Covid-19 News

Quote from THHuxleynew

The continued spread of SARS-CoV-2 is a practical demonstration of what happens when science denial supplants evidence-based decision-making at multiple levels of government, from mask mandates to reopening schools mid-pandemic. Denial has led to needless deaths and suffering.

Here we fully agree. The total denial of Ivermectin evidence among 1'000'000'000 Indian's that now are free from CoV-19 is outraging. Pro vaxx terror is denying evidence and science that shows that a RNA gen therapy just produces antibodies and a mediocre immune memory and suddenly wanes after 6 months.

RNA gen therapy is only a first AID solution for people at risk. It is dangerous for healthy people age < 65. See also the newest compilation of swprs: https://swprs.org/the-latest-o…d-vaccine-adverse-events/

Quote from THHuxleynew

I am not telling you that you are wrong over what you have said there (though if you explained precisely your reasoning I might view it is wrong - I don't know. Certainly you have not supported it with evidence here). All i know is that you view COVID R value as influenced by weather - where we agree. But I suspect you rate that influence higher than I would. Still, that is a reasonable debate.

I am saying that W's and RBs ecological comparisons about India and UP as proving ivermectin works are rubbish. Provably so. I've just done that. I've corrected them, in detail, many times. They go on posting the same false numbers, saying this proves ivermectin is an effective treatment (or sometimes prophylactic - the above posts are about low IFR and hence a claim it is a good treatment) and ignoring the refutations which are as clear as your nose.

If you don't see that, after reading the above posts, you could try to explain why. Otherwise I'll view you as posting dishonest rhetoric that you know is false when you back them. You may have a whole load of other ideas I disagree with - I don't see that as dishonest and would never normally accuse anyone of that. But, over this one issue, because it is so clear, RB and W have continued to argue it, and it has been comprehensively refuted. Yes, persisting with it without addressing the refutation is dishonest.

Dishonest rhetoric? FU!!!!!

On ecological studies (I'm tired of always saying the same thing myself - so will let David Gorski do it this time):

Ivermectin is the new hydroxychloroquine, take 5: The Nobel Prize gambit

As regular readers know, I was on vacation last week. In my absence, guest blogger Dr. William Paolo provided an excellent fourth installment for our…

sciencebasedmedicine.org

Lastly, the authors cite data from Peru:

The clinical experience of IVM treatments of COVID-19 in 25 countries extends far beyond the RCT results summarized, yet incomplete tracking and lack of control data exclude most of this for evaluation. The record of nationally authorized such treatments in Peru provides a notable exception [42]. In ten states of Peru, mass IVM treatments of COVID-19 were conducted through a broadside, army-led effort, Mega-Operación Tayta (MOT), that began on different dates in each state. In these MOT states, excess deaths dropped sharply over 30 days from peak deaths by a mean of 74%, in close time conjunction with MOT start date (Figure 1B). In 14 states of Peru having locally administered IVM distributions, the mean reduction in excess deaths over 30 days from peak deaths was 53%, while in Lima, which had minimal IVM distributions during the first wave of the pandemic due to restrictive government policies there, the corresponding 30-day decrease in excess deaths was 25%.
Reductions in excess deaths by state (absolute values) correlated with extent of IVM distribution (maximal-MOT states, moderate-local distributions, and minimal-Lima) with Kendall τb = 0.524, p<0.002, as shown in Figure 1C. Nationwide, excess deaths decreased 14-fold over four months through December 1, 2020. After a restrictive IVM treatment policy was enacted under a new Peruvian president who took office on November 17, however, deaths increased 13-fold over the two months following December 1, through February 1, 2021 (Figure 1A).

Does this sound familiar? It’s the same sort of ecological “analysis” that an astroturf group was doing for hydroxychloroquine last year that I discussed. The methods of this study are equally awful, which is probably why this article, too, is only on a preprint server thus far, and guess what? It’s a study whose first author is David Scheim, a man with no discernable expertise in the sort of complex epidemiology that would be required to make sense of the Peruvian data, while the other author is Juan Chamie of—you guessed it!—the FLCCC. I’ll say about this study the same thing that I said about the HCQ astroturf site: This is all utter rubbish, methods, conclusion, and all, as you will see. It’s so bad that it reminds me of a study by two antivaxxers without any qualifications in epidemiology, Neil Z. Miller and Gary S. Goldman, that tried—and failed—to correlate the number of vaccines in the recommended vaccine schedules of various countries with those countries’ infant mortality rates.

Seriously, this is some really bad stuff. Let’s just put it this way. Ecological studies of the use of a drug are pretty much worthless because it’s impossible to control adequately for other potentially confounding factors or, in the case of a pandemic, the unexpected resurgence of a virus due to new variants, such as what we are seeing in the US due to the delta variant. But COVID-19 cranks do love their “real world evidence,” don’t they?

It is ironic that the bad statistics traditionally used by dishonest big pharma to persuade people there is some merit in dubious drugs are being used in these ecological studies to promote anti-big-pharma ivermectin.

The p-value fallacy.

Simplified: if you take random numbers and test 100 different hypotheses you will typically find 5 or so of them show, on the random data, a statistically significant effect (less than 5% by chance).

Drug companies generate positive tests by running a randomised double-blind trial with a small number of patients, testing 20 different independent and fairly random things, and highlighting the ones that have statistically significant correlations with the drug. Except that p-values cannot be used that way - you have to find the result statistically significant over the null hypothesis, which is that none of the 20 different things show an individual 5% or less likelihood given chance. Used like this, correctly, the fake evidence is not sen as evidence. But it is a mistake very often made to ignore the need for a null hypothesis and take p-value 0.05 or less as proof of causation.

That is obviously wrong. It is often misunderstood and leads to false attribution of causation to correlations. In the case of ecological comparisons such as the ones in Peru there are 100s of different comparisons over different cities, nations, time periods that could be made. Choosing one where ivermectin distribution or not correlates with better or worse COVID infection is child's play.

