Cont: The One Covid-19 Science and Medicine Thread Part 2

[JeanTate]

Thanks.

This is a very good point.

I've looked for studies that explore variations in how people are characterized as symptomatic or not. This really isn't that hard a study to do and might yield better info on Covid-19 effects.

Who doesn't wake up and perhaps cough? Symptoms are quite nebulous and frankly, pretty common. I sneeze about half the time after I eat. And sometimes I'll cough a bit non-productively. But it's just something I've always done as long as I remember.

The NYT article gives at least one concrete example of how an incomplete picture can create a misleading conclusion.

If a test is positive (and not a false positive) and - later - there are symptoms, you need to associate the two/three records (same patient). Simple, right? But what if the “later” symptoms are “too late” (patient already recovered, screen didn’t probe symptom history carefully enough)?

In the NYT article, the carrier initially thought nothing of the symptoms, just like her usual jet-lag and job stress. For her, they did develop into far more easily recognized covid-19, but what if they hadn’t?

Etc.

 

[Arcade22]

It is almost 2 months old so there might be better research by now. I'm not buying the assertion teachers in Sweden aren't getting COVID 19 without some actual research.

No one has said that they are not getting infected. It's about how common it is.

Day-care, preschools and primary schools were never closed here in Sweden and even in regions where there has been widespread infection there's absolutely nothing to suggest that teachers are at any significantly higher risk of being infected. If there were at a notably higher risk of infection it would have been obvious at this point since it has been months.

Studies have been done by the public health agencies in Norway and Denmark where they concluded that closing their schools had no significant impact on the rate of infection.

 

[Fast Eddie B]

And as I said, 80% of cases are mild.

The point has been made that “mild” is relative.

You can be sicker than you’ve ever been, maybe even hospitalized, and still be classified as a “moderate” case.

From the University of Oxford, re: Covid 19:

Mild or moderate cases were generally defined based on less severe clinical symptoms (low grade fever, cough, discomfort) with no evidence of pneumonia and not requiring admission to ICU. However, some studies included people with pneumonia or respiratory tract infections as mild cases, as long as they did not develop ARDS, organ failure or have an ICU admission.

 

[Skeptic Ginger]

No one has said that they are not getting infected. It's about how common it is.

Day-care, preschools and primary schools were never closed here in Sweden and even in regions where there has been widespread infection there's absolutely nothing to suggest that teachers are at any significantly higher risk of being infected. If there were at a notably higher risk of infection it would have been obvious at this point since it has been months.

Studies have been done by the public health agencies in Norway and Denmark where they concluded that closing their schools had no significant impact on the rate of infection.

Blah blah blah.... How about some actual evidence?

 

[Orphia Nay]

You wouldn't want to expose thousands of kids to the virus, however, without concern for the small number that do experience life threatening disease. There's no way to know if your kid will be the one that is the exception.

There is definitely concern.

I'm also suspecting that we will probably all get the virus before there are any vaccines.

 

[Orphia Nay]

The point has been made that “mild” is relative.

You can be sicker than you’ve ever been, maybe even hospitalized, and still be classified as a “moderate” case.

From the University of Oxford, re: Covid 19:

Mild or moderate cases were generally defined based on less severe clinical symptoms (low grade fever, cough, discomfort) with no evidence of pneumonia and not requiring admission to ICU. However, some studies included people with pneumonia or respiratory tract infections as mild cases, as long as they did not develop ARDS, organ failure or have an ICU admission.

It's all on a scale.

But you're choosing the most extreme of the most extreme.

 

[Arcade22]

Blah blah blah.... How about some actual evidence?

I'm sorry but if you are just going to dismiss the actual evidence I gave you and then ask for evidence I'm not going to bother.

 

[Skeptic Ginger]

There is definitely concern.

I'm also suspecting that we will probably all get the virus before there are any vaccines.

I sure as hell hope I don't because it's likely to be a death sentence for me.

BTW, are you getting better?

