Tuesday, June 16, 2020

The More That Covid-19 Gets Studied, The More It Looks Like a Paper Tiger

That's the conclusion of NPR, of all places, quoted in the Foundation for Economic Education (FEE) news mailing.  The conclusion is surprising for them, but not how they start - which is to discredit the W administration and the '03 war in Iraq.
The Iraq War WMD debacle is arguably the greatest expert “fail” in generations. The holy triumvirate—lawmakers, bureaucrats, and media—all failed to sniff out the truth. If any of them had, a war that cost trillions of dollars and claimed the lives of 100,000-200,000 people likely could have been avoided.

It would be difficult to surpass the Iraq blunder, but emerging evidence on COVID-19 suggests the experts—again: lawmakers, bureaucrats, and media—may have subjected us to a blunder of equally disastrous proportions.
They go on to say that mounting evidence says that the coronavirus is more common and less deadly than it first appeared.  Originally, the claims for the numbers who would die were wildly terrifying, and you probably know the many times those estimates were revised downwards.  Neil Ferguson, professor of mathematical biology at Imperial College London, predicted millions would die in the “best-case scenario.”  As FEE points out, Neil Ferguson said in 2005 that up to 200 million might die from bird flu worldwide.  About 100 did.  Not 100 Million; 100. A bit too much reliance on models that aren't too accurate.

Similarly, Infection Fatality Rates were pegged in the 3 to even 5% rate.  In reality, no study I see says it's over 1%.
"The current best estimates for the infection fatality risk are between 0.5% and 1%," says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security.
With all due respect to Dr. Rivers, Dr. John P. Ioannidis published work last week reporting:
Infection fatality rates ranged from 0.02% to 0.86% (median 0.26%) and corrected values ranged from 0.02% to 0.78% (median 0.25%). Among people under 70 years old, infection fatality rates ranged from 0.00% to 0.26% with median of 0.05% (corrected, 0.00-0.23% with median of 0.04%).
Among people under age 70, a median Infection Fatality Rate of 0.04%  The horrific death rates from New York Generalissimo Cuomo shoving patients with Covid-19 infections into nursing homes can really skew those numbers.

The main thrust of Dr. Ioannidis' paper is that the lockdowns were - at best - unnecessary, and could have done more harm than good.   This is a theme coming out of research all around the world and that I reported on a month ago (almost to the day).  Marko Kolanovic, a physicist and strategist for JP Morgan, pointed out that a majority of nations saw declines in infection rates after the lockdowns were lifted.


As I said in that post a month ago, early on when people first started talking about this virus, before the lockdowns, before much information was out, I pretty quickly concluded that eventually everyone other than the very few people living hundreds of miles from human contact will get the virus and develop antibodies to it.  Some people, obviously, will die and every death is a tragedy.  Thankfully, it looks like well over 99% will recover from it just fine.
Early on in the spread of the disease, it was pretty easy to come to the conclusion that eventually everyone on earth will be exposed to this.  It's a new virus, and new viruses jump from animals to humans pretty regularly; it's simply how the world works.  I don't have strong numbers to base this on, but I believe the nationwide downward trend in new infections will continue downward, this numbers guy says the worst of the epidemic is over, but the virus will be back next fall.  It's my understanding that coronaviruses, as a group, are hard to create vaccines for.  The common cold is one of many such viruses that we're always exposed to, for example, and there's no good vaccine for the common cold, right?
EDIT: 6/17/20 7:38 AM - I left out a link to my old post, which has a very worthwhile graphic as well as background info.



20 comments:

  1. I still concur with Glen Reynolds theories: "So here’s a thought: What elevated this in my mind from “oh, the annual rumors of a new disease outbreak in China” to “holy crap, better pay attention” was the Chinese government’s own rather dramatic response. Hypothesis: They knew it had leaked from the lab, but weren’t sure yet which infectious agent had leaked from the lab, hence the dramatic response, more appropriate to a much deadlier disease. Second hypothesis: From this, we can assume that there is a worse infectious agent in that lab. Or at least that there was."
    Day by day we acquire more evidence of the efficacy of Hydroxychloroquine/Zinc as treatment with vitamin D as an important adjunct. This morning had a story about Dexamethasone as steroid to mitigate the cytokine storm which is the real killer for many of the small susceptible population.
    My only risk factor is age (67), but if I get even a hint of symptoms this fall and winter, I know how I'm going to be treated even if I have to doctor shop and raise holy hell to get it. Even if there is a vaccine released, I won't touch it until it gets a good deal of qualified results published.