That is why Gorski is so dismissive of the argument. You could look at his detailed refutation linked above) I have not done that and wonder is it the same as mine - or different. Anyway mine is correct as common sense will tell you. You can find lots and lots of neat example of you look for popular explanations of p-value fallacy.

THH

A Litany of Problems With p-values | Statistical Thinking

With the many problems that p-values have, and the temptation to "bless" research when the p-value falls below an arbitrary threshold such as 0.05 or 0.005,…

www.fharrell.com

Here is someone who does not like using p-value arguments for anything (he is a Bayesian). But, even if you like p-value testing, which is valid if used correctly, you can check down the list here to see various ways it might go wrong and avoid them.

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In my opinion, null hypothesis testing and p-values have done significant harm to science. The purpose of this note is to catalog the many problems caused by p-values. As readers post new problems in their comments, more will be incorporated into the list, so this is a work in progress.

The American Statistical Association has done a great service by issuing its Statement on Statistical Significance and P-values. Now it’s time to act. To create the needed motivation to change, we need to fully describe the depth of the problem.

It is important to note that no statistical paradigm is perfect. Statisticians should choose paradigms that solve the greatest number of real problems and have the fewest number of faults. This is why I believe that the Bayesian and likelihood paradigms should replace frequentist inference.

Consider an assertion such as “the coin is fair”, “treatment A yields the same blood pressure as treatment B”, “B yields lower blood pressure than A”, or “B lowers blood pressure at least 5mmHg before A.” Consider also a compound assertion such as “A lowers blood pressure by at least 3mmHg and does not raise the risk of stroke.”

A. Problems With Conditioning

1. p-values condition on what is unknown (the assertion of interest; H~0~) and do not condition on what is known (the data).
2. This conditioning does not respect the flow of time and information; p-values are backward probabilities.

B. Indirectness

1. Because of A above, p-values provide only indirect evidence and are problematic as evidence metrics. They are sometimes monotonically related to the evidence (e.g., when the prior distribution is flat) we need but are not properly calibrated for decision making.
2. p-values are used to bring indirect evidence against an assertion but cannot bring evidence in favor of the assertion.
3. As detailed here, the idea of proof by contradiction is a stretch when working with probabilities, so trying to quantify evidence for an assertion by bringing evidence against its complement is on shaky ground.
4. Because of A, p-values are difficult to interpret and very few non-statisticians get it right. The best article on misinterpretations I’ve found is here.

C. Problem Defining the Event Whose Probability is Computed

1. In the continuous data case, the probability of getting a result as extreme as that observed with our sample is zero, so the p-value is the probability of getting a result more extreme than that observed. Is this the correct point of reference?
2. How does more extreme get defined if there are sequential analyses and multiple endpoints or subgroups? For sequential analyses do we consider planned analyses are analyses intended to be run even if they were not?

D. Problems Actually Computing p-values

1. In some discrete data cases, e.g., comparing two proportions, there is tremendous disagreement among statisticians about how p-values should be calculated. In a famous 2x2 table from an ECMO adaptive clinical trial, 13 p-values have been computed from the same data, ranging from 0.001 to 1.0. And many statisticians do not realize that Fisher’s so-called “exact” test is not very accurate in many cases.
2. Outside of binomial, exponential, and normal (with equal variance) and a few other cases, p-values are actually very difficult to compute exactly, and many p-values computed by statisticians are of unknown accuracy (e.g., in logistic regression and mixed effects models). The more non-quadratic the log likelihood function the more problematic this becomes in many cases.
3. One can compute (sometimes requiring simulation) the type-I error of many multi-stage procedures, but actually computing a p-value that can be taken out of context can be quite difficult and sometimes impossible. One example: one can control the false discovery probability (incorrectly usually referred to as a rate), and ad hoc modifications of nominal p-values have been proposed, but these are not necessarily in line with the real definition of a p-value.

E. The Multiplicity Mess

1. Frequentist statistics does not have a recipe or blueprint leading to a unique solution for multiplicity problems, so when many p-values are computed, the way they are penalized for multiple comparisons results in endless arguments. A Bonferroni multiplicity adjustment is consistent with a Bayesian prior distribution specifying that the probability that all null hypotheses are true is a constant no matter how many hypotheses are tested. By contrast, Bayesian inference reflects the facts that P(A ∪ B) ≥ max(P(A), P(B)) and P(A ∩ B) ≤ min(P(A), P(B)) when A and B are assertions about a true effect.
2. There remains controversy over the choice of 1-tailed vs. 2-tailed tests. The 2-tailed test can be thought of as a multiplicity penalty for being potentially excited about either a positive effect or a negative effect of a treatment. But few researchers want to bring evidence that a treatment harms patients; a pharmaceutical company would not seek a licensing claim of harm. So when one computes the probability of obtaining an effect larger than that observed if there is no true effect, why do we too often ignore the sign of the effect and compute the (2-tailed) p-value?
3. Because it is a very difficult problem to compute p-values when the assertion is compound, researchers using frequentist methods do not attempt to provide simultaneous evidence regarding such assertions and instead rely on ad hoc multiplicity adjustments.
4. Because of A1, statistical testing with multiple looks at the data, e.g., in sequential data monitoring, is ad hoc and complex. Scientific flexibility is discouraged. The p-value for an early data look must be adjusted for future looks. The p-value at the final data look must be adjusted for the earlier inconsequential looks. Unblinded sample size re-estimation is another case in point. If the sample size is expanded to gain more information, there is a multiplicity problem and some of the methods commonly used to analyze the final data effectively discount the first wave of subjects. How can that make any scientific sense?
5. Most practitioners of frequentist inference do not understand that multiplicity comes from chances you give data to be extreme, not from chances you give true effects to be present.

F. Problems With Non-Trivial Hypotheses

1. It is difficult to test non-point hypotheses such as “drug A is similar to drug B”.
2. There is no straightforward way to test compound hypotheses coming from logical unions and intersections.

