COVID19 Factors We Should Consider/Current Events

[Haghstull]

The more literate the troll, the higher the threshold for deletion? Is this your assumption?

I don't know what to say except that I am completely sincere in my fiscally left/socially conservative views, despite what Hurling types. You must have met people who occupy my region of the 2D ideological spectrum before; we inveigh vociferously against capitalism, but still share more with you in terms of moral/philosophical instincts than you have acknowledged. Why do you think I am trolling you?

Meanwhile, the MSM is just now beginning to panic about a trend that has been developing for a few weeks now: New polling suggest Trump's position has stabilized - CNNPolitics

Are people finally getting fed up with the dem-led media and public health response?

[jfsully]

I have pointed out several times that the Case Rate and the Infection Rate are two different numbers, the CR being completely dependent on testing rates -- you acknowledge this by saying the death rate will come down. Your "covid fatality rate" is the number of confirmed cases that die, and this is absolutely and completely a bullshit statistic, and you should know this. In the absence of a true estimate of the number of infections, the number of cases is useful only as propaganda -- and it's being used that way every minute of every day. The "Death rate from COVID-19" is the only number of any value, the DRC19, the number of people dead of COVID-19 as a percentage of the population. Even that is bullshit, since we know about the games being played with death coding and the incentives in place for doing so. So, in a nation of 328.2 million people, ~159,000 have died "of COVID-19." This is 0.048%. Same with the flu -- we don't know how many had it, so we don't know the death rate from the disease, we only know how many who died from it and what % of the population this constitutes. It's about 0.018%, about 1/3 as deadly as COVID-19 so far, even if you believe their numbers.

So, compare 0.048% and 0.018%, and then compare the responses by the government to each number. Remember that between 2.5 and 3 million people die in the US every year, which is ~0.837% of the population, headed towards 1%. Bigger picture, sully.

Ah, got me. I was sloppy with the numbers, which is especially annoying because I have posted several times on IFR/CFR.

The problem is that we don’t have a good IFR for flu. We can compare the CFR of 2017 flu (0.13%) with the CFR of covid (>3%) which makes the point that covid’s a tougher illness if you get it, but you’re right that that doesn’t correlate well with the cost to the whole population. I do think the IFR for covid (currently <3%) will wind up around 1% (where flu is <0.13%). And the fatalities are not all people on their deathbeds already.

Basically, I still think that the potential for excess death from covid is significant enough to warrant some control measures. I wish they had been done more thoughtfully from the beginning so everyone wasn’t so broke and pissed off.

[Mark Rippetoe]

And the fatalities are not all people on their deathbeds already.

Again, same as the flu. I don't think you see my point.

[Mark E. Hurling]

I don't know what to say except that I am completely sincere in my fiscally left/socially conservative views, despite what Hurling types.

As Mary McCarthy once said of Lilllian Hellman, "Every word she writes is a lie, including ‘and’ and ‘the.'"

Except in this instance words are also being repurposed from their actual meanings. Real Ministry of Truth doublespeak being deployed to scratch the itch of unwiped ennui.

[Barry Charles]

Basically, I still think that the potential for excess death from covid is significant enough to warrant some control measures. I wish they had been done more thoughtfully from the beginning so everyone wasn’t so broke and pissed off.

I’m not necessarily in agreement but it is reasonable.

There is a another dimension of this particular disease that may be relevant. That is risk as a function of situation. For example, age. An 80yr old is 10x more likely to die than a 20yr old (or whatever). If this is true and the evidence certainly strongly supports that it is. Doesn’t this have to be considered when considering if a death rate is “high “ or “low”?

Individuals care greatly on mortality rates, but policy cares more about life expectancy than mortality rates I think. It seems mathematically plausible that a very high mortality rate for a given disease doesn't change life expectancy at all. Am I missing something?

[jfsully]

I am assuming you understand the difference between case fatality rate and an infection fatality rate as it pertains to infectious disease. Assuming you do, how do you define a "case?"

Addressed above. Yes, i made an error in terminology.

In your understanding of the statistics above, how does a positive antibody test in relation to a positive PCR test play a role in the fatality rate?

Not sure what you’re getting at here. One is a test for current/recent infection, the other is a test for current OR past infection. Neither can tell you whether someone is or was symptomatic. I suppose antibody tests if done widely can help to dial in the IFR, depending on how long covid antibodies hang around. But the PCR test seems to be positive for about a month after infection onset, so the wide use of PCR in the short term can serve this purpose too.

[Jovan Dragisic]

My favorite new doctor line is how young people should stop trying to have fun until given permission.

[Nicholas Laureys]

Basically, I still think that the potential for excess death from covid is significant enough to warrant some control measures. I wish they had been done more thoughtfully from the beginning so everyone wasn’t so broke and pissed off.

