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Thread: COVID19 Factors We Should Consider/Current Events

  1. #5631
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    The trouble with COVID-19 is that we were in danger of waiting for statistics we could not measure whilst seeing footage from first world country ITU’s looking like war zones. Obviously the gold standard for deciding how deadly it is is the infection mortality rate -- in early stages the infection fatality rate was obviously poorly extrapolated from the case fatality rate because testing was sparse and people were getting COVID-19 without thinking they had it (vague tiredness, taste loss etc). As testing and antibody testing evolves we may be able to work it out better, but we still need to agree on what a COVID-19 death actually is! A 45 year old with no comorbidities getting flu like symptoms and then dying of ARDS would be, but an 89 year old skeletal demented moribund nursing home resident dies 90% from their pathologies and 10% from COVID-19. There is then bias and downright manipulation of figures to contend with.

    At the risk of enraging members who are skeptical of doctors, I have kind of been on the front line of this and sometimes observational data can be helpful. During the bad weeks in the UK some nursing homes got badly affected -- I spent a lot of time with relatives trying to convince them to let me keep their loved ones out of hospital to die at home, way worse than a bad flu season. But the avalanche of others dying did not materialise as badly as expected, although it was scary for all the 60 something diabetic Indian males for a while. However I am worried how many advanced skin cancers I will be seeing now that my secondment from dermatology to primary care has ended. And how many small business owners who have gone under may end up blowing their brains out.

    It is a shit situation.

  2. #5632
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    Cuomo Talks Reopening Gyms as Schools Fate Looms; NYC Launches More COVID Checkpoints – NBC New York

    Look at the first sentence:

    Over the last seven days, one person has died every 80 seconds from COVID in America. And the pace at which those 7,486 people died appears to be accelerating, NBC News reports
    This is an astonishingly effective propaganda device. Doesn't matter that it's bullshit, it's still very scary. And that's the common feature of all this fear porn. It amazes me that every day they can think of a new way into the brains of the general public. And then there's Governor Cuomo:

    Asked on a conference call with reporters Thursday when he might lift the restrictions on health clubs, Cuomo pointed to the record COVID surges sweeping more than half of America and said simply "now is not the time."

    "We know gyms are highly problematic from the other states. They opened them and they had to close them," Cuomo said. "We're here, poised delicately on this island of New York state with this sea of spread all around us so we know we have this storm and we have to be very very careful."

    "It almost defies common sense that we could be maintaining our low numbers in the midst of what's going on," he added. "We're precariously perched."
    How do you learn to think this way, and communicate like this? Serious question. Is there a Sociopath School somewhere in NY?

  3. #5633
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    Quote Originally Posted by Haghstull View Post
    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?
    Use Cottonelle, it wipes clean.

  4. #5634
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    Cuomo Talks Reopening Gyms as Schools Fate Looms; NYC Launches More COVID Checkpoints – NBC New York

    I can't resolve the contradiction of checkpoints for out of staters with full resumption of schools. If what I heard about full reopening of schools this morning is still what is going to happen.

    Not that I think the school part is wrong, but how can anyone think that is OK and checkpoints are not completely absurd? If not totalitarian. It's like the Articles of Confederation never got superseded by the Constitution.

  5. #5635
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    Quote Originally Posted by Mark Rippetoe View Post

    How do you learn to think this way, and communicate like this? Serious question. Is there a Sociopath School somewhere in NY?
    YOU could do it. You would be exceptionally good at at it both written and verbally. I can do it verbally. I do a fair bit of oral presentation and teaching etc. Like many skills it can be used for good or evil.

    It must be a learned behavior to lie like a jackass without shame. Experience and practice always helps. The question is if or when do you lose your integrity? I lost mine when I started my professional career 1986 and I got my integrity back around the year 2000.

  6. #5636
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    In the U.K. we are told that it’s either the pubs or the schools that it can’t be both that stay open. The SAGE committee are also beavering away trying to close indoor gyms. Return from Spanish holidays now requires a quarantine stay, which effectively rules out a lot of booked holidays. The press continue screaming that the beaches are too crowded and there isn’t any anti-social distancing going on.

    I could easily draw a connection here-it’s the working classes that go to pubs, gyms, Spanish holidays and the beach.