G. Inability to Incorporate Context and Other Information

1. Because extraordinary claims require extraordinary evidence, there is a serious problem with the p-value’s inability to incorporate context or prior evidence. A Bayesian analysis of the existence of ESP would no doubt start with a very skeptical prior that would require extraordinary data to overcome, but the bar for getting a “significant” p-value is fairly low. Frequentist inference has a greater risk for getting the direction of an effect wrong (see here for more).
2. p-values are unable to incorporate outside evidence. As a converse to 1, strong prior beliefs are unable to be handled by p-values, and in some cases the results in a lack of progress. Nate Silver in The Signal and the Noise beautifully details how the conclusion that cigarette smoking causes lung cancer was greatly delayed (with a large negative effect on public health) because scientists (especially Fisher) were caught up in the frequentist way of thinking, dictating that only randomized trial data would yield a valid p-value for testing cause and effect. A Bayesian prior that was very strongly against the belief that smoking was causal is obliterated by the incredibly strong observational data. Only by incorporating prior skepticism could one make a strong conclusion with non-randomized data in the smoking-lung cancer debate.
3. p-values require subjective input from the producer of the data rather than from the consumer of the data.

H. Problems Interpreting and Acting on “Positive” Findings

1. With a large enough sample, a trivial effect can cause an impressively small p-value (statistical significance ≠ clinical significance).
2. Statisticians and subject matter researchers (especially the latter) sought a “seal of approval” for their research by naming a cutoff on what should be considered “statistically significant”, and a cutoff of p=0.05 is most commonly used. Any time there is a threshold there is a motive to game the system, and gaming (p-hacking) is rampant. Hypotheses are exchanged if the original H~0~ is not rejected, subjects are excluded, and because statistical analysis plans are not pre-specified as required in clinical trials and regulatory activities, researchers and their all-too-accommodating statisticians play with the analysis until something “significant” emerges.
3. When the p-value is small, researchers act as though the point estimate of the effect is a population value.
4. When the p-value is small, researchers believe that their conceptual framework has been validated.

I. Problems Interpreting and Acting on “Negative” Findings

1. Because of B2, large p-values are uninformative and do not assist the researcher in decision making (Fisher said that a large p-value means “get more data”).

J. Distortion of Scientific Conclusions

1. Greenwald, Gonzalez, Harris, and Guthrie’s paper Effect sizes and p values: What should be reported and what should be replicated? nicely describes subtle distortions in the scientific research process caused by the usage of null hypotheses:

One of the more important varieties of prejudince against the null hypothesis ... comes about as a consequence of researchers much more identifying their own theoretical predictions with rejections (rather than with acceptances) of the null hypothesis. The consequence is an ego involvement with rejection of the null hypothesis that often leads researchers to interpret null hypothesis rejections as valid confirmations of their theoretical beliefs while interpreting nonrejections as uninformative and possibly the result of flawed mehods.

French study: 20% severe Covid patients have genetic or immune issue

French study: 20% severe Covid patients have genetic or immune issue

French study: 20% severe Covid patients have genetic or immune issue

www.connexionfrance.com

Two new studies by researchers in France show that one in five people with severe forms of Covid has a genetic issue that stops their cells from fighting against the virus

Almost a quarter of people who suffer severe forms of Covid-19 have a genetic or immune anomaly, a major Paris hospital group has said, citing two new French studies.

In a statement, the Assistance publique – Hôpitaux de Paris (AP-HP) highlighted two new studies on the subject. Both were published in scientific journal Science Immunology.

They are the result of international collaboration, including researchers from national medical institute l’Institut national de la santé et de la recherche médicale (Inserm), the University of Paris, and the human genetics lab of infectious diseases at the AP-HP.

‘Genetic abnormality’

In the first study, researchers focused on men, as they are more likely to suffer from severe forms of Covid. Researchers sequenced the X chromosome of 1,202 male patients who had had a severe form of the virus.

Of these, 16 patients were found to have a genetic variation on the TLR7 gene, dubbed a “loss of function”, which led to the development of severe forms of the virus.

This is because this gene “plays a major role in the production and mechanism of IFN 1”, which is a protein that is produced in response to a viral threat, and which “inhibits the replication of the virus in infected cells”, the AP-HP said.

It summarised: “The 16 patients who presented a deficit in IFN 1 stopped their cells from being able to fight against the SARS-CoV-2 infection, which explains the severe forms.”

The study recruited patients from all over the world, “involving 400 research centres in 38 different countries” the hospital group said, which enabled researchers to gather a representative sample of people and avoid excess ethnicity bias.

This means that the results can be used to make predictions and conclusions about the general population.

Overall, the study concluded: “It appears that 1.3% of several forms of Covid-19 can be explained by a genetic abnormality of the TLR7 gene in men. This deficit is more frequent (1.8%) in patients under 60.”

Less resistance to severe forms over age 65

The second study showed that 15-20% of severe forms of Covid are due to the patient’s blood having antibodies that “specifically target the IFN 1”.

The study looked at 3,595 patients who had had a severe form of Covid, 1,639 who had an asymptomatic form, and 34,159 people in good health. The participants were from 38 different countries.

In its statement, AP-HP said: “They showed that these antibodies block the protecting effects of IFN 1 on the virus replication. The SARS-CoV-2 virus penetrates into the cells without meeting any resistance and replicates uncontrollably.”

The study also showed that these antibodies against IFN 1 increase with age. They are very rare before the age of 65 (0.2-0.5%), and increase exponentially as you age, reaching 4% between the ages of 70-79, and 7% between the ages of 80-85.

Researchers do not yet know why this is, but the study does partly help to explain why age is a risk factor in the development of severe forms of Covid.

France is still recording relatively high numbers of cases of the virus, and of hospital admissions.

