COVID topic vol 2

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IlliniDave
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Re: COVID topic vol 2

Post by IlliniDave »

SIAP

https://www.reuters.com/article/us-heal ... ce=twitter

I still think back to a bout of crud I had in early/mid January. Not severe or anything, just a little different-feeling compared to the run-of-the-mill winter crud.

I'm a little leery of the return to work the week after Thanksgiving. Had a marked upturn is cases around here, but not yet up to the ~June peak numbers. So people in general seem to be planning normal Thanksgivings so far.

chenda
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Re: COVID topic vol 2

Post by chenda »

IlliniDave wrote:
Mon Nov 16, 2020 7:27 am
SIAP.
That's a new one for me: :)

https://www.acronymfinder.com/SIAP.html

@j +1

jacob
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Re: COVID topic vol 2

Post by jacob »

https://investors.modernatx.com/news-re ... y-efficacy

Moderna achieves 94.5% efficacy in first analysis of phase 3.

So now there are probably two candidates (the other one from Pfizer/BiogenX).

Alphaville
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Re: COVID topic vol 2

Post by Alphaville »

a thought: we have 250k covid deaths in the us roughly, but how many permanently damaged/disabled patients? any numbers on that anywhere?

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jennypenny
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Re: COVID topic vol 2

Post by jennypenny »

@ID -- DS's HS is all virtual the week after thanksgiving to avoid an uptick after holiday gatherings. Same after xmas/new years week.

FYI ... it's impossible to rent a tent anywhere near me. I guess everyone had the same idea of holding thanksgiving outdoors.

Alphaville
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Re: COVID topic vol 2

Post by Alphaville »

jennypenny wrote:
Mon Nov 16, 2020 9:21 am

FYI ... it's impossible to rent a tent anywhere near me. I guess everyone had the same idea of holding thanksgiving outdoors.
i sometimes have dinner with people over facetime these days and it’s fun to see distant friends but ymmv

UK-with-kids
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Re: COVID topic vol 2

Post by UK-with-kids »

Alphaville wrote:
Mon Nov 16, 2020 9:04 am
a thought: we have 250k covid deaths in the us roughly, but how many permanently damaged/disabled patients? any numbers on that anywhere?
Probably a lot, but to get a non sensationalist figure you would need to deduct the number who weren't already damaged before they got it... don't forget the overwhelming majority of severely affected patients had multiple pre-existing conditions (whether you count being severely obese as damaged/disabled is debatable).

Alphaville
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Re: COVID topic vol 2

Post by Alphaville »

UK-with-kids wrote:
Mon Nov 16, 2020 11:37 am
Probably a lot, but to get a non sensationalist figure you would need to deduct the number who weren't already damaged before they got it... don't forget the overwhelming majority of severely affected patients had multiple pre-existing conditions (whether you count being severely obese as damaged/disabled is debatable).
ah, that’s true.

i linked the heart article as an example of something i’m not seeing counted, not as the whole thing,.

e.g. i know someone who got severely brain damaged, and while perhaps “chubby” previously, wasn’t brain-damaged before.

how many such people are out there? “deaths” is a bad metric in war; casualty counts include the wounded. go to any veteran’s hospital to see the huge toll beyond mere death.

but with covid, i was watching bloomberg early this morning and they mentioned “deaths” along with the weekend infection spikes. and i was left thinking about the “veterans”, so to speak, and i realized that i have no clue about those numbers. who keeps tabs?
Last edited by Alphaville on Mon Nov 16, 2020 11:53 am, edited 1 time in total.

UK-with-kids
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Re: COVID topic vol 2

Post by UK-with-kids »

Lemon wrote:
Sat Nov 14, 2020 1:41 pm
There is a really good interview by Chris Whitty in last weeks BMJ talking about how there is no 'good' option: here obviously UK focussed
Thanks @Lemon that's a really good article. Absolutely full of very astute observations and from a credible individual with integrity and first hand knowledge.

I'm not sure if it's the same in the US, but for many years in the UK there's been this fear that a particularly harsh winter flu season could overwhelm the national health service. To the extent that holding the last general election in December was seen as a little risky but still a lot better for the government than waiting until later in the winter when there might be negative headlines about hospitals unable to cope. With so little spare capacity it's hardly surprising that all efforts are on keeping Covid cases low.