 

[Skeptic Ginger]

I'm sorry but if you are just going to dismiss the actual evidence I gave you and then ask for evidence I'm not going to bother.

What evidence?

By all means tell me what post it was in.

 

[The Atheist]

Blah blah blah.... How about some actual evidence?

Jeez, a little more snippy than necessary, I'd have said.

There's this one, about child infectiousness in general: https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.15371

Or, the Swedish government stats which show that teachers are no more likely than other adult groups to catch Covid, and far lower than some employment categories.

https://www.thelocal.se/20200625/st...represented-in-swedens-coronavirus-statistics

 

[The Atheist]

There is definitely concern.

I'm also suspecting that we will probably all get the virus before there are any vaccines.

I'm going to say the opposite. All the news on vaccines to date has been very positive, the stability of the virus says it should work well, and I reckon we're six months from the first vaccine being available.

The science looks pretty good, the production facilities are past ready to go, with some in production in hope, and I think quite a lot of countries* will keep the foot on M. Covid's throat until vaccination can be achieved.

This is probably why we should keep trying. We're already ~$15T in the hole, be a bit silly to waste it all.

*Not including every country other than Canada from the entire Americas.

 

[Orphia Nay]

I sure as hell hope I don't because it's likely to be a death sentence for me.

BTW, are you getting better?

I was better 5 days after it started, back in Mid-March.

I hope you don't get it.

I'm going to say the opposite. All the news on vaccines to date has been very positive, the stability of the virus says it should work well, and I reckon we're six months from the first vaccine being available.

The science looks pretty good, the production facilities are past ready to go, with some in production in hope, and I think quite a lot of countries* will keep the foot on M. Covid's throat until vaccination can be achieved.

This is probably why we should keep trying. We're already ~$15T in the hole, be a bit silly to waste it all.

*Not including every country other than Canada from the entire Americas.

I do hope we get a vaccine quickly. Last week I was saying we would soon.

I've been listening to a lot of doomsayers (not antivaxxers) who are scared of any new vaccine and say new ones take 3-5 years to test properly.

Meanwhile I'm happy to be a test subject. I had antibody testing done this week.

I think people tend to look at the prognosis of the situation from their own position.

SG from a position of certain death.

Me from a "we'll all get it, I did easily and was OK".

Between all of us, there is some useful data.

Not sure anyone can have an objective overall analysis.

 

[marting]

Thanks.


The NYT article gives at least one concrete example of how an incomplete picture can create a misleading conclusion.

If a test is positive (and not a false positive) and - later - there are symptoms, you need to associate the two/three records (same patient). Simple, right? But what if the “later” symptoms are “too late” (patient already recovered, screen didn’t probe symptom history carefully enough)?

In the NYT article, the carrier initially thought nothing of the symptoms, just like her usual jet-lag and job stress. For her, they did develop into far more easily recognized covid-19, but what if they hadn’t?

Etc.

Great article Jean.

It captures the ambiguity of when a mild case of feeling just a bit off rises to the level it would be characterized as a symptom. Also interesting is the palpable fear that pre-symptomatic transmission might be material. I can see the bind governments were in. It just was not something they wanted to hear so went with what they hoped was the case.

But then hope is not a plan.

 

[Orphia Nay]

Thanks.


The NYT article gives at least one concrete example of how an incomplete picture can create a misleading conclusion.

If a test is positive (and not a false positive) and - later - there are symptoms, you need to associate the two/three records (same patient). Simple, right? But what if the “later” symptoms are “too late” (patient already recovered, screen didn’t probe symptom history carefully enough)?

In the NYT article, the carrier initially thought nothing of the symptoms, just like her usual jet-lag and job stress. For her, they did develop into far more easily recognized covid-19, but what if they hadn’t?

Etc.

I only noticed 4 main symptoms because I am normally 100% fine.

These ones I never have:

Sore/croaky throat
Headache
Stomach upset
Aches and pains.

