Geo-strategic issues Intelligent Design Medicine UD Newswatch highlights UD's Sci-Tech watch

Covid-19 Tracking the peak of Wave1 (w. OWID)

Spread the love

We can best see the peak in the death statistics, as global daily deaths begin to decline:

However, we seem to have a prolonged inflexion, giving a linear growth since mid April, i.e. growth and saturation are in rough equipoise, though the very end is beginning to tip over:

The pattern of doubling time has shifted, with major countries slowing significantly, e.g. here is the USA in immediate context:

Daily fresh global cases shows the flattened peaking:

National patterns show this too, with China showing secondary etc waves:

It is noteworthy that the UK now views China’s data as questionable:

The British government will no longer recognise the number of coronavirus deaths reported by the Chinese Communist Party (CCP) over fears that the country is producing fake data during the pandemic.

The figures from the communist regime were included in Downing Street’s “global death comparison” until last week as questions began to mount over the accuracy of the strikingly low numbers of deaths in the country from which the virus was spawned.

“This data is used to judge the effectiveness of our own response, whether good or bad. It’s important we are comparing like with like, otherwise our own responses could be distorted leading to more deaths in the UK. Clearly No 10 believes the same as the rest of the world — that China’s data is unreliable and possibly false,” the Conservative Party chairman of the foreign affairs select committee, Tom Tugendhat said according to the Evening Standard.

So, overall, Wave1 is peaking but by no means over. We have to prepare for onward waves. END

F/N: The SWOT-ALT vs BAU scenario based decision framework for strategic change:

56 Replies to “Covid-19 Tracking the peak of Wave1 (w. OWID)

  1. 1
    kairosfocus says:

    Covid-19 Tracking the peak of Wave1 (w. OWID)

  2. 2
    daveS says:

    Looks like this might be mostly over by mid-June eh?

  3. 3
    kairosfocus says:

    Maybe for Wave1, likely except Africa which is getting started now. Wave2?

  4. 4
    Ed George says:

    The USA is still 41st in testing per capita. Even if we limit this to medium to large sized developed nations, they barely crack the top twenty.

  5. 5
    kairosfocus says:

    EG, from the beginning, I noted how an exponential growth phase implies spreading at a rate dependent on the mass present, i.e. on absolute rather than proportional numbers. Proportional rankings are thus of little real value. Further to such, we have a general problem that we are tracking noisy proxies not the absolute truth; including that one reason for the plateau currently may be that more are being tested than previously, given the evidence of a high proportion of asymptomatic cases. That said, the US is part of the band followed by most industrial countries, showing a similar degree of policy success or failure. Attempts to single it out as though it were a unique failure, are ill advised. One key failure is that the FDA tried to create a special test, but this failed due to being contaminated with the virus itself and there was a linked bureaucratic challenge to get through with recognition of other testing. This is of a piece with the general problem of a new drugs etc system that is unresponsive to the pacing of a pandemic. . KF

  6. 6
    Ed George says:

    KF, what the data shows is, that with a few exceptions, the countries with the most testing per capita are doing better than those with lower levels. But testing without effective follow-up is of little value.

    Testing should me mandatory for all front line workers, including those in the food chain. There is no point in keeping grocery stores open if the meat packers are closed due to the virus.

    It is the testing that gives you the information necessary to make correct decisions. The more the better. And compared to many of the other COVID tool kit, testing is very cheap.

  7. 7
    kairosfocus says:

    EG, The fact remains — scroll up and look at the OP charts courtesy OWID — that the USA plots to the same band as other developed countries. The difference in plateau level is likely that it has more population to grow into, especially in the zone with NYC. While testing for virus presence and for antibodies is important, we must remember that we are simply tracking proxies, noisy ones. Where also, the mathematics of exponential growth shows definitively that growth is on absolute mass, not proportions. Testing is an absolute process and so is contact tracing. Discounting for the FDA fumble, the USA is doing a responsible job with testing. Where, we must realise a basic fact: five minutes after a test, one can get infected, that is it is preventive measures and effective treatments that will make a difference, especially for frontline workers. On that front, I find it interesting that the same folks talking testing like a mantra are falling into gold standard fallacies in the teeth of evidence of an effective, low cost, readily deployable treatment that may actually be already making a difference under the radar. Vaccines are likely 1 – 2 years out and the standard bureaucratic process for drugs is too costly, cumbersome and time consuming to be relevant to pandemics. We need to go back to understanding what empirical evidence is, how warrant can be built up, why no inductive case can achieve incorrigible certainty and more. KF

