Cont: The One Covid-19 Science and Medicine Thread Part 4

[Aridas]

And I would argue that those deaths are due, directly or indirectly, to Covid.

Perhaps. I did make it clear that Covid is relevant and linked to the situation there. Yet, at some point, one needs to draw a line for practical purposes. Direct death significantly due to Covid is one thing. Death where covid's lasting after-effects contributed is another, but there's a somewhat clear rationale for grouping it together with direct damage. Death where COVID had no direct or lasting effects that matter to the cause of death, on the other hand, should not be mixed in with that, especially in a medical context like you were invoking. While COVID may not be irrelevant in every sense, it is in the normal usage for how cause of death is determined. One could easily blame politicians and propagandists messing up the response to COVID very badly, rather than COVID, among a myriad of other reasons, all of which are potentially true enough, but once we're into behavior of large populations territory, things get murky and difficult to properly show with all the factors that affect behavior of populations in various ways. Hence, if one didn't get screened for cancer for whatever reasons and later dies of cancer that could have been caught and handled, the cause of death will be cancer, not the whatever reasons that only might have affected behavior in that case.

 

[dann]

However, I recently saw that COVID-19 is now mentioned in some places in the USA when coronary deaths are assumed to be due to the sequelae of COVID-19 infections.

I don't know if it is "clearly not Covid related". It could well be, to some extent.

That said, the question is whether or not it is from acute Covid infections, which I think it probably is not, and long-term after effects of Covid, which it could be.

The approximate number of registered and reported (!) COVID-19 deaths in the UK in recent months:
April: 2,200
May: 1.200
June: 106 (not one single death reported to Our World in Data since June 11!)

The approximate number of C-19 deaths in Denmark (still registering and reporting), in comparison:
April: 160
May: 150
June: 50 (17 deaths from June 11 to June 30; latest registered deaths on July 4)

Our World in Data, April, May, June 2023:
Daily new confirmed COVID-19 deaths
Cumulative confirmed COVID-19 deaths

It is obvious that many countries have stopped reporting their numbers. I don't know if they still register those numbers somewhere.
The Atheist, much like Clutch Cargo during the first year of the pandemic, now pretends that the apparent zero C-19 death toll in many countries reflects reality. See posts 2,991 and 2,996.
Whatever it takes to make the pandemic look innocuous.

 

[dann]

The fact remains that the excess deaths in 2023 is below the number of excess deaths in 2015 and 2018.

Clearly, it's not covid related. The numbers from 2020, when there were a hell of a lot of covid deaths is a guide, but feel free to keep being wrong.

And yet excess deaths continue even though C-19 was supposed to have weeded out only the 'dry tinder', the people who were going to die next month anyway, the people who were 'already wearing toe-tags'.
If that were the case, one would expect the healthy and strong survivors to prosper and live long and fulfilling lives instead of ruining the excess deaths statistics! Only wussies would let themselves be affected enough by C-19 sequelae to die ...


ETA: New Swedish study!

 

[FatherLukeduke]

And how reliable do you think the data is, given that practically no testing for Covid is being done now? And, if you read the thread,

I found it unreadable, frankly. I reads like drunken rambling and clicking through to the source it reinforces that feeling. The guy was just spamming his own posts with his own replies and so on. It also makes ludicrous statements such as:

Death has become so normalised now, that it’s not even newsworthy anymore.

OK mate.

If it's not Covid, what do you think the excess deaths are due to?

I think it's complicated and will take a long time for experts to get to the bottom of it. Partly it is due to many people not getting diagnosed during the lockdowns - "deaths in private residences" is up significantly, suggesting people are dying of conditions they weren't aware of. Or, and this is another big factor, they are waiting to see a doctor or obtain treatment. Our national health service is in meltdown and waiting lists are at an all time high - I don't think anyone thinks this isn't a contributing factor, apart from maybe a few covid monomaniacs.

We are also a nation with poor public health and this got significantly worse due to a combination of covid itself and changes in lifestyles and mental health due to the the lockdowns. These current excess deaths will become the baseline for future measures.

 

[dann]

Not just during the lockdowns. Many people didn't get diagnosed because hospitals were inundated with COVID-19 patients, and hospitals weren't locked down, obviously. There is no reason to blame the lockdowns for "people not getting diagnosed." Most countries didn't have long and very strict lockdowns. Sweden probably has longer waiting lists for patients waiting to see doctors than the other Nordics, for instance.
It would be interesting to know how many 'people dying of conditions they weren't aware of' die of the now relatively well-known C-19-caused blood clots.

