Coronavirus Those who ignore history are doomed to repeat it
#1141
Posted 2021-February-01, 04:52
#1142
Posted 2021-February-01, 05:56
David Leonhardt at NYT said:
The news about the vaccines continues to be excellent — and the public discussion of it continues to be more negative than the facts warrant.
Here’s the key fact: All five vaccines with public results have eliminated Covid-19 deaths. They have also drastically reduced hospitalizations. “They’re all good trial results,” Caitlin Rivers, an epidemiologist at Johns Hopkins University, told me. “It’s great news.”
Many people are instead focusing on relatively minor differences among the vaccine results and wrongly assuming that those differences mean that some vaccines won’t prevent serious illnesses. It’s still too early to be sure, because a few of the vaccine makers have released only a small amount of data. But the available data is very encouraging — including about the vaccines’ effect on the virus’s variants.
“The vaccines are poised to deliver what people so desperately want: an end, however protracted, to this pandemic,” as Julia Marcus of Harvard Medical School recently wrote in The Atlantic.
Why is the public understanding more negative than it should be? Much of the confusion revolves around the meaning of the word “effective.”
What do we care about?
In the official language of research science, a vaccine is typically considered effective only if it prevents people from coming down with any degree of illness. With a disease that’s always or usually horrible, like ebola or rabies, that definition is also the most meaningful one.
But it’s not the most meaningful definition for most coronavirus infections.
Whether you realize it or not, you have almost certainly had a coronavirus. Coronaviruses have been circulating for decades if not centuries, and they’re often mild. The common cold can be a coronavirus. The world isn’t going to eliminate coronaviruses — or this particular one, known as SARS-CoV-2 — anytime soon.
Yet we don’t need to eliminate it for life to return to normal. We instead need to downgrade it from a deadly pandemic to a normal virus. Once that happens, adults can go back to work, and children back to school. Grandparents can nuzzle their grandchildren, and you can meet your friends at a restaurant.
As Dr. Ashish Jha, the dean of the Brown University School of Public Health, told me this weekend: “I don’t actually care about infections. I care about hospitalizations and deaths and long-term complications.”
The data
By those measures, all five of the vaccines — from Pfizer, Moderna, AstraZeneca, Novavax and Johnson & Johnson — look extremely good. Of the roughly 75,000 people who have received one of the five in a research trial, not a single person has died from Covid, and only a few people appear to have been hospitalized. None have remained hospitalized 28 days after receiving a shot.
To put that in perspective, it helps to think about what Covid has done so far to a representative group of 75,000 American adults: It has killed roughly 150 of them and sent several hundred more to the hospital. The vaccines reduce those numbers to zero and nearly zero, based on the research trials.
Zero isn’t even the most relevant benchmark. A typical U.S. flu season kills between five and 15 out of every 75,000 adults and hospitalizes more than 100 of them.
I assume you would agree that any vaccine that transforms Covid into something much milder than a typical flu deserves to be called effective. But that is not the scientific definition. When you read that the Johnson & Johnson vaccine was 66 percent effective or that the Novavax vaccine was 89 percent effective, those numbers are referring to the prevention of all illness. They count mild symptoms as a failure.
“In terms of the severe outcomes, which is what we really care about, the news is fantastic,” Dr. Aaron Richterman, an infectious-disease specialist at the University of Pennsylvania, said.
The variants
What about the highly contagious new virus variants that have emerged in Britain, Brazil and South Africa? The South African variant does appear to make the vaccines less effective at eliminating infections.
Fortunately, there is no evidence yet that it increases deaths among vaccinated people. Two of the five vaccines — from Johnson & Johnson and Novavax — have reported some results from South Africa, and none of the people there who received a vaccine died of Covid. “People are still not getting serious illness. They’re still not dying,” Dr. Rebecca Wurtz of the University of Minnesota School of Public Health told me.
The most likely reason, epidemiologists say, is that the vaccines still provide considerable protection against the variant, albeit not quite as much as against the original version. Some protection appears to be enough to turn this coronavirus into a fairly normal disease in the vast majority of cases.
