COVID discussion thread VI

by Judith Curry

A roundup of interesting articles on COVID-19.

 

A new, experimental wearable device is capable of catching early signs and symptoms associated with the coronavirus. [link]

Lets have an honest debate about herd immunity [link]

47 old drugs that might treat coronavirus [link]

COVID19 deaths analyzed by race and ethnicity [link]

The mystery of India’s low COVID-19 death rate [link]

New York researcher says preliminary results of hydroxychloroquine study are ready, but state hasn’t released them [link]

Italian scientist says she discovered main mechanism behind COVID19 [link]

Face masks against COVID-19: An evidence review [link]

The odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment. [link]

Just released German antibody study estimates the fatality rate of the SARS-CoV-2 infection to be 0.36% and poses new question marks. ukbonn.de/C12582D3002FD2

This paper finds nursing home residents comprise 57% of all COVID-19 deaths in Spain, 53% in Italy, and 45% in France. ltccovid.org/wp-content/upl

Individual variation in the likelihood of COVID-19 infection may mean we’ll reach herd immunity sooner than expected [Preprint] medrxiv.org/content/10.110

Scientists learned that the coronavirus needs two particular proteins to take over our cells. Could they be the key to an effective drug treatment? [link]

From Iceland, which has the most extensive testing in the world: “We have not found a single instance of a child infecting parents.” sciencemuseumgroup.org.uk/hunting-down-c

The underground doctors’ movement questioning the use of ventilators [link]

Bill Gates sees RNA vaccines as best options for quick coronavirus treatment hill.cm/RFKbK7Z

Five things to know as intelligence community probes coronavirus’s origins hill.cm/aI8t8ea

New publication on the ‘Flow Physics of COVID-19’ looking at what we do – and perhaps more importantly don’t – know about the fluid mechanics of disease spread. doi.org/10.1017/jfm.20

What the coronavirus models can’t see [link]

Bombshell dossier lays out coronavirus case against China [link]

Serum 25(OH)D (=Vitamin D) level was *lowest* in critical cases, but *highest* in mild cases. Vitamin D status is significantly associated with clinical outcomes. papers.ssrn.com/sol3/papers.cf

The info war on Chloroquine has slowed COVID-19 science [link]

First data  out of Iran. Looks like a very careful randomized cluster sample that finds 14-29% (with central tendency at 21%) infection in Guilan Province, Iran. 69% asymptomatic medrxiv.org/content/10.110

Comparing COVID-19 deaths to flu deaths is like comparing apples to oranges [link]

Giving blood thinners to severely ill covid19 patients gaining ground [link]

Policy

Treat the patient, not the virus [link]

The great price of America’s great lockdown [link]

Efficient #testing has enabled #Germany—Europe’s most populous country, with almost twice as many inhabitants as Spain, to avoid the worst of the #coronavirus scourge. How did Germany do it? By minimizing bureaucratic impediments. [link]

Gilead’s lobbying rose as interest in COVID-19 treatment climbed [link]

Why weren’t we ready for the coronavirus? [link]

China was in violation of International Health Regulations. What do we do now? [link]

Competing Science: Coronavirus Red-Team to make case for use of facemasks and quicker end to lockdown [link]

How we can prevent the next pandemic [link]

Sociology

UK scientists being drawn into very unpleasant political situation [link]

Americans have to accept uncertainty [link]

Independent SAGE group is an oxymoron [link]

The Coronavirus Is Rewriting Our Imaginations newyorker.com/culture/annals

449 responses to “COVID discussion thread VI

  1. Roger Knights

    New CRISPR Coronavirus Test Could Be a Pandemic ‘Game-Changer’
    Cheap accurate testing would enable the safe reopening of the U.S. economy.
    RONALD BAILEY | 5.6.2020 3:00 PM

    The researchers have created molecular tags that latch onto sections of viral genes and emit a signal when their presence is detected. The new STOPCovid https://www.stopcovid.science/ test enables the detection of as few as 100 copies of the coronavirus in a sample. “As a result, the STOPCovid test allows for rapid, accurate, and highly sensitive detection of Covid-19 that can be conducted outside clinical laboratory settings,” note the researchers. The test initially used standard nasal swab samples, but preliminary data suggest that it will work using much more easily collected saliva samples.

    The research team is talking with manufacturers to further simplify and produce the test. The New York Times reports https://www.nytimes.com/2020/05/05/health/crispr-coronavirus-covid-test.html that they estimate that the materials for one test would cost about six dollars now and would fall even further when mass-produced. “The ability to test for Covid-19 at home, or even in pharmacies or places of employment, could be a game-changer for getting people safely back to work and into their communities,” said team member Feng Zhang in the press release.
    https://reason.com/2020/05/06/new-crispr-coronavirus-test-could-be-a-pandemic-game-changer/?utm_medium=email

    • Roger Knights

      PS: The FDA has just approved one company’s use of this type of test. In coming weeks a few more should be approved. I hope production can ramp up very quickly.

    • Roger Knights

      “The ability to test for Covid-19 at home, or even in pharmacies or places of employment, could be a game-changer for getting people safely back to work and into their communities,”

      IOW, factories could quickly and cheaply and unobtrusively test workers arriving each morning and exclude those who test positive. This would prevent their workplaces from becoming sites where the virus would spread—which is the only reason for closing them.

      Attendees at crowd-gatherings like sports events, concerts, and movies could likewise be tested before admission, assuming the cost per test can be lowered enough, and attendees are willing to put up with delays.

      • Roger Knights

        PS: Once masks are in good supply, workers and event-attendees can be handed them when they enter, further reducing the risk of virus-spreading.

  2. David L. Hagen (HagenDL)

    MD says end Lockdowns
    UPMC Chief Medical Officer: ‘What we cannot do is extended social isolation’
    “Dr. Steven Shapiro believes it’s time for phased and smart reopening”
    “”We are concerned that the longer we do social isolation, we’re already seeing the mental health consequences of loneliness, and economic devastation is going to add to it,” Shapiro said.”

    • Would be great if Trump followed Merkel’s lead on opening up. Unfortunately, it will require a lot of catching up, and Trump seems incapable.

      I hope it isn’t too late for him to get it together.

      • stanonstuff

        Just stop. Your hatred is eating your brain.

      • He’s right about Trump, and lots of people see it even if you don’t.

      • Trump said we have the best testing in the world. That’s simply not true. We’re about 41rst in the world in testing per capita. That’s particularly a problem because our ratio of identified cases to tests conducted is pretty bad, comparatively. It implies that we have a relatively high infection rate – which only puts more importance on us identifying positive cases to minimize spread.

        Trump said that anyone who wants a test can get a test. That’s a flat out lie.

        Why is it so difficult for his supporters to accept that he isn’t infalible?

      • Don Monfort

        He occasionally wriggles forth from his derelict off-the-grid shack in the dark bowels of Ilhan Omar’s dismal TDS infested Congressional district to take a pathetically weak swipe at the Big Orange Fella. If they can’t somehow get their little minds right, four more years might kill them.

  3. David L. Hagen (HagenDL)

    82% lower COVID-19 Hospital Deaths by Hyderoxychloroquine & Azithromycin
    Southern France Morning Post SARS-CoV2 Mediterranee Infection France 06/05/2020
    Before: 2.95% deaths (142 deaths/4818 COVID19 cases)
    After: 0.52% fatalities (17 deaths/3241 COVID19 cases) as of 6 May 2020
    Didier Raoult @raoult_didier linked to:
    Colson, P., Fournier, P.E., Amrane, S., Hocquart, M., Mailhe, M., Esteves-Vieira, V., Doudier, B., Aubry, C., Correard, F., Giraud-Gatineau, A. and Roussel, Y., Full-length title: Early treatment of 1061 COVID-19 patients with hydroxychloroquine and azithromycin, Marseille, France.
    https://doi.org/10.1016/j.tmaid.2020.101738
    https://sciencedirect.com/science/article/pii/S1477893920302179?

    Results: A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years – range 14–95 years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < .001) but viral culture was negative at day 10. All but one, were PCR-cleared at day 15. A poor clinical outcome (PClinO) was observed for 46 patients (4.3%) and 8 died (0.75%) (74–95 years old). All deaths resulted from respiratory failure and not from cardiac toxicity. Five patients are still hospitalized (98.7% of patients cured so far). PClinO was associated with older age (OR 1.11), severity at admission (OR 10.05) and low HCQ serum concentration. PClinO was independently associated with the use of selective beta-blocking agents and angiotensin II receptor blockers (p < .05). A total of 2.3% of patients reported mild adverse events (gastrointestinal or skin symptoms, headache, insomnia and transient blurred vision).
    Conclusion: Administration of the HCQ+AZ combination before COVID-19 complications occur is safe and associated with very low fatality rate in patients.

    • . 9% CFR is low. Hopefully that pans out.

      • dougbadgero

        0.9% IFR is likely the upper bound. It is what was assumed in the IC study weeks ago. Serologic tests point to 0.2 to 0.8% IFR depending on location and assumptions about deaths. Considering that no one started with immunity this will result in significant mortality consistent with what we have seen IMO.

        Whether that justifies locking down the US and shutting down nearly all elective and preventive medicine is quite another matter.

    • Thanks, David. We had seen the pre-print. Apparently this has now been peer reviewed and awaits publishing. Evidence for hydroxychloroquine is piling up.

      • joe - Dallas

        Thanks, David. We had seen the pre-print. Apparently this has now been peer reviewed and awaits publishing. Evidence for hydroxychloroquine is piling up.

        Not among those with TDS!

        That being said, Based on the the study cited / promoted by Fauci for Remdesivir, it doesnt seem all that promising. the delta for death 8% v 11% is very significant. the 31% improvement is length of illness – seems very subjective in the analysis.

      • Don Monfort

        joe: the delta for death 8% v 11% is very significant. the 31% improvement is length of illness – seems very subjective in the analysis.

        Here you will find a professional analysis of the Remdesivir data, from a China trial report as well as the U.S study:

        If the link doesn’t work, search title:

        Coronavirus Pandemic Update 64: Remdesivir COVID-19 Treatment Update

        https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

        “An independent data and safety monitoring board (DSMB) overseeing the trial met on April 27 to review data and shared their interim analysis with the study team. Based upon their review of the data, they noted that remdesivir was better than placebo from the perspective of the primary endpoint, time to recovery, a metric often used in influenza trials. Recovery in this study was defined as being well enough for hospital discharge or returning to normal activity level.

        Preliminary results indicate that patients who received remdesivir had a 31% faster time to recovery than those who received placebo (p<0.001). Specifically, the median time to recovery was 11 days for patients treated with remdesivir compared with 15 days for those who received placebo. Results also suggested a survival benefit, with a mortality rate of 8.0% for the group receiving remdesivir versus 11.6% for the placebo group (p=0.059)."

        The improvement in length of illness seems solid (p<0.001). The criteria is not as objective as 'dead, or alive', but what can you do. Survival benefit borders on being statistically significant (p=0.059), and according to Dr. Seheult had the trial not been ended by the DSMB because it had met the primary endpoint, it coulda/woulda reached stat significance.

        An improvement of 4 days in recovery time can save a lot of hospital time and expense and some amount of suffering. The mortality rate benefit, if it holds up, is also substantial.

        I am expecting a similar outcome with the Univ. of Minn. PEP trial. The DSMB has already said the planned patient number can be reduced by 1/3, due to "the event rate of COVID-19 illness observed in the control group." The DSMB anticipates the downsized trial being able "to demonstrate conclusively whether or not there is a 50% reduction in symptomatic illness with a 5-day course of hydroxychloroquine after a high-risk exposure to someone with COIVD-19."

        The left loon TDS media are not making a big deal of Trump "touting" Remdesivir. They will also forget that Trump "touted" hydroxychloroquine should it pass a strenuous trial and that little weasel Fauci is forced to admit he was wrong in being negative and dragging his little feet.

      • Don Monfort: An improvement of 4 days in recovery time can save a lot of hospital time and expense and some amount of suffering. The mortality rate benefit, if it holds up, is also substantial.

        Inasmuch as I often disagree, it’s only fair for me to say that I agree with you on both counts there.

    • Truth will out.
      H/t Chaucer.

      • Still 40-50% of those with more severe conditions had poor clinical outcomes. Looks like it doesn’t work.

      • stevenreincarnated

        Doesn’t work on what? If it reduces the damage a person’s immune system does then it doesn’t work after the damage is already done. What you are saying is it doesn’t work to reduce fatalities if you drop your speed from 100 mph to 0 mph after you already hit the tree.

      • Steve,

        Basically this study was done with 95% people who have few or minor symptoms. Less than a quarter actually could be cultured to show live virus. It’s unclear whether many of these might have tested positive on the PCR tests as false positives or they had the disease and fought it off and the test picked up dead genetic material.

        At any rate, that 5% had severe symptoms is pretty much reflective of how the virus affects the population as a whole. A small percentage of people develop severe complications but, of those that do, a large number die and many stay in the hospital for a long time.

        In this study people with worse symptoms had bad clinical outcomes about 50% of the time. I’m not sure that it is much different than what happens without this treatment.

        I guess the study does show that not many people will be poisoned by the treatment.

      • stevenreincarnated

        Jim, Turkey uses early intervention and claims it has reduced their pneumonia cases from CV-19 patients by about two thirds. If you can tell me how that happened by pure coincidence then that would be an interesting tale I’m sure. If you can’t then I am going with the hypothesis that a drug known to be useful in autoimmune diseases is reducing the damage caused by the immune system since that is what causes the secondary infections.

    • Can you explain what this means?

      “Successful isolation of virus in cell culture was obtained from 204 patients among 915 tested (22.3%) on nasopharyngeal sample collected before treatment.”

      Does that mean that most of the patients treated didn’t test positive?

      Also, the table shows that 95% were clinical classification low. Does that mean they were treating mostly people who weren’t sick or were barely sick.

      • “Does that mean they were treating mostly people who weren’t sick or were barely sick.” I would say yes but one could also think of it as most people were prevented from becoming very sick by the early treatment.

      • Don Monfort

        I will help you, jimmy. You are worried that they are trying to slip something over on you and you think you have caught them. Let not your little mind be troubled.

        The 1061 patients were confirmed to have COVID 19 infection by PCR testing and extensive follow up testing was done as described. PCR tests detect COVID 19 RNA. If you are really interested, which I doubt, you can easily find a detailed explanation of how that is done. PCR does not involve isolation of the little virus buggers in cell culture. That is a much more involved process.

      • Don,

        Did they did study the asymptomatic cases?

      • Don Monfort

        Why don’t you read the thing, jimmy.

      • Don,

        Also, the table shows that 95% were clinical classification low. So I assume that most of the people they were treating either were asymptomatic or barely sick.

        Thanks.

      • Don Monfort

        You don’t know how to read or you just don’t care, jimmy. All the patients were positive for COVID 19. They all had been infected. The number who were asymptomatic at the beginning of their enrollment is stated. You are not smart enough to find it. Anyway, it’s easier for the lazy and willfully ignorant to make assumptions.

        Do you have some objection to treating people, before they get too sick to save?

      • Don Monfort

        If you were smart, you would notice that a low, meaning relatively good, Clinical classification at the beginning of treatment did not correlate with avoidance of a Poor Clinical Outcome, as anybody but a dolt would notice:

        Clinical classification (NEWS score)
        0–4 (low) 43 (91.5%)* 948 (97.4%) 19 (41.3%)*** 1008 (95.0%)
        5–6 (medium) 2 (4.3%) 14 (1.4%) 10 (21.7%) 25 (2.4%)
        ≥ 7 (high) 2 (4.3%) 11 (1.1%) 17 (37.0%) 28 (2.6%)

        Watch this, 19 (41.3%) of the 46 Poor Clinical Outcomes came from the 0-4 Low NEWS score class.

      • David L. Hagen (HagenDL)

        Also ALL were already in the hospital!

    • “PClinO was independently associated with the use of selective beta-blocking agents and angiotensin II receptor blockers (p < .05)”

      This is not getting nearly enough attention. It may go a long way towards explaining the differences in mortality in different areas.

    • Re: “Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France”

      That’s another case series with no control group from Raoult’s group. As I went over before, that makes it lower quality than the case-control and cohort studies that were recently published:

      https://judithcurry.com/2020/03/14/coronavirus-discussion-thread/#comment-916797

      Experts have been justifiably complaining about this type of lower quality study design for awhile now:

      Journal of Clinical Epidemiology review : “COVID-19 coronavirus research has overall low methodological quality thus far: case in point for chloroquine/hydroxychloroquine”
      Annals of Pharmacotherapy review : “Emergency approval of chloroquine and hydroxychloroquine for treatment of COVID-19”
      “A rush to judgment? Rapid reporting and dissemination of results and its consequences regarding the use of hydroxychloroquine for COVID-19”

      At some point, Raoult needs to learn to use a control group, and to stop coming up with asinine excuses for not doing so. This clinical study design 101:

      “[Raoult] is, fundamentally, a contrarian.
      […]
      Raoult likes to think of himself as a doctor first, however, with a moral obligation to treat his patients that supersedes any desire to produce reliable data. “We’re not going to tell someone, ‘Listen, today’s not your lucky day, you’re getting the placebo, you’re going to be dying,’” he told me. He believes it to be unnecessary, in addition to being unethical, to run randomized controlled trials, or R.C.T.s, of treatments for deadly infectious diseases. If these have become the accepted standard in biomedical research, Raoult contends, it is only because they appeal to statisticians “who have never seen a patient.” He refers to these scientists disdainfully as “methodologists.””

      [ http://archive.is/swyHI#selection-1233.125-1233.813 ]

      Raoult’s reasoning is silly, since a properly-done double-blind trial wouldn’t allow him know which patients received a placebo, and thus he wouldn’t have to tell them that anyway. Furthermore, hydroxychloroquine was not well-tested in COVID-19 patients yet (with numerous, replicated studies show it was beneficial), so he didn’t know if it would harm them more than placebo. Thus he was in no position to preemptively tell them they were worse off with a placebo than with hydroxychloroquine. That’s in contrast to other situations in which this ethics argument would apply, such as withholding a blood transfusion from a heavily bleeding patient, even after decades of research showed that transfusions saves lives in that situation. Finally, it’s not as if the placebo control group gets nothing. They should get standard-of-care, which can include ventilator support if they need it, medications to ease symptoms, and so on.

