Coronavirus

[MXLRplus]

If I’m not mistaken, we’re probably the largest country not handing out free masks to the public.

Somehow, we’re fine printing thousands of dollars for everyone, but can’t seem to get the necessary masks to everyone.

Having people buy their own is cheaper: Hand out $20 a month worth of masks, get charged $200 a person for the pork flavoring by Congress, and end up with trash all over our streets and waterways.

The money handout was a bad joke that we will pay for indefinitely. It should have been used for businesses that COVID mandates destroyed or unemployment. Giving it to people who are not in need might be politically advantageous but short-sighted and harmful in the long run.

 

[jerry33]

I'm surprised we haven't had rumors of infections from food.

My understanding is: Cooked food is safe. Washing fruits and vegetables in the same manner that you wash your hands gets rid of the virus. The time from field to store to consumer reduces the virus count (sometimes to zero). So while it might be possible, it's an unlikely source. (Meat would be a different situation, but people are already pretty careful about raw meat.)

And here's a question I haven't heard discussed. Does the virus need oxygen to survive? (I'm thinking of oxygen absorbers such as the kind used to store grain and other dried foods.)

 

[dfwatt]

In California we have warning signs telling us wood lumber is a carcinogen. Handwringer Heaven.

Wait until we find that our shadows are deadly.

We should just for the sake of argument all agree that the hubbub over coronavirus is overblown and that we're all just a bunch of snowflakes. Thank God we've got a real 'Murican male like you to straighten us out!

 

[EVNow]

Consider TN "sock masks" as being worse than a 100% cotton shirt shown on this image.

View attachment 546104

Tests of commonly considered materials to make masks - using the same machines used to certify N95 masks.

Here's exactly how well 20 materials for homemade masks — from folded bandanas to blue shop towels — can filter tiny, potentially-dangerous particles, according to an N95 testing company

test results — DIY MASK FAQ

From these test results, it appears the best material for homemade masks is Filti brand mask material. Two layers of blue shop towels is perhaps the most economical option. Two layers of 100% cotton had the worst filtration efficiency, and coffee filters had the worst breathability. Keep in mind many homemade materials tested here may not be approved for mask usage, contact the manufacturer for safety information. ​

 

[dhanson865]

Tests of commonly considered materials to make masks - using the same machines used to certify N95 masks.

Here's exactly how well 20 materials for homemade masks — from folded bandanas to blue shop towels — can filter tiny, potentially-dangerous particles, according to an N95 testing company

test results — DIY MASK FAQ

From these test results, it appears the best material for homemade masks is Filti brand mask material. Two layers of blue shop towels is perhaps the most economical option. Two layers of 100% cotton had the worst filtration efficiency, and coffee filters had the worst breathability. Keep in mind many homemade materials tested here may not be approved for mask usage, contact the manufacturer for safety information. ​

I've found a single layer shop towel mask is more effective at filtering than the cheap unrated dust masks I used to get for yard work. I'd say it's just below a N95 mask in practical terms.

I've got allergies and wear a mask for all yard work so I get direct immediate feedback if the mask I'm wearing doesn't filter well or doesn't fit well.

 

[Bobfitz1]

@SageBrush

Mid-term, let's say by end of summer, I've been hoping that a good monoclonal antibody would become available. A cocktail of monoclonal antibodies turned out to be the best treatment for ebola, so perhaps covid19 will see a good solution too. The advantage of monoclonal antibodies is that they can be given to someone with the disease and very quickly improvement is possible. Such a breakthrough would buy us time for a vaccine.

The vaccine would of course be the best solution, and there's talk about large quantities of a workable vaccine being available by year's end. The U.S. is throwing money at the problem by paying to ramp up production of vaccines that might never pan out. Given what there is to lose, I'm okay with that approach. All we need is one that works. If it costs a billion dollars to ramp production for a single vaccine and the country is losing trillions of economic activity in the meantime, I think it's a fair tradeoff.

@Papafox I am assuming that when you speak of "large quantities" of effective vaccine being available by year's end, you mean enough does to vaccinate everyone in the U.S. From your postings I'm sure you know that the group from Oxford U. are saying if next stage trials show effectiveness and safety they believe they can have several million doses available by September. I think I saw mentioned a few day ago that some pharma company has said the vaccine they are developing if validated could have several million doses by October.

