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

  1. #2281
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    Quote Originally Posted by Copernicus View Post
    There are many factors. How does this affect riots, hunger, suicide, economics.
    Those are outside the scope of this thread.
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    Quote Originally Posted by Noclevername View Post
    Those are outside the scope of this thread.
    I'm just saying follow the science is cliche. There are many factors than just the disease to consider. They are all science.
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    Quote Originally Posted by grant hutchison View Post
    Likewise the Oxford vaccine. The ChAdOx1 vaccine vector has been used in several previous vaccines. We're fortunate this all kicked off at a time when vaccines can be assembled from tested components.

    Grant Hutchison
    The news reported that “they” want to shorten phase 3 trials by getting volunteers to become deliberately infected after receiving the vaccine. It wasn’t clear to me how seriously this is being considered.


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    Quote Originally Posted by Extravoice View Post
    The news reported that “they” want to shorten phase 3 trials by getting volunteers to become deliberately infected after receiving the vaccine. It wasn’t clear to me how seriously this is being considered.
    Very seriously. It's not a new idea. So-called "human challenge" vaccine trials have been carried out in several diseases in the past, and the WHO has published legal and ethical guidelines. They have a document dealing specifically with Covid-19 here. You can sign up as a volunteer for a Covid-19 challenge trial here. More on the ethics here.

    ETA: And the open letter to the National Institutes of Health in the USA, setting out the case for human challenge testing.

    Grant Hutchison
    Last edited by grant hutchison; 2020-Aug-07 at 08:26 PM.

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    There’s a fair amount of material there. I looked for selection criteria but if it there I didn’t find it, but admittedly didn’t look through all of it. I would guess they would, initially at least, select healthy younger participants - no high blood pressure, diabetes, etc. then depending on how effective it is they might move on to higher risk population.

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    Quote Originally Posted by grant hutchison View Post
    <snip>You can sign up as a volunteer for a Covid-19 challenge trial here. More on the ethics here.

    Grant Hutchison
    I volunteered for a COVID study in Atlanta but have not heard back. I may be too old (65) to qualify or they may need actual COVID patients or at least subjects with symptoms; the qualification survey was not specific. Interestingly the NIH says there are 39 studies taking place in Georgia alone and more than 500 across the US.

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    Quote Originally Posted by Copernicus View Post
    I'm just saying follow the science is cliche. There are many factors than just the disease to consider. They are all science.
    But first, we DO have to consider the science. Many leaders seem to disregard that as step one.
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    There seems to be no shortage of volunteers for challenge trials where as few as 40 volunteers with no control group, all get the vaccine then , at the right time afterwards, an inhaled dose of virus. The trial can start small because the statistics for a direct challenge would be very significant. The missing part is the long term effects, if any, of receiving the vaccine, the longer controlled trials, ie having some receive placebo, are for that check.
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    Quote Originally Posted by Jim View Post

    Well, turns out we've been at it for years. In 2008 a group of researchers started looking for a vaccine for RSV. What they learned as a result has given them a huge head start on the novel coronavirus.
    That's interesting. My wife and I had RSV last year. Not fun at all; I wish I'd had a vaccination instead!
    Cum catapultae proscriptae erunt tum soli proscript catapultas habebunt.