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    1. One of the more interesting things I ran across was just how big an influence Vitamin D levels were just by themselves. I have a graph in an old post (which I see I forgot to link to). Having a vitamin D deficiency (less than 20 ng/ml) made the odds of surviving the virus 1/10 of those with normal levels (more than 30 ng/ml).

      My only risk factor is also age. I'm out in the sun for an hour several times in a week, so while my Vitamin D levels should be good, I've never had them checked and we do get worse at making D as we age.

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    2. Until I retired, I worked in medical technology. In just the past ten years we've seen testing for vitamin D go from rare, a couple requests per week exploding to hundreds per day in just our hospital lab. Something in medical literature sparked that; I'm not sure what or when but it was long before the Kung Flu.
      As a supplement, vitamin D is dirt cheap, hence big pharma has little interest in it. Unlike vitamin C, it can be overdosed, so don't go nuts eating it. Tidbit: It's the reason polar bear liver is toxic to humans: the insane levels of vitamin D in it.

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  2. They built a Potemkin Village and want us all to live in it as if it's real. True, people have died, and will continue to die as they do with any bad flu. The political drama continues and the progs hope that we all play along.

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    1. I keep telling myself that it wasn't really crazy to do a shutdown when we knew nothing about this virus, but it really was an epic overreaction. Historically, haven't we've always isolated the people with the disease or those most susceptible? That's much more like Sweden or here in Florida than most places.

      The mayor of El Lay says they might not reopen until there's a cure. Depending on how that's defined, he could mean never.

      As long as the thing they measure is the number of cases, and nothing about the suicides, people dying at home out of fear of going to the hospital, or any other effects, they'll miss the big picture.

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  3. Given the current political atmosphere. Of both sides lying through their teeth on a daily basis...I'm inclined to go ahead and just stay away from crowds.

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    1. Spud, I'm always that way. For me, going out in a crowd is the grocery store in the workweek at mid-afternoon. It's about as empty as they get.

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  4. All of the models were based on the hospitals being overwhelmed and there not being enough beds for all of the people who would need them. Since we pretty much shut down the country, infection rates plummeted, and the hospitals weren't overwhelmed.

    It's kind of like being saved by a seatbelt, and then saying we didn't need to wear the seatbelt because the car accident didn't kill you.

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    1. The counterargument is the places that didn't shut down, and the strong similarity between the progression of the pandemic in places that didn't shut down and those who did or places that shut down differently.

      I link to several papers in the previous post;
      https://thesilicongraybeard.blogspot.com/2020/05/some-virus-stories-that-have-grabbed-my.html

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    2. Look at the timing, and look at the population density. You have to compare like and like.

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  5. I think if you assume that it was out and about in November or December it explains the similarity between locked and unlocked reactions.

    We locked down in March. Three or four months too late if the Nov-Dec start of community spread is true.

    Considering how large a percentage of people who contract the disease are completely without symptoms...

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  6. 1) Anything with Ioaniddis' sticky fingerprints on it regarding COVID is like reading the NYTimes discussing Trump, and expecting an honest dealer of information. He and Fauci are like Waldo and Odlaw. Caveat lectorum.

    2) If this isn't any bigger thing than annual flu, explain everyone's lying eyes, as NYFC was up to its neck in dead bodies (exactly like happens there during every flu season...NEVER). I'll wait.
    BTW, putting it in convo homes doesn't make more people die, because virulence and mortality aren't malleable. It just ensures they'll get it and die sooner than with normal patterns of pandemic spread.

    3) Now explain how that worked for Nawlins, which helpfully didn't, AFAIK, do the same "let's jam COVID-sick people into convo homes" trick NYFS did.

    4) The states that did nothing were distant from the early infection.
    A far better explanation is that this never spread to more than a few percent of the population because of lockdowns (WY, for example, was probably less than 0.5% penetration of population), except in COVID petrie dishes which never actually locked down, like NYFS, which might have had a 10% infection penetration rate, given they ran the subway daily, and didn't even ponder disinfecting it each night until 80 days into things (DeBlasio genius, right there).