The most recent figures – to August 21 – from Santé publique France show that there were 22,636 confirmed cases in the previous 24 hours, and 81 deaths. There were 6,008 new hospitalisations in the past seven days, and 1,316 critical care admissions in the same time, including 969 into intensive care units.

Un quart des formes sévères de Covid-19 s’expliquent par une anomalie génétique ou immunologique

Un quart des formes sévères de Covid-19 s’expliquent par une anomalie génétique ou immunologique

Quote from RobertBryant

even though I can't really follow the logic of why

a synthetic process in2021 should necessarily be as quick as a natural process 100 years ago for

a totally different disease.

Two reasons:

1. Your use of the term "synthetic" here has no meaning. Nature does not make a distinction between antibodies from a disease and those from a vaccine. They are physically the same down to the molecule. They have the same effect. In the case of COVID, the vaccine produces more of them so they are more effective.

2. It is a different disease, but all epidemics follow certain biological, evolutionary and mathematical laws. You can draw conclusions about one by studying others. It is not as if there is a completely different biology and mathematics for each epidemic, and we have to discover them from scratch every time. Mathematical modelling of epidemics began with Bernoulli.

Here are more heartbreaking video interviews. A 53-year old guy says he still has doubts about the vaccine that he refused to take. Nine days later, he died. Half the medical staff are unvaccinated.

This may be behind a paywall.

Opinion | Dying in the Name of Vaccine Freedom

In Arkansas, many are choosing personal liberty over vaccination — at a heavy cost.

www.nytimes.com

Another prominent anti-vaxxer died from COVID. I hope his supporters take a lesson from this.

Conservative talk show host Phil Valentine dies after battle with Covid-19, his employer says

Phil Valentine, a Nashville-based conservative radio talk show host who had questioned whether it was necessary for all people to get Covid-19 vaccines, died…

www.cnn.com

Sugary molecules may be one way to prevent COVID; patients getting younger

Sugary molecules may be one way to prevent COVID; patients getting younger

Here is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be…

www.reuters.com

Aug 20 (Reuters) - Here is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be certified by peer review.

Sugar-molecule 'gates' help coronavirus infect cells

Researchers have discovered a sugary residue on the spike of the novel coronavirus that helps it to break into cells and infect them, according to a study published in Nature Chemistry on Thursday. The molecules that make up the sugary coating, called glycans, act as "gates" that open to let the spike's receptor-binding domain attach itself to a cell. Without this gate, the receptor-binding domain cannot take the shape it needs to break into the cell, Rommie Amaro of the University of California San Diego, who coauthored the study, said in a press statement. If drugs could be developed that "lock" the glycan gates closed, the virus would be prevented from entering and infecting cells, the researchers said.

COVID-19 patients were younger in early 2021 vs late 2020

The average hospitalized COVID-19 patient was younger this past spring than last winter, researchers at a large Pennsylvania health system found. They analyzed data from nearly 39,000 COVID-19 patients, including 7,774 who were hospitalized. People who tested positive in March and April 2021, when the Alpha variant of the coronavirus was circulating, were younger and less likely to die compared to those diagnosed between November 2020 and January 2021. Among patients under 50, those who tested positive the spring were three times as likely to be hospitalized and twice as likely to require ICU admission or mechanical ventilation as those diagnosed in the winter before Alpha was widely circulating, according to a report posted on Wednesday on medRxiv ahead of peer review. "The widespread availability of highly effective vaccines holds promise," they said, "but infections and deaths from the disease continue...This dynamic is particularly concerning in light of the continued emergence of novel SARS-CoV-2 variants."

U.S. childbirth problems no worse during pandemic

Problematic childbirths did not increase in the United States during the pandemic, researchers found in a study of nearly 838,500 women, including more than 225,000 who gave birth during the pandemic. There were no differences in rates of preterm birth, blood pressure problems in the mother, stillbirth, low birth weight, placenta problems, Cesarean deliveries, or uncontrolled bleeding after delivery, when comparing the March through December 2020 period to the pre-pandemic years of 2017 to 2019, the research team reported in Obstetrics & Gynecology. Roughly half of the women had been tested for the coronavirus while pregnant, and about 7% of them had tested positive. There were no differences in childbirth outcomes between these groups. The authors were not able to distinguish between asymptomatic and symptomatic coronavirus infections, or severity of disease, which could have varying effects on pregnancy outcomes, or whether infection earlier or later in pregnancy made a difference. They only looked at labor and delivery outcomes, not at problems that might have occurred earlier in pregnancy.

More nursing home data points to vaccine concerns

Doctors who immunized 120 nursing home residents against COVID-19 with the Pfizer/BioNTech mRNA vaccine found protective antibodies in only 28% of the residents six months later, compared to 84% of residents immediately after full vaccination. The research, published on medRxiv in advance of peer review, adds to evidence showing that protection from the vaccines wanes over time. Vaccinated healthcare workers had higher antibody levels than residents, which is not surprising because they were younger and healthier, but they too experienced "significant declines" in protection over time, the researchers reported. Given the "rapid antibody decline" and "the rapid spread of the Delta variant and reports of vaccine breakthrough," they concluded that booster doses are probably needed. On Wednesday, the U.S. Centers for Disease Control and Prevention said it would "begin efforts to deliver booster shots directly to residents of long-term care facilities," starting in September.

Click for a Reuters graphic on vaccines in development.

Ivermectin Included in National Government Protocol for Treating COVID-19

Ivermectin Included in National Government Protocol for Treating COVID-19

TrialSite recently learned via its worldwide network, including the Front Line COVID-19 Critical Care Alliance (FLCCC) that the nation of

trialsitenews.com

TrialSite recently learned via its worldwide network, including the Front Line COVID-19 Critical Care Alliance (FLCCC) that the nation of Cambodia has included ivermectin in the Government Protocol for Treating COVID-19. A confluence of local physicians, a small, non-governmental organization, and a faith-based organization led to this milestone. Advocates spent countless days, essentially a long and twisting path involving frequent meetings with the Deputy Director of the Department of International Cooperation, Ministry of Health Dr. Him Sokrey, as well as many others lobbying for early care treatment options targeting SARS-CoV-2. TrialSite couldn’t confirm via the Ministry that the authorization occurred; however, a group of faith-based organizations, including the International Baptist Church, are actively participating in early home treatment options in that country, and TrialSite inspected an email declaring the event.

