Covid II: Medical Info and Implications

[Robert J Anderson]

13 minutes ago, Calm said:

Equating wearing masks with shutting down businesses is ridiculous.  No one is making that argument here, please don't waste our time and space with shifting the comments to lockdowns.  If we are talking masks,stick to masks.

I think masks and shutting down business is part of the same hysteria.  But as you wish, we can discuss masks only. 

In any event, I wonder how much masks slow down the spread, as in how much more likely is a person to get covid while wearing a mask as opposed to not wearing one?  Has there been a study on this issue that you are aware of? 

[Robert J Anderson]

3 minutes ago, Calm said:

If you want to take the thread in a political direction, please start another thread instead.

Don't have a problem with questioning medical info in here, debating government tactics is out of bounds while using them to support medical claims is not (success or lack of success of government direct shows support or not for ______, a medical claim).....know it is a fine line. 

I don't know how you can avoid discussing the rationality of government suggestions or mandates when discussing mask usage.  Governments are behind the mask issue.  If it weren't for government agency action and recommendations, mask usage would probably be not that prevalent or an issue in the first place.

[Calm]

4 minutes ago, Robert J Anderson said:

I think masks and shutting down business is part of the same hysteria.  But as you wish, we can discuss masks only. 

In any event, I wonder how much masks slow down the spread, as in how much more likely is a person to get covid while wearing a mask as opposed to not wearing one?  Has there been a study on this issue that you are aware of? 

It is not just getting Covid though, but how bad you get it.  If wearing masks (you wearing it and others around you wearing them) lower both rate you get it and how bad you get it, how is asking people to wear masks "hysteria" any more than asking them to wear seat belts, don't drink till you are drunk and then drive, or wearing helmets on a motorcycle?  For the vast majority of people,wearing masks is an inconvience they can quickly adapt to (watching many kids wear masks without fiddling with them all the time or complain is demonstrating it is mostly a perception issue to me, once accepted no big deal...and I on occasion have anxiety attacks triggered by masks so I am not downplaying those types of issues; if people who just don't want to wear them would wear them, that would allow those who have issues more space not to wear them since to have the most effect a certain percentage will need to wear them...will dig up the numbers later) like wearing seatbelt and helmets.

If Pogi doesn't put stuff up, I will later...I am supposed to be sleeping.  Should not have peeked in.

The Friendly Epidemlogist I linked to above has some great FB posts where she provides documentation for her claims and analyses.

[Calm]

15 minutes ago, Robert J Anderson said:

I don't know how you can avoid discussing the rationality of government suggestions or mandates when discussing mask usage.  Governments are behind the mask issue.  If it weren't for government agency action and recommendations, mask usage would probably be not that prevalent or an issue in the first place.

If that is your belief and your assumptions, then best start your own thread to discuss it.

Assumption of this thread is mask wearing is science based.  This thread is for those who want to hear about the science and medical info.

Edited October 25, 2020 by Calm

[Calm]

Pogi, came across this site that presents the info in a way that I like, very digestible.  Does it look credible to you? (It may have already been talked about, brain is at low capacity right now)

https://covidactnow.org/us/utah-ut?s=1200292

[Robert J Anderson]

3 minutes ago, Calm said:

If that is your belief and your assumptions, then best start your own thread to discuss it.

Assumption of this thread is mask wearing is science based.

I don't know if it has already been discussed, but there are studies where researchers found that masks are ineffective at stopping virus particles.  Here is one:  https://wwwnc.cdc.gov/eid/article/26/5/19-0994_article?fbclid=IwAR3ASxBUrRE5LHeZsZF-iHrpTuX2PprS8FnkKGUpEUDEIAnH6s5wQOpkOJI

[Robert J Anderson]

10 minutes ago, Calm said:

Pogi, came across this site that presents the info in a way that I like, very digestible.  Does it look credible to you? (It may have already been talked about, brain is at low capacity right now)

https://covidactnow.org/us/utah-ut?s=1200292

It says the infection rate is slow, steady and controlled since April, 2020.  That is good news.  So, I guess whatever Utah was doing then and doing now is effective.

