Category: Coronapanic

From April 6, Best guess as to when the first successful COVID-19 therapy will be widely available?

Keeping in mind that it took months for coronavirus tests to be invented, approved, and manufactured (still not in sufficient quantities except for those who are hospitalized), what’s your best guess as to when you can go into the hospital ED, have the nurse shout out “COVID-19” and then an assistant comes in with some pills or a shot that will keep the symptoms down to some reasonable level of misery?

My guess: between July 2020 and March 2021, with October 2020 as the best single month guess.

How do we rate this prediction? I’m going to go with “Spectacularly wrong.” I started the April 6 post with “I’m a big believer that viruses are smarter than human beings.” Even with that, I was gulled into thinking that all of the world’s humans devoting nearly 100 percent of their energy to fighting coronavirus would actually be able to come up with something.

What do we have? From October 22, “FDA Approves First Treatment for COVID-19”:

Today, the U.S. Food and Drug Administration approved the antiviral drug Veklury (remdesivir) for use in adult and pediatric patients 12 years of age and older and weighing at least 40 kilograms (about 88 pounds) for the treatment of COVID-19 requiring hospitalization. Veklury should only be administered in a hospital or in a healthcare setting capable of providing acute care comparable to inpatient hospital care. Veklury is the first treatment for COVID-19 to receive FDA approval.

Mission Accomplished?

A second randomized, open-label multi-center clinical trial of hospitalized adult subjects with moderate COVID-19 compared treatment with Veklury for five days (n=191) and treatment with Veklury for 10 days (n=193) with standard of care (n=200). Researchers evaluated the clinical status of subjects on Day 11. Overall, the odds of a subject’s COVID-19 symptoms improving were statistically significantly higher in the five-day Veklury group at Day 11 when compared to those receiving only standard of care. The odds of improvement with the 10-day treatment group when compared to those receiving only standard of care were numerically favorable, but not statistically significantly different.

In other words, you need multiple studies and a Zoom session full of statisticians to tease out any useful effect.

Does GB get the prize for accuracy so far? His comment:

Some of the fat and lung comprised will die and the rest will be cured, by virtue of not already being unhealthy. Medical cure, nope, modern medicine ain’t that good.

Who wants to make a new or revised prediction of when medicine will simply cure us of Covid-19?

Related:

• A typical failure… “Lilly Statement Regarding NIH’s ACTIV-3 Clinical Trial” (October 26): Based on an updated dataset from the trial reviewed on October 26, no additional COVID-19 patients in this hospitalized setting will receive bamlanivimab. This recommendation was based on trial data suggesting that bamlanivimab is unlikely to help hospitalized COVID-19 patients recover from this advanced stage of their disease. In this updated dataset, differences in safety outcomes between the groups were not significant.

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From mass.gov, “Halloween During COVID-19” (“Consistent with the Halloween activity guidance released by the Centers for Disease Control and Prevention”). First some Dos:

• A costume mask is not a substitute for a face mask or face covering. To protect yourself and others, ensure you are wearing a protective face mask or covering instead of or in addition to a costume mask. [A bandana is legal and effective PPE against coronavirus, but a Batman mask is not?]
• Hold virtual costume contests or pumpkin carving events.

Now the Don’ts:

• Attending crowded costume parties held indoors, or any gatherings that exceed indoor or outdoor gathering limits;
• Going to an indoor haunted house where people may be crowded together and screaming; and
• Going on hayrides or tractor rides with people who are not in your household.

Related:

• Ivy League debate over Halloween costumes

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A Russian IFR student told me that his parents back in Moscow are participating in a Phase 3 trial of a COVID-19 vaccine. I responded that I was informed by the U.S. media that this vaccine development had been rushed, that it was likely extremely dangerous, and that Americans would expect the Russians to be testing this on condemned criminals. How did his parents end up as guinea pigs?

“My dad is the CEO of a big industrial company,” he responded. “And found out that all of the top politicians were getting it. So he managed to get himself and my mom into the trial.”

How about masks? “My parents complain that nobody is wearing them. They’re compulsory in the metro, though, and also disposable gloves. But the gloves are provided.”

(Separately, we did an IFR training trip to Washington, D.C. He and his (Russian) wife walked around the White House and Mall, their first time in the Nation’s Capital. What did they think? “I was amazed at how many police with military weapons there are,” he responded. “Even the Kremlin is not that intensively guarded.” I wonder if the $64 million White House fence is done!)

From a 2017 trip to Moscow:

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It isn’t obvious why rich white Americans should have become Mask Karens. All through the first half of 2020, the World Health Organization told humans that masks for the general public wouldn’t save them from a respiratory virus (archive.org). Looking at infection and hospitalization rates versus mask law dates does not suggest a strong and reliable effect. Some charts:

A friend who is a professor of cognitive science:

It’s the usual causality problem with epidemiology. Upper middle class Northeasterners (like me) are adamant about mask wearing, and they rarely get sick. So it must be working.

