The Unique US Failure to Control the Virus

There is no "Obamacare Tax" on masks! This propaganda is Neverending!

And the only "game" Trump has figured out is to have the drugmakers to increase their already-massive gifts to Trump and Republicans to elect them again as the Republicans and Trump allow drugmakers to increase costs to Americans 20% to 500% while those same drugmakers to sell everyone else in the world even lower prices!

 

But there are many items that are federal. Closing borders, travel bans. Mandatory quarantine of international arrivals. The CDC rolling out tests. The FDA approving stuff. The US strategic supply of PPE. The Office for Pandemic Preparedness or whatever it was called. I could go on. Partnerships and investments and grants to secure medications and vaccine development. HHS, the NIH. I could go on. Actually there is more to do at the federal level than at the state level. States were supposed to handle local lockdown orders, true. But they shouldn't have needed to fend for themselves for PPE, for example. Don't we have an agency especially for that? FEMA?

Commuting today from work I was listening to satellite political radio talk shows, and someone made an interesting point (well, a bit of a forced analogy but still, interesting): "when we were at war against Germany and Japan, the states didn't have to fight the enemy on their own; now we're facing an enemy although it is tiny and invisible to the naked eye, but states are supposed to fend for themselves."

 

In animal studies, not in human ones because that's not the point of phase 1 and 2 which have more to do with safety: you want to test 45 people then 600 people, in order to know if you can afford to give it to 30,000 people, in terms of bad reactions. Safety continues to be the point of phase 3 but efficacy is added to phase 3; that's why phase 3 is supposed to happen in hot spots where the population is exposed to the virus (thus why Brazil and South Africa have been scenarios for phase 3 for several vaccine candidates). So, we'll know, soon.
But there's been data on Rhesus macaques receiving the vaccine and then virus being blown at them, showing protection (not getting sick, or getting only mild illness).

 

I know that what I'll say will not earn me any popularity points (since there are many who love non-human animals more than humans and they tend to assume that whoever doesn't share their views on this is simply not a good person - I couldn't disagree more). Don't read me wrong, I love animals, I am 100% incapable of mistreating an animal, I get really angry at the jerks who mistreat animals, although I'm guilty of not being a vegetarian or a vegan. But I'm in the business of saving HUMAN lives and I do place the human species on that pedestal as the crown jewel of creation, and I'll tell you why. Once you show me a non-human animal capable of composing Beethoven's 9th Symphony and a group of non-human animals capable of landing a spacecraft on the Moon, then I may revise my opinion that humans and only humans are the crown jewel of creation.

 

Look, folks, any RATIONAL country would have acted like this:

SCENARIO:

We're at some point still early in the pandemic. Alarming signs come from China and the thing starts spreading to other countries and sticks its ugly (tiny) head into America.

All network TVs are summoned to the White House, to broadcast an address to all Americans. Speaking: President Donald Trump. Vice-President Mike Pence. Senate Majority Leader Mitch McConnell. Senate Minority Leader Chuck Schumer. Speaker of the House Nancy Pelosi. House Minority Leader Kevin McCarthy. At the time, the two front runners for the Democratic presidential nomination, Joe Biden and Bernie Sanders. The Democratic governor of California. The Republican governor of Texas. So, the highest ranked Republicans and Democrats, five from each party.

President Trump starts by saying: "My fellow Americans, I have here with me this country's leaders in terms of elected office; we are the people who were honored to receive your votes in order to exercise leadership on your behalf. Given that this is an electoral year, and in 2021 either I will remain the president, or one of these two gentlemen will succeed me, Vice-President Biden or Senator Sanders, I have invited them too, because what we have to tell you should not be partisan and should not be tainted by electoral year politics. To represent the governors (and I want all other 48 engaged too) I also invited the Democratic and Republican governors of our two most popular states. What I have to tell you is that we are about to face some very challenging times given that our shores are being invaded by an enemy. In times of war, we Americans have always relinquished our domestic political differences in order to face the enemy, united. Well, we got an enemy coming, and it's called the novel coronavirus. It is tiny and invisible but make no mistake, it is a powerful enemy. So, I and these four other fine Republican leaders, together with these five fine Democratic leaders, come before you to ask you to help us defeat this enemy, all together, all united, all Americans, because the enemy couldn't care less if we are Republicans or Democrats, progressives or conservatives, members of a racial majority or a racial minority, members of various religions or non-believers, residents of a large or a small state... this virus will infect, kill, and maim us as an equal opportunity offender, and we have to act together to conquer it. May our united response to this be exercised together, so that any failures or successes will be, God forbid the failures, or hopefully the successes, of all of us, and won't become a sore political point. If we let our political differences interfere with our response, we won't do it well. So now I'll pass the microphone to these fine American politicians, and together we'll ask you to engage in some sacrifices, so that just like in war time, we beat this enemy."

