Your medical speculation thread

by liberal japonicus

Russell posted on a government reset, and I thought that a thread where we just talked about the medicine and the science of CoVID-19 might be nice. Fair warning: you bring politics in here, your comment will be deleted but your name will be left up to be ridiculed. I understand that questions about demographics and such could invite some political questions, but I'd prefer this to be about hard science of CoVID and talking about it.

Comments

[russell]

In case anyone's interested, the Instagram founders put together this site. It claims to track the effective R0 value - the rate at which the virus is transmitted from person to person - for each of the 50 states.

Don't know if this is accurate or meaningful or valuable or not. I'm neither a statistician or an epidemiologist. Just passing along something that crossed my path.

Something viral, as it were. For good or ill. We're all, or at least I am, just flailing here, trying to make sense of it all.

Take it as meaningful, or take it as another example of tech bros playing with their big data frameworks and presenting it as reality.

stay safe everyone!

[hairshirthedonist]

Scrolling down to see Rt over time in each state, the early peaks in NY and NJ are literally off the charts. (Fortunately for me, though I'm in NJ, I'm not in NYC metro. Things are much closer to the national average in my county.)

[liberal japonicus]

Well clearly, I'm the only one interested in this. And it's coming thru news articles which are not really the best. But some interesting things

The role of ventilators is one of the things that has been interestring. A lot of times, it seems that a ventilator is only something to prevent the inevitable. This article gives some insight as to why this may be.

https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html

Of course, everyone has learned a lot about ventilators. Here are some articles that were surprising to me
off label use
https://e-vent.mit.edu/

This article mentions going thru the 'grey literature', things outside academic and commercial publications
https://f1000research.com/articles/9-218

The whole open source ventilator push
https://hackernoon.com/the-open-source-ventilator-game-has-changed-ambovent-and-medtronic-covid-19-ventilators-open-source-s77l3y4s

Still, this seems like dealing with a symptom rather than the problem. I understand that we want more ventilators, and I suppose I'm going to get more DIY articles because of what I look at than I will get for medicines. But this article gives a run down of the various drug treatments.
https://www.scientificamerican.com/article/heres-what-we-know-about-the-most-touted-drugs-tested-for-covid-191/

when things were starting in China, I was on a different board, unrelated to anything when a big fight in the thread broke out. One poster seemed to have inside information about Chinese efforts to make a generic version of remdesivi. This was early and there were some noisy posters who insisted it was just like the flu. Well, the guy seemed right
http://www.gabionline.net/Generics/News/Chinese-company-makes-copy-of-patented-coronavirus-treatment-remdesivir

http://med.stanford.edu/news/all-news/2020/04/stanford-medicine-tests-anti-viral-drug-to-treat-covid-19.html

Another fascinating rabbit hole is the assertion that the BCG vaccine somehow grants protection. Here in Japan, there were a lot of people touting this because Japan used a form of the BCG. When it was pointed out that other places that used the BCG vaccine were having CoVID outbreaks, the person would usually say well, that was a different kind of BCG.

https://theconversation.com/coronavirus-could-the-pandemic-be-controlled-using-existing-vaccines-like-mmr-or-bcg-136429

But that talk has dried up here as it looks like Japan is on the same curve. A friend said that it seems like every country needs to learn the same lesson and there is no short cut.

The discussion about blood clots and CoVID is also interesting
https://www.latimes.com/science/story/2020-04-11/doctor-treating-coronavirus-patients-gambles-on-clot-busting-drug

This article seems comprehesive in its timeline
https://www.healthline.com/health-news/heres-exactly-where-were-at-with-vaccines-and-treatments-for-covid-19#Vaccine

[russell]

FWIW you're not the only one interested, thank you for the links. I'll be reading them over the course of the day(s).

[liberal japonicus]

And hairshirt and russell posted as I was writing.

Some other things, not science-y but science ish

Vietnam
https://thediplomat.com/2020/04/the-secret-to-vietnams-covid-19-response-success/

Faroe Islands repurposing a salmon virus reesarch center to test everyone
https://www.theguardian.com/world/2020/apr/08/vetinary-scientist-hailed-faroe-islands-lack-covid-19-deaths

The whole animals taking over thing
https://www.weforum.org/agenda/2020/04/coronavirus-animals-wildlife-biodiversity-tiger-boar-pandas-zoos/

stay safe!

[hairshirthedonist]

Not sure what the deal is with the length of this link, but it works. Practical information on effectiveness of different mask materials.

https://www.huffpost.com/entry/best-coronavirus-face-mask-materials-new-study_l_5e99b576c5b6a92100e63129?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cueWFob28uY29tL2h1ZmZwb3N0L2Jlc3QtY29yb25hdmlydXMtZmFjZS1tYXNrLW1hdGVyaWFscy1uZXctc3R1ZHktMTIwMDAwNjI0Lmh0bWw&guce_referrer_sig=AQAAAHXUCmM2t6qzQ_8f6v_7hlD9UxNBbGHehphYBEhxKu27Ys3BK-D8ZrcPxvZFsNt12GkccWU6ChIcVDhVbZonFVHIr9_MoHip2u8JiXTasE4OULGktEj8I5DF-U5kNxejcPSE3MnYsAwKbjvSlMs0xcdZDmcus2g11ZbyC2_HWNJF

[CharlesWT]

"Stopping the Cytokine Storm
We recently kicked off a new challenge in the fight against coronavirus: design a protein that might help keep a person's immune system under control. In this video, we are joined by Umut Ulge, MD PhD, who explains what can happen to somebody's immune system after they get sick with COVID-19."
Foldit: Solve Puzzles for Science

[CharlesWT]

As an aside, you can usually delete from a link everything starting with the "?" mark. Otherwise, you're just letting those evil corporations track you.