    5) Explain, please, how any lockdown makes casualties worse. I really want to hear that one broken down.

    6) Forced to rely on my own lying eyes, rather than people on both sides of this cherry-picking the stories that confirm their respective prejudices, I can tell you it isn't getting any better in SoCal, and it's still killing people quite reliably, and both of them far more frequently and virulently than any flu I've ever witnessed professionally, but I'm not 110 years old, so it's possible Spanish Flu was worse than this on an individual basis.
    The people I've seen this kill from a full-blown symptomatic presentation died within 36 hours of hospital admission. (I'm talking about the ones who get severely sick, which is still a single-digit function of the whole number infected.)

    7) A vaccine may or may not happen, but until it does, it's made of equal parts hopeium and unobtanium.

    8) If the rest of the country is acting like NV and AZ are currently (Masks? For what?), this is going to come roaring back. And L.A. is working very hard at becoming NYFC II, because NYFC levels of both official and general stupidity. OTOH, if we'd gone with universal masking (IF we'd had adequate supplies and virus testing at the outset, which we didn't have in either case) and simple handwashing, we could probably have skipped any lockdowns. As it is, the Gilligan Effect is still likely going to kill twice as many people by year's end as lockdown COVID did in the initial 90 days.

    9) Silver lining: Residual blowback from the people who do distance, mask, and handwash might at least get us one of the mildest flu seasons in decades this fall. And long term, the Social Security/Medicare bankruptcy dates may get pushed back a decade or more.
    Bummer about all those dead grannies and grampas though.

    10) I make the exact same amount no matter what happens with this.
    My unsubstantiated hunch about everything that's transpired since the initial outbreak could be explained by rigorous and relentless application of the central question: "cui bono?".

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    1. Not sure I have the room to go through this but:

      1. Just as it's sloppy thinking to automatically accept a paper from someone because they were right before, it's sloppy thinking to automatically reject a paper from someone because they were wrong before. Nobody who has done more than one paper has published without being wrong. Always go on the merit of the research itself. By all means, though, go with Dr. Caitlin Rivers 0.5 to 1.0%. I've seen several other authors saying 0.25 to under 0.1%, though. Ioannidis isn't the only one.

      2. Show me the line where I said this was just like the annual flu or a cold, and while I'm waiting I'll explain why "NYFC was up to its neck in dead bodies". The answer is simply that the reason it was worst in the nursing home is because that's where you find the population most likely to die from the disease. If those people were out walking around, they would have gotten it that way and still died at higher rates. The catch is one of the conditions that lead to high mortality is the inability to be out and walking around.

      3. I'm perfectly willing to say "I don't know" - I haven't read much on Nawlins.

      4. I live in a state with a bigger population than New York, but that isn't concentrated in one cesspool, um, city. Our state tried to protect the most likely to die and do as little as necessary to the rest. The media is (predictably) going nuts because the increase of testing is leading to more cases being discovered. Meanwhile hospitalizations and deaths are both decreasing, so IFR and CFR are both going down.

      5. One of the first guys who did the numbers on that was asked that same question. That was Dr. (as in Professor, not M.D.) Yitzhak Ben Israel of Tel Aviv University, who also serves on the research and development advisory board for Teva Pharmaceutical Industries. His answer was great: "I have no explanation. There are all kinds of speculation: maybe it's climate-related, maybe the virus has its own life cycle". The only thing better he could have said was, "Dammit, Jim, I'm a mathematician not a virologist"

      The way I understood them saying the lockdowns may have made casualties worse was a few things. First, families locked down having someone get the virus and bring it home, giving it to someone in the home with worse metabolic health. That would have been less likely had they not all been locked up together. Second would be the things nobody is counting, like how many people are dying at home who likely would have been saved in an ER, but were too afraid of hospitals to go. Or how early stage cancers are not being found now because people aren't going to their doctor or aren't getting scans or biopsies because of the hospitals being reserved for Covid patients and blocking elective procedures. Or how suicides are up because of the social agony it's causing.