Then each one of them encourages the population to listen and to cooperate with what needs to be done. Together they propose:

-"We'll close our borders to all arrivals of non-Americans and non-lawful permanent residents of the United States and their immediate families, from anywhere in the world.
- Those Americans, lawful permanent residents, and their immediate family members allowed to come back home from abroad, will be quarantined for 14 days under strict supervision
- We will engage in an unprecedented effort to domestically produce test kits to be able to track and trace the contagion, invoking the Defense Production Act.
- We will engage in an unprecedented effort to domestically produce hundreds of millions of pieces of PPE including high quality masks, face shields, and hand sanitizers, invoking the Defense Production Act. While these are not ready and delivered we'll teach people how to make homemade cloth masks that are not ideal but are better than nothing.
- Every. Single. American above the age of 2 will be asked to wear masks anytime they are not inside their own household and only interacting with household members. We won't need any mandatory orders because we trust that you will all listen to the ten of us and will do what is necessary. We are, all ten of us, asking a personal favor of each of you regardless of your political ideology: please wear masks. They may be inconvenient and they are only partially effective but they do decrease the odds of transmitting and catching the disease to various degrees, and we'll do a TV campaign to teach people how to use them correctly.
- All Americans will be asked to do their best to stay 6 feet away from others whenever possible (and don't let the masks make you too confident; you need the masks AND the distance).
- All Americans will be asked to avoid crowds in bars, restaurants, sports arenas and stadiums, concerts, etc. We will strongly encourage these businesses to go ahead and close down temporarily, and we'll give them grants to keep them afloat while they are closed.

We are confident that if we do well all of the above with high adherence to this advice and to these favors we are all asking of you, we can keep the contagion to a minimum and can continue to operate our economy in most sectors. But if God forbid things still spiral out of control because this virus is very infectious and in most places it has defeated attempts to keep it at bay, then we'll have to engage in bigger sacrifices and bigger measures to stop it: we may have to shut down the whole economy for a while (minus essential parts of it like the food chain, pharmacies, healthcare, and law enforcement) until the contagion dies down again to manageable numbers that can be again be dealt with with testing, contact tracing, and these measures of mask use, hand hygiene, and social distancing. If we do have to shut down it will be terrible as it will cause economic hardship and recession. But these legislators here will vote, and the president will sign, bills to provide relief, especially, strong payroll protection so that businesses will not lay off their employees. Businesses will be given loans to continue to pay salaries, but they will NOT need to pay back the loans if they don't lay off anybody, so that the loans will become grants as long as businesses keep their employees on payroll. With this robustly in place, we will be able to shelter at home without major economic losses for individual Americans and for business owners. But let us all try to avoid having to go that route because even with the best protections, it will still be painful and economically damaging. So let's avoid that by doing well what we are asking you to do: masks, hand hygiene, social distancing, avoiding crowds. Those are cheap and won't hurt the economy as much, and they work as long as everybody does it.

We are putting together a task force made of the top Infectious Diseases experts in the administration - Dr. Fauci, Dr. Birx - plus the head of the CDC, the HHS Secretary, the head of the FDA, and the head of the NIH. These six officials will be assisted by an ad hoc consulting committee made of 30 people: the chairmen of the Infectious Diseases, Virology, and Epidemiology departments of each of America's top ten medical schools - Harvard, Johns Hopkins, UPenn, NYU, Stanford, Columbia, Mayo Clinic, UCLA, UCSF, and Washington U in St. Louis. These officials and these world class specialists of the highest possible level will call most of the shots in what needs to be done; we politicians will listen to them and execute. They will tell us what research steps need to be accomplished, what treatment protocols need to be diffused to all American hospitals, what medications should be pursued, and how to get us effective and safe vaccines. We politicians will give them all the conditions they need to do what they know how to do, and we won't second-guess their learned conclusions. All 8 of us here will ask the American people to heed these experts' advice. We have the best medical schools in the world; let's make good use of them. Viruses are a matter for science; we'll allow science to take the lead. Parallel to that, we will put together another committee of top businessmen who will assist us in manufacturing and distributing everything we need to face the outbreak: PPE, ventilators, test kits, etc., and get private-public partnerships for development and production of medications and vaccines.