[hairshirthedonist]

Thanks for the tip, CharlesWT. Now that you've pointed it out, I see "guccounter=" just after the "?" in the link.

[hairshirthedonist]

Tested in preview. It works.

[JanieM]

More about the cytokine storm -- no hype, just an exploration of possibilities.

[Nigel]

The discussion about blood clots and CoVID is also interesting

It is.
There are numerous reports documenting hypercoagulation associated with Covid - often in the lung microvasculature.
From what I can understand (I'm not a medic), the mechanism behind this is still a matter of intense debate.

[John Thullen]

https://www.motherjones.com/kevin-drum/2020/04/heres-a-lifesaving-covid-19-test-that-costs-almost-nothing/

[Marty]

Actually, I use my phone as a pulse oximeter and it works pretty well. I have tested against the real thing and it is pretty accurate. Gor reasons other than covid I check my oxygen level everyday, and always after exertion.

[hairshirthedonist]

From JTs MJ link:

ANOTHER POSTSCRIPT: The fact that an ER doctor in New York is routinely finding COVID-19 in patients who come in for unrelated problems is yet another sign that the infection rate of the coronavirus may be much higher than we think.

How reliably this can be quantified is another question, but it seems to be a recurring theme.

[Girl from the North Country]

Marty, I use my phone to check pulse, but didn't know it could test blood oxygen level, and doubt it can, which I thought was the whole point of the pulse oximeter test for early stage Covid?

[hairshirthedonist]

I'm copying my comment from another thread, since it fits in here (minus the link that landed it in the spam bucket).

According to current numbers at worldometers dot info/coronavirus/, the world's leader in per-capita testing is Iceland. They've tested over 12% of their population.

They currently have 1778 total cases, with 351 still active. Their deaths total 10, with 5 of their active cases listed as serious/critical.

If you assume the 5 serious/critical cases will result in death, you get a death rate of 0.8% of total cases.

UAE is the next best, not considering the Faeroe Islands and the Falkland Islands because of their extremely small populations.

UAE has tested 8% of their population, has total cases of 7755, 46 deaths, and 6266 active cases, one of which is serious/critical. Those are some odd numbers, given the high number of active cases relative to total cases and the single serious/critical case.

But adding that one serious/critical case to the number of deaths, you get a death rate of 0.6%.

South Korea is surprisingly (to me, anyway) low on the list sorted by per-capita testing - behind the US, in fact. I don't know if it's a reporting issue or what. At any rate, following suit with the previous calculations, you get a death rate of 2.7% for South Korea.

What all that means, I leave to people who know more than I do.

[cleek]

i admit i did just order a pulse oximeter. the rest of that article was pretty scary - you might think you're asymptomatic, but that's only because you unconsciously compensate for what the virus is doing to your lungs. and then you suddenly notice you're always out of breath for some reason.

hard pass.

[Marty]

GftNC, I have a Samsung phone S9 that does measure blood oxygen level. Nice feature that was important to me.

[Hartmut]

Should I be grateful to have sleep hypopnoe and thus able to use a CPAP machine at home? Does not come with an oxygen measuring device though.
Except for any fever I notice a lot of symptoms but those I am so used to individually that I have ne reason to attribute them to corona now (in particluar with the birches in bloom and grasses starting).

[Girl from the North Country]

Thanks Marty, will check if anything similar exists for my Sony Xperia. If not, I may order an oximeter, as cleek did. Seems like it could be a useful thing to have around for a while.

[hairshirthedonist]

Here's something weird I noticed about the numbers on Iceland, UAE, and South Korea.

Iceland, who's done the most per-capita testing, has a number of total cases that is 4% of the number of tests conducted. UAE's percentage is about 1% and South Korea's is just under 2%.

Again, maybe it's a reporting thing with tests not being counted on the same schedule as cases. But you'd expect that countries testing fewer people would be concentrating more on suspected cases and would have higher percentages.

[hairshirthedonist]

Incidentally, total cases are almost 20% of total tests for the US. Maybe the lesson here is don't bother looking at these numbers for a few months until testing has become more widespread and has been analyzed for randomness/representative v. concentrated on suspected cases.

[hairshirthedonist]

Sorry for the serial commenting, but I suppose Iceland's size relative to the other two means that it's more subject to statistical vagaries.

UAE and South Korea, relative to each other, are more or less consistent with the idea that wider testing will result in lower case percentages. Still too many unknowns, though.

[JanieM]

Maybe the lesson here is don't bother looking at these numbers for a few months until testing has become more widespread and has been analyzed for randomness/representative v. concentrated on suspected cases.

I'd say that's wise. Testing is being done on such a different basis in different places that the numbers are like apples and oranges. I've read story after story of people in the US with all the symptoms, but not quite badly enough to get one of the precious tests. Meanwhile, as of this April 3 article, almost half of its testing was being done on the population at large rather than on people with symptoms.

