Archive for the ‘Science’ Category

The False Choice between Lockdowns and Nothing

Wednesday, June 10th, 2020

Much of the conversation in the U.S. has been about the effectiveness of lockdowns, as opposed to doing nothing, to stop COVID-19. I was pleased to see Jennifer Nuzzo remark,”Though I think Sweden’s high case fatality is worrisome, I don’t think the lesson is that total lockdowns are the way to go. Other countries successfully avoided major lockdowns through targeted public health measures—testing, tracing and isolation.”

COVID-19: Italy Versus the U.S.

Wednesday, June 10th, 2020

Max Roser of Our World in Data writes, “There was no difference in the speed of the outbreak between Italy and the U.S. The difference—which is leading to the rapidly rising death toll in the US—is that European countries achieved a much faster decline of the outbreak.” He shows a chart showing a much steeper decline in daily cases per million in Italy versus the United States.

COVID-19 Trouble in Arizona

Wednesday, June 10th, 2020

COVID-19 hospitalizations are going down in Colorado. Arizona, on the other hand, seems to be having trouble. Reported cases are up. More tellingly: “Hospitalizations have steadily risen. Statewide hospitalizations as of Sunday were at 1,266 inpatients in Arizona with suspected and confirmed COVID-19, which was the second highest number, behind Friday, since the state began reporting the data on April 9. The past eight days have seen inpatient hospitalizations statewide for suspected and confirmed COVID-19 eclipse 1,000. The percentage of positive tests per week increased from 5% a month ago to 6% three weeks ago to 9% two weeks ago, and 12% last week.” That’s really bad. By contrast, the positivity numbers in Colorado are under 3%, and new reported cases are somewhat down.

Cases in Utah also are on the rise. Texas, Florida, and California also are having trouble.

Trouble in Belgium

Wednesday, June 10th, 2020

I was looking at Our World in Data’s chart on total COVID-19 deaths per million, by nation, and at first I thought the UK was highest with 602. By contrast, the U.S. has 338, Brazil has 181, and New Zealand has 5. But then someone pointed out that Belgium, a country of 12 million people, has 830 deaths per million. So what’s going on there? A May 17 Washington Post article points out that other countries may be undercounting their deaths. Moreover: “One explanation, he [health official Steven Van Gucht] said, might be Belgium’s relative population density in comparison to its neighbors: the Brussels airport, an international transportation hub, might have helped seed the disease in the crowded capital region. And many Belgians were on skiing vacations in northern Italy during national school vacations in late February.” And: “Belgium’s nursing homes account for more than half of its deaths, partly because older Belgians are more likely than their counterparts in other European countries to live in elder-care housing.”

Masks Work

Wednesday, June 10th, 2020

Lyman Stone reviews data from the USS Theodore Roosevelt and concludes, “Masks work. What’s amazing here is that this is individual protection, not community-based protection: prior studies suggested masks were NOT very good for individual protection. . . . By the way, that serology studies turned up an 80% attack rate among non-mask-wearers suggests that herd immunity probably won’t occur . . . until 80%. . . . That masks worked as well as they did in a contained environment with tons of unavoidable close contact is pretty remarkable. I would have bet against masks doing much in this scenario.” Of course, my guess is that people in the military have good masks and good discipline in wearing them. From what I’ve seen, many people in the general public have neither.

A study (lead Timo Mitze) that looks at Germany finds that “face masks reduce the daily growth rate of reported infections by around 40%.”

Mainstream Pseudoscience

Wednesday, June 10th, 2020

Thiago Arzua runs down some of the history of phrenology and eugenics. Today it’s hard to believe, but, as Timothée Poisot notes, phrenology once was “mainstream science.” Mainstream pseudoscience, more accurately. The important thing to bear is mind is that many people believed this nonsense. Many people find it extremely easy to fall into biased and prejudicial thinking.

Asymptomatic Versus Presymptomatic

Wednesday, June 10th, 2020

The World Health Organization recently has caused a lot of consternation by claiming that “asymptomatic” people rarely spread the coronavirus. Carl Bergstrom explains: “Much of the problem is that ‘asymptomatic patients’ sounds like it refers to anyone without symptoms. It doesn’t. It’s epidemiology jargon for a patient who never will develop symptoms, in contrast with ‘pre-symptomatic patients’ who don’t have symptoms yet but will shortly.” Obviously this can only be determined after the fact. The relevant questions are, of those with an infection, how many will spread it to others, when will they spread it, how many will develop serious noticeable symptoms, and how many will develop serious symptoms.

