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

[JeanTate]

Just to reiterate on vaccines, Dr Fauci - whom I think everyone in this thread would defer to - is confident we will see a vaccine by the end of this year: https://www.vox.com/2020/6/23/21300563/coronavirus-vaccine-fauci-trump-testimony-house

Isn't he one of the guys who said, back in March or so, that there was no evidence that face masks had the effect of significantly reducing person-to-person transmission?

I'm less certain of this: didn't he also say, early on, that there was no evidence that people without symptoms (but who were infected) could infect others?

ETA: ninja'd by SG ...

 

[Skeptic Ginger]

There is a lot of speculating here that there will be a vaccine. Even yourself in this post. I am less confident that there will. I sincerely hope I am wrong, but that is my opinion and it is not your place to tell me I should not post it.

You can post any damn thing you want. I'm pointing out specifically why you are wrong.

And it doesn't have anything to do with whether there will or won't be a vaccine.

 

[Skeptic Ginger]

Isn't he one of the guys who said, back in March or so, that there was no evidence that face masks had the effect of significantly reducing person-to-person transmission?

I'm less certain of this: didn't he also say, early on, that there was no evidence that people without symptoms (but who were infected) could infect others?

Why yes, yes he is. He said both things.

 

[Arcade22]

But that's not the only way to study the role kids might play in spreading the virus. We need to start by looking at viral shedding in asymptomatic infections in children.

No we don't because there's no evidence that children are contagious enough to warrant that kind of study. The authorities have been looking for signs that children could be significant sources of infection, but there's nothing that indicates this at all. If children were contagious to any significant degree it would have been seen by now.

You don't do studies on kids just to confirm what's clear: children are not a significant factor in the spread of this virus.

 

[Skeptic Ginger]

I repost this link because apparently it has been dismissed.

An analysis of SARS-CoV-2 viral load by patient age

Abstract
Data on viral load, as estimated by real-time RT-PCR threshold cycle values from 3,712
COVID-19 patients were analysed to examine the relationship between patient age and
SARS-CoV-2 viral load. Analysis of variance of viral loads in patients of different age categories
found no significant difference between any pair of age categories including children. In
particular, these data indicate that viral loads in the very young do not differ significantly from
those of adults. Based on these results, we have to caution against an unlimited re-opening of
schools and kindergartens in the present situation. Children may be as infectious as adults.

It had a large sample size:

Results
From January to 26
th April, 2020, virology laboratories at Charité and Labor Berlin screened
59,831 patients for COVID-19 infection, 3,712 (6.2%) with a positive real-time RT-PCR result.
We divided patients according to two categorizations to investigate whether there is a
relationship between patient age and viral load. The first categorization is based on ten-year
brackets, ages 1-10, 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90, and 91-100. The
second categorization is based on broad social strata: kindergarten (ages 0-6), grade school
(ages 7-11), high school (ages 12-19), university (ages 20-25), adult (26-45 years), and mature
(age over 45). Patient counts in each age group, and number and percentage of PCR positive
patients are shown in Table 1. A comparison of age stratification in tested cases versus the
Berlin population is shown in Figure A1. Of note, whereas younger age groups have lower
detection rates (Table 1), this does not imply an age-based estimate of infection prevalence
because of mostly symptoms-directed testing. ...

Look at Table 2 showing the viral loads in fluid recovered from the nasopharynx by age groups:

Table 2: Statistics describing the viral load distributions in C1 and C2. The mean, standard
deviation (SD), standard error (SE), 95% Confidence Interval (95% Conf.), and the interval are
shown for the base-10 logarithm of viral load for A) categorization C1 (by age class), and B)
categorization C2 (by schooling/social). KG: kindergarten; GS: grade school; HS: high school;
Uni: University.

Limitation:

Whereas the attack rate in children seems to correspond to that in adults (2), it is obvious that
children are under-represented in clinical studies and less frequently diagnosed due to mild or
absent symptoms.

And what I've been saying:

For instance, the age profile during the
early phase of the outbreak in many European countries makes it difficult to derive transmission
rates from household contact studies. Early transmission clusters were started by travellers of
adult age, making children less likely to be index cases in households (4). Another circumstance
making children less likely to carry the virus into households is that kindergartens and schools
were closed early in the outbreak in Germany These combined effects will cause children to be
more likely to receive rather than spread infections in households for purely circumstantial
reasons. This observation may be misunderstood as an indication of children being less
infectious.

The study was in Germany.

 

[The Atheist]

So "0.2-1.0%" is "within margin of error of 0.5%"?

Now you're conflating different things.