A team of health activists and faith-based leaders in the country led the charge. They were influenced by the work of Drs. Paul Marik and Pierre Kory, founders of the Front Line COVID-19 Critical Care Alliance (FLCCC), who have showcased for many months now the benefits of ivermectin to what is now millions of people on the planet using the drug for COVID-19. The FLCCC is influenced by their ivermectin meta-analysis. Other groups have conducted meta-analyses showing positive results, while one website tracks all ivermectin studies, which total 63 now. Mainstream media showcased a few neutral studies and one with questionable data—TrialSite reports on those cases and the positive ones. TrialSite also reports a handful of countries have accepted its use formally for COVID-19.

Most health authorities worldwide don’t recognize or validate the existing evidence, pointing out that bigger and better studies must be accomplished for accurate evidence and any change in decision. In the media, a growing negative coverage suggests no evidence. That, of course, is outrageous. A handful of large Phase 3 clinical trials in America and the U.K., for example, exemplify that some supporting evidence exists. Otherwise, the cost and effort of a Phase 3 clinical trial would not happen.

While Cambodia experiences higher COVID-19 vaccination rates than many comparable countries classified as low-and-middle-income countries or “LMICS,” the delta surge has pushed this country’s health care system capacity. The government here, although widely criticized by many for several mistakes during this crisis, has emphasized home treatment in addition to vaccination. Breakthrough infections are more common with the Delta variant of SARS-CoV-2, but the breakthrough rates in Cambodia are unknown or what percentage of that population experiences severe symptoms.

COVID-19 in Cambodia

With about 16.5 million people, this Southeast Asian nation spans tropical flatlands, the Mekong Delta on mountains, and the Gulf of Thailand coastline. The country’s population was primarily shielded from the COVID-19 pandemic for much of the time until the emergence of the Delta variant in early March where there was finally an uptick in cases. That turned into an explosion of cases in April, leading to nearly 1,000 new cases reported daily for several days in July. In August, cases have waned, with the most recent count at a 7-day average of daily cases at 569 reported on August 20th.

With an explosion of cases by May, Prime Minister Hun Sen ordered health officials to prepare to treat COVID-19 patients at home to ease pressure on the health system.

Since the late outbreak here, the country has struggled, reports the Khmer Times, due to many factors from lack of clear testing and care protocols to coordination factors at the national and local levels. Interestingly, the military took over the vaccination campaign, as reported in July. Like in many other nations, health authorities here are criticized for not being prepared.

And perhaps that just might be working as the rate of vaccination accelerated in this Southeastern Asian nation as according to Our World in Data, 46.9% of Cambodia’s population are fully vaccinated, while 57.6% have received at least one dose. These numbers approach many wealthy developed countries.

Earlier this month, Reuters shared that about half the population was inoculated mostly with COVID-19 vaccines from China, although millions of vaccines from the West (America and U.K.). TrialSite has reported that Chinese vaccines are not as effective as those from Moderna and Pfizer-BioNTech.

Call to Action: TrialSite will update the network with additional information. For more information on the country, also visit the U.S. Embassy for Cambodia website.

Jamaica Public Hospitals Approach the Brink While Ivermectin Shipment in Delay

Jamaica Public Hospitals Approach the Brink While Ivermectin Shipment in Delay

Recently TrialSite updated https://trialsitenews.com/jamaica-struggles-in-what-emerges-as-the-worst-covid-19-pandemic-surge-to-date/ the world that

trialsitenews.com

Recently TrialSite updated https://trialsitenews.com/jama…9-pandemic-surge-to-date/ the world that Jamaica was headed toward a very hard period of this pandemic. That’s now happening with the Delta variant circulating around the island. At least a third of the population here polls that they won’t take a vaccine and the supplies to this poor nation, like many other ones, evidences health inequity at work. Recently the Health Minister authorized ivermectin to enter the country for off-label use. However because Christopher Tufton follows the World Health Organization (WHO) recommendations, he won’t allow ivermectin use in the public hospitals such as the one here. TrialSite’s network of health care professionals sent us a video today as to what one of these hospitals looks like now with the crisis raging. Meanwhile the shipment of ivermectin authorized for possible “off-label” use is in delay due to logistics. Meaning in a nation that’s less than 5% fully vaccinated and less than 10% even partially vaccinated, combined with no means of early care leads to an unfolding worsening of the health crisis.

It isn’t pretty as care is in short supply here. Moreover while vaccine distribution has been slow to make it to this Caribbean island, the ivermectin supply approved by authorities here is also in delay TrialSite’s contacts reports, due to logistics.

Various health authorities are scrambling here. As reported in the Jamaica Observer https://www.jamaicaobserver.co…re_COVID-19_hospital_beds hospitals across regions are at full capacity. In Cornwall Regional Hospital in St. James and several others, full capacity is the norm declared the Western Regional Health Authority. The Jamaica Gleaner reports https://jamaica-gleaner.com/ar…-beds-donated-covid-wards donations are coming in such as 48 hospital beds from the Canadian Fund for Local Initiatives to support the expansion of COVID-19 wards. A donation worth $11.3 million went to Dr. Christopher Tufton, Minister of Health and Wellness.

Jamaica needs help, like a lot of other places around the world. While rich nations will now expand their vaccination programs to a third booster, many poor nations have barely vaccinated 10% of their populations. In Jamaica less than 5% have received both doses and less than 10% have received even one dose. A third of the population is opposed to vaccination and other early treatments must be accelerated.