      • Don Monfort

        The savaging of Dr. Raoult’s stellar reputation is obscene. There is no definitive evidence on the effectiveness of HCQ, one way or the other. The studies of Dr Raoult are as good or better than anybody else’s retrospective studies. On safety, there is squat to indicate that HCQ is the deadly poison that left loon propagandists portray it to be, only because Trump “touted” it. Notice they don’t have anything negative to say about Remdesivir, which has managed to get over a low threshold in a marginally informative trial. No mention in all the coverage I have seen that Trump “touted” Remdesivir, at the same time he expressed hope that HCQ would be proven to be effective.

        https://clinicaltrials.gov/ct2/results?cond=covid+19&term=hydroxychloroquine&cntry=&state=&city=&dist=

        There are now 185 formal clinical trials for HCQ vs. the COVID 19 virus. 3 added since yesterday. Why all the interest? Why all those resources directed towards HCQ research? We will find out soon, if it works. The propagandists will either celebrate that a desperately needed drug candidate has failed to be proven helpful against a deadly pandemic virus, or they will ignore the good news and find something else to whine about. The little varmints.

      • Don Monfort: The savaging of Dr. Raoult’s stellar reputation is obscene.

        There is nothing more inimical to the progress of medical science than the belief that the answer is already known. Dr. Raoult’s work exemplifies the cost of that attitude. Thousands of patients on, we can still not tell from his work whether HCQ is effective against COVID-19, in patients from his practice area, when treated by his team. What little information we can glean from the skimpy reporting of his cases is that his patients were healthier than the patients in other studies, and they would have survived without HCQ.

        If you think “reputation” is a substitute for evidence, you need to read more medical history, starting with Dr Ignatz Semmelweis and non-doctor volunteer Florence Nightingale. Both of them were vilified for savaging the reputations of Drs with stellar reputations, and both were proved right by the evidence as it was accumulated.

        About this “quote”: “We’re not going to tell someone, ‘Listen, today’s not your lucky day, you’re getting the placebo, you’re going to be dying,’” he told me. He believes it to be unnecessary, in addition to being unethical, to run randomized controlled trials, or R.C.T.s, of treatments for deadly infectious diseases. If these have become the accepted standard in biomedical research, Raoult contends, it is only because they appeal to statisticians “who have never seen a patient.” He refers to these scientists disdainfully as “methodologists.””

        If that is a fair transcription of what he actually said, then he is naive or ignorant.

      • Don Monfort

        You are not qualified to judge Dr. Raoult’s work. He did not set out to prove anything to unqualified dim bulbs. He has chosen so far not to conduct double blind placebo controlled clinical trials. He has been giving the best treatment he knows how to his patients with a potentially deadly disease with NO approved treatment, which in Dr. Raoult’s judgement doesn’t include giving placebos to half of them. His reputation and the extensive body of his medical research work is stellar and you are nobody.

        Accusing Dr. Raoult of cherry picking healthier subjects is low character assassination. You are stubbornly ignorant and to keep insisting that Dr. Raoult has to conduct double blind clinical trials is arrogant foolishness. You have dunked on yourself many times in this discussion proving that you don’t have a clue about medicine, ethical medical practice and clinical trials. When you are conclusively confronted with your lack of knowledge, you clam up and move on. Pathetic.

        In the last several hours there have been 2 more authorized trials added to the list. Now it’s 187. Dr. Raoult is not holding anybody back. In fact, it is a certainty that Dr. Raoult’s work and the work of thousands of other docs all over the world who use HCQ as their standard first line treatment for COVID 19 have inspired these trials. Maybe all those docs are wrong. We will see:

        https://clinicaltrials.gov/ct2/results?cond=covid+19&term=hydroxychloroquine&cntry=&state=&city=&dist=

        And the quote of what Dr. Raoult allegedly said is broken up with some joker adding his own commentary/spin. Are you really silly and dim enough to interpret the actual words of Dr. Raoult to mean he is disdainful of clinical trials?

        “We’re not going to tell someone, ‘Listen, today’s not your lucky day, you’re getting the placebo, you’re going to be dying,’” he told me. He believes it to be unnecessary, in addition to being unethical, to run randomized controlled trials, or R.C.T.s, of treatments for deadly infectious diseases. If these have become the accepted standard in biomedical research, Raoult contends, it is only because they appeal to statisticians “who have never seen a patient.” He refers to these scientists disdainfully as “methodologists.””

        The spin is false. Dr. Raoult’s words are being taken out of context and context added by a dishonest “reporter”. Dr. Raoult is defending himself against “methodologists”, who are criticizing him for practicing medicine, instead of doing clinical research.

        If Dr. Raoult actually said “He believes it to be unnecessary, in addition to being unethical, to run randomized controlled trials, or R.C.T.s, of treatments for deadly infectious diseases.”, why not quote him saying it? This is just another hatchet job of reporting. Dr. Raoult chooses not to conduct clinical trials on patients with a deadly disease. His choice. And you are stubbornly ignorant.

      • Don Monfort

        My comment went to moderation. F— it. No more time for your foolishness.

      • Matthew –

        + 1

        That said, delicate his dubious approach towards validating evidence, there’s always a chance that Raoult’s approach will prove beneficial here as has happened previously.

        But the pandering towards Raoult, from the pro-virus killing old people in NY crowd, is unfortunate.

      • Don Monfort

        187 Studies found for: hydroxychloroquine | covid 19
        Also searched for SARS-CoV-2 and Plaquenil.

        https://clinicaltrials.gov/ct2/results?cond=covid+19&term=hydroxychloroquine&cntry=&state=&city=&dist=

        But there is something wrong, dishonest, unethical, evil, shady etc. about Dr. Raoult treating patients with it, when there is no formally approved treatment for a novel and deadly pandemic disease.

        So, what compels the NYslimes to chop an interview up into sentence fragments and single words, then insert a lot of BS that they could have quoted Dr. Raoult espousing, if he actually espoused it? Well, it’s the NYslimes and they slime people they don’t like.

        You know you are in trouble when joshie is on your side, mattie.

      • @Don Monfort

        Re: “You are not qualified to judge Dr. Raoult’s work.”

        Strange argument for you to make, since many of you on here act like you’re qualified to judge the work of climate scientists, even though you lack expertise in the subject. Anyway, as I said on the other thread, qualified experts judge Raoult’s work to be of lower quality. And I agree with them, since I’ve been trained in how to evaluate medical studies, with years of practice in doing it. I didn’t all of a sudden think I understood medical science just out of a politically-motivated desire to defend what Donald Trump and various right-wingers said about hydroxychloroquine. So I know Raoult’s ‘case series with no control group’ study design is inferior to the case-control and cohort studies showing hydroxychloroquine is ineffective. And that’s not even touching on the other deficiencies in Raoult’s co-authored work:

        https://judithcurry.com/2020/03/14/coronavirus-discussion-thread/#comment-916797

        “COVID-19 coronavirus research has overall low methodological quality thus far: case in point for chloroquine/hydroxychloroquine”
        “Emergency approval of chloroquine and hydroxychloroquine for treatment of COVID-19”
        “A rush to judgment? Rapid reporting and dissemination of results and its consequences regarding the use of hydroxychloroquine for COVID-19”

        We can know add the American College of Physicians (ACP) to the list, since they now note that hydroxychloroquine should not be used as a treatment (nor a prophylaxis) for COVID-19, outside of clinical trials:

        “ACP: Evidence Does Not Support Chloroquine or HCQ Use Alone or in Combination with Azithromycin as Prophylaxis for COVID-19
        […]
        At this time, the authors of the Practice Points have identified that chloroquine or hydroxychloroquine alone or in combination with azithromycin to prevent COVID-19 after infection with novel coronavirus (SARS-CoV-2), or for treatment of patients with COVID-19 should not be used. The Practice Points also state that the drugs may only be used to treat hospitalized COVID-19 positive patients in the context of a clinical trial following shared and informed decision-making between clinicians and patients (and their families) that includes a discussion of known harms of chloroquine and hydroxychloroquine and very uncertain evidence of benefit for COVID-19 patients.”

        https://www.acponline.org/acp-newsroom/acp-evidence-does-not-support-chloroquine-or-hcq-use-alone-or-in-combination-with-azithromycin-as

        “Should clinicians use chloroquine or hydroxychloroquine alone or in combination with azithromycin for the prophylaxis or treatment of COVID-19? Living Practice Points From the American College of Physicians (Version 1)”
        https://www.acpjournals.org/doi/10.7326/M20-1998

        https://pbs.twimg.com/media/EYBA6JgXQAIekMn?format=jpg

      • Don Monfort

        More foolish jibber jabber. Dr. Raoult does not have to do double blind placebo controlled trials. He is treating patients and has reported his peer reviewed results in a journal:

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102549/

        There are 187 HCQ-COVID 19 trials underway. More coming on line every day. Why do you harpies harp on Dr. Raoult not choosing to do a trial that requires feeding half the patients faux medicine? Do you know what a placebo is?

        Name the trial that contradicts Dr. Raoult’s work that is double blind, placebo controlled and peer reviewed. Don’t just jabber about it, provide the links.

        Just a few days ago we had super left loon TDS “journalist” Chuck Todd use the old chop up the interview trick, to claim that AG Bill Barr said stuff that he didn’t say. It’s standard TDS left loon “journalism”. They are going after Dr. Raoult, because Orange Man Bad. That’s why you are harping on about it. Shame on the lot of you. Why should we be impressed that you have attacked Dr. Raoult’s reputation and credibility citing that chopped up sliced and diced put through the left loon TDS spin machine interview crap from the NYslimes? Not impressed.

        Dr. Didier Raoult 3,287 articles listed in Google Scholar:

        https://scholar.google.com/citations?view_op=new_articles&hl=en&imq=Dr,+Didier+Raoult#

        Over 100k citations. What are your credentials, anonymous whatever you claim to be? Oh, I remember: epididdlymologist.

      • Don Monfort

        The left loons are giving Dr. Raoult the same smear treatment they use on climate scientists, who don’t obsequiously toe the party line. The only reason this character pokes his little pointy head in here is to denigrate Dr. Curry’s blog and attempt to sully her reputation. He’s not the only one. They all have a smarmy slimy pomposity that they should try to hide, if they really want to get the results they are after.

      • Don, you need to learn what the “evidence pyramid” is. It’s fundamental to reading and comparing medical studies in evidence-based medicine. I’ve explained this to you before. You don’t grasp it, which makes you ill-equipped to evaluate Raoult’s research, especially in comparison to research. So instead you substitute in your political bias (ex: desire to defend Donald Trump), hero worship of someone you (incorrectly) think is being persecuted, and so on, in the place of understanding, as you do on climate science.

        So here’s a simple query for you: I’m going to (again) link you to sources on the “evidence pyramid”. Then I’m going to (again) point you to case-control and cohort studies on hydroxychloroquine not being effective. In response, you should tell me whether a case series with no control group (e.g. much of Raoult’s work) is lower on the evidence pyramid than a case-control study or cohort study. I predict that you won’t meet my request, and will instead (again) demand an randomized controlled trial to get around the fact that the case-control and cohort studies are better than Raoult’s work on case series with no control group.

        evidence pyramid: https://amedd.libguides.com/c.php?g=476751&p=3259492 ; https://library.triton.edu/c.php?g=433673&p=3720267
        “New evidence pyramid” [ https://ebm.bmj.com/content/21/4/125 ]
        “Justification for the hierarchical pyramid of evidence-based medicine and a defense of randomization” [ https://sci-hub.tw/10.1007/978-3-030-44270-5_7 ]

        Autoimmunity Reviews, case-control study : “Continuous hydroxychloroquine or colchicine therapy does not prevent infection with SARS-CoV-2: Insights from a large healthcare database analysis”
        JAMA paper, cohort study : “Association of treatment With hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State”
        NEJM paper, cohort study : “Observational study of hydroxychloroquine in hospitalized patients with Covid-19”
        NEJM companion piece : “The urgency of care during the Covid-19 pandemic — Learning as we go”

      • It’s truly disgusting to watch anonymous internet hacks attack scientists and doctors. Why not just let the science play out? This whole HDCQ issue has now morphed into a political struggle for the left wing hacks to use as just another talking point. We will know soon enough if it works or not. Get a life and stop the attacks.

      • Matthew R Marler

        Don Monfort: He has been giving the best treatment he knows how to his patients with a potentially deadly disease with NO approved treatment, which in Dr. Raoult’s judgement doesn’t include giving placebos to half of them. His reputation and the extensive body of his medical research work is stellar and you are nobody.

        This is not a criticism of his character, it is a critique of the quality of his results as evidence concerning the effectiveness of HCQ. He didn’t set out to obtain good evidence, and he did not obtain good evidence. It isn’t about my reputation vs his reputation, it is about whether the purported evidence from his reports can withstand professional criticism. It does not stand up well. If you are going to cite his work as evidence that HCQ works, then you have to endure the critique of its evidentiary value. Or, you can say, as you often do, that as clinical work it should not be judged as evidence.

      • verytallguy

        dpy, you’re hilarious

        “Why not just let the science play out? This whole HDCQ issue has now morphed into a political struggle…”

        Yeah, it’s disgusting how those left wing hacks forced Donald Trump to make unsupported claims on an unproven treatment.

        They sicken me.

      • @dpy6629

        Your response was just evidence-free complaining. Let me know when you can actually address the published evidence I cited. Remember you gave the following insult-laden reply to me on the other thread (which Curry conveniently kept up, while deleting my response to your comment):

        “My brother holds an MD and is medical director for a network of hospitals. He researched the literature himself and says that the major and scary side effects of Hydroxychloroquine come only after years of use. He is using a 5 day regimen. The medication has a long half life, so physicians are told to use conservative doses.
        […]
        My brother would tell you to go to hell and that’s my attitude too. MD’s are qualified to prescribe off label. Anonymous internet hacks should just shut up.”

        https://judithcurry.com/2020/03/14/coronavirus-discussion-thread/#comment-915145

        Are you now going to tell the American College of Physicians (ACP) to “shut up” as well? Are you going to call them “[a]nonymous internet hacks”? You haven’t really thought this through, have you?
        Feel free to use your usual excuses for evading the point (ex: ‘oh, your post is too long for my attention-span!’).

        “ACP: Evidence Does Not Support Chloroquine or HCQ Use Alone or in Combination with Azithromycin as Prophylaxis for COVID-19
        […]
        At this time, the authors of the Practice Points have identified that chloroquine or hydroxychloroquine alone or in combination with azithromycin to prevent COVID-19 after infection with novel coronavirus (SARS-CoV-2), or for treatment of patients with COVID-19 should not be used. The Practice Points also state that the drugs may only be used to treat hospitalized COVID-19 positive patients in the context of a clinical trial following shared and informed decision-making between clinicians and patients (and their families) that includes a discussion of known harms of chloroquine and hydroxychloroquine and very uncertain evidence of benefit for COVID-19 patients.”

        https://www.acponline.org/acp-newsroom/acp-evidence-does-not-support-chloroquine-or-hcq-use-alone-or-in-combination-with-azithromycin-as

      • We’ll have proof soon enough. Wasting your time prejudging those results shows political motivations and someone with nothing productive to do with their time. No one will care what anonymous internet personas say. Getting a life and making a contribution will be more rewarding.

      • Re: “We’ll have proof soon enough.”

        No, we won’t, since this is science, not math or formal logic. Instead we’ll have more evidence. We have evidence now, including via the case-control and cohort studies I cited. You’re just willfully ignoring the evidence and substituting in insults instead, as usual. Let me know when you’re finally done lashing out. I won’t hold my breath.

        “From a philosophical perspective, science never proves anything—in the manner that mathematics or other formal logical systems prove thing —because science is fundamentally based on observations.”
        https://www.nap.edu/read/12782/chapter/4#21

      • Don Monfort

        More jibber jabber from the pointy headed epididdlymologist. I challenged this jabbering character:

        Name the trial that contradicts Dr. Raoult’s work that is double blind, placebo controlled and peer reviewed. Don’t just jabber about it, provide the links.

        Still waiting. Meanwhile another 5 trials added at clinicaltrials.gov in the last few hours:

        192 Studies found for: hydroxychloroquine | covid 19
        Also searched for SARS-CoV-2 and Plaquenil.

        Including 2000 patient trial begun by the NIH:
        https://www.nih.gov/news-events/news-releases/nih-begins-clinical-trial-hydroxychloroquine-azithromycin-treat-covid-19

        Thank you Dr Didier Raoult and the thousands of other docs, whose clinical experience treating COVID 19 victims has inspired the yuuge interest and investment of resources in pursuing HCQ as a possible effective treatment for the deadly pandemic virus COVID 19. All people of good faith hope that the left loon virus cheerleaders are mightily embarrassed, when the results of randomized double-blind, placebo controlled trials start rolling in.

      • This is so simple, perhaps too simple for anonymous unqualified internet personas to understand.

        1. Doctors all over the world are using HDCQ because they think there is adequate evidence that it will help their patients.
        2. They are qualified and licensed to do so. Anonymous internet hacks are not qualified to attack their expert judgment. What you are doing here is perfect merchants of doubt behavior.
        3. The hours spent by said internet hacks typing comments that no one will read or care about would be well advised to spend their time actually doing some analysis or otherwise making a contribution of substance.
        4. I do this to learn and have learned a lot from many posts and commenters. Sanakan and VTG have never taught me anything because what they post is either cherry picked, wrong, or mere sarcasm. Adults have better things to do with their time.

      • And both dpy + Don response in the substance-free responses predicted. without addressing any of the cited evidence. Typical.

      • verytallguy

        dpy

        “Adults have better things to do with their time”

        Yet here you are.

      • Don Monfort

        More jibber jabber from the pointy headed epididdlymologist. I challenged this jabbering character:

        Name the trial that contradicts Dr. Raoult’s work that is double blind, placebo controlled and peer reviewed. Don’t just jabber about it, provide the links.

        Still waiting.

      • Don Monfort

        Hmmm, sounds like a vast right wing conspiracy.

        “1. Doctors all over the world are using HDCQ because they think there is adequate evidence that it will help their patients.”

        Somebody notify the NYslimes.

      • Don,

        I just watched Trump’s news conference and not a mention of hydroxychloroquine. He did mention remdesivir. Sounds like he’s moved on. Maybe you should too.

        BTW, just so you know that I’m not always completely partisan, the plans for Warp Speed actually sound coherent and in the right direction. I ‘ll still wait to see how well the plan gets carried out but actually I won’t be too critical if the timeline slips.

      • Don Monfort

        The things that pop out of your pointy little head. Maybe The Big Orange Fella has decided not to give the shameful left loon China virus cheerleaders, look in the mirror, any more opportunities to attack HQC because Orange Man Bad.

        Last time I looked there were 192 clinical trials underway, with a new 2000 patient trial just announced by NIH. Does that look like anybody is moving on from HQC? Does that look like there is any significant evidence to discourage medical researchers from investing time, money and effort in HQC vs. Covid 19 research?

      • James –

        > BTW, just so you know that I’m not always completely partisan, the plans for Warp Speed actually sound coherent and in the right direction.

        So did the plans for the testing in every parking lot in the country – you know, where Trump and Pence and all those CEOs spend an hour fluffing each other? Too bad that didn’t work out as well as it sounded; they fall ridiculously short of their promises. And how about that Google website? Jeez.

