Coronavirus

[AlanSubie4Life]

Not very contagious?

Relative.

Only has to have reproduction rate above 1 to be a huge problem.

This was of course the whole point of the post. If it is below 1 all is well.

 

[PACEMD]

Relative.

Only has to have reproduction rate above 1 to be a huge problem.

This was of course the whole point of the post. If it is below 1 all is well.

Ok, no worries. 2020 and 2021 were not bad influenza years, true enough. But some years are just not bad influenza years. We have mostly speculated that masks and isolation were the reasons. I have no doubt that was a significant factor. But we also were not looking. We did not have combination swabs in those ancient times and early on covid was a send-out test. A lot of what, the year before, would have been assumed to be influenza, tested or not, was then assumed to be covid. Viral illness, cxr not too bad, oxygen levels acceptable, go home, good luck. Monitor your oxygen levels at home and come back if you get worse. Did we test those folks for influenza, for the most part no, we did not. In medicine, you find what you look for. Like last year finding RSV in adults, hey, what the hell, RSV in adults? But we never before the combo swabs had looked for RSV in adults. Point is speculation and assumptions are just that. In medicine, you have to learn not to let those natural tendencies interfere with reality. Not always easy that.......

 

[madodel]

Perhaps, but that's a very different statement than saying influenza is not very contagious. If someone wants to compare how theoretically contagious various viruses are have at it. An intellectual game. In a practical sense, it doesn't tell you a lot........

Doesn't Flu also have rapid onset of symptoms so people know they are sick (and therefore contagious) while with COVID people were frequently asymptomatic yet still able to spread the virus?

 

[DrGriz]

Doesn't Flu also have rapid onset of symptoms so people know they are sick (and therefore contagious) while with COVID people were frequently asymptomatic yet still able to spread the virus?

Yes. In the graphic I posted above, you can see that the incubation period, during part of which a person can be contagious, is 2-3 times longer for covid than the 2 days for influenza.

 

[DrGriz]

Ok, no worries. 2020 and 2021 were not bad influenza years, true enough. But some years are just not bad influenza years. We have mostly speculated that masks and isolation were the reasons. I have no doubt that was a significant factor. But we also were not looking. We did not have combination swabs in those ancient times and early on covid was a send-out test. A lot of what, the year before, would have been assumed to be influenza, tested or not, was then assumed to be covid. Viral illness, cxr not too bad, oxygen levels acceptable, go home, good luck. Monitor your oxygen levels at home and come back if you get worse. Did we test those folks for influenza, for the most part no, we did not. In medicine, you find what you look for. Like last year finding RSV in adults, hey, what the hell, RSV in adults? But we never before the combo swabs had looked for RSV in adults. Point is speculation and assumptions are just that. In medicine, you have to learn not to let those natural tendencies interfere with reality. Not always easy that.......

It's true. When you don't go fishing, you don't catch fish.

When we were doing parking lot testing, We'd take a little history, do a swab on one person, and if it was positive send the whole car on it's way. Sometimes we'd do further testing, depending, but I bet at least some influenzas slipped through.

 

[DrGriz]

If people would be considerate of others by wearing proper N95 masks and doing frequent hand washing, neither would be as much of a concern as they are is today. But I suppose that's too much to ask. Sigh

Our community orchestra and choir are having a spring concert tomorrow. My wife plays in the orchestra and is the coordinator.

We know of several members who recently were sick with covid and continued to come to practice within the 5 days. Singing, and playing the baritone horn (basically blasting out virus). We already know there are some people exposed to these folks at church who are sick. Only 3 or 4 people, including my wife, are wearing masks in the orchestra (most are wearing KN95 or N95). Of course, the choir is not.

Who knows how many people are now infected? It might be an amazing superspreader since most of the audience won't be masked either.

Interestingly, there's some discussion of changing the 5 day isolation guidance to "stay home when you are sick".

there is one lingering residual: the five-day isolation period following a covid diagnosis. We believe it’s time for the Centers for Disease Control and Prevention to retire that policy and move to an alternative guidance: Stay home when sick; return to work and school when you are better.

Hopefully not paywalled since it is Covid:

https://www.washingtonpost.com/opinions/2023/04/12/covid-cdc-five-day-isolation-guidance/

I think an orchestra and a choir maybe are different from the average person just going to the grocery store. After all, some of the first known spreading events came from choirs.