I didn't even notice the fever until I was at the testing station because of being surprised I had 3 of those symptoms, and was told I had a fever and the virus, on March 20.

 

[rjh01]

<snip>

I do hope we get a vaccine quickly. Last week I was saying we would soon.

I've been listening to a lot of doomsayers (not antivaxxers) who are scared of any new vaccine and say new ones take 3-5 years to test properly.

Meanwhile I'm happy to be a test subject. I had antibody testing done this week.

If you already have had the virus then there will be no point in giving you the virus other than to test its safety on people who already have had the virus.

There is always a % of people who get a vaccine, but never develop immunity to whatever. Then because they are testing they will deliberately give a fake vaccine (placebo) to some people. Then to all these people they deliberately give them the virus. If you have not been given a good vaccine then you will get the virus. Some people take months to recover. And that is even assuming you are healthy to start. They may give the vaccine to unhealthy people just to prove it works in this type of person. This even assumes that the vaccine works.

The above is not standard practice. They normally do not give people the virus, they just wait to see if these vaccinated people get it over a year or two. But in this case, doing this will cost many lives.

The above has been discussed in this thread.

 

[marting]

Official CDC list of Covid-19 symptoms that are commonly caused by lots of other things.

Fever or chills,
cough,
fatigue,
muscle or body aches,
headache,
sore throat,
congestion or runny nose,
nausea or vomiting,
diarrhea,

Most of these are not yes/no symptoms but have wide ranges that might not even be noticeable unless pointed out. And some of them afflict a lot of us regularly. Most people cough from time to time or is it just "clearing your throat" Muscle aches? Fatigue? I suffer fatigue every night when I go to bed. Or is fatigue not the same as being tired?

There are ways to calibrate symptom reporting. For instance using interviewers that don't know whether the patient being interviewed is positive or negative or is even a suspected contact. Add in randomly selected people. Gather statistics on the differences. Calibrate interviewers as each one may inadvertently, and innocently influence answers.

It's astonishing how non blinded testing can skew things. Facilitated Communication being a classic.

 

[Skeptic Ginger]

Jeez, a little more snippy than necessary, I'd have said.

There's this one, about child infectiousness in general: https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.15371

Or, the Swedish government stats which show that teachers are no more likely than other adult groups to catch Covid, and far lower than some employment categories.

https://www.thelocal.se/20200625/st...represented-in-swedens-coronavirus-statistics

I was snippy because I had asked more than once and got the same answer, arcade22 says so.

Re the first link:

We identified 700 scientific papers and letters and 47 full texts were studied in detail. Children accounted for a small fraction of COVID-19 cases

We know that. And the kids with mild cases were not being detected for multiple reasons.

and mostly had social contacts with peers or parents, rather than older people at risk of severe disease.

Unless I'm reading that wrong that's saying the kids weren't visiting grandma.

Data on viral loads were scarce, but indicated that children may have lower levels than adults, partly because they often have fewer symptoms, and this should decrease the transmission risk.

And the reason the data is scarce is because kids have yet to be studied for early viral shedding.

Household transmission studies showed that children were rarely the index case and case studies suggested that children with COVID-19 seldom caused outbreaks. However, it is highly likely that children can transmit the SARS-COV-2 virus, which causes COVID-19, and even asymptomatic children

That children were rarely the index case can be explained by the circumstances this virus was spreading person to person. Adults were spreading it to adults.

It's like saying the kindling on that side of the forest isn't a hazard because the fire spread in the kindling on this side of the forest and we haven't seen any fire over there yet.


People in this thread are looking at the data and drawing all sorts of conclusions that make logical sense. I've said it before, we don't have any thorough epidemiological evidence. We have bits and pieces.

You don't know the role kids play because the pandemic did not run the usual course. This virus spread out from China, probably starting in late 2019. It was spotted so to speak, and at that point a lot of people went into lockdown. Kids have been home from school.

Normally a virus would begin spreading in a community unnoticed. Kids get infected then spread it to classmates who go on to spread it to their parents who spread it further in the community.