[pogi]

1 hour ago, Robert J Anderson said:

Where does the WHO disagree with my math? 

That is not how you calculate IFR. 

From WHO:

Reported deaths is not the same as actual deaths. 

1 hour ago, Robert J Anderson said:

How do you know that the deaths are under-reported worldwide? 

Do you really think that places in West Africa, India, North Korea, etc are accurately reporting?  I don't think you are being honest with yourself if you think their reported numbers are accurate.  If you know that they are not testing/reporting infections accurately, how do you expect them to be identifying deaths due to Covid if they are not testing and/or reporting?  Think of all the places in the world with millions and millions of squatters and little to no access to health care/testing.  People are dying from Covid and not being reported.  Period.  It is estimated that they are likely way undercounted in the States:

 

Quote

Counts of deaths due to COVID-19 are most likely undercounting the true number of deaths due to COVID-19 because:

• testing availability and criteria may have caused many cases to go unrecognized;
• COVID-19 may affect many body systems, and thus may not always be recognized as a cause of death;
• COVID-19 may amplify pre-existing health conditions leading to death, but not be recognized as a cause of death by the medical certifier; and
• many of the excess deaths that are not reported as due to COVID-19 may be caused by COVID-19, as well as other causes. https://www.cdc.gov/nchs/covid19/faq.htm

• https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

1 hour ago, Robert J Anderson said:

How do you know if they aren't being over-reported given the financial incentives there are to report covid cases in hospitals?

https://www.factcheck.org/2020/04/hospital-payments-and-the-covid-19-death-count/

The people who actually diagnose and write the death certificates (coroners etc.) don't see any of that money and have no incentive to commit medical fraud and put their license on the line.  

1 hour ago, Robert J Anderson said:

The ICU at the UofU may be full but aren't there other hospitals that could take these cases if the UofU can't?  Surely, LDS Hospital or Salt Lake Regional Medical Center would take these patients?  Don't you think it is over-hyping to focus on the UofU when other hospitals have excess capacity?  

Obviously, they would transport them to different hospitals.  The concern is that they are also filling up quickly and staff is burned out.  I don't know if you have been watching local Utah news, but hospitals are scared right now.   Numbers keep going up, hospitalizations are soaring, and staff morale is declining while exhaustion is maxed out.  Don't expect to get awesome care if you need the ICU right now.  That is scary, especially when numbers keep going up.   They are making contingency plans for when capacity is exceeded.  

I pointed out UofU hospital because that is completely unusual to be maxed out this time of year.  Again, flu season is just beginning.  So don't pretend like I am being overzealous. 

1 hour ago, Robert J Anderson said:

I socially distance and wear masks.  So, what else should I do to supposedly take this seriously?  Is the nebulous statement "not taking it seriously" a talking point given out by the Utah government?  It seems to be a thing to tell people that are questioning our leaders on this one.

Great, it seems you are doing exactly what you are supposed to be doing, so why are you suggesting that I am "over-reacting" by encouraging people to do exactly that?  

I am curious though, if we are over-reacting, death rate is 0.1%, masks don't really do anything, and ...why do you wear a mask?  Do you wear a mask at extended family gatherings?  Are you going to be wearing them for the holidays (except while eating)?  Social distancing from family?  No hugging/kissing extended family, etc.?   If so, cool.  

Why are you downplaying things here if you claim to be taking it "seriously"?

 

Edited October 25, 2020 by pogi

[Robert J Anderson]

14 minutes ago, pogi said:

That is not how you calculate IFR. 

From WHO:

Reported deaths is not the same as actual deaths. 