      6. One of the biggest problems I have is the data are absolute shit. We have the Fed.gov financially incentivizing reporting everything as Covid related, since February. If all you ever count is the number of cases that's all you'll ever know. Just the other day, Comrade Deblasio said no one was allowed to ask new cases if they were in the protests/riots, so we will never know if that lack of social distancing causes more transmission.

      Did it ever occur to you that the population you're seeing may not be statistically normal but rather skewed to the most sick people there are? If I was designing an experiment to see the effects population wide, yeah, I'd have some ER input, but I'd also look pretty much every place else, too. I live in a county with a population of about 600,000. Just this week, with the increased testing, we crossed 0.1% of the population. What's the chance of crossing paths with one of those 0.1%? Of the roughly 20 people I talk with regularly, nobody has gotten it nor has anybody else they cross paths with.

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    2. 7. Vaccines: don't hold your breath. My gut feeling is that it probably won't happen.

      8. The rest of the world seems to indicate that hand washing is the most valuable thing we can do. Since the WHO reverses their position on anything they say within 24 hours, and our own Exalted Leaders have been proven to lie about it, I don't think I know what the real data on masks is. The fact that some cities require them and others don't means nothing to me. I'm old enough that when I took an undergrad virology class, viruses were said to pass through any filter. Which would say a mask might stop liquid droplets, but not keep individual virus particles out.

      10. It's very easy to see a train of thought that leads to this entire thing being the attempted destruction of Trump. This is all tin foil hat stuff.

      China is pissed about tariffs and relentless "America First", so they release a virus to cripple our economy. Democrats/press see it as a follow on to impeachment. They figure "the strongest thing Trump has going for him is the economy so let's destroy that. Let's weaken him to the point the people will elect a Democrat." Does the condemnation of a Trump rally in Oklahoma contrasted with praise for rioters in every big city and attempts to make sure spread of the virus can't be associated with the riots/demonstrations fit here?

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  7. 1. The problem with Ioaniddis isn't that he's right or wrong, it's that he comes to the table with a pre-ground axe to pooh-pooh the virulence and fatality rate of the virus, and hasn't been shy about using any dopey-ass methods that come to hand to try and make that point, science be damned. He is not an honest dealer. Ever. Period. Falsus in unum, falsus in omnibus.

    2) You didn't do any such thing. You quoted Ioaniddis doing it, when he places the CFR at and below 0.1%, the CFR of annual flu since ever. And I get the nursing home problem; I see those trainwrecks every day. Even discounting the half of fatalities in NYFS in those locations, they still had a full 1/6th of all fatalities nationwide, all from among those others not invalids in convo homes, the very ones "out and about", which is overwhelmingly likely how they caught it in the first place.

    3. Briefly, they had fatality numbers per capita very like NYFC, except from among those who went out and played in Early COVID Mardi Gras (Instant Stupid = Just Add Alcohol). Once again, being out and about, and not locked in as invalids. This yet again points out that placing the virulence and mortality of COVID tantamount to annual flu is simply recockulous, and even without convo home fatalities to drive the bus, it was much worse than any version of flu since 1918, if not ever.
    (cont.)

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  8. (cont.)
    4. Infection rates are unimportant to me, until we have tests for "got it" or "had it" that scores above 66% accuracy, and specifically for Kung Flu, versus any generic coronavirus. None of the current testing is even that good, per last reports. That situation is unchanged since January 1st of this year. Hospitalizations and deaths, OTOH, are much harder to fake or misrepresent, since they generally require a body, living or dead, rather than hopeium-fueled pseudo-tests with a vague relationship to actual science. (For reference, if you had 2 chances out of 3 that crossing an intersection on a green light wouldn't result in a collision, who'd try that? You'd get the same odds if Stevie Wonder was your Uber driver.)

    5. First, families locked down having someone get the virus and bring it home, giving it to someone in the home with worse metabolic health. That would have been less likely had they not all been locked up together.
    Nope. More than overcome by the number who aren't out getting it to bring home, and interfamilial transmission is always a given. Circulation is the problem, and lockdowns nip that in the bud. Unless you're in the Gilligan family.
    (cont.)