“This variant is clearly making it a little tougher to get the most vigorous response that you would want to have,” Dr. Francis Collins, director of the National Institutes of Health, said. “But still, for severe disease, it’s looking really good.”
What would an expert do?
The biggest caveat is the possibility that future data will be less heartening. Johnson & Johnson and Novavax, for example, have issued press releases about their data, but no independent group has yet released an analysis. It will also be important to see much more data about how the vaccines interact with the variants.
But don’t confuse uncertainty with bad news. The available vaccine evidence is nearly as positive as it could conceivably be. And our overly negative interpretation of it is causing real problems.
Some people worry that schools cannot reopen even after teachers are vaccinated. Others are left with the mistaken impression that only the two vaccines with the highest official effectiveness rates — from Moderna and Pfizer — are worth getting.
In truth, so long as the data holds up, any of the five vaccines can save your life.
Last week, Dr. William Schaffner of Vanderbilt University told my colleague Denise Grady about a conversation he had with other experts. During it, they imagined that a close relative had to choose between getting the Johnson & Johnson vaccine now or waiting three weeks to get the Moderna or Pfizer vaccine. “All of us said, ‘Get the one tomorrow,’” Schaffner said. “The virus is bad. You’re risking three more weeks of exposure as opposed to getting protection tomorrow.”
#1143
Posted 2021-February-01, 06:26
#1144
Posted 2021-February-01, 20:55
cherdano, on 2021-February-01, 06:26, said:
Agree about tldr
Here's another link of the trials and status that WHO knows about. There seem to be others.
Do we really need this many
https://www.who.int/...didate-vaccines
#1145
Posted 2021-February-01, 23:27
thepossum, on 2021-February-01, 20:55, said:
Here's another link of the trials and status that WHO knows about. There seem to be others.
Do we really need this many
https://www.who.int/...didate-vaccines
The clearly obvious answer is Yes, we needed that many.
While there was optimism about developing a covid vaccine, there were no guarantees that any one company would be successful. For example, last week, Merck announced they were discontinuing development on 2 vaccine candidates because the results were disappointing. At least of couple of the Chinese vaccines may not even be as effective as the minimum CDC standard of 50% effectiveness, so would be considered failures if that is true. Japan is developing a vaccine but it isn't likely to be available until 2022, if development even continues. I'm sure there are other failures that have not been as well publicized.
Some vaccines may not be approved until much of the world population is already vaccinated, which really matters as the infections are getting out of control world wide. It matters that we have started vaccinating millions of people, even if the situation is still a disaster.
In different scenarios, the handful of vaccines that are currently in emergency use may have been failures, and some other approach may have been the successful one but wasn't taken because somebody decided that we would put our faith in just a handful of candidates. So yes, we needed to explore as many possible vaccines as we did.
#1146
Posted 2021-February-01, 23:30
The 'sacred' purpose is to ensure that a method does what it is meant to do and does no harm.
And, if it does harm, the harm is acceptable ("I heard that the level of political killings in El Salvador is acceptable - My question is Acceptable to whom" JK Galbraith)
But there is another reason that big Pharma do trials. First, they want to put their compound into the hands of 'opinion leaders' - an old fashioned term for social influencers I guess.
These people - who run the trials - then ensure that their colleagues use the compound.
Big Pharma is not a 'virus' it really does like it when its product works. But more important to them is that it sells.
This may be less obvious with a vaccine, but I have no reason to doubt that it still operates.
After the compound is in the community comes the post-marketing surveillance.
As one Professor remarked when I was training - every patient is in a trial.
Good post-marketing surveillance should IMHO be part of the original trial.
Unfortunately, this approach doesn't suit the current paradigm where academics get 'likes/citations' for individual publications.
Science, in general, has failed to keep up with technology.
#1147
Posted 2021-February-03, 00:31
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#1148
Posted 2021-February-05, 10:40
pilowsky, on 2021-January-30, 17:42, said:
Hint: it doesn't involve software...
It's true, they eradicated polio without software to manage the vaccination effort.
But things are different now. The population is much larger, it's an international effort, some of the vaccines require fancier technology to transport and keep.