The ONLY THING that should have been done earlier is sealing off the border immediately from China, then, Western Europe, and then delaying the return of those US citizens on that cruise ship from returning, for a much longer time.

Or, what else do you mean, Sully, when you say measures were delayed, or not strong enough, soon enough? What was it that the government should have done stronger, sooner?

Probably it's something political, like President Trump didn't begin widespread testing soon enough, or we should have spent more money....do you really think steps like those would have been more helpful?

I am not calling you out individually, Sully -your argument here (repeated in your last few posts) that STRONGER restrictions should have been implemented SOONER has been made by others on this forum repeatedly, and is the boilerplate response from "that" crowd. You are simply the most recent poster to make this claim again and again, that not enough was done quickly enough to prevent us from being put into the situation that we're all in now. So, what else should have been done, back in January and February?

Go out on social media to discuss this topic, and write that our governments were idiotic in their responses (meaning authoritarian; too restrictive), and the average reply you get will be agreement, but they mean that the governments were idiotic because THEY DIDN'T DO ENOUGH, QUICKLY ENOUGH! Pathetic.

Russia, interestingly, shut its Chinese border around that time, in January or February, and even cut off incoming flights (or at least was heavily testing incoming citizens from those flights, AND requiring mandatory, yet self-monitored, 14-day self-quarantines) from Italy, and then gradually the UK, and even the USA! Isn't THIS the "something, stronger, sooner" that should have been done? Sadly even Russia somehow didn't act quickly or strongly enough, even with these measures (probably should've mandatorily quarantined people, like they did with incoming Africans during the recent Ebola scare, if their goal was to keep CoVid out as long as possible), as the first cases that appeared in Russia were from people who had been on incoming flights from Italy.

So, let's be honest, even if such measures would have been highly effective and protective of American citizens, the borders NEVER would have been shut down to these places, nor citizens on cruises delayed entry to our country. Why? Is Russia smarter than us (meaning, the West)? Do its leaders care more about their people? Are they *less polite and more savage* than us?
Choose another country that imposed measures that impacted its citizens less with better results in restraining CoVid, if you like- Sweden, Belarus,....who else??
But don't say that we could have avoided all this mess by doing more, sooner, without describing what opportunities were missed - unless this is just a backhanded swipe at Trump. . Because you cannot be implying that we should have closed our borders sooner - that's impossible in today's America; we're too smart, sophisticated, and polite for any icky, early-20th century political decisions like THOSE (or WALLS, for that matter!).

And BTW, I hope you see in the example of Russia how trying to keep CoVid out as long as possible, or restrict its spread, EVEN AT THE POINT WERE AT TODAY, is a futile aim -- comical, even, if it weren't so destructive to all us peasants.

[Haghstull]

As Mary McCarthy once said of Lilllian Hellman, "Every word she writes is a lie, including ‘and’ and ‘the.'"

Except in this instance words are also being repurposed from their actual meanings. Real Ministry of Truth doublespeak being deployed to scratch the itch of unwiped ennui.

Heh. The lifelong socialist George Orwell is much more likely to think that the way I use these terms is apt. Do you think he would have understood Cuomo as a leftist, Hurling?

[johnst_nhb]

Addressed above. Yes, i made an error in terminology.

Dr. Sully, Thank you for the clarification above.

Not sure what you’re getting at here. One is a test for current/recent infection, the other is a test for current OR past infection. Neither can tell you whether someone is or was symptomatic. I suppose antibody tests if done widely can help to dial in the IFR, depending on how long covid antibodies hang around. But the PCR test seems to be positive for about a month after infection onset, so the wide use of PCR in the short term can serve this purpose too.

What I am getting at is really what your take on the below is. Note that I am not challenging you, I am just genuinely interested in your take as a physician.

I made a previous post in this thread about what antibody tests show vs PCR but this is not a popular narrative.

There is a clear narrative happening now that any positive test is a "case." We also know that antibody and PCR tests are being commingled in order to boost overall numbers* of "cases." But scientists know that an antibody test does not necessarily mean you are currently infected (I am skipping over the additional complication of possible specificity issues with antibody tests), therefore they should not be used in the absence of a PCR test to determine infection. But can be used accurately to determine previous infection (as you are saying above.) So the actual IFR is being ignored because it is significantly lower than politicians want to hear.

In your experience, does the medical establishment conventionally consider a positive antibody test or a positive PCR test a "case" in the absence of symptoms? I've worked very closely with physicians and researchers in molecular biology and virology but have never experienced this line of thinking. A "case" was a reference to displaying malaise in some due to the infection, or in situations where the infection can be directly linked to that malaise. But that was a while back and things change.

Kind of like, can a person be diagnosed as depressed because of clinically determined "imbalance of chemicals in the brain" even if they are not exhibiting depressive symptoms?

*perhaps. Another explanation is just incompetence.

Appreciate your thoughts.