Now let's go and beat this virus. God bless the United States of America."

-------------

Had we done all of the above, we'd be today where Germany is. They have a fourth of our population. They had about 9,000 deaths total, 2 today. So, multiply this by roughly 4 and they would have had about 36,000 deaths total; about 8 today, if their population were about the size of ours. Instead, we have 164,000 deaths, and about 1,300 today. Our unemployment is about 12% (it will get worse as the recovery that mitigated it a little has already stagnated and is now reversing). Theirs is 6%. Our economy is sinking (annualized GDP contraction, an unprecedented 32.9%). Theirs is rebounding nicely.

What is the main difference among these two countries? Rational political leadership over there, doing what is right for the country, not for the parties. Over here? Well...NOT!!!

How did we fail to do the above? I'm blaming all of us. Our two main parties. Our elected officials at Federal, State, and City levels, both parties. We, the people, with our stupid divisiveness, our conspiracy theories, our distrust of science, our selfishness.

We all failed.

We've been always proud of what we call the American Exceptionalism. Well in this, the only thing we were exceptional at, was that we were exceptionally dumb.

 

These issues seem to be more prevalent in America, though. Plenty of other nations didn't have such widespread resistance.

 

Sure, in the good times. In an emergency all bets are off.

 

Yes, I specifically mentioned controlling the borders as the first order of business. I mean really controlling the border. It’s a legitimate role of the federal government.

Can you make a case for the CDC handling testing development and rollout better than states if the CDC/FDA wasn’t interfering in state’s ability to do so? Can you be sure the University Medical center in my state couldn’t have done a faster development and rollout of testing than the CDC’s failure if from the beginning we knew it was our responsibility to do so at the state level?

How about the failure of federal PPE supplies? Would states have been better or worse off if they had not depended on federal stashes that turned out to be inadequate anyway?

Wasn’t there at least one company that had a pcr test ready to go but because of slow invocation of Emergency Use Authorization by the Administration/FDA it was delayed a significant amount of time?

I’m not opposed to federal agencies playing a role, but in this case I don’t think their track record is glowing advertisement to rely on them instead of state resources.

Federalism and the resulting efficiencies and innovation from competition would be better than centralized bureaucracy in my opinion. I think the evidence above supports my position. I think the founders supported my position. Many would be appalled at the size and control exerted by federal agencies.

If the war had been fought here instead of overseas it may be a more interesting analogy. I’ll bet radio analogy guy didn’t bring up things like local draft boards etc. implemented to optimize efficiency at local and state levels during the war either.

I believe the federal government has a role and states have a role. Otherwise having states is a waste of resources. The federal government has roles in border closures and quarantine of international travel. That’s their job. But states should be responsible for things that need to be tailored to local needs and conditions. The needs of states like mine in comparison to say New York are too extreme in difference for the federal government to plan for and implement even if they were supremely competent in every way.

 

HUGE problem in America, apparently.

Where did it come from? It's not specifically a First World thing .. Japan being a great example of wealth AND self-discipline.

 

Wow, very different to Australia. We get door-knocked by police or military if we're asked to self-quarantine. Travellers are held in official quarantine for 14 days (under armed guard). In the city with the outbreak, you can't travel more than 5km (as crow flies) from home, masks are mandatory once you leave your front door, and there's an 8pm curfew. Most businesses are closed. Very few people are still working, and you can't go out for anything but food or brief exercise on foot .. once a day, and only one person from house can go unless there's a valid reason two must go. $5k fine for first breach of rules, $20k if you're caught more than once, plus criminal charges. We don't muck around.

 

It's the short attention span of the toddler. Again, where does it come from?

 

Thanks. Wasn’t clear on exact definitions of each phase. I remember reading about the macaques but I was interested in human efficacy trials. I should have been more clear. But you addressed everything I was looking for anyway. Oh, except for what “soon” means.

 

Yes, Italy indicted 40,000 citizens for "aiding an epidemic" with sentence guideline of 12 years in prison. The Army was out on the streets to enforce it. Several countries in the world took this very seriously (and then beat the virus). Over here, if someone *asks* you to wear a mask, you scream to the top of your lungs that it's slavery and you're not sheep. Then, what is going on, happens: we're the advanced country most hit by the pandemic. Scratch that, we're the country most hit by it, period. Stupid us.