It's not fair to compare different time periods. You can't say that personal computers and refrigerators are not necessary because they didn't have them in the 19th century.
#1149
Posted 2021-February-05, 15:46
barmar, on 2021-February-05, 10:40, said:
But things are different now. The population is much larger, it's an international effort, some of the vaccines require fancier technology to transport and keep.
It's not fair to compare different time periods. You can't say that personal computers and refrigerators are not necessary because they didn't have them in the 19th century.
Polio existed in the 1800's true. Polio was not brought under control until the 1950's and '60's. There are two vaccines - the injectable one used in America was first and was very effective. I had the oral Sabin vaccine - a pink liquid on a plastic spoon: delicious.
You may have read it, but I recommend Waldrop's book "The Dream Machine; JCR Licklider and the revolution that made computing personal".
I started University in 1976 there were no personal computers.
Neurotrophic viruses are still a problem. I even co-authored a paper about one of them.
#1150
Posted 2021-February-05, 17:09
thepossum, on 2021-February-03, 00:31, said:
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On some level, they all do the same thing: somehow produce copies of the coronavirus spike protein inside your body, so your immune system learns to fight it.
In the case of mRNA vaccines, they just spam cells in your body with the RNA code to produce the spike protein. (This is part of the normal replication process of viruses within the body - hijacking your cells with their RNA to reproduce copies of the original virus.) In the case of AstraZeneca, Sputnik, Johnson & Johnson, they changed the genetic code of another (harmless to humans) virus so that it also includes the coronavirus spike protein. In the case of Novavax, they basically grow lots of spike proteins in their factories, which you then get injected directly.
#1151
Posted 2021-February-05, 19:32
This instantly led to two fears, neither of which is supported by any evidence.
First, people thought that if you were being treated for hypertension with drugs that blocked Angiotensin receptors then this might somehow make COVID19 worse [1]. I think this is the opposite of the truth. If you stop taking effective antihypertensive then you are probably going to be more unwell. Secondly, one of the reasons that America is suffering so badly is that they have an obesity epidemic. There is a close association between obesity, bad lipids, hypertension and diabetes. It is so well-known that it has a name: The metabolic syndrome (or Syndrome X - same thing).
Secondly, people were concerned that because the vaccine acts on something that is part of normal mammalian physiology, there may be a risk of autoimmune problems [2]. This also turns out not to be true.
In summary, get whatever vaccine you can as soon as you can UNLESS you have a specific contraindication - that's why someone will take a brief history from you (or should) when you get it.
Some people can be allergic to the carrier (very very very rare - but bad if you happen to be the one).
As for variance, it depends on the outcome being measured. Even the so-called 'poor vaccines' still markedly reduce viral load thereby decreasing the risk of serious illness. The same is true of 'flu vaccines.
Finally, please do not just believe anything you read on Google or Wikipedia. Even some scientific 'Journals' are bogus, but you have to be in the biz to know which publishers are reputable, and which are not.
1. https://www.ncbi.nlm...les/PMC7296326/
2. https://www.ncbi.nlm...les/PMC7428639/
#1152
Posted 2021-February-07, 13:13
And the Trump supporters still refuse to wear masks.
The devastation from Trump's insistence on denial is moving from incalculable to unimaginable.
We will do what we can, but it would really help if Trump supporters would acknowledge reality.
#1153
Posted 2021-February-07, 13:45
kenberg, on 2021-February-07, 13:13, said:
And the Trump supporters still refuse to wear masks.
The devastation from Trump's insistence on denial is moving from incalculable to unimaginable.
We will do what we can, but it would really help if Trump supporters would acknowledge reality.
The problem with calling them 'Trump' supporters is that although voting for Trump is a characteristic of all of this 'set' of people. It does not explain their bizarre thinking and behaviour.
There is something very 'child-like' about the approach to life in general of these people.
They seem to have only three considerations in any social interaction: me, me and me.
Couple this with a highly-synthesised fatalism - I control nothing I do only by an ephemeral supreme being (God, Q whoever it doesn't really matter) and suddenly you have a Manson family of 76,000,000 people - approximately.
