Coronavirus

[TEG]

Remdesivir works by preferentially mimicking ATP to arrest the action of RdRp, the viral enzyme responsible for RNA viral replication inside the cell, so the earlier it is administered should be the better, to prevent the buildup of viral load. It has been suggested as a prophylactic for frontline healthcare workers but I think it has not seen such use thus far.
The bio-molecular mechanisms are well explained in these 2 videos:
RNA virus replication
Action of Remdesivir

So, is RdRp created in only infected cells, so Remdesivir would not cause harm to normal cell operations?
Is Remdesivir delivered some way that it only gets into targeted infected cells, or does it get inside all cells?
It seems like some sort of "ATP function distruptor" could do some bad things too...?

 

[AlanSubie4Life]

Does that mean we should not discuss facts and data?

As you can see from my post history, I do generally quote facts and data. I posted this anecdote in response to your repeated claims which seem to minimize the risk in healthy populations.

Fact: This disease has killed over 700 people nationwide under age 50 (more than 2% of the deaths, from a population making up ~73% of the US population, so the remaining ~98% of deaths come from the ~27% of people above age 50).
"Similarly, in New York, 64 percent of patients between the ages of 30 and 39 who died of the disease suffered from a preexisting condition, usually high blood pressure or diabetes. But that still leaves about a third of cases without such a possible contributing factor."

https://www.washingtonpost.com/health/2020/04/08/young-people-coronavirus-deaths/

Let's look at your focus on "facts and data," specifically as it refers to your take on "shelter-at-home" orders and effect on virus spread:

it seems that the cases really accelerated after the shut down,

it went exponential after the shut down

it was relatively flat until after the shut down in late March.

Also, the school closing happened on March 18... and yes, after that we do see a bigger acceleration.

but I do believe that in the case of NYC, the curve would have been flatter had they done nothing / stuck with the status quo.

For NYC really they got the high one, though they were shooting for the low one. Letting things go per usual (with some non-disruptive measures like good hygiene) would have stretched out the curve. Peak would have come later, as is happening in Sweden.

The NY data shows it really took off after SAH

I'm using first principles

Perhaps you should study up on first principles such as: incubation period, and time from symptom onset to presentation for diagnosis. And also see: Exponential growth.

Your take on the current number of infected:

And then the fact that the virus has spread to a degree where there's not many new to infect given the current situation.

You're asking me for numbers; no one knows; it's just a guess.

I focus on cases as cases show the spread.

Do you have some data to support your claim of "there's not many new to infect?" Can you quantify what you mean by that?

As far as "cases showing the spread," can you support that? It's generally thought that infections are 10x-20x the case numbers, but the exact ratio will depend on location and positivity rates, so relying on cases to show the spread seems like a questionable methodology.

Your take on what young (please define) and healthy people should do:

If you're concerned, then get healthy. Lose weight. Exercise. Eat right. Don't be deficient in vitamins

If I were in charge, I would tell everyone they need to walk/bike/etc at least a total of 1 hour a day. If people exercise and lose weight they will be less susceptible. More adipose tissue makes it harder to breathe and steals oxygen.

Isolate the at-risk and the sick only. And make everyone exercise to get healthier.

A young, healthy person can go about per usual.

Young, healthy people have virtually zero chance of dying from Covid. True statement.

Can you define "virtually zero" for us here, since we're talking about "data?" Can you explain the ~1/3 of deaths in patients under 50 with no known preconditions?

Your take on basic reproductive number before interventions:

That paper says it's an estimate and puts it between 0.3 and 1.2, quite low.

Your take on immunology:

It is being exposed to things that creates a robust human.

I feel like what's going on now, with everyone wearing masks, in addition to all the other measures, is we are getting super hygienic. Probably many different types of airborne pathogens are dissipating. Which might be good; but it's overkill. And may weaken our ability to fight disease in the long run.

And I have heard, yes from doctors, that prolonged contact is needed.

Please post some facts and data to support your claims about the immune system.

Your comparison with the flu:

Actually for 99% of people it is like cold or flu.

In bad flu seasons the outcome is similar to what we are seeing with Covid.

Please support these two claims with data. My data: in the past three weeks, the US has experienced the number of COVID deaths seen in a typical flu season, and it looks like the cumulative number of deaths from the first wave alone, in just two months total time, will likely match a "bad" flu season (80k deaths in 2017-2018). And this is with shelter-at-home orders in place.