 

I forgot to mention, the efficacy part even in phase 1 and 2 is what we call immunogenicity. So you look for safety (bad reactions) but also for whether or not the vaccine induces the making of antibodies, and whether or not those are neutralizing antibodies. So what you add in phase 3 is that you put that to test in real world situation, in areas where transmission is occurring, to see if the people who get vaccinated then are less likely to get the infection, or if they still get it, less likely to get sick from it (severity). The good news is that the front runners have shown robust immonogenicity in phases 1 and 2, so now what is left to be seen is if the higher number of people (which in phase 3 is supposed to include older and less healthy people) will bring about safety concerns, AND if the antibodies produced by the vaccine will indeed be protective. Phases 1 and 2 are also supposed to gauge vaccine dose and need for boosters. Then you get a game plan, a certain dose, in single administration or with a booster, and then you go out and do it in 30,000 to 50,000 people, and then also look at how protective the vaccine was in real life.

About "soon" - Pfizer expects to finish Phase 3 by the end of October. I think they'll be the first ones to finish. Oxford and Moderna expect to finish theirs by the end of the year. *If* everything goes well, I'm hopefull that all three will be delivering viable, safe, efficacious, and approved vials of their vaccines to the population (starting with healthcare workers, yay, and the vulnerable population, followed in 2021 by everybody else who wants it (and our STUPID population is likely to reject by the tens and tens of millions; I'll be surprised if we get to vaccinate half of the population).

Now, the above timelines only work if NOTHING goes wrong in phase 3, including, if there isn't a major viral mutation. Anything that goes wrong could significantly delay everything. Fingers crossed.

I expect the first few approved vaccines to be only partially protective. Maybe given another year or so we'll have better vaccines. But any partially protective vaccine now will already be a big advancement.

 

Ten-four. Yeh, doesn’t make much sense to proceed if you aren’t stimulating the adaptive immune system. Another odd question. If a company could find participants, could they attempt intentional infections after vaccination in trials? I’ve never found that really discussed in depth in anything I’ve read.

I suppose I better start paying closer attention and looking into details of these three if they will likely be the first available. I’m curious now about similarities and differences of the three.

I’m going to be civil and hopefully helpful here. But I’m going to have to be frank. Bear with me.

The surest way to guarantee 50% of people refuse a vaccine is to call them stupid. Months ago on this forum I encouraged people to start thinking about how this was bound to play out. I emphasized there would be pressure to conform, I’m not sure how much pressure or how it will be applied. I’ve been thinking about it a lot. And I’ve been polling people I talk to as to whether they will be vaccinated. I have not had one person say they will actively pursue it.

I’ve had a variety of nuanced responses and my full list includes everything from veterinarians to old military veterans that worked blue collar jobs their whole life but are now millionaires, but I’ll just share a couple examples. First, I have a friend who I met because she was my banker when I started my business and started purchasing land. I’ve never cared much for bankers, but in a couple years she earned my trust and respect. She is the only banker I’ve ever asked for advice and it was always sound advice. Unfortunately she retired from banking and has since pioneered the transition from on site live estate auctions to online auctions in my area. She is also a cancer survivor, finishing up chemotherapy treatments in April or May. She says that was a bit difficult in the middle of a pandemic. Anyway, bottom line, she is not interested in a vaccine. She is not stupid.

Second example, I have a local fuel supplier. He delivers to my home fuel barrels as well as to tractors in the field. He serves about 1/4 of the state with fuel delivery as well as overseeing the operation of the full service gas station and full service mechanics shop his delivery service is based out of. Over the years this man has saved me thousands of dollars. He knows energy markets from politics to futures to retail. He freely gives advice on timing of large fuel and gasoline purchases and is correct nearly every time he makes a recommendation. If he doesn’t know he says so. He had open heart surgery three years ago and is in his late 60’s I believe. He told me he is reading everything he can find on these vaccines. He said he’s officially undecided but is certainly not going to be an early recipient. He wants to see millions of safe vaccinations with good efficacy before he decides. He is not stupid.

Now, I know both these people pretty well. We aren’t best friends but we discuss heavy subjects enough I know how their minds work. Being called stupid will guarantee neither will consider vaccination.

Many people I know don’t and won’t get a flu vaccination. Why? The same reason they don’t buy $19.99 widgets off tv commercials. They figure something that has to be hyped isn’t legitimate or as much of a value as advertised. The harder it’s marketed, the more resistance occurs. When talk of physical, financial, or social pressure becomes part of the equation it’s over. You’ve lost them for good. They believe a product must sell itself on it’s merits. A vaccine will have to sell me on it’s merits.