  8. 8
    daveS says:

    KF,

    [Warning: I’m from the USA, so I have no idea what’s going on beyond our shores. 😛 Therefore I’m only addressing your post as it relates to my country .]

    We need to go back to understanding what empirical evidence is, how warrant can be built up, why no inductive case can achieve incorrigible certainty and more.

    While I’m sure there are a lot of lessons to be learned here, do you think Anthony Fauci or Robert Redfield don’t understand what empirical evidence is? I really doubt these people are quite that ignorant.

    They’re trying to manage a very complex problem to get the best outcome they can. Moreover, they have to consider the reputations of the institutions they lead and that every step they are taking now will be analyzed in the years to come. I don’t think they need a Phil 101 refresher course at this point.

  9. 9
    ET says:

    Ed George:

    There is no point in keeping grocery stores open if the meat packers are closed due to the virus.

    That’s plain stupid. Grocery stores sell much more than meat.

    And seeing that OTC supplements can beat this virus, too, testing isn’t really necessary.

  10. 10
    asauber says:

    “they have to consider the reputations of the institutions they lead”

    daveS,

    Doesn’t sound very scientific to me. Reputations? Why wouldn’t science be the primary concern?

    Andrew

  11. 11
    asauber says:

    “They’re trying to manage a very complex problem”

    daveS,

    Don’t they earn large salaries just for occasions like this? Sounds like whining.

    Andrew

  12. 12
    daveS says:

    The science police have arrived 🙂

  13. 13
    asauber says:

    “The science police have arrived”

    daveS,

    And you get a ticket for for failure to maintain a scientific posture. 😉

    Andrew

  14. 14
    kairosfocus says:

    DS, the evidence I am seeing is that collectively, there has been an ensconcing of gold standard fallacies, undermining valuable evidence that could make a difference in good time. I already discussed a Guardian piece on this, here: https://uncommondescent.com/ethics/guardian-exemplifies-the-placebo-control-gold-standard-fallacy/ KF

    PS: A little probability illustration. Say the odds that X happens by chance rather than by a candidate causally driven effect E are x, where obviously, each observation is independent. Now, string together n observations of X. The likelihood that it is a chance fluctuation all n times is x^n, so as n rises, it falls exponentially. Now set x = 0.38 and set n = 100. 0.38^100 = 9.5*10^-43.

  15. 15
    daveS says:

    KF,

    Do you have evidence showing that the changes you propose will result in a better overall outcome? From my perspective, that’s what’s most important.

    Edit: I think I understand your example (but am not positive). I am familiar with the binomial probability formula, however.

    Exactly what does your example illustrate?

  16. 16
    kairosfocus says:

    DS,

    first, let me go back a step: the SWOT-BAU-vs.-ALT sustainability oriented strategic change, decision-making framework is perhaps superficially simple. It has to LOOK fairly simple, if it is to work with ordinary stakeholders in consultations.

    It is in fact a subtle participative, scenario planning approach using world- models- rooted- in- bio-physical, socio-cultural, econ-governance & policy contexts to resolve problematiques that also embrace capacity-building challenges. It is not really original to me, I have adapted what Argentina’s Bariloche Foundation put on the table 20+ years ago.

    That is, it is specifically designed to deal with challenges of mind bogglingly complex environmentally sensitive decision-making in the context of deep rooted highly polarised conflicts.

    Indeed, the diagram you may have seen is literally designed to be used with wall sized charts and stakeholder based community consultations, to create self-documenting deliberations. (Are you familiar with the ZOPP trick of using bristol board strips integrated into a larger framework . . . a sort of scaled up post it notes trick?)