I said that the final IFR will be 0.5%. or "within margin of error" of that number.

The 0.2 - 1% is the consensus opinion, and it happens the 0.5% (which I've mentioned many times previously) is right in that range.

I need a LOT more convincing ...

Not my problem - I don't post to convince people of anything, I just like to look at evidence.

Then there's Vitamin D ... if "the world IFR at the end of Covid looks like 0.5%", Vitamin D won't make any difference, will it?

Yet again, all I'm going to add on the subject is we will know for certain in the future and I'll be happy to admit to being wrong, if I am.

Suggestion: re-read your original post (the one I first responded to), and see how many examples of poor logic you can find. Here's a good example: "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."

I'm not sure whether you're hopeless at arithmetic, or what the problem is, but there's no weakness of logic in what I'm saying - it's backed by a large and growing weight of evidence.

Can you not even understand the simple equations I gave you?

20% (0.2) of x is identical to 2% (0.02) of 10x. Even my 10 year old understands that.

Feel free to show some actual numbers - not from Iceland, Taiwan or Singapore, because cherry-picking countries is absurd.

I could equally point to San Marino, which with 17% of the entire population tested, is showing an IFR of 6%. Everyone panic!

News flash: there are reliable media items galore about people who were sick, with symptoms that resembled those of Covid-19, but who were not tested, so they did not get counted as a Covid-19 "case" ....

I have no idea how you think that has any relevance whatsoever, so do feel free to enlighten me. "News items galore" doesn't cut any mustard.

I recommend you start with filling in the gaps in your knowledge on sheep and work forwards slowly.

 

[JeanTate]

I missed this ...

<snip>

And wrong again - sheep don't grow merino, they grow wool. Merino sheep grow merino wool.

Sensible option to raise sheep incorrectly when the other bloke's a Kiwi.

<snip>

So, you did get it!

"Merino thinking" means "wooly thinking" (or perhaps "woolly thinking"), and the term itself is an example!

(there's an English word for such words, can't think of it just now ...)

 

[Orphia Nay]

[...]
Here's a simple model, for a nasty infectious disease:
- it kills everyone 70 and over, but no one under 70 (except those with condition X)
- it kills all those with condition X (BMI>40, perhaps), but no one else (under 70)

* On Island A ("young, healthy"), everyone is under 70, and no one has X
What is the IFR?

* On Island B ("old, unhealthy"), everyone is 70 or over and everyone has X
What is the IFR?

* On Island C ("young, unhealthy"), everyone is under 70, and half have X
What is the IFR?

* the world comprises Islands A, B, and C only; pre-nasty infectious disease, their populations were equal.
Post nasty disease, what is the global IFR?

Then there's Vitamin D ... if "the world IFR at the end of Covid looks like 0.5%", Vitamin D won't make any difference, will it?

Now we're getting somewhere.

Today I was going to mention islands.

Australia & NZ (Flight/ship entry with quarantine only).
UK (Quarantine only began last week for land entry).

Let's look at other islands and their IFR.

 

[JeanTate]

Thanks.

Now you're conflating different things.

I said that the final IFR will be 0.5%. or "within margin of error" of that number.

The 0.2 - 1% is the consensus opinion, and it happens the 0.5% (which I've mentioned many times previously) is right in that range.

I think you may be conflating "margin of error" with "range" or "variance" (or similar).

Example: country A at time t₁ 11.0±0.1; country B at time t₂ 13.0±0.1. The difference between the two results is real, well outside the combined confidence interval (unless there's a really weird distribution). Combine them, to get a weighted arithmetic mean say (perhaps 12.2), and the range (2.0) is not a margin of error.

Not my problem - I don't post to convince people of anything, I just like to look at evidence.

Indeed.

I wonder who wrote this? "There are other studies going right back to February, so let me know if you need more convincing."

Yet again, all I'm going to add on the subject is we will know for certain in the future and I'll be happy to admit to being wrong, if I am.

Indeed.

Yet you yourself indirectly said it won't have any significant effect.

The IFR, today, is 0.5% (per your two sources). And "the world IFR at the end of Covid looks like 0.5%". So, at some point in the future, the IFR will be ~the same as it is today, meaning that dex, Vitamin D, etc make no significant difference.

I'm not sure whether you're hopeless at arithmetic, or what the problem is, but there's no weakness of logic in what I'm saying - it's backed by a large and growing weight of evidence.

Can you not even understand the simple equations I gave you?

20% (0.2) of x is identical to 2% (0.02) of 10x. Even my 10 year old understands that.

Feel free to show some actual numbers - not from Iceland, Taiwan or Singapore, because cherry-picking countries is absurd.