Now I know you aren’t intentionally calling people I know stupid. I’m not insinuating that or trying to be disagreeable. I understand your frustration. My commentary is meant to be helpful. But if a high percentage of people being vaccinated is the real goal I encourage you and anyone else with influence to not use the tactics used with masks. You will lose undecideds in droves and guarantee those mildly opposed will permanently be unreachable.

When masking became popular and those in favor started in with the “you’re an idiot if you don’t wear a mask” and “you should be forced to wear a mask” I made a serious attempt (with evidence) at showing reverse psychology would be a much better tactic to reach the resistant. I maintain that position today. Well, obviously I failed at convincing anyone.

Oh, and this one better be all honest and out in the open. No misrepresentation of efficacy, no withholding of information on adverse reactions, no financial scandals, etc. Mistrust of government especially and to a lesser extent “big pharmaceutical” is rampant. Whether it’s justified or not isn’t the point here. The point is there is no room for error in transparency of the process.

Again, I’m not indicting anyone, I’m just telling you how it is out here in flyover country and how NOT to approach skeptical people.

Kind of a scary “if”. I certainly hope this doesn’t end up like the AIDS vaccine. I think we know enough at this point about the immune response to this bugger that’s very unlikely. But a mutation could change that for sure.

I agree. I’ll be surprised if it approaches 50%. But that’s huge as you say.

 

Yes, it's been done. It's called a "Human Challenge Trial." I don't like it. I personally consider it unethical. Remember the Hippocratic Oath? From the original version, you'll find this line, there, among many others (it is beautiful): "I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect."

It's been done for vaccines against cholera, malaria, and typhoid fever. However, these have rescue medications to be given if the subject gets the disease. Not so for COVID-19.

But yes, it's under consideration. The WHO had a 19-person panel weighing on the issue. The panel split over several issues but ended up issuing guidelines for it, recommending volunteers with no underlying health conditions and between the ages of 18 to 25, also to be inoculated with a very small amount of the virus to try to prevent serious illness.

Over here, believe it or not, the NIAID is trying to find attenuated strains of the virus that could be used in such trials. The CDC however has issued a statement against it, citing serious ethical considerations. But the field is split. Certain bioethicists are actually for it, such as NYU's Arthur Caplan.

All three are mRNA vaccines targetting the S-protein. I don't think they are that different. Two very different ones are also in phase 3, both from China, one made by Sinovac, and the other one by Sinopharm. They are both adenovirus vector vaccines.

Interesting piece of info, and one of the reasons why I'm optimistic. Unlike regular medications, vaccines have a track record of phase 3 success. 75% of vaccines that reach phase 3 ultimately are approved as safe and efficacious. That's not always the case for regular meds, but for vaccines, the real big problems are often seen since phase 2, and if they don't have any by then, chances are that they will survive phase 3.

I read the Moderna paper on their phase 1 results and I liked what I saw. Nothing really concerning. They tried 3 different doses, all three followed by a booster a month later. The higher dose, second shot, caused more issues but since then, they dropped that dose as too strong.

Sure, you are right; in real life I never approach it this way. I'm very gentle and I think after decades of experience I've developed a lot of people skills. And I'm all for educational campaigns rather than mandatory orders ("one catches more flies with honey than with vinegar"). I also respect patient autonomy. All I can do is inform. That's the principle of informed consent. The patient is the ultimate decision maker.

But hey, that's real life. Over here it is some escapism. Over here I can vent my frustrations, and yes, I do believe that people who refuse a safe and efficacious vaccine in the middle of a very dangerous pandemic, are *being* stupid. It doesn't mean that they are stupid in all walks of life. Very intelligent people do stupid things all the time. Don't hear my STUPID in all caps as synonymous with intellectually deficient, as in low IQ. Your friend may be a brilliant banker, and... she's being stupid as far as vaccines go. Same with your fuel supplier. He is good at reading the market, and likely intelligent, but *in this* he is *being* stupid. Of course if he were a patient of mine and I were attempting to inform him well enough so that he'd decide to take the vaccine, I'd never be implying that he was making a stupid decision by refusing it. I'd gently reason with him, presenting the issue from several angles.