In other words, “Coastal Elite” (at home on Zoom) and “Essential Critical Infrastructure Worker” (exposed to dozens or hundreds of strangers each day) seldom overlap. (See also infection/death rates versus race.)

Professor Karen didn’t think that a mistaken belief regarding the efficacy of masks was bad because it would help Biden/Harris defeat Donald Trump. It turns out that a guy whose salary has depended on government funding for four decades is a passionate supporter of the political party that promises to expand government…

A few mask papers:

• Ahmad, et al (2001). “The Effect of Wearing the Veil by Saudi Ladies on the Occurrence of Respiratory Diseases.” Journal of Asthma, 38(5), 423–426. doi:10.1081/jas-100001497: The most interesting finding in this paper is that wearing the veil is more associated with asthma and the common cold. This is probably related to the means of transmission of respiratory tract infections, with the veil being so close to the face leading to a wet area in front of the mouth and nose that facilitates the growth of microorganisms
• “Unmasking the surgeons: the evidence base behind the use of facemasks in surgery” (JRSM, 2015): there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination. … Masks are a quintessential part of the surgical attire that has become so deeply ingrained in the public perception of the profession. However, even today, it remains unclear as to whether they confer any tangible benefits to surgical outcomes.

Related (things that Americans aren’t doing because they believe that masks will, in fact, stop the plague):

• Plague-proof Florida and Texas with shaded outdoor classrooms?
• Build downdraft paint booths for K-12 schools?
• Train Americans to use masks the way that surgeons do or restructure the physical environment?

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“Chris Christie says he ‘was wrong’ not to wear face mask at White House” (The Hill):

Former New Jersey Gov. Chris Christie (R) said Thursday that he “was wrong” not to wear a face mask at the White House after testing positive for COVID-19 and spending a week in the hospital.

Christie told The New York Times that he thought he was in a “safe zone” when he attended the Sept. 26 event where President Trump officially nominated Judge Amy Coney Barrett to the Supreme Court. Days later on Oct. 1, President Trump announced he and the first lady had tested positive for COVID-19.

The former governor announced his positive test on Oct. 3 and checked into the hospital after his doctor recommended he do so due to his asthma and weight. He spent days in the intensive care unit of Morristown Medical Center in New Jersey.

I wonder if this is a good illustration of the destructive power of faith in masks. A morbidly obese guy such as Chris Christie should be hiding in a bunker, not relying on a 2-cent surgical mask to keep coronavirus from finding its perfect host (his corpulence). Other than having gotten sick after not wearing a mask, what has Christie learned that would contradict this chart example:

Do we really want other morbidly obese guys pushing 60 to put their faith in masks because Christie thinks he would have had a different outcome if he’d used a bandana or similar for PPE?

Related:

• Train Americans to use masks the way that surgeons do or restructure the physical environment? (every day we put our faith in masks is a day that we don’t reconfigure our world and our lives to be Covid-19-resistant)
• “Spain imposes state of emergency on Madrid” (BBC, October 9): after months of universal masking… a raging plague.

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A Boston friend who is about 60 years old recently shared that the 50+ shutdown orders from the Maskachusetts governor had resulted in the loss of her fitness habits, a cessation in her gym visits, a substantial weight gain, and a general feeling of poor health. The shutdown that protected her from Covid-19, in other words, has rendered her far more vulnerable to Covid-19 than she ever was previously (see “Extra Pounds May Raise Risk of Severe Covid-19” (NYT, October 10, filed under “belaboring the obvious”).

Had this weakened her faith in the Church of Shutdown and made her think that we can’t prevent deaths, but only shift them from the elderly to the non-elderly? (see “The COVID-19 shutdown will cost Americans millions of years of life” for a partial calculation of how Americans will die prematurely over the coming years)

No!

She still believed in the religion for herself and others. I related to her the complaint of a 35-year-old helicopter instrument student that the shutdown was orchestrated by married people home in their big houses with their kids. “What about people like me,” he asked, “who still want to find someone to have children with? My social and dating lives were destroyed by the lockdown. Then, just as soon as things started to open a bit, I had to work 15 extra hours per week and go on the night shift because so many guys were home collecting their $600 per week and wouldn’t come back.” (I refrained from sharing that he might want to consider moving away from the jurisdiction of Massachusetts family law if his goal is to have children and remain part of their lives after the mom decided she needs to have sex with some new friends while hanging onto his paycheck.) Her response was simply to deny that the 35-year-old had suffered a loss. She imagined herself better situated to evaluate the impact of the shutdown on his life than he himself was.

She has some opportunities to observe high-school and college-age residents of the Boston area. As far as she can tell, they are not heeding directives to maintain social distance, wear masks when together, etc. As long as there is this substantial segment of the population ignoring most of the orders, doesn’t that mean that the plague will eventually spread widely, even if the orders could have worked in a more efficient police state? Apparently not!

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