Not only that, but there have been reports of lots of false negatives, and that same article also mentions, by implication, that there's more than one test (and maybe even more than one kind of test) in use.

Sorry for the serial commenting

You've got to be kidding. ;-)

[JanieM]

almost half of its testing

"It" being Iceland.

[bobbyp]

I gaze at K. Drum's charts every day. It strikes me that many countries have the steep initial infection curve to a peak....then a less steep decline...but, but, but....they all show the curve shallowing out to what now seems to be a "steady state" daily death toll. Is that due to the log scale? Or am I just misinterpreting?

[JanieM]

bobbyp -- I don't normally look at Kevin Drum (I don't "normally" look at very many sites, I tend to follow links from a few trusted sources, when I have time/interest).

Also -- standard disclaimer -- I love numbers but I have no training in anything related to this situation, not even so much as a stats course in my shady past.

All that said -- what I see when I go over there isn't on a log scale, it's graphs of six-day rolling averages of # of deaths, by day, per million of population. (If you can point me to some of K Drum's charts that say they're on a log scale, please do.)

I like the deaths per million metric -- I have been looking at the the Worldometer site (thanks hsh) for deaths per million of population for a while, but not in any detail, and certainly not in terms of 6-day rolling averages. (In particular: US vs Ireland, just because Ireland is so dear to my heart. But other European countries as well.)

As to the shape -- here's where I *really* don't know anything, but am happy to make a guess or two. :-)

-- Initial spread was fast, followed by the effect of massive measures taken to slow the spread. But meanwhile a huge backlog of cases developed (so, steep curve at the beginning), in part because of...

-- Lag time between exposure/spread, and development of serious cases.

hsh -- what are your guesses here?

[bobbyp]

Thank you, JanieM. Yes, my mistake. The log scale shows a fairly straight upward sloping line that hopefully gets to "horizontal" which would indicate the deaths have fallen to zero.

My poor understanding of it, in any event.

Agree the death toll, absent something spectacular like an effective vaccine, would be expected to decline slowly.

Too slow is what I see.

Stay safe.

[JanieM]

Okay, "I like the deaths per million metric" sounds ghoulish. I am appalled by the deaths per million numbers.

But as a way to try to compare what's going on in different places, it does seem useful, especially as more time goes by.

[hairshirthedonist]

hsh -- what are your guesses here?

Pretty much the same as yours. I'm not a stats person, either.

[hairshirthedonist]

One thing I'll add is that I'd like to see multi-day-moving-average graphs on worldometers, just to smooth out the noise of random day-to-day variations in actual events and the reporting thereof.

[John Thullen]

Here's the latest:

https://twitter.com/Stop_Trump20/status/1252260186577948672?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1252260186577948672&ref_url=https%3A%2F%2Fwww.balloon-juice.com%2F

Turn up the volume.

[Priest]

New daily high for US deaths today. That will pull up the multi-day average.

[CharlesWT]

"The scientists and doctors of the world are working at a fever pitch to try and form a full understanding of SARS-CoV-2 and how it interacts with our bodies. On that note, one of the biggest questions out there right now is why some people have a much harder time with the coronavirus than others. Now, a new study just released by the American Society for Microbiology is suggesting that genetic variations in people’s immune systems play a big role in explaining these case-by-case discrepancies. "
Scientists find genes can determine if you are at higher risk for fatal COVID-19

[JakeB]

hsh--

I think that part of the unclarity comes from the amount and effectiveness of contact tracing in some countries as opposed to others. If you are keeping track of who infected people come in contact with, and you can be reasonably confident after some point that you know who those people are, you may only test those people who are likely to have been exposed. This requires an effective government, of course, which rules out certain countries.

[Nigel]

Testing is being done on such a different basis in different places that the numbers are like apples and oranges

That applies for death rates, too.
There is significant under reporting of the number of Covid related deaths (the extent of which will vary from country to country depending upon local practices). Certainly in the UK, the daily numbers relate to deaths reported in hospitals.
Over the last month, it’s become clear that there are at least half as many again occurring in care homes, the vast majority of which aren’t reported os Covid deaths, as the victims were never tested. There are similar reports from France and Italy.
Another example is the spike in the number of coronary deaths in New York.

Countries collect statistics on all deaths, of course. But the systems for registering deaths don’t generate daily figures (in the UK, for example, it can take weeks, or in some cases even months for a death to be registered). And national systems vary tremendously.
As figures for the previous months come through, the Office of National Statistics will report and revise the overall reported death rate, and we are now beginning to see a spike in deaths considerably larger than the reported deaths from Covid.

Bottom line is that the official death rates, even in countries with good reporting systems, will be revised upwards over time. And depending on the country, either many, or in some cases most Covid related deaths will never be recorded as such.

The worldometers site has other issues too, but it would be tedious to go into that.

[Nigel]

the amount and effectiveness of contact tracing

Effective contact tracing is being done in very few countries with large outbreaks. Of the larger nations, really only South Korea and Germany.

If you don’t have the testing infrastructure and systems already there, it quickly becomes impossible.
The UK abandoned the effort some time back, and like Italy, France, New York and others, concentrated on testing hospital admissions.

It will, hopefully, resume after the lockdown sufficiently suppresses the pandemic, and capacity is built up, but it is a hard problem.