But let me tell you why it's stupid. It's because things can *sound* dangerous and scary to an individual, especially one that is not used to thinking in public health terms, but only in risks for himself. So, how do *lay* people get to hear about these things? From anecdotes. From horror stories in the lay press interested in selling print copies and collecting web clicks.

"Mr. John Smith took the COVID-19 vaccine today, got a little sore, felt a little tiny temperature rise the next morning then by the afternoon he was feeling fine. He went about his business. Six months later, he hasn't caught the virus although five of his co-workers did. He was tested for antibodies and they remain strong."

Huh, no. That doesn't sell newspapers. That isn't news. What newspapers are interested in, is the horrible Guillain-Barré Syndrome Mr. Peter Smith got from the vaccine.

So, your friend will say "I'll wait for more safety data." Sounds intelligent and prudent, right? Well, it isn't. It's stupid. Because you have to think of it in terms of probability. This virus is spreading in a way that is likely to get to a LOT of susceptible people, even while they wait to see what happens to the vaccine.

Say you get a phase 3 and you have 30,000 people, and 3 serious reactions. That's 1 in 10,000. The newspapers will zoom on these three and be alarmist. Your friend will be negatively impressed. But see, that's 1 in 10,000. And for vaccines, that's considered bad because when given to hundreds of millions, you'll find lots of serious reactions... but what about the 9,999 people you protected from the illness, among those 10,000?

Now, look at the disease. It kills 1 in 100. As you probably know by now, that's not the whole story. Did you see the German paper (I posted it) in which 78% of people who survived the virus, were found to have been left with significant heart damage (seen in imaging and troponin blood tests), including, 67% of them having had mild cases that allowed them to recover at home, not even needing to go to a hospital? Sure, small study, with only 100 subjects, but that's darn scary. The authors expressed concern about heart failure down the road, in a few years.

In a very long post of mine I engaged in very complex calculations trying to factor in the asymptomatic cases (they haven't been studied for this, so it's not even excluded that they have it too, but supposing that they don't, which is optimistic), less susceptible populations (such as type O blood), those naturally immune from having encountered too many coronaviruses in the past, and so on. I came up with the most optimistic scenario possible, with 1 in 20 people catching this, and ending up with serious heart trouble.

Now, that's only ONE organ. Say, 5% of people will have serious heart trouble in a few years. Now let's consider all the other problems. A lot of people are coming out with severe pulmonary fibrosis. Many have strokes. Some have renal insufficiency. Many have neuropsychiatric issues including cognitive difficulties. Many have chronic fatigue syndrome. I mean, the way the consequences have been piling up in reports and papers, the way this disease is only 9 months old, I'm starting to think that it is very possible that at least 10% of people will have serious consequences even if they are asymptomatic. Say, 1% die and 9% more get seriously maimed, for life, and have a shortened life span. So that's 1 in 10.

Also do consider that not only Guillain-Barré Syndrome is very rare after vaccines (usually much rarer than this, but in a bad vaccine, 1 in 10,000) it's only like 3% to 7% of people who die from it; 95% recover, no problem. Let's go for the average of 5%. So that's 1 in 20. So from the 1 in 10,000 now we have 1 in 200,000 with a *really* serious complication.

Now let's go back to your fuel expert. Intelligent man, right?

Say, he is in a situation where he is stuck in a mountainous desert, no satellite phone, nobody knows where he is to come and rescue him, his water is dwindling, and he needs to go back to civilization otherwise he will die. He gets his map and his guide book, and it says - from this patch of desert there are only two ways back to civilization, these two roads. Road A to the left is very slightly dangerous. 1 in 200,000 people who travel it suffer accidents, the car falls from it, and they get seriously injured or killed. Road B is a lot more dangerous; narrow, with avalanches, it crumbles in places, so 1 in 10 people traveling through it get killed or seriously injured.

OK, question. What road do you suppose your intelligent fuel specialist will pick??? Road A, right? Would you call a decision to go for Road B, well, stupid? Yeah, me too, I would.

That's EXACTLY what he'll be doing if decides not to take a vaccine that causes Guillain-Barré Syndrome in 1 in 10,000 recipients (of which only 5% get seriously in trouble, or 1 in 200,000), while risking a disease that kills or seriously maim 1 in 10 people.

But even intelligent people are not used to thinking this way, so they make stupid decisions all the time.

If he's my patient I'll gently show him these numbers and will not call him stupid. But if he ultimately decides to not take it, I'll say, "OK, sir, good luck, stay safe, keep looking into it and if you reconsider you know where to find me; have a nice day," and will move to the next patient. But yeah, deep inside I'll think "Oh my God, what a stupid decision, by an otherwise intelligent man!"

