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Posted

Austria did a random study using PCR tests ( somit would capture those that overcome the infection already) and they have a 0.33% infection rate estimate for their population:

https://www.tagesschau.de/ausland/oesterreich-corona-101.html

 

This is almost exactly equal to what Iceland's random testing showed.

 

It should be remembered though that PCR will be negative in someone who has recovered (no more viral RNA) and is immune. Antibody tests will tell you overall how many have been infected and that "German Wuhan" region showing 15% is not reassuring for herd immunity crowd.

 

And none of these numbers are at all consistent with "this has been widespread for months" hypothesis.

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Posted

thanks for that, but to be clear, my point is that the doctors/epidemiologists making these huge policy recommendations regarding mitigation have a misguided (dangerous) mindset that was borne out of their experience with HIV.  of course, HIV and covid are not comparable along many dimensions, but the recommendation of social distancing is equivalent to safe sex in prevention objective, with one important difference....safe sex wont shut down the nation while social distancing will and has.  all the more reason why this was such a bad recommendation that covid is far less dangerous than HIV, even though more easily transmitted

 

Yeah, I think that epidemiologists who have spent decades of their lives studying diseases are a bit more sophisticated than just copying the HIV strategy. I think they've probably spent a fair amount of time analysing about how our reaction to a disease should be impacted by the way that disease is spread.

 

Like, maybe you're thought about this stuff for three hours a day for the past two months. If that's the case, many of them have probably spent well over 100 times that much time thinking about the issues, and they actually been educated on this topic specifically. At some point, you might want to consider whether the Dunning-Kruger effect might be relevant in this situation.

 

People who wake up one morning and think they've thought of stuff that people who think about this for a living haven't thought about say more about themselves than the epidemiologists.

 

This 2017 book might help them get up to speed on what epidemiologists actually think about:

 

https://www.amazon.ca/Deadliest-Enemy-Against-Killer-Germs/dp/0316343692/

Posted

thanks for that, but to be clear, my point is that the doctors/epidemiologists making these huge policy recommendations regarding mitigation have a misguided (dangerous) mindset that was borne out of their experience with HIV.  of course, HIV and covid are not comparable along many dimensions, but the recommendation of social distancing is equivalent to safe sex in prevention objective, with one important difference....safe sex wont shut down the nation while social distancing will and has.  all the more reason why this was such a bad recommendation that covid is far less dangerous than HIV, even though more easily transmitted

 

Yeah, I think that epidemiologists who have spent decades of their lives studying diseases are a bit more sophisticated than just copying the HIV strategy. I think they've probably spent a fair amount of time analysing about how our reaction to a disease should be impacted by the way that disease is spread.

 

Like, maybe you're thought about this stuff for three hours a day for the past two months. If that's the case, many of them have probably spent well over 100 times that much time thinking about the issues, and they actually been educated on this topic specifically. At some point, you might want to consider whether the Dunning-Kruger effect might be relevant in this situation.

 

People who wake up one morning and think they've thought of stuff that people who think about this for a living haven't thought about say more about themselves than the epidemiologists.

 

This 2017 book might help them get up to speed on what epidemiologists actually think about:

 

https://www.amazon.ca/Deadliest-Enemy-Against-Killer-Germs/dp/0316343692/

 

Just wait for them to find that one epidemiologist/MD/PhD who agrees with what they are saying.

 

It's like finding that one "scientist" PhD who doesn't believe in climate change and using that to bolster their arguments when the consensus is clearly oriented the opposite way.

Posted

Just wait for them to find that one epidemiologist/MD/PhD who agrees with what they are saying.

 

It's like finding that one "scientist" PhD who doesn't believe in climate change and using that to bolster their arguments when the consensus is clearly oriented the opposite way.

 

Yeah, and that one's person claims always has way more weight to these people than the 250,000 others who disagree with detailed explanations why the thing doesn't make sense, for some reason.

Posted

https://www.afp.com/en/news/15/virus-appears-strike-men-overweight-people-harder-doc-1qi7wt1

 

In the emergency rooms of virus hotspots around the world, medical staff are seeing a greater number of men than women suffering severe symptoms of COVID-19, with obesity emerging as another potentially aggravating factor. But experts are still unsure why.

 

Also, Peter Attia thread on the hypoxia/hemoglobinopathy theory:

 

 

The hemoglobin binding notion is very unlikely IMO. For one, Covid does not infect RBCs (where hemoglobin is). And for another, there is a very easy explanation for hypoxia in these patients: ARDS. Occam's razor is useful here.

 

And let's not forget that the vast majority of "in silico" computational binding studies are very low utility and certainly not predictive, even weaker than in vitro studies (which is itself inferior to in vivo and then in situ).