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    Quote Originally Posted by Trebuchet View Post
    That's interesting. My wife and I had RSV last year. Not fun at all; I wish I'd had a vaccination instead!
    As far as I know, the RSV vaccine is mainly for premature babies, as the disease is very deadly for them. And, I think there are many variations of RSV. As a nurse, it is stressful taking care of babies with RSV because the repercussions are so serious. Usually it affects their lungs for a long time afterwards, until about age six. Reactive airway disease, that used to be diagnosed as asthma.
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    Quote Originally Posted by Noclevername View Post
    But first, we DO have to consider the science. Many leaders seem to disregard that as step one.
    As far as I know, there is rarely enough science to make a scientific decision. There is still no evidence that masks work for this disease, if you want a double blind, gold standard, study. Now Fauci says you should wear goggles as well. Do you want to wait for the evidence of a double blind, gold standard study. Some do, some don't. Even if we have a gold standard study, how does this change affect the many other parameters of life?
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    Quote Originally Posted by Copernicus View Post
    As far as I know, there is rarely enough science to make a scientific decision. There is still no evidence that masks work for this disease, if you want a double blind, gold standard, study. Now Fauci says you should wear goggles as well. Do you want to wait for the evidence of a double blind, gold standard study. Some do, some don't. Even if we have a gold standard study, how does this change affect the many other parameters of life?
    I said nothing about "gold standard", whatever that means. I'm talking about the current recommendations, according to the consensus of medical groups. Almost all recommend a standardized, universal set of requirements, usually distancing, washing/sanitizing, contract tracing, testing and masks combination.
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    Quote Originally Posted by Noclevername View Post
    I said nothing about "gold standard", whatever that means. I'm talking about the current recommendations, according to the consensus of medical groups. Almost all recommend a standardized, universal set of requirements, usually distancing, washing/sanitizing, contract tracing, testing and masks combination.
    All those things were being done to some extent, but there is a whole other group of scientists that could be studying the social and economic costs of following all this to the letter. What about their consensus recommendations? Keep in mind that the consensus is not equivalent to science. Consensus is a kind of democratic election by scientists in a particular field.
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    Quote Originally Posted by Copernicus View Post
    All those things were being done to some extent, but there is a whole other group of scientists that could be studying the social and economic costs of following all this to the letter. What about their consensus recommendations? Keep in mind that the consensus is not equivalent to science. Consensus is a kind of democratic election by scientists in a particular field.
    Those things are not what I was talking about. Right now, there are plenty of leaders who are not even at step one, are denying or ignoring the basic recommendations that all the reliable medical sources agree to. That's my focus.
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    But if you want to talk masks in particular, here's results of a new test of mask droplet prevention:
    https://advances.sciencemag.org/cont...sciadv.abd3083
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    Quote Originally Posted by Noclevername View Post
    But if you want to talk masks in particular, here's results of a new test of mask droplet prevention:
    https://advances.sciencemag.org/cont...sciadv.abd3083
    Ah-ha. So there's now a bit of evidence that some face covers actually do convert large droplets (which fall out quickly and at short range) into small droplets (which fall out slowly and travel farther), as I hypothesized earlier in this thread.
    That's going to mess with the epidemiology. As if things weren't complicated enough.

    Grant Hutchison

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    Quote Originally Posted by grant hutchison View Post
    As if things weren't complicated enough.

    Grant Hutchison
    And politicized enough, as well.
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    Quote Originally Posted by Noclevername View Post
    I said nothing about "gold standard", whatever that means. I'm talking about the current recommendations, according to the consensus of medical groups. Almost all recommend a standardized, universal set of requirements, usually distancing, washing/sanitizing, contract tracing, testing and masks combination.
    A gold standard means data that would be nearly universally accepted, and in medicine tends to refer to a controlled trial. So if you could take a group of infected people and put them in theaters, some with masks and some without, and then follow other attendees and see whether it was transmitted, you would have some pretty persuasive data. Obviously pretty hard to pull off in the real world!
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    Quote Originally Posted by Noclevername View Post
    But if you want to talk masks in particular, here's results of a new test of mask droplet prevention:
    https://advances.sciencemag.org/cont...sciadv.abd3083
    Somebody once said, my people die for lack of knowledge. In the end it is very difficult to even figure out what the best knowledge and science is, as pointed out by Grant. Even intelligent, good people have differences of what is best. I prefer science and tradition to guide us and hope for the best because who likes to be around someone who is glum.
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    Quote Originally Posted by Copernicus View Post
    All those things were being done to some extent, but there is a whole other group of scientists that could be studying the social and economic costs of following all this to the letter.
    So this really goes back to my previous comment, which I'd be happy to know what you think about. It's not epidemiologists who are making policy. They are specialists in stopping infectious diseases, and make recommendations to government officials, who are the ones who impose policies. And my general impression is that precisely because of a consideration of economic effects and the like, politicians tend to impose lighter measures than those recommended by epidemiologists. But earlier on you seemed to be saying that there are cases where people impose stricter measures than those proposed by experts. Because you said:

    How about more harshly imposed rules from people who think they know better!
    So presumably this means politicians who are going beyond what infectious disease experts recommend.