Actually, to make a small digression into politics, a former Conservative minister famously said the British only have one true religion, the national health service, and unfortunately his party are seen as non-believers. To allow events to unfold as they did in Italy in the spring would be electoral suicide. No wonder Chris Whitty says he won't get involved in politics!

nomadscientist
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Re: COVID topic vol 2

Post by nomadscientist »

To my mind he answers these questions like any politician, starting from the very first answer*. More consequentially, his statement that mortality varies "slightly" with age is both false and grotesquely dishonest.

Once a 'scientist' becomes both empowered to make decisions and publicly identifiable, he becomes a politician. And people at the top of hierarchies (special advisor posts, lab directors, etc.) are politicians in their day jobs already.

Scientism is a PR action. It's an attempt to present value judgements (death reduction is more valuable than disrupted social functions) as facts, and hypotheses (Western-style lockdowns reduce mortality) as conclusions.




*an independent scientist would've said something like "I'm fine, not that it matters." Both through the mindset, and actually being in a position to not care what anyone thinks of him. This guy is courting a positive public image, and he does it so slickly it's surely deliberate.

ZAFCorrection
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Re: COVID topic vol 2

Post by ZAFCorrection »

Scientism indeed.

95% of my criticism of the professional response to this pandemic would be addressed by an admission that they explicitly decided to ignore every dimension other than death, and to a lesser extent, disability due to the virus itself. In keeping with that plan, widespread social intervention will be demanded until an effective vaccine is rolled out, nevermind if herd immunity is already being reached in certain areas. Because medical technocracy is going to have the win on this one.

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Re: COVID topic vol 2

Post by jacob »

Therein lies the problem of specialization.

Based on the few public health/epidemiology (text)books I've read, the variables to optimize are something like morbidity or health years. The constraints are money (budget) and "culture" (e.g. treatments should be respectful of the patient's beliefs). While "differences in culture" is semi-easy to spot when you're treating patients from a very different culture, it becomes much harder when the doctor and the patient come from the same culture. In that case it becomes much harder for the fish to think about the water, they're both swimming in. For example in the US the dominant religion is consumerism but scientists are blind to that (because they themselves are part of it and thus don't see it as a belief-system). Thus they do not respect the strongly held beliefs when proposing treatment plans.

The second issue is the specialist's tendency to reduce other specialization to boundary conditions. While they may know that health policy plans influence the economy, they don't grok it because their understanding of the economy is at the layman level which is to say close to non-existent. Instead it's just assumed that other specialists (economists) will come up with a solution that corrects for it. It is similar to how economists and politicians presume scientists will create a technology solution to CC while scientists are calling for a political or economical solution.

As informed individuals we just have to understand the limits of what a tightly coupled network of specialists is actually capable of solving when the transmission of knowledge across the links is actually somewhat weak.

I tend to be quite sympathetic to the scientists' position though. It's often a choice between 1) Creating results suboptimal to the goal of the patient by communicating things as they are because the "patient" (individual, population, politician) lacks "reading comprehension". 2) Creating results in more close alignment to the goal of the patient which takes the lack of "reading comprehension" into account. A good example would be how public health deals with diabetes. It's easier to teach people how to inject themselves with insulin than it is to teach them how to eat correctly. Therefore, the former has better health outcomes and so that becomes the strategy. We should not ignore the role that a largely uninformed and easily manipulated public plays in this either. Most people don't have an operational understanding of germ theory. It's impossible to fix stupid.

nomadscientist
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Re: COVID topic vol 2

Post by nomadscientist »

The UK system (""death panel""/socialised medicine) already judges efficacy of medical interventions generally by the DALY measure (cost per Disability Adjusted Life Year saved) on a national basis, so I don't see any cultural or other difficulties in judging corona interventions by the DALY measure either. It's the standard measure and there would have to be an extraordinary reason to not use it*.

I do not see any DALY calculations justifying the current measures. It seems likely that they would not justify the current measures even given a large range of uncertainty**.

I also do not see any attempt to quantitatively limit the uncertainty in either the "DALYs saved" or the "cost" components of the calculation.

Instead I see curation of facts to justify the current measures endlessly (even, increasingly, attempts to justify them past the end of the pandemic). Chris Witty does not talk like a narrow specialist who refuses to answer non-technical questions outside a narrow range. He talks like a politician intending to make a bundled package of decisions sound appealing to the audience.

The reality is we do not hear anything from working scientists. We hear from science administrators who have been filtered by multiple promotion gateways for political outlook and aptitude.