Posted

https://www.afp.com/en/news/15/virus-appears-strike-men-overweight-people-harder-doc-1qi7wt1

 

In the emergency rooms of virus hotspots around the world, medical staff are seeing a greater number of men than women suffering severe symptoms of COVID-19, with obesity emerging as another potentially aggravating factor. But experts are still unsure why.

 

Also, Peter Attia thread on the hypoxia/hemoglobinopathy theory:

 

 

The hemoglobin binding notion is very unlikely IMO. For one, Covid does not infect RBCs (where hemoglobin is). And for another, there is a very easy explanation for hypoxia in these patients: ARDS. Occam's razor is useful here.

 

And let's not forget that the vast majority of "in silico" computational binding studies are very low utility and certainly not predictive, even weaker than in vitro studies (which is itself inferior to in vivo and then in situ).

 

Bill Gates in the video posted by Liberty doesn’t believe it works either. He mentioned it looks good in the lab, so they surely have looked into this.

 

Personally, if I get COVID-19, I would ask my doc to give it a try. It’s not like there are many other options and I don’t have or existing conditions the would make it dangerous for me to use. More upside than downside I think.

Posted

https://www.afp.com/en/news/15/virus-appears-strike-men-overweight-people-harder-doc-1qi7wt1

 

In the emergency rooms of virus hotspots around the world, medical staff are seeing a greater number of men than women suffering severe symptoms of COVID-19, with obesity emerging as another potentially aggravating factor. But experts are still unsure why.

 

Also, Peter Attia thread on the hypoxia/hemoglobinopathy theory:

 

 

The hemoglobin binding notion is very unlikely IMO. For one, Covid does not infect RBCs (where hemoglobin is). And for another, there is a very easy explanation for hypoxia in these patients: ARDS. Occam's razor is useful here.

 

And let's not forget that the vast majority of "in silico" computational binding studies are very low utility and certainly not predictive, even weaker than in vitro studies (which is itself inferior to in vivo and then in situ).

 

Bill Gates in the video posted by Liberty doesn’t believe it works either. He mentioned it looks good in the lab, so they surely have looked into this.

 

Personally, if I get COVID-19, I would ask my doc to give it a try. It’s not like there are many other options and I don’t have or existing conditions the would make it dangerous for me to use. More upside than downside I think.

 

I forgot to add--Red Blood Cells have no nucleus, no DNA, and no RNA. So a virus cannot hijack RBC machinery to replicate (and form its proteins) like it can in other cell types. Hence very unlikely the virus infects RBCs. Again a major hole in the hemoglobin binding hypothesis.

 

Also, AFAIK there is no effective treatment even if the hemoglobin theory is true. Furthermore, covid patients respond to oxygen treatment which is another hole in the theory.

 

Edit: Wikipedia to the rescue:

Because of the lack of nuclei and organelles, mature red blood cells do not contain DNA and cannot synthesize any RNA, and consequently cannot divide and have limited repair capabilities. The inability to carry out protein synthesis means that no virus can evolve to target mammalian red blood cells.

 

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

Posted

The mainstream media here should be all over this story but it’s too busy hating on Trump. Huge disservice to the people.

 

Yes, the mainstream media should be all over a silly spat between China and an Australia newspaper. That should distract us from the mass graves being dug in NYC:

https://www.nbcnews.com/news/us-news/video-shows-giant-trench-getting-built-nyc-s-hart-island-n1181056

 

Don’t mean that specifically but the role China and WHO played in all this.

Should be investigative reporting on the cover up.

And WHO/Tedros/China connection. And censorship of Taiwan.

Also, the misinformation campaigns being waged against Taiwan and world right now.

If world and media doesn’t investigate this, it’ll just repeat again. Just like coverup of SARS I in 2003.

Taiwan warned WHO  at the end of last December about human-to-human transmission.  Yet, nobody in the mainstream media wonders why WHO never passed this information?  Even worse, on January 14th, WHO even published a note saying that there is no evidence of human-to-human transmission.

 

Even after January 23rd, when China shut down traffic between Hubei and rest of the China, WHO on one hand praised China's response and at the same time said that other countries should not follow suits to restrict traffic to China.

 

Trump may not be perfect. But I think WHO fails miserably.

Being in Taiwan, compared to the SARS outbreak, we look at the way how WHO acted this time and think that it is just a mouthpiece of Chinese government.

https://www.ft.com/content/2a70a02a-644a-11ea-a6cd-df28cc3c6a68

Taiwan said its doctors had heard from mainland colleagues that medical staff were getting ill — a sign of human-to-human transmission. Taipei officials said they reported this to both International Health Regulations (IHR), a WHO framework for exchange of epidemic prevention and response data between 196 countries, and Chinese health authorities on December 31.