[doretta]

I just read what purports to be the most current CDC guidelines on testing and there is still an emphasis on "respiratory distress" in determining who gets tested. Seems to me that a pulse oximeter is not just good for tracking your own status (and that of whoever is around you) but also for convincing the ER or other doctors that you are sick enough that they need to see you.

It's haunting to read so many stories of people who got turned away for testing and/or treatment because they didn't report enough respiratory distress to satisfy the guidelines, but then died within days or hours.

One reason you want social distancing to continue for a while is so that fewer people get sick while we are still so ignorant about how the virus works and what we can do about it. Give doctors more time to understand what to look for and to come up with potential treatments. Many lives might be saved even in the absence of those cures or vaccines that will inevitably be a long time coming if they ever do arrive.

[Snarki, child of Loki]

Re: reporting COVID deaths.

I've been working my way through "Journal of the Plague Year".

Same reporting issues ("it wasn't plague, it was a spotted fever!") Same need for distancing, same evasion of stay-at-home rules.

[CharlesWT]

"French researchers are planning to test nicotine patches on coronavirus patients and frontline health workers after a study suggested smokers may be much less at risk of contracting the virus.

The study at a major Paris hospital suggests a substance in tobacco – possibly nicotine – may be stopping patients who smoke from catching Covid-19. Clinical trials of nicotine patches are awaiting the approval of the country’s health authorities."
French researchers to test nicotine patches on coronavirus patients: Study – which stresses serious health risks of smoking – suggest substance in tobacco may lower risk of getting coronavirus

[Nigel]

If you're interested in the interaction between the virus and the immune system, and what approaches are going to work for vaccines and therapeutics, this is an exceptionally good lecture by one of the senior vaccine researchers at the Scripps institute.

He's very optimistic about an effective vaccine:

If HIV is a genius, and flu is an honours student...
SARS-CoV-2 flunked immunology 101...

https://www.youtube.com/watch?v=sjc1EIMQIwA

'Webinar'/lecture itself starts about 6 mins in.

[liberal japonicus]

A news article, but another interesting possible symptom
https://www.cbs17.com/community/health/coronavirus/covid-toes-puzzling-condition-a-possible-coronavirus-symptom-in-young-people/

Haven't heard much talk lately about anosmia (but I am happy to learn a new word) but here are some articles
https://www.healthline.com/health-news/covid-19-losing-sense-of-smell

https://www.entuk.org/sites/default/files/files/Loss%20of%20sense%20of%20smell%20as%20marker%20of%20COVID.pdf

https://edition.cnn.com/2020/04/03/health/smell-taste-test-coronavirus-wellness/index.html

This is interesting because the US forces in Korea gave guards apple vinegar to use as a check

https://www.stripes.com/news/pacific/smell-test-us-army-garrison-in-south-korea-tries-new-way-to-sniff-out-coronavirus-1.624940

[hairshirthedonist]

The worldometers site has other issues too, but it would be tedious to go into that.

I'd be interested in a general characterization of the issues at least, if that's possible without too much tedium.

[Nigel]

The short version is this:
https://xkcd.com/2295/

[Nigel]

But you’d be better off spending an hour listening to the lecture I posted a link to.
It is really very good indeed.

[JanieM]

I can't remember if I saw this here or somewhere else, but it doesn't suffer from repetition. It's about pushing back the date of the earliest known (so far...) death in the US from COVID-19 to 2/6 instead of late February.

It was infuriating to hear, well into March, stories of people trying to get treated/tested and being told that if they had no "relevant" travel history, they couldn't possibly have COVID-19.

The CDC website said at least a month ago that the earliest date for someone with known symptoms was January 12.

Dr. Cody led the effort to issue the nation’s first stay-at-home orders on March 16. But she said she would have issued them even earlier had she known about the February deaths.

“I think if we had had widespread testing earlier and if we had been able to document the level of transmission in the county, if we had understood then that people were already dying, we probably would have acted earlier than we did,” Dr. Cody said. She said officials had been hearing about a lot of people who were ill but did not meet the criteria for testing.

“It was just sort of this understanding that the testing capacity at the C.D.C. was very, very, very limited,” she said. When doctors would call them with suspicious cases, she said, county health authorities would have to explain that the cases did not qualify for testing.

“It got increasingly uncomfortable, right?” she said. “It didn’t make any sense. How are you going to detect community transmission if you’re only testing people with a travel history? Well you’re not.”

[Snarki, child of Loki]

From Journal of the Plague Year, by Daniel Defoe:

Here also I ought to leave a further remark for the use of posterity, concerning the manner of people's infecting one
another; namely, that it was not the sick people only from whom the plague was immediately received by others that were sound, but the well. To explain myself: by the sick people I mean those who were known to be sick, had taken their beds, had been under cure, or had swellings and tumours upon them, and the like; these everybody could beware of; they were either in their beds or in such condition as could not be concealed.

By the well I mean such as had received the contagion, and had it really upon them, and in their blood, yet did not show the consequences of it in their countenances: nay, even were not sensible of it themselves, as many were not for several days. These breathed death in every place, and upon everybody who came near them; nay, their very clothes retained the infection, their hands would infect the things they touched, especially if they were warm and sweaty, and they were generally apt to sweat too.

Just like in 2020, and also:

And this is the reason why it is impossible in a visitation to prevent the spreading of the plague by the utmost human vigilance: viz., that it is impossible to know the infected people from the sound, or that the infected people should perfectly know themselves.... shutting up the well or removing the sick will not do it, unless they can go back and shut up all those that the sick had conversed with, even before they knew themselves to be sick, and none knows how far to carry that back, or where to stop; for none knows when or where or how they may have received the infection, or from whom.