    Now I am aware of some cases that might kind of fit that. For example, recently the US government warned about travel to New Zealand! And presumably it is a sort of revenge for being banned there. But other than that, do you really get the impression that politicians are often imposing rules that are tougher than those recommended by experts?
    As above, so below

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    Quote Originally Posted by Copernicus View Post
    Somebody once said, my people die for lack of knowledge. In the end it is very difficult to even figure out what the best knowledge and science is, as pointed out by Grant. Even intelligent, good people have differences of what is best. I prefer science and tradition to guide us and hope for the best because who likes to be around someone who is glum.
    I also would like to be guided by the science. But right now, at least in the part of the world I inhabit, that's not what's happening.
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    Quote Originally Posted by Jens View Post
    So this really goes back to my previous comment, which I'd be happy to know what you think about. It's not epidemiologists who are making policy. They are specialists in stopping infectious diseases, and make recommendations to government officials, who are the ones who impose policies. And my general impression is that precisely because of a consideration of economic effects and the like, politicians tend to impose lighter measures than those recommended by epidemiologists. But earlier on you seemed to be saying that there are cases where people impose stricter measures than those proposed by experts. Because you said:



    So presumably this means politicians who are going beyond what infectious disease experts recommend.

    Now I am aware of some cases that might kind of fit that. For example, recently the US government warned about travel to New Zealand! And presumably it is a sort of revenge for being banned there. But other than that, do you really get the impression that politicians are often imposing rules that are tougher than those recommended by experts?
    I was just saying that we don't always know better even though we think we do. In Sweden's model, not much was closed down. In most of the rest of Europe much was closed down, as well as in the US, much was closed down. I think in Japan, not much of the economy was closed down. Sweden had much the same result as the rest of Europe, as far as deaths are concerned, Japan had far fewer deaths, the US has largely the same results, as far as deaths, as Europe. So, we thought closing everything down, hurting the economy tremendously, would help. Closing the economy turned out to be a very harsh treatment imposed by those who thought they knew better. Closing the economy didn't have better results than Japan or Sweden. I know that comparing to two countries is narrow, but one does have to consider if closing everything down, was harsh and useless at best.
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    Quote Originally Posted by Copernicus View Post
    In most of the rest of Europe much was closed down, as well as in the US, much was closed down.
    The US was and is, a patchwork of local and inconsistent applications. States, towns, counties, and cities all differed in their actions and degrees of closure and isolation. Testing penetration is still poor.

    IMO no blanket statement can be made about the US' various policies. We are a giant trial-and-error experiment, still ongoing.
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    Quote Originally Posted by Noclevername View Post
    The US was and is, a patchwork of local and inconsistent applications. States, towns, counties, and cities all differed in their actions and degrees of closure and isolation. Testing penetration is still poor.

    IMO no blanket statement can be made about the US' various policies. We are a giant trial-and-error experiment, still ongoing.
    I agree that different states have taken different strategies, but by and large, at first, it was almost universal, shut down and distance. After reopening, the virus came back. If the virus had a lower R naught, this strategy may have worked, to shut everything down. Once the R naught goes back up, the virus comes back until we have a vaccine, or we have community herd immunity, or some combination of vaccine and here immunity. We could just be glad that for whatever reason, there is some natural immunity and it is not nearly as deadly as first feared and effective treatments are better and better all the time.
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    Quote Originally Posted by Copernicus View Post
    I was just saying that we don't always know better even though we think we do.
    In general, I don't have any problem with the sentences that follow after that. The problem to me is that "we" don't always know better even though "we" think we do. It's really unclear who this "we" is. You say "we don't always know better even though we think we do." But I don't understand the comparison. "Know better" than who? Nobody really knows the best way to overcome COVID-19. We don't necessarily think we know better. Who says that we think we do? I don't think think that I know better. If you are saying that we don't know the best way to fight against COVID-19, sure, I completely agree.
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    Quote Originally Posted by Copernicus View Post
    I agree that different states have taken different strategies, but by and large, at first, it was almost universal, shut down and distance. After reopening, the virus came back.
    Not really. In many states, shutdowns and isolation were only recommendations rather than requirements, not enforced. A few are still that way.
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    Quote Originally Posted by Jens View Post
    In general, I don't have any problem with the sentences that follow after that. The problem to me is that "we" don't always know better even though "we" think we do. It's really unclear who this "we" is. You say "we don't always know better even though we think we do." But I don't understand the comparison. "Know better" than who? Nobody really knows the best way to overcome COVID-19. We don't necessarily think we know better. Who says that we think we do? I don't think think that I know better. If you are saying that we don't know the best way to fight against COVID-19, sure, I completely agree.
    "We" is often used to try to avoid looking like a particular group or person is being blamed. "We" are in this together. There is sometimes a chorus of people saying we should follow the CDC or WHO guidelines. The CDC and WHO are supposed to be the authority of who would know best.
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    Quote Originally Posted by Copernicus View Post
    "We" is often used to try to avoid looking like a particular group or person is being blamed. "We" are in this together. There is sometimes a chorus of people saying we should follow the CDC or WHO guidelines. The CDC and WHO are supposed to be the authority of who would know best.
    OK, so then in your last statement, you say of the CDC and WHO "should know best." The implication to me at least is that you are implying that they do not. Let me maybe address the CDC, because I think it's easier. First, they have expert epidemiologists there, and I think they do know better. In the same sense that a professional pilot knows more than I do about flying a plane. And professional pilots do crash planes due to pilot error, so they are not infallible, just better. The chance of me safely landing a plane will be smaller. So I do think that the experts at CDC do know better, but we are in a situation where there are lots of unknowns, so we can't expect them to make perfect decisions all the time.

