COVID19 Factors We Should Consider/Current Events COVID19 Factors We Should Consider/Current Events - Page 520

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Thread: COVID19 Factors We Should Consider/Current Events

  1. #5191
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    Quote Originally Posted by Rob Waskis View Post
    My first instinct is to kind of repeat myself and say that "a trend" is impossible to identify because it is a made up thing in this context. Maybe I just don't understand what you're getting at, so I'll ask you: what is "a trend"?
    OK, I am not a statistician by a long shot. As a physician, I think I am reasonably good at critically reading studies and basic stats, but I may not have the jargon down, and I may misunderstand even some basic stats. When I refer to a trend, I am saying that a study calculated, say, an odds ratio that was not 1, but the confidence interval included 1. Sometimes it is close enough to 1 that it seems clear there's nothing there, and we should embrace the null hypothesis. Other times, it's clear the results are diluted by study limitations. When I was on an IRB, we had a resident statistician who would frequently point out that a proposed study was underpowered to test the hypothesis they wanted to test. So they were never going to disprove the null hypothesis, whatever they found. Let's say their hypothesis was correct, but they were unable to clearly demonstrate it due to the study design. In that case they may find a "trend" toward their hypothesis being true, but their CI may still include the null hypothesis. If study finds this and was well-powered and properly designed, you're probably done. If not, the "trend" may be a signal that there may be something useful there to retool and study again.


    Quote Originally Posted by Rob Waskis View Post
    Strictly speaking, inferential statistics never "prove" or "disprove" anything. They only "fail to disprove". I agree with you that citing the meta to say masks don't work is incorrect. However, it's not incorrect to say that the review did not find evidence to suggest that masks are useful.
    I agree, yet we have often seen a study fail to prove something, and many people interpret it as "disproving" it. Most people aren't used to the precision and subtlety of the language here, and sometimes get annoyed that you're being lawyerly or something if you try to clarify for them. In the majority of the mask studies discussed in the video linked above, for example, they were not actually looking at masks vs no masks, so saying they "proved that masks did not work" was wrong on several levels. I can see how the video narrator sloppily made that leap, and then he simplified further to get an exciting conclusion. This was the main problem I was trying to point out.

    Quote Originally Posted by Rob Waskis View Post
    JF, I value your input in this thread very highly, but regardless of how you define a trend, this is wholly incorrect.

    The only reason something doesn't reach statistical significance is that there is not enough evidence for it to do so. Full Stop. Whether you have small sample bias or study design is difficult or whatever else you come up with, there isn't enough evidence. Additionally, you can disagree with the inclusion criteria of the meta, but that's a different argument altogether.
    I would say that what you're saying is true within the context of a specific study, but does not mean that the evidence or reality is not out there. If a study is underpowered and poorly designed, it may not be able to demonstrate that lifting weights makes you stronger, for example, yet other studies have shown this to be true, and we all would agree that it is essentially fact. I have seen many poorly designed studies that failed to find statistically significant results where these same results were later shown by larger or better-designed studies.

    Quote Originally Posted by Rob Waskis View Post
    Not to sound like a broken record, but my position in this thread has been (I think) pretty consistent. This isn't a case of "absence of evidence is not evidence of absence". Despite cries of "we must follow the SCIENCE" and such drivel, objective decisions are not being made based on evidence. Case in point: in NJ, wrestling is ok (as long as it's outdoors), but I still can't go to a damn gym. I can go to a BLM protest, but I can't sit down and eat a meal inside a restaurant. What objective evidence led to those genius decisions?

    Decisions are being made based on politics, emotions, and money. As they almost always are.
    I agree that most people do things that don't make rational sense, and/or don't match their stated motives (I am a psychiatrist after all, I make a living off of this particular human discrepancy you might say). This is especially true of politicians, and I agree that politics and emotions clearly overtake rational thought for most people. I am not immune to this, but I do my best to consciously struggle against these tendencies, and I'm willing to change my mind based on new information. It's not always comfortable to do so. I'm glad that many people here, for example, still want to talk about the evidence and the science, and I don't think we should give that up just because so many people have essentially gone mad. It's easy and fun to say "we should follow the SCIENCE!" but following scientific findings in real time is a fool's errand. I'm sure you agree, and thanks for your thoughtful comments.