        Let’s hope this one works better. Testing those vaccines in time will be tough. Human challenge trials can be a big obstacle.

        But yeah, let’s hope this one works better.

      • @Don Monfort

        Re: “More jibber jabber from the pointy headed epididdlymologist. I challenged this jabbering character:
        Name the trial that contradicts Dr. Raoult’s work that is double blind, placebo controlled and peer reviewed. Don’t just jabber about it, provide the links.
        Still waiting.”

        Well…

        “Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial
        […]
        Administration of hydroxychloroquine did not result in a significantly higher probability of negative conversion than standard of care alone in patients admitted to hospital with mainly persistent mild to moderate covid-19. Adverse events were higher in hydroxychloroquine recipients than in non recipients.”

        https://www.bmj.com/content/369/bmj.m1849

        I predict Don will move the goalposts or evade in some other way, since that’s what he’s done before. Maybe he’ll complain that the study uses no placebo, even though that isn’t necessarily required when one is using standard-of-care for the control group, as I’ve noted elsewhere in the thread ( https://judithcurry.com/2020/05/06/covid-discussion-thread-vi/#comment-916904 ).

      • The drug tocilizumab may be a better option than hydroxychloroquine:

        “Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia
        […]
        Patients admitted before March 13th (n=23) were prescribed the standard therapy (hydroxychloroquine, lopinavir and ritonavir) and were considered controls. On March 13th tocilizumab was available and patients admitted thereafter (n=62) received tocilizumab once within 4 days from admission, plus the standard care.
        […]
        Patients receiving tocilizumab showed significantly greater survival rate as compared to control patients (hazard ratio for death, 0.035; 95% confidence interval [CI], 0.004 to 0.347; p = 0.004), adjusting for baseline clinical characteristics.
        […]
        Tocilizumab results to have a positive impact if used early during Covid-19 pneumonia with severe respiratory syndrome in terms of increased survival and favorable clinical course.”

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219361/

        To go over this in more detail, I’ll start with what I said elsewhere:

        “Hydroxychloroquine differs from chloroquine. But this class of medication has previously been used to treat viral infections.
        […]
        This makes some sense since this class of medication helps limit hyper-inflammatory responses, as would occur in a cytokine storm. To simplify: one of the problems with COVID is that one’s immune system over-reacts to the virus. Medications like hydroxychloroquine help limit that immune response, which is why these medications are sometimes given to people who have conditions like rheumatoid arthritis and lupus, in which one’s immune system is hyperactive.”
        https://judithcurry.com/2020/03/14/coronavirus-discussion-thread/#comment-914377

        One of the inflammatory molecules (inflammatory cytokines) involved in this process is interleukin-6, also known as IL-6. So blocking IL-6 signaling would limit the hyperactive immune response, thereby possibly helping with COVID-19. Tocilizumab is an antibody that binds to the receptor for IL-6 (a.k.a. IL-6R), blocking IL-6 signaling; so doctors use tocilizumab and hydroxychloroquine to treat some of the same autoimmune conditions, such as rheumatoid arthritis. Hence tocilizumab also being investigated as a treatment for COVID-19. For further context on this, see:

        “Why tocilizumab could be an effective treatment for severe COVID 19?”
        “The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality”
        Non-peer-reviewed: “Profiling COVID-19 pneumonia progressing into the cytokine storm syndrome: results from a single Italian Centre study on tocilizumab versus standard of care”

        Some studies investigated how safe tocilizumab was for patients, and showed patients improved with tocilizumab treatment. However, these studies were case series lacking a control group, and therefore aren’t a very good design for assessing how effective tocilizumab is, as per the evidence pyramid. Some sources discussing this:

        “Effective treatment of severe COVID-19 patients with tocilizumab”
        “Treat 2019 novel coronavirus (COVID-19) with IL-6 inhibitor: Are we already that far?”
        “Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy”
        “Pilot prospective open, single-arm multicentre study on off-label use of tocilizumab in severe patients with COVID-19”
        “Tocilizumab treatment in COVID-19: A single center experience”
        Non-peer-reviewed: “The cardio-toxicity of chloroquine, hydroxychloroquine, azithromycin and tocilizumab: Implications for the treatment of SARS-CoV-2 (COVID-19)”

        So far, studies using a control group end up with more mixed results, with the study I mentioned before showing a better chance of survival with tocilizumab treatment, while preliminary results from another study failed to show this:

        “Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia”
        “Tocilizumab for treatment of severe COVID-19 patients: Preliminary results from SMAtteo COvid19 REgistry (SMACORE)”

        There are some clinical trials investigating tocilizumab, but hydroxychloroquine has received more attention, both in terms of the number of trials and in terms of public attention:

        Non-peer-reviewed: “The race to find a SARS-CoV-2 drug can only be won by a few chosen drugs: a systematic review of registers of clinical trials of drugs aimed at preventing or treating COVID-19”

        Hopefully people will now pay relatively more attention to tocilizumab vs. of hydroxychloroquine, especially in light of the previously discussed, higher-quality studies showing hydroxychloroquine is ineffective.

      • Don Monfort

        anonymous pompous pathetic epididdlymologist says:

        “Name the trial that contradicts Dr. Raoult’s work that is double blind, placebo controlled and peer reviewed. Don’t just jabber about it, provide the links.
        Still waiting.”

        Well…

        “Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial”

        Covered that flawed inconclusive trial last night, bottom of these comments. Look for it, if you want to get educated. Among several other issues, it’s open label and has no placebo.

        Still waiting.

      • At this point, the chances are quite remote for hydroxychloroquine to show both a statistically significant and clinically significant benefit:

        “Hydroxychloroquine versus COVID-19: A periodic systematic review and meta-analysis
        […]
        This systematic review and meta-analysis not only showed no clinical benefits regarding HCQ treatment with/without azithromycin for COVID-19 patients, but according to multiple sensitivity analysis, the higher mortality rates were observed for both HCQ and HCQ+AZM regimen groups, especially in the latter. Also, frequency of adverse effects was higher in HCQ regimen group. However, due to that most of the studies were nonrandomized and results were not homogenous, selection bias was unavoidable and further large randomized clinical trials following comprehensive meta-analysis should be taken into account in order to achieve more reliable findings.”

        Click to access 2020.04.14.20065276v3.full.pdf

        Dr. David Gorski:
        “So, basically, the evidence for hydroxychloroquine is basically all negative, except for studies from Didier Raoult’s group (and those are singularly uninformative) and a small study long ago. This leads me to ask: Why did the NIH just announce a large randomized clinical trial of hydroxychloroquine:
        […]
        Given the existing state of the evidence, I would argue that the pretest probability of a positive study is very low. Existing preliminary evidence for hydroxychloroquine, were this any other drug and were we not in a pandemic, would very likely not justify a large randomized clinical trial.”

        https://respectfulinsolence.com/2020/05/15/raoult-in-the-nyt/

        Dr. Steven Novella:
        “The current level of evidence, multiple large trials that are observational but rigorous in different settings with different researchers, all finding no benefit, and if anything a negative or neutral trend, is pretty damning. This is the level of evidence that would be used to determine if the investment and risk to patients of doing controlled trials is worth it, and the answer would likely be no.
        […]
        The probability that more rigorous or larger studies will find a significant effect missed by these trials is vanishingly small.”

        https://theness.com/neurologicablog/index.php/no-benefit-from-hydroxychloroquine-for-covid-19/

        “”The nail has virtually been put in the coffin of hydroxychloroquine,” said Dr. William Schaffner, an infectious disease expert and longtime adviser to the US Centers for Disease Control and Prevention.”
        https://www.cnn.com/2020/05/11/health/hydroxychloroquine-doesnt-work-coronavirus/index.html

        Tocilizumab is now a more viable option, as discussed elsewhere. Time to move on, until the results from larger randomized clinical trials show otherwise:

        https://judithcurry.com/2020/05/06/covid-discussion-thread-vi/#comment-917166

        Tocilizumab effective:
        “Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia”
        “Profiling COVID-19 pneumonia progressing into the cytokine storm syndrome: results from a single Italian Centre study on tocilizumab versus standard of care”
        “Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients”
        Non-peer-reviewed : “Improved survival outcome in SARs-CoV-2 (COVID-19) Acute Respiratory Distress Syndrome patients with tocilizumab administration”

        Tocilizumab ineffective:
        “Tocilizumab for treatment of severe COVID-19 patients: Preliminary results from SMAtteo COvid19 REgistry (SMACORE)”

  4. David L. Hagen (HagenDL)

    COVID-19 Mortality <0.01% in Lupus/Rheumatoid Arthritis patients on Hydroxychloroquine in Italy. Only ~0.03% tested COVID-19 positive (20/65000) though Italy had 207,428 cases & 28,236 deaths from COVID-19. Coronavirus, revealed how it works: that’s why hydroxychloroquine could work. by Peter D’Angelo APRIL 28, 2020 (from Italian via google translate)
    https://www.iltempo.it/salute/2020/04/28/news/coronavirus-farmaci-efficaci-news-danni-cura-annalisa-chiusolo-artrite-terapia-idrossiclorochina-sars-cov2-1321227/

  5. David L. Hagen (HagenDL)

    Clinical Trials: Avni Thakore MD, St. Francis Hospital, New York
    Hydroxychloroquine and Zinc With Either Azithromycin or Doxycycline for Treatment of COVID-19 in Outpatient Setting

    This is a randomized, open-label trial to assess the safety and efficacy of hydroxychloroquine, and zinc in combination with either azithromycin or doxycycline in a higher risk COVID-19 positive outpatient population.
    COVID-19 is an aggressive and contagious virus, found to have high mortality especially in persons with comorbidities (Age>60, hypertension [HTN], diabetes mellitus [DM], Cancer, and otherwise immunocompromised). Zinc is a supplement with possible antiviral properties, having been shown to have effect in the common cold, many of which are due to coronavirus. In addition, elderly patients and patients with co-morbidities have high incidence of zinc deficiency. We are repleting zinc in all patients and studying its direct effect in combination with hydroxychloroquine, and an antibiotic, either azithromycin or doxycycline to see if there is enhanced treatment efficacy in early COVID-19 infection and assess the safety of these two regimen.

    https://clinicaltrials.gov/ct2/show/NCT04370782

  6. Could you please reshare the link to the German antibody study? The link seems to be wrong. Thanks

  7. The BBC article, “India coronavirus: The ‘mystery’ of low Covid-19 death rates,” ends with the ambiguous phrase that covid deaths are ‘unarguably low’ when in fact, the article details very well all of the reasons why there is no mystery as to why we don’t know and will never know the real number for India.

    • Oh, maybe I get it – that’s why, going back to the headline, they put ‘mystery’ in quotes… there is no mystery.

    • My husband collaborates with some people in India. One of his collaborators told him she is taking hydroxychloroquine daily as a COVID-19 prophylactic. She said because of the very high rate of malaria in India there is ready and easy availability of hydroxychloroquine. This means a lot of people may be doing that and that may be a factor in what is going on.

      • There are many anomalies globally that should give researchers years of fertile territory. Other countries, such as Ethiopia with a population of over 100 million and 4 deaths, have incredibly low death rates. It may be too soon for conclusions but it seems there’s a growing list of mysteries to be solved.

      • That’s for sure. Thailand is another mystery place with low mortality. The Thais have an exceptionally good public health care system, widespread public education about the spread of infectious diseases because of their efforts about AIDS and they were also one of the first if not the first places on Earth to have an antibody test. They are also fair skinned and have higher levels of vitamin D as a population. Vitamin D seems to be part of the equation as well.

      • Don Monfort

        Malaria and use of anti-malarial drugs also prevalent in Ethiopia.

      • TWS –

        > They are also fair skinned and have higher levels of vitamin D as a population

        Really? I never noticed that when traveling in Thailand.

        Actually, there is pretty wide variance. The indigenous Thais have darker skin than those who are of Chinese descent.

      • I have never been there myself so I am merely going by reports overall from people there.

  8. Excellent article on evidence and possibility of dangerous mutations of SARSCoV2.

    https://t.co/QNYVKzgM7w?amp=1

    • Isn’t it more typical for just the opposite to occur? That is, the severity of the pandemic wanes as the virus mutates. Muller’s Ratchet or something along those lines?

  9. One quote from the Wired review introducing the U MInn study:
    The info war on Chloroquine has slowed COVID-19 science

    “The social media perspective is: About half of people think it’s an unethical trial because it clearly works, and the other half thinks it’s clearly dangerous and we shouldn’t do it,” Boulware says. “We’re just trying to get the answer. Having a solid study design and having the actual answer is really important for both the country and the world, and that’s our goal.”

    Succinct review of limitations of extant data and advocacy of more clinical trials. Strong beliefs among people in the catchment area seem to have dramatically reduced the rate of recruitment into the study so it may not achieve its target enrollment of 1000.

    • Trump said he regrets ever bringing it up simply because the irrational hatred of him is so intense and pervasive he must be proven wrong regardless of the science involved. If he hadn’t talked about it as a possibility there would not be anywhere near so much resistance to it.

      • > If he hadn’t talked about it as a possibility there would not be anywhere near so much resistance to it.

        Nor would there be so many people that are getting ahead of the validated evidence. The politicization runs both ways.

        Hopefully, it will turn out effective and getting out in front of the evidence will prove beneficial.

      • Let’s hope all the results come in without politicization. I don’t recall Trump ever saying anything but it was a possibility and it might work and he always spoke of it in the context of doctors using it, not individuals running out and using aquarium cleaner. Unfortunately, for some people anything Trump says or does is always 100% wrong 100% of the time. If he said the sky was blue in the rose garden CNN would have a blazing headline about there were thunderstorms in Texas while Trump said the skies were blue and Trump is an uncaring monster and liar to say the sky is blue while people in Texas have to worry about tornados.

      • > Unfortunately, for some people anything Trump says or does is always 100% wrong 100% of the time.

        You describe it as if it is a one-way phenomenon. It isn’t. In this example, there are actually potential downside aspects of Trump raising the issue of HCQ, and his supporters have a similar tribalistic reaction to addressing those downsides as Trump haters show with their reaction to his promotion of HCQ.

        Trump plays to the partisan hatred because he thinks there is a personal advantage to him doing so. It’s not something that’s unique to him among politicians. But, arguably, he does it more than other politicians do because it is more of an explicit strategy for him. He plays to his base and he’s at least more open about leveraging hostility towards his non-base to enhance his support from his base.

        But another aspect of all of this is that few in his base are interested in holding him accountable for his strategy. No doubt, they largely feel a sense of grievance – that he seeks to exacerbate and capitalize on.

        What’s particularly interesting is that often those who seem to want to portray Trump as some sort of victim one minute celebrate his manipulation of the media and antipathy towards Trump in the next minute.

      • stanonstuff

        The vicious political attacks aren’t just against Trump and his comments. They are on any and every doctor who talks about successful treatment protocols that disagree with the CDC and WHO. Even if Trump never mentions them.

      • Don Monfort

        Trump did not politicize hydroxychloroquine, joshie. It was in widespread use against COVID 19, well before Trump ever heard of it. Ideologically motivated people like you get up in the morning and check to see what Trump has said while you slept and then you all go about trying to convince folks that he’s crazy/evil for saying whatever it was that he said. A concerted deliberate effort to undermine the POTUS. Pathetic.

      • Joshua: “Nor would there be so many people that are getting ahead of the validated evidence.”

        Who got ahead of the validated evidence? All the comments about it from Trump and his supporters (at least those attacked relentlessly by the media) said there was anecdotal evidence that it worked, doctors were looking at it and trials would be conducted. In other words, they talked about a possible treatment regimen- something that all decent people actually do when thousands are dying of a contagious virus.

        That said, there were certainly some people who got way ahead of the evidence. The columnists and politicians who urged everyone not to take Trump’s “quack cure” may have blood on their hands.

    • I have been in touch with them. Say they will complete trial. They have over 800 patients.

  10. DATE NEW CASES INCREASE % # TESTS
    4/24/2020 39,887 7,763 24.1 465,986
    4/25/2020 36,342 -3,545 -8.8 251,263
    4/26/2020 39,806 3,462 9.5 256,441
    4/27/2020 23,095 -16,711 -41.9 216,029
    28-Apr 22,840 -255 -1.1 179,755
    4/29/2020 29,025 6,185 27 259,856
    4/30/2020 28,117 -908 -3.1 194,323
    5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    We are back TREADING WATER. We have about 350,000 asynptomatic people in the USA,
    14 days to clear the virus. we are removing 25,000 a day. Simle math.
    MORE TESTS!!!

  11. No sympathy for Ferguson. Like so many elitists he creates rules for everyone else but won’t bother to follow them himself. Hypocrites can’t be trusted. Our prime minister of Canada is another untrustworthy hypocrite. He tells all Canadians to stay home, don’t spend Easter with their families, don’t travel to you cottage in the country, don’t cross provincial boundaries, and then he promptly leaves to go spend Easter with his family at their summer across provincial lines.

  12. Robert Clark

    DATE NEW CASES INCREASE % # TESTS
    4/24/2020 39,887 7,763 24.1 465,986
    4/25/2020 36,342 -3,545 -8.8 251,263
    4/26/2020 39,806 3,462 9.5 256,441
    4/27/2020 23,095 -16,711 -41.9 216,029
    28-Apr 22,840 -255 -1.1 179,755
    4/29/2020 29,025 6,185 27 259,856
    4/30/2020 28,117 -908 -3.1 194,323
    5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203

    • Hard to beleice the lack of testing in this country. We’re something like 14th in classes per million and something like 41rst in testing per million.

      When will the federal government stop making excuses for their failures and start to be accountable?

      Answer = never.

      • Should be 14th in *cases* per million..

        Why do Trump fans just accept this failure?

        Is the rationale that it’s just fine that our performance in testing is so lacking? Have they convinced themselves that it just doesn’t matter?

        Richest country in the world. 41rst in per capita testing.

        Unreal.

      • You’re out of date. The USA is currently 6th in the world after Iceland, Estonia, Italy, Norway and Switzerland but I suspect you would be complaining even if the USA we first because well… Trump you know. Source: https://ourworldindata.org/coronavirus-testing#world-map-total-tests-performed-relative-to-the-size-of-population

      • Tumbleweed.

        Sort by testing per million. Then count.

        https://www.worldometers.info/coronavirus/

      • Don Monfort

        He’s still harping on testing. Blames it on Trump. It’s also Trump’s fault that the Cuomo-De Blasio syndicate just started cleaning the subway trains at night. Just started ordering the cops to enforce the lockdown. Just caught onto the fact that sending COVID 19 infected patients back to nursing homes was a catastrophic anthropogenic boneheaded simple-minded negligent dereliction of duty. Just learned that 2/3 rds of new COVID cases are stay-at-homes. When are those two clowns going to get on the ball, we ask our little putz who lives in a tiny studio apartment in the deep dark bowels of AOC’s pathetic Congressional district.