Here is a misstatement of fact:

The diamond princess had 50% asymptomatic.
1% IFR with an OLD population.

Speaking of data, this is false. 14 have died. 712 infections were identified, 46.5% of whom were asymptomatic at the time of the positive test. Seems like 2% IFR in this old and generally healthy population, and very unlikely that they missed over 712 infections.

Here is your data-driven take on average age of death from COVID-19:

(avg age of death from Covid is 80).

The avg age of death from Covid is 80. Think about that.

The avg age of death of Covid is 80,

Since you are focused on facts and data:
Please post the data from a representative sample of deaths, showing this to be the case. Even in Washington State, which had massive initial infiltration into multiple nursing homes, the average age of death appears to be about 75 years old. (35% of the cases are in people above age 60, so they are over-represented in terms of infections.)

I have been unable to obtain US demographic data on average age of death.

Here is your take on effect on life expectancy:

You can't just look at raw numbers. No context. Doesn't tell you anything

Death causes are a zero sum game;

it's not like the plague or the spanish flu, which would show an increase in the yearly death total because it would kill a bunch of young and otherwise healthy people who wouldn't normally have died soon.

which will yield zero change in net annual deaths.

yes in absolute terms, it would reduce it,

I didn't say it wouldn't reduce life expectancy.

I was just going by a global average.

. But it seems those numbers agree with my hypothesis.
It really depends on what % increase in net deaths for each age group are moved by Covid. Seems it would be an immaterial % from napkin

Please post your back of the napkin calculations for us to review! Facts and data are important - we should see about your claim. It's very unclear exactly what you are trying to claim here, and some hard numbers would help.

Everyone assumed it's 3/100

That is incorrect. That was the initial CFR reported by the WHO, though it was widely misrreported as an IFR as far as I can tell. Most epidemiologists have assumed an IFR of around 1% so far.

you're

*your.

You'll be happy to hear that for most of the apparently false claims you've made above, I've spared you the "disagree," until you have chance to support each of them with facts. I'd be grateful to you (since you care about disagrees apparently), that you would also stop rating my posts disagree, or at least tell me what you disagree with. Otherwise I might have to start rating your posts based on my own fact check results.

We are sacrificing our kids to save the grandparents, and that's wrong! The grandparents already got to live a full life. Let our kids do that

This particular argument of yours is not currently a data-driven argument. It's an ethical/social question. And the tradeoff depends on the numbers we are talking about. So let's see those numbers.
Here are my numbers, which will also affect the tradeoff you're talking about. You are apparently assuming that things will go back to normal:
Derek Thompson on Twitter
Dr Emma Hodcroft on Twitter

We should have results from larger and better tests soon. Unfortunately, due to anchoring bias and confirmation bias, I expect opinions to lag the data that emerges, as people apply a much higher standard of proof to information that contradicts their opinions than to information that confirms them and to the very poor quality RT-PCR data that has formed their opinions so far.

I am looking forward to it. I am especially looking forward to you posting those test results as the become available!

I think the evidence so far -- as spotty as it is -- points strongly toward the PCR testing conducted to date massively undercounting the number of infections.

Yes, this is generally accepted by pretty much everyone! Epidemiologists expect to see about 10-20x the number of cases identified by PCR testing, in the United States (likely higher in places with higher test positivity rates, and lower in places with lower positivity). There is no surprise with that claim (will result in 1% IFR or so when deaths are complete). What would be surprising in the United States, on average, is 50x to 100x (would result in ~0.1 to ~0.2% IFR, "just like a flu").

Just want to be sure we have the expectations set appropriately for what constitutes a "surprise" over the coming week.

 

[bkp_duke]

Any thoughts yet medically on what what might be triggering these reactions? I know the virus for chicken pox can lay dormant, right?, and emerge as shingles later in life. Could this be somehow reactivating things in the body or overstimulating other conditions in the body? I can see where infants and young children wouldn’t have built up their immune system yet (and maybe not had all their vaccinations yet). That lady in the video however doesn’t fall into that age category and her toes looked horrible. Can’t imagine touching them and having them bleed like that.

Different viruses manifest differently in different age groups, sexes, etc. It's just one of those "givens" we accept in biology. We just observe it, catalog it, and move on.

What I've noted here on TMC is that we have a lot of "engineering minded" people. Specifically, that people think in a binary mode and want to attribute something with essentially 1s and 0s or yes's and no's.