The alleged "changes in lifestyles and mental health" may not actually be as "significantly worse" as you and many C-19 minimizers claim:
What impact did the pandemic really have on mental health? (Mental Health Research, March 10, 2023)
Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts (BMJ, March 8, 2023)

 

[zooterkin]

I found it unreadable, frankly. I reads like drunken rambling and clicking through to the source it reinforces that feeling. The guy was just spamming his own posts with his own replies and so on.

Yes, it beats me why Twitter has become the main channel for serious discussion with its ludicrous word limits. He's not spamming, that seems to be the way to present an argument longer than 288 characters.

 

[angrysoba]

Yes, it beats me why Twitter has become the main channel for serious discussion with its ludicrous word limits. He's not spamming, that seems to be the way to present an argument longer than 288 characters.

Indeed. It’s a Twitter thread which is a completely normal use of Twitter.

 

[dann]

There is a lot of BS on Twitter, but it is also often the place where references and links to new C-19 studies appear.
I don't know if serious tweeters will now migrate to Zuckerberg's Threads and leave Twitter to the Nazis, antivaxxers and C-19 minimizers.
It will be a rude awakening for Musk if the income from ads for MyPillows, MAGA hats and AR15s is all he's left with, but I think he deserves it.

 

[dann]

I first mentioned the surge in Okinawa in post 2,991.

I doubt that they knew how fitting the name of this festival would turn out to be:

Corona Sunset Festival 2023
Date: July 15, 2023 (Sat), July 16, 2023 (Sun) 13:00~
Location: Toyosaki Seaside Park (5-1 Toyosaki, Toyonaka City, Okinawa Prefecture)
CORONA SUNSET FESTIVAL (MyFunNow, May 28, 2023)

 

[Dr.Sid]

Beach festival ? Sounds bad .. one thing I noticed in Japan is how percentage of masked people sharply drops after 10pm, when people start leaving pubs.

 

[dann]

... as does social distancing even before leaving the pub - and not just in Japan.
A beach party (outdoors, obviously) doesn't sound so bad until you see photos from the pre-pandemic version of this festival. And it is not as if the Okinawa health-care system has plenty of surplus capacity right now.

Hospital bed usage in the prefecture had risen to 78% as of Wednesday.
COVID-19 Infections Spreading Fast in Japan's Okinawa Pref. (JapanNews, July 8, 2023)

Devastating COVID-19 surge in Okinawa exposes lies that the pandemic is over (WSWS.org, July 8, 2023)

I mentioned this in the Sweden thread yesterday: Norrland University Hospital in reinforcement mode
I am not even sure that it is caused by C-19, directly or indirectly, but it is weird that they don't even mention why the hospital is suddenly full. This time of the year, the patients can't all be Danish tourists who don't know how to ski.

 

[angrysoba]

... as does social distancing even before leaving the pub - and not just in Japan.
A beach party (outdoors, obviously) doesn't sound so bad until you see photos from the pre-pandemic version of this festival. And it is not as if the Okinawa health-care system has plenty of surplus capacity right now.




Devastating COVID-19 surge in Okinawa exposes lies that the pandemic is over (WSWS.org, July 8, 2023)

I mentioned this in the Sweden thread yesterday: Norrland University Hospital in reinforcement mode
I am not even sure that it is caused by C-19, directly or indirectly, but it is weird that they don't even mention why the hospital is suddenly full. This time of the year, the patients can't all be Danish tourists who don't know how to ski.

As someone who lives in Japan, I can tell you that almost nobody thinks the pandemic is over. People by and large keep wearing masks in most crowded public settings such as trains etc…

BUT as with all things in life you have to balance safety with other aspects of life. If you could be completely safe by wearing a hazmat suit at all times, you would miss out on other aspects of life and so it is with masking and social distancing etc….

Now you can go to a baseball game, for example, and not be required to mask, and it is easier to go now that full capacity games have been restored. Yet certain things are still not done such as the mass release of balloons during the seventh innings of Hanshin Tigers games.

Why allow full capacity games but ban the balloons? Is it hypocrisy or inconsistency? No! It’s just an attempt to balance things by making reasonable mitigation strategies while by and large allowing people to go about their lives.

I’m pretty sure I’ve said it before but I will say it again, Japan has had a good pandemic. The public essentially bought into reasonable restrictions and safety measures and got vaccinated to a degree that surpassed most of the rest of the so-called developed world. It didn’t impose draconian restrictions such as those pursuers by some European countries or idiotically ideological libertarian policies that were urged by the charlatans of the Great Barrington Declaration. Instead, it combined strong recommendations with individual responsibility.