Risk and benefit analysis suggests if a drug with a well-established, safe profile can help then then why wouldn’t such a drug be used? TrialSite recently reported https://trialsitenews.com/jama…9-pandemic-surge-to-date/ on the comments of a Reggae star Tanya Stephens who recently announced via Instagram:

“I need to take something to protect others. But taking it won’t stop me getting or giving the malady to the others I’m supposed to be doing it for. It will reduce my symptoms (something the pill they’re fighting has constantly done) which, in essence, means this is supposedly only of real benefit to me, but I don’t get to decide on an alternative.”

While she didn’t explicitly call out ivermectin, that’s what she was referring to. She went on intensifying her critique of the governing class there:

“Meanwhile, every mention of any proven alternative and research results which counter the narrative being sold is censored and the trial being pushed is slowly becoming mandatory as per demand for proof of it to gain access to regulatory human activities, and that info is also being censored.”

TrialSite emphasizes that transcending this pandemic necessitates compassion locally and globally. Vaccination is absolutely key to a comprehensive, flexible, and proactive program driven by risk, equity and collaboration. So is early stage treatments and other measures that protect a population from transmission where and when possible. But care providers in the trenches have been saying since day one that the key to mitigate damage in fact is early treatment. After all many of the world’s nations are heavily vaccinated yet Delta-driven surges occur anyway, often reinfecting the vaccinated and turning them into vectors to infect others. The world’s governing structures have embraced a more rigid, top down, vaccination-centric approach—its that or nothing. That doesn’t work in the real world, especially in poorer nations in a highly coin-operated market system. The governing classes, public health authorities and health systems should open up, establish more networked assistance and support, and embrace where and when possible care for those such as we are seeing in this Jamaican hospital.

Those Anti-COVID Plastic Barriers May Make Things Worse

Those Anti-COVID Plastic Barriers May Make Things Worse

The New York Times reports that the clear barriers do little to stop the spread of the coronavirus.

www.scarymommy.com

The New York Times reports that the clear barriers do little to stop the spread of the coronavirus

The coronavirus sucks, y’all. After more than 15 months of public health protocols, the world continues to struggle with adjusting to a new normal. As schools and businesses contemplate reopening while the Delta variant sweeps across the nation, more and more organizations put dividers in place to help stop the spread of the highly contagious virus. Now, in news that will please no one, research suggests that barriers can interfere with normal ventilation.

Scientists who study aerosols, airflow and ventilation say that much of the time, the barriers don’t help and probably give people a false sense of security, reports The New York Times. Brace yourself: scientists say sometimes the barriers can make things worse.

If you have a forest of barriers in a classroom, it’s going to interfere with proper ventilation of that room,” said Linsey Marr, professor of civil and environmental engineering at Virginia Tech and one of the world’s leading experts on viral transmission, tells the Times. “Everybody’s aerosols are going to be trapped and stuck there and building up, and they will end up spreading beyond your own desk.”

The science shows the barriers work on bigger droplets, like a sneeze or a cough. COVID however, spreads mainly through unseen aerosol particles. The Times article points to research in the U.S. and Britain that is…. unsettling:

A Johns Hopkins study showed that desk screens in classrooms were associated with an increased risk of coronavirus infection. Researchers also found that plexiglass dividers with sidewalls in the main office were impeding air flow. And a study of schools in Georgia found that desk barriers had little effect on the spread of the coronavirus compared with ventilation improvements and masking.”

In a disturbing passage, Times referenced a study published in 2014 found that office cubicle dividers were among the factors that may have contributed to disease transmission during a tuberculosis outbreak in Australia.

Finally, the Times wrote about a British study:

“…[In] modeling studies simulating what happens when a person on one side of a barrier — like a customer in a store — exhales particles while speaking or coughing under various ventilation conditions. The screen is more effective when the person coughs, because the larger particles have greater momentum and hit the barrier. But when a person speaks, the screen doesn’t trap the exhaled particles — which just float around it. While the store clerk may avoid an immediate and direct hit, the particles are still in the room, posing a risk to the clerk and others who may inhale the contaminated air.”

Finally, the Times wrote about a British study:

“…[In] modeling studies simulating what happens when a person on one side of a barrier — like a customer in a store — exhales particles while speaking or coughing under various ventilation conditions. The screen is more effective when the person coughs, because the larger particles have greater momentum and hit the barrier. But when a person speaks, the screen doesn’t trap the exhaled particles — which just float around it. While the store clerk may avoid an immediate and direct hit, the particles are still in the room, posing a risk to the clerk and others who may inhale the contaminated air.”

It remains to be seen how organizations will implement this information in their workplaces, offices, and schools.

Quote from THHuxleynew

Drug companies generate positive tests by running a randomised double-blind trial with a small number of patients, testing 20 different independent and fairly random things, and highlighting the ones that have statistically significant correlations with the drug.

You seem shocked by the high efficiency of Ivermectin even in pampa states like Peru! And these damn trials use such large sets - millions of people or even hundred millions of people (India) that leaves no way for cheating FUD'ers like you.

Take a beer and calm down and forget that you soon will loose your vaccine protection

Quote from THHuxleynew

The p-value fallacy.

Simplified: if you take random numbers and test 100 different hypotheses you will typically find 5 or so of them show, on the random data, a statistically significant effect (less than 5% by chance).

Drug companies generate positive tests by running a randomised double-blind trial with a small number of patients, testing 20 different independent and fairly random things, and highlighting the ones that have statistically significant correlations with the drug. Except that p-values cannot be used that way

This effect gets worse if the researcher decides to tweak the variables of the best fitting hypotheses. With stochastic data you can lower the p-value dramatically but also kill the predictive power of the model.

Even if they don’t do this, the only way to be sure you're not fooling yourself is to try the exact same model on fresh data - from a different country, say.

You can’t take an equally untested model from a different country, and claim that the two support each other. Or, well… you can, but if you do, there’s a reasonably high risk of being wrong.

off subject but interesting. Could this be a treatment for long covid?