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  9. (cont.)
    Second would be the things nobody is counting, like how many people are dying at home who likely would have been saved in an ER, but were too afraid of hospitals to go. Negligible. Most people sick enough came in anyways, even if later, and most people don't die. Conversely, numbers of shootings, stabbings, auto accidents, and miscellaneous trauma stupidity, usually a multi-nightly occurrence, absolutely fell off a cliff, for months on end.
    Or how early stage cancers are not being found now because people aren't going to their doctor or aren't getting scans or biopsies because of the hospitals being reserved for Covid patients and blocking elective procedures.
    Possibly an actual factor, albeit minor, but it will take multi-year studies to detect that blip. And I'll freely grant that shutting down routine medical care, from orthodontia to cancer screening, without any regard to that, was and is asinine in the extreme.
    Or how suicides are up because of the social agony it's causing.
    The only relevant study claiming anything like that came to the conclusion that suicides because of societal disruption peaked six months before the disruption. Yes, you read that right; the study concluded disruption caused people to kill themselves in greater numbers (something like 1 in 100,000 more) six months before their lives were disrupted. So apparently, social disruption grants the mentally ill clairvoyance and prescience enough to see them coming, and kill themselves, in numbers slightly higher than the number of times a year police officers shoot unarmed black men just for being black.
    No points for guessing W.H.O. funded and published that crock of horsesh...er, rose fertilizer.
    I call b.s. on the whole idea that increased suicide is even a statistically significant thing, based purely on all available evidence.

    I'm open to anyone with actual evidence that lockdowns increased deaths in any significant way.
    Stress? Yes.
    Financial woes? Hell yes.
    Death? Not so much.
    (cont.)

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  10. 6. I absolutely interact with the sickest (and/or stupidest) subset of the general population.
    So, you weren't clear: in your county, are you saying 0.1% have been tested, or 0.1% found to be positive, or 0.1% actually infected?

    And yes, the numbers are shit, coast to coast, for a host of reasons.
    1) the CDC couldn't find its own ass with both hands, a map, a mirror, and anatomical landmarks marked in Sharpie and yellow highlighter.
    2) The opposite ends of the political bell curve are either pimping everything to be COVID, or nothing to be so. On the IQ bell curve, those people are all way over on the same left-hand little end.
    QED
    3) As scientists, the media makes Gilligan seem like the Professor.
    That goes triple for most of the hacks with credentials after their names, who haven't worked at patients' bedsides for decades, and remember less about medical school than they do about pre-calculus, let alone basic statistics.

    But regarding crossing paths with, I'll give you an anecdotal lesson in Six Degrees of Bacon.
    I've lived in SoCal a good while; nearly my entire life. There are currently 40M residents, and there were nearly 20M even when I was a youngster.
    Despite that, I illustrate it thusly, with some random examples:

    Number of steps from me to Ronald Reagan: two.
    Number of steps from me to Colin Powell: three.
    Number of steps from me to Charles Manson: two.
    Number of steps from me to John Wayne: two.
    Number of steps from me to Arnold Schwarzenegger: zero.
    Number of steps from me to Cass Eliot or John Phillips of the Mamas and the Papas: two.
    Number of steps from me to Rev. Franklin Graham: three.
    Number of steps from me to the entire original Brady Bunch: one to two.
    Number of steps from me to any member of Star Trek TOS: two, maybe three.
    Really.

    Think about those people, and how many steps from them to nearly anyone else on the planet.

    This is why pandemics pandemic.
    (cont.)

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  11. 8. Viruses don't free-float, fortunately. They hitch-hike in liquid droplets, which is why masks work. If they penetrated like gamma rays, we'd all have died at the outset.

    10. The outbreak was almost certainly accidental. No one releases bio-weapons, because of exactly what's happened.
    The rampant opportunism that followed closely in the wake of that, however, is pure Alinsky 101.
    No tin-foil millinery required.
    Half of everything since the end of January has been "How can we leverage this to de-throne OrangeMan? And destabilize the entire civilization to our own advantage?"

    And the Right-wing moonbats knee-jerk swimming upstream against that throw the baby out with the bathwater, and poured gasoline on the flames of the culture war.

    This thing is scratching everyone's itch except the brighter folks, and there are never enough of them in any group to matter much.

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