This guy FIGURED OUT WHAT TO DO in 1665, but didn't have the technology. We can do the job in 2020, if we have the will.

Step #1: remove dotard.

[JanieM]

Stanford study "news."

The wives of scientists recruit their research subjects? Hmmmm.

[John Thullen]

Snarki, I just received Defoe's Journal in the mail .... yeah, that mail.

The first thing I did, after wiping the package off with a disinfectant, was wipe the book itself off too to avoid Covid-19 transmission.

I'm thinking do I need to disinfect page by page?

I wish I was Robinson Crusoe at this point. I'd have to hose down Friday if he appeared, though I'd spare him the conversion to Christianity.

He'd probably be thinking the same thing about me, or maybe he'd be careful if he had sussed out that I was an American, to cover his tracks and lay low on the other side of the island for fear I'd give him the bleach cure, me coming from the more primitive civilization.

[Ufficio]

Recruiting using bald-faced lies.

[hairshirthedonist]

So what was the goal of the Stanford thing? Get some splashy headlines only to look like an idiot, an asshole, or both a week later?

[hairshirthedonist]

Holy ever-loving shitballs...

https://www.theguardian.com/world/2020/apr/24/revealed-leader-group-peddling-bleach-cure-lobbied-trump-coronavirus?CMP=Share_iOSApp_Other&fbclid=IwAR0andp3KdGeQOXc19rVFt9_oH3OdmkYVsfjTj0USQVrJfRZlrWoHw2fIb4

[hairshirthedonist]

Grenon styles himself as “archbishop” of Genesis II – a Florida-based outfit that claims to be a church but which in fact is the largest producer and distributor of chlorine dioxide bleach as a “miracle cure” in the US. He brands the chemical as MMS, “miracle mineral solution”, and claims fraudulently that it can cure 99% of all illnesses including cancer, malaria, HIV/Aids as well as autism.

[liberal japonicus]

Jesus wept. Why the hell didn't the wife just stick to paying ungodly sums of money to get her kids into college?

And the Hoover Institution, the place that give Victor Priapus Hanson a sinecure, leaps on that!
https://www.hoover.org/research/questioning-conventional-wisdom-covid-19-crisis-dr-jay-bhattacharya-1

And now for the head author of the study
https://undark.org/2020/04/24/john-ioannidis-covid-19-death-rate-critics/

In the week after the study’s release, Ioannidis has made the rounds on Fox News, appearing on Tucker Carlson’s show and on “The Ingraham Angle,” hosted by Laura Ingraham. (Bhattacharya, a former research fellow at the politically conservative Hoover Institution, has also appeared on Carlson’s show talking about Covid-19 death rates). Last Sunday, Ioannidis was also on the Fox News show “Life, Liberty, and Levin,” to talk about why he thought the Covid-19 risk had been overstated.

grifters gotta grift.

[wj]

So what was the goal of the Stanford thing? Get some splashy headlines only to look like an idiot, an asshole, or both a week later?

If he's got a Trump-level planning horizon, what might happen a week later is far, far less important that today's headline.

[nous]

Just for the sake of keeping things straight, I don't believe that Stanford study is the same one that broke into the news cycle last week (or the week before - it's all a big light blur).

Different lead researcher names.

Could be the same study and lazy reporting - I have not gone back to scan through all of the names - but I'm guessing that this is just one of several studies and that they are all getting lumped together in the popular discourse.

[hairshirthedonist]

Hoovers gotta hoov?

[Ufficio]

It's the same study we were discussing on the other thread:

https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1.full.pdf

[nous]

So then the Buzzfeed reporter should not have said that Bhattacharya was leading the team. He's the last name on that list of authors. That's its own problem. How much of this is problems with the study and how much is problems with the reporting? Hard to tell.

Seems like the study needs more scrutiny from people qualified to sort through it. That's clearly not who's reporting this.

The reporter should have done better. The editor should absolutely have done better.

The sciences desperately need better science reporting.

[nous]

I'm also wondering who is responsible for putting that study in the public eye this early in the process? If there are methodological problems, then those should kill the whole thing at the peer review stage and it should just quietly go away.

My guess is that all the connections to the Palo Alto crowd meant that someone in the chain somewhere couldn't resist flapping their vaporware gums about this.

I'd ignore the whole thing had social media not made it necessary that a bunch of people waste their time with an uncooked study.

[JanieM]

I go back to Cheryl Rofer's comment that I quoted last time this came up -- she scornfully said one of the authors of the paper was a "venture capitalist." I think that's Bogan, although he does have some science background. Ditto with a few of the others -- big roles/titles in businesses right now, some science on their resume. (Cheryl is a scientist herself, or was before she retired. I take what she says with fewer grains of salt than average for what I read online.)

Is it usual to put people like that on the list of authors of medical research papers? Do funders, for example, get listed as researchers/authors?

It seems like kind of a clusterfuck to me. I don't disagree with your (nous's) point about science reporting -- a lot of it (not that I see a ton) is abysmal. But why did any reporters even know about this study in the first place, unless someone involved with it wanted the publicity? Maybe the same blabbermouth whose wife recruited research subjects...?