We all want an effective vaccine for all that will shut covid down fully so there are no hospitalizations or deaths. However I haven't heard much about how millions of doses by early this Fall could be intelligently deployed as a powerful tool to minimize infections in hot spots and reduce risk of severe and fatal infections among the most vulnerable people. Those first few million doses could be prioritized for those at greatest risk. Portions of the limited supply might also be used to tamp down hot spots when new ones get started.

If the monoclonal antibody treatments become available (plus currently increasing use of Remdesivir, antibody in serum from recovered donors, etc.) by early fall, it seems to me a second wave of large proportions killing tens of thousands when Fall/Winter arrive will be unlikely.
Not in any way to suggest that realistic expectation for such new tools by then, should prevent hot spot states from pulling back from reopening until they have in place all the measures we know can limit spread now.

 

[MXLRplus]

Having people buy their own is cheaper: Hand out $20 a month worth of masks, get charged $200 a person for the pork flavoring by Congress, and end up with trash all over our streets and waterways.

The money handout was a bad joke that we will pay for indefinitely. It should have been used for businesses that COVID mandates destroyed or unemployment. Giving it to people who are not in need might be politically advantageous but short-sighted and harmful in the long run.

I love the fact that there are actually 3 humans in the US who believe you should take money from the workers to give to people who don't need it. Greed Is Good.

 

[madodel]

Aren't states requiring tests of any deceased person who had symptoms that could be related to COVID-19?
Coronavirus death toll may be undercounted by thousands in Pennsylvania and New Jersey

 

[dfwatt]

I love the fact that there are actually 3 humans in the US who believe you should take money from the workers to give to people who don't need it. Greed Is Good.

And yet despite your glib dismissal and the fact that most people don't believe in giving to the rich and robbing the poor, that's exactly what the covid-19 bailout appears to have done at least in certain critical ways. Little money appears to have gone to people (and state governments) who need it the most and yet big corporations got billions of dollars. The final post-mortem on the bailout (and its complex packaging) has yet to be written and may never be written given the current administration's investment in covering up the dirty details, but it all looks like the operational definition of a sloppy plutocracy, perhaps somewhat mitigated by the House's attempts at getting some fairness into the distributions. But the Administration appears to believe, just like you say, that greed is good. Grab anything that isn't nailed down and make sure you screw the next guy. Nice!

 

[Papafox]

STOP saying this. This is a blatant fabrication by saying "44% less morbidity". It was a "second layer statistic" of a hazard ratio.

Literally you keep coming to conclusions on this paper that the researchers themselves, in the LAST PARAGRAPH of the paper, said cannot be made.

Zinc . . . Vitamin C . . . Vitamin D . . . as docs we have seen all of these before. Everytime something new pops up, these old candidates get polished off by their (extremely biased) proponents and cherry-picked data published that sends everyone into a tizzy. Then, after billions of dollars later we come to the same conclusion . . . . they are vitamins (and minerals). By definition if you don't have enough you have problems, but "super sizing" with them doesn't provide protective effects.

Let's look at your two points:
1) You suggest that stating a 44% improvement in morbidity is a "fabrication" when zinc is added and treatment is begun before ICU status for the patient. Let's look at the data from Table 4:

The circled data is the *** data, corresponding to After excluding all ICU patients. Once the patient is in the ICU it's too late to begin the HCQ treatment and receive substantial benefits. Looks like 6.9% of treatment patients receiving zinc either expired or were moved to hospice, but without zinc that number was 13.2%, with an Adjusted Odds Ratio of 44.9%.

Check out some of the other lines of Table 4, though. 8% of the patients given zinc required invasive ventilation, but more than double that number, 16.5% of non-zinc patients required ventilation. That again is a massive improvement. The percentage of patients who avoided entry into ICU was starkly improved, as well with the zinc patients.

2) Here's the final two sentence of the report after the mention of possible limitations of the study:
In light of these limitations, this study should not be used to guide clinical practice. Rather, our observations support the initiation of future randomized clinical trials investigating zinc sulfate against COVID-19.