    The resolution to such challenges is that participative empowerment and contemplation of scenarios and world models informed by environment threat and opportunity profiles embracing the multidimensional span of the environment . . . think, PESTL + BP . . . are transformative towards creating critical mass and mainstreaming robust, novel, well supported solutions.

    So, yes, I am all too familiar with management of high complexity and trade-offs.

    The application of this framework to deciding on robust pandemic treatment and response strategies is just that, application to an emergent bio-threat informed by the obvious want of sustainability and responsiveness of the cumbersome, $1 bn a shot decade long development exercises that have become all too typical.

    That is in part why the focus is that we have to shorten the OODA decisional loop drastically in the face of doing medicine on the micro-bio battlespace in WW V, the fifth World War, with a virus [or more realistically, an escalating chain of same since HIV and SARS etc now SARS2]. The pivot to that is we need to revert to prudence based epistemology, instead of hyperskepticism, scientism and blind unbalanced technocracy.

    In that context the point is, placebo effects are said to work 38% of the time, why that number as an allusion. The odds of a long, consistent chain in the hundreds being little more than belief-kills, belief-cures action are so vanishingly small as to be ludicrous.

    Let me clip the rather charming Ms Lin as Jerry just pointed us to:

    Hydroxychloroquine used by Korea for Covid-19 while US is divided
    Apr 27, 2020, 9:52 PM

    South Korea recommended the anti-malarial drug HCQ to treat Covid-19 while political interference in the US over the drug has alarmed medical experts

    [ . . . ]

    Medical treatments have traditionally been a private decision between patients and doctors, but now it seems politicians are usurping their right to choose. According to Dr Jeffrey Singer, a general surgeon and Cato Institute fellow, this threatens the integrity of the medical profession and indirectly imperils patients, by denying them emergency options when no other alternatives are available.

    Moreover, the politicization of treatment options would not help Americans, given the fact countries such as Belgium, France and South Korea have used HCQ to treat Covid-19 with a good degree of success.

    South Korea was one of the first countries to be hit by the virus after China, reporting its first case on January 20 and peaking by late February, before suddenly tapering off in early March and “flattening the curve.” It also has a comparatively low mortality rate through a combination of testing, tracing, containment and HCQ . . . .

    Hydroxychloroquine (HCQ), a well-known anti-malarial drug that has been around for decades, is now a political football between the Trump administration and Democrats during an election year in the United States.

    US President Donald Trump has repeatedly touted the drug and received significant pushback from the media and the Democratic Party, with the governors of Nevada, Michigan and New York even going so far as to issue executive orders restricting how doctors can use HCQ to treat patients suffering from Covid-19.

    Medical treatments have traditionally been a private decision between patients and doctors, but now it seems politicians are usurping their right to choose. According to Dr Jeffrey Singer, a general surgeon and Cato Institute fellow, this threatens the integrity of the medical profession and indirectly imperils patients, by denying them emergency options when no other alternatives are available.

    Moreover, the politicization of treatment options would not help Americans, given the fact countries such as Belgium, France and South Korea have used HCQ to treat Covid-19 with a good degree of success.

    South Korea was one of the first countries to be hit by the virus after China, reporting its first case on January 20 and peaking by late February, before suddenly tapering off in early March and “flattening the curve.” It also has a comparatively low mortality rate through a combination of testing, tracing, containment and HCQ.

    Last month, the Korea Centers for Disease Control and Prevention, the Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, Korean Society of Pediatric Infectious Diseases and a tuberculosis association recommended the use of Kaletra, an anti-HIV medication, in combination with HCQ, to treat Covid-19.

    This was bolstered by a French study that showed HCQ had an antiviral effect against Covid-19 in confirmed cases. Used in conjunction with the azithromycin Z-Pak, most patients cleared the virus in three to six days rather than the 20 days observed in China, drastically narrowing the period during which a patient can spread the virus to others.