That no "super-spreader events" have originated in schools can't be said to mean it won't or can't occur. it could have gone unnoticed. How many people are infected who cannot identify the source of the spread? The majority of those infected.

Now take the fact bus drivers are infected at a greater rate in Sweden than teachers. It's a no brainer to an epidemiologist. Bus drivers are exposed to many different people, mostly adults. Teachers are exposed to kids, and few adults.

It looks like a slam dunk, kids aren't spreading it. But there are other variables not being considered, mainly where are the kids being infected, if they are? How long are they shedding virus? Are teachers exposed to single classes so that the virus is only going to spread one classroom at a time?

Are their parents staying home, protecting the family? While older teens and young adults go out partying without social distancing, getting infected at higher rates? Because apparently older kids are spreading the virus.

Super-spreader events are occurring at bars and restaurants, meat-packing plants, nursing homes, cruise ships, travel from places having lots of cases, and you can bet that Trump's rallies are going to be found to be super-spreader events in the next couple weeks.

It may very well turn out kids only shed virus for short periods of time. Maybe we haven't seen widespread children infected yet, not because they are immune, but because they've yet to be exposed en masse.

I'm looking at the evidence. I have a bit of experience with epidemiology. I've only been working in this field for 30 years.

It may turn out kids are immune, not spreading it, no problem. I'm not ruling that out. But I am speaking up that there are variables involved that we don't know yet.

You have to have a large, representative sample in order to look at all the variables and pin down the ones that matter.

But you all carry on. Just saying where I'm at here.

 

[Skeptic Ginger]

Great article Jean.

It captures the ambiguity of when a mild case of feeling just a bit off rises to the level it would be characterized as a symptom. Also interesting is the palpable fear that pre-symptomatic transmission might be material. I can see the bind governments were in. It just was not something they wanted to hear so went with what they hoped was the case.

But then hope is not a plan.

This is a good description of the problems so far reading the tea leaves.

 

[Orphia Nay]

If you already have had the virus then there will be no point in giving you the virus other than to test its safety on people who already have had the virus.

There is always a % of people who get a vaccine, but never develop immunity to whatever. Then because they are testing they will deliberately give a fake vaccine (placebo) to some people. Then to all these people they deliberately give them the virus. If you have not been given a good vaccine then you will get the virus. Some people take months to recover. And that is even assuming you are healthy to start. They may give the vaccine to unhealthy people just to prove it works in this type of person. This even assumes that the vaccine works.

The above is not standard practice. They normally do not give people the virus, they just wait to see if these vaccinated people get it over a year or two. But in this case, doing this will cost many lives.

The above has been discussed in this thread.

Yes, I know.

If the antibody test shows I have not had it I can still be a test subject.

 

[The Atheist]

Not sure anyone can have an objective overall analysis.

I don't think that's too hard, actually and I've tried so hard to be objective that some people accused me of wanting a pandemic at the start.

There's enough evidence now that we can be fairly sure that age, morbid obesity and hypertension are the big dangers.

We can be fairly sure the IFR will be within margin of error of 0.5%.

We are very sure that 90% of cases are never counted, which means that it's not 80% of disease that's mild, it's 98% are asymptomatic or very mildly symptomatic. Given that 98% of Americans are obese, it shows that it's not that deadly, because they're holding to the 0.5%.

Within that 25 of severe illness, an unknown - but very small - number of younger people end up with a debilitating and long-lasting disease, for reasons also unknown. Or die.

All those numbers are small, but the problem is that when everyone gets it at the same time, it screws health systems big time, leading to the unenviable situation of triaging for death. We can increase the size of ICUs all we like, but ya gotta have people to staff them.

If you don't mind saying, what blood type are you?

It may turn out kids are immune, not spreading it, no problem. I'm not ruling that out. But I am speaking up that there are variables involved that we don't know yet.

I agree, and I wouldn't say kids aren't spreading it, but the evidence appears pretty solid that they're an insignificant vector.