      • Don Monfort

        The biggest mistake Trump ever made was not building a wall around the NY metro area:

        NYC primary source for infections around the country

      • Josh, What is the science behind mass testing? You are just lashing out based on emotions. The real value of testing lies in doing random samples of various risk groups. We have plenty of testing for that.

        You still seem to believe that we can stamp this infection out via mass testing, tracking, etc. It’s too late. It’s physically impossible. We need to get busy with herd immunity.

      • Don Monfort

        Testing is all they have left. First, it was racism and xenophobia, because the Big Orange Fella banned China travel. Then it was ventilators, hospital beds, toilet paper and turnips. Not enough turnips. Too many briefings. Too many opportunities for the press to make fools of themselves. He’s trying to dispel fear and spread hope. Orange Man bad. Now that all that has been taken care of, it’s testing. He has to test everybody now, and tomorrow test them again, because they might catch it over night. OMG! He’s not wearing a face mask. Almost forgot that one.

      • Better yet, have some 40%+ infected, and running around, without knowing who’s infected. And protect the vulnerable.

      • Best testing in the world.

        Anyone who wants a test can get a test.

        Doesn’t matter what he says. Doesn’t matter how he fails. It’s a cult.

      • (antibody) testing is also useful for getting people back to work.

      • Don –

        Could you remind me again how many deaths you predicted?

      • Don, you forgot they all want to keep the total economic collapse going as long as possible. God forbid anyone goes to work, which must not happen until everyone in the US is tested 16 times. And is the reason why it is simply impossible that any treatment could prove even remotely beneficial.
        Thank goodness it won’t work. Now that layoffs are hitting government workers, their base wants to get back to work. And in the private sector, fewer and fewer people are honoring the lockdowns even in the deepest blue places.

      • Jeff –

        > Don, you forgot they all want to keep the total economic collapse going as long as possible.

        Yup. That’s what people really want. And you saw right through the ruse!

        > God forbid anyone goes to work, which must not happen until everyone in the US is tested 16 times.

        Do you really not understand the purpose of testing? The point is to identify people who are infectious at a given time, so as to enable an isolation strategy as people are engaging more and more in public. The point isn’t to achieve something perfect, where everyone is identified now and forever.

        > Now that layoffs are hitting government workers, their base wants to get back to work. And in the private sector, fewer and fewer people are honoring the lockdowns even in the deepest blue places.

        And we will see at that point that the economic damage taking place is not simply a function of the “lockdowns.”

      • Tumbleweed –

        We’re sixth in the list at that site – but that list isn’t a comprehensive one.

      • Don,

        If testing isn’t important, then why is everyone around the President and Vice President getting tested all the time?

        The big question I have is where did the valet pick up the virus from? From a Super Spreader maybe?

      • Don –

        > The weasel doc and the scarf lady doc initially said 2 million.

        The 2 million number was at the high end of a range. The low end was much lower. That number was a projection, yours was a prediction.

        Further, and most importantly, that 2 million number was under the condition that absolutely no social distancing would be taking place. In the report itself, they said that such a condition was not even remotely likely. Stop spinning. People are dying.

        I’m going to give you an example of the harmful spin you’re employing:

        I’m going to “prove” to you that rightwingers “want” people who “stay at home” to die.

        Remember conditional probability is hard.

        In rightwing web comment pages, there are a lot of people making a big deal out of a recent survey that found that recently, 66% of hospitalizations were people who had been “staying at home.”

        Sounds really bad, right? It proves that “lockdowns” don’t work, right?

        But I don’t see those folks making a big deal out of this asking what % of New Yorkers would describe themsevles as staying at home. Imagine it is 80%. If so, what would it mean that 66% of hospitalizations were among people who self-report “staying at home.” Suppose it were only 30%. Again, even in that case, some 66% reporting they were staying at home would take on a very different meaning that if it were only 10%.

        Further, such a survey of self-report is notoriously likely to be inaccurate.

        Now imagine that people were saying that the rightwingers “wanted” results such as this survey because it “proved” that rightwingers want people who “stay at home” to die.

        That is essentially the logic that you’re employing, constantly.

        Stop spinning. People are dying.

      • That 1-2 million came from Ferguson. His IFR is 1.0%. That’s an overestimate of a factor of 4-5. The real number with no mitigation is 250K – 500K.

        You keep beating this dead horse about fatalities among those who stay at home. What’s the point? If you think people on other sites are wrong, why are you rebutting them here? It’s a waste of your free time of which you seem to have too much.

      • > fatalities among those who stay at home.

        All cause mortality rates show that deaths of COVID could be double those reported.

        > That’s an overestimate of a factor of 4-5.

        There’s still a lot of uncertainty. Especially cross nationality. Stop spinning.

        > The real number with no mitigation is 250K – 500K

        even at half the 1.0%, depending on what % of infections “herd immunity” would take, depending on levels of immunity, timing of onset and duration, with no mitigation the numbers could be significantly higher

        Respect uncertainty.

      • Don Monfort

        I will no longer read the comments of joshie and jimmy. It’s just aggravation, disappointment and time wasted that one can never get back.

      • Don Monfort: I will no longer read the comments of joshie and jimmy. It’s just aggravation, disappointment and time wasted that one can never get back.

        Focus on the ideas, or expressions of ideas, not the persons. And expect lots of point-counterpoint. You’ll be happier.

      • Here’s a sample for estimating IFR:

        https://www.usatoday.com/story/news/investigations/2020/05/06/meatpacking-industry-hits-grim-milestone-10-000-coronavirus-cases/5176342002/

        10,000 cases, 45 deaths.

        Certainly non-representative w/r/t infection rate. My guess is it might be fairly representative in SES, although not likely in ethnicity/race. Probably no worse than doing what they did with the Santa Clara study – which was to take a non-representative (and non-random) sample and from that calculate an infection rate and then from that extrapolate to a broadly applicable IFR.

      • Should point out also that with the meat packers as a sample…

        I’d assume that sample would include relatively few over 60, probably no one over 75… which would make the IFR with that sample lower than a representative sample given the much higher IFR in association with age over 60.

        Also, I would note that the # of deaths might likely go up over the next two weeks with that same sample.

      • Josh, The Miami Dade data is perhaps the best one available because they tried to make it a random sample. Based on that data and waiting 21 days to take the fatality number (others have used a 14 day delay) I get .17% to .31% for the IFR. That’s probably too high but applying that to the US (assuming 2/3 of those infected would die from other causes within a year as Ferguson assumes) that’s 6% to 11% excess mortality in a year. It’s tragic but not the end of the world and not worth the massive pain our over reaction will cause over the next decade.

        You should stop denying the science which is really very clear by now. The serological test studies are getting to be very conclusive.

      • > Josh, The Miami Dade data is perhaps the best one available because they tried to make it a random sample

        The question is whether it is nationally representative. Why is that so difficult for you to understand?

        The Santa Clara study had two categories of problems. The first was with respect to whether it was actually random and representative for Santa Clara. The second was whether it was nationally representative. Santa Clara is NOT representative in terms of SES and race/ethnicity. Both of those aspects have a very large signal in health outcomes.

        And then there’s the issue of whether identified deaths due to COVID are accurate. There are good reasons to think in balance, it is a significant undercount.

        You keep jumping from infection rate to (a broad based) fatality rate in ways that aren’t scientifically sound.

      • Also, Miami-Date, like Santa Clara, and Chelsea, and NY, and other places that have been sampled in serological surveys, is a hotspot.

        Rather than trying to extrapolate from non-representative sampling because it aligns with your political ideology, you should wait for true random and true representative sampling.

        And even there, the value has some limitations since there is clearly a heterogeneity issue.

      • Josh, Are you sober this evening? There are many serological testing datasets and they all pretty much say the same thing.

        I think you are pretty close to science denial by nit picking any study that doesn’t fit your preconceived ideological biases.

      • David –

        Respect uncertainty. Wait until you have good evidence to draw conclusions. For example, if you want to assess an IFR based in serological studies you should be using random and representative samples. We don’t have that yet. Meanwhile, we have stuff like this:

        https://www.healthleadersmedia.com/covid-19/study-puts-us-covid-19-infection-fatality-rate-13

        And this:

        https://www.google.com/amp/s/medicalxpress.com/news/2020-05-team-covid-infection-fatality.amp

        Both of which put the symptomatic infection rate at 1.3%. There’s some evidence that puts asymptomatic infections at around 50%. Other evidence more like 20% (like the Diamond Princess – which given the conditions much have had a relatively high infection rate).

        You do the math.

        At any rate, we don’t have enough data to say.

        Quite remarkable.

        Anyway David. Respect uncertainty. Wait for the evidence to catch up with your desire to advocate based on your political orientation.

        Respect uncertainty.

      • David –

        My bad – the German study puts the it at .37%.

        But we know that the rate in the US is quite likely higher than in Germany for a number of reasons. That German study did put the asymptomatic rate at around 20%

        This was the other source that pegged the symptomatic rate at 1.3%:

        https://www.managedhealthcareexecutive.com/news/uw-researcher-covid-19s-infection-fatality-rate-10-times-larger-flus

        At any rate – the point being to respect the uncertainty, until we have better data.

        BTW – also interesting from the German study:

        >

      • > For studies planned to take place across Germany with an estimated infection rate of approximately one to two percent a one percent false positive rate pose rather a problem.

        So they estimated an infection rate in a more representative sample to be one to two percent.

        I try to tell you to look at representativeness of the sampling but you just won’t listen.

      • And then there’s this, David –

        > Miami-Dade researchers partnered with Florida Power & Light to randomly generate phone numbers and invite people to come to 10 drive-thru testing locations.

        That’s not random sampling. It’s quite likely to have a self-selection bias.

        Additionally, Miami-Dade is a hotspot.

        You really need to think about sampling methodology some more. Oh, and respect uncertainty.

      • Josh, It’s getting very boring checking out your pseudoscientific links. The first one to HealthLeaders is a bad study using top liner case numbers. It’s results are meaningless because the more you test, the more cases you find.

        With respect, I would suggest looking for actual scientists doing high quality science, not “journalist” reports using meaningless numbers.

      • David –

        > With respect, I would suggest looking for actual scientists doing high quality science,

        With respect, the study was published in Health Affairs:

        >. Health Affairs’ Impact Factor Reaches 5, Ranking First Among Health Policy Journals

        https://www.healthaffairs.org/do/10.1377/hblog20160620.055444/full/

      • Your reference is worthless. From the KEY TAKEAWAYS

        “The researchers looked at 116 counties in 33 states and found 40,835 confirmed cases and 1,620 confirmed deaths through April 20.Asymptomatic COVID-19 patients who recovered with no symptoms were not counted in the data, which could have skewed results.”

        That it was published in a journal is just you making an argument from authority.

      • David –

        > That it was published in a journal is just you making an argument from authority

        Yes. Did you read it?

        I only brought up the high impact factor because you apparently didn’t realize it was published in a highly regarded journal.

        They discussed the fact that it is a symptomatic IFR. Thats why it is as high as 1.3%. I discussed it also, and pointed out that it is the symptomatic infection fatality rate. I also discussed the implications of the asymptomatic rate being 20% as on the Diamond Princess cruise shop. It was also discussed in the article.

        Make the asymptomatic rate 50%. You still have a rate much higher than the upper bound of the rate you tried to get from extrapolating from non-random and non-representative samples.

      • Don Monfort

        the character formerly known as mattstat: Focus on the ideas, or expressions of ideas, not the persons. And expect lots of point-counterpoint. You’ll be happier.

        You just made the list.

      • @Joshua

        I assume you’re used to the ridiculous mistreatment and evidence-free responses you’re getting from dpy6629. That’s just how he is. Anyway, below are most, if not all, of the IFR (infection fatality ratio/rate) estimates in peer-reviewed journals, as of May 13, 2020:

        0.9% , 2.4% (Beijing, China as a whole) : “Estimating the infection fatality rate among symptomatic COVID-19 cases in the United States”
        1.3% (0.6% – 2.1%) : “Estimating the infection fatality rate among symptomatic COVID-19 cases in the United States”
        0.7% (0.4% – 1.0%) : “Estimating the burden of SARS-CoV-2 in France”
        0.7% (0.4% – 1.3%) : “Estimates of the severity of coronavirus disease 2019: a model-based analysis”
        (0.5% – 0.8%) : “Real-time estimation of the risk of death from novel coronavirus (COVID-19) infection: inference using exported cases”
        0.6% (0.2% – 1.3%) : “Estimating the infection and case fatality ratio for coronavirus disease (COVID-19) using age-adjusted data from the outbreak on the Diamond Princess cruise ship, February 2020”
        (0.3% – 0.6%) : “The rate of underascertainment of novel coronavirus (2019-nCoV) infection: estimation using Japanese passengers data on evacuation flights”
        (0.05% – 0.134%) : “Estimating the COVID-19 infection rate: Anatomy of an inference problem”

        Folks should remember that the IFR is the seasonal flu is 0.02% – 0.05%, possibly lower, while the CFR (case fatality ratio/rate) of the seasonal flu is ~0.1%. So SARS-CoV-2-induced COVID-19 is at least 10 times deadlier than the seasonal flu, as public health experts have been saying from the beginning.

        You might also notice the ‘Santa Clara’ study (a.k.a. ‘the Stanford study’, co-authored by John Ioannidis) is not on the list above, because it’s not peer-reviewed. It’s already had to go through revisions in response to public criticism. And that’s even before it’s finished formal, anonymous peer review:

        “COVID-19 antibody seroprevalence in Santa Clara County, California”

        But if people want to go with non-peer-reviewed sources, then there’s still been plenty of criticism of that ‘Santa Clara’ work. For instance:

        Non-peer-reviewed: “Estimating COVID-19 antibody seroprevalence in Santa Clara County, California. A re-analysis of Bendavid et al.”
        Non-peer-reviewed: “Meta-analysis of diagnostic performance of serological tests for SARS-CoV-2 antibodies and
        public health implications”

        https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-stanford-study-of-coronavirus-prevalence/
        https://www.sciencemag.org/news/2020/04/antibody-surveys-suggesting-vast-undercount-coronavirus-infections-may-be-unreliable
        https://science.sciencemag.org/content/368/6489/350.full
        https://arstechnica.com/science/2020/04/experts-demolish-studies-suggesting-covid-19-is-no-worse-than-flu/

      • Wiley Coyote, This is a new low even for you. Most of your papers are using old data from January or early February from small data sets. That’s why they have had a chance to get through the peer review process. A couple also “estimate the IFR in symptomatic patients). If you are really an epidemiologist (which I doubt) you would know that these are not true IFR’s.

        There are at least now 10 more meaningful serological studies from around the world.

        1. There is a Danish one of blood donors Joshua pointed out. IFR is 0.08.
        2. There is the Santa Clara study which was strengthened by a revision.
        3. There is a Los Angeles County study which shows a low IFR too.
        4. Miami Dade county which shows an IFR of 0.17-0.31% even when I took fatalities from 21 days after the mean testing date.
        5. State of Arizona comes in around 0.28%.

        All of these are much less than 0.5%. Others are higher, such as the study of a German town. They came in a 0.37% but that’s probably an underestimate.

        Bottom line is that IFR will vary widely depending on the age structure of the exposed population. If vastly more vulnerable people are exposed, the IFR will be higher. If more young people are exposed, it will be lower. I personally. I personally think the US as a whole is more similar to the 4 US datasets I mentioned above.

        Bottom line, selecting “peer reviewed” papers is transparently a biased way to select data when vastly better datasets have become available but there has not been enough time for the papers to get reviewed.. I can’t take seriously anyone who would commit such an obvious error.

        We also have a vaccine for the flu that vastly reduces its IFR. This epidemic is probably more comparable to the Hong Kong flu in 1969. There were no lockdowns.

        Using Ferguson’s IFR numbers by age cohort (which are probably at least a factor of 2 too high) if everyone under 40 got infected, about 30K would die. If everyone under 50 was infected, 60K. The real pain comes in those over 60 or those in ill health. These people need special provisions to be made.

      • Feel free to use any of your usual tactics for evading evidence-based points (ex: ‘your comments are too long for me to keep up with!’). My responses aren’t for your benefit.

        Re: “Bottom line, selecting “peer reviewed” papers is transparently a biased way to select data when vastly better datasets have become available but there has not been enough time for the papers to get reviewed”

        Peer-review plays an important role in mitigating errors in research. For example, informal peer review helped catch numerous mistakes in the Santa Clara non-formally-peer-reviewed manuscript so many of you were previously championing due to your motivated reasoning. Let me know when you better understand the role of peer review in science:

        DOI: 10.1093/eurpub/ckn139
        DOI: 10.1177/0002764213477096

        But as I mentioned in my previous comment, if people want to go with non-peer-reviewed sources, then there’s still been plenty of criticism of that ‘Santa Clara’ work and other antibody-based / serologic studies. Issues include, but are not limited to:

        1) Under-estimating the rate of false positives [‘false positive’ means that the test says you were infected {i.e. have antibodies} when you actually weren’t].
        2) Using a sample size of people who tested positive that’s small enough to exacerbate the relative impact of over-estimating the test’s false positive rate.
        3) Variation in quality between different serologic kits.

        Further discussion on this below:

        https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-stanford-study-of-coronavirus-prevalence/
        Non-peer-reviewed: “Estimating COVID-19 antibody seroprevalence in Santa Clara County, California. A re-analysis of Bendavid et al.”
        Non-peer-reviewed: “Meta-analysis of diagnostic performance of serological tests for SARS-CoV-2 antibodies and public health implications”
        Non-peer-reviewed: “A note on COVID-19 seroprevalence studies: a meta-analysis using hierarchical modelling”
        Non-peer-reviewed: “Estimation of COVID-19 prevalence from serology tests: A partial identification approach”

        Re: “We also have a vaccine for the flu that vastly reduces its IFR.”

        Great job recognizing another one of the factors that make this COVID-19 pandemic far worse than the seasonal flu. You’re making my point for me.

        Re: “This epidemic is probably more comparable to the Hong Kong flu in 1969. There were no lockdowns.”

        Let me know when you have a shred of evidence that the current pandemic is more like the one in 1968. Because the evidence shows that the 1968/1969 pandemic, on average, had a lower R0 and a lower excess mortality ratio, while it affected a larger proportion of younger people than did the current pandemic:

        “Fifty years of influenza A(H3N2) following the pandemic of 1968”
        “Estimates of the reproduction number for seasonal, pandemic, and zoonotic influenza: a systematic review of the literature”
        “Pandemic versus epidemic influenza mortality: a pattern of changing age distribution”
        “Multinational impact of the 1968 Hong Kong influenza pandemic: Evidence for a smoldering pandemic”

        So stop distorting the science to suit your politically-motivated position against lockdowns. I’ve already covered that on another thread:

        https://judithcurry.com/2020/05/10/why-herd-immunity-to-covid-19-is-reached-much-earlier-than-thought/#comment-916999

        Re: “A couple also “estimate the IFR in symptomatic patients).”