    As such, Dr Jeff Colyer, chairman of the US National Advisory Commission on Rural Health, and Dr Daniel Hinthorn, director of the Division of Infectious Disease at the University of Kansas Medical Center, in a Wall Street Journal article recommended that the US could adopt this approach and use the treatment cocktail early rather than wait until a patient is on a ventilator in an intensive care unit.

    To be clear, these scientists and doctors now recommend HCQ as a treatment, not a preventive measure, for Covid-19. They argue that a positive effect of using HCQ early is the reduction of virus transmission to other people given the shorter number of days the patients remain contagious, thereby flattening the curve sooner.

    There’s considerable food for thought in that clip, including on the obvious not invented here factor that is driving a lot of the dismissiveness and hyperskepticism.

    KF

  17. 17
    kairosfocus says:

    F/N: I added the chart for the framework above in the OP

  18. 18
  19. 19
    daveS says:

    KF,

    rather charming Ms Lin

    😬

    I’m sure she’ll be glad to know this.

    More seriously, I’m curious whether you have presented these ideas to your own health authority?

    I guess it’s a change in process, but I don’t know whether it will result in better outcomes (I’m not equipped to make such a determination, in any case).

  20. 20
    kairosfocus says:

    DS, I am a policy person. Things I find relevant (starting with a Taiwanese doctor who had a design for a cloth mask that can take a filter insert) I have shared and will share, and that is across a regional network. The decision making framework was literally shared globally 20 years ago under UN auspices. I have found it consistently useful ever since. I am using it to see that we can rationalise baseline vs plausible alternative decision making and use it to frame evaluation of case data. Note, I also find a common problem in novel situations: dirty and partly contradictory data (hence, noisy proxies), bits and pieces of the puzzle from all over, requiring synthesis, conflict requiring going back to first principles of empirical, inductive reasoning, need to build critical mass, need to take in a wide bandwidth across the span of the environment, need for capacity building, need to find points of hope, light and steadiness. Remember, I have seen low grade civil war and chaotic disruption through volcano crisis [our friend has been quiet]. The problem is, just about everyone has his own views (often, media driven or peer/reference group driven) and on health matters there is now a movement in the name of natural remedies and health that at some levels will dismiss anything coming out of conventional medicine. Oh yes, the South Koreans are the clear case of beating this wave of SARS2, so we should take their conclusions seriously, just look for the SK trend lines in the charts. KF

  21. 21
    jerry says:

    For those of those who live in the US and are interested, it is possible to get a consultation with a doctor in each of the 50 states you live in. It is then possible to get a prescription from that interview and an online pharmacy that will deliver the prescription to you over night. They handle C19 issues.

    Obviously this is limited to those things. that could be discussed on line. If there is a requirement for lab work or other medical hands on tests, I do not know how. that works.

    But it is not for those who consider themselves liberal because it is partially sponsored by Jerome Corsi, noted conservative conspiracy theorist. (obviously sarcasm but I am sure no politics are ever discussed.). The link to the site is https://speakwithanmd.com/

  22. 22
    jerry says:

    For those interested in statistics, here is a report from the Association of American Physicians and Surgeons (AAPS) titled

    The probabilities of clinical success using
    hydroxychloroquine with or without azithromycin +/-
    zinc against the novel betacoronavirus, SARS-CoV-2

    It is dated Sunday. https://bit.ly/3bON2Pl

    It is a list of various studies done and most of the deaths are from the VA survey covered here last week.

  23. 23
    daveS says:

    KF,

    I should add that none of the skeptics are saying that what happened in those studies is akin to observing a weighted coin (38% chance heads) come up heads 100 times in 100 trials. They are saying that the assumptions in the coin-flip model plausibly do not hold in the studies, of course.