 

[AlanSubie4Life]

Sometimes we'd do further testing, depending, but I bet at least some influenzas slipped through.

Sure. But this would look very different than what we saw.

It’s not like there wasn’t extensive testing for influenza.

The CDC and WHO data is pretty rock solid.

 

[DrGriz]

Sure. But this would look very different than what we saw.

It’s not like there wasn’t extensive testing for influenza.

The CDC and WHO data is pretty rock solid.

Oh, yes. I agree. The flu cases were way down. No question. We all knew it at the time. One of my jobs at the time was to report on the respiratory disease data. I think the deaths from flu that year for our state were either one or none. Unheard of.

 

[bkp_duke]

Oh, yes. I agree. The flu cases were way down. No question. We all knew it at the time.

The near zero influenza cases is good evidence that the playbook used on for COVID, which was designed based upon a flu pandemic, was great for a virus of that type, R0, and CFR.

The same playbook was only partially effective against COVID, which had a higher R0, but lower CFR (than pandemic influenza, not seasonal).

 

[DrGriz]

The near zero influenza cases is good evidence that the playbook used on for COVID, which was designed based upon a flu pandemic, was great for a virus of that type, R0, and CFR.

The same playbook was only partially effective against COVID, which had a higher R0, but lower CFR (than pandemic influenza, not seasonal).

And it didn't help that the playbook had been thrown out just months earlier.

 

[bkp_duke]

And it didn't help that the playbook had been thrown out 6 months earlier.

True, but playing devils advocate here . . . if you look at historical accounts of the 1918 pandemic there was a lot of social unrest with that one as well.

 

[DrGriz]

True, but playing devils advocate here . . . if you look at historical accounts of the 1918 pandemic there was a lot of social unrest with that one as well.

Very true. Having a playbook doesn't do much for you if nobody wants to follow the game plan.

 

[PACEMD]

Sure. But this would look very different than what we saw.

It’s not like there wasn’t extensive testing for influenza.

The CDC and WHO data is pretty rock solid.

I would definitely say there was not extensive testing for influenza in those years. Clearly not. That was one of my points to the story above. Assumptions changed perception of reality. And the CDC and WHO are great, but they play within the limits of their own reality.

 

[PACEMD]

Doesn't Flu also have rapid onset of symptoms so people know they are sick (and therefore contagious) while with COVID people were frequently asymptomatic yet still able to spread the virus?

Maybe, but we have never on a significant scale tested asymptomatic people for influenza. And clearly not like we did later with covid. With influenza, we often have not even tested symptomatic people. Not unless that test matters. It generally doesn't. There is no real treatment for influenza so you're either sick enough to need in-house supportive treatment or not. Don't cough on other people and tough it out. With covid, it mattered because we didn't know if it mattered. Meaning we tested asymptomatic people as part of the learning process. That's why research should eliminate assumptions. And observational studies are just observations. Observations just generate speculation.

 

[PACEMD]

And understand the above post is a setup to mention Tamiflu. Don't. A medicine that statistically gets you better 18 hours sooner is not a significant true treatment. We still use it for risky cases, but only because there are no other known options.

 

[AlanSubie4Life]

I would definitely say there was not extensive testing for influenza in those years. Clearly not. That was one of my points to the story above. Assumptions changed perception of reality. And the CDC and WHO are great, but they play within the limits of their own reality.

Sure, I could see testing being way different and most likely reduced for many reasons.

Just doesn’t explain any of the behaviors that we see though, of course!

Fundamentally it is just different reproduction rates between COVID and flu and cutting them down. In one case interventions dropped the reproduction rate consistently below 1. In the case of COVID, not so much.

The amount of testing is neither here nor there. Sure maybe it was reduced by a factor of 10 (of course it didn’t) - still wouldn’t remotely explain the results.

There’s not any doubt here. It’s just the facts of what happened, and it was fully expected.

The learning of course is that with proper masking in selective settings and at certain times of year, we could reduce influenza mortality. Not near to the extent seen in the pandemic - that would require more extreme measures, somewhat less than what we have done in the past, and no one is going to think that saving 50k lives a year makes that worth the inconvenience and restrictions on their freedom to spread disease. People have to die somehow after all. May as well let the old people die of influenza if it is going to be a pain. Fortunately halfway measures will probably help. And old people in the know will just slap on N95s (stock up while they are cheap!) and give the finger to all the hacking people around them (if you have dementia you will not be doing this).

