5 ms·

The reliance on unusual concepts - like asymptomatic transmission and the effect of wearing masks which have become semi-religious in their belief even though t

The reliance on unusual concepts - like asymptomatic transmission and the effect of wearing masks which have become semi-religious in their belief even though there isn’t really any actual solid RCT evidence they do that much good out in the field rather than in the lab (much like hydroxychloroquine which is similarly effective in a lab but not in the field). There is no blow out in Texas et al and Sweden has just tracked the same path as everybody else suffering much less than Belgium for example, and today isn’t anywhere near the top of the charts. There’s an awful lot of curve fitting to beliefs going on - because it is so difficult to do solid experiments.

watwut 6y ago
How is symptomatic transmission unusual concept?
- timr 6y ago
  Asymptomatic transmission is the concept in question. Symptomatic transmission is the typical case -- you cough, sneeze, etc., and give it to others. There's still quite a bit of debate over this question, despite the article's insistence that the matter is settled. The data supporting it comes mostly from modeling studies, and real-world data is thin on the ground. Mostly anecdotes. We have lots of examples of pre-symptomatic (or minimally-symptomatic) transmission for other illnesses, but these tend to be limited (e.g. spread within households), and it's always been a bit of a stretch to make the claim that completely healthy people are spreading diseases widely in "super-spreader" events via casual encounters. Does it happen? Sure. Is it common? Ehhhh. Even with Covid, we know that the majority of transmission (something like 80%) occurs within households. Of the remainder, as TFA notes, there's an "overdispersion", where a few people are responsible for most of the spread. Is it really likely that these "superspreader" people are mostly completely healthy, without symptoms, and yet unknowingly spreading it to vast numbers of people? Or is that just something that we've found a few times, and makes the most memorable anecdotes? It is certainly not the hypothesis you would favor based on parsimony alone. If you were a betting person, you'd probably put your money on the idea that someone is a little bit sick (but not so sick as to stay home in bed), and the disease can spread by aerosol or droplet with low probability. That's a much simpler explanation for the same pattern: someone has a tickle in their throat or a slight fever, but goes to the restaurant/office/wherever anyway. Set the probability of transmission to a low p-value, and let the poisson distribution do the rest. Just by chance alone, you will see rare occasions where large(r) groups of people get infected.
  - watwut 6y ago
    I had typo. But AFAIK, asymptomatic transmission is not novel concept. We have been learning about it in elementary school in the context of other diseases. There is absolutely nothing new about it as concept. It is not something that appeared with covid first time in history of diseases.
    - neilwilson 6y ago
      If it was a concept in this situation we could easily prove it. Get people who pass a lateral flow test or PCR test into a room and measure their pre-sympomatic viral output. Why hasn't that experiment been done?
      - dTal 6y ago
        It has? Repeatedly? This is the news from three days ago: https://www.independent.co.uk/news/health/covid-symptoms-report-coronavirus-ons-b1828361.html https://www.independent.co.uk/news/health/covid-symptoms-rep...
        timr 6y ago
        Showing that people with Covid can be asymptomatic is not evidence that asymptomatic people transmit the virus, and the article you linked to just leaps directly to the conclusion. Here's an actual paper from 2021 that shows that -- as you might expect -- that exhaled particles correlate with age, weight and viral load: https://www.pnas.org/content/118/8/e2021830118 https://www.pnas.org/content/118/8/e2021830118 In other words: older, fatter, sicker people are more likely to shed the kind of particles that facilitate transmission. They make a point of noting that nobody in their test under the age of 26 was a significant source of aerosol. Anyway, GP is not wrong. We could do these experiments, instead of just guessing.
Fomite 6y ago
Asymptomatic transmission isn't at all an unusual concept in infectious disease epidemiology.
- henrikschroder 6y ago
  The question isn't whether or not it can happen, I think everyone agrees that this virus can spread through both presymptomatic and asymptomatic individuals. The question is how common is it? How large a percentage of all cases are caused by it? And the whole "always wear a mask" hinges on asymptomatic/presumptomatic spread being high. Because if it isn't high, then we're focusing on the wrong thing, we're needlessly being suspicious of every single random stranger, we're choosing something that's easily virtue-signalable, over things that actually stop the spread.
  - raverbashing 6y ago
    If it isn't high the situation wouldn't have gotten as bad as it got. Especially with people more alert to people showing symptoms
    - xxxxhhhh 6y ago
      So basically you have no direct evidence, this is biased supposition.
worker767424 6y ago
> ...wearing masks which have become semi-religious in their belief even though there isn’t really any actual solid RCT evidence My favorite example of how it's become semi-religious is people wearing them on outdoor walks in the suburbs where, worst case, they'll with within 6 feet of someone for a total of 30 seconds. The virus spreads very poorly in those conditions. Ironically, you're more likely to get the virus at home from a family member, but there's been minimal push for masking at home because it's political suicide.
- remarkEon 6y ago
  It’s definitely become a semi-religious thing where I’m at. I generally don’t wear a mask outside and people have asked me to put one on from about 10m away. I’ll comply, just to not be combative at that particular moment in time, but remove it once they’ve passed by. I’m fully vaccinated now. I expect this social norm to be semi-permanent and I don’t really have a good idea for how to break it. Even carrying a vaccine card everywhere would, I expect, elicit pseudoscientific retorts that “vaccines don’t affect transmission”.
  - SergeAx 6y ago
    But we really don't have an evidence that vaccine-induced immunity response prevents virus transmission. And we do have evidence that people recovered from COVID-19 months ago can bear high viral load in their respiratory system: https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v1.full-text https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v...
    - wrycoder 6y ago
      Two out of 6,614 previously infected were reinfected and showed documented high viral load. That’s a very low proportion. A prior history of SARS-CoV-2 infection was associated with an 83% lower risk of infection
      - SergeAx 6y ago
Daho0n 6y ago
>Sweden has just tracked the same path as everybody else That's very much false. You compare apples to apples to get a useable result, not apples to sour grapes. Sweden's policy have caused much much worse results compared to the countries you should compare it to: Norway, Denmark and Finland. For example deaths per 100k citizens is 12 in Norway and 134 in Sweden. Sweden is the perfect counterexample to your point. Nice graphs (Sweden is the yellow line that always stand out): https://www.vg.no/spesial/corona/norden/ https://www.vg.no/spesial/corona/norden/
- neilwilson 6y ago
  Why not Belgium, Peru, Poland, Hungary, Romania, even Gibraltar or the UK? Why do you want to compare to those specific countries you quote rather than the countries, say, that Sweden has distant transport links to? See what I mean about myths propagating.
  - Isinlor 6y ago
    Because Nordic countries are very similar culturally and compare between each other all the time. I have a Finnish girlfriend and my impression is that first thing that Finnish people do when considering a policy is to ask how it's done in Sweden. They overall rejected Swedish approach with good results. All the other countries you mentioned have vastly different cultures. E.g. I'm Polish and I can say that Polish government doesn't care about law and Polish people are fine with it. It's not to the extent Ukraine or Russia does it, but still. Poles also do not respect authority. This is in exact opposite to how things go in Finland or Sweden. It's almost a taboo to question authorities in Sweden or Finland.
- mike_hearn 6y ago
  There's no biological theory underpinning cherry picking of a handful of Sweden's neighbours. It's not like Sweden is ground zero of some genetically identical but non-deadly strain of SARS-CoV-2 that inexplicably can only spread within physical proximity of Stockholm. So not surprisingly, if you do the cherry picking honestly by including all Sweden's neighbours, including Latvia, Estonia, Lithuania etc, then Sweden stops being the worst in that little bounding box and we're back to Sweden disproving the models. Which it has done, comprehensively, because no model or theory postulates a Nordic exception.