  24. 24
    kairosfocus says:

    DS, no and that is not what I said either. Assume for the moment, the cocktail is useless. We deal with placebos that unpredictably work; classically, 38% of the time. The chances of a 100 string of successes under that as a simple case would be as indicated. The point is that placebo effects work sometimes but not always. But that is just to give a simple illustration of the real point, which is that extreme fluctuations in large enough systems are exceedingly rare. So, if we see a high proportion of cases treated with the cocktails showing a consistent rapid progress in clearing the virus as say Ms Lin described, the best explanation for that is not extreme fluctuation but a successful designed causal intervention. In short, the treatment works highly reliably under reasonable conditions. And yes, this is an application of the design inference. KF

  25. 25
    daveS says:

    KF,

    I have been trying to read some of the posts from stats people here and elsewhere, and I gather that a key issue is whether or not an “extreme fluctuation” actually occurred. For example, lack of a control group, possible bias in selection of treatment and control groups, etc.

  26. 26
    daveS says:

    PS: Not that this is news to you; obviously you have participated in those discussions.

  27. 27
    kairosfocus says:

    DS, the point of the decision framework is that there is no need to construct an artificial [and ethically challenged . . . ] baseline as a natural one exists in the de facto standard treatment. It is in that context that we see a sharp reduction in time to clear virus load and in expected death rate; the latter, by some 90+ percent. On a baseline of cumulatively thousands of cases. Ms Lin’s summary in 16 above speaks to that. Likewise, Italy has similar results. I gather that Dr Zelenko is in process of formal publication. That sort of result for so many cases is not plausibly explained on a particularly effective placebo result; that is, the matter of fluctuations is material. As for objections, far too many of them pivot on imposing a fallacious gold standard that locks out the sort of timely evidence we can expect and some have gone to the point of the hyperskeptical no evidence. With the sort of consequences in view and the dismal choice we confront, we have to do better. Hence, my point that we have to go back to the basics of empirically grounded reasoning. KF

  28. 28
    JVL says:

    As of this morning: April 29th:

    The USA has 1,035,765 registered cases of COVID-19, more than the next six countries (Spain, Italy, France, Uk, Germany and Turkey) combined. and about one-third of the planet total. Of those USA cases 854,261 are still considered active.

    The USA had about 60,000 registered COVID-19 deaths, about the same as the next two countries (Italy and Spain) combined, and over a quarter of the world total. I heard it pointed out that that’s more than the total number of US deaths during the Vietnam War. It’s also more than the US deaths attributed to influenza in 2017 (55,672) according to the CDC (https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm). All within three months, the first active US case being declared at the end of January.

    The USA has/had over 3000 cases/1 million pop, less that Italy and Spain but ahead of France, UK, Germany and Turkey and well ahead of the world average of just over 400 cases/1 million pop.

    The USA now has about 179 deaths/1 million pop, less than Italy (453), Spain (510), UK (319) and France (362). IF the USA catches up with the UK on this measure that would mean over 100,000 COVID-19 deaths in the US.

    Obviously the world totals and averages will change as there will be some really hard hit countries that have probably only begun their ‘journey’. When you look at the Daily New Cases and Daily Deaths for the USA it looks like things are slowing down but there’s still a long ways to go. Considering the number of active cases and the stats from other developed countries I expect the USA total to increase a lot yet. Relaxing the lockdown restrictions will expose some people who got missed so far. And many epidemiologists are saying a second wave is quite likely.

    Meanwhile New Zealand has claimed to have become new infections free. It looks like Australia is pretty much there as well.

  29. 29
    kairosfocus says:

    JVL, all global numbers are affected by the dubious nature of numbers out of China, something that led to recent action by the UK. I just looked at OWID, and see for China’s daily deaths an utterly improbable mesa structure; and yes, that is a design inference. The US is having a flattened peak that may be beginning to trend downwards. Several countries have had that, and that leads to linear cumulative growth in totals, as can be seen in the global trend. I suspect the flattening is in part an artifact of growing testing, digging down into the bulk of the iceberg where mild and asymptomatic cases lurk. It also suggests a steady decline in number of onward cases per present case, which should eventually lead to stronger saturation and absolute falloff in the wave. The US, in a few days slipped from cases doubled in 12 days to now in 18 days, with UK just behind at 17 days; earlier they were at 2 – 3 days. Singapore has slipped to doubling in 8. Onward waves are historically likely. I am not a fan of ratios to population as the exponential growth phase points to a rate dependent on the actual mass of cases. KF

  30. 30
    jerry says:

    this measure that would mean over 100,000 COVID-19 deaths in the US.

