23 ms·

Yeah, I read that part and was like... but I remember reading & hearing pretty damn early in the pandemic that a fairly high percentage of infections are asympt

by bamfly 3y ago

Yeah, I read that part and was like... but I remember reading & hearing pretty damn early in the pandemic that a fairly high percentage of infections are asymptomatic, and continuing to see that stated periodically and never (that I read or heard) contradicted for the whole rest of the pandemic. And sure enough, most households I know that had Covid roll through (which is, at this point, practically every household of everyone I know) played out like that—it was more common than not for at least one person in the house to never get signs or symptoms. Right? Is that not how it went?

mike_hearn 3y ago
Yes that's how it went. That experience was very common. It was unexpected. The models deployed to justify lockdown assumed 100% susceptibility to COVID-the-disease on the grounds that the virus was "novel". Although they had some crude notion of chance involved in transmission, they didn't have any notion that you could be heavily and repeatedly exposed to the virus and just never catch it at all. When did governments admit that this expectation had been violated, that must be a lot of pre-existing immunity? IIRC, they never did. And what's the official explanation for how that happened? AFAIK there isn't one? There were some attempts at the edges to claim that all these people must have had symptoms, just so mild they didn't notice. But if neither you nor anyone else ever notice you got sick, then you didn't get sick using any conventional definition of sickness because disease is defined as a collection of symptoms.
- bamfly 3y ago
  Ah, OK, I see the distinction you intended now. Thanks.
- tripletao 3y ago
  > But if neither you nor anyone else ever notice you got sick, then you didn't get sick using any conventional definition of sickness because disease is defined as a collection of symptoms. So was Typhoid Mary sick? Is an asymptomatic patient with a positive HIV test? Kary Mullis--the inventor of PCR!--says no: > A man with gray hair and a goatee raises his hand. He says he's been HIV-positive since 1984, that he took the anti-AIDS drug AZT for a couple years but stopped. Now, he says, his T-cell count -- the number of a kind of white blood cell that is killed by HIV -- has gone way down. > Mullis interrupts him: "Change doctors!" > The man continues. His T-cell count is down to 150, which is usually thought of as dangerously low. He asks Mullis for advice. > "I would say there is no evidence that I can find in the scientific literature that you should worry about HIV or your T-cell count," Mullis tells him. "If you'd stop worrying, maybe you'll be all right. You look pretty healthy to me." https://www.washingtonpost.com/archive/lifestyle/1998/11/03/nobel-chemist-kary-mullis-making-waves-as-a-mind-surfer/31e7e720-44e4-49ff-8458-a9822cdcb47e/ https://www.washingtonpost.com/archive/lifestyle/1998/11/03/... Do you think he gave that patient good advice?
  - mike_hearn 3y ago
    HIV and AIDS is a good example of separating pathogen and disease. Being HIV+ isn't the same thing as having AIDS. You can have HIV+ and not be sick as the anecdote from the story indicates (14 years HIV+ without developing AIDS?).
    - tripletao 3y ago
      If he's not sick, then why should he take AZT? And if Typhoid Mary isn't sick, then why can't she work as a cook? The point is that even if you feel good now, a positive HIV test means that without treatment, you'll almost certainly die within the next 10-20 years. You can also infect others, and they'll die too. (As to the 14 years, the patient Mullis talked to was presumably some combination of lucky and/or benefiting from the AZT he'd taken previously.) Likewise, a positive SARS-CoV-2 test meant that you'll die with p ~ 1%[1] within the next couple months. That's much less bad than HIV, and the relative benefits of treatment are much smaller; but that's spectacularly higher than baseline mortality, so the test is clearly predictive. The concept of asymptomatic disease is well-recognized in medicine; just google the phrase. I'm not sure how Kary Mullis managed to convince so many people to reject it. 1. That's a CFR over all ages, confirmed deaths divided by confirmed positives. The IFR is of course lower, but the statement is conditioned on a positive test.
      - mike_hearn 3y ago
        You're conflating asymptomatic with pre-symptomatic. The former means you never develop symptoms. The latter means you are about to get sick but aren't currently.
        tripletao 3y ago
        That HIV patient was indeed near-certain to be symptomatic later, but Typhoid Mary was permanently asymptomatic. That's unusual for typhoid, but for other pathogens (e.g. cytomegalovirus) most infected patients are permanently asymptomatic, with only a small minority of patients showing symptoms: https://www.cdc.gov/cmv/congenital-infection.html https://www.cdc.gov/cmv/congenital-infection.html Your claims are inconsistent with at least a century of boring, uncontroversial medicine. I don't know whether you're doing it knowingly, but you're closely repeating the arguments of Kary Mullis, who was clearly smart (he invented PCR!) but not exactly reliable (he denied that HIV causes AIDS! he saw a talking, fluorescent raccoon!).

