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Thanks joshua. By infectious I meant the basic reproduction number, but I believe SARS-2 is also more infectious (in the sense if likelihood of infection per e
by __blockcipher__ 6y ago
Thanks joshua.
By infectious I meant the basic reproduction number, but I believe SARS-2 is also more infectious (in the sense if likelihood of infection per exposure event) given its incredibly high binding affinities. It seems to be unusually good at infecting humans in a way SARS-1 wasn’t. Not sure if that’s due to furin cleavage or what. I’m a bit rusty on the mechanics there so open to dissenting opinions.
Also I don’t believe SARS-2 exhibits asymptomatic spread; that seems to be largely a myth. It does undeniably exhibit PRE-SYMPTOMATIC spread however. My hunch is that the early course interferon mediated immunosuppression explains that phenomenon.
IMO the true asymptomatics (never showing symptoms) are asymptomatic largely because of T-cell cross reactivity which theoretically will reduce or entirely prevent spread. Thus why we really don’t have good evidence of asymptomatic spread but we have a wealth of evidence on pre-symptomatic.
> Also worth remembering that NYC would have run out of hospital beds entirely if they didn't implement strict lockdown measures. The NYC (or really NY) stay at home order went into effect on March 20, and daily cases peaked plateaued 1.5 weeks later.
There is absolutely no way for you to prove this nor for me to disprove it, which tells you about its explanatory value. I personally find it much more likely that the dropoff in cases is purely explainable by timing; NY was already rounding the bend when it enforced its (IMO pseudoscientific and deleterious) measures.
Basically everywhere in the globe, including Sweden, showed a large uptick for some time followed by a peak and wind-down. That’s just the pattern infectious diseases show. To immediately attribute it to human intervention when SARS-2 landed on our shores months earlier than originally thought just seems like hubris to me. In any case the statement is not falsifiable so I won’t focus on it any further.
> There was a period of time when NYC was globally short on ventilators and ICU beds.
New York as a whole was a huge proponent of early invasive ventilation which probably ended up killing people
unnecessarily. NY’s implied IFR was something like .7%, a number so bad it is unmatched by anywhere else in the US. My guess is not good pre-existing Vitamin D3 levels exacerbated by being directed to stay inside, combined with stress, fear, lack of exercise and lost sleep attributable to lockdown + general hysteria, and finally the aforementioned iatrogenic harm caused by excessive ventilation.
In retrospect it seemed the ventilator panic was only marginally more rational than the toilet paper panic.
I should note that, if we assume every use of a ventilator prevented a certain death, ventilators still had only a marginal effect since something like 90% of those ventilated died, and it’s only those with incredibly severe COVID-19 who end up ventilated (well, ironically except NY which seemed to ventilate “early and often”, so the cases were still severe but not incredibly severe)
> At this point we have more known Covid-19 long haulers in the US than there are Sars-1 infections globally. Comparisons to SARS-1 don't much matter.
I have a lot of trouble believing in a bunch of anecsotsl cases of people on Twittwr with very obvious political leanings, given that most long haulers I have seen are in popupations with next to no risk or SARS-2. It’s much more likely to be that the 20-something year olds are either inducing psychosomatic symptoms, or exaggerating their actual symptoms, or coincidentally got Epstein-Barr virus or similar at the same time.
I would expect bad COVID cases to have lingering effects for a few months, sure. But not “long-term” - although maybe we have different definitions there. Fatigue 1 month after successful resolution of infection doesn’t really say anything to me. But to give you something more tangible, I don’t believe anyone who’s in their 20s and otherwise healthy is really experiencing this mysterious syndrome, with a few very rare exceptions of course. You have to keep in mind the incredible psychoemotional environment we are living in currently.
- hcurtiss 6y agoJust a note to thank you for your extraordinary contributions to this thread. You’re dead on the money. If I had more time on a Saturday, I would be writing many of the same things.
- joshuamorton 6y ago> It does undeniably exhibit PRE-SYMPTOMATIC spread however. Yes, I mostly agree with this characterization. > There is absolutely no way for you to prove this nor for me to disprove it, which tells you about its explanatory value. I personally find it much more likely that the dropoff in cases is purely explainable by timing; NY was already rounding the bend when it enforced its (IMO pseudoscientific and deleterious) measures. There are multiple studies that support my assertion (that lockdowns reduce R0 and without them cases continue growing at near-exponential rates). Thanks to a wide variety of government policies, we have reasonable sample sizes. See for example https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268966/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268966/ (longitudinal) and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293850/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293850/ (correlational). So yes, I'd argue your assertion here is wrong and there's strong evidence to state that. > Basically everywhere in the globe, including Sweden, showed a large uptick for some time followed by a peak and wind-down. This is a misconception. While not as extreme as other places, Sweden did implement social distancing measures. And you're actually incorrect about the shape of sweden's case count graph. It went up, paused, went up again a month later, and then went down some. You can argue all kinds of things about herd immunity and whatnot, but that's not well supported. From the evidence we have the only conclusion you can make is that lockdowns do work in reducing spread, and they keep spread low later. That's the only conclusion based in evidence. Anything else is based on conjecture about things unseen. > My guess is not good pre-existing Vitamin D3 levels exacerbated by being directed to stay inside, combined with stress, fear, lack of exercise and lost sleep attributable to lockdown + general hysteria, and finally the aforementioned iatrogenic harm caused by excessive ventilation. Like this. This is not supported by any evidence. It was possible to go outside, it was possible to exercise. Stress and fear would be raised independent of lockdown measures. You're being just as hysterical about stay at home orderers as you accuse lawmakers of being about covid. > I have a lot of trouble believing in a bunch of anecsotsl cases of people on Twittwr with very obvious political leanings, given that most long haulers I have seen are in popupations with next to no risk or SARS-2. It’s much more likely to be that the 20-something year olds are either inducing psychosomatic symptoms, or exaggerating their actual symptoms, or coincidentally got Epstein-Barr virus or similar at the same time. I generally agree that long haulers are probably at least somewhat exaggerated, but we have indisputable evidence that serious, but non-fatal cases cause long lasting side effects in many (most!) severe patients (https://www.nature.com/articles/d41586-020-02598-6 https://www.nature.com/articles/d41586-020-02598-6). If that eventually wears off, that's good, but until we understand these things further, we should be cautious. A disease with a .4% IFR is very different than one with a .4% IFR and a 2% or 5% chance of leaving you with lifelong severe breathing problems, and there's a reasonable chance that Covid-19 is the second and not the first.