This disclaimer is entirely consistent with what I've been saying. It states that the limitations of this retrospective study are such that other studies be launched to investigate the role of zinc in COVID-19 treatment. The disclaimer DOES NOT SAY that the study is without value.It suggests the opposite: that this study (because of its findings) SHOULD inspire additional studies. Let's move forward with those additional studies.

 

[bkp_duke]

Let's look at your two points:
1) You suggest that stating a 44% improvement in morbidity is a "fabrication" when zinc is added and treatment is begun before ICU status for the patient. Let's look at the data from Table 4:
View attachment 546266
The circled data is the *** data, corresponding to After excluding all ICU patients. Once the patient is in the ICU it's too late to begin the HCQ treatment and receive substantial benefits. Looks like 6.9% of treatment patients receiving zinc either expired or were moved to hospice, but without zinc that number was 13.2%, with an Adjusted Odds Ratio of 44.9%.

Check out some of the other lines of Table 4, though. 8% of the patients given zinc required invasive ventilation, but more than double that number, 16.5% of non-zinc patients required ventilation. That again is a massive improvement. The percentage of patients who avoided entry into ICU was starkly improved, as well with the zinc patients.

2) Here's the final two sentence of the report after the mention of possible limitations of the study:
In light of these limitations, this study should not be used to guide clinical practice. Rather, our observations support the initiation of future randomized clinical trials investigating zinc sulfate against COVID-19.

This disclaimer is entirely consistent with what I've been saying. It states that the limitations of this retrospective study are such that the study suggests that other studies be launched to investigate the role of zinc in COVID-19 treatment. Let's move forward with those studies!

You keep clinging to a STATISTICALLY INSIGNIFICANT STUDY. How many MDs here do you need to tell you that?

Additionally, that's not 44% morbidity improvement, it's an ODDS RATIO of 0.449. You keep incorrectly stating "a 44% improvement in morbidity" - THAT IS A FLAT OUT LIE YOU ARE PERPETUATING. You are specifically doing exactly what the authors say you cannot do, extrapolating a survival or improvement percentage from a limited data set that REQUIRED a lot of statistical data massaging to find a POSSIBLE significance. You CANNOT do that with retrospective studies. You need to perform an INTERVENTIONAL TRIAL to show that and make a claim like that.


Zinc was supposed to cure the common cold . . . 30 years ago. How well did that turn out? Coronaviruses are elements of the common cold, and if Zinc were really a "cure" for them, we would have much much MUCH better data than what you are trying to fabricate this study says, that it doesn't actually say.



For point 2 - I've been telling you to read that since the beginning. The authors clearly state it should ONLY be used for future research studies, not clinical guidance. RESEARCHERS ALWAYS PUT STUFF LIKE THIS INTO RETROSPECTIVE STUDIES BECAUSE THEY ARE HOPING TO GAIN A GRANT TO STUDY THINGS FURTHER WITH AN INTERVENTIONAL STUDY (AND PAY THEIR SALARIES). Sorry to be blunt, but this really is a crappy "study". When you have to perform multivariate analyses like this you are TRYING to find something in the statistical noise, and that is simply a trap for personal bias.

 

[AlanSubie4Life]

Having people buy their own is cheaper: Hand out $20 a month worth of masks, get charged $200 a person for the pork flavoring by Congress, and end up with trash all over our streets and waterways.

The money handout was a bad joke that we will pay for indefinitely. It should have been used for businesses that COVID mandates destroyed or unemployment.

Pretty sure the government could do the masks really efficiently - way better than the situation we have now in any case. It’s just a matter of executing competently.

I’d say the bigger issue is that we don’t have the capacity to make 1 billion masks a month. From what I understand that is because local mask manufacturers can’t get a guarantee that there will be continued long term orders to justify starting up production in the first place. As with any business, they want a sustainable longer term plan, rather than having the market collapse once a vaccine comes along.

I think there are likely opportunities to generate a long term market that are beneficial to public health - readily available masks for all long term care facility workers, masks for all people in the health care system, and public policy encouraging mask use for those who are ill (regardless of the reason), and providing said masks for free as part of the health care system or through pharmacies.