 

Correct. Since Trump repealed the Obamascare medical device tax the tax on surgical gloves is also gone.
https://taxfoundation.org/new-research-provides-more-reasons-to-repeal-the-medical-device-tax/

Obama had 8 years to fix the disparity between prices charged in the US versus foreign countries that fix the prices they will pay. He failed. He was your maestro of healthcare ,,, who used up and failed to replace the stockpile of PPE after he infected 60.8 million Americans with swine flu in 2009-2010.

 

I reference the IFR, not the CFR. The actual IFR is extremely low because they haven't a clue about how many have been infected without going into the record books. The official IFR was .65 about a month ago. Because the number of deaths FROM the virus has been conflated with deaths WITH the virus, the actual IFR is calculated by some to be .03

Your last sentence suggests you would rather not talk about it, and it's funny.

 

In reading your post, I realized - in this case - I'm very much a nationalist. I think that combating the virus should very much be a national effort. As has been done in many other countries. The lack of a national response let to states fighting among themselves for vital supplies. And it has left some regions with a serious shortage of resources to help their citizens (check out the Rio Grande Valley and their challenges).

Why, if this should all be left to the states, does the federal government have a stockpile of supplies? And why was Trump on TV every day for a couple of months talking about the virus? I respect and understand those who believe that governing should be left to States - but in this case - it hasn't worked.

 

Great conversation with little to no partisanship.
It is possible!

I've not much to add except this on mandating the observance of best practice.
I've been trying to take this pandemic seriously. I argue for following the guidelines all the time.
I believe that masks do more good than harm and think that people should wear them.
My government has been recommending the wearing of masks since May.
With all that I've said, it was not until masks were required by law that I got around to buying some masks and started wearing one.
Part of my apathy was because I was social distancing so well I didn't really need one.
I didn't go into a supermarket for the first time until mask-wearing became compulsory.
So not only did forcing me to wear a mask have the positive effect of making me finally start wearing one, but it also got me back spending money in shops.
I don't feel any less free.

 

No, I don't want to talk about conspiracy theories such as China man-made it to attack the United States. That's ridiculous as it has been debunked by genomic analysis of the virus. Yes, the IFR is likely to be about 0.65% and it is absolutely ridiculous to suppose it is 0.03%. Infinitely ridiculous and contrary to all evidence. Just think of it: the CDC has published, much before this pandemic, an analysis of the average daily death rate by the flu, going back 31 years. Maximum average for a given day: 64. Well, the coronavirus at pick got to 2,900. Months into the outbreak we are still posting 1,300 deaths per day. Pray tell, how is this consistent with its IFR being much smaller than the flu's??? Then look at other pieces of evidence, such as the 4,000 people confined to the Diamond Princess. All 4,000 were counted, passengers and crew. Slightly slanted sample given the passenger's older age as opposed to the general population, but mitigated by the crew's younger age. NO cases were missed so what we have here is a true IFR for this given population. Wanna guess what it was? 1.4%. How do you get from that to 0.03% beats me.

So, it's calculated by "some" as 0.03? Who? Lay people? Journalists with an agenda? Pundits with partisan bias? People who plot the number of deaths against the full US population, ignoring that the virus hasn't spread yet to the whole population??? Because no serious epidemiologists entertains the notion that the true IFR is as low as 0.03%. I used to work with 0.8% based on a large number of data and observations. I did believe in the downgrade to 0.65% (best current estimate) for the reason that we've learned to treat the critical cases much better now and the ICU recovery rate went sharply up (by using early anticoagulation with enoxaparin, early steroids to dampen the cytokine storm with methylprednisolone or dexamethasone, by avoiding invasive ventilation in favor of high volume oxygen flow, etc.) so that death rate in the beginning of the pandemic was higher than it is now because we're rescuing more people. But 0.03?? If this weren't a tragic situation I'be rolling on the floor laughing.

By the way, the idea that we are missing 9 out of 10 diagnoses is an estimate. Maybe we're not even missing that many, given that now testing is more widespread, the percentage of positive tests among the ones tested remains relatively low, and other data points to this idea of 9 out of 10 being overblown, such as how Sweden, way into their share of the pandemic and with no lockdown, only found 7% of their population with positive antibodies. Such as how the UAE have tested more than half of their population already of 9.9 million people (they've tested 5.4 million) and they have found only 62,300 cases. So, it's starting to look like the wild claims that we're missing 9 out of 10 cases are a huge exaggeration, which as you know would push the IFR up.