Do you really think that places in West Africa, India, North Korea, etc are accurately reporting?  I don't think you are being honest with yourself if you think their reported numbers are accurate.  If you know that they are not testing/reporting infections accurately, how do you expect them to be identifying deaths due to Covid if they are not testing and/or reporting?  Think of all the places in the world with millions and millions of squatters and little to no access to health care/testing.  People are dying from Covid and not being reported.  Period.  It is estimated that they are likely way undercounted in the States:

 

• https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm

https://www.factcheck.org/2020/04/hospital-payments-and-the-covid-19-death-count/

The people who actually diagnose and write the death certificates (coroners etc.) don't see any of that money and have no incentive to commit medical fraud and put their license on the line.  

Obviously, they would transport them to different hospitals.  The concern is that they are also filling up quickly and staff is burned out.  I don't know if you have been watching local Utah news, but hospitals are scared right now.   Numbers keep going up, hospitalizations are soaring, and staff morale is declining while exhaustion is maxed out.  Don't expect to get awesome care if you need the ICU right now.  That is scary, especially when numbers keep going up.   They are making contingency plans for when capacity is exceeded.  

I pointed out UofU hospital because that is completely unusual to be maxed out this time of year.  Again, flu season is just beginning.  So don't pretend like I am being overzealous. 

Great, it seems you are doing exactly what you are supposed to be doing, so why are you suggesting that I am "over-reacting" by encouraging people to do exactly that?  

I am curious though, if we are over-reacting, death rate is 0.1%, masks don't really do anything, and ...why do you wear a mask?  Do you wear a mask at extended family gatherings?  Are you going to be wearing them for the holidays (except while eating)?  Social distancing from family?  No hugging/kissing extended family, etc.?   If so, cool.  

Why are you downplaying things here if you claim to be taking it "seriously"?

 

1.  Look at my calculation again.  I used the estimated exposure provided by the WHO for the denominator and the number of deaths reported in real clear politics.  Sure, perhaps some countries are under reporting deaths and perhaps there are covid deaths that really should be reported as deaths from the underlying cause, such as heart disease or diabetes or old age, etc.?  Also, because testing is not that wide-spread, who is to say that there aren't many many more cases out there that are not reported either, thus making the fraction lower.  However, you may choose to view the possibilities in a light that adds to the panic when perhaps cooler heads should prevail?

2. I don't know whether or not there is medical fraud going on.  Although medicaid fraud and medicare fraud is a thing in hospitals and medical groups.  Additionally, take a look at this admission from Dr. Redfield: https://www.washingtonexaminer.com/news/cdc-director-acknowledges-hospitals-have-a-monetary-incentive-to-overcount-coronavirus-deaths

3. I am not pretending that you are overzealous.  You are focusing on the negative possibilities, all things being equal, with your focus on the DN article about the UofU hospital, your focus on increasing the number of deaths but minimizing the possibility that the 10% exposure number may or should equate to the denominator in the equation cited above.  I can only conclude that you are being overzealous, no pretending.

4. Finally, I wear a mask when forced to do so.  I've been exposed to sars-cov-2 already on many occasions.  I had family, friends, colleagues, clients and clients of others who all had it and exposed me to it as I had close contact with all of them.  Of course "serious" is a loaded word that is relatively meaningless unless further defined.  If "serious" is wearing the stupid mask all the time unless eating, no, I'm not going to do that.  I'm not going to socially distance from family as they have already been exposed.  My mother had it when it first hit the U.S. and exposed all of us already.  She survived but was really sick for a few weeks as she is in her 80's and has underlying health issues.  I try to socially distance when I am out and about and I work mostly from home.  When I see clients, I respect their mask decisions and mask up if they want me to.  Most hate the masks and are relieved when I say it is optional in my office. 

It is time to lessen the hysteria, not increase it.

[Calm]

1 hour ago, Robert J Anderson said:

says the infection rate is slow, steady and controlled since April, 2020.

That is not exactly what it said. You need to look at all indicators.  
 

“Dangerous numbers of new cases”

”A relatively high percentage (16.3%) of COVID tests were positive, which indicates that testing in Utah is limited and that most cases may go undetected. At these levels, it is hard to know how fast COVID is actually spreading, and there is risk of being surprised by a second wave of disease. Caution is warranted.”