In many cases, it may be beneficial for people in cities (due to pollution) to wear masks more routinely, anyway. Particulates apparently have extreme effects on long-term respiratory health, at great cost to our health care system (which we all pay for, whether it is public or private). These respirators could also be provided through pharmacies, etc., at minimal or zero cost.

These are just ideas, and of course you always have to be on the lookout for perverse incentives. I just think there are likely good public policy ideas that could make proper masks (and even comfortable, highly functional respirators - I’m sure there are innovations to be made still!) more readily available to all. And it might save money long term (and would virtually guarantee saving money short term, in the current situation).

Remember, the government is often much more efficient than private industry! Not always, but often. You just have to set up an efficient framework for delivery (possibly public/private partnership) and a policy with proper incentives.

This is a pretty clear situation of the government being able to properly account for negative externalities affecting the population, and take policy action that reduces these externalities - action that otherwise would not occur (since the population is not fully cognizant of the costs).

 

[AlanSubie4Life]

Symptom onset to test (STT) greater than 8 days, or cycle threshold (Ct) in PCR amplification greater than 24 is correlated with no viable virus:
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa638/5842165
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa638/5842165

More analysis needed, however. (In other words, don’t go running around 8 days after you get sick, even if you are feeling better...)

 

[Doggydogworld]

No way are any of those infection rates within an order of magnitude of reality. 0.4% in Italy? Or are you talking about active cases, not including recovered or never symptomatic? 0.4% of Italy is 240k people and there are at least 35k deaths there.

Covid Projections shows estimates for:

Newly infected - those infected on a given day
Currently infected - all active infections
Total infected - cumulative total of all who've been infected since day one

I quoted currently infected as a rough proxy of those who are contagious and of concern to a country formulating travel policy. Technically, some of the currently infected group contracted the virus too recently to be contagious yet, but I'm not going to split that hair. They'll be contagious soon enough.

Chinese CDC says animal to human transition did not happen at the wet market

The Chinese CDC now says the coronavirus didn't jump to people at the Wuhan wet market — instead, it was the site of a super-spreader event

Kind of a weird article. How did they travel back in time and test the animals that were at the market in November/December?

 

[Papafox]

@Papafox I am assuming that when you speak of "large quantities" of effective vaccine being available by year's end, you mean enough does to vaccinate everyone in the U.S. From your postings I'm sure you know that the group from Oxford U. are saying if next stage trials show effectiveness and safety they believe they can have several million doses available by September. I think I saw mentioned a few day ago that some pharma company has said the vaccine they are developing if validated could have several million doses by October.

We all want an effective vaccine for all that will shut covid down fully so there are no hospitalizations or deaths. However I haven't heard much about how millions of doses by early this Fall could be intelligently deployed as a powerful tool to minimize infections in hot spots and reduce risk of severe and fatal infections among the most vulnerable people. Those first few million doses could be prioritized for those at greatest risk. Portions of the limited supply might also be used to tamp down hot spots when new ones get started.

If the monoclonal antibody treatments become available (plus currently increasing use of Remdesivir, antibody in serum from recovered donors, etc.) by early fall, it seems to me a second wave of large proportions killing tens of thousands when Fall/Winter arrive will be unlikely.
Not in any way to suggest that realistic expectation for such new tools by then, should prevent hot spot states from pulling back from reopening until they have in place all the measures we know can limit spread now.

This Reuters article says that the U.S. has secured commitments for 300 million doses of the UK vaccine. My understanding is that the U.S. will be securing commitments for other promising vaccines as well, with the hope that one of them pans out.

 

[Papafox]

You keep clinging to a STATISTICALLY INSIGNIFICANT STUDY. How many MDs here do you need to tell you that?

Additionally, that's not 44% morbidity improvement, it's an ODDS RATIO of 0.449. You keep incorrectly stating "a 44% improvement in morbidity" - THAT IS A FLAT OUT LIE YOU ARE PERPETUATING. You are specifically doing exactly what the authors say you cannot do, extrapolating a survival or improvement percentage from a limited data set that REQUIRED a lot of statistical data massaging to find a POSSIBLE significance. You CANNOT do that with retrospective studies. You need to perform an INTERVENTIONAL TRIAL to show that and make a claim like that.