Time‐Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above‐Normal Blood Pressure

https://www.ahajournals.org/doi/10.1161/JAHA.121.020980

Abstract

Background

High‐resistance inspiratory muscle strength training (IMST) is a novel, time‐efficient physical training modality.

Methods and Results

We performed a double‐blind, randomized, sham‐controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50–79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long‐lasting effects. Thirty‐six participants completed high‐resistance IMST (75% maximal inspiratory pressure, n=18) or low‐resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg (P<0.01) with IMST, which was ≈75% sustained 6 weeks after IMST (P<0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P=0.03); blood pressure was unaffected by sham training (all P>0.05). Twenty‐four hour systolic blood pressure was lower after IMST versus sham training (P=0.01). Brachial artery flow‐mediated dilation improved ≈45% with IMST (P<0.01) but was unchanged with sham training (P=0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity (P<0.05). IMST decreased C‐reactive protein (P=0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness (P>0.05).

Conclusions

High‐resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above‐normal initial systolic blood pressure.

Registration

URL: https://www.clinicaltrials.gov; Unique identifier: NCT03266510.

Future COVID-19 Pandemic Burden Could Be Mitigated Via Respiratory Muscle Training

Future COVID-19 Pandemic Burden Could Be Mitigated Via Respiratory Muscle Training

Patients with COVID-19 who also have poor baseline health and/or obesity are more likely to demonstrate impaired respiratory muscle performance.

www.pulmonologyadvisor.com

Quote from Fm1

Dishonest rhetoric? FU!!!!!

FM1 - you are getting as bad as W. it don't suit you.

If you think I am in any way dishonest posting here you are an idiot.

Quote from Wyttenbach

You seem shocked by the high efficiency of Ivermectin even in pampa states like Peru! And these damn trials use such large sets - millions of people or even hundred millions of people (India) that leaves no way for cheating FUD'ers like you.

Take a beer and calm down and forget that you soon will loose your vaccine protection

Just to remind those people here who have not been paying attention. There is no evidence for ivermectin having high efficiency from any of those ecological studies. the one particularly favoured by W (Uttar Pradesh) turns out totally bust as in my previous post.

And, again to remind people, it is dishonest for W to say that I sound shocked when I exactly said in my last post that I expected it to be possible to show any correlation with ivermectin by cherry-picking specific times and places, given all the random and geographic factors that affect COVID spread. The opposite of shocked. And I linked the relevant maths which W is pretending not to know - but which is really just common sense so I guess most people would not need to be reminded of it.

Now, I have calmed down - and as I promised I'll remind everyone when W is lying. Not always - that would exhaust even me! But enough to preserve the sanity of this thread.

The Growing Rage of the Informed

The Growing Rage of the Informed

Note that views expressed in this opinion article are the writer’s personal views and not necessarily those of TrialSite. In a New York Times Op-Ed

trialsitenews.com

Note that views expressed in this opinion article are the writer’s personal views and not necessarily those of TrialSite.

In a New York Times Op-Ed article published this week; well-respected economist Paul Krugman pens what he terms the ‘Quiet Rage of the Responsible’. His rage, just like that of many progressives in the media is neither quiet nor based on facts and succumbs to some breakdowns in logic that a man of his stature and training should know better than to commit.

We all want COVID-19 to end, and for many, the summer months and the promise of widely available, effective, and safe vaccines was the light at the end of the tunnel we had been waiting for. Progressives (in particular) rushed to get inoculated at the first available opportunity. Many of them posting images of the happy event on social media with statements such as: “Fully vaxxed – who wants to hang out?” What has become increasingly obvious as the summer has progressed is that the hope of a return to normalcy is sliding rapidly away, just about as fast as Dr. Anthony Fauci’s faltering credibility.

So why the rage?

Americans are a stubborn bunch, and it should not be a surprise that many people would hesitate to accept what amounts to an inadequately tested experimental vaccine, rushed into production by a handful of profit-motivated companies, and boosted by an extremely well-funded and aggressive marketing campaign of fear-mongering. The US government has spent over a billion dollars trying to convince us to get vaccinated. The message is ‘Get Vaccinated’ but the unfortunate implementation of it is ‘Be Afraid’. Fear sells, and the media has gleefully jumped on this financial free-for-all with ever more outrageous, fear-driven messages. The word ‘variant’ has entered the common lexicon, repeated in casual talk millions of times across the nation. The media has bolstered it with vacuous titles like “Delta on Steroids” and even the disgusting “Doomsday Variant.” Have they no shame? And yet it has certainly worked, not to get everyone vaccinated, but to scare the hell out of them. People are indeed, terrified. This approach doesn’t serve the common good but rather contributes to ever-intensifying divisiveness.

We have been told by everyone from President Biden on down, to the CDC Director Walenski that “breakthrough infections are rare” – they are not – that this has become a “pandemic of the unvaccinated” – it is not – and most disturbingly and illogically (talking to you Mr. Krugman), that the reason we are not all having dinner parties right now is that the unvaccinated have let the rest of us responsible people down, that they alone are responsible for the emergence of Delta, and the perpetuation of this awful pandemic. No wonder progressives are feeling enraged.

Misplaced rage

I also have rage, Mr. Krugman.

I am aggravated by my government telling me to be afraid when part of their job is to keep people calm. I am tired of so-called Fact Checkers conducting coordinated smear campaigns against highly credentialed experts that have dedicated their lives to helping others and have done nothing more than question the mainstream narrative espoused by political operatives like CDC’s Walenski and the compromised Dr. Fauci. The attempt at eradicating any scientific debate and dissension is maddening.

I am enraged that thousands of small business owners have lost their lives ‘ work and their livelihoods at the illogical instructions of detached bureaucrats more interested in political theatre than science. Since when does a virus not infect you when you are seated, but only when you enter or leave a restaurant, or get up to use the restroom? Yet we are all subjected to this absurdity every time we go out to dinner. Restaurant owners are so grateful to be allowed to finally open their doors that they willingly comply with these instructions no matter how nonsensical they are to any thinking human being.