    Most of the deaths would be unnecessary if were not for politics. The real crisis in our society is not the virus but cynicism. And callousness.

    Too many in the world are like Harry Lyme from the Third Man. It’s too their personal advantage often just psychological that others die. They are just little dots, in our case statistics on a website, insignificant to them. For others these dots are not necessarily advantageous but still just insignificant as the virus hasn’t hit them personally.

    The number of virus cases is not the issue. But the deaths are unnecessary. In theory we all have to get it. That means 300+ million.

  31. 31
    kairosfocus says:

    Jerry, the strong, politically tinged resistance to an increasingly credible treatment speaks for itself. I note from Ms Lin, “South Korea was one of the first countries to be hit by the virus after China, reporting its first case on January 20 and peaking by late February, before suddenly tapering off in early March and “flattening the curve.” It also has a comparatively low mortality rate through a combination of testing, tracing, containment and HCQ.” KF

  32. 32
    jerry says:

    Another encouraging treatment? This time plasma. Bring it on!!!

    https://bit.ly/2KG3yFx

  33. 33
    kairosfocus says:

    Jerry, it’s an old remedy and it works. It makes sense on what we know about the immune system. Jump-starting immune response by using survivor plasma plausibly provides an early stock of antibodies, reducing stress and buying time for one’s own immune system to kick in. IIRC colostrum, first mother’s milk also does something similar as does antivenin. I am wondering, does this need type O donors, or even type O-negative [or else type-matched]? Again, ponder the notion of double-blind placebo testing to create an artificial baseline, vs comparison with the business as usual treatment pattern and results. Notice they report, on a run of 2600 cases, “We’re quite encouraged by the results that we’ve seen. … Nationally, what we’re hearing is that it does appear to be a very safe treatment.” So, what is the observed difference in outcomes . . . the dog that didn’t bark. A clue in itself. KF

  34. 34
    daveS says:

    KF,

    the point of the decision framework is that there is no need to construct an artificial [and ethically challenged . . . ] baseline as a natural one exists in the de facto standard treatment.

    Err, it might be more accurate to refer to “natural baselines” here, which highlights one issue.

    As I’ve said before once or twice, I’m not sure if there is a big disagreement here about what is happening on the ground (at least in the US; I don’t know how this is playing out elsewhere). These drugs are being given to patients already. They have been “approved” in some fashion by our FDA. Jerry points out that the inimitable Jerome Corsi is helping to get the drugs to patients who want them. Sounds good to me.

    On the other hand, I think Dr Fauci responded appropriately. Perhaps this is where we get into values. I expect health authorities to err on the side of caution in a case like this. In particular, don’t say something that has a good chance of being overturned in 6 months when the results of more carefully designed experiments come in.

  35. 35
    kairosfocus says:

    DS, there is a baseline that naturally emerged, Flu with complications extended to CV19. Imposing misleadingly labelled sugar pills or the like is an artificial baseline and with what is going on, raises ethical questions. Yes, doctors are prescribing and FDA issued two preliminary tiers. However there is a raft of serious issues at stake. Caution is appropriate but not selective hyperskepticism, given the elephant in the middle of the room. Thousands of cases. The problem with placebo controls here is first, ethical in the face of do no harm. Second, the gold standard fallacy causes improper dismissal of timely and otherwise legitimate evidence, in favour of a counsel of perfection that likely would take a year or more to meet bureaucratic requirements. We need capability to respond without undue controversy in real time to a pandemic. The polarisation is manifestly dangerous. KF

  36. 36
    jerry says:

    I expect health authorities to err on the side of caution in a case like this.

    They’re terrified of lawyers suing them. If they do not have an accepted protocol to go by and something happens, the lawyers will be taking tickets to sue if there is a bad result.

    This is driving a lot of the reaction to HCQ not reluctance to use the drug which is essentially harmless. For those who disagree that it is essentially harmless, it is recommended by the CDC as a prophylactic and appropriate for pregnant women and children. The one negative is if you have psoriasis.