        Yet they end up with values consistent with the other peer-reviewed studies. What does that tell you? Think it through.

        Re: “If you are really an epidemiologist (which I doubt) you would know that these are not true IFR’s.”

        I never claimed to be an epidemiologist, despite you + Don Monfort continually pretending otherwise. Let me know when either of you finally learn what an “immunologist” is.

      • “When will the federal government stop making excuses for their failures and start to be accountable?”

        A question you can ask for any year in the past 50. And no we don’t want to by like the rest of the World. A failed Western European country? No thanks. Where is the money? Right here in the United States. Not in some authoritarian country either.

        Policy is better left to the States. Stop asking for the Feds to save us. We have to save ourselves. Like adults.

      • @dpy6629

        Re: “2. There is the Santa Clara study which was strengthened by a revision.”
        […]
        This epidemic is probably more comparable to the Hong Kong flu in 1969. There were no lockdowns.

        I really hope the points below aren’t true regarding the ‘Santa Clara,’ non-formally-peer-reviewed study (a.k.a. the “Stanford” study co-authored by John Ioannidis):

        “JetBlue’s Founder Helped Fund A Stanford Study That Said The Coronavirus Wasn’t That Deadly
        A Stanford whistleblower complaint alleges that the controversial John Ioannidis study failed to disclose important financial ties and ignored scientists’ concerns that their antibody test was inaccurate.
        A highly influential coronavirus antibody study was funded in part by David Neeleman, the JetBlue Airways founder and a vocal proponent of the idea that the pandemic isn’t deadly enough to justify continued lockdowns.”

        https://www.buzzfeednews.com/article/stephaniemlee/stanford-coronavirus-neeleman-ioannidis-whistleblower

      • The point is that there is a growing body of data showing that the number of infections is 10 to 80 times the official number of cases and that the IFR is much lower than initial estimates. IFRs always decline as epidemics progress.

      • Re: “Point is that there is a growing body of data showing that the number of infections is 10 to 80 times the official number of cases […]”

        Duh. The number of infections is greater than the number of cases (i.e. IFR is less than CFR) for virtually very pathogen-induced disease, unless one is somehow able to catch every single infection as a case. That’s epidemiology 101. You pointing this out like it’s a big deal, is like telling a geneticist that DNA is not RNA, as if they didn’t already know that. Did you just learn this, dpy, when you reached your politically-motivated conclusions during the pandemic?

        Your claim that it’s a factor of “10 to 80 times” just results from you (again) ignoring peer-reviewed evidence.

        Re; “[…] and that the IFR is much lower than initial estimates.

        Let me know when you have some peer-reviewed, published evidence on this. Because so far, you’re just dodging the published evidence that shows you’re wrong.

        Re: IFRs always decline as epidemics progress.”

        False. For example, a pathogen can mutate into a more virulent form during the epidemic, leading to a subsequent spike in IFR. Or healthcare systems can later become overwhelmed by an increasing number of cases, causing IFR to spike. Or the pathogen can later hit a weakened population that was previously protected by barriers (ex: the elderly in nursing homes), leading to a spike in IFR. Or…

        Please get this through your head, dpy: you’re not going to fool me on this topic. Your usual evidence-free, insult-laden bluffing that you pull on climate science won’t work here either. Unlike you, I know what I’m talking about; I’m trained to.

  13. Early on I displayed the Colorado case testing data. Case data is basically worthless for general infection statistics, but it does give a random sample of how many of the sick population has the COVID. The general population sickness is maybe somewhat proportional.
    This proved true as it basically gave a signal for the epidemic (tho noisy):

  14. This is the latest from China

    “The state-run Xinhua news service added a bit more CCP cheerleading to its coverage, putting heavier emphasis on Xi’s implication that most of China’s coronavirus problems are coming from beyond its borders and portraying the Central Committee’s policy recommendations as improvements to a nearly flawless system:

    Xi said that the group had spared no effort to curb the spread of the virus and worked hard to build a strong first line of defense, making important contributions to winning the people’s war against the epidemic.

    He said the spread of the virus overseas has not been effectively curbed yet and cluster cases were reported in a few areas in China, posing considerable uncertainty to the epidemic control.”

    The latest report from worldometer indicates only 2 new cases and no new deaths.

    If they are going to fake it, at least they could make it sound more plausible.

  15. Curious George

    Amazing how easily we throw away chances to learn more about the virus epidemiology. From the Wikipedia:
    “Some 94% of the crew [of the USS_Theodore_Roosevelt] had been tested for the virus, yielding 678 positive and 3,904 negative results…About 60% of the people who tested positive did not have symptoms….Some sailors volunteered for antibody testing.”
    A highly infectious disease spreads through the crew, ultimately infecting one person in six. Maybe more – some people who tested negative may have already recovered from the disease; without an antibody test, we will never know. One sailor had died. Does it sound like a real Apocalypse? How many of us are immune to the disease?

  16. This is very hopeful:

  17. For Tony and any other UK denizens. More politics than science, but since this as all about the Venn diagram….

    An interesting contrast between The Telegraph’s Covid-19 take yesterday and today?

  18. I’ve made a quick purview of long term health care facilities by county in Michigan. In some situations a single facility has a significant portion of that county’s total cases.
    A few facilities also have multiple deaths. Just one such facility had more deaths than the combined deaths of the following countries: Namibia, Laos, Botswana, Angola, Mongolia, South Sudan, Mozambique, Uganda, Cambodia, Madagascar, Ethiopia and Vietnam.
    Each of these facilities is a closed system with rules of admittance and I assume testing. Cuomo announced 66% of New Yorkers recently hospitalized were locked down at home. In the end, you can have the strictest rules and the most elaborate testing and monitoring systems but the weakest link still determines the strength of the chain.

    • > Cuomo announced 66% of New Yorkers recently hospitalized were locked down at home.

      What % of the public were “locked down at home” If it was 80%, then what would it mean if 66% of those hospitalized were “locked down at home.” Especially, when you consider that those “locked down at home” may well be more likely to be older.

      • And don’t forget:

        Self-report data is notoriously unreliable. And the definition of “stayed at home” is highly ambiguous.

        Conditional probability is hard.

      • Not the point. Rules or no rules, if they don’t follow them what use are they.

        Wake up. It’s not that hard to understand.

        I see you finally conceded US testing per million greater than S.K. It didn’t take you too long to admit that. Only a couple of weeks. You have potential.

      • Correction – looks like we’re up to around 41rst in testing per capita…but unfortunately also we’ve ticked up a notch to 13th in cases per capita. Still, the discrepancy between our rank in testing and our rank in cases is not a good sign.

        Where will we be in cases per capita if we rise up to near the top in testing per capita?

      • Please stop beating the dead horse of mass testing. We have plenty of tests for nursing homes, hospitals, and medical workers. There is no scientific basis for using mass testing to try to “stamp” out the virus. Even if you could, there would be a second wave at some point.

      • > There is no scientific basis for using mass testing to try to “stamp” out the virus

        Total straw man. It is necessary for identifying the infectious to enable contact tracing and isolation.

      • > We have plenty of tests for nursing homes, hospitals, and medical workers.

        And that, of course, is categorically untrue. Check out the article that Matt just linked:

        https://www.statnews.com/2020/05/08/nursing-homes-veterans-homes-national-epicenters-covid-19/

      • Testing by itself is pointless if it is not combined with isolation of the ill, tracking contacts, and isolation of the contacts. With sufficient testing, tracking, and isolation, the economy could open safely.

      • Josh, You didn’t even read your own link. There are plenty of test kits available. It’s a matter of deploying them correctly. Its idiot governors like Cuomo who are to blame for this one. They didn’t direct adequate resources to nursing homes.

  19. The linkage of Covid19 to affluence deserves discussion. Our World in Data shows that log, log graphs show a straight line relation between deaths/M and national GDP
    https://rclutz.files.wordpress.com/2020/05/covid-vs-gdp.png?w=1000&h=521
    “It is not difficult to think of mediating factors that feed into the wealth-COVID relationship. Richer countries undertake more international business and pleasure travel, and attract more of it. The citizens within them are generally more mobile and more urbanized. People in the richer countries live longer, so their populations tend to have more old and vulnerable persons. Obesity is a known co-morbidity of COVID, and the rich countries have more of that, too — along with higher rates of hypertension and type 2 diabetes. And those countries are, of course, concentrated in one hemisphere of the globe: nobody knows anything meaningful yet about how weather (or any other regional phenomenon) affects SARS-CoV-2.”

    The contrast is remarkable between societies who use carbon fuels extensively and those who do not. Societies with fossil fuels have citizens who are healthier, live longer, have higher standards of living, and enjoy cleaner air and drinking water, to boot. Not only do healthier, more mobile people create social wealth and prosperity, carbon-based energy is heavily taxed by every society that uses it. Those added government revenues go (at least some of it) into the social welfare of the citizenry. By almost any measure, carbon-based energy makes the difference between developed and underdeveloped populations.

    In addition, developed societies protect most of their citizenry from natural disasters, including extreme weather events. Clearly, the wealthier nations build and maintain more robust structures and infrastructures, which incur costly damages from natural events, but which greatly reduce human deprivation and deaths.

    Ironically, these advantaged nations now provide large numbers of attractive hosts for this novel coronavirus,absent defences from medical technology. It is also the case that these privileged populations are so rooted in presumed physical security that the hysterical media has triggered a panic pandemic, overshadowing the actual viral outbreak.
    https://rclutz.wordpress.com/2020/05/08/covid19-linked-to-affluence/

    • You ignore the inverse associations between COVID-19 infection rate, and COVID-19 morbidity and mortality rate, and SES within countries like the US and the UK.

      Why?

      > It is also the case that these privileged populations are so rooted in presumed physical security that the hysterical media has triggered a panic pandemic, overshadowing the actual viral outbreak.

      A completely subjective evaluation. How do you know how much of the concern about COVID 19 is due to hundreds of thousands of deaths, and a greater amount of illness by orders of magnitude, and how much is due to “panic” that is “triggered” by an “hysterical media?”

      • Not completely subjective, but listening to data, such as it is.

      • First, you have no way to determine where people’s fear/concern comes from. Completely subjective. So your comment is non-responsive.

        Second, his characterization of the IFR is rhetorical spin. He says, it’s 0.1. He’s cherry picking. It’s highly uncertain. Spin.

        He ignores the widespread prevalence of comorbidities and age-related risk.

        He ignores the impact of morbidity, work absences, etc.

        It’s spin. Spin. Spin. Spin.

      • More merchants of doubt from Josh the anonymous unqualified internet presence. His number is within the range of the serological studies, albeit at the low end.

  20. CLINTEL says “Don’t fight nature, but adapt to it”
    By David Wojick
    https://www.cfact.org/2020/05/06/clintel-says-dont-fight-nature-but-adapt-to-it/

    Here is the beginning of the article:

    Over at Climate Depot, Marc Morano has been collecting foolish alarmist calls for using the economic crisis to further their goofy green deals. https://www.climatedepot.com/
    CLINTEL has issued a counter call, asking government to quit trying to stop naturally occurring events, like the emergence of a new virus, and climate change, especially so-called green deals.

    The format is a letter that will be sent to parliaments around the world, beginning with the Netherlands where CLINTEL is headquartered. The lead author of the letter is Professor Guus Berkhout, CLINTEL’s president. See https://clintel.org.

    Professor Berkhout puts it this way: “CLINTEL gives members of parliament a shot in the arm and offers them a spot on the horizon to get the economy back on its feet without utopian experiments.“

    The letter is titled “Don’t fight nature, but adapt to it” and the first paragraph is this:

    “After lifting the COVID-19 lockdowns, national parliaments must oppose the impracticable green agendas of supranational organizations to construct a utopian Earth. Instead of spending trillions of dollars on fighting the unpredictable changes caused by natural variability (‘autonomous changes’), parliaments should focus on adapting to those changes. Dear members of parliament, with all due respect, do not fight against climate change and virus outbreaks, but adapt to the consequences. The world must move from top-down mitigation to bottom-up adaptation.“

    Note that this does not mean do not fight the spread of new viruses. On the contrary the idea is to adapt to their existence by being prepared for them. The same is true for climate change, extreme events, sea level rise, etc., no matter how these things are caused.

    According to CLINTEL the primary obstacle to efficient adaptation is the pernicious influence of supranational organizations, wielding computer models and calling for unworkable technological fixes. Here is how the second paragraph describes this unhealthy political engineering:

    “Believing computer models is believing the makers

    Decisions about the comings and goings of society are increasingly taken by poorly informed politicians who have a rock-solid faith in the outcome of computer models and immature technologies. The belief that people can solve all problems with supercomputers – the ideology of constructing a utopian Earth – has grown strongly in recent years. By linking computer-controlled policies to supranational governance, experiments are started to engineer a ‘perfect’ society in which idealists believe all current global problems can be solved.

    But the reality is very different. The climate debate in recent years and the coronavirus chaos of today show that the prophesied blessings of a politically engineered world do not exist. We are collectively being pushed into the wrong direction. National parliaments have become puppets of the megalomaniacal supranational organizations, as created by the UN and the EU.”

    The rest of the CLINTEL open letter to parliaments is included, plus some observations on my part.

    Please share this.

    David

  21. Robert Clark

    DATE NEW CASES INCREASE % # TESTS
    4/24/2020 39,887 7,763 24.1 465,986
    4/25/2020 36,342 -3,545 -8.8 251,263
    4/26/2020 39,806 3,462 9.5 256,441
    4/27/2020 23,095 -16,711 -41.9 216,029
    28-Apr 22,840 -255 -1.1 179,755
    4/29/2020 29,025 6,185 27 259,856
    4/30/2020 28,117 -908 -3.1 194,323
    5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    We are getting to a point where the testing % positive is 10% positive or lower. than total testing for country.
    I suggest the states be rated by testing % positive
    5% or higher massive testing. heavy testing.
    1% to 5% testing.
    less than 1% sampling.
    Eventually we set up a national sampling system. It would involve all general practitioner doctors, nurse practitioners, all EMT personnel, all dentists. The Federal Government would supply quick test kits. They will be required to test every individual they treated and report every positive result to the Federal Government Web Site.
    This will be our Federal sampling system.

  22. Lodovico Volponi

    As long as the ultimate goal is immortality, we’ll never be able to recover from this crisis. Perhaps already said, but worth repeating.

  23. Ireneusz Palmowski

    My advice: vaccinate medical staff with a proven and safe tuberculosis vaccine. The autumn and winter wave may be worse than the spring one. Even more so when combined with seasonal flu.

    • Joe - dallasm

      That is why we should stop trying to contain the virus. The sooner we have 40-60% immunity in the population , the likely we will have a nasty second wave.

      There will be a second wave – the question is how to make it a mild second wave.

      My educated guess to to develop immunity early be getting the non vunerable exposed as quickly as possible.

    • Very good advice.
      In Greece we have the estimate 70% of the over 70 years old people positive to Mantoux tuberculosis test.
      In Greece we have 150 deaths in total.
      Government has taken very strict measures earlier than other countries, but maybe the tuberculosis immune old population plays role too.

  24. Is this the New York hydroxychloroquine study referenced above?
    (New York researcher says preliminary results of hydroxychloroquine study are ready, but state hasn’t released them)

    https://www.cnbc.com/2020/05/07/hydroxychloroquine-fails-to-help-hospitalized-coronavirus-patients-in-us-government-funded-study.html

    Another non-randomized observational study. The Minnesota study grows more important by the day.

    • From the NEJM report of the study:

      https://www.nejm.org/doi/full/10.1056/NEJMoa2012410?query=featured_home

      “Hydroxychloroquine-treated patients had a lower Pao2:Fio2 at baseline than did patients who did not receive hydroxychloroquine (median, 233 vs. 360 mm Hg).”

      That means that the patients treated with hydroxychloroquine were significantly worse off at baseline than those not treated with HDQ. Median ratio of partial pressure of arterial oxygen: the fraction of inspired oxygen 223 vs. 360.

      Arterial oxygen is kind of important to survival. The hydroxychloroquine patients were already in the cytokine storm and resulting Acute Respiratory Distress Syndrome:

      ARDS Severity……..PaO2/FiO2…….Mortality

      Mild……………………..200 – 300………..27%
      Moderate……………..100 – 200………..32%
      Severe………………..< 100……………….45%

      Another garbage study, in my very humble opinion.

      • Don Monfort

        PS:1376 patients received hydroxychloroquine 232 died. That’s a 17% fatality rate. I would take that over the ARDS fatality rate.

      • Don Monfort: “Hydroxychloroquine-treated patients had a lower Pao2:Fio2 at baseline than did patients who did not receive hydroxychloroquine (median, 233 vs. 360 mm Hg).”

        That means that the patients treated with hydroxychloroquine were significantly worse off at baseline than those not treated with HDQ. Median ratio of partial pressure of arterial oxygen: the fraction of inspired oxygen 223 vs. 360.

        Just so. Another example of the perils of non-randomized assignment. Randomization does not always work to balance the two groups, but every other alternative always produces imbalances.

        You’ll have noticed I suspect the possibility of the opposite bias in the Marseille studies: without intending to, the investigator has confined his treatment to people who, for diverse reasons, have a higher survival probability than the “historical controls”.

        Biases have been so common in clinical research that the default guess has to be that they are present, not absent.

        The results of the NY study were eagerly awaited before we learned of this bias.

  25. There are now 175 clinical trials for hydroxychloroquine-COVID 19 listed on:

    https://clinicaltrials.gov/ct2/results?cond=covid+19&term=hydroxychloroquine&cntry=&state=&city=&dist=

    Recent listing of trial at Univ of Chicago. They don’t seem to be frightened by alleged toxicity. The dosage is BIG:

    https://clinicaltrials.gov/ct2/show/NCT04351620?term=hydroxychloroquine&cond=covid+19&draw=2&rank=6

    Drug: Hydroxychloroquine
    Tolerability study of HCQ 1200 mg administered daily in divided doses for a duration of 5-10 days

    • thanks for the link. “Don’t seem to be frightened … .” is a curious phrase to address to a study designed to assess tolerability.

      Other details expressing caution.