So yes, people will have festivals and they will enjoy them more or less with no social distancing. People who think it is a risk can stay away, but at this point they can’t and won’t demand that everyone else do the same.

 

[marting]

The Cleveland Clinic? Really?! This Cleveland Clinic???
Cleveland Clinic Doctor Goes Full Anti-Vaccine (Forbes, Jan 7, 2017)

Interesting but doesn't appear to be the case re Covid-19 as it predates by years and the doc involved is different.

What's interesting is that the Cleveland Clinic Covid-19 Pfizer vaccine effectiveness was first published about 6 months after the vaccines first came out. Not only did they show high effectiveness but it was even slightly higher than the original Pfizer paper. In other words damned good. Nabin K. Shrestha et al reports:

https://www.medrxiv.org/content/10.1101/2021.06.02.21258231v1

After adjusting for the slope of the epidemic curve, age, and job type, vaccination was associated with a significantly reduced risk of SARS-CoV-2 infection (HR 0.03, 95% C.I. 0.02 – 0.06, p < 0.001), corresponding to a vaccine effectiveness rate of 97.1% (95% CI 94.3 – 98.5).

Gee, sure doesn't conform to the notion Cleveland Clinic's Shrestha is an anti-vaxxer.

Then, Nabin K. Shrestha et al, reported:

https://academic.oup.com/ofid/article/10/6/ofad209/7131292

Among 51 017 employees, COVID-19 occurred in 4424 (8.7%) during the study. In multivariable analysis, the bivalent-vaccinated state was associated with lower risk of COVID-19 during the BA.4/5-dominant (hazard ratio, 0.71 [95% confidence interval, .63–79]) and the BQ-dominant (0.80 [.69–.94]) phases, but decreased risk was not found during the XBB-dominant phase (0.96 [.82–.1.12]). The estimated vaccine effectiveness was 29% (95% confidence interval, 21%–37%), 20% (6%–31%), and 4% (−12% to 18%), during the BA.4/5-, BQ-, and XBB-dominant phases, respectively. The risk of COVID-19 also increased with time since the most recent prior COVID-19 episode and with the number of vaccine doses previously received.

It's the same population of young workers with little serious illness. So what changed? I've looked around for other current studies of infection rates v vax status. No luck finding anything. Most other studies are PCR status upon hospitalization since home tests aren't even counted. And vaccines provide significant effectiveness against sever disease/death. I've discussed and linked to people that have a reasonable take on why vaccines seem to now be associated with higher infection rates in that cohort even while reducing serious illness/death. But I have no reason to believe the study is fraudulent or biased.

See this discussion for possible causes.
https://www.icpcovid.com/en/news/7-...covid-vaccine-effectiveness-during-successive

 

[Skeptic Ginger]

Six yrs ago SBM claims the director of the "Wellness" center at the CC posted anti-vaxxer misinformation.

SBM's issue was about any 'integrated/alternative' medicine POV at all. Then

The Cleveland Clinic promptly disavowed [the anti-vax stuff],

And it was before the COVID pandemic.

I don't know much about the specific issue but painting the CC with that broad brush is not consistent with my experience using their website as a resource.

 

[dann]

Interesting but doesn't appear to be the case re Covid-19 as it predates by years and the doc involved is different.

You amputated the quotation from my post! I never claimed that that particular link was about the pandemic. What I said was that the Cleveland Clinic appears to have a long tradition of quackery - not limited to pre-pandemic times:

The Cleveland Clinic? Really?! This Cleveland Clinic???
Cleveland Clinic Doctor Goes Full Anti-Vaccine (Forbes, Jan 7, 2017)

The Cleveland Clinic seems to have a long tradition of quackery:Traditional Chinese herbalism at the Cleveland Clinic? What happened to science-based medicine? (Science-Based Medicine, April 26, 2014)
The Medical Director of The Cleveland Clinic Wellness Institute spewed antivaccine misinformation last week. Why is anyone surprised? (Science-Based Medicine, Jan 9. 2017)
Why Do Prestigious Hospitals Sell Snake Oil? (Science-Based Medicine, Mar 8, 2017)
Cleveland Clinic genetic experts call out functional medicine on worthless genetic testing and supplement prescribing (Science-Based Medicine, Feb 15, 2018)
Frequency Specific Microcurrent (Science-Based Medicine, Jan 16, 2019)
Cleveland Clinic Drops the Ball in an Attempt to Educate Parents on Safe Sleep (Science-Based Medicine, June 10, 2022)

And then you also leave out my link to the article that criticizes the Cleveland Clinic C-19 vaccine study specifically:

What's interesting is that the Cleveland Clinic Covid-19 Pfizer vaccine effectiveness was first published about 6 months after the vaccines first came out. Not only did they show high effectiveness but it was even slightly higher than the original Pfizer paper. In other words damned good. Nabin K. Shrestha et al reports:

https://www.medrxiv.org/content/10.1101/2021.06.02.21258231v1


Gee, sure doesn't conform to the notion Cleveland Clinic's Shrestha is an anti-vaxxer.