I despair at people that are willing to take everything they hear at face value. The problem for other people in their orbit is that they only choose to believe things that seem to give a positive short-term benefit to themselves.
Everything, to the contrary, is 'wrong'.
I listened to Marjorie Taylor Greens yesterday interacting with a CNN journalist. She spoke the same way as Kayleigh M. Or Donald T. - smug, self-satisfied, arrogant and completely off the point. Even slime mould behaves socially in times of stress. These group of people haven't developed emotionally past the age of 10.
If there is something, they want or need; they will shoot you to get it. Grown-ups do not behave this way.
They are the same as the 'pod people' in 'Night of the living dead', or the 'Stepford wives': they look like people, they use words, they walk on two legs, but something isn't there: http://bit.ly/ZombiesShesNotThere
#1154
Posted 2021-February-07, 15:20
#1155
Posted 2021-February-07, 17:04
If he had encouraged taking the virus seriously his followers, many of them, would have acted more responsibly.
But if course he didn't. He encouraged fantasy. We all know that.
My point is that many of us look to leaders for advice. Unfortunately, that means many looked to Trump.
And now we are approaching a half million deaths and a mutating virus.
I'll argue about Libertarianism some other time.
Here, I am hoping people, more people, will think a bit and decide the obvious.
We are in one hell of a mess and we need all hands on deck to deal with it. I am confident that there are still some people out there who will come around.
Of course, people are responsible for their own mistakes. But Trump could have helped. He hindered. Seriously hindered. History will judge him, harshly no doubt.
But right now, right here, I want to encourage anyone who still can't bring themselves to put on a mask and treat this seriously to think again.
As to Greene, there will always be a nut. But she got elected? Trump said how great she was. So his followers voted for her. It's bizarre, seriously bizarre, but that's what happened. Same with masks.
In speaking with someone who does not see the need to wear a mask, I put it simply "You get to commit suicide, you don't get to take others with you". Some will think about it and change, some won't. But but but, some will. We need to encourage it.
#1156
Posted 2021-February-07, 18:20
kenberg, on 2021-February-07, 17:04, said:
If he had encouraged taking the virus seriously his followers, many of them, would have acted more responsibly.
But if course he didn't. He encouraged fantasy. We all know that.
My point is that many of us look to leaders for advice. Unfortunately, that means many looked to Trump.
And now we are approaching a half million deaths and a mutating virus.
I'll argue about Libertarianism some other time.
Here, I am hoping people, more people, will think a bit and decide the obvious.
We are in one hell of a mess and we need all hands on deck to deal with it. I am confident that there are still some people out there who will come around.
Of course, people are responsible for their own mistakes. But Trump could have helped. He hindered. Seriously hindered. History will judge him, harshly no doubt.
But right now, right here, I want to encourage anyone who still can't bring themselves to put on a mask and treat this seriously to think again.
As to Greene, there will always be a nut. But she got elected? Trump said how great she was. So his followers voted for her. It's bizarre, seriously bizarre, but that's what happened. Same with masks.
In speaking with someone who does not see the need to wear a mask, I put it simply "You get to commit suicide, you don't get to take others with you". Some will think about it and change, some won't. But but but, some will. We need to encourage it.
I agree with everything you are saying. I admit that I cannot comprehend how anyone can become enslaved by a personality - or join a cult.
But at the same time I do not believe the cult of Trump is as big as thought. And because it is not that big, it means that a large number of people who support him do so while holding their noses and pretending he isn't so bad. I'm sure history has had a number of authoritarians who eventually gained power with the same type of supporters.
The problem is that it doesn't take that many to ignore the pandemic to make it almost impossible to overcome. Fauci is now saying that it takes 70-85% vaccinated to reach herd immunity. If 20% refuse, that leaves little room for error among the rest.
Perhaps those who refuse would like the climate on Elba?
#1157
Posted 2021-February-07, 18:51
Instead, what you get is a praecox feeling1 (http://bit.ly/Praecox). It's as though you are talking to someone, they seem to be listening, but they aren't.
I'm sure that you have had students like this. No matter how you try to explain something, they lack the mental agility to pick at it and discover what you are getting at.