    And then one other thing, is that the CDC, like all organizations like that, is made up of actual scientists and of people who make the decisions, management. And the management will be influenced by several things, but mainly: the recommendations of experts within its organization, and the pressure from politicians outside the organization. And I think mainly what you will have is, experts saying that we should restrict domestic travel (because they are concerned with the spread) and politicians saying we shouldn't because it will hurt the airline industry, for example. So the pressure from outside is mainly going to be to resist strict measures.

    That is my analysis of the dynamics anyway. I assume that you have a different take on it, but don't really understand how you see it. It might help if you explain how you see the dynamics.
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    Quote Originally Posted by Jens View Post
    OK, so then in your last statement, you say of the CDC and WHO "should know best." The implication to me at least is that you are implying that they do not. Let me maybe address the CDC, because I think it's easier. First, they have expert epidemiologists there, and I think they do know better. In the same sense that a professional pilot knows more than I do about flying a plane. And professional pilots do crash planes due to pilot error, so they are not infallible, just better. The chance of me safely landing a plane will be smaller. So I do think that the experts at CDC do know better, but we are in a situation where there are lots of unknowns, so we can't expect them to make perfect decisions all the time.

    And then one other thing, is that the CDC, like all organizations like that, is made up of actual scientists and of people who make the decisions, management. And the management will be influenced by several things, but mainly: the recommendations of experts within its organization, and the pressure from politicians outside the organization. And I think mainly what you will have is, experts saying that we should restrict domestic travel (because they are concerned with the spread) and politicians saying we shouldn't because it will hurt the airline industry, for example. So the pressure from outside is mainly going to be to resist strict measures.

    That is my analysis of the dynamics anyway. I assume that you have a different take on it, but don't really understand how you see it. It might help if you explain how you see the dynamics.
    I'm not complaining about the CDC or WHO, I am not advocating for them either. I was saying that there are also economic scientists that may say if you shut down the economy it will create more massive problems than the disease. There are also social scientists that may say if you seclude everybody it may create more problems for peoples mental health that will have repercussions that are much greater than the disease. Keep in mind that I am making up the specifics to make a point. Which experts do the politicians look at. They are all experts. We have many social organizations and traditional organizations that have evolved over thousands of years and have passed the test of time. There traditions may have input in how to weather these types of problems. How much do the politicians listen to these groups. Different countries choose different strategies. After a while it may show which strategy worked better, it may be better to analyze which strategy or culture worked better and emulate, because it may be impossible at first to know which are the best strategies. It is always easy to blame the decision makers and blame them for not listening to science, but there are different aspects to science and different benefits that different cultures can offer.
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    Quote Originally Posted by Copernicus View Post
    I'm not complaining about the CDC or WHO, I am not advocating for them either. I was saying that there are also economic scientists that may say if you shut down the economy it will create more massive problems than the disease. There are also social scientists that may say if you seclude everybody it may create more problems for peoples mental health that will have repercussions that are much greater than the disease. Keep in mind that I am making up the specifics to make a point. Which experts do the politicians look at. They are all experts. We have many social organizations and traditional organizations that have evolved over thousands of years and have passed the test of time. There traditions may have input in how to weather these types of problems. How much do the politicians listen to these groups. Different countries choose different strategies. After a while it may show which strategy worked better, it may be better to analyze which strategy or culture worked better and emulate, because it may be impossible at first to know which are the best strategies. It is always easy to blame the decision makers and blame them for not listening to science, but there are different aspects to science and different benefits that different cultures can offer.
    my bold

    Since you admit you are making up the specifics that are possibly science, and the rest seems to be a rant on policy and politics, I think you need to drop this entire discussion now. This is a science forum and we are trying to keep the discussion of this pandemic civil and scientific. Your comments are not helping.
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