    But without an accepted protocol for this particular use, if anything goes wrong, the doctor will be subject to a malpractice suit. So they are personally better off letting patients die. And they are encouraged by the press not to use this drug which is providing cover for their real malpractice, not prescribing the drug.

  37. 37
    daveS says:

    KF,

    Caution is appropriate but not selective hyperskepticism, given the elephant in the middle of the room. Thousands of cases.

    Not necessarily selective hyperskepticism, but a difference in values. We all have our own risk profiles. I gather that yours is quite different from mine, perhaps due in part to differences in background. In this particular instance, I am perhaps more averse to the risk of a type I error than you are. This is not something that can be settled by reviewing the rules of right reason, etc., incidentally.

  38. 38
    Bob O'H says:

    Jerry –

    This is driving a lot of the reaction to HCQ not reluctance to use the drug which is essentially harmless. For those who disagree that it is essentially harmless, it is recommended by the CDC as a prophylactic and appropriate for pregnant women and children. The one negative is if you have psoriasis.

    Or if you have a heart.

  39. 39
    Ed George says:

    There is only one thing for certain with regard to the use of HCQ as a treatment. The media and the politicians should just keep their nose out of it, other than high level briefings on treatments being examined, and let the doctors, epidemiologists and statisticians do the jobs that they are highly trained for.

    As the old saying goes, ‘There are three types of people in the world. those who understand math and those who don’t.’

  40. 40
    jerry says:

    Or if you have a heart.

    The CDC doesn’t mention it. Nor have any of the high users of the drug seen problems with the heart. Certainly those who have heart problems should be monitored closely and the risks should be weighed.

    It is always interesting to see what you picked out to comment on.

  41. 41
    kairosfocus says:

    Jerry, ambulance-chasing predatory lawyers thereby show themselves to be part of the problem not the solution. If doctors are intimidated into negligence, that to is a sobering sign. KF

  42. 42
    kairosfocus says:

    DS, my policy analysis is driven by the implications of a pandemic vs those of locking down into recession, depression and famine, with war a likely onward horseman. We face a dismal choice where some lives will inevitably be lost once a pandemic is on the gallop. Further, we have a fast-acting, fast spreading deadly disease in a context where the “gold standard” trials process would deliberately expose some to ineffective treatments to create an artificial baseline and would take so long that likely Wave 1 and Wave 2 would go through before we have something duly approved. Further the linked fallacy fails to understand cumulative evidence and the obvious natural baseline, allowing a comparison on cases. Where, the assumption of ineffective alternatives already gives ridiculously implausible odds that a placebo like effect or raw chance could give a string of even 100 successes. In short, there is an epistemological problem, and a suppression of the fact that across time any number of effective treatments, solutions, technologies etc have been successfully validated on chains of cases. Indeed, replicability is a part of science in general. We are seeing deep problems that we need to face and fix. KF

  43. 43
    daveS says:

    KF,

    DS, my policy analysis is driven by the implications of a pandemic vs those of locking down into recession, depression and famine, with war a likely onward horseman.

    In addition to your values and risk profile, of course.

  44. 44
    jerry says:

    For those who are interested in how the virus works and new treatments.

    Is there another arrow in the anti virus quiver? The antacid Pepcid. See Medcram episode 62 the latest video for a study now being done with HCQ and famotidine which is the main ingredient in Pepcid. Apparently patients in China who took famotidine had a lower death rate. There is apparently a molecular fit between famotidine and virus which disrupts the virus somehow.

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

    Part of this video at the end is about what some think is the main way the virus acts. On blood ACE receptors in lining of blood vessels that lead to constriction of the blood vessels and coagulation. This puts the body under oxidative stress. This will be covered in more detail in subsequent MedCram lectures. (caveat – not sure of all the details)

  45. 45
    kairosfocus says:

    DS, the relevant value is that if we face loss of life as an inevitable outcome, such losses should be minimised on the full balance of alternatives. The loss of life from epidemic is ongoing. That due to economic dislocation is already on the table. So, we needed to get an idea of what we are up against, justifying measures that could trigger dislocation, given that unchecked Spanish Flu cost lives in the World War range. The Great Depression materially contributed to loss of life directly and through opening the way to a second world war. I rather doubt that there is much disagreement on the relevant values and lessons of history bought with blood and tears. KF

  46. 46
    daveS says:

    KF,

    This includes having our authorities behave in such a way as to preserve the public health in the long term. In order to do this, these authorities must maintain credibility among the citizenry.