Bergstrom on Virulence Changes

Tuesday, June 9th, 2020

Matt Ridley suggests that perhaps lockdowns prevent SARS-CoV-2 from evolving into a less virulent form. Carl Bergstrom is skeptical. He points out that various pathogens remain quite destructive. And the myxoma virus in rabbits became less virulent but then more so. He summarizes, “Virulence evolution is not a simple, predictable, one-way trajectory.” He adds, “The really bad things that COVID-19 does to people happen (1) only in a small subset of people and (2) after most or all of the transmission has already taken place.” His thread offers much more detail.

Little Asymptomatic Spread?

Monday, June 8th, 2020

“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual,” said Dr. Maria Van Kerkhove of the World Health Organization. Could it be that we don’t really need all that much testing and tracing but should just diligently tell people with any symptoms to self-isolate?

Not so fast. James Surowiecki warns, “This was yet another example of terrible communication by the WHO. By ‘asymptomatic,’ she meant only people who get the virus but never develop symptoms, not people who are pre-symptomatic. They still commonly transmit the virus without having any symptoms.” Andy Slavitt also has strong concerns. So does Natalie Dean.

Swab Tests Pick Up Inactive Virus

Monday, June 8th, 2020

A hospital prevented a woman from holding or nursing her baby for two months, because the woman tested positive for coronavirus. Keeping a newborn from its mother imposes extraordinary harm. “There’s concern that such tests are being misinterpreted to suggest people are infectious when they probably are not,” writes Helen Branswell. Look, just because we’re in a pandemic, doesn’t mean we should throw common sense overboard.

Lockdowns for Thee but Not for Me

Monday, June 8th, 2020

Tyler Cowen worries about health experts who supported the lockdowns and also the protests. Discussing one such party, Cowen writes, “My worries run deep. Should the original lockdown recommendations have been asterisked with a ‘this is my lesser, non-citizen self speaking’ disclaimer? Should those who broke the earlier lockdowns, to save their jobs or visit their relatives, or go to their churches, or they wanted to see their dying grandma but couldn’t . . . have been able to cite their role as ‘citizens’ as good reason for opposing the recommendations of the ‘scientists’? Does the author have much scientific expertise in how likely these protests are to prove successful? Does typing the word ‘c-i-t-i-z-e-n’ relieve one of the burden of estimating how much public health credibility will be lost if/when we are told that another lockdown is needed to forestall a really quite possible second wave? Does the author have a deep understanding of the actual literature on the ‘science/citizen’ distinction, value freedom in science, the normative role of the advisor, and so on?”

As I have noted, various health experts have indeed voiced concerns about the protests spreading SARS-CoV-2. Still, Cowen has a point.

Related: Dan Diamond writes, “For months, public health experts have urged Americans to take every precaution to stop the spread of Covid-19—stay at home, steer clear of friends and extended family, and absolutely avoid large gatherings. Now some of those experts are broadcasting a new message: It’s time to get out of the house and join the mass protests against racism.”

I’m going to watch the numbers closely. If it turns out that the protests don’t lead to a disease spike, I’m going to totally stop worrying about outdoor activities. If there is a spike, I’ll maintain stricter distancing.

COVID-19 Updates

Sunday, June 7th, 2020

Ed Yong writes, “COVID-19 can last for several months. The disease’s ‘long-haulers’ have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends.” Around 80% of infections are asymptomatic, and most of the rest involve recovery in around two weeks, but at least “thousands” of people have sustained problems, Yong writes.

Scott Gottlieb writes, “The Houston, Texas region shows continued Covid spread and rising hospitalization rates.”

Men, especially balding men, may be at greater risk of hospitalization, due to hormones.

Max Roser writes, “I think we are still in the early days of the pandemic and why I’m very pessimistic about the coming months. The number of daily new cases is rising continuously in many large countries,” even as testing remains inadequate. “These countries – like many others – see confirmed cases rise despite being in lockdowns. Lockdowns are very costly, socially and economically, and cannot remain for a very long time; especially in poor countries.”

The number of coronavirus cases tied to meatpacking plants has [topped] 20,400 infections across 216 plants in 33 states.”

Jacob Sullum: “Lockdown Supporters Embraced Wildly Wrong COVID-19 Projections That Fit Their Preconceptions.” I think the basic problem is looking at these models as predictions rather than as simulations. In brief, the models assume that, if people do not independently take mitigating actions, then such and such will happen. Of course the “if” conditional fails.

Viral load data from Germany has been reanalysed, and continues to suggest no meaningful difference between the viral load of children and adults.”

Australia: “We didn’t realise how effective we could be. We’ve actually crushed the curve and now we talking about potentially eliminating the disease locally.” See the write-up by Jill Margo.

Scott Gottlieb: “The expectation should be that this is going to be a seasonal vaccine. You’re going to need this shot regularly, and maybe annually.” The fear is that immunity won’t last very long.