Zinc was supposed to cure the common cold . . . 30 years ago. How well did that turn out? Coronaviruses are elements of the common cold, and if Zinc were really a "cure" for them, we would have much much MUCH better data than what you are trying to fabricate this study says, that it doesn't actually say.



For point 2 - I've been telling you to read that since the beginning. The authors clearly state it should ONLY be used for future research studies, not clinical guidance. RESEARCHERS ALWAYS PUT STUFF LIKE THIS INTO RETROSPECTIVE STUDIES BECAUSE THEY ARE HOPING TO GAIN A GRANT TO STUDY THINGS FURTHER WITH AN INTERVENTIONAL STUDY (AND PAY THEIR SALARIES). Sorry to be blunt, but this really is a crappy "study". When you have to perform multivariate analyses like this you are TRYING to find something in the statistical noise, and that is simply a trap for personal bias.

Good Lord, @bkp_duke , would you cut out the name calling? I'm not privy to the technical definition of odds ratio, but the data I put forward suggests massive improvements when zinc is added.

Look at the percentage of cases moving to the ventilator. Less than half as many patients (on a percentage basis) had to move to ventilators when zinc was added than when it was not. That's a massive improvement and we know how horrible a patient's chance of survival are once they go on the ventilator.

We both agree that another study is needed that does random selection, double-blind testing, and large enough numbers to draw conclusions that could be considered scientifically valid enough to affect treatment. Nonetheless, this NYU study shows sufficient promise of adding zinc to treatment protocol that it justifies another study. My point is that the next study needs to focus on treatment parameters that actually show promise. We don't want to study zinc added to the HCQ+azithromycin treatment if it is given to ICU patients. We already know that doesn't work well. We don't want to do another study that lacks zinc in at least one arm of the study because the NYU study shows great improvements when zinc is added and the Lancet article suggests HCQ+azithromycin by themselves are not the way to go.

If you feel there's no reason for doing a follow-up study of this retrospective study, given the data in Table 4, then I would say your biases on this topic are outweighing your scientific mind.

 

[dfwatt]

Covid Projections shows estimates for:

Newly infected - those infected on a given day
Currently infected - all active infections
Total infected - cumulative total of all who've been infected since day one

I quoted currently infected as a rough proxy of those who are contagious and of concern to a country formulating travel policy. Technically, some of the currently infected group contracted the virus too recently to be contagious yet, but I'm not going to split that hair. They'll be contagious soon enough.

Kind of a weird article. How did they travel back in time and test the animals that were at the market in November/December?

Haven't read that yet and I'll try to get to it but my suspicion is the time travel was done via genetic analysis.

 

[Norbert]

Now there is another large scale serological study:

Carl T. Bergstrom on Twitter

More on the 60,000-person Spanish serotype study that found 5% had COVID antibodies nationwide, ranging from 1% to 14% in different regions. My take is that it seems to have been done very well and the results should be quite reliable.

Researchers Applaud Spanish COVID-19 Serological Survey

I haven't read it in whole yet, but the sample size is 60,000 (which is enormous relative to existing ones), and found that Spain's infection level is 5%.

According to worldometers, Spain's population is 46,753,246, and the current number of deaths is 27,125. Spain seems pretty much at the end of its curve, so I'll ignore the time-to-death lag correction.

So the IFR estimate resulting from these numbers is 27,125 / (5% * 46,753,246), which is IFR = 1.16%

 

[dfwatt]

Good Lord, @bkp_duke , would you cut out the name calling? I'm not privy to the technical definition of odds ratio, but the data I put forward suggests massive improvements when zinc is added.

Look at the percentage of cases moving to the ventilator. Less than half as many patients (on a percentage basis) had to move to ventilators when zinc was added than when it was not. That's a massive improvement and we know how horrible a patient's chance of survival are once they go on the ventilator.

We both agree that another study is needed that does random selection, double-blind testing, and large enough numbers to draw conclusions that could be considered scientifically valid enough to affect treatment. Nonetheless, this NYU study shows sufficient promise of adding zinc to treatment protocol that it justifies another study. My point is that the next study needs to focus on treatment parameters that actually show promise. We don't want to study zinc added to the HCQ+azithromycin treatment if it is given to ICU patients. We already know that doesn't work well. We don't want to do another study that lacks zinc in at least one arm of the study because the NYU study shows great improvements when zinc is added and the Lancet article suggests HCQ+azithromycin by themselves are not the way to go.