“Utah has about 664 ICU beds. Based on best available data, we estimate that 37% (245) are currently occupied by non-COVID patients. Of the 419 ICU beds remaining, 110 are needed by COVID cases, or 26% of available beds. This suggests there is likely enough capacity to absorb a wave of new COVID infections”

”Per our best available data, Utah has 1,200contact tracers, fulfilling 17% of this staffing requirement. With insufficient contact tracing staff, Utah is unlikely to be able to successfully identify and isolate sources of disease spread fast enough to prevent new outbreaks.”

Edited October 25, 2020 by Calm

[Calm]

11 minutes ago, Robert J Anderson said:

However, you may choose to view the possibilities in a light that adds to the panic when perhaps cooler heads should prevail?

Please stop making this accusation if you wish to continue posting in this thread. 
 

Pogi, please avoid making claims of downplaying comments and just focus on misrepresentation if it is there. 

Edited October 25, 2020 by Calm

[pogi]

42 minutes ago, Robert J Anderson said:

 Also, because testing is not that wide-spread, who is to say that there aren't many many more cases out there that are not reported either, thus making the fraction lower.  However, you may choose to view the possibilities in a light that adds to the panic when perhaps cooler heads should prevail?

Let me help you understand the numbers.  The 10% figure “estimated” by the WHO is already accounting for those cases which are not confirmed and/or reported. 
 

The actual confirmed/reported cases worldwide is currently around 42.8 million.  That is NOWHERE close to 10%. 
The confirmed/reported deaths are at 1.15 million.  We can confidently conclude that because the positive cases are WAY under reported, that so too are the deaths (how else can you confirm a death if they are not testing?)

You are calculating estimated total infections with the reported deaths.  How do you not see that as a clear manipulation to undercount the actual death rate?  You should be calculating confirmed with confirmed (this is called the CFR) and estimated with estimated (This is called the IFR), but you are misleading by calculating estimated with confirmed (this is called BS).

If you calculate confirmed cases with confirmed deaths, we are at 2.7%. 
 

If demanding an accurate reporting of death rate calculations is being hysterical, then I guess I have given into hysteria.  
 

Cool heads should prevail, as you say, but so too should honesty and science.   You can’t show me one major medical organization which agrees with your 99.9% figure.  You have not answered the CFR and I ask you to retract your misleading and false figures.  That is YOUR calculation, but I asked for a reference which agrees with your figure of 99.9%  You have failed.
 

I should note that accusing   me of hysteria for my responses to you here is not a good example of keeping a cool head.  You are out of line.

Edited October 25, 2020 by pogi

[pogi]

43 minutes ago, Robert J Anderson said:

4. Finally, I wear a mask when forced to do so. 

So I am right, you are not taking the prevention guidelines seriously.  

[Robert J Anderson]

19 minutes ago, pogi said:

Let me help you understand the numbers.  The 10% figure “estimated” by the WHO is already accounting for those cases which are not confirmed and/or reported. 
 

The actual confirmed/reported cases worldwide is currently around 42.8 million.  That is NOWHERE close to 10%. 
The confirmed/reported deaths are at 1.15 million.  We can confidently conclude that because the positive cases are WAY under reported, that so too are the deaths (how else can you confirm a death if they are not testing?)

You are calculating estimated total infections with the reported deaths.  How do you not see that as a clear manipulation to undercount the actual death rate?  You should be calculating confirmed with confirmed (this is called the CFR) and estimated with estimated (This is called the IFR), but you are misleading by calculating estimated with confirmed (this is called BS).

If you calculate confirmed cases with confirmed deaths, we are at 2.7%. 
 

If demanding an accurate reporting of death rate calculations is being hysterical, then I guess I have given into hysteria.  
 

Cool heads should prevail, as you say, but so too should honesty and science.   You can’t show me one major medical organization which agrees with your 99.9% figure.  You have not answered the CFR and I ask you to retract your misleading and false figures.  That is YOUR calculation, but I asked for a reference which agrees with your figure of 99.9%  You have failed.
 

