps to avoid becoming a victim. But if your number comes up, your number comes up.

 

I checked and did not find confirmation that masks in surgery help.  But may be I missed something.  Could you let me know any study you know that masks in surgery helps reduce infections?

[cwericb]

 

I checked and did not find confirmation that masks in surgery help.  But may be I missed something.  Could you let me know any study you know that masks in surgery helps reduce infections?

 

Hopefully that was sarcasm.

 

I will add to this original post.

 

On second thought, I have to agree that while there seems to be a lack of study into the effectiveness of masks in surgeries, there is a certain amount of common sense involved.

 

When breathing we often exhale bodily droplets. If that person were carrying a disease those droplets could spread that disease to others because we know that is one way disease is spread. Wearing a mask might not completely stop the spread, but it would certainly reduce the amount of those droplets going into the air.

 

If masks serve no purpose, we must have a lot of dumb doctors.

 

To go back to my original post, would you prefer that doctors and nurses involved in operating on you wear masks or not?