watwut 6y ago

How is symptomatic transmission unusual concept?

timr 6y ago
Asymptomatic transmission is the concept in question. Symptomatic transmission is the typical case -- you cough, sneeze, etc., and give it to others. There's still quite a bit of debate over this question, despite the article's insistence that the matter is settled. The data supporting it comes mostly from modeling studies, and real-world data is thin on the ground. Mostly anecdotes. We have lots of examples of pre-symptomatic (or minimally-symptomatic) transmission for other illnesses, but these tend to be limited (e.g. spread within households), and it's always been a bit of a stretch to make the claim that completely healthy people are spreading diseases widely in "super-spreader" events via casual encounters. Does it happen? Sure. Is it common? Ehhhh. Even with Covid, we know that the majority of transmission (something like 80%) occurs within households. Of the remainder, as TFA notes, there's an "overdispersion", where a few people are responsible for most of the spread. Is it really likely that these "superspreader" people are mostly completely healthy, without symptoms, and yet unknowingly spreading it to vast numbers of people? Or is that just something that we've found a few times, and makes the most memorable anecdotes? It is certainly not the hypothesis you would favor based on parsimony alone. If you were a betting person, you'd probably put your money on the idea that someone is a little bit sick (but not so sick as to stay home in bed), and the disease can spread by aerosol or droplet with low probability. That's a much simpler explanation for the same pattern: someone has a tickle in their throat or a slight fever, but goes to the restaurant/office/wherever anyway. Set the probability of transmission to a low p-value, and let the poisson distribution do the rest. Just by chance alone, you will see rare occasions where large(r) groups of people get infected.
- watwut 6y ago
  I had typo. But AFAIK, asymptomatic transmission is not novel concept. We have been learning about it in elementary school in the context of other diseases. There is absolutely nothing new about it as concept. It is not something that appeared with covid first time in history of diseases.
  - neilwilson 6y ago
    If it was a concept in this situation we could easily prove it. Get people who pass a lateral flow test or PCR test into a room and measure their pre-sympomatic viral output. Why hasn't that experiment been done?
    - dTal 6y ago
      It has? Repeatedly? This is the news from three days ago: https://www.independent.co.uk/news/health/covid-symptoms-report-coronavirus-ons-b1828361.html https://www.independent.co.uk/news/health/covid-symptoms-rep...
      - timr 6y ago
        Showing that people with Covid can be asymptomatic is not evidence that asymptomatic people transmit the virus, and the article you linked to just leaps directly to the conclusion. Here's an actual paper from 2021 that shows that -- as you might expect -- that exhaled particles correlate with age, weight and viral load: https://www.pnas.org/content/118/8/e2021830118 https://www.pnas.org/content/118/8/e2021830118 In other words: older, fatter, sicker people are more likely to shed the kind of particles that facilitate transmission. They make a point of noting that nobody in their test under the age of 26 was a significant source of aerosol. Anyway, GP is not wrong. We could do these experiments, instead of just guessing.