I could equally point to San Marino, which with 17% of the entire population tested, is showing an IFR of 6%. Everyone panic!



I have no idea how you think that has any relevance whatsoever, so do feel free to enlighten me. "News items galore" doesn't cut any mustard.

<snip>

What %-age of the "90% of cases" that were "never counted" were mild? Asymptomatic? Serious? Severe? We already know that a significant number of those who died of/with Covid-19 have yet to be "counted"*

It seems to me that you are saying ~all the cases which were "never counted" were "asymptomatic or very mildly symptomatic". Are you? If so, cite please.

Note that "never counted" can only be retrospective.

*the first example I can recall is when China made an adjustment in its "deaths", based on a retrospective examination of cases in Wuhan (some time in March?). More recently, New Jersey has added a "probable deaths" category. And I think New York (state) did something similar, in May.

 

[JeanTate]

Now we're getting somewhere.

Today I was going to mention islands.

Australia & NZ (Flight/ship entry with quarantine only).
UK (Quarantine only began last week for land entry).

Let's look at other islands and their IFR.

Dividing the "deaths" by the "confirmed cases" in the WHO situation reports may suggest a possible maximum for IFR (while both are surely under-estimates of actual deaths by/with Covid-19 and Covid-19 infections, the former may be closer to actual).

You have to leave out places with "small numbers", say fewer than 1k cases or 20 deaths.

And you have to make a call re reliablity of the data (Nicaragua, for example, is reporting numbers which are hard to accept; not that it's an island of course).

So, how about this as a preliminary list (no particular order)?
- Australia
- Cuba
- Iceland
- Ireland
- NZ
- Cyprus
- UK
- Madagascar
- Haiti
- Dominican Republic
- Puerto Rico
- Indonesia
- Philippines
- Sri Lanka

 

[Arcade22]

I repost this link because apparently it has been dismissed.

Even when this study was reported by the media its conclusion was not consistent with reports of how people were infected. No one was reporting that children were infecting adults to any significant degree.

Two months later and that has not changed.

 

[The Atheist]

I think you may be conflating "margin of error" with "range" or "variance" (or similar).

Nope - you're still conflating two completely different subjects.

I wonder who wrote this? "There are other studies going right back to February, so let me know if you need more convincing."

Oh, for Zarquon's sake, you asked me to convince you, right here:

I need a LOT more convincing ...

I do find it interesting that people will be so dishonest over such trivial matters.

What %-age of the "90% of cases" that were "never counted" were mild? Asymptomatic? Serious? Severe? We already know that a significant number of those who died of/with Covid-19 have yet to be "counted"*

The age and demographics are utterly irrelevant. Your understanding of simple arithmetic is so lacking that you don't understand what an average is, so I can't do much for you, sorry.

It seems to me that you are saying ~all the cases which were "never counted" were "asymptomatic or very mildly symptomatic". Are you? If so, cite please.

Well, they didn't all die, or cemeteries would have noticed and they didn't go to hospital, so I'm pretty confident in saying they were almost exclusively mild or asymptomatic.

It's funny how that stuff works, eh?

Note that "never counted" can only be retrospective.

Oh, very good! You're going to make it all the way to understanding evidence and maths if you work forward from there.

 

[Orphia Nay]

Islands. Here goes.
Iceland.

On April 3, in Iceland:

https://7news.com.au/lifestyle/heal...half-covid-19-cases-have-no-symptoms-c-950989

“The results of the additional tests performed by deCODE have given an indication that efforts to limit the spread of the virus have been effective so far,” the government wrote last week, adding “testing in the general population will continue to elicit a much clearer picture of the actual spread of the SARS-CoV-2 virus in Iceland.”

Some of the revelations have been stark. Although fewer than 1% of the tests came back positive for the virus, the company’s founder Dr. Kári Stefánsson told CNN that around 50% of those who tested positive said they were asymptomatic, confirming multiple studies that show that asymptomatic, or mildly symptomatic, people have played an important role in spreading the virus.

On April 14, the final study is published:

https://www.nejm.org/doi/full/10.1056/NEJMoa2006100

RESULTS
As of April 4, a total of 1221 of 9199 persons (13.3%) who were recruited for targeted testing had positive results for infection with SARS-CoV-2. Of those tested in the general population, 87 (0.8%) in the open-invitation screening and 13 (0.6%) in the random-population screening tested positive for the virus. In total, 6% of the population was screened. Most persons in the targeted-testing group who received positive tests early in the study had recently traveled internationally, in contrast to those who tested positive later in the study. Children under 10 years of age were less likely to receive a positive result than were persons 10 years of age or older, with percentages of 6.7% and 13.7%, respectively, for targeted testing; in the population screening, no child under 10 years of age had a positive result, as compared with 0.8% of those 10 years of age or older. Fewer females than males received positive results both in targeted testing (11.0% vs. 16.7%) and in population screening (0.6% vs. 0.9%). The haplotypes of the sequenced SARS-CoV-2 viruses were diverse and changed over time. The percentage of infected participants that was determined through population screening remained stable for the 20-day duration of screening.