 

[PACEMD]

Sure, I could see testing being way different and most likely reduced for many reasons.

Just doesn’t explain any of the behaviors that we see though, of course!

Fundamentally it is just different reproduction rates between COVID and flu and cutting them down. In one case interventions dropped the reproduction rate consistently below 1. In the case of COVID, not so much.

The amount of testing is neither here nor there. Sure maybe it was reduced by a factor of 10 (of course it didn’t) - still wouldn’t remotely explain the results.

There’s not any doubt here. It’s just the facts of what happened, and it was fully expected.

Please don't take this as an offense Alan, but what does any of that mean? And those words have what to do with what? Obfuscation may be fun and all but to what purpose? Seriously, I tried my best to make sense of that. I failed. I'm not trying to be critical, Alan, but no way I can understand how that applies to anything. Is that the intent? Obfuscation as its own merit? Or is it just challenged expression? You keep saying things that are clearly wrapped in scaled assumptions and then branch down that dusty scared path. Adding a belief of certainty only overflows into the bucket of doubts.

 

[PACEMD]

So you said, the flu is not very contagious. I questioned that and your reply.......well I just meant compared to things that are even more contagious than the flu. What? If just a communication error clarify and acknowledge that and move on.

Then you said there was extensive testing for influenza in those heavy covid years. I questioned that and you said what? Well maybe testing was down just a bit but no worries, testing wasn't really the thing anyway. Or something, who knows?

You keep implying.......here are the facts, nothing can change that! Well, the facts ain't always the facts, are they? That's a fact. Without an open/active mind, those proclaimed facts pile on one another and crush the outcome.........

 

[AlanSubie4Life]

So you said, the flu is not very contagious. I questioned that and your reply.......well I just meant compared to things that are even more contagious than the flu. What? If just a communication error clarify and acknowledge that and move on.

Then you said there was extensive testing for influenza in those heavy covid years. I questioned that and you said what? Well maybe testing was down just a bit but no worries, testing wasn't really the thing anyway. Or something, who knows?

You keep implying.......here are the facts, nothing can change that! Well, the facts ain't always the facts, are they? That's a fact. Without an open/active mind, those proclaimed facts pile on one another and crush the outcome.........

I think it is important to not sow doubt when things are well established.

You can read the original post and it is clear that I was saying that influenza is less contagious than COVID. Which is not the same as not contagious!!! (To be clear, I started the post saying “influenza is not very contagious” - but that has to be taken in context!!!)

Which was the key point. Obviously it can still spread and cause a lot of problems - I said that (summer shuts it down, is what I said, which is the same thing - I even said it could spread widely!).

Furthermore, there was extensive testing for influenza during the pandemic. I am sure you can dig up the number of tests and all that data from the CDC if you try.

And that’s all we need to know. We were testing extensively for influenza, perhaps less than normal, and influenza nearly disappeared, as one would expect since it is substantially less contagious (perhaps inherently, perhaps not) than COVID in this population (the world), at that time. And we were successful in bringing COVID spread to levels where it decayed, at times.

There’s no reason to discuss further really. It’s obvious and clear and the specific quantitative details and subtleties which undoubtedly exist can be left to the researchers. I don’t care.

You keep saying things that are clearly wrapped in scaled assumptions and then branch down that dusty scared path. Adding a belief of certainty only overflows into the bucket of doubts.

There’s no doubt in the original post. Which I stand by. I haven’t seen any evidence presented which would cause me to consider other hypotheses - which of course I am completely open to. It could be something else! But it would have to be supported by facts.

That is the way this works - I have certainty about things, and then if the evidence base changes, I can completely change what I think.

your reply.......well I just meant compared to things that are even more contagious than the flu.

Yeah that was in the original post.

If just a communication error clarify and acknowledge that and move on.

Yeah I clarified though it was already pretty clear.

 

[shinytop]

The people of our country responded in many different ways to the mitigation attempts because we had Luddite politicians giving opposite advice and in some cases pushing through laws that made the mitigation actions illegal. We live in a fabulous country.

At a time when we needed leadership we had politicians.