Biology is more of a spectrum, and even symptoms are in a spectrum. While children are showing the presention with spots on the feet, hearing that one or more adults has it also would not surprise me, although I don't think it is reported as a majority. It's just one of those things we observe, and move on.

Hilariously - the most common disease in adults to present on the hands and feet is . . . syphilis. That one is "pathognomonic".

 

[bkp_duke]

So, is RdRp created in only infected cells, so Remdesivir would not cause harm to normal cell operations?
Is it delivered some way that it only gets into targeted infected cells, or does it get inside all cells?
It seems like some sort of "ATP function distruptor" could do some bad things too...?

It's not that clean cut, as there are some indications that Remdesivir could cause birth defects . . . but . . .

yes, for the most part, Remdesivir is SPECIFIC as a "nucleoside analog" to the RdRp protein. It causes those proteins to produce copies of the viral RNA that has Remdesivir incorporated (if they build it at all), thereby making those new viral particles useless.

To be clear, there are not enough Remdesivir molecules to completely stop the virus. They simply slow the replication of it, thereby allowing the immune system to get the upper hand and win the battle.

 

[Norbert]

What would be surprising in the United States, on average, is 50x to 100x (would result in ~0.1 to ~0.2% IFR, "just like a flu").

Just want to be sure we have the expectations set appropriately for what constitutes a "surprise" over the coming week.

Well, agree otherwise, but an IFR of ~0.1% isn't possible anymore, at least not for New York City, where the mortality is already ~0.16% and still rising.

 

[EinSV]

Abbott Labs has developed a high throughput covid-19 antibody testing system. They report 100% sensitivity and 99.6% specificity based on 1200 test samples. University of Washington virology has independently validated the test.

I haven't seen the underlying data, but an article on it is here for anyone interested: Univ. of Washington ramps up Abbott Labs’ ‘fantastic’ test for COVID-19 antibodies

Roche is also rolling out an antibody test (I haven't looked for specs).

It's the wild west of testing right now but that should change quickly.

 

[bkp_duke]

Abbott Labs has developed a high throughput covid-19 antibody testing system. They report 100% sensitivity and 99.6% specificity based on 1200 test samples. University of Washington virology has independently validated the test.

I haven't seen the underlying data, but an article on it is here for anyone interested: Univ. of Washington ramps up Abbott Labs’ ‘fantastic’ test for COVID-19 antibodies

Roche is also rolling out an antibody test (I haven't looked for specs).

It's the wild west of testing right now but that should change quickly.

99.6% is very respectable. We should not be thinking linearly on the specificity of these tests, but on a log curve. 100% is an asymptote that can never really be reasched.

 

[EVNow]

1.5% in the CA study is far from "ridiculous". It's also VERY far from herd immunity level.

That study is anyway getting harsh reviews because of methodological issues.

Concerns with that Stanford study of coronavirus prevalence [Andrew Gelman, Columbia University] : COVID19

 

[EinSV]

99.6% is very respectable. We should not be thinking linearly on the specificity of these tests, but on a log curve. 100% is an asymptote that can never really be reasched.

Seems like there are tests that are becoming available that are sufficiently accurate to get a general sense of the level of infections, especially in highly infected places like New York. It will probably be hard to get a truly random sample so maybe we'll still be able to fight about that.

 

[dqd88]

As you can see from my post history, I do generally quote facts and data. I posted this anecdote in response to your repeated claims which seem to minimize the risk in healthy populations.

Fact: This disease has killed over 700 people nationwide under age 50 (more than 2% of the deaths, from a population making up ~73% of the US population, so the remaining ~98% of deaths come from the ~27% of people above age 50).
"Similarly, in New York, 64 percent of patients between the ages of 30 and 39 who died of the disease suffered from a preexisting condition, usually high blood pressure or diabetes. But that still leaves about a third of cases without such a possible contributing factor."

https://www.washingtonpost.com/health/2020/04/08/young-people-coronavirus-deaths/

Let's look at your focus on "facts and data," specifically as it refers to your take on "shelter-at-home" orders and effect on virus spread:









Perhaps you should study up on first principles such as: incubation period, and time from symptom onset to presentation for diagnosis. And also see: Exponential growth.

Your take on the current number of infected:




Do you have some data to support your claim of "there's not many new to infect?" Can you quantify what you mean by that?