Reductio ad absurdum, if all people could store, synthesise and understand everything you told them, Einstein would not have discovered relativity, my grandfather, the trainee Rabbi, would have.
And so would all his mates, but they didn't - as Dr Suess might say.
In that way, Bridge is a synecdoche for life; some people will rapidly grasp all the game's key elements (even the Laws and Rulings) and rapidly become superstars.
Others of us are doomed to be 'bound in shallows and in miseries', which is not good luck, partner.
When you say 'Trump supporters' - we have them in Australia as well - I imagine a group of people that are susceptible to believing in something not because it makes sense, but because they want it to be true so much that it anaesthetises that part of their brain that thinks rationally.
In Good Will Hunting, the maths Professor asks his Social Sciences colleague (after his friend has bought a lottery ticket) what he thinks the chances of winning the million-dollar prize is. "Oh, about one in seven".
There is nothing you can do to convince these people. Everything they say and do is just a bit of fun.
In fact, they probably enjoy the sense of outrage they can see that it provokes as you turn slightly red and say 'but but but..'
What motivates them? They enjoy the life they have, the 'Harm principle' (http://bit.ly/HarmPNAS)2 means about as much to them as the feelings of fish mean to Great White Shark.
Sure they get that it's bad to be eaten, but hey man I'm hungry, I want to open my travel/coffee shop and sell masterpoints to apparently intelligent people (or fish - they don't care).
Well, I think I've mangled that metaphor as much as possible - I'll leave it at that for now.
![Posted Image](https://www.bridgebase.com/forums/public/style_emoticons/default/cool.gif)
1. The praecox feeling concept is undergoing a bit of a rethink in psychiatry, but it is a great shorthand. Review Schizophr Bull. 2019 Sep 11;45(5):966-970. DOI: 10.1093/schbul/sby17
2. I would love to know what the mathematicians make of this paper! Reassessing "Praecox Feeling" in Diagnostic Decision Making in Schizophrenia: A Critical Review. 2017 Jul 10. DOI: 10.1073/pnas.1706693114)
#1158
Posted 2021-February-10, 01:48
cherdano, on 2021-February-05, 17:09, said:
In the case of mRNA vaccines, they just spam cells in your body with the RNA code to produce the spike protein. (This is part of the normal replication process of viruses within the body - hijacking your cells with their RNA to reproduce copies of the original virus.) In the case of AstraZeneca, Sputnik, Johnson & Johnson, they changed the genetic code of another (harmless to humans) virus so that it also includes the coronavirus spike protein. In the case of Novavax, they basically grow lots of spike proteins in their factories, which you then get injected directly.
Thx Cherdano. Was wondering if it was just a variant on the "all psychotherapies are about as effective as each other" thing
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Some of us out here like variance. Its gives us a bit more trust
![:)](https://www.bridgebase.com/forums/public/style_emoticons/default/smile.gif)
Some of us also like outliers, extremes, strange distributions, despite so many being taught they have to delete those annoying things
If anyone asked me what concerns me most about people's understanding of statistics it would be lack of understanding of the Central Limit Theorem
But something of even more concern is the possible impact of the dollar over peoples approach to analysis
E
#1159
Posted 2021-February-10, 03:50
Winstonm, on 2021-February-07, 18:20, said:
The problem is that it doesn't take that many to ignore the pandemic to make it almost impossible to overcome. Fauci is now saying that it takes 70-85% vaccinated to reach herd immunity. If 20% refuse, that leaves little room for error among the rest.
About 25% of the population is under 18, and there isn't emergency use for <18 Moderna, and <16 for Pfizer. No telling when the vaccines will be ok'd for minors. So the margin of error to get to herd immunity is very small indeed.
Over 30 percent of Americans say they won't get COVID-19 vaccine: poll
Quote
The poll found that people ages 30-44, Republican voters and people without college degrees were among the most likely to say that they “definitely will not” get a COVID-19 vaccine when one becomes available to them.
#1160
Posted 2021-February-11, 17:28
It turns out that Jimmy Page wanted to be a biologist and study germs.
But he got distracted, which is a shame.
http://bit.ly/JimmyPageGerms
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