      Exclusion Criteria:

      Participation in any other clinical trial of an experimental agent treatment for COVID-19
      Current hospitalization
      Known hypersensitivity to hydroxyxhloroquine or chloroquine
      Known chronic kidney disease, stage 4-5, or receiving dialysis
      History of retinal disease
      History of uncontrolled hypertension, defined as systolic blood pressure > 180 mmHg and or diastolic blood pressure > 100 mmHg at the most recent physical medical encounter or by patient report.
      History of QT prolongation (QT > 500 ms) or history of Torsades de Pointes
      History of arrhythmias
      Current use of loop diuretics and potassium supplementation or documented history of hypokalemia.
      Pregnancy and lactation
      Known glucose-6-phosphate dehydrogenase (G6PD) deficiency
      Current use of any of the following medications: flecainide (Tambocor), amiodarone (Cordarone, Pacerone), digoxin (Digox, Digitek), procainamide (Procan, Procanbid), propafenone (Rythmal), antiepileptic agents (phenytoin, phenobarbital, valproic acid, lamotrigine, topiramate), tamoxifen, tricyclic antidepressants (nortriptyline, amitriptyline, imipramine, clomipramine)

      • Don Monfort

        Why do you find that curious? Don’t you think they could be frightened by the Brazil “study” using 1200 mg/day that according to the NYslimes killed about a dozen patients? Tolerability includes not being killed by the stuff. Just so you know.

      • Don Monfort: Why do you find that curious? Don’t you think they could be frightened by the Brazil “study” using 1200 mg/day that according to the NYslimes killed about a dozen patients?

        It’s a standard dose-finding (Phase I) trial to discern whether a dose found necessary in a lab test would be tolerated in humans. Notice that they have specific protocols for people who might need slower dosing (3×400 daily) or absolute discontinuation). As with nearly every trial approved by an IRB, they have a list of exclusion criteria, which includes A-fib and a bunch of CNS-acting or cardio-active drugs.

        “Don’t seem to be frightened … .” is a curious phrase to describe a group of researchers so clearly alert to the possibility of adverse reactions.

        I mentioned already that in the US and EU, 14% of people over the age of 70 have A-fib. If someone can treat thousands of patients without noting even a single case of A-fib, then he or she is probably treating an unusually healthy and young cohort.

      • Don Monfort

        Didn’t you used to be mattstat? You have become really odd. What is “curious” about me saying they don’t seem to be frightened about using a dosage that has been falsely reported by the NYslimes to have caused 11 deaths in a few dozen patients? Are you unaware of all the hysterical warnings about the potential DANGEROUS FATAL SIDE EFFECTS of HDQ? The media and a large part of the medical establishment are certainly trying to scare docs and patients off the use of hydroxychloroquine.

        I was being only slightly facetious, when I said the Chicago researchers weren’t frightened about using a dosage that is equal to that used in the Brazil trial, that the NYslimes falsely claims killed about a dozen patients.

        The Univ. of Chicago trial is recruiting outpatients with mild COVID 19. The patients are on their own and call in if they have a problem to report. I am all for HDQ, but I got to say that’s a gutsy protocol with a dose of 1.2 grams/day. What about EKG monitoring? But this is just a tolerance test. So, there is no problem with the lack of monitoring. Right? If they don’t call in for a couple of days, just mark them down as a fatality.

        You are only worried about trials that you suspect are conducted by docs who for whatever reason you imagine cherry pick young healthy patients, who are not at elevated risk of atrial fibrilation, which has got nothing to do with potential dangerous cardiac side effects related to hydroxychloroquine. Of course, you can’t cite studies by any docs who have actually done that.

        The alleged possible dangerous side effect associated with the use of HDQ is prolongation of QT interval as measured on an EKG (ballpark >500ms), which would indicate danger of a patient going into ventricular arrythmia, which can lead to cardiac arrest, which can lead to death. Atrial fibrilation is a different banana. Tip: don’t comment on stuff that you do not understand.

        You waste a lot of my time and I am thinking of putting you on my ignore list.

  26. Ireneusz Palmowski

    However the increase in the rate of developing antibodies means that the much sought-after group immunity – where there are so many people immune to the virus that it has little or no opportunity of spreading – is still a long way off.

    Experts generally reckon that it would take a minimum of 70% of people with antibodies before group immunity is present. At a rate of 3% every three weeks, that target would only be attained in late July 2021.
    https://www.brusselstimes.com/all-news/belgium-all-news/110496/national-security-council-used-phone-data-to-help-inform-decisions/

  27. Ireneusz Palmowski

    “Fighting the inflammatory process
    He also explains that the cytokine storm is the body’s immune state in which it begins to produce various types of substances that on the one hand are designed to fight the inflammatory process, but on the other can also intensify the inflammatory response. So, as a consequence, the patient’s condition can get much worse.
     – Knowing about the occurrence of such a situation, we reach for Tocilizumab – a drug that counteracts the inflammatory storm arising as a result of virus infection – says prof. Życińska. He points out that Tocilizumab is an antibody that blocks an important substance that enhances the development of inflammation – interleukin 6.”
    The Australasian Society for Clinical Immunology and Allergy recommend tocilizumab be considered as an off-label treatment for those with COVID-19 related acute respiratory distress syndrome. It states this because of its known benefit in cytokine storms caused by a specific cancer treatment, and that the cytokine storm may be a contributor to mortality in severe COVID-19.[36]

    On 11 March 2020, Italian physician Paolo Ascierto reported that tocilizumab appeared to be effective in three severe cases of COVID-19 in Italy.[37] On 14 March 2020, three of the six treated patients in Naples had shown signs of improvement prompting the Italian Pharmacological Agency (AIFA) to expand testing in five other hospitals.[38] Roche and the WHO are each launching separate trials for its use in severe COVID-19 cases.[39]

    In March 2020 a randomized study, at 11 locations in China, which should conclude by 31 May 2020, started to compare favipiravir versus tocilizumab versus both.[40]
    https://en.wikipedia.org/wiki/Tocilizumab

  28. In Minnesota, near Minneapolis.

    https://www.startribune.com/death-toll-climbs-to-55-at-new-hope-nursing-home-hard-hit-by-coronavirus/570308142/

    Out of 87 counties in Minnesota, 79 had single digit number of deaths.

  29. “At least 25,600 residents and workers have died from the coronavirus at nursing homes and other long-term care facilities for older adults in the
    United States, according to a New York Times database. The virus so far has infected more than 143,000 at some 7,500 facilities.”

    1/3 of deaths at nursing homes and long term facilities

  30. “New numbers from the Texas Health and Human Services Commission show 395 nursing home and assisted living facility residents have died from the virus. That means about 45% of all COVID-19 deaths in Texas are tied to senior care facilities.”

  31. Robert Clark

    4/24/2020 39,887 7,763 24.1 465,986
    4/25/2020 36,342 -3,545 -8.8 251,263
    4/26/2020 39,806 3,462 9.5 256,441
    4/27/2020 23,095 -16,711 -41.9 216,029
    28-Apr 22,840 -255 -1.1 179,755
    4/29/2020 29,025 6,185 27 259,856
    4/30/2020 28,117 -908 -3.1 194,323
    5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 1,052 -5.6 311,965
    Still need more tests, but at least they are going the right direction.
    27,713 is 8.8% of total tests.

  32. BTW –

    With respect to this hysterical, snowflake, binary-thinking, politically expedient, tribal whining about “tyrants,” people’s behavior mostly changed well before the government mandated shelter in place policies:

    > data shows that residents there were staying home well before their governors issued stay-at-home orders.

    https://fivethirtyeight.com/features/americans-didnt-wait-for-their-governors-to-tell-them-to-stay-home-because-of-covid-19/?ex_cid=trump-approval

    So can we also get people to think past the inane argument that the severe economic downturn is only because of the government mandates?

    • Joshua: So can we also get people to think past the inane argument that the severe economic downturn is only because of the government mandates?

      Has someone said that it is only government mandates? I think the claim is that governors’ mandates have made everything worse and there is no point in continuing them.

      • matthew –

        > Has someone said that it is only government mandates? I think the claim is that governors’ mandates have made everything worse and there is no point in continuing them.

        Fair points. Yes, the question as to whether the mandates have made it worse deserves due diligence.

        I do think that there is at least often an implied argument that it is the mandates that have caused the harm…but I’ll admit some rhetorical gamesmanship slipped in there on my part.

    • Yes. To review, I do personal income taxes. Some people decided to defer doing them. Foot traffic at my office was way off. Completed returns which will eventually be filed are down 15%. Though this number means I don’t know? Some were all ready done and some are always late. So the middle ones dropped off if we divide into early, middle and late.

      More specifically, people did decide to social distance at my office. They could slide them through our mail slot or drop them in a suitcase outside a big window while speaking with us on their phone.

      At the same time, the media and governments do lead here.

      • Ragnar –

        > At the same time, the media and governments do lead here.

        They lead AND they follow. It’s not that simple.

      • Ragnaar –

        Some people argue that the same number will get infected irrespective of government interventions.

        The corollary is that reaching that number slowly will cause less economic harm, and that the differential harm from shelter in place orders is unambiguously enormous as compared to a slower spread where some 50%? of the population gets infected.

        That argument, of course, is easy to make but only if you fail to respect the enormous uncertainties involved.
        You might look at the economic impact on Denmark vs. Sweden as an example, but cross-country comparisons are fraught with uncontrolled variables.

        There are plenty of reasons to believe that with building testing, tracing, and isolating infrastructure rather than just opening things up, the economic impact can be mitigated. And of course, there no reason why opening up and building thst infrastructure need to be mutually exclusive.

        But where people want to be indignant and see petty tyrants to rail against, they will do so. One way that people deflect fear is to see themselves as victims.

  33. Comparing COVID-19 deaths to flu deaths is like comparing apples to oranges

    I am always amused by people who think that apples and oranges are relevant to something else.

  34. “Second Analysis of Ferguson’s Model” for covid19. Worse than climate most models?
    https://lockdownsceptics.org/second-analysis-of-fergusons-model/

  35. The Italian scientist noted above says SARS-Cov-2 needs porphyrins. Would this explain a higher incidence in meat packing plants? Or the survival of the disease at wet markets once turned loose?

  36. 5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829

    To me an essential worker is anyone working a 40-hour week. If you are an employer give each essential worker a $50 gift card to a local fast food restaurant if they get a test. It may cost you an employee for 2 weeks, but it could keep you from loosing 2 or three for 2 weeks.
    Still need more tests.
    24,835 is 8.6% of total tests.

  37. Matthew R Marler
  38. SeroPrevalence in Geneva:

    Click to access 2020.05.02.20088898v1.full.pdf

    47 Methods: Taking advantage of a pool of adult participants from population-representative surveys
    48 conducted in Geneva, Switzerland, we implemented a study consisting of 8 weekly serosurveys among
    49 these participants and their household members older than 5 years. We tested each participant for anti50 SARS-CoV-2-IgG antibodies using a commercially available enzyme-linked immunosorbent assay
    51 (Euroimmun AG, Lübeck, Germany). We estimated seroprevalence using a Bayesian regression model
    52 taking into account test performance and adjusting for the age and sex of Geneva’s population.
    53
    54 Results: In the first three weeks, we enrolled 1335 participants coming from 633 households, with
    55 16% <20 years of age and 53.6% female, a distribution similar to that of Geneva. In the first week, we
    56 estimated a seroprevalence of 3.1% (95% CI 0.2-5.99, n=343). This increased to 6.1% (95% CI 2.6-
    57 9.33, n=416) in the second, and to 9.7% (95% CI 6.1-13.11, n=576) in the third week. We found that
    58 5-19 year-olds (6.0%, 95% CI 2.3-10.2%) had similar seroprevalence to 20-49 year olds (8.5%,
    59 95%CI 4.99-11.7), while significantly lower seroprevalence was observed among those 50 and older
    60 (3.7%, 95% CI 0.99-6.0, p=0.0008).

  39. latest IHME prediction, reported in San Diego Union Tribune: Christopher Murray, director of the University of Washington’s Institute for Health Metrics and Evaluation, said Sunday on CBS’ “Face the Nation” that the institute’s latest projections suggested the nationwide fatality count would reach 137,000 by Aug. 4. It stands now at nearly 80,000.

    The picture is mixed in some of the country’s most populous states, he said.

    “Some good-ish news coming out of New York and New Jersey and Michigan, where the death cases and death numbers are coming down faster than expected,” he said. “Some other states where cases and deaths are going up more than we expected — Illinois and then Arizona, Florida, California as examples of that.”

    The researchers are now predicting that California could see more than 6,000 COVID-19 deaths by the end of August, up about 1,420 from projections they released on Monday. It’s the fifth-largest increase in projected death tolls among the U.S. states, after Pennsylvania, Illinois, Arizona and Florida.

    That’s consistent with my much less formal tabulation of daily death rates and some extrapolations.

    For California, with its population of nearly 36M that works out to about 167 deaths per million, much less than the NorthEastern seaboard has suffered already. I don’t see that as justification for California (or the much publicized Alameda County) to continue the lockdown.

    • That is a very interesting post, Matthew.
      The first death in California was 92 days ago and, per the Washington Post today, there have been 2,847 deaths.
      The “end of August” is 112 days from your post- roughly the same number of days since the outbreak started in California.
      In other words, they’re projecting the same number of deaths per day in California (on average) with or without lockdowns. At least 40 days of the pandemic so far in California were without even social distancing.

      About the best that can be said for that, if correct, is that they’re telling us lockdowns don’t save any lives, they just take a little longer to kill people who were gonna be killed anyway. So the only question is whether we want people to be bankrupt.

  40. DATE NEW CASES INCREASE % # TESTS
    5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829
    5/11/2020 21,122 -3,713 -14.9 540,847
    21,122 is 3.9% of total tests.
    Looks good. Last time we were near this total tests, old slow were used and showed for the next 2 days. We will wait and see.

  41. OK. Now this is classic:

    > Just 0.7% of Major League Baseball employees tested positive for antibodies to Covid-19. The small number of positive tests, came as the league continues to plan to start its delayed season.

    […]

    “I was expecting a little bit of a higher number,” Bhattacharya said. “The set of people in the MLB employee population that we tested in some sense have been less affected by the Covid epidemic than their surrounding communities.”

    ——

    So I expected a result based on my theory, and I tested my theory and got a different result. Obviously there must be something wrong with the sample I used because they didn’t match the results I expected. I mean it isn’t like there could have been a problem with my theory, right?

    https://www.google.com/amp/s/amp.theguardian.com/sport/2020/may/11/mlb-baseball-covid-19-coronavirus-antibodies-test

    Also, please note (if you read the article) the researcher’s sudden focus in the media reports on the SES representativeness of the sample.

    I mean in a sense that’s a good thing – but in the context of the PR campaign after the Santa Clara study, where they went on national TV to extrapolate from non-representative data to advocate for particular policies, it’s pretty disturbing.

    • Joshua: but in the context of the PR campaign after the Santa Clara study, where they went on national TV to extrapolate from non-representative data to advocate for particular policies, it’s pretty disturbing.

      I would say “noteworthy” instead of “disturbing”, but that’s a good catch.

    • Results on RCT not yet out… but…heart issues reported.

      Hopefully, the Dons can explain why these researchers are wrong.

  42. 5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829
    5/11/2020 21,122 -3,713 -14.9 540,847
    5/12/2029 19,534 -1,588 -7.5 164,139
    This one makes no sense. This is what I would have expected if we had done the same amount of tests or larger..
    19,534 is 11.9% of total tests
    Tomorrow is another day. Lets hope the jail break does not occure to soon!!!

    • There is another chart that goes from Midnight GMT to Midnight which is 7:PM CDT. It is now 3:00 PM CDT. That from Midnight GMT to present, 3:PM CDT, The test count is 229,426 tests. I believe both the positive and test numbers of the above are incorrectI will put the results of the other one in after midnight GMT. We will see my normal one tomorrow.

  43. Matthew R Marler

    from The Lancet: Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial

    Prof Ivan Fan-Ngai Hung, MD
    Kwok-Cheung Lung, FRCP
    Eugene Yuk-Keung Tso, FRCP
    Raymond Liu, FRCP
    Tom Wai-Hin Chung, MRCP
    Man-Yee Chu, MRCP
    et al.
    Show all authors
    Published:May 08, 2020

  44. https://off-guardian.org/2020/05/13/covid19-a-case-for-medical-detectives/

    Very interesting comments by Dr. Wodarg on hydroxychloroquine and glucose-6-dehydrogenase deficiency, or “G6PD deficiency”, one of the most common genetic peculiarities, which can lead to threatening haemolysis (dissolution of red blood cells), mainly in men, when certain drugs or chemicals are taken.

    So HCQ can help many if given early but on the other hand can kill others??

  45. New cases, counts and % increase, over last 7 days in the US:

    25049, 2.0%; 29531, 2.3%; 29162 2.2%; 25524, 1.9%; 20329, 1.6%;
    18192, 1.3%; 22802, 1.65%

    New deaths, counts and % increase, over last 7 days in the US.

    2520, 3.5%; 2129, 2.9%; 1687, 2.2%; 1422, 1.8%; 750, 0.9%;
    1008, 1.3%; 1630, 2.0%.

    this is improvement over a month ago, but 160,000 dead by Sept is not “inconceivable” (c.f. The Princess Bride.)

    • matthewrmarler,

      Since we are reduced to just looking at numbers, is there any Quality Assurance process is in place for testing, diagnosing, attribution, and reporting of COVID-related stuff?

      Andrew

      • Bad Andrew: is there any Quality Assurance process is in place for testing, diagnosing, attribution, and reporting of COVID-related stuff?

        I hope it’s good enough that the decline since early April is indicative of a real decline, but sometimes I despair.

        As far as I know, they are not all based on the same assay for the virus, and the error rates of the diverse tests have not been made public. If any inter-laboratory comparisons have been made, I have not read of them. People who die at home are likely not included. Of people who die of other problems while infected there is over-attribution of death to COVID-19.

        FDA requires good information, but how performance in the hospitals compares to performance in development usually isn’t known. I am only guessing that everyone involved is as alert as I and the teams I worked on were when we did test development, PK, and data entry.

      • matthew –

        Re he Denmark study, this was interesting:

        > Conversely, blood donor prevalence increases with income and we speculate that this leads to
        higher risk of exposure through travel and social activity. We may therefore either under or
        overestimate the true population immunity.

        Probably doesn’t work that way in the States. Sure maybe more travel with wealthy but poorer people more likely to have more exposure (use public transportation, be an essential worker) here.

      • Matthew R Marler

        Bad Andrew, here is some bad news:

        https://www.msn.com/en-us/money/markets/false-negatives-raise-more-questions-about-virus-test-accuracy/ar-BB143341

        I don’t expect really sound information for a few months yet. You’ll note the question about whether the users are following instructions correctly — maybe the protocol is not adequately described. Lots of things can go wrong.

  46. 5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829
    5/11/2020 21,122 -3,713 -14.9 540,847
    5/12/2020 19,534 -1,588 -7.5 164,139
    5/13/2020 23,704 4,170 21.3 340,173
    The average of the last 2 days is 21,619 positive and 252,156 tests per day.
    8.5% positive tests of total.
    Now is the time to begin setting up the National sampling system.