Fomite 6y ago

Asymptomatic transmission isn't at all an unusual concept in infectious disease epidemiology.

henrikschroder 6y ago
The question isn't whether or not it can happen, I think everyone agrees that this virus can spread through both presymptomatic and asymptomatic individuals. The question is how common is it? How large a percentage of all cases are caused by it? And the whole "always wear a mask" hinges on asymptomatic/presumptomatic spread being high. Because if it isn't high, then we're focusing on the wrong thing, we're needlessly being suspicious of every single random stranger, we're choosing something that's easily virtue-signalable, over things that actually stop the spread.
- raverbashing 6y ago
  If it isn't high the situation wouldn't have gotten as bad as it got. Especially with people more alert to people showing symptoms
  - xxxxhhhh 6y ago
    So basically you have no direct evidence, this is biased supposition.

worker767424 6y ago

> ...wearing masks which have become semi-religious in their belief even though there isn’t really any actual solid RCT evidence My favorite example of how it's become semi-religious is people wearing them on outdoor walks in the suburbs where, worst case, they'll with within 6 feet of someone for a total of 30 seconds. The virus spreads very poorly in those conditions. Ironically, you're more likely to get the virus at home from a family member, but there's been minimal push for masking at home because it's political suicide.

remarkEon 6y ago
It’s definitely become a semi-religious thing where I’m at. I generally don’t wear a mask outside and people have asked me to put one on from about 10m away. I’ll comply, just to not be combative at that particular moment in time, but remove it once they’ve passed by. I’m fully vaccinated now. I expect this social norm to be semi-permanent and I don’t really have a good idea for how to break it. Even carrying a vaccine card everywhere would, I expect, elicit pseudoscientific retorts that “vaccines don’t affect transmission”.
- SergeAx 6y ago
  But we really don't have an evidence that vaccine-induced immunity response prevents virus transmission. And we do have evidence that people recovered from COVID-19 months ago can bear high viral load in their respiratory system: https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v1.full-text https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v...
  - wrycoder 6y ago
    Two out of 6,614 previously infected were reinfected and showed documented high viral load. That’s a very low proportion. A prior history of SARS-CoV-2 infection was associated with an 83% lower risk of infection
    - SergeAx 6y ago

Daho0n 6y ago

>Sweden has just tracked the same path as everybody else That's very much false. You compare apples to apples to get a useable result, not apples to sour grapes. Sweden's policy have caused much much worse results compared to the countries you should compare it to: Norway, Denmark and Finland. For example deaths per 100k citizens is 12 in Norway and 134 in Sweden. Sweden is the perfect counterexample to your point. Nice graphs (Sweden is the yellow line that always stand out): https://www.vg.no/spesial/corona/norden/ https://www.vg.no/spesial/corona/norden/

neilwilson 6y ago
Why not Belgium, Peru, Poland, Hungary, Romania, even Gibraltar or the UK? Why do you want to compare to those specific countries you quote rather than the countries, say, that Sweden has distant transport links to? See what I mean about myths propagating.
- Isinlor 6y ago
  Because Nordic countries are very similar culturally and compare between each other all the time. I have a Finnish girlfriend and my impression is that first thing that Finnish people do when considering a policy is to ask how it's done in Sweden. They overall rejected Swedish approach with good results. All the other countries you mentioned have vastly different cultures. E.g. I'm Polish and I can say that Polish government doesn't care about law and Polish people are fine with it. It's not to the extent Ukraine or Russia does it, but still. Poles also do not respect authority. This is in exact opposite to how things go in Finland or Sweden. It's almost a taboo to question authorities in Sweden or Finland.
mike_hearn 6y ago
There's no biological theory underpinning cherry picking of a handful of Sweden's neighbours. It's not like Sweden is ground zero of some genetically identical but non-deadly strain of SARS-CoV-2 that inexplicably can only spread within physical proximity of Stockholm. So not surprisingly, if you do the cherry picking honestly by including all Sweden's neighbours, including Latvia, Estonia, Lithuania etc, then Sweden stops being the worst in that little bounding box and we're back to Sweden disproving the models. Which it has done, comprehensively, because no model or theory postulates a Nordic exception.