As far as "cases showing the spread," can you support that? It's generally thought that infections are 10x-20x the case numbers, but the exact ratio will depend on location and positivity rates, so relying on cases to show the spread seems like a questionable methodology.

Your take on what young (please define) and healthy people should do:






Can you define "virtually zero" for us here, since we're talking about "data?" Can you explain the ~1/3 of deaths in patients under 50 with no known preconditions?

Your take on basic reproductive number before interventions:


Your take on immunology:




Please post some facts and data to support your claims about the immune system.

Your comparison with the flu:



Please support these two claims with data. My data: in the past three weeks, the US has experienced the number of COVID deaths seen in a typical flu season, and it looks like the cumulative number of deaths from the first wave alone, in just two months total time, will likely match a "bad" flu season (80k deaths in 2017-2018). And this is with shelter-at-home orders in place.

Here is a misstatement of fact:


Speaking of data, this is false. 14 have died. 712 infections were identified, 46.5% of whom were asymptomatic at the time of the positive test. Seems like 2% IFR in this old and generally healthy population, and very unlikely that they missed over 712 infections.

Here is your data-driven take on average age of death from COVID-19:




Since you are focused on facts and data:
Please post the data from a representative sample of deaths, showing this to be the case. Even in Washington State, which had massive initial infiltration into multiple nursing homes, the average age of death appears to be about 75 years old. (35% of the cases are in people above age 60, so they are over-represented in terms of infections.)

I have been unable to obtain US demographic data on average age of death.

Here is your take on effect on life expectancy:









Please post your back of the napkin calculations for us to review! Facts and data are important - we should see about your claim. It's very unclear exactly what you are trying to claim here, and some hard numbers would help.



That is incorrect. That was the initial CFR reported by the WHO, though it was widely misrreported as an IFR as far as I can tell. Most epidemiologists have assumed an IFR of around 1% so far.



*your.

You'll be happy to hear that for most of the apparently false claims you've made above, I've spared you the "disagree," until you have chance to support each of them with facts. I'd be grateful to you (since you care about disagrees apparently), that you would also stop rating my posts disagree, or at least tell me what you disagree with. Otherwise I might have to start rating your posts based on my own fact check results.



This particular argument of yours is not currently a data-driven argument. It's an ethical/social question. And the tradeoff depends on the numbers we are talking about. So let's see those numbers.
Here are my numbers, which will also affect the tradeoff you're talking about. You are apparently assuming that things will go back to normal:
Derek Thompson on Twitter
Dr Emma Hodcroft on Twitter



I am looking forward to it. I am especially looking forward to you posting those test results as the become available!



Yes, this is generally accepted by pretty much everyone! Epidemiologists expect to see about 10-20x the number of cases identified by PCR testing, in the United States (likely higher in places with higher test positivity rates, and lower in places with lower positivity). There is no surprise with that claim (will result in 1% IFR or so when deaths are complete). What would be surprising in the United States, on average, is 50x to 100x (would result in ~0.1 to ~0.2% IFR, "just like a flu").

Just want to be sure we have the expectations set appropriately for what constitutes a "surprise" over the coming week.

My, this is a lot to respond to. I appreciate your replies. But I don't know that I'll have the time. I will try at some point.

 

[bkp_duke]

That study is anyway getting harsh reviews because of methodological issues.

Concerns with that Stanford study of coronavirus prevalence [Andrew Gelman, Columbia University] : COVID19

Not surprised. Most of these kinds of studies would never be published with those kinds of systematic problems, but because everything is being rushed out in view of the greater good, as it should be, we are getting things that would normally be hammered on hard during peer review.

 

[bkp_duke]

Seems like there are tests that are becoming available that are sufficiently accurate to get a general sense of the level of infections, especially in highly infected places like New York. It will probably be hard to get a truly random sample so maybe we'll still be able to fight about that.

Absolutely. In a place like NYC, 99.6% specificity would be a very valid test to work with.

 

[kbM3]

What I've noted here on TMC is that we have a lot of "engineering minded" people. Specifically, that people think in a binary mode and want to attribute something with essentially 1s and 0s or yes's and no's.

Biology is more of a spectrum, and even symptoms are in a spectrum. While children are showing the presention with spots on the feet, hearing that one or more adults has it also would not surprise me, although I don't think it is reported as a majority. It's just one of those things we observe, and move on.

Hilariously - the most common disease in adults to present on the hands and feet is . . . syphilis. That one is "pathognomonic".