 

Taiwanese government officials told the Financial Times the warning was not shared with other countries.

Posted

As long as people's agendas dictate what stories get told, nothing will change. WHO is a bs organization, funded by handouts and run by bureaucrats. They probably mean well, but also fail on the same levels most other similarly run and structured organizations do.

Posted

As long as people's agendas dictate what stories get told, nothing will change. WHO is a bs organization, funded by handouts and run by bureaucrats. They probably mean well, but also fail on the same levels most other similarly run and structured organizations do.

 

Yeah, it's clear that they were giving out inaccurate information.  The real question I wonder about is whether they were doing that because they're corrupt or because they knew that if they gave out accurate information, China would screw them, potentially making their response even worse. Did they choose the lesser of two evils, or are they just bad?

 

Across all of this, the one definitive lesson to be learned is that the CCP is a big problem and big western nations ought to distance themselves from China, even if it costs money. It's a shame that America isn't in position right now to step up and take international leadership in doing that.

Posted

Important thread to understand what the antibodies tests actually mean:

 

 

Antibody tests are coming online. Never before have humans needed to understand Bayes rule more. Let's talk about why it's critical NOT to assume you are immune to covid-19 when you have a positive antibody test. Seriously, people need to understand this to prevent many deaths.

 

Several companies have tests of varying quality, but Cellex makes a FDA-approved antibody test. The goal is to test for immunity due to prior exposure rather than an active infection. Cellex's test has a "sensitivity" of 93.8% and a "specificity" of 95.6%. Lets interpret this

 

The Cellex test appears to have higher rates than others. Sensitivity: Probability person tests positive if they are infected. Specificity: Probability person tests negative given that they are negative. 93.8% and 95.6% sound good, they mean that only 6.2% of + people test -, and

 

only 4.4% of - people test +. But what does it mean when you test positive? Since the sensitivity is high, you'd assume that you're positive and immune to covid-19. But sensitivity measures prob testing + given that you are +. We want prob of BEING + GIVEN that you TEST +

 

The conditionality is reversed. Probability you are + given that you test positive can be written as Pr(are+|test+). Let's just derive Bayes theorem real quick in this context so you don't have to just trust me. Pr(are+|test+) equals the sensitivity Pr(test+|are+) multiplied by..

 

EVNj58HU0AESfEi?format=png&name=medium

 

the probability you are+ irrespective of how you test, which is the same as the proportion of positives in the population. Let's assume that in the USA this is ~1% or ~3.3 million people are really infected. The final term in the denominator is the probability you test positive.

 

The probability you test positive must be decomposed into the people who test positive and are positive plus the people who test positive and aren't. We have all the necessary numbers for this probability expression and get a denominator of 0.053. Plugging it all in to Bayes rule

 

EVNqpJ2VAAIt5Dv?format=png&name=medium

 

f we plug in sensitivity, Pr(test+|are+), the probability a random person is positive, and the probability a random person tests positive, then a randomly tested person who TESTS positive, only has a 17.7% chance of actually BEING positive. More that 82% of people will be wrong!

 

EVNrZOPU8AUZqSx?format=png&name=900x900

 

If you get a positive antibody test result and think you're immune and quit socially distancing, you are far more likely than not to make a big mistake. When millions of people make the same mistake rather that appreciate conditional probability and Bayes rule, many people die.

 

But it gets worse. If you never had symptoms but test positive and conclude you're one of the lucky people who had an asymptomatic infection, you're even more likely to make a big mistake. Of course, as a higher proportion of  population becomes infected, this mistake diminishes.

 

The take home is that a high sensitivity, Pr(test+|are+)=0.938, does NOT mean that Pr(are+|test+) is  high. 82 of 100 people who get a positive test will still be susceptible to the virus. Once 10% of population has been infected, this drops to 30%, but that is a LOT of people!

 

etc etc

Posted

As long as people's agendas dictate what stories get told, nothing will change. WHO is a bs organization, funded by handouts and run by bureaucrats. They probably mean well, but also fail on the same levels most other similarly run and structured organizations do.

 

Yeah, it's clear that they were giving out inaccurate information.  The real question I wonder about is whether they were doing that because they're corrupt or because they knew that if they gave out accurate information, China would screw them, potentially making their response even worse. Did they choose the lesser of two evils, or are they just bad?

 

Across all of this, the one definitive lesson to be learned is that the CCP is a big problem and big western nations ought to distance themselves from China, even if it costs money. It's a shame that America isn't in position right now to step up and take international leadership in doing that.