Then, Nabin K. Shrestha et al, reported:

https://academic.oup.com/ofid/article/10/6/ofad209/7131292

It's the same population of young workers with little serious illness. So what changed? I've looked around for other current studies of infection rates v vax status. No luck finding anything. Most other studies are PCR status upon hospitalization since home tests aren't even counted. And vaccines provide significant effectiveness against sever disease/death. I've discussed and linked to people that have a reasonable take on why vaccines seem to now be associated with higher infection rates in that cohort even while reducing serious illness/death. But I have no reason to believe the study is fraudulent or biased.

See this discussion for possible causes.
https://www.icpcovid.com/en/news/7-...covid-vaccine-effectiveness-during-successive

This was the part of my post specifically about the Cleveland Clinic's vaccine study:

It shouldn't come as a surprise to anybody that antivaxxers and minimizers love the Cleveland Clinic study! People are free to find it amusing if that kind of humor appeals to them, but I would recommend reading this before resorting to :
Cleveland Clinic Study Did Not Show Vaccines Increase COVID-19 Risk (FactCheck.org, June 16, 2023)

Why leave out the link to this article?


ETA: What do you think of The Atheist's conclusions based on your post about the Cleveland Clinic study?

Some people are going to lose their **** over that.
It's a good reason to not get booster shots, because we know the protection against severe disease does last, so you're better to let the disease take its course and build up personal and herd immunity.
I'm quite amused by it.

ETA2:

Cleveland Clinic paper does not say the bivalent booster increases the risk of catching COVID, but rather, that it reduced infections by 30 per cent.
Vaccine study that has people worried is being misinterpreted (Montreal Gazette/McGill University, Office for Science and Society, Feb 10, 2023)

(Notice that this article is about some people's (false) interpretation of the preprint of the Cleveland Clinic study. An easier read than the FactCheck article.)

 

[marting]

You amputated the quotation from my post! I never claimed that that particular link was about the pandemic. What I said was that the Cleveland Clinic appears to have a long tradition of quackery - not limited to pre-pandemic times:

So Cleveland Clinic has a "Wellness Center." Lots of large health groups have these to cater to that crowd. For that matter so do academic groups that cater to fringes. Duke and Stanford come to mind.

But let's look at the criticism in your link. It's quite correct to note that observational studies can have confounders. And, of course, all studies after the original randomized, blinded, placebo ones are observational for ethical and practical reasons. And observational studies show associations or correlations, not causality.

Shrestha's paper with the same Cleveland Clinic cohort that examined effectiveness in the first part of 2021 showed that the unvaxxed were 30x more likely to be infected than the vaxxed. That wasn't proof of causality being observational and not randomized and blinded. It was still compelling given the large ratio. Interesting that whatever confounders may have been at work in the Cleveland cohort resulted in an even greater effectiveness than the original Pfizer study.

Shrestha's latest paper shows that the vaxxed and boosted workers were 2x more likely to be infected than the unvaxxed. Observational and not proof of causality.

Technically, it doesn't even show the Cleveland Clinic workers were more likely to get Covid if vaxxed. What it does show is if Cleveland Clinic workers that wanted paid time off and hence had to get PCR tested were 2X more likely to test positive if they were vaccinated and boosted.

Even the purpose of the study, evaluating effectiveness of the bi-valent booster, doesn't prove that vaccine reduced symptomatic infection 29%. Since it was, of course, observational and subject to the similar confounders. It was a 29% reduction in the cohort that chose to get the bi-valent vaccine. For that matter, those that chose to get the bi-valent vax still had an almost 2X greater chance of testing positive than those unvaxxed.

So no, we don't know whether vaccines increase chances of infection against the latest Omicron variants. Nor do we know if they decrease chances of infection. The only thing we can be reasonably certain of is that vaccines do significantly decrease the risk of severe disease/death with all the variants seen to date. And that's rather important.