  47. 5/1/2020 30,093 1,979 7 83,643
    5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829
    5/11/2020 21,122 -3,713 -14.9 540,847
    5/12/2020 19,534 -1,588 -7.5 164,139
    5/13/2020 23,704 4,170 21.3 340,173
    5/14/2020 21,710 -1,994 -8.4 340,721
    The total posative is 6.3% of total tests.
    It appears we are back treading water in the low 20,000’s
    I believe there are presently 294,000 active cases of the virus out there. I do not know how much better they can do when there are about 130 million individuals about to be let loose. A good samping progrem will be required.

    • Robert –

      What would explain in the 200k difference in # of tests and more or less same number of positives on the 11th and the 14th? Kind of makes no sense to me.

  48. Interesting…

    https://www.nih.gov/news-events/news-releases/nih-begins-clinical-trial-hydroxychloroquine-azithromycin-treat-covid-19

    > “We urgently need a safe and effective treatment for COVID-19. Repurposing existing drugs is an attractive option because these medications have undergone extensive testing, allowing them to move quickly into clinical trials and accelerating their potential approval for COVID-19 treatment,” said NIAID Director Anthony S. Fauci, M.D. “Although there is anecdotal evidence that hydroxychloroquine and azithromycin may benefit people with COVID-19, we need solid data from a large randomized, controlled clinical trial to determine whether this experimental treatment is safe and can improve clinical outcomes.”

    • Also interesting is this:

      > The investigators anticipate that many of those enrolled will be 60 years of age or older or have a comorbidity associated with developing serious complications from COVID-19, such as cardiovascular disease or diabetes.

      So they are apparently willing to do this without requiring constant monitoring of cardiac side-effects. That would perhaps suggest that they anticipate that the likelihood of cardiac side-effects are small.

  49. So cases are down in 25 states, 17 flat. Even as testing has presumably increased in most of those states. Not a bad sign. However, it shouldn’t be lost on us that the trend in the US is among the worst around the world. Do we just excuse our relatively poor performance on issues unrelated to poor federal leadership?

    You decide.

  50. Re vaccine development:

    Discussion here of challenge trials…

    https://www.npr.org/transcripts/847755751

    As well as coronavirus antibody dependent enhancement

    > Since the 1960s, tests of vaccine candidates for diseases such as dengue, respiratory syncytial virus (RSV), and severe acute respiratory syndrome (SARS) have shown a paradoxical phenomenon: Some animals or people who received the vaccine and were later exposed to the virus developed more severe disease than those who had not been vaccinated (1). The vaccine-primed immune system, in certain cases, seemed to launch a shoddy response to the natural infection. “That is something we want to avoid,” says Kanta Subbarao, director of the World Health Organization Collaborating Centre for Reference and Research on Influenza in Melbourne, Australia.

    https://www.pnas.org/content/117/15/8218

  51. I hope Judith will talk some sense into Willis Eschenbach, lest his covid sermonizing contribute to the body count:

    https://vvattsupwiththat.blogspot.com/2020/05/primum-non-nocere.html

    • Well, the recommended dosage for acute Malaria is 1.5g the first day and 500mg for the next two days, for a total dose of 2.5g over 3 days. Willis recommended 4.5g over 3 days. One of the Covid19 trials used 1.2g per day for multiple days, and this continuing dosage was scaled back at day 13 after some of the higher dosage folks had QTc events exceeding 500ms.

      • Don Monfort

        We had this discussion over this pointy head’s foolishness some time back. Looks like he is going to drop in periodically to beat a dead horse.

        The pointy head was fooled by Willis’s statement that he took a few weeks dosage of chloroquine in 3 days. What the pointy head apparently still does not realize is that the prophylaxis dosage over 3 weeks is a piddling. Like the pointy heads comments are a piddling.

        He foolishly implies it’s Judith’s responsibility to manage Willis’s health. The real reason for pointy head’s visits here is to ridicule and discredit Judith, because she doesn’t toe the party line. Shameful behavior. Secondary reason is to try to trick folks into visiting his lonely and very lame impostor blog. More shameful behavior.

  52. Once again,

    I think there may some merit to the view that the Swedish approach will result in the same death rate as “lockdowns,” but it rests on a few important considerations…among them that there would be no vaccine developed before the fast/short, slow/long approach to infections would equalize, and as well, there would be no therapeutics developed during that longer time frame that would significantly reduce fatality rates.

    Also, mixed into this is a simplistic notion that the “lockdowns” have a significant differential negative effect on the economy as opposed to the kind of economic outcomes that Sweden will realize based on its approach. (1) that is a highly dubious assumption, even to the point of determining which direction the effect might go in the long term. In the short term, a comparison of the economic effect of a “lockdown” in Denmark versus a “no lockdown” in Sweden shows no such differential effect and, (2) it’s waaay too early to be drawing any conclusions anyway.

    In short, I think that these cross-country comparison are of very limited value. In part, because they fail to control for very important variables, such as hospital capacity, rate of comorbidities among the citizenry, access to healthcare, population density, % of people who live in single-family households, etc. ‘

    This NYTimes article touches on some of those factors – and also discusses how the comparison to excess deaths versus deaths per capita might be important to consider.

  53. On the 10th I put this on the bottom of the list.
    To me an essential worker is anyone working a 40-hour week. If you are an employer give each essential worker a $50 gift card to a local fast food restaurant if they get a test. It may cost you an employee for 2 weeks, but it could keep you from loosing 2 or 3 for 2 weeks.
    Still need more tests.
    On the 11th we did 540,847 tessts. I do not know if this caused the rise but the next day we begaqn this treading water. and we are in the 21,000 positive range. If you know an essentail worker, show that individual what their getting a test will do twords opening the country. If we can get to around 500,000 or better daily we can make a large increase in lowering the number.

  54. As a fan of irony – some thoughts for consideration:

    Trump supporters rail about the “lockdowns” as tyranny, yet ignore his pivotal role them being institited.

    Trump supporters rail against the Imperial College projections, yet ignore Trump’s constant reference to them to promote his greatness.

    Trump supporters say testing isn’t really necessary, uett ignore the wall to wall testing at the Whitehouse.

    Trump supporters praise a “herd immunity” approach AND support Trump who days we’ll have a vaccine very, very soon. But to the extent that a herd immunity approach will work, it relies on the logic of trading off a lot of people dying and getting sick quickly (even assuming the idea that protecting everyone vulnerable, which is highly unlikely) for a slower rate of infection. If a vaccine is developed and distributed quickly, it may well mean that many people will get sick and die needlessly in comparison to a long and slow approach to infection.

  55. “Gov. Andrew M. Cuomo finds himself engulfed in scandal as a growing number of Democrats join state Republicans in demanding an independent investigation into his controversial policies and how questionable actions may might have contributed to the catastrophic outbreak of coronavirus in New York nursing homes.

    More details have emerged in recent days raising major questions about potentially fatal decisions made under Cuomo’s watch as the death toll in New York’s nursing homes swells to over 5300 and continues to climb.”

    Who couldn’t see this coming? There goes another Alt-Joe Movement up in flames. What would Pop Mario say?

    • We need America’s Mayor and former United States Attorney for the Southern District of New York scourge of the mob, Rudy Giuliani, to lead the investigation into the NY Cuomo-DeBlasio syndicate’s deadly reign of terror. First move, is to confiscate their passports.

  56. People interested in HCQ+AZM as preemptive therapy against Covid19 should note that NIH has started a clinical Trial.
    News release is at https://www.nih.gov/news-events/news-releases/nih-begins-clinical-trial-hydroxychloroquine-azithromycin-treat-covid-19
    My synopsis is https://rclutz.wordpress.com/2020/05/14/nih-starts-hcq-act-trial-may-14-update/

  57. dpy might appreciate.

    • I am deeply shocked. Did he pay for the study with frequent flier miles ?

    • Wow! According to left loon buzzfeed, all those formerly eminent scientists sold out for $5000. They got $3.47 each, after expenses for the study.
      Thanks, willie

      • The pleasure is all yours, Don Don:

        Neeleman is feeling the hit. On top of starting JetBlue in 1999, the entrepreneur founded Azul Brazilian Airlines, cofounded WestJet of Canada and Morris Air, and holds a major stake in TAP Air Portugal.

        On April 7, he vented in an op-ed for the Daily Wire, the right-wing news website helmed by political commentator Ben Shapiro. “Since the outbreak, I have spent all my days and a lot of my nights trying to find a solution to save as many as possible of the 40,000 jobs I am responsible for and do what I can to help avoid an economic catastrophe in the making,” Neeleman wrote.

        His “search for a solution,” he continued, had led him to “three amazing and dedicated professors and scientists from Stanford University School of Medicine with impeccable credentials”: Jay Bhattacharya, Eran Bendavid, and John Ioannidis. “I have come to know them personally,” Neeleman added.

        https://www.buzzfeednews.com/article/stephaniemlee/stanford-coronavirus-neeleman-ioannidis-whistleblower

      • Imo, the funding connection is the least of it.

        > Others had received an email from Bhattacharya’s wife, falsely claiming that an “FDA approved” test would definitively reveal if they could “return to work without fear,” as BuzzFeed News has reported.

        How is that not an ethics violation? How could it possibly pass an IRB review?

        > One email, without a visible timestamp or sender that was sent to Bogan’s and Neeleman’s addresses, read: “David, I think you should write Taia a note and tell her you’ll support her lab if she validates this kit.” Bendavid confirmed that he put Neeleman and Wang in touch.

        > And Neeleman did write to her. “First and absolutely most importantly, we have to establish without any doubt, the efficacy of these tests,” he wrote. “I am frustrated by what appears to be the lack of urgency.”

        Jesus.

        > Bendavid mentioned that he was particularly worried about the test’s rate of false positives. If the test generated more false positives than the scientists were expecting, the results would throw off their infection estimates and affect what they could tell people about their antibody status, he wrote.

        Well, that might put John’s work in research methodology in a slightly differ light, I’d say.

        > Bendavid seemed “resistant to the idea” that people with positive results should be contacted and retested, Boyd continued: “Is this because it would take some time to do so?” Furthermore, he noted, Wang had told him that she did not think her experiments “validated or verified the accuracy of the Premier Biotech kits at all.”

        Jesus. If this is true, Bendavid needs to be fired.

        > Ioannidis also pointed out that it was a preprint, not a published study, and therefore subject to further revisions.

        Whaaa? He went on a national TV campaign based on that preprint. This just keeps getting worse.

      • Don Monfort

        OK, let’s pretend that Neeleman bought what he wanted for $5000 and the small effort in coming to know some professors personally, which must be code for somehow gaining control over their minds and actions. When was the last time that left loon totally corrupt buzzfeed has blown the whistle on George Soros for throwing around $BILLION$ of his dirty money to get his sinister far left loon agenda implemented?

    • Yes Don, It’s a classic merchant of doubt tactic. You are an anonymous internet activist with no scientific expertise like Willard. Since you can’t say anything substantive you subtly imply there might be a questionable motive. Pretty shameful. Right up there with Schmidt’s disgusting tweet smearing Ioannidis. On the internet, schoolyard bullies get to wear hoods.

      • The funding is the least of it.

        There might have been zero influence from the funder (although not declaring a conflict of interest would be a violation), well neve know. It’s the rest of the article that’s really damming.

        If what’s in that article is true, then there is no legitimate excuse. I’m actually amazed that you don’t see that, David. And at this point it takes a lot to amaze me with regard to how “motivated” people can get in their reasoning.

      • And either they lied about the recruitment, or the IRB at Stanford need to be fired.

      • Thank you for this other scientific contribution, dpy number six six two nine.

        You might also like:

    • Of course, this whole canard has zero scientific relevance. There are now at least 10 serologic studies around the world that give results similar to the Santa Clara study. This whole thing is just noise and political trash talk.

      • Don Monfort

        Speaking of left loon corrupt media, CNN did a virtual faux townhall bogus discussion with a lame a– panel of coronavirus experts, including the little Scandalnavian scold angry girl expert on climate and all things woke:

      • Well, the last refuge of a scoundrel is to change the subject. On the point here your canard is of nil scientific or mathematical significance. Virtually all researchers take soft money from lots of sources and most don’t let it influence their results even though a few do.

      • Wasn’t.

        She was interviewed. Alone. And not presented as an expert.

        Like I said, you’ve been had.

      • Don

        I don’t know if you saw this report that the UK Govt has just bought £20 million worth of a variety of drugs for anti virus tests?

        https://www.telegraph.co.uk/news/2020/05/15/uk-pays-20m-donald-trumps-malaria-drug-covid-cure/

        I remain neutral on this although it is evident that some drugs work better when applied at the right time, which may be in the early rather than very late stages of covid 19

        tonyb

      • Don Monfort

        Thanks, tony. The article contains the usual gratuitous swipe at Trump. They always fail to mention that Trump also “touted” “trumpeted” Remdesivir, which little hero of the left loons, Dr. Fauci, has anointed as the standard of care for COVID 19, based on one so-so trail.

        The Chinese trial reported in BMJ is flawed and inconclusive. Discussed at bottom of comments. Haven’t seen the French trial they say was reported in BMJ. Will look into it.

        What’s interesting is this:

        https://www.telegraph.co.uk/news/2020/05/11/drug-championed-donald-trump-trialed-uk-among-vulnerable-groups/

        “Drug championed by Donald Trump to be trialled in UK among vulnerable groups
        Antimalarial hydroxychloroquine has so far proved ineffective, but scientists believe it may help if given sooner”

        “More than 500 GP practices are now recruiting pensioners, and over-50s with underlying health conditions, to see if giving them the antimalarial hydroxychloroquine lessens the symptoms of covid.”

        Of course, it hasn’t been proved ineffective, but they can’t help themselves, because Orange Man Bad. This trial with 500 GP practices involved should be very interesting. Just the kind of study to scare the bejesus out of the left loon virus cheerleaders.

    • I thought we lost you. Welcome back Willard.

      • Yeah. Perhaps. Just don’t look at excess deaths, the number of people dying at home or long term care facility without being tested.

        Only consider uncertainty in one direction.

        Why change style now, right?

      • You lost me. Find the highest rule. People should make their own decisions. Or Science people should make them for us.

    • https://www.foxnews.com/us/colorado-lowers-coronavirus-death-count

      Perhaps Birx is right that CDC covid death stats are too high by 25%.

  58. I will not know how well you did today until noon tomorrow. If what I see at this time, you will all be amazed. If you can get your fellow essential workers tested, that have not had a tested after the 10th, tested before the 22nd you will have saved us 3 TRILLION DOLLARS.

    • Why are you touting that stuff? Where are the randomized, quadruple blind, placebo controlled, peer reviewed clinical trial results? Shame on you for raising hopes of the sick and dying based on a Fox News blurb.

      • Don Monfort: Why are you touting that stuff? Where are the randomized, quadruple blind, placebo controlled, peer reviewed clinical trial results?

        I wasn’t “touting” it. It’s just another report of the widespread and diverse work on the problem. Have you come around to the view that evidence of efficacy is actually required?

  59. disappointing news about HCQ:
    https://www.bmj.com/content/369/bmj.m1849

    Don Monfort: Where are the randomized, quadruple blind, placebo controlled, peer reviewed clinical trial results?

    Just so. No evidence that it works against the target infection, in the infected people, in actual clinics. Hence my “maybe”. Source is not Fox News but the biotech company.

    • I don’t believe you bothered to read that alleged disappointing news about HCQ, mattie.

      The trial was not double-blind, no placebo. Under powered sample size, not able to recruit patient number in protocol. Premature ending of trial caused increased censoring of data. And a lot of other issues you can find in “Strengths and limitations of study”, if you care to actually read the paper.

      The mean duration from onset of symptoms to randomization was 16.6 days. Meaning, mattie, that early HCQ intervention was not in the game. That’s what we are waiting for, mattie. Let us know if you run across it.

      Results with all the trials shortcomings could best be described as inconclusive with a slight edge for HCQ, on the primary outcome.

      More adverse events in the HCQ group. Nothing serious. If they had handed out placebos, that group would have some imaginary reactions. Patient psychology. That’s how it goes.

      “Overall, the probability of negative conversion of SARS-CoV-2 among patients who were assigned to receive standard of care plus hydroxychloroquine was 85.4% (95% confidence interval 73.8% to 93.8%) by 28 days, similar to that of the standard of care group (81.3%, 71.2% to 89.6%). The difference in the probability of negative conversion between standard of care plus hydroxychloroquine and standard of care alone was 4.1% (95% confidence interval –10.3% to 18.5%).”

      Don Monfort: Where are the randomized, quadruple blind, placebo controlled, peer reviewed clinical trial results?

      We are still waiting for it, mattie. Keep looking and hoping that your stubborn ignorance will be vindicated. I spent more time on this than I should have, but I do enjoy demonstrating how little you know, of what you think you know.

      • Don Monfort: Results with all the trials shortcomings could best be described as inconclusive with a slight edge for HCQ, on the primary outcome.

        Where has the slight edge been demonstrated? All the reports put together are inconclusive. Except possibly for the claim that HCQ is ineffective if given late.

      • Don Monfort

        I didn’t say a slight edge was “demonstrated”, mattie. Inconclusive does not mean demonstrated.

        “inconclusive with a slight edge for HCQ, on the primary outcome”

        “Overall, the probability of negative conversion of SARS-CoV-2 among patients who were assigned to receive standard of care plus hydroxychloroquine was 85.4% (95% confidence interval 73.8% to 93.8%) by 28 days, similar to that of the standard of care group (81.3%, 71.2% to 89.6%). The difference in the probability of negative conversion between standard of care plus hydroxychloroquine and standard of care alone was 4.1% (95% confidence interval –10.3% to 18.5%).”

        Those are the inconclusive primary outcome numbers, in the flawed inconclusive trial. They are what they are. It’s a slight edge, ain’t it? If it was a NBA game it would be marked down as a W. But I shouldn’t have said it. Only caused you more confusion.

        Please don’t keep posting links to and commenting on things that you have not read.

      • Don Monfort:I didn’t say a slight edge was “demonstrated”, mattie. Inconclusive does not mean demonstrated.

        “inconclusive with a slight edge for HCQ, on the primary outcome”

        Fair enough. with a slight edge for HCQ that has not been demonstrated.

  60. You have it wrong as usual, mattie. Your source, that you linked to, was Fox News. Why would you bother touting this antibody since Fox News gave you zero scientific or clinical justification for the company’s bold claims:

    “As soon as it is infused, that patient is now immune to the disease,” Dr. Brunswick said to Fox News. “For the length of time, the antibody is in that system. So, if we were approved [by the FDA] today, everyone who gets that antibody can go back to work and have no fear of catching COVID-19.”

    “Dr. Ji pointed out that the antibody can be used as preventative therapy since there are no side effects, and that it can be more effective than any vaccine that may be developed”

    As close as they came to explaining how it allegedly works:

    “This puts its arms around the virus. It wraps around the virus and moves them out of the body.”

    All that is based on in vitro testing, not yet peer reviewed and published. If I didn’t know this company and own it’s stock, I would think this is a typical fly-by-night biotech pump and dump scheme. You are really gullible and you obviously don’t know anything about monoclonal antibodies. And you persist in blaming Dr. Raoult for your ignorance on HCQ treatment of COVID 19.
    Get a grip, dude.