CONCLUSIONS
In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males. The proportion of infected persons identified through population screening did not change substantially during the screening period, which was consistent with a beneficial effect of containment efforts. (Funded by deCODE Genetics–Amgen.)

This shows what I've been saying all along:

Most people have a mild case, even to the extent of not noticing it;

Men generally have worse obesity & health than women and children which affects COVID-19 symptoms severity;

Islands can contain the virus' spread within from external increases.


Did Iceland impose strict social distancing, cleanliness, lockdown, etc?

In the conclusion, a non-sequitur:

"The proportion of infected persons identified through population screening did not change substantially during the screening period, which was consistent with a beneficial effect of containment efforts."

People kept getting infected within the island, despite containment efforts.

 

[The Atheist]

I see the numbers out of Aussie aren't very encouraging - 81 cases reported today.

(I wouldn't be at all surprised if we end up in that boat in the next week or two)

 

[arthwollipot]

I see the numbers out of Aussie aren't very encouraging - 81 cases reported today.

(I wouldn't be at all surprised if we end up in that boat in the next week or two)

Mostly in Melbourne. The rest of the country is doing pretty well.

 

[rjh01]

Mostly in Melbourne. The rest of the country is doing pretty well.

Big problem is that it might spread to the rest of Australia. It only takes a few people to go to Melbourne, get the virus and then go home. They each spread it to several people and they each spread to several other people before it is detected. By then it will be almost too late to contain it by any method other than another lockdown. This is what has happened in China recently.

It could also spread if a few people, from Melbourne, with the virus, have an interstate holiday. The effect would be the same. I also also seeing the numbers increase in NSW, but only slowly. In Victoria they are doubling every week and have been since the end of May. In the last fortnight there have been a total of 308 new cases in Victoria.

Edit https://www.theguardian.com/world/l...08a9bfb6232fec#block-5ef940f88f08a9bfb6232fec

Victorian authorities are updating that situation now – but 75 new cases in the last 24 hours

More detail here https://www.theguardian.com/world/2...ired-cases-recorded-in-highest-daily-increase

 

[Steve]

You can post any damn thing you want. I'm pointing out specifically why you are wrong.

[/HILITE]And it doesn't have anything to do with whether there will or won't be a vaccine[/HILITE].

My sole point is that I am pessimistic that an effective and practical vaccine will be developed in a timely manner. My opinion is based on two things:
- a successful vaccine has not been developed for any other coronavirus.
- recent evidence that antibodies developed by those infected fade in a time frame of months.

Conversely, those posting here that are optimistic about the development of a vaccine seem to be relying solely on optimistic statements from the vaccine developers, and not on any actual evidence.

Yes, I am speculating. The vast majority of posts in ISF are speculation. If everyone here stopped speculating and offering opinions based on inconclusive information the Forum would quickly die from lack of interest.

I have already conceded that my comparison to functional medical aspects of flu vaccines likely wrong so you do not need to keep harping on that. I was looking at how the flu vaccine is an annual event and thinking how practical a vaccine that needs to be repeated every 6 months or so would really be.

 

[alfaniner]

The new thing being pushed is that masks may actually help protect you from getting the virus. That was the original push for wearing masks in the first place! It had evolved that they said you should wear a mask to protect others from getting infected by you.

ffs, just wear a mask!

 

[JeanTate]

Once more ...

<snip>

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%.

<snip>

my hilite

That's nonsense, of course.

Per the US CDC (source): "The prevalence of obesity was 42.4% in 2017~2018. [Read CDC National Center for Health Statistics (NCHS) data brief]" The context is adults. For children, per the CDC (source) "Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds." And here's the study these results are from: Prevalence of Obesity Among Adults and Youth: United States, 2015–2016.

But hey TA, maybe you can cite a reliable source which concludes that "98% of Americans are obese"?

 

[Trebuchet]

I see the numbers out of Aussie aren't very encouraging - 81 cases reported today.

(I wouldn't be at all surprised if we end up in that boat in the next week or two)

More than 100 times that in Florida alone yesterday. 40,450 in the USA, on a Sunday, when reporting is usually lower. Very bad news.