  47. 47
    jerry says:

    For those of you interested, Jerome Corsi had two doctors who are pushing the Zelenko approach on his show today. They are Doctors Karladine Graves and Dr. JamesTodaro.. Skip to 1:30 seconds in order to avoid pr at beginning.

    Dr. Todaro has a plan for reopening the country using Zelenko’s protocol. I haven’t watched it but just found it.

  48. 48
    Bob O'H says:

    Jerry @ 40 – the CDC might not know much, because it’s a drug, so they leave that to the Food and Drug Administration. And the FDA are basically saying don’t take it for COVID-19 “outside of the hospital setting or a clinical trial due to risk of heart rhythm problems”.

  49. 49
    kairosfocus says:

    Jerry from about 19 minutes in and from 10. At 12, recent Italy study of 65k lupus patients on long term HCQ, only 20 came down with CV19, using incidence for Italy we would expect 200 not 20. Much more.

  50. 50
    kairosfocus says:

    BO’H, note, the remark in an Italian article previously highlighted, via GT:

    Hydroxychloroquine is one of the treatments against Coronavirus being tested, and is approved by AIFA (Italian Medicines Agency). The pioneer in this field is the Director of Hematology-Oncology of Piacenza, Luigi Cavanna. It was the first in Italy to use it, an intuition that is proving significant. “Since February 25, I have treated 209 patients and in 90% of cases the response has been positive. Hospitalizations have collapsed: from 30% of hospitalized (serious or moderate cases) to less than 5% “. The change, according to Cavanna, came with the administration of hydroxychloroquine from the earliest stages of the disease, when patients were at home, and resulted in the hospitalization of very few cases in acute conditions. A treatment that, according to preliminary data collected and systematized by 5 different ASLs on 1,039 patients, is working throughout Italy.

    Yet more “no evidence”

    KF

    PS With Remdesivir they are happy to report reduction from 15 to 11 days.

  51. 51
    jerry says:

    the CDC might not know much, because it’s a drug, so they leave that to the Food and Drug Administration

    So are you saying that those responsible for disease control do not know much about drugs? Do you know how specious a comment that it?

    Given that the CDC did make some major mistakes in its control of the virus. It is what happens when too much depends on bureaucrats.

  52. 52
    Bob O'H says:

    Jerry – no, I’m not. But I am suggesting that those responsible for drug administration might be the people to go to. I suspect the CDC would say that too.

  53. 53
    jerry says:

    The price of Zelenko’s cure which has a 90% reduction in deaths.

    Zinc sulfate- 7 cents a dose per day of 200 mg

    HCQ – 40 cents a dose per day of 400 mg – two 200 mg tablets

    Azithromycin – $1.33 a dose per day of 500 mg

    Cost per day $1.80 or $9 for 5 days. The recommended treatment period. These are posted pharmacy prices which mean they are actually much cheaper in mass purchase.

    For this combination of essentially harmless drugs, two of which are common prophylactics, we have sentenced tens of thousands to die. And we watch in real time here and elsewhere inane objections to their use which is essentially recommending no treatment and then watching hundreds of thousands die.

    The objections really are inane. Often criticisms of grammar or word usage to justify opinions.

  54. 54
    daveS says:

    KF,

    Have you seen the Oxford vaccine that some are saying could be widely available by September?

  55. 55
    kairosfocus says:

    DS, I will believe it when I see it, and I wonder about the trials process issues. Wonderful if we get a working vaccine accepted by relevant bodies, but I am not holding my breath. KF

  56. 56
    daveS says:

    I feel the same way, I guess. It seems almost too good to be true.

Leave a Reply