  7. #5637
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    Quote Originally Posted by johnst_nhb View Post
    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.
    When a doctor says “case,” the meaning depends on context. Most physicians see patients who are ill, so if they saw 10 “cases” of something, it would generally mean 10 people with illness. This would be the meaning 90% of the time.

    Covid is an unusual situation because we test asymptomatic people, which we don’t generally do for other illnesses. So I have seen “cases” applied to positive PCR tests, meaning that someone testing positive is actively infected, regardless if they have symptoms. So our hospital has seen several hundred “cases” but many were not symptomatic and so wouldn’t be a “case” in epidemiology parlance. Most doctors caring for patients don’t talk about IFR or CFR. Thats for epidemiologists and public health researchers.

    In terms of the media and covid, the cats out of the bag, and to expect precision of medical jargon is just unrealistic, unfortunately, so you have to just pay attention to what people are talking about. I’m pretty careful to be precise, and mixed up apples and oranges myself, so I can’t drag anyone else too hard for making that error.

    If you have antibodies from a previous infection, say Hep B antibodies from a vaccine, we would not call a positive antibody test a “case” in the clinic. This is probably a poor example because people with antibodies from a vaccination most likely never had the illness, but even if you had, nobody would say “I saw a case of hep B today” just from seeing someone with a positive antibody test.

    In terms of depression, since you mentioned it, the diagnosis is always and only made based on symptoms reported and observed, not on a physiologic test.

  8. #5638
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    Quote Originally Posted by jfsully View Post
    Covid is an unusual situation because we test asymptomatic people, which we don’t generally do for other illnesses.
    I wonder why.

    Covid Cases Go Undercounted With Muddy Data From U.S. States

    Isn't it fascinating that the data is only "muddy" if it shows decreasing "case" numbers?

  9. #5639
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    Quote Originally Posted by Mark Rippetoe View Post
    I wonder why.

    Covid Cases Go Undercounted With Muddy Data From U.S. States

    Isn't it fascinating that the data is only "muddy" if it shows decreasing "case" numbers?
    There are 2 other ways data is being manipulated for the narrative. One is using cumulative cases as a reference. It shows a nice, never-ending upward slope. They should be using epidemiological graphs. They show a much different story.

    The other utilizes this method:
    COVID-19 'death harvesting' distorts improving reality in Florida - Conservative Review

    And no one is the wiser for it.

    Also to piggyback on jfsully’s earlier point, it’s true the vast majority don’t know what a virus is and they certainly can’t read a simple graph.

    Quote Originally Posted by jfsully View Post
    When a doctor says “case,” the meaning depends on context. Most physicians see patients who are ill, so if they saw 10 “cases” of something, it would generally mean 10 people with illness. This would be the meaning 90% of the time.

    Covid is an unusual situation because we test asymptomatic people, which we don’t generally do for other illnesses. So I have seen “cases” applied to positive PCR tests, meaning that someone testing positive is actively infected, regardless if they have symptoms. So our hospital has seen several hundred “cases” but many were not symptomatic and so wouldn’t be a “case” in epidemiology parlance. Most doctors caring for patients don’t talk about IFR or CFR. Thats for epidemiologists and public health researchers.

    In terms of the media and covid, the cats out of the bag, and to expect precision of medical jargon is just unrealistic, unfortunately, so you have to just pay attention to what people are talking about. I’m pretty careful to be precise, and mixed up apples and oranges myself, so I can’t drag anyone else too hard for making that error.

    If you have antibodies from a previous infection, say Hep B antibodies from a vaccine, we would not call a positive antibody test a “case” in the clinic. This is probably a poor example because people with antibodies from a vaccination most likely never had the illness, but even if you had, nobody would say “I saw a case of hep B today” just from seeing someone with a positive antibody test.

    In terms of depression, since you mentioned it, the diagnosis is always and only made based on symptoms reported and observed, not on a physiologic test.
    Thank you for this reply!

  10. #5640
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    The kind of physical realities which elude very serious data scientists in news media:
    Deaths for specific individuals occur on specific days, not some arbitrary range of days
    Remember this when California resolves its boondoggles and reports a false peak.

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