[JanieM]

nous - We cross-posted. I didn't see your 2:35 before I pushed "post" on my 2:40.

[nous]

JanieM - It's good to know I'm not alone in wondering these things.

Authors lists in science publications are often small-p-politics as much as they are indications of who did the research. The lead name can sometimes be the person who did all the work to put together the grants rather than the (lesser known) person who did the lion's share of the research. Later names could be grad students they are looking to give a boost to by giving them a role in the study or people who were consulted for information outside of the research team's collective expertise, etc. Lots of people might get a courtesy nod in that list. Others might get snubbed despite having done as much as some of the later names.

Science remains, despite the passive voice, a human endeavor done within human institutions.

[nous]

All of which has me listening to The Dead Milkmen:

https://www.youtube.com/watch?v=0T3g1wFe_DU

Bleach Boys. 1988. They knew.

[John Thullen]

Clots and strokes:

https://digbysblog.net/2020/04/unreality-tv-2/

Remember ... it seems like years ago ... Kudlow saying they had this pandemic under control, and wrapped up "airtight".

He actually used the word "airtight", as if they, whomever they is, had used their magical thinking to cleanse the very air of the virus.

The Chinese air, wafting across our borders in the tariff-free jet stream.

Kudlow just appeared on FOX and admitted to violating social distancing by going out in public and getting a haircut so he could look nice for Laura Ingraham.

Do they test her bile daily, I hope?

He thinks the air around him is "tight" somehow, as in a bubble.

Kudlow added, demurely it seemed, that he just got tested for the virus last week and was negative.

For what? Sentience? This guy had his own fucking TV show!

Cramer practically tears up with affection on CNBC when he talks about Kudlow, the malign prat.

Like Joe Exotic, the Tiger King, psychopaths do have crying jags.

Tested? I can't get a test. There are humans, far superior in their humanity to Kudlow's presumed humanity, who are held to be presumptively infected and suffering symptoms from the virus, who can't get a test, maybe not even until their autopsy, which as trump might advise, pointing to his head in which is housed his massive thinking cap, that brilliant people would say it's ... possibly .. we don't know, we're looking into it ... too late.

Ah, it's to allow the vermin leader of the country, his air made tight, to go without a mask for vain aesthetic purposes, and so we can see his lips move when he lies into the camera about loving us and wanting to take care of us, and to make us safe.

I wonder, when you purchase a gun, do they ask you to list the names of the people you are planning to shoot? They should, considering there is no other reason to purchase a gun except to shoot someone. So, who is it, already?

Wouldn't it be kind of a red flag of suspicion if you had no idea of the specific people you were going to shoot.

Like maybe EVERYONE might be a target. Narrow it down, so we can keep an eye out.

Oddly,"I don't know" would be an acceptable answer in America. Would they say, "Oh, come on, you are purchasing a weapon designed expressly by people to shoot OTHER people. Surely you must have a special person in mind. How 'bout a first name at least.

I'd be in there all day making my list.

I just read, in a New Yorker article, that since 2018 England has had a Minister of Loneliness.

Her last name is "Crouch", I believe. It would be funny if she decided not to have any meetings because she prefers to be left alone. "I'm not lonely. I like my solitude. See, my Assistant Minister of Forlornness, please, should you have inquiries. If you don't care one or another, the Office of Ennui is just down the hall if you can summon the energy to lodge a written complaint."

What about us? Or has Kushner folded loneliness into his substantial portfolio of things he wouldn't know anything about even if they bit him on the ass. "Anomie is my thing. Loneliness is for twats" he would protest.

I hope Joe Biden names a Cabinet Secretary of Fucking Stupidity to kind of look into things as they are and issue a report.

[GftNC]

For your reading pleasure, this. I am just about to read it myself, but I am confident recommending it because a) Marina Hyde is normally so good, and so witty, and b) I loved the subheading, which is The president’s advice involves ingesting bleach, which for some of us is beginning to seem like the only rational response.

[GftNC]

Hey this isn't half bad either. For Kinks fans, and others. What luck so many things sound like LOLA...

https://www.youtube.com/watch?v=P-qKl4LIabA

[hairshirthedonist]

and so witty

I laughed at the first clause of the first sentence.

[Nigel]

I'm also wondering who is responsible for putting that study in the public eye this early in the process? If there are methodological problems, then those should kill the whole thing at the peer review stage...

Preprint of most coronavirus papers are appearing online before peer review.
That is actually a good thing - and the wheat gets sorted from the chaff pretty quickly.
It has massively sped up the usual process of scientific communication.

There are plenty of downsides to the normal peer review process in any event - limited number of reviewers; delay; gatekeeping by the establishment in particular disciplines; cost of access to current journals etc.

I like the new normal.
There will always be idiots and frauds. I don’t think the current publish and be damned setup does a bad job of identifying them.

[wj]

My wife reports seeing a new (pseudo-I-think) ad:

Clorox . . . chewables!

At least some of us are managing to keep laughing.

[nous]

The flip side of that, Nigel, is that we have a lot of bad actors who are seizing upon preprint studies and dumping them straight into a bunch of discourse communities that are heavy on confirmation bias and Dunning-Kruger. It won't matter to them if the study is chaff. They will have seized on the narrative and be looking for another bit to add to the pile. Meanwhile, the disinformation merchants will have moved in and will find ways to shore up the confirmation bias and flood the zone with more shit.