 

The simplest explanation is the best imo and they are just bad and kept regurgating what China told them. WHOhas good People and probably incompetent ones. Let’s also remember Dr Carlo Urbani, a WHO Doctor who probably prevented a SARS epidemic in 2003 and paid for it with his life.

 

Also, let’s face it a nation like the USA doesn’t rely on the WHO. The US has its own boots on the ground and knew about the virus early January if not earlier. They sure have people and informants their as well Aswath ing social media

Posted

https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

 

Of the 61 patients who received at least one dose of remdesivir, data from 8 could not be analyzed (including 7 patients with no post-treatment data and 1 with a dosing error). Of the 53 patients whose data were analyzed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated. A total of 25 patients (47%) were discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive ventilation.

 

Looks like it has some efficacy. More data to come this month.

Posted

I had read an article that the Italian Health Minister said that they had brought the RO down from 3 to 1 with the lockdown.

 

What that means is that Italy hasn't been able to kill the virus. 

 

I still see people in my neighborhood too close to each other etc.  Which means many are not being careful.

 

At this point I don't see how this virus goes away unless there is herd immunity and Covid is here to stay for awhile.  A "cure" or solution could be found.

 

It might be 2 years for normal life to return.  A least it better than the black death!

Posted

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Posted

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Rest of  China had a lockdown too that was more stringent than in Europe or the US. Population is wearing masks and companies go to great length to avoid infection at the work place (I mentioned before that they shut down air circulation systems in factories /offices and vent with fresh air. They possibly are very good at contact tracing too (Big brother state).

 

I also think that the  Chinese government is lying about cases to some extend. Now if it were a full fledged epidemics, lying doesn’t work, but a few dozen unreported cases  orevendeath here and there to avoid public unrest seem to be plausible, If not likely...

Posted

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Rest of  China had a lockdown too that was more stringent than in Europe or the US. Population is wearing masks and companies go to great length to avoid infection at the work place (I mentioned before that they shut down air circulation systems in factories /offices and vent with fresh air. They possibly are very good at contact tracing too (Big brother state).

 

I also think that the  Chinese government is lying about cases to some extend. Now if it were a full fledged epidemics, lying doesn’t work, but a few dozen unreported cases  or even death here and there to avoid public unrest seem to be plausible, If not likely...

 

Interesting. So did the rest of China do physical distancing / lockdown like what we are doing in Canada/USA/Europe?

 

I know Wuhan was shut and just opened a few days ago.  It seems pretty amazing China managed to keep the rest of the country operating.

 

 

 

Posted

So does anyone know why is it that after Wuhan was shut down, we didn't see so many other cases in the rest of China?

I mean if it was so easy for Europe and the US to get out of control - surely it would have just been as easily for the rest of China to go out of control too...

what did the rest of China do that made the cases much lower than Europe / USA?

 

Rest of  China had a lockdown too that was more stringent than in Europe or the US. Population is wearing masks and companies go to great length to avoid infection at the work place (I mentioned before that they shut down air circulation systems in factories /offices and vent with fresh air. They possibly are very good at contact tracing too (Big brother state).

 

I also think that the  Chinese government is lying about cases to some extend. Now if it were a full fledged epidemics, lying doesn’t work, but a few dozen unreported cases  or even death here and there to avoid public unrest seem to be plausible, If not likely...

 

Interesting. So did the rest of China do physical distancing / lockdown like what we are doing in Canada/USA/Europe?

 

I know Wuhan was shut and just opened a few days ago.  It seems pretty amazing China managed to keep the rest of the country operating.

 

https://www.medrxiv.org/content/10.1101/2020.02.22.20025791v1

 

Results

There were in total 24,232 confirmed cases in China and 26 overseas countries. In total, 16,480 cases (68.01%) were from Hubei Province. The lgN rose as the average temperature went up to a peak of 8.72℃ and then slowly declined.

Posted

Important thread to understand what the antibodies tests actually mean:

...

The sensitivity and specificity of tests in a diagnostic context also apply this principle with the pre-test probability based on clinical presentation ie the test will increase the possibility that you have the disease if + and decrease the possibility of disease if -.

 

When used for screening, even slightly imperfect test specificity can raise significant issues. The concept that the thread describes is the positive predictive value. It can be a problem when (opposite scenario to CV) you receive a positive screening test while not having the disease. In this case 1-PPV means regret probability. Regret because it means one has to go through additional procedures, pain and anxiety for a statistical artefact. For the CV, the opposite plays out with the potential to create false confidence (think immunity is there while not having it for real) and this questions the usefulness of the immunity passport that some people suggested. Even if the prevalence goes up, on an individual basis, the positive predictive value increases and the individual likelihood of a true result increases but one is still left with a large absolute number of members of the population who are considered to be immune when they're not.