by bamfly 3y ago

mike_hearn 3y ago

Yes that's how it went. That experience was very common. It was unexpected. The models deployed to justify lockdown assumed 100% susceptibility to COVID-the-disease on the grounds that the virus was "novel". Although they had some crude notion of chance involved in transmission, they didn't have any notion that you could be heavily and repeatedly exposed to the virus and just never catch it at all. When did governments admit that this expectation had been violated, that must be a lot of pre-existing immunity? IIRC, they never did. And what's the official explanation for how that happened? AFAIK there isn't one? There were some attempts at the edges to claim that all these people must have had symptoms, just so mild they didn't notice. But if neither you nor anyone else ever notice you got sick, then you didn't get sick using any conventional definition of sickness because disease is defined as a collection of symptoms.

bamfly 3y ago
Ah, OK, I see the distinction you intended now. Thanks.
tripletao 3y ago
> But if neither you nor anyone else ever notice you got sick, then you didn't get sick using any conventional definition of sickness because disease is defined as a collection of symptoms. So was Typhoid Mary sick? Is an asymptomatic patient with a positive HIV test? Kary Mullis--the inventor of PCR!--says no: > A man with gray hair and a goatee raises his hand. He says he's been HIV-positive since 1984, that he took the anti-AIDS drug AZT for a couple years but stopped. Now, he says, his T-cell count -- the number of a kind of white blood cell that is killed by HIV -- has gone way down. > Mullis interrupts him: "Change doctors!" > The man continues. His T-cell count is down to 150, which is usually thought of as dangerously low. He asks Mullis for advice. > "I would say there is no evidence that I can find in the scientific literature that you should worry about HIV or your T-cell count," Mullis tells him. "If you'd stop worrying, maybe you'll be all right. You look pretty healthy to me." https://www.washingtonpost.com/archive/lifestyle/1998/11/03/nobel-chemist-kary-mullis-making-waves-as-a-mind-surfer/31e7e720-44e4-49ff-8458-a9822cdcb47e/ https://www.washingtonpost.com/archive/lifestyle/1998/11/03/... Do you think he gave that patient good advice?
- mike_hearn 3y ago
  HIV and AIDS is a good example of separating pathogen and disease. Being HIV+ isn't the same thing as having AIDS. You can have HIV+ and not be sick as the anecdote from the story indicates (14 years HIV+ without developing AIDS?).
  - tripletao 3y ago
    If he's not sick, then why should he take AZT? And if Typhoid Mary isn't sick, then why can't she work as a cook? The point is that even if you feel good now, a positive HIV test means that without treatment, you'll almost certainly die within the next 10-20 years. You can also infect others, and they'll die too. (As to the 14 years, the patient Mullis talked to was presumably some combination of lucky and/or benefiting from the AZT he'd taken previously.) Likewise, a positive SARS-CoV-2 test meant that you'll die with p ~ 1%[1] within the next couple months. That's much less bad than HIV, and the relative benefits of treatment are much smaller; but that's spectacularly higher than baseline mortality, so the test is clearly predictive. The concept of asymptomatic disease is well-recognized in medicine; just google the phrase. I'm not sure how Kary Mullis managed to convince so many people to reject it. 1. That's a CFR over all ages, confirmed deaths divided by confirmed positives. The IFR is of course lower, but the statement is conditioned on a positive test.
    - mike_hearn 3y ago
      You're conflating asymptomatic with pre-symptomatic. The former means you never develop symptoms. The latter means you are about to get sick but aren't currently.
      - tripletao 3y ago
        That HIV patient was indeed near-certain to be symptomatic later, but Typhoid Mary was permanently asymptomatic. That's unusual for typhoid, but for other pathogens (e.g. cytomegalovirus) most infected patients are permanently asymptomatic, with only a small minority of patients showing symptoms: https://www.cdc.gov/cmv/congenital-infection.html https://www.cdc.gov/cmv/congenital-infection.html Your claims are inconsistent with at least a century of boring, uncontroversial medicine. I don't know whether you're doing it knowingly, but you're closely repeating the arguments of Kary Mullis, who was clearly smart (he invented PCR!) but not exactly reliable (he denied that HIV causes AIDS! he saw a talking, fluorescent raccoon!).