EtoA:
As for TA's comment, I have chosen to get boosters but am not going to double up on the bi-valent. I expect to get the new mono booster as soon as it becomes available absent newer negative data. From the data I've seen it appears to materially broaden antibody response.

 

[marting]

Here's a Lancet study out of Qatar that aligns with the Cleveland Clinic results. It shows that those vaccinated with boosters were initially effective with a Ve around 50%. However, there is rapid waning and effectiveness becomes negative after 6 months. And after 10 months the boosted were almost twice as likely to have symptomatic infection as those with just the primary series. That said, unlike the Cleveland Clinic study which was mostly young workers, the Qatar study showed higher effectiveness against severe disease/death and it appeared not to be impacted by imprinting (original antigenic sin) though the numbers were too small to reach statistical significance.

Here's some quotes from the paper:

There were 20 528 incident infections in the three-dose cohort and 30 771 infections in the two-dose cohort. Booster effectiveness relative to primary series was 26·2% (95% CI 23·6–28·6) against infection and 75·1% (40·2–89·6) against severe, critical, or fatal COVID-19, during 1-year follow-up after the booster.
...
Although imprinting is of concern when an antigenically divergent virus emerges, it does not negate the public health value of booster vaccinations. Imprinting affected protection against infection in the long term, but the booster was protective against infection in the short term, and overall infection incidence for the whole follow-up period was lower in the group with three doses than in the group with two doses. There was no evidence that imprinting affected protection against severe COVID-19, which remained high after a year of follow-up.

Long-term COVID-19 booster effectiveness by infection history and clinical vulnerability and immune imprinting: a retrospective population-based cohort study
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00058-0/fulltext

 

[Roger Ramjets]

Shrestha's latest paper shows that the vaxxed and boosted workers were 2x more likely to be infected than the unvaxxed. Observational and not proof of causality.

Technically, it doesn't even show the Cleveland Clinic workers were more likely to get Covid if vaxxed. What it does show is if Cleveland Clinic workers that wanted paid time off and hence had to get PCR tested were 2X more likely to test positive if they were vaccinated and boosted.

Exactly. Nobody said getting vaccinated would prevent you from testing positive, or even showing symptoms. They said it would likely reduce the severity of the disease. The vaccinated might even be more likely to get infected because they are less careful to avoid it.

EtoA:
As for TA's comment, I have chosen to get boosters but am not going to double up on the bi-valent. I expect to get the new mono booster as soon as it becomes available absent newer negative data. From the data I've seen it appears to materially broaden antibody response.

I get every one I can. That puts me in with a mere 8% of the population. The rest may think 2 or 3 vaccinations is enough, but 50% of new cases are reinfections from 90+ days previous, which means these people are now catching newer variants than they had previously (variants before CH.1.1 are nonexistent now). Case numbers are way down from the peak, but still much higher than during lockdowns. I wouldn't want to be less than fully vaccinated even today.

 

[Planigale]

Without directly looking at the specifics here, it's likely worth the reminder that the aftereffects and problems caused by COVID are not limited to direct/lasting damage by COVID itself. For example, a lot of routine preventative care has been skipped, such as cancer screenings that would normally catch various cancers early enough for them to be dealt with. Hence, an excess death rate because of cancer as an indirect result of COVID likely accounts for a portion of those excess deaths, among other indirect effects.

The impact of 'screening' for cancer will not be great. The object is to detect cancers early when treatable rather than waiting for them to present later. The benefits of screening will persist after screening has stopped for a period, whilst the 'missed' cancers won't present for years.

Also cancer screening did not stop with covid in the UK.

The impact is likely greater for those cancers where there is not a screening program. My personal experience is delayed diagnosis of TB because people with coughs had covid tests but no CXR. A joke in the TB community is 'How many Covid tests does it take to diagnoses TB?' Whilst I don't see lung cancer patients the tendency to attribute respiratory symptoms to covid and not do a CXR is likely to result in delayed diagnosis.

A point I have made before is that for both pneumonia and influenza the increased risk of death from vascular disease (both stroke and heart attack) following flu or pneumonia is actually greater than directly from the infection. You are more likely to die from a heart attack following pneumonia than the pneumonia itself (and I mean the increased risk). Most of these excess deaths will not be attributed to the respiratory infection as it happens after apparent recovery.

 

[Chris_Halkides]

Oh, deer

“The more species it’s in and the more transmission that occurs, the greater the risk of new variants. However, it’s hard to say whether deer constitute much of a risk in the grand scheme at this point,” said Scott Weese, a veterinarian who studies diseases that pass between animals and people at the University of Guelph in Canada. CNN