*for instance, if the disease would kill 100% of the population if uncontrolled, it would not make sense to assign stopping this a merely finite monetary value, regardless how large; however, this disease threatens to kill ~0.3% of the population if uncontrolled.

**for example, it's far gone beyond a simple tradeoff of "health vs economy", a dichotomy that both imposes ideological factions on each view and also paints one as the bad guy; it's disrupting all sorts of non-monetary functions like family formation that are ultimately far more important to most people than either monetary or health considerations.

ZAFCorrection
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Re: COVID topic vol 2

Post by ZAFCorrection »

@Jacob

Simplifying everyone's complaints about the response to the pandemic, the attitude seems to be that the benefits don't outweigh the costs. Since the professional model can't even see costs to intervention (only preventing deaths matters, afterall), I don't buy the argument that we should give the scientists a break because they are specialized.

Even an immunologist should be able to admit it is theoretically possible for the cure to be worse than the disease and then to ghetto up some economics. Instead the medical community is doubling down when many people in the public already don't believe them. The noble lie is kinda pointless when people already see it as a lie, even if their reasoning was stupid.

classical_Liberal
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Re: COVID topic vol 2

Post by classical_Liberal »

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Anne Fadiman is a pretty great book dealing with culture, patient centered care, best solution treatment vs a technically correct one, etc. All the stuff @jacob talks about in his last post. It presents a case study of bad outcome because technical/scientific best practice approaches didn't consider the holistic nature of the patient. Imagine how all of this is exponentially complicated by having to create solutions within a large, complex cultural-economic system, instead of a singular patient. I think it's message is pertinent to these conversations and highly recommend it, it's a really good read anyway, so worth anyone's time.

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Re: COVID topic vol 2

Post by jacob »

I wonder how much of the SNAFU is due to humans not wanting to have that uncomfortable conversations that nature is increasingly forcing us to have. I happen to think that drives most of the conversation.

For COVID it's the unwillingness to admit wanting to sacrifice the freedom of the old for the freedom of the young so instead [the dichotomy] becomes economics vs health.

For CC it's the unwillingness to admit to sacrificing the welfare of future generations for the welfare of Boomers and GenXers so instead it becomes about whether the science is true.

Humanity just keeps finding a way to type-cast individual/tribal interests into simplistic frameworks no matter how fundamental.

Riggerjack
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Re: COVID topic vol 2

Post by Riggerjack »

Simplifying everyone's complaints about the response to the pandemic, the attitude seems to be that the benefits
Which they don't/can't calculate.
don't outweigh the costs.
Which they don't/can't calculate.

Yeah, man. Cuz math is hard. Harder when it's all variables. Harder still, when the variables get filled in by experts in crossword puzzles. :shock:

Or, we could embrace the vast amount of unknown (and at this point, unknowable) information missing from the knowledge base necessary to do the math accurately.

Or I guess we could just assume away any uncertainty, and just pretend that anything unknown is irrelevant...
Even an immunologist should be able to admit it is theoretically possible for the cure to be worse than the disease and then to ghetto up some economics.
Yeah, just like that. :lol:
Last edited by Riggerjack on Mon Nov 16, 2020 9:43 pm, edited 1 time in total.

ZAFCorrection
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Re: COVID topic vol 2

Post by ZAFCorrection »

@riggerjack

Ya, it basically is incalculable. But the only scientific disciplines which have been successful do it by quantifying shit. And if you want credit for having a quantified scientific answer to something, you got to quantify everything at least somewhat accurately, or justify leaving stuff out of the model. Otherwise, the errors you ignore are basically going to drown out any signal you get from the bits of math/quantification.

That's a basic issue in research, and the dudes who are waving labcoats around are engaging in tribalistic behavior unless they have an answer.

Laura Ingalls
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Re: COVID topic vol 2

Post by Laura Ingalls »

classical_Liberal wrote:
Mon Nov 16, 2020 6:14 pm
The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Anne Fadiman is a pretty great book dealing with culture, patient centered care, best solution treatment vs a technically correct one, etc.
Excellent book. I read it while having a Hmong student with severe Grand mal seizures (and severe hearing loss) in the school I worked in. The dad was an elder in the community and our Hmong interpreter held him in very high esteem.

chenda
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Re: COVID topic vol 2

Post by chenda »

nomadscientist wrote:
Mon Nov 16, 2020 3:21 pm
I do not see any DALY calculations justifying the current measures. It seems likely that they would not justify the current measures even given a large range of uncertainty**.
What would you do instead ? If you were benevolent dictator.

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