Haha. I can assure that engineers (who designed whatever device you used to post this hilariously uninformed comment along with all the medical technology that allows doctors to practice at a higher level than 16th century medicine) are capable of far more nuanced thinking than that.

 

[bkp_duke]

Haha. I can assure that engineers (who designed whatever device you used to post this hilariously uninformed comment along with all the medical technology that allows doctors to practice at a higher level than 16th century medicine) are capable of far more nuanced thinking than that.

Yes, it was a broad statement. But just based upon an observation here in this thread.

 

[SMAlset]

Have to say this was a powerful interview with Pierce Morgan and his message to Trump, Johnson and the media. Kind of surprised me.

Watch Piers Morgan's stunning advice for his friend Donald Trump - CNN Video

 

[kbM3]

Yes, it was a broad statement. But just based upon an observation here in this thread.

Based on this thread, maybe you should have used medical professionals as your proxy for unclear thinking

 

[AlanSubie4Life]

Well, agree otherwise, but an IFR of ~0.1% isn't possible anymore, at least not for New York City, where the mortality is already ~0.16% and still rising.

Agreed, it is starting to establish a lower bound for that particular demographic, but due to the strong age dependence of mortality due to this virus, the exact lower bound does depend on which populations have been infected so far (do the elderly represent a disproportionate (relative to their proportion of the population) share of the infected, so far? I have no idea...I have no data). So you’d want to correct for the observed attack rate so far and back calculate that lower bound (pessimistically assuming the attack rate is actually the same “inherently” in all populations - which may not be a valid assumption). In reality it is possible the attack rate would inherently be lower in some younger populations (no idea why, but seems possible - my understanding is this can happen), which would reduce the lower bound of the true mortality rate a little when extending to the entire population.

EDIT: As @Norbert points out below, this is of course the lower bound already for this demographic (and it's almost certainly going to go up to 0.2+%). How this can be extrapolated to other populations would depend on the attack rates observed in NYC, and the distribution of vulnerable people in other populations.

 

[Norbert]

Agreed, it is starting to establish a lower bound for that particular demographic, but due to the strong age dependence of mortality due to this virus, the exact lower bound does depend on which populations have been infected so far (do the elderly represent a disproportionate (relative to their proportion of the population) share of the infected, so far? I have no idea...I have no data). So you’d want to correct for the observed attack rate so far and back calculate that lower bound (pessimistically assuming the attack rate is actually the same “inherently” in all populations - which may not be a valid assumption). In reality it is possible the attack rate would inherently be lower in some younger populations (no idea why, but seems possible - my understanding is this can happen), which would reduce the lower bound of the true mortality rate a little when extending to the entire population.

Within NYC, this IFR minimum can only increase from here on out. It could be lower elsewhere, but on the other hand, NYC isn't completely over the hill yet, so this minimum will still increase. Also this number assumes that everyone is infected already, and would be larger otherwise.

NYC is a pretty large population, 8.4 million, so I wouldn't expect extremes. Maybe it has more smokers than average, or something like that, but I haven't heard anything of the kind as about Italy.

And as it is, 0.16% is already well above 0.1%.

 

[wdolson]

Census Bureau! Census Bureau ramps up hiring efforts for 2020 Census

The U.S. Census Bureau is ramping up its national recruiting efforts to hire up to 500,000 temporary, part-time census takers for the 2020 Census in communities across the country to reach its goal of more than 2 million applicants.

It is physically possible to hire all the contact trace people needed, but the political will isn't there. Nobody in politics is even talking about it.

It will be very hard, but I am not of the belief that herd immunity is required. We have the technology and the medical know-how to be able to keep this thing from spreading. But first we need to get the number of active cases to a low level, to make the problem manageable.

Some places like South Korea and Taiwan have successfully slowed this down. It looks like New Zealand and Australia will too. But all those places have very easy to control borders and in the case of Taiwan and South Korea the population knew what to do with this sort of pandemic because they went through it with SARS. Throughout Asia masks became the norm overnight.

None of these countries are out of the woods. Singapore appeared to be on the same track as Taiwan and South Korea, but cases there exploded about a week ago.

People with HIV/AIDS can control the disease, but they can't kill it. Through careful living and support drugs people with HIV can live normal lives. A population with COVID-19 is like an HIV patient right now. Because there is no herd immunity, there are many ways the pandemic can get out of control and careful, constant management of the spread within the population is necessary.