A recent article from the Lancet (lead Nicholas G. Davies) finds that “only lockdown periods were sufficient to bring R0 near or below 1″ in the UK and that “intensive interventions with lockdown periods would need to be in place for a large proportion of the coming year to prevent health-care demand exceeding availability.” But I smell a lot of “if” coming off of these models. One issue is that the study pits lockdowns against “physical distancing,” but the entire point of a lockdown is to achieve greater physical distancing. Thus, the study has to be making some background assumptions here about voluntary versus coerced levels of physical distancing that I doubt reflect reality. Anyway, to me the study entirely misses the point, which is to figure out how to implement a sufficiently robust hygiene-test-trace-isolate capacity to facilitate social interactions while keeping the disease at low levels of spread.

Health Experts Debate Protests during a Pandemic

Sunday, June 7th, 2020

Carl Bergstrom writes, “Many people have asked me whether the ongoing Black Lives Matter protests around the country pose a risk of increasing coronavirus spread. As a scientist, I acknowledge that they may. As a citizen, I wholeheartedly support the protests nonetheless.” He worries that police use of tear gas “exacerbate matters substantially.” He adds, “Especially in areas without aggressive police responses, I do not expect a greater burst of COVID transmission due to protest than due to reopening activity.”

Eric Feigl-Ding writes, “I’m nervous about such big rallies during pandemic. . . . Definitely wear masks, but they are not fool proof. But I’ve [been] incredibly torn. BLM is an important movement to support.” He worries that U.S. cases have been increasing. He continues, “As public health scientists, we would lose the moral high ground of science if we conveniently dismiss dangers of these high human density & high vocal shouting in these rallies, all while previously telling people you can’t see your family on their death beds or funerals.”

Tom Frieden writes, “Some very large, densely packed crowds at protests yesterday. Although outdoors WAY less risky than indoors, and although the vast majority of people protesting wore masks, crowding and large numbers increase risk of spread.”

Trevor Bedfor writes, “There is no doubt that mass gatherings facilitate transmission. This study investigates seroprevalence in Gangelt, Germany, finding a 2.5X increase in rate of infection of those attending carnival celebrations. . . . Wearing masks and protesting outdoors has to help, but shouting, tear gas, pepper spray and closely packed jails will increase transmission potential.”

Jonah Goldberg refers to “the treason of epidemiologists,” which is rather much, and which doesn’t account for various relevant views.

Meanwhile, let’s remember Bill de Blasio’s April 28 Tweet: “My message to the Jewish community, and all communities, is this simple: the time for warnings has passed. I have instructed the NYPD to proceed immediately to summons or even arrest those who gather in large groups. This is about stopping this disease and saving lives. Period.” The “period” has been changed to a “comma, but.”

COVID-19 Care Improving

Saturday, June 6th, 2020

The novel coronavirus has become less lethal over the past few months. . . . Treatments have improved enormously as scientists have learned more.”

Colorado: “Nearly 1,000 Coronavirus Patients Have Been Treated With Plasma.”

COVID-19 Background

Saturday, June 6th, 2020

For those who haven’t seen it, I’ve written extensive notes about COVID-19 in three parts: March 24 to April 27, April 28 to March 22, and May 23 to June 4. One issue I discuss extensively is the debate over lockdowns. (In brief: I think they did increase social distancing and hence slow the spread of the disease, but not by nearly as much as many assume.)

Ridley on COVID-19

Saturday, June 6th, 2020

Matt Ridley is hopeful that the recent protests will not much spread COVID-19, because the events are outdoors and largely involve younger people. He also thinks that maybe a large fraction of people are basically invulnerable to the disease, which implies a population could reach “natural” herd immunity at a much lower level of infection than commonly assumed.

Gates COVID Conspiracy Theories

Friday, June 5th, 2020

Elan Journo talks about COVID-19 conspiracy theories about Bill Gates. Laura Ingraham pushed one such theory.

The New York Times discusses how Gates “has been attacked with falsehoods that he created the coronavirus and wants to profit from it.

Child and Romantic Attachments

Friday, June 5th, 2020

Nicole Barbaro argues that child attachment and romantic attachment are evolutionarily distinct phenomenon. But I’d be surprised if there weren’t some ultimate commonality.

COVID-19 and the George Floyd Protests

Friday, June 5th, 2020

KPCW: “Tear-Gassing Protesters During An Infectious Outbreak Called ‘A Recipe For Disaster.'” Amesh Adalja said, “If [protesters are] coughing, the particles actually emanate and are projectiles that travel about six feet or so and could land on other people. This is a way to almost induce the virus to be expelled from people when they are exposed to these agents.”