So it may move the scientific community towards and answer more quickly, but the politics that make it possible to act on those answers become more difficult.

I watch this shit happen real time on family members' FB feeds.

It would be great if we had some middle ground where pre-print papers went out more widely, but there were still some minimum level of competence and subject matter expertise required to ride on the ride.

The critical feedback loops are too open and too sensitive.

[hairshirthedonist]

More on the Santa Clara and LA studies.

https://arstechnica.com/science/2020/04/experts-demolish-studies-suggesting-covid-19-is-no-worse-than-flu/

[John Thullen]

Do the math:

https://www.lawyersgunsmoneyblog.com/2020/04/hey-nineteen

[JanieM]

hsh, thanks for that link. It's a treat to read something so clear and orderly for once.

Just a couple of excerpts to flag:

...the restrictive mitigation efforts currently strangling the economy

Calling TP! The anthropomorphizing of "the economy" is getting old fast.

Also:

Last, Hanage suggests that people should pay closest attention to antibody studies that have been done in places known to have a lot of infections. Put simply, having larger numbers to work with can help firm up the math around prevalence estimates.

I read the article pretty fast, and -- to repeat myself -- I'm not a statistician nor do I play one on TV. But it seems like you can't possibly deal with numbers that small without having to make disclaimers just on the basis of rounding errors, if nothing else.

[hairshirthedonist]

This jumped out at me:

In the Santa Clara study, the researchers only found 50 samples out of 3,330 were positive. That’s a 1.5-percent positive rate. Given that the false positive rate may be up to 1.7 percent, it’s possible (if unlikely) that every positive test detected was a false positive.

The point is not that critics think that every positive sample the study authors found was actually a false positive. Rather, they note this because it means that assessing the accuracy of the positive sample with precision is impossible.

[JanieM]

Yeah, no kidding.

Ioannidis clearly had an agenda that he had made clear before this "study." The whole thing is a textbook example of why, for anything that gets published, it's important to try to figure out whether someone is trying to fit the numbers to an agenda, or to just follow where the numbers take them.

That's not easy in its own right and at the best of times, but the more depressing thing is that it doesn't even really matter. These people (or most of them) were so hot to get their slant on things out there that they didn't give a shit about sloppy methodology or sloppy math. And part of the reason they could do it that way was that they knew it didn't matter. We weren't their audience. To put it mildly.

[JanieM]

Proving my point, the WSJ:

The Bearer of Good Coronavirus News

Stanford scientist John Ioannidis finds himself under attack for questioning the prevailing wisdom about lockdowns.

I can't read the piece because I don't subscribe and certainly won't register with them, but I could probably almost write it myself at this point. Ewwww. No, on second thought, I couldn't.

[JanieM]

I mean, he's not under attack for questioning the prevailing wisdom, he's under attack for bewing a dishonest hack who goes to press with sloppy, not to say downright dishonest, "research."

And this WSJ writer should be under attack, or fired, for the same reason.

But no........

[cleek]

Do the math:

FYI, that COVID19 numerology image is a fake. her actual sign said "Give me liberty of give me death". someone altered it.

the original pic is linked several times in the thread.

[russell]

I saw the best minds of my generation destroyed by sheer dumbassery

[John Thullen]

"Do the math":

"Give me liberty or give me death" is even funnier, and quite frankly, doesn't quite add up either.

Besides, she didn't mean that old chestnut either.

She meant something along the lines of "Give me liberty even if we have to give death to tens of thousands of codgers in nursing homes."

And Patrick Henry's fiery speech in 1795 was, in the swamps of time, meant only metaphorically, especially the word "me" in its second go-round in the final clause of the declaration.

As he explained in the same speech, what he meant was that militias should be raised so that others should be given death, while he gets to stick around for the liberty part of the deal.

Even though he commanded forces for a mere six months in the Revolutionary War, in pursuit of his valiant but imaginary death, he lived on for a couple of decades and died in his bed, like that woman probably will too, hopefully NOT in a nursing home, unless she got accidentally run over standing in the middle of the street with a sign.

Besides, wait until we witness the photo shopped pics of Biden and Democrats that will begin showing up as the campaign heats up, courtesy of black ops republican groups originating here and abroad.

This:

https://time.com/5827651/pentagon-testing-coronavirus/

The logic seems to be that we need to prioritize testing all those ready to launch our nuclear weapons in case they need to kill "EVERYONE" remaining after the virus gets some of the rest of us.

I realize of course that we must let the federal government do the most important, crucial, essential, lifesaving, protective things on our behalf because it is stealing our money, over-funded, overpaid, incompetent, unaccountable, takes long lunches, and of course, is deep, because the state and local governments and the private sector are so brilliant and effective that they can be left to take care of all of the least important stuff.

[Nigel]

I saw the best minds of my generation destroyed by sheer dumbassery
And it's a hard, it's a hard, it's a hard, it's a hard
It's a hard rain's a-gonna fall

[Marty]

You're an idiot babe, it's a wonder that you still know how to breathe

[Girl from the North Country]

She meant something along the lines of "Give me liberty even if we have to give death to tens of thousands of codgers in nursing homes."

In the UK, there is no proper estimate even of the (huge) numbers of elderly dying in care homes, due to extraordinary decisions made by in the first weeks of the pandemic. Since the issue of "social care", and how it is to be paid for, has bedevilled the last few administrations, and certainly damaged Theresa May even before the ongoing Brexit issue did her in, I have been watching this unfold with what many would no doubt call a much too cynical eye. I suspect that the government have, without a Wannsee Conference or making it in any way explicit, decided that this is going to be a good way to dispose of the problem for a generation: a sort of not-quite final solution. I would be interested to know if Nigel agrees.

[John Thullen]

Second greatest lyricist, to Dylan's first, washed his hands.

https://www.youtube.com/watch?v=yq1INpHjfgI

[GftNC]

made by omission.

https://www.theguardian.com/world/2020/apr/22/without-a-plan-its-not-going-to-stop-care-homes-fear-worst-yet-to-come-covid-19

[Girl from the North Country]

Second greatest lyricist, to Dylan's first, washed his hands

If you like that sort of thing. I give him the lyrics to West Side Story, I suppose. (There is no special font for musicals-haters).

[John Thullen]

I've never liked the lyrics to Happy Birthday either, but I sing "Something's Coming" when I get the chance, although the lyrics could be repurposed for the Covid and the upcoming electoral catastrophe.

One of the interesting little tidbits regarding the Lennon-McCartney partnership was that John HATED musicals and on the odd occasion when Paul would talk him into seeing a musical in a theater, John would crinch, cover his face and mutter "Bloody Hell" when a character would, halfway through a conversation, break into song, as Paul, of course, toe-tapped along and harmonized.

I would like it if in everyday life crowds of people, say, just walking down Fifth Avenue during rush hour to see who trump murdered broke into song and a synchronized dance number.

I'm looking forward to Busby Berkeley-style song and dance numbers commemorating the Covid year, with, of course, proper social distancing and masking observed.

[John Thullen]

Azar is rumored to be out at Health and Human Services for being a veterinarian.

Trump is leaning toward this replacement, a genius of the ninth order:

https://www.youtube.com/watch?v=Mx7W9SFM93w

[CharlesWT]

"The fast-growing list of possible treatments for the novel coronavirus includes an unlikely candidate: famotidine, the active compound in the over-the-counter heartburn drug Pepcid. On 7 April, the first COVID-19 patients at Northwell Health in the New York City area began receiving famotidine intravenously, at nine times the heartburn dose. Unlike other drugs the 23-hospital system is testing, including Regeneron’s sarilumab and Gilead Science’s remdesivir, Northwell kept the famotidine study under wraps to secure a research stockpile before other hospitals, or even the federal government, started buying it. “If we talked about this to the wrong people or too soon, the drug supply would be gone,” says Kevin Tracey, a former neurosurgeon in charge of the hospital system’s research."
New York clinical trial quietly tests heartburn remedy against coronavirus: The heartburn remedy famotidine may disable a key enzyme that the new coronavirus uses to make copies of itself

[John Thullen]

Meanwhile, Regeneron's sarilumab looks to be ineffectual:

https://seekingalpha.com/news/3564541-regeneron-and-sanofis-kevzara-shows-no-clinical-benefit-in-covidminus-19-study

[hairshirthedonist]

I have a bottle of famotidine! Yay!

[hairshirthedonist]

But don't tell anyone. I don't want people breaking into my house for it.

[Snarki, child of Loki]

I've never liked the lyrics to Happy Birthday either

I've always preferred:

Happy birthday! Hunnh!
Happy birthday! Hunnh!
May the cities in your wake
burn like candles on your cake
Happy birthday! Hunnh!

Amusing for all, apropos for teens and toddlers.

[wj]

I heard that as the second verse. Between

Happy birthday! Hunnh!
Happy birthday! Hunnh!
Death, destruction and dispair,
People dying everywhere
Happy birthday! Hunnh!

and

Happy birthday! Hunnh!
Happy birthday! Hunnh!
Now that you're the age you are
Your demise cannot be far
Happy birthday! Hunnh!

Labeled as The Mongol Happy Birthday.

Optimism is a fine old tradition....

[hairshirthedonist]

These a**holes...

https://calmatters.org/health/2020/04/debunking-bakersfield-doctors-covid-spread-conclusions/

The doctors should never have assumed that the patients they tested — who came for walk-in COVID-19 tests or who sought urgent care for symptoms they experienced in the middle of a pandemic — are representative of the general population, said Dr. Carl Bergstrom, a University of Washington biologist who specializes in infectious disease modeling.

(...)

The doctors “basically hyped a bunch of data and weren’t transparent about their methods. And they really played on the fact that they’re physicians. I think it’s quite disingenuous of them.” Pan said. “Then we have to push back on any media that promotes this information. They’re really doing this as a way to fish for attention.”

(...)

But already the Bakersfield doctors — who tout their support of President Donald Trump and refuse to wear masks in public — had become heroes on social platforms and conservative media outlets, with some commenters calling them “brave.” Others who support continuing to shelter-in-place described the doctors as self-promoters whose chain of urgent care centers would benefit from reopening. Non-COVID medical visits have plummeted during the pandemic, endangering the practices of many doctors.

[hairshirthedonist]

And this dick...

https://thehill.com/homenews/administration/495079-pence-flouts-mayo-clinic-policy-by-not-wearing-face-covering

[sapient]

Kind of the medical version of his performance here.

[hairshirthedonist]

He probably gets yelled at in art museums. "Hands off the Monet, jackass!"