Also consider that a couple of studies used to make this wild claim of 9 out of 10 missed or more, were later found to be irreparably flawed. For example, the Santa Clara serology survey used a flawed antibody test with a huge false positive rate, and also had the stupidest biased sample ever, as they did not randomize the survey but asked for volunteers on Facebook!!! So people who had had symptoms but weren't PCR-tested because of shortage of tests, were curious to know if what they had was indeed mild COVID-19, and flocked to the study. This biased sample + false positives was then extrapolated to the whole population of the county and compared to the number of confirmed cases, postulating that they were missing 9 out of 10 cases... well, they weren't, because their numbers were completely off. So, hold your horses with this idea that the IFR is much lower due to missed cases. It sure is lower than the CFR, but not as low as 0.03%. Again, I do think that the CDC's best estimate of 0.65% is likely to be relatively accurate, and that's 65 times higher than the flu's, which is much more consistent with the daily death peaks and the increase in deaths by all causes (more on this below). Pray tell, how can an infection that in 4 months kills several times more than the seasonal flu kills in one year (contrary to popular belief, the "seasonal" flu doesn't only kill in the winter) have a lower IFR??? That's so ridiculous, I get irritated just by having to make this point. Enough of this silliness. This thing IS a killer and trying to ignore it won't resuscitate people. Gee!

Oh, so, the number of deaths FROM the virus has been conflated with deaths WITH the virus, say you? That's just a partisan talking point. It may have happened in a handful of fringe and anecdotal cases, but the vast majority of death certificates are correctly issued and there is plenty of evidence that the total is much more likely to be UNDERcounted due to deaths at home and in rural areas that never got tested and were issued certificates as unspecified viral pneumonia. Do you want a way to know that deaths do absolutely come from COVID-19? Just look at the total deaths by all causes. These are precisely counted because in the United States, if your death didn't occur in the hands of a serial killer who buried you in his backyard, your death will be counted (rather than you just being considered a missing person in the serial killer's case). So, you take any given period of say, a week, or a month, in one of the epicenters, get their total deaths from all causes for that period, then compare it to the average of, say, the last ten years for that same one week or one month calendar period. What do you see? An increase by 80% to 300% for that period depending on the epicenter, with a surplus that is actually bigger than the total death certificates FROM COVID-19 issued in that location for that period (demonstrating the undercount). The idea of cooked numbers is a partisan EXCUSE for the United State's failure to contain our share of this pandemic, as compared to other advanced countries. Sticking your head in the sand to ignore that people are actually dying FROM this illness is silly and backfires on us. Any attempt to minimize this serious situation only makes it worse, and it doesn't match reality. You want to dwell in "alternative facts", be my guest; I'll stick with real facts.

 

Great post. This is exactly what should be said everywhere. A simple public health measure is being politicized and characterized with hyperboles as bad as calling it slavery. All the people who protest this vehemently keep quoting that the economy needs to get going. Well, the economy would be going much better if people just followed these simple and harmless guidelines. The cognitive dissonance is mind-boggling. That's what happens when partisan politics gets in the middle of a simple matter of pubic health. Countries where this hasn't happened, are faring much better as their population reacted to the virus in a more homogeneous and consistent way.

By the way, look at what happened in Kansas. The governor's state-wide mask mandate was taken down by the courts, so counties were left to implement their own ordinances. Guess what? In ALL of the 15 counties that chose to mandate masks, the rate of contagion went sharply down. It didn't happen in any of the other counties that chose not to implement this mandate. That's real life demonstration that masks work (they are not perfect but they do help). This needs to be saved and re-posted every time someone yells that masks don't work. and mind you, it happened even though these 15 counties are the most urban and densely populated where contagion was riskier than in other counties. And it happened with people wearing their pitiful cloth masks... would have happened even more sharply if the population were receiving high quality medical grade ASTM level 3 masks like countries that did not outsource their PPE domestic production to China still have... So even though our masks are pitiful (not mine, by the way, but "our" in the sense of we, Americans), they still help.

https://apnews.com/f218e1a38cce6b2af63c1cd23f1d234e

 

@Eleuthera sorry, too late to edit my mistake as it's past the 15-minute window but I said 65 times higher when it I should have said 6.5 times higher (0.65 versus 0.1).