If you feel there's no reason for doing a follow-up study of this retrospective study, given the data in Table 4, then I would say your biases on this topic are outweighing your scientific mind.

But I think with all due respect that dkp_Duke is right and underscoring that you cannot draw therapeutic conclusions from a retrospective study like this - that requires a different kind of study. For example, how do you know that the apparent therapeutic effect of the zinc isn't related to some other variable that you haven't accounted for and perhaps haven't even considered? For example we can't look at sepsis scores in these two groups to determine whether or not the zinc is being given more to patients who don't have the beginning or even a moderate stage of sepsis? And that's just one potential confound that comes to mind immediately but I'm sure I could cook up five other ones without too much work. You have to control for every single one of those. How do you know in other words that you are looking at a cause and not simply a correlation? This is a basic problem in medicine in relationship to all forms of treatment. You may be looking at a correlation (with other hidden causal variables) but not a Cause in itself.

One of the problems again is the small N in the study does not give you confidence that you were looking at something that might not actually load onto other factors. None of this says that zinc if you can get it intracellularly may not be protective. But there's lots of reason to believe that this is easier said than done because we know that past its role as a trace element zinc is indeed toxic. Indeed the study argues that zinc having a protective role may be true, and cannot be excluded. But you can't draw conclusions of the kind that you're looking for without the kinds of studies that both adequately powered in terms of cases and in terms of randomized arms and esp. in terms of controls on illness severity/comorbidity and age. If you take any of those shortcuts, you simply can't conclude that you're measuring something that isn't an artifact. There certainly is plenty of evidence in vitro that zinc prevents the hijacking of ribosomes and delimits viral illnesses. I would love to see that translated into a therapy that is both non-toxic and effective and that could moderate illness severity. However, in the absence of a randomized control trial and not a retrospective trial with a small N you cannot draw the kinds of conclusions that you're hoping to draw. And I can also tell you how many in vitro therapies fail in Vivo. The vast majority of them.

Those are unfortunately the sobering and at times confining (even infuriating!) rules that you have to live with in science. We've just seen too many examples of how humans want to find evidence for what they believe in, and we're really good at doing that. All those methodological strictures along with the financial rules, governing conflicts of interest, and indeed the whole passel of scientific restrictions are there to delimit the effect of bias and wishful thinking in science. Even with all those limitations, it's still a factor, sometimes a big one. But you can't have it be the determining Factor explaining a large chunk of the variance. Then you simply have a cooked result. We saw the results of that in the Santa Clara antibody study. It's a great negative case example of how not to do science.

 

[bkp_duke]

Good Lord, @bkp_duke , would you cut out the name calling? I'm not privy to the technical definition of odds ratio, but the data I put forward suggests massive improvements when zinc is added.

Look at the percentage of cases moving to the ventilator. Less than half as many patients (on a percentage basis) had to move to ventilators when zinc was added than when it was not. That's a massive improvement and we know how horrible a patient's chance of survival are once they go on the ventilator.

We both agree that another study is needed that does random selection, double-blind testing, and large enough numbers to draw conclusions that could be considered scientifically valid enough to affect treatment. Nonetheless, this NYU study shows sufficient promise of adding zinc to treatment protocol that it justifies another study. My point is that the next study needs to focus on treatment parameters that actually show promise. We don't want to study zinc added to the HCQ+azithromycin treatment if it is given to ICU patients. We already know that doesn't work well. We don't want to do another study that lacks zinc in at least one arm of the study because the NYU study shows great improvements when zinc is added and the Lancet article suggests HCQ+azithromycin by themselves are not the way to go.

If you feel there's no reason for doing a follow-up study of this retrospective study, given the data in Table 4, then I would say your biases on this topic are outweighing your scientific mind.

Pipe dream. No IRB is going to allow a study in non-acute patients given the side effect profile of HCQ.

You need to give this one up, it will never happen, and it has nothing to do with politics.