 

Specificity can be improved by repeat testing with the same test at a different time or a different test at the same time but the complexity of the combination may not be worth it.

 

Exit scenarios may involve a certain amount of controlled trials and errors.

Posted

https://www.wsj.com/articles/health-authorities-roll-out-new-coronavirus-tests-to-gauge-infections-spread-11586511004

 

"There are early signs that past infection by the new coronavirus can prevent future disease. But some infectious-disease experts say there are too many unknowns about the immune system’s response to the virus—including how long immunity might last and the likelihood of reinfection—to rely on the tests to predict complete immunity. “I don’t know we have enough trust in what an exposure means that it would change the way we deploy our workforce,” Kimberly Hanson, an infectious-disease physician at the University of Utah School of Medicine, said at a media briefing. “We’re still trying to figure out what detecting an antibody response means, and if it’s protective or not, we don’t know.” Given the potential shortcomings, early serology tests might prove more useful as a tool for gauging the spread of the virus through communities, rather than for determining whether individuals have full immunity, said Stanford’s Dr. Bendavid."

 

https://www.wsj.com/articles/why-doesnt-flu-tank-economy-like-covid-19-11586511000?mod=trending_now_4

 

"For starters, the flu tallies are estimates of total flu burden, while the Covid-19 figures are confirmed cases only. Eventually, the CDC will estimate the total Covid-19 burden, but for now, the numbers are not an apples-to-apples comparison.“We always know confirmed cases are an underestimate,” said Lynnette Brammer, who leads the CDC’s domestic influenza-surveillance team.

 

In addition, Covid-19 differs from the flu in how quickly it spreads, the length and severity of the illness, and the unusual demands a contagion with no cure places on medical staff and facilities. Instead of gentle waves of cases cascading across the country over a span of six months, like the flu, a tidal wave of Covid-19 cases has swept over a handful of cities in half the time. The concentration of quickly amassing serious infections overwhelmed the affected areas, and the fear is that without social distancing—for now the only effective intervention—other places will have a similar experience. A snapshot of the 2009 H1N1 influenza pandemic shows the difference in the speed of transmission between a raging flu and the new coronavirus. Comparing only laboratory-confirmed cases, in the first 102 days of the H1N1 flu pandemic, the CDC reported 43,677 illnesses and 302 deaths. In 22 fewer days, Covid-19 infected 11 times as many people and killed 60 times as many. “The flu season is spread out,” said William Schaffner, an infectious-disease specialist at Vanderbilt University Medical Center in Nashville. “This is being jammed up in a short time frame.” Covid-19 outbreaks have also been highly localized. “You’ve got a hot-spot pattern instead of an even pattern,” said Emily Martin, an epidemiologist at the University of Michigan School of Public Health. “All the pressure is concentrated in small areas.”

 

Not only are more Covid-19 patients coming into hospitals, they require longer care.The median length of stay for adults hospitalized with seasonal flu is 3.6 days, according to research published in the journal Clinical Infectious Diseases. In nine Seattle-area hospitals, where 12 of 24 Covid-19 patients died through March 23, the median stay was 12 days in the hospital, 9 days in ICU and 10 days on mechanical ventilators. (The median for survivors was 17 days in the hospital, 14 in ICU and 11 on a ventilator.) Having a hospital full of highly contagious patients leads to diminished stores of equipment intended to protect staff members who are also at risk of infection. The University of Michigan Medical Center now requires everyone to wear a mask. Additionally, anyone caring for patients who have or are suspected of having Covid-19 must wear a gown and eye protection. During flu season, the center uses “droplet protection” only in some rooms, and there is no universal masking requirement. “It’s a different world,” Dr. Lauring said. Most people have some immunity to the flu, either from vaccines or previous exposure, and nearly all health-care workers are protected by the flu shot. “It’s not unusual to have compliance rates above 95%,” Vanderbilt’s Dr. Schaffner said, referring to vaccinations of hospital employees. “That’s everybody—doctors, nurses, dietitians, people who clean at night—everybody.” Currently, there is no vaccine or specific treatment for Covid-19, so slowing or stopping its spread has required social distancing.

 

But there is one quality that might make Covid-19 less problematic than flu. “It’s not changing and mutating at the rate the flu can do,” said Allison Weinmann, an infectious-disease physician at Henry Ford Health System in Detroit. That could make it easier for pharmaceutical companies to develop an effective vaccine—and render Covid-19 no more remarkable than the seasonal flu."

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