    • You keep saying that Dr. Raoult is prolonging ignorance on HCQ treatment of COVID 19, because he is not conducting blah blah blah clinical trials. Get a grip.

      “It’s one example of a large amount of preclinical work that is being conducted. Maybe it will work.”

      The story didn’t say it was pre-clinical work. Is that what you really thought? Why would you even give it a “maybe” not having a clue about the science and research behind those extravagant claims?

      Are you going to post a comment and a link, every time you find some vague outlandish pronouncements like that? I hope the SEC doesn’t get on them for telling that bizarre story. Gullible people like you piled into the stock today. I’ll probably sell tomorrow and get back in when the excitement based on unpublished in vitro results dies down. That’s how we do it. Take advantage of opportunities presented by gullible know-nothings.

  61. nobodysknowledge

    I see some pictures from US political events.
    It is a sad view. How the coronavirus lock-down protests, and the pro Trump rallies turn into giant superspreading events. Is the message that God and Fight for Freedom will protect you from illness?

    • You must have really extraordinary vision:

      “How the coronavirus lock-down protests, and the pro Trump rallies turn into giant superspreading events.”

      You can draw that conclusion, just from looking at some pictures. Not very bright.

    • nobodysknowledge

      Recipe for transmittance of viruses:
      Close face-to-face-contact.
      Shouting, talking loud, laughing.
      Touching clothes and common surfaces.
      Not wearing masks.
      So, just look at pictures and videos, and judge.

      • Don Monfort

        I’ll leave it to you to look at pictures and make your Epididdlymology for Dummies assumptions. But would appreciate when you get the evidence that validates your home-brewed prognostications, that you come back and share it with us.

      • nobodysknowledge

        Headline from Sky News: “Dozens may have been infected with COVID-19 at Wisconsin anti-lockdown rally.” Just one of hundreds demonstrations.

      • Don Monfort

        Sky News headline about dozens “may” have been infected only qualifies as evidence to ersatz epididdlymologist dummies, who have been educated by exposure to Epididdlymology for Dummies. Think about what you are doing here.

  62. C’mon. Not as good as the first one, but you gotta laugh.

    Right?

  63. 5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829
    5/11/2020 21,122 -3,713 -14.9 540,847
    5/12/2020 19,534 -1,588 -7.5 164,139
    5/13/2020 23,704 4,170 21.3 340,173
    5/14/2020 21,710 -1,994 -8.4 340,721
    5/15/2020 29,276 7,566 25.8 385,164
    5/16/2020 25,812 -3,464 -11.8 433,742
    25812 is 5.9% of total tests.
    Today was day
    Today was day 6 of 14. Lets keep it up for thenext 8 and see how we did.
    In the mean time the Frederal, State and Local governments can set up a testing system before the the14 days are over.

    • > Washington Times – Politics, Breaking News, US and World News logo

      Michigan Gov. Gretchen Whitmer slapped with lawsuit over ‘drastic’ lockdown
      In a pool photo provided by the Michigan Office of the Governor, Michigan Gov. Gretchen Whitmer addresses the state during a speech in Lansing, Mich., Monday, May 11, 2020. Protests against Whitmer have erupted in recent weeks as she has put in place restrictions on businesses and Michigan residents, including a sweeping stay-at-home order, intending to limit gatherings as a way to reduce the spread of coronavirus. (Michigan Office of the Governor via AP, Pool)
      In a pool photo provided by the Michigan Office of the Governor, Michigan Gov. Gretchen Whitmer addresses the state during a speech in Lansing, Mich., Monday, May 11, 2020. Protests against Whitmer have erupted in recent weeks as she has …
      By James Varney – The Washington Times – Thursday, May 14, 2020
      Medical professionals and a patient in Michigan have filed a lawsuit against Democratic Gov. Gretchen Whitmer as the battles grow between her and those favoring relaxing the economic shutdown she has imposed in response to the coronavirus crisis.

      Their lawsuit in federal court comes at a time when Ms. Whitmer continues to engage in a public spat with a 77-year-old barber, who has defied various orders and as of Thursday morning continued to cut hair at his Owosso shop.

      The plaintiffs allege in federal court that Ms. Whitmer’s “drastic, unprecedented [and] unilateral executive actions” to cease economic activity that her office deemed nonessential were based on “grossly inaccurate” models that no longer apply and therefore should be lifted.

      TOP ARTICLES
      3/5
      Roger Stone accuses Steve Bannon
      of lying under oath about Trump campaign and WikiLeaks

      “Medical providers are on the brink of financial ruin, facing extreme revenue shortages caused by the Governor’s order forcing the postponement or cancellation of so-called ‘non-essential’ procedures,” said the suit filed by the Mackinac Center Legal Foundation and a private law firm, Miller Johnson. “Thousands of healthcare workers across Michigan have been furloughed or laid off.”

      In addition to the economic devastation, Ms. Whitmer’s order has left hospitals and patients facing a dangerous backlog on procedures that will create a public health catastrophe of its own, said Dr. Randal Baker, a general surgeon and president of Grand Health Partners, a plaintiff based in Grand Rapids.

      “This whole ‘elective-procedure’ thing is now a time bomb,” Dr. Baker told The Washington Times. “There is no good reason to have a ban on elective surgery any more. This is now a significant health problem for the people of Michigan and our patients, and I’ve had one patient attempt suicide — a very serious attempt.”

      A patient of Grand Health Partners needing to repair a damaged feeding tube has been unable to have the procedure performed, and another needing gallbladder surgery has developed gangrene during the enforced shutdown, the lawsuit alleged.

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      Similarly, Jordan Warnsholz, a physician assistant who owns two Michigan clinics and is a plaintiff, blasted Ms. Whitmer as engaging in a one-size-fits-all policy and having an imperious attitude.

      “There’s immense fear in the medical community toward Gov. Whitmer and how terribly she’s treated other people,” Mr. Warnsholz said. “What we have seen is tremendous damage, excessive damage to patients that was largely preventable if she had put in place better parameters than her blanket restrictions.”

      Last week, Ms. Whitmer intimated “important” medical work was never prohibited under her orders, but Mr. Warnsholz disputed that and said to date there has been no change in Michigan’s public health code that would make him and other practitioners comfortable resuming work.

      MORE IN HOME

      Michael Flynn adversary’s law firm backs Democrats: FEC records

      Trump adviser: China paying ‘compensatory damages’ for pandemic should be under consideration

      Mueller judges could be impeachment targets if GOP retakes House, Roger Stone predicts

      Trump hits McConnell on response to ‘Russian collusion hoax’

      New York tourist arrested in Hawaii for breaking quarantine after Instagram posts of his outings
      “She’s backtracking — she says her original order did not imply a complete ban of ‘non-emergency’ medical procedures and she’s right, it explicitly banned them,” he said.

      In addition to Ms. Whitmer, the suit names Michigan’s Attorney General Dana Nessel and Robert Gordon, the state’s Department of Health and Human Services director as defendants.

      A call to Ms. Whitmer’s office seeking comment was not returned.
      > The lawsuit is but one salvo in an escalating battle between Ms. Whitmer and those who believe Michigan must more rapidly open up its economy to stave off an economic catastrophe. The lawsuit said the lockdown orders were issued at a time when one estimate from the Centers for Disease Control and Prevention put the projected number of nationwide infections at between 160 million and 214 million, with deaths of between 200,000 and 1.7 million.

      >> Those figures have proved wildly inflated thus far, the lawsuit noted. As of Thursday, more than 85,000 deaths have been attributed to the coronavirus which afflicted the U.S. and other nations after first infecting people last year in Wuhan, China.

      Remarkable that there was no mention of the effect of government interventions, and even non-government mandated social distancing, on the model projections.

      Pure propaganda.

      • Media have biases Josh. You didn’t show that what you quoted was wrong.

      • Don Monfort

        “You didn’t show that what you quoted was wrong.”

        Tip: I got that without reading all that crap.

  64. more on the health costs of the lockdowns:

  65. With respect to comparing the effects of a “lockdown” in one country to voluntary social distancing in another, (or, I might add, extrapolating a national fatality rate from an infection rate in a non-random sample from one locality that isn’t nationally representative on such basic metrics such as SES and race/ethnicity) ::

    > On the other hand during the past month I have witnessed, on Facebook, Twitter, Whatsup, mailing lists, etcetera a rather widespread attitude in a large number of colleagues, who have started to entertain themselves with publically available data on contagions, deaths, hospitalized patients, and related geographical information. It began as a trickle of graphs posted on Facebook or Twitter, showing an exponential function overlaid to a few data points, and then it became very quickly a flood of plots of all kinds, where the data were tortured to confess they wanted to plateau somewhere; this was invariably done using this or that single-dimensional parametrization, picked up without justification, “because the chisquare looks good”.

    I saw curves describing data from one country overlaid with other curves describing data from other countries, shifted according to ad-hoc criteria;…

    https://www.science20.com/tommaso_dorigo/the_virus_that_turns_physicists_into_crackpots-246490

    • Joshua: https://www.science20.com/tommaso_dorigo/the_virus_that_turns_physicists_into_crackpots-246490

      Thanks for the link. It would have been better if he had shown examples illustrating his general themes, and if he had shown that the physicists were less accurate than the widely cited experienced biologists and epidemiologists.

      I saw curves describing data from one country overlaid with other curves describing data from other countries, shifted according to ad-hoc criteria;…

      I have not seen one of these shifted according to ad-hoc criteria. But all that does is shift the curves left and right; if you plot them vs calendar days, they are more spread out horizontally, but all the comparisons relevant to rates of change are the same.

  66. Roger Knights

    Neuro-COVID: Gaining Recognition as New Disease Terminology
    There’re 3 types of Neuro-COVID, and it progresses through 3 stages — involving the brain’s respiratory center.
    Shin Jie Yong May 14 · 4 min read

    Extracts:
    In a May 5 published paper in Brain, Behavior, and Immunity, researchers at the University of Brescia in Italy said there are three distinct features of clinical COVID-19 neuroinfection: (1) Cerebral thrombosis with hemorrhagic infarction, (2) demyelinating lesions, and (3) encephalopathy. “We defined this condition as Neuro-COVID for the overwhelming CNS involvement in COVID-19,” they proposed.

    Two other papers by researchers in China support the proposed neuroinfection route the Italian researchers, which involve either olfactory nerve transport or blood-brain-barrier crossing, or both.

    Other research groups have also linked the brainstem — brain’s respiratory center — to COVID-19. …
    View at Medium.com

  67. As I reported, when doubt was raised about the Univ. of Minnesota’s ability to complete their HCQ early intervention trials due to recruitment problems, I was informed that they would finish the trials:

    https://covidpep.umn.edu/updates

    May 15, 2020

    Two Covid-19 hydroxychloroquine randomized, double-blind, placebo-controlled clinical trials, conducted by the University of Minnesota, McGill University, University of Manitoba, and University of Alberta, completed enrollment on May 6. These trials tested post-exposure prophylaxis and preemptive early treatment with hydroxychloroquine for Covid-19. Analysis, results, and manuscripts are in process, and following scientific peer review, we will release our results.

    • Don –

      Let’s hope they have better results than these studies:

      http://Www.scitechdaily.com/results-from-randomized-clinical-trial-do-not-support-hydroxychloroquine-for-covid-19/amp/

      I see that UW is starting a study. Hard to believe they’d do that unless they had reason. Same with the NIH study. It’s all pretty weird.

      http://www.kiro7.com/news/uw-enrolling-patients-study-test-hydroxychloroquine-azithromycin-covid-19-treatment/JG3X5AFTVZGKLE2CTNH72KCWAM/%3foutputType=amp

      • Don Monfort

        One faulty trial already debunked and a 404 error. The SARS virus cheerleaders are struggling. Pathetic.

      • Re: “So, you must be horrified that plasma taken from recovered COVID 19 patients containing CD4+ T cells is being infused into patients currently suffering from the disease. Answer that one you disingenuous little clown.”

        Please feel free to provide a shred of evidence that’s being done, Don. Remember, you’re talking to an immunologist, so your usual bluffing won’t work.

        Isolated plasma typically doesn’t contain cells. And when it’s used to treat patients, it typically in the context of IV-Ig; i.e. you’re giving the patient antibodies from the plasma. You usually don’t want to give the patient other people’s immune cells because the host’s immune system will view them as foreign and kill them off. Same response would happen to other cell types if you got an organ transplant; hence why people need to undergo immunosuppression when they get a transplant.

        A better way to use T cells here would be to isolate them from the person, modify them in vitro to help them be better at suppressing the virus, and then inject them back into the same person (somewhat analogous to what happens with autologous CAR T cells). But I highly doubt that’s happening yet, since I haven’t seen any evidence that we have enough knowledge on how to skew the CD4+ T cells toward a phenotype that would help in clearing this virus. So it’s very unlikely that you have a source saying that doctors are infusing patients with plasma containing CD4+ T cells from other people, Don. But if you do, I’d like to see it. Maybe they’re doing transfers between identical twins, other closely related individuals, HLA matched individuals, etc.?

        Another issue is that the CD4+ T cell profile post-recovery from COVID-19 likely differs from the profile from before COVID-19 and from during COVID-19. After all, once a patient recovers from COVID-19, they aren’t undergoing the cytokine storm that pathogenic T cells contribute to during COVID-19. Also, they probably has some CD4+ Tregs appear suppress the inflammation from the cytokine storm. And they likely now have a population of memory T cells for that pathogen which they didn’t have before. Thus the make-up of T cells and cytokines will likely be different before, during, and after COVID-19. So, Don, even if they were infusing T cells from after people recovered from COVID-19, that does nothing to rebut my point about pre-existing cross-reactive T cells from before COVID-19 and pathogenic T cells from during COVID-19.

        Re: “The encouraging thing that the authors noted is that they might confer some amount of immunity to SARS2 CoV.
        If you don’t catch it, you ain’t going to get a cytokine storm.”

        Yes, thank you for the trivial observation that if you don’t catch SARS-CoV-2, then you don’t get cytokine storm in the context of COVID-19. Will you next be telling me that people don’t get immunosuppression in the context of AIDS unlike they catch HIV?

        And you keep evading the fact that the authors explicitly say it’s unclear whether these pre-existing T cells are beneficial vs. pathogenic:

        “There is also great uncertainty about whether adaptive immune responses to SARS-CoV-2 are protective or pathogenic, or whether both scenarios can occur depending on timing, composition, or magnitude of the adaptive immune response.
        […]
        Immunopathogenesis in COVID-19 is a serious concern (Cao, 2020; Peeples, 2020). It is most likely that an early CD4+ and CD8+ T cell response against SARS-CoV-2 is protective, but an early response is difficult to generate because of efficient innate immune evasion mechanisms of SARSCoV-2 in humans […]. Immune evasion by SARS-CoV-2 is likely exacerbated by reduced myeloid cell antigen presenting cell (APC) function or availability in the elderly […]. In such cases, it is conceivable that late T cell responses may instead amplify pathogenic inflammatory outcomes in the presence of sustained high viral loads in the lungs, by multiple hypothetical possible mechanisms […]. Critical (ICU) and fatal COVID-19 (and SARS) outcomes are associated with elevated levels of inflammatory cytokines and chemokines, including IL-6 […].”

        https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2930610-3

      • Re: “pointy headed rascal […] So, you must be horrified that plasma taken from recovered COVID 19 patients containing CD4+ T cells is being infused into patients currently suffering from the disease. Answer that one you disingenuous little clown.”

        It will be telling if you fail to back up your claim, after I asked you to support it up in my previous comment. If you were wrong, then have the integrity to admit you were wrong, and next time learn not to insult those who correct you.

        In the meantime, I’ve found candidates for the the research you may have been referring to:

        “Effectiveness of convalescent plasma therapy in severe COVID-19 patients”
        “Treatment of 5 critically ill patients with COVID-19 with convalescent plasma”
        “Use of convalescent plasma therapy in two COVID-19 patients with acute respiratory distress syndrome in Korea”

        As I expected, it’s basically like IV-Ig; they’re transferring plasma in order to increase antibody titers. Nothing particularly novel about that; it’s something that’s been known about for decades. None of the papers mention the transferred plasma containing CD4+ T cells; plasma therapy typically isn’t meant to contain immune cells, for the reasons I already explained to you. I also forgot to mention the risk of graft-versus-host disease, from the transferred immune cells attacking the host.

        And just FYI, Don:

        “Plasma, by definition, is a cell-free blood product. However, complete elimination of cells cannot be achieved consistently by current manufacturing methods, except for S/D-treated plasma. Usually, the number of leukocytes present in one unit of single-donor plasma (250 mL) does not exceed 0.5 × 106 [24]. Assuming that less than 50% of donors’ leukocytes are lymphocytes and that, after freezing and thawing, less than 0.2% of these cells will be viable [25], less than 500 viable lymphocytes are transfused routinely with a single unit of plasma.”
        https://www.sciencedirect.com/science/article/pii/S1473050210001497?casa_token=bm1kxdJqCMwAAAAA:khKtnrkR7C9cFrtZUm68yXIwkVeFUC9VenIA4aDIfICDqJYPVl1wFVgDVB6Z825caTaVwmxo

        Dumbed down for you:

        “Plasma is a component of the blood: it contains proteins, nutrients, metabolic products, hormones and inorganic electrolytes, but it is cell-free. According to some researchers, patients suffering from very severe forms of COVID-19 could be treated with “hyperimmune plasma”, i.e. the plasma of people healed by Coronavirus because this substance is rich in antibodies.”
        https://www.thepatent.news/2020/05/04/coronavirus-plasma-therapy/

        That was your immunology and medical science lesson for the day, Don. Try to actually learn something this time.

      • Don Monfort

        Ah, yes it is true that no CD4 T cells in the plasma. But if you are an immunologist you should know that plasma from recovered COVID 19 patients has been infused into a lot of patients with active disease. I never said there was anything novel about it, you said it wasn’t being done. You are a clown.

        Google it clown:

        “plasma from COVID recovered patients infused into patients with covid 19”

        About 7,670,000 results (0.34 seconds)

        Why would an immunologist who pretends to know everything that’s going on with COVID 19, not be aware of any of that?

        Anyway, you keep insisting that I believe that blah blah blah, when I have provided you with quotes that prove you are repeating a lie. It’s all in this thread. You are a liar. I admit when I make an error, you just keep on lying.

        The point is that according to those researchers many folks who never had COVID 19 have been found to have CD4 T cells that might give them some level of immunity to the CoV virus. I said that is encouraging. That’s my opinion. I don’t give a flying —-, if you don’t think it is encouraging. I also said we need to see more research. You persist in pretending I didn’t say that, you lying clown.

        You keep harping on cytokine storm which is totally irrelevant if those folks are not actