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Thread: Disease and pandemics thread (because it's science)

  1. #2371
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    Quote Originally Posted by Copernicus View Post
    I feel like people are making stuff up. First Sweden is criticized for not doing what everybody else did because it was foolish not to do what everybody else did. Now that we see there is no second wave there now the narrative was that they did do a bunch of stuff.
    What do you mean by "narrative"? Are you accusing me of lying about something?
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    Quote Originally Posted by Jens View Post
    What do you mean by "narrative"? Are you accusing me of lying about something?
    No I'm not talking about you. There has just been such an attack on Sweden because they chose a different way to attain herd immunity. Now they they are not having a second wave and there are so many articles about what they did is wrong and that they haven't attain herd immunity, yet there is no second wave like france, spain, UK and many other nations. There are so many organizations with political motives and they have to come up with narratives to explain Sweden.
    How does someone explain the lack of cases of coronavirus. In February the US supposedly had 4 million cases of the flu in just one week. Its R naught is about 1. The R naught for the coronavirus is about 2 to 3. It should expand so much faster than the flu, but there are only 27 million cases in the whole world. These two numbers are not consistent. If you want, look at New York, New Jersey Massachusetts. There cases are very small now, no second wave. The virus basically went through those states uncontrolled the first time. They have the same shape curve as Sweden. Is it magic?
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    Quote Originally Posted by Copernicus View Post
    No I'm not talking about you. There has just been such an attack on Sweden because they chose a different way to attain herd immunity. Now they they are not having a second wave and there are so many articles about what they did is wrong and that they haven't attain herd immunity, yet there is no second wave like france, spain, UK and many other nations. There are so many organizations with political motives and they have to come up with narratives to explain Sweden.
    Regarding Sweden, it's unfortunate that it has become a sort of political issue. As you say, there were people who argued that Sweden was doing fine despite having no lockdowns, and then there were people who pointed out how poorly they did compared to their Nordic neighbors, often depending on whether the person was arguing that lockdowns were good or bad. But somehow in that debate the real fact, which is that Sweden was not just doing nothing, seems to have been lost. I was trying to point that out. If you look around the world, Sweden is not an outlier either in a good or bad way. In Japan as well, we had no strict lockdown (like in Sweden, it's not legally possible), and we have gotten through so far with a case rate that is much lower than Sweden or really any European country. Incidentally, Sweden's neighbors, like Norway and Sweden, have also not had second waves, and honestly speaking I don't know why that is. The UK hasn't had much of one either.
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    Quote Originally Posted by Copernicus View Post
    How does someone explain the lack of cases of coronavirus. In February the US supposedly had 4 million cases of the flu in just one week. Its R naught is about 1. The R naught for the coronavirus is about 2 to 3. It should expand so much faster than the flu, but there are only 27 million cases in the whole world. These two numbers are not consistent. If you want, look at New York, New Jersey Massachusetts. There cases are very small now, no second wave. The virus basically went through those states uncontrolled the first time. They have the same shape curve as Sweden. Is it magic?
    I'm not sure why you give "magic" as the alternative. It almost sounds like you want to make anyone who doesn't accept your theory a believer in magic.

    I would not say that herd immunity has nothing to do with the drop in cases in places like New York, because yes, R0 gets driven down by the fact that people have gotten the virus and acquired immunity. But it seems clearly to me that that is not the whole explanation. Again, in Japan, and other places in Asia, we have been hit by the virus but the number of cases is basically flat or falling, even though the number of people who have been infected is not significant enough to cause any herd immunity. I think they did random testing in Tokyo and found antibodies in only 0.4% of people or something like that. And in Europe, other countries have had just as many cases as Sweden, so they should have the same amount of herd immunity, and yet they are seeing resurgences. Maybe Swedish people don't stand or sit as close together as people in more southern parts of Europe do. I don't know how to explain it, but I don't think it's just asymptomatic cases.
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    Quote Originally Posted by Copernicus View Post
    ...are the recovered people, who are shedding dead or damaged virus, actually vaccinating, without infecting people.
    If you wear a mask to prevent deep inhalation of the bug, but just get a smaller load from fingers here and there?
    I have heard of contact highs, but not contact vaccination...

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    And also, regarding seasonal influenza, I'll like to get Grant's thoughts on this, because he is more knowledgeable, but note that there are other diseases with much higher R0s than influenza, like SARS, AIDS, Ebola, that have not spread like it does. Frankly, I don't know why seasonal influenza is so good at spreading when it only has an R0 or 1.4 or so. But it's clearly not magic, because the same was true with SARS, and that was contained.
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    Quote Originally Posted by Jens View Post
    I'm not sure why you give "magic" as the alternative. It almost sounds like you want to make anyone who doesn't accept your theory a believer in magic.

    I would not say that herd immunity has nothing to do with the drop in cases in places like New York, because yes, R0 gets driven down by the fact that people have gotten the virus and acquired immunity. But it seems clearly to me that that is not the whole explanation. Again, in Japan, and other places in Asia, we have been hit by the virus but the number of cases is basically flat or falling, even though the number of people who have been infected is not significant enough to cause any herd immunity. I think they did random testing in Tokyo and found antibodies in only 0.4% of people or something like that. And in Europe, other countries have had just as many cases as Sweden, so they should have the same amount of herd immunity, and yet they are seeing resurgences. Maybe Swedish people don't stand or sit as close together as people in more southern parts of Europe do. I don't know how to explain it, but I don't think it's just asymptomatic cases.
    There are some serious mysteries aren't there. Why does the far east have so few cases? There is so much politics in a lot of it. Blaming countries for mishandling their response only to find out other countries are now getting second waves. Policy, while it may be better in the far east, seems unlikely to explain the enormous difference in cases.
    My boss blamed a staff member for getting the coronavirus saying such and such a policy could have been followed better, only to have my boss get the virus two weeks later. Viruses are very difficult to stop.
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  8. #2378
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    Quote Originally Posted by Jens View Post
    And also, regarding seasonal influenza, I'll like to get Grant's thoughts on this, because he is more knowledgeable, but note that there are other diseases with much higher R0s than influenza, like SARS, AIDS, Ebola, that have not spread like it does. Frankly, I don't know why seasonal influenza is so good at spreading when it only has an R0 or 1.4 or so. But it's clearly not magic, because the same was true with SARS, and that was contained.
    Seasonal flu has an R0 of 1.3 or 1.4 in our normal society, which we run as usual during flu season. Covid-19 has an R0 of 3 or 4 in our normal society, which doesn't exist any more. There are probably now no countries in the world in which R for Covid-19 is 3 or 4 at a national level, because everywhere is mitigating to some extent.
    We need to just forget about the historical R0, and look at Re ("e" for "effective") in our societies as they are currently working. My little part of the world has been opening up slowly, and keeping Re at somewhere between 0.9 and 1.1. Life is not normal, but we're doing things that are approximations to normal in various ways. Which is how Sweden ran (and is still running) throughout the pandemic, and why Mike Ryan at the WHO suggested Sweden would turn out to be a model of "post lockdown" society.
    There are a couple of problems. One is that when prevalence is low, Re is difficult to calculate, and the calculated value is exquisitely sensitive to local outbreaks. (We're having one of those at present, with R maybe as high as 1.4 for Scotland, but local exceedence concentrated in a few geographically small hotspot areas.) The other is that people forget the causal link between "society heavily modified" and "Covid less of a problem", and start saying "Well, now that Covid's less of problem, we should start abandoning all the stuff we did to control it."

    Grant Hutchison

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    Quote Originally Posted by grant hutchison View Post
    Seasonal flu has an R0 of 1.3 or 1.4 in our normal society, which we run as usual during flu season. Covid-19 has an R0 of 3 or 4 in our normal society, which doesn't exist any more. There are probably now no countries in the world in which R for Covid-19 is 3 or 4 at a national level, because everywhere is mitigating to some extent.
    We need to just forget about the historical R0, and look at Re ("e" for "effective") in our societies as they are currently working. My little part of the world has been opening up slowly, and keeping Re at somewhere between 0.9 and 1.1. Life is not normal, but we're doing things that are approximations to normal in various ways. Which is how Sweden ran (and is still running) throughout the pandemic, and why Mike Ryan at the WHO suggested Sweden would turn out to be a model of "post lockdown" society.
    There are a couple of problems. One is that when prevalence is low, Re is difficult to calculate, and the calculated value is exquisitely sensitive to local outbreaks. (We're having one of those at present, with R maybe as high as 1.4 for Scotland, but local exceedence concentrated in a few geographically small hotspot areas.) The other is that people forget the causal link between "society heavily modified" and "Covid less of a problem", and start saying "Well, now that Covid's less of problem, we should start abandoning all the stuff we did to control it."

    Grant Hutchison
    I'm just saying, the amount of people infected, is way too low to make any sense, even considering means to control it.
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    Quote Originally Posted by Copernicus View Post
    I'm just saying, the amount of people infected, is way too low to make any sense, even considering means to control it.
    The amount of people known to be infected. Asymptomatic and untested also means uncounted.
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    Quote Originally Posted by Copernicus View Post
    I'm just saying, the amount of people infected, is way too low to make any sense, even considering means to control it.
    I would just say that there are lots of scientists and health professionals who are actually doing things like modeling the spread of the disease and analyzing cases and how it spreads and what measures make it spread more or less easily. And they are not saying, "it doesn't make any sense." SARS had a similar r naught, and there have been several outbreaks, but they were contained without the disease ever spreading so widely that there would be herd immunity to it. You really have to look at the details.
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    AstraZeneca has paused its vaccine trial due to a possible adverse reaction in a test subject. Bummer.
    Cum catapultae proscriptae erunt tum soli proscript catapultas habebunt.

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    Quote Originally Posted by Trebuchet View Post
    AstraZeneca has paused its vaccine trial due to a possible adverse reaction in a test subject. Bummer.
    I wouldn't worry too much. This is routine stuff, and not even the first time it has happened in that trial. Basically, any random unpleasant thing that happens to anyone in the trial triggers a protocol that pauses recruitment and launches a clinical investigation. When you're dealing with large numbers of people, someone will end up in hospital with something at some point during the trial. My Wife The Professor used to run into these fairly regularly during her research--there would be a lot of work and documentation to get through, and then the trial would restart.

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    I look at it like this: they are taking safety seriously which will make me feel better about taking it if the tests go well and it is approved. I’d be more concerned about the Russian or Chinese vaccines that appear to have been really rushed into use.

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    Quote Originally Posted by grant hutchison View Post
    I wouldn't worry too much. This is routine stuff, and not even the first time it has happened in that trial. Basically, any random unpleasant thing that happens to anyone in the trial triggers a protocol that pauses recruitment and launches a clinical investigation. When you're dealing with large numbers of people, someone will end up in hospital with something at some point during the trial. My Wife The Professor used to run into these fairly regularly during her research--there would be a lot of work and documentation to get through, and then the trial would restart.

    Grant Hutchison
    Transverse myelitis* sounds like potentially more than an unpleasant thing, but I agree that it could be unrelated. Fortunately, AstraZeneca/Oxford appears to be doing their due diligence.

    *Reported by NY Times according to BBC


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    Quote Originally Posted by Extravoice View Post
    Transverse myelitis* sounds like potentially more than an unpleasant thing ...
    Well, in standard medical vocabulary, there is actually no category beyond unpleasant. But there are certainly other more unpleasant "serious acute neurological episodes temporally associated with vaccination", if that's any comfort.
    First thing they'll do is break the randomization code, and see if the affected person received the vaccine or the control. Then they'll go through the steps dictated by the WHO's Causality Assessment of an Adverse Event Following Immunization manual, which is the bible in these matters.
    This stuff happens all the time during Phase III vaccine trials--we just don't generally hear about it. And it's why we don't "fast track" vaccines.

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    Quote Originally Posted by headrush View Post
    There has been a lot of shouting, I agree. Having witnessed the carping from the traditional and social media, it appears to me that if a sensible, science based approach to a problem is to succeed, then more harshly imposed rules are needed. There has been and still is too much shouting from the back of the room by people who think they know better.

    This could be why the likes of Korea and possibly Germany have generally managed this crisis better than the UK and USA. Respect for (the correct) authority.
    So now that the second wave is hitting Europe and the middle east hard, can we stop blaming the UK and the USA as being inept. Viruses go where they will go. I do think masks are the best protection for slowing down the disease, but in the end I don't think they are the answer for stopping the disease because the R naught is too high, or if people want the adjusted R naught after interventions. Herd immunity will stop it. In the US 3 out of a hundred people die who get the disease, now it is less because of summer and better treatments, but everybody getting sick at once would cause chaos.
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    Quote Originally Posted by Copernicus View Post
    So now that the second wave is hitting Europe and the middle east hard, can we stop blaming the UK and the USA as being inept.
    I'm not sure who is blaming the UK and USA for being inept. Certainly there are people in the US who have criticized the administration for failing to get testing ready quickly, and people in the UK who blamed their PM for initially taking a stance they think was bad. But in Japan, lots of people are blaming the government here for going ahead with the "go to travel" campaign despite the fact that there are continuing infections here as well. Also, even in Europe it depends where you look. Italy is not experiencing a really big second wave, and the UK seems to be experiencing a small one. Spain and France have been hit fairly hard, but not Germany, and who knows why. I think it's a complex situation, and I don't think that anybody knows exactly what the right way to handle it is.
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    Quote Originally Posted by Copernicus View Post
    Herd immunity will stop it.
    Unfortunately in certain contexts that is questionable. In Tokyo, we are getting like 200 new cases a day. With a population of about 10 million, that means that in order to have 40% of the population infected, it will take more than 50 years. And actually it's worse than that, because I think about 250 babies are born every day, so we will never catch up with it. So really, social distancing type measures seem the only way until a vaccine (hopefully) becomes available.
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    Quote Originally Posted by Jens View Post
    I'm not sure who is blaming the UK and USA for being inept. Certainly there are people in the US who have criticized the administration for failing to get testing ready quickly, and people in the UK who blamed their PM for initially taking a stance they think was bad.[...] I think it's a complex situation, and I don't think that anybody knows exactly what the right way to handle it is.
    I’ve seen arguments from both in and outside the US that we should have prepared to test earlier, stepped up contingency preparations like pushing N95 mask production by January with the proviso it wasn’t certain it would be needed this time, and promoted a stay at home process nationally at least a couple weeks earlier than when they started.

    I think there’s a good argument it could and should have been tried, but agree that given the way things have gotten away from some other countries there is a real possibility it wouldn’t have mattered much. Even in California, we were doing fairly well and were more proactive than most, but messed up starting to open up in June.

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    Closed pending moderator discussion.
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    Quote Originally Posted by Copernicus View Post
    So now that the second wave is hitting Europe and the middle east hard, can we stop blaming the UK and the USA as being inept. Viruses go where they will go. I do think masks are the best protection for slowing down the disease, but in the end I don't think they are the answer for stopping the disease because the R naught is too high, or if people want the adjusted R naught after interventions. Herd immunity will stop it. In the US 3 out of a hundred people die who get the disease, now it is less because of summer and better treatments, but everybody getting sick at once would cause chaos.
    Copernicus

    You seem determined to get as close as you can to violating our rules on politics and non-mainstream ideas, particularly in this thread. Your last several posts have come very close to getting you infracted and possibly suspended. You need to stop pushing the envelope. We are trying to allow this discussion, but we need people to concentrate on the science (this is a science forum).
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    We hear a lot of talk about herd immunity, but I’m not sure I understand how it could work with this virus.
    If immunity drops off quickly after an infection* could enough people be immune at the same time for herd immunity to come into play?

    * I think the jury is still out on that assertion.


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    I work as a nurse on the Covid-19 floor. I handle three to four coronavirus patients every shift. I have saved a lot of lives, just by doing my job and paying attention to what is going on with my patients. None of that is science because it is just anecdotal what I have experienced. I have had covid-19 infection. I have to work with coworkers who have gotten the coronavirus and we have talked about our experiences with the covid-19 infection. None of that is science because it is just anecdotal. But for me all of this is very real.
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    Any thoughts on how well this nasal vaccine will work? Seems like a good idea to me. https://www.corona-stocks.com/china-...id-19-vaccine/
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    Quote Originally Posted by Extravoice View Post
    We hear a lot of talk about herd immunity, but I’m not sure I understand how it could work with this virus.
    If immunity drops off quickly after an infection* could enough people be immune at the same time for herd immunity to come into play?

    * I think the jury is still out on that assertion.
    You seem to be answering your own question. The faster immunity declines in individuals, the less likely is any given prevalence of immunity in the population.

    Grant Hutchison
    Last edited by grant hutchison; 2020-Sep-12 at 02:13 PM.

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    Quote Originally Posted by Copernicus View Post
    I work as a nurse on the Covid-19 floor. I handle three to four coronavirus patients every shift. I have saved a lot of lives, just by doing my job and paying attention to what is going on with my patients. None of that is science because it is just anecdotal what I have experienced. I have had covid-19 infection. I have to work with coworkers who have gotten the coronavirus and we have talked about our experiences with the covid-19 infection. None of that is science because it is just anecdotal. But for me all of this is very real.
    There is a non-science Corona virus thread in OTB, if you wish to share experiences rather than scientific data.
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    Quote Originally Posted by Copernicus View Post
    Any thoughts on how well this nasal vaccine will work? Seems like a good idea to me. https://www.corona-stocks.com/china-...id-19-vaccine/
    It says it is undergoing the first human trials. Are there some ways to get an indication of efficacy and safety prior to trials?

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    Quote Originally Posted by Extravoice View Post
    Transverse myelitis* sounds like potentially more than an unpleasant thing, but I agree that it could be unrelated. Fortunately, AstraZeneca/Oxford appears to be doing their due diligence.

    *Reported by NY Times according to BBC
    So the MHRA (the UK medical regulatory body that oversees clinical trials) has completed its adverse event review and allowed the Oxford vaccine trial in the UK to restart. I'd anticipate that other countries where the vaccine is being trialed will follow suit.
    The report of transverse myelitis seems to have been an overinterpretation of remarks by Astra-Zeneca's CEO. The affected trial participant was in fact admitted to hospital with symptoms "consistent with" transverse myelitis. There are several conditions that can produce such symptoms, but because transverse myelitis is on the list of Serious Acute Neurological Episodes potentially associated with vaccines, such a constellation of symptoms would trigger a pause in recruitment.

    Grant Hutchison

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    Quote Originally Posted by grant hutchison View Post
    You seem to be answering your own question. The faster immunity declines in individuals, the less likely is any given prevalence of immunity in the population.

    Grant Hutchison
    Based on my understanding, it seemed likely to be the case. However, I learned long ago that I shouldn’t assume I know all the variables that might be at play. Thanks for the clarification.


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