    My personal views, based on experience combined with my reading of the evidence, are that surgical masks are likely modestly helpful at containing germs to the wearer. Combining this with rigorous hand hygiene and social distancing should further reduce the rate of covid spread, possibly to near zero if there were 100% proper compliance (which is of course unlikely). Also, N95 masks are likely quite effective at keeping germs like covid out of the mouth and nose of the wearer, but are only maximally effective when combined with full PPE. I saw COVID sweep rapidly through an inpatient hospital unit before we were using masks, infecting both patients and staff, and also saw that there were no new staff infections once patients had surgical masks and staff was using full PPE/N95, even though all patients on the unit were covid+. This experience biases me for sure. We may never have great evidence on some of these things, but we have to make decisions and act now, as it will take too long for high quality evidence to arrive in most cases, if it ever does.

    It does annoy me that the masked vs unmasked factions seem to take it out on each other, since neither really have the facts or cost/benefit calculations entirely on their side. I have been berated in person by people for wearing and also for not wearing a mask, in fact. It (the berating) didn't help anyone or change my behavior. I do my thing as I see fit, and offer opinions only when they are sought (or, in the case of this forum, when I think I have something useful to add). If someone asks me why I am wearing or not wearing a mask in a particular situation, I'll explain myself. If they scold me, I roll my eyes and move along. If I am not willing to change my mind as a result of a particular conversation/argument, I generally don't bother with it. I don't like to debate in bad faith. Once it's clear that the other person is a zealot who will not engage in some legit back-and-forth and is unwilling or unable to change their mind, I'm out. Some people might enjoy those kind of interactions, and at times I have too. Lately, though, I have other places to devote my energy. Again, despite a fair amount of posts in this thread getting heated, I think there has been some good discussion here. Thanks again Rob for your comments.

  2. #5192
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    Quote Originally Posted by Brian Harlin View Post
    I would think this is suitable cause for being disbarred.
    Has any lawyer ever been disbarred for being a radical democrat activist?

    Quote Originally Posted by jfsully View Post
    My personal views, based on experience combined with my reading of the evidence, are that surgical masks are likely modestly helpful at containing germs to the wearer. Combining this with rigorous hand hygiene and social distancing should further reduce the rate of covid spread, possibly to near zero if there were 100% proper compliance (which is of course unlikely).
    Is this actually desirable?

    And here is a great summary article of the COVID-19 situation: The COVID Coup - The American Mind

    From early March 2020 on, the best-known authorities on epidemics—the World Health Organization and the U.S. Centers for Disease Control—presented the COVID-19 respiratory disease to the Western world as a danger equivalent to the plague. But China’s experience, which its government obfuscated, had already shown that the COVID-19 virus is much less like the plague and more like the flu. All that has happened since followed from falsifying this basic truth.

    Our “best and brightest,” at first having minimized fears of person-to person contagion during January and February, during which the disease spread from China to the West, then declared that the virus is unusually contagious, and posited—on zero factual basis—that it would kill up to one in twenty persons it infected—5% infection/fatality rate (IFR). Based on that imagined fatality rate, they adopted mathematical models from Britain and the University of Washington that predicted that up to two million Americans would die of it.

    The U.S. Institute for Health Metrics and Evaluation (IHME) modeled the authoritative predictions on which the U.S. lockdowns were based. Its model also predicted COVID deaths for un-locked-down Sweden. On May 3 it wrote that, as of May 14, Sweden would suffer up to 2800 daily deaths. The actual number was below 40. Whether magnifying this falsehood was reckless or willful, it amounted to shouting “fire!” in a crowded theater. What justifies listening to, and paying, people who do that kind of science?

  3. #5193
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    Quote Originally Posted by David A. Rowe View Post
    A summary:

    1. Masks have never been given the level of scrutiny that other medical devices or practices have been. It's a practice that seems logical and has continued because of some obvious benefits in very specific environments.

    2. This has only been identified and seriously challenged within the last ten years. A significant amount of data is from modeling and laboratory experiments, and their conclusions fail immediately for clinical settings, RCTs and case studies in various populations and countries the world over.

    3. Up until this year, almost universally all studies and meta-analysis have concluded that far more needs to be taken into account and more data is necessary. So, they have largely recommended that healthcare workers continue mask usage and the general public does not use masks. There is not sufficient evidence either way, and there are more than enough unanswered questions to give pause in the creation of policy or law.