Unlike HIV, once a high percentage of the population is immune (from either having it, or a vaccine), it will die off. But until we get to that point, there is a rough analogy between how HIV affects and individual and how COIVD affects a population.

What's happening in some parts of the US is akin to someone HIV positive continuing to participate in the lifestyle that got them infected in the first place. Some parts are being responsible and they are being successful in keeping case loads manageable, but other parts of the US aren't doing this and they are seeing sharp increases in cases.

I don't quite understand this sentence in the context of other things you wrote. South Korea succeeded in stopping it, to a large degree by test & trace (nothing that should be impossible for the US), and China was apparently able to limit it to one region (more or less, probably) by different means. No country, at least not as a whole, has gone through the herd immunity process. Not even NYC is close, Herd immunity just is not an option.

Plus, this most likely will not be the last pandemic. The next one might be even more deadly. If we don't learn to stop an epidemic this time, next time we may not be able to learn it fast enough even if we try.

The evidence I've seen appears to show that COVID-19 is still spreading in China, but the government has managed to put better locks on the news.

Tracing cases is impossible when the number of cases is high, the disease is easily spread, and the base population is large. You can get this thing if you walk through a droplet cloud left by someone who passed through that spot and sneezed or coughed a few minutes ago. One droplet simulation I saw showed someone coughing in a supermarket and infect someone on the next aisle.

Just before NYC shut down people were posting pictures of what the subways looked like. Someone who got COVID-19 from that would never know who they got it from. There would be no way to start.

In places like Sioux City, SD where a large number of people at the meat packing plant got sick, it's pretty obvious that plant was a nexus and they may be able to find patient zero at the plant, but so many people were infected that most of the town was exposed.

With a disease that has a more limited way of spreading, or is rarer in the population, contact tracing is possible. For example STD tracing works because most people who get STDs can remember the people they had sex with over a given period. Contact tracing for SARS worked too because it didn't spread as easily as this virus.

Once the overall number of cases drops to a relatively low level, contact tracing will become possible. But any contact tracing done now is only being done for research purposes. It does nothing to protect the population.

@wdolson I got the impression from the WSJ article that South Korea wasn't able to re-test people after they were cleared at this point easily (like no after clearing mandatory re-check) but were only re-testing those that came back to their doctors with complaints of coughing for example. That and those that kind of were "captive" patients in nursing homes where it was easy to check. Thinking those could be part of why the numbers at this point are low?

From what I read they have tested a fair number of people who had recovered and less than 2% tested positive for COVID-19 again. I think the article I saw said that 2% was 131 people, which means they've tested over 6000 people who recovered.

Yes, it was a broad statement. But just based upon an observation here in this thread.

As an electronic engineer by training, I mostly agree with you. Most engineering disciplines are rooted in Physics (not all are, but most are) which is the most definitive science until you start getting into Quantum Mechanics. If you perform a Physics experiment and are careful to take into account all the factors, you should get the same results each time. If you don't, you probably made a mistake in the experiment.

But biology is less deterministic and behavior of living creatures is even less so. With the less deterministic sciences studies of populations is usually done because while one monkey might have some odd anomalies from the pack, studying all the monkeys in the pack will tell you the common traits of the breed, or whatever you are looking at specifically.

That's why humans do polling and why medical studies look at many people. Ask one person on the street what they think about topic X and you'll get the opinion of that one person, but you have no idea what that means for the upcoming election or whatever you're asking about. Physically critters can vary so much that testing drug X on critter Y may have great results, but test the same drug on a group of critter Ys and you may kill a quarter of them.

Humans have some of the narrowest genetic diversity of all animals.
Largest yet survey of human genetic diversity : Nature News

But we can still vary dramatically from one person to another. I'm very sensitive to quite a few drugs. The ones I can tolerate, I get the best results with doses much lower than the recommended dose. I have a friend who is so tolerant of pain killers nothing short of codeine works for pain. Some sensitivities can be traced back to genetics (for example the red head gene is documented to be related to anesthesia sensitivity and how fast they metabolize it). But other differences can be due to conditions in the womb, things you encountered in your life, and even what's going on in your mind.

Medicine is far more complex than Physics because there are so many variables you can't control. Even just figuring out what they are can be impossible.

 

[AlanSubie4Life]

Within NYC, this IFR minimum can only increase from here on out.

Yes, that's correct, since 0.17% of the population has died. My original post was kind of missing the forest for the trees.