I should note that accusing   me of hysteria for my responses to you here is not a good example of keeping a cool head.  You are out of line.

The WHO estimated that 10% have been exposed.  Are they wrong in stating this? This is their estimate, not mine.  How do you determine that the 10% figure is wrong if you think it is?  Why do you insist on reported infections but want to focus on a supposed undercount of reported deaths?  Isn't the supposed death undercount based on an estimate as well, your estimate?  Why do you want to make it seem worse?  Further, if economies were to open up, you may still remain indoors and away from everyone.  We know that the elderly and those with other conditions are much more susceptible to getting really sick.  Why not quarantine them while allowing the rest of us to live?  I've been exposed many times and haven't become sick.  Most have the same experience based on the WHO estimate.  Why not let us go about our business while you self-quarantine?

[strappinglad]

I hesitate to report that in my province , two major outbreaks are in large hospitals and they have had to reduce staff to bare minimums because of infections in the personnel. This from places that are supposed to be very well instructed and protected. What hope do we mere lay-folks have? Mind you there is an obviously greater chance of exposure on a daily basis when dealing with covid patients and visitors.  

[Calm]

2 hours ago, Robert J Anderson said:

Why not let us go about our business while you self-quarantine?

I am high risk. I have not had access to basic medical care, my physical therapy, because no one else there will wear a mask...it is basically a gym with small treatment rooms attached, not that great of ventilation, and while numbers were low to begin with, not so much now.   Back is now in pretty bad shape with me having to stay in bed even more time than I usually do.  My daughter who is even more high risk than I only leaves the house for doctor’s visits. 
 

This is acceptable to me because I can control exposure in these cases. However, my husband is a professor and is required to have f2f classes. So he gets exposed every day to groups of one of the biggest spreaders and then comes home to us. He thankfully wears a mask and requires the students to wear masks, but classes are longer than an hour so aerosols are an issue. Given our past record, high probability if he gets sick my daughter and I will. Even a mild case if it results in long term decrease of energy, etc as has been reported by many, will be devastating for my daughter who is barely on the road to recovery from thyroid surgery. 
 

So the problem is self quarantining with no exposure is a myth for most people.  Even those in care facilities like my mother who we have only seen through glass since March are exposed to Covid through staff (they have had two breakouts, last one cause by a mortified BYU student who worked there).

Maybe those who are retired and can still care for themselves and can afford to get groceries delivered can actually self quarantine for months on end. The rest of us have to live with those who refuse to engage in basic, reasonable measures of social distancing and mask wearing (notice I didn’t say lockdown). 

Edited October 25, 2020 by Calm

[pogi]

1 hour ago, Robert J Anderson said:

The WHO estimated that 10% have been exposed.  Are they wrong in stating this? This is their estimate, not mine.  How do you determine that the 10% figure is wrong if you think it is?  

Where did I disagree with the 10% figure?  

1 hour ago, Robert J Anderson said:

Why do you insist on reported infections but want to focus on a supposed undercount of reported deaths? 

I am not insisting on using reported infections (unless you want to calculate the CFR - case fatality rate).  I am suggesting that if you want to use the estimated infections (as you have done) in the calculation, that is fine but you then also have to use the estimated death count (which you did not do).  Again this is called the IFR - Infection Fatality Ratio.  And if you want to use the reported infections, then you also have to use the reported death count.  Again, this is called the CFR. Your calculation is not representative of the IFR or the CFR.  I think I made this pretty clear.

1 hour ago, Robert J Anderson said:

 Isn't the supposed death undercount based on an estimate as well, your estimate?  

Yes, it is just an estimate, just like the 10% figure.  I don't recall giving you an estimate, so I don't know what you mean.

1 hour ago, Robert J Anderson said:

Why do you want to make it seem worse?

By "worse", you mean more accurate, right?

Why do insist on flubbing the numbers to make it seems less severe? 

No, I just want true calculations for CFRs and IFRs.  I want science and not politics and personal interests to determine the risks.  You are not being true with your calculation.   You are not calculating the CFR or the IFR.  Your figure is a worthless manipulation.