    4. Two of the critical studies this year are extremely suspect with one having an official letter of retraction submitted to PNAS to have it pulled (Zhang et al. 2020). Even if they weren't intentionally used to subvert understanding of medical professionals and policy makers, they would have absolutely not been given the level of scrutiny and verification necessary to be useful in such important capacities.

    5. Suddenly, while the pandemic is already beyond the point where our minuscule knowledge base and consensus (read: collective best guess) speculates you would have to begin interventions like mask usage in the general population, local and state governments pass ordinances, laws, and issue mandates to wear masks. Even by the data this is absurd, and by every measure of scientific, medical and professional ethics is unconscionable at best.

    In conclusion:

    If you want to wear a mask, you always were afforded the option to do so until well beyond the point where the extremely small potential benefit you propose might have had some effect. That Rip or anyone else might laugh at you for it is absolutely unimportant.

    Nothing, on the aggregate, was cherry-picked in this thread. Not everything may have been presented explicitly, but more than enough has been presented and discussed so that the meta-analysis gist of what transpired was well established -- as well as it possible could be given the inherent limitations of the circumstances we find ourselves in. Which is that there is much yet we still have yet to learn about the virus, but petty tyrants there will always be. And the road to hell is still paved with good intentions.
    Sorry, David. You're no JFS, but your posts have been okay, too.

  4. #5194
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    Quote Originally Posted by Mark Rippetoe View Post

    And here is a great summary article of the COVID-19 situation: The COVID Coup - The American Mind
    I read that one last night. The guy nailed it.

  5. #5195
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    Quote Originally Posted by Mark Rippetoe View Post
    Has any lawyer ever been disbarred for being a radical democrat activist?
    Mike Nifong of Duke lacrosse infamy. Although I'm not sure of his political affiliation.

  6. #5196
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    Quote Originally Posted by Mark Rippetoe View Post
    And here is a great summary article of the COVID-19 situation: The COVID Coup - The American Mind
    Codevilla, street creds. Looking forward to this read.

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    Quote Originally Posted by Mark Rippetoe View Post
    Has any lawyer ever been disbarred for being a radical democrat activist?...
    Poll: 62% of Americans Say They Have Political Views They’re Afraid to Share | Cato Institute

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    Quote Originally Posted by Mark Rippetoe View Post
    Has any lawyer ever been disbarred for being a radical democrat activist?
    The only D I know of that has been disbarred lied to a grand jury about getting a blow job or something. I guess itís my bad for having any faith in the justice system. Something I should be well past after Flynn , Kavanaugh vs Biden sex allegations and Hillaryís private email servers. All the double standards Iím not sure how that lady with the scales hasnít toppled over.

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    Quote Originally Posted by Mark Rippetoe View Post
    And here is a great summary article of the COVID-19 situation: The COVID Coup - The American Mind
    Pungent:

    It should be clear that the COVID event in America is only tangentially about health. It is essentially a political campaign based on the pretense of health. Mere perusal of news from abroad is enough to see that this is true as well throughout the Western world. Throughout, the campaign by governments and associated elites has essentially smothered social and economic activity. Not leastóand by no means incidentallyóit has smothered the overt political opposition which had increasingly beleaguered said governments and elites throughout the Western world.

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    Quote Originally Posted by jfsully View Post
    My personal views, based on experience combined with my reading of the evidence, are that surgical masks are likely modestly helpful at containing germs to the wearer. Combining this with rigorous hand hygiene and social distancing should further reduce the rate of covid spread, possibly to near zero if there were 100% proper compliance (which is of course unlikely). Also, N95 masks are likely quite effective at keeping germs like covid out of the mouth and nose of the wearer, but are only maximally effective when combined with full PPE.
    This is where I get frustrated and despondent. Arguments like this around masks are still premised, implicitly, on the idea that this virus is super deadly and warrants this kind of debate in the first place. At the outset early in the year, we were shocked so severely into regarding this virus as a world-altering pathogen killing between 5-10% of the people it infected. Even though we know now this virus has an estimated mortality rate of 0.2-0.6% (and this range keeps dropping) we're still treating it like Ebola. A healthy and asymptomatic college athlete tests positive and we lower the flags to half mast, say prayers, and sniff that this means college sports simply cannot continue.

    The data is in, but we're still scared shitless. So if the data cannot bring us back to rationality, what can?

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