I am enraged that the US government spent $66 million dollars (over 20 years) on research grants for ‘Gain of Function’ experiments that should never have been allowed to take place. That Dr. Fauci oversaw the distribution of some of these funds, including cynically moving the research to China when it was outlawed by the Obama administration as if that would make it less risky to humanity. I am enraged that Dr. Fauci plays with words when he is questioned by Senators, making statements like “this is not gain of function” when he knows very well that dangerous viruses were deliberately modified to make them transmissible in humans. Who cares what it’s called Dr. Fauci? That is hardly the salient point when the world has been devastated by this awful work you were involved in.

I am enraged that friends of mine seem to think it’s okay to shame people into taking what by definition is still an investigational vaccine as defined by Pfizer itself. That what I choose to put in my body is anyone’s business but my own. It’s like one unreported side effect of these vaccines is to turn you into a total ass! Mind your own business – I am not telling you what to do with your body.

I am enraged that there have been over 13,000 deaths reported to the CDC’s own adverse event reporting database (VAERS), but that any objective analysis of this data is dismissed by the media and others as ‘not conclusive or no evidence of being causal’. Since when do hundreds of children and otherwise healthy adults die in their sleep within days of receiving an investigational product? Since when do young people experience heart problems, and any number of other disabling maladies where there were none before?

Let’s not even call it a vaccine. A vaccine protects you from getting sick pretty much 100% of the time. We are not even a year into this, and fully vaccinated people are getting sick in their thousands, with many of them dying on ventilators. We have moved from one shot to a second and we are already handing out booster shots, all within twelve months. The so-called vaccine is not working as advertised, and it’s illogical to blame the unvaccinated. Look at the data out of Israel where over 78% of people over the age of 12 are fully vaccinated and they are now experiencing a full-on rebirth of Covid as strong as ever before.

I am livid that in the quest to get to high overall vaccination rates, the government has turned to children and teens as easy targets to bolster the numbers, even though they are in the lowest risk cohort for Covid. My daughter got sick with Covid and recovered within days, and now has natural immunity of the body. She does not need this vaccine with no long-term safety testing forced upon her young body. Technically the clinical trial isn’t even done for the existing emergency use authorized vaccines although Pfizer and the government are now in a rush to secure formal approval. But I am not sure I am ready to risk my daughter’s health without more long-term data. Is that unreasonable of a father? Yet the mindless bureaucrats that govern our school districts are dutifully falling into line around ‘school vaccine mandates’. How am I to explain to my daughter that what she hears on the news is biased, that her friends’ parents are not critical thinkers, and that she cannot attend school events because I have concerns about the health of her body in the coming years where she to subject herself to this unprecedented clinical trial? I don’t test other experimental drugs on her, why would I agree to this one?

Where do we go from here?

It should be clear to all by now that Covid is not going away. Indeed, there are rational, science-based arguments from extremely credible experts that the vaccination campaign itself is causing the variants to arise. So-called ‘escape variants’ that become ever more equipped to infect, spread and thrive amongst the vaccinated populace. Of course, there is no absolute proof one way or another, but I don’t believe that this anger and finger-pointing is helpful to our society or our collective mental health.

We need to learn to live with this virus. We need to look after our health with common sense solutions that lower our risk of serious illness and death. We need to address obesity which dramatically raises our risk profiles. We need to embrace the proven treatment capabilities of repurposed drugs with high safely profiles like Ivermectin and others that have been tested over decades of use.

Our leaders need to stop making up facts to support their agendas and deliver honest information to the public, and they need to stop this disgusting fear-mongering. Its toll on our mental health is becoming intolerable.

We need to get out of the way of small business people and let them rebuild the economy and their livelihoods. At this point, we all know what Covid is and what its risks are. If we don’t feel safe in a restaurant or a gym, we won’t go. We don’t need the government stepping on the necks of business owners who choose to be open to customers.

Most of all, we need to stop with the finger-pointing and self-righteous blame and start to love and appreciate one another again. We need to heal this country and the world from the devastation that has occurred

Quote from Fm1

But when a person speaks, the screen doesn’t trap the exhaled particles — which just float around it. While the store clerk may avoid an immediate and direct hit, the particles are still in the room, posing a risk to the clerk and others who may inhale the contaminated air.”

We think about this stuff in the UK, running a high COVID infection rate though due to very high at risk vaccination rates not running a high death rate.

Mostly, schools and Unis are putting up CO2 meters everywhere to determine whether ventilation is good enough (CO2 level < 700ppm). Ventilation is the one thing that most helps COVID spread. The UK government says 1000-2000ppm is questionable and should be investigated. But outside CO2 is 400ppm, so 1000ppm, as a limit, is double the best practice limit.

As those who have been following know the UK government is sort of Sweden-lite. The worst of both worlds. Lock people down, get everyone scared, while simultaneously telling them it is freedom day and COVID is over, and being totally diorganised about the little things like ventilation everywhere that would make a big difference,

Masks would be a good idea too - both to stop people breathing directly into others faces - and to reduce a bit the spread in a room.

Quote from THHuxleynew

And, again to remind people, it is dishonest for W to say that I sound shocked when I exactly said in my last post that I expected it to be possible to show any correlation with ivermectin by cherry-picking specific times and places, given all the random and geographic factors that affect COVID spread.

You are a simple minded bullshit talker. Uttar Pradesh did not distribute cherries everybody got Ivermectin. Tokyo just now discusses doing the same...Only fools do broadly vaxx...

OK Average age of Dogs in Uttar Pradesh is below 10 years could be one reason for the local success... Same for Delhi with the young cows...

Do you plan for a booster soon? Two more years of interferon/immune suppression... ? Happy virus days are coming soon may be some here will miss you.