1 hour ago, Robert J Anderson said:

Why not let us go about our business while you self-quarantine?

When have I suggested you can't go about your business?  I am talking about CFRs, INR's and effectiveness of masks and prevention measures.  Don't change the topic.

Remember that article you linked to where the WHO estimated that 10% of the population has been infected.  Interesting that you forgot to include this:

Quote

 

The global death toll of over 1 million fatalities is also an undercount, according to WHO Director General Tedros Adhanom Ghebreyesus.

https://www.usnews.com/news/health-news/articles/2020-10-05/who-estimates-coronavirus-has-infected-10-of-global-population

 

 

So, they estimate that both infections and deaths are undercounted, yet you attempt to calculate the estimated infections with the undercounted deaths.  Come on Robert, lets get honest here.  You know that will give you a misguided death ratio - downplaying the risk. 

I have noted that you still have not provided the CFR.  I have also noted that you have still not retracted the claim.  Do one or the other or I will report you. 

as to expecting all those who are at increased risk to live in a bubble while the rest of you run around maskless (unless you are "forced"), sorry.  Not realistic.  You are showing your lack of understanding of how this disease works. 

 

 

Edited October 25, 2020 by pogi

[Calm]

1 hour ago, strappinglad said:

they have had to reduce staff to bare minimums because of infections in the personnel.

Burnout of personnel from emotional and physical fatigue even when not maxed out needs to be a concern.  And training to replace those who are sick or who have died is not an overnight effort.

[pogi]

4 hours ago, strappinglad said:

This from places that are supposed to be very well instructed and protected. What hope do we mere lay-folks have? 

I’d say we have much higher chances of avoiding infection (if we are trying to follow recommendations) than hospital staff who are directly working with Covid patients on high stress 12 hour shifts.  I don’t care how well trained you are, maintaining perfect protocol with PPE with those kind of hours, stress, and exhaustion is nearly impossible.  It is just a high risk (as in higher risk then the general public) career.  Much more chances of exposure and making a mistake.  

[pogi]

https://apple.news/AxYlBLS3FQNCDaENcBKfwGA
 

This national article has a lot about our hospital situation in Utah right now.  Not where we want to be just before the holidays.  Stay safe people and protect your loved ones.

Edited October 26, 2020 by pogi

[bsjkki]

Therapeutics 

https://www.politico.eu/article/are-monoclonal-antibodies-the-next-hope-against-the-coronavirus/amp/?__twitter_impression=true

Amid alarming spikes in infections and a wave of new restrictions announced across Europe, some good news is emerging: Monoclonal antibodies are likely to be the first game-changing therapy against COVID-19.

Big drugmakers have ample experience in manufacturing these kinds of medicines, and their existing facilities can readily be converted to produce doses of a future COVID-19 treatment, experts say. 

Edited October 26, 2020 by bsjkki

[bsjkki]

So are we supposed to just ignore this?

[pogi]

2 hours ago, bsjkki said:

So are we supposed to just ignore this?

Do you have a link to the article?

I would suggest that you pay less attention to 2-week intervals and short-term trends (those are constantly fluctuating up and down) and look at the bigger picture.  Total infections etc. 

Can we ignore Taiwan and South Korea?

https://www.psychologytoday.com/us/blog/getting-healthy-now/202004/defending-the-right-infect

Edited October 26, 2020 by pogi

[bsjkki]

https://thehill.com/policy/healthcare/522743-astrazeneca-says-its-vaccine-produces-immune-response-in-older-adults?amp&__twitter_impression=true

Vaccine news.

[strappinglad]

For those who like numbers , here are a lot of them. If you scroll down to the Global Stats you will see the results of 218 countries. USA # 1 , Canada # 30 , China # 54.

There are lies, damned lies and statistics , covid - 19 : hold my beer. Anyone who thinks that China has had half the deaths of Canada is... shall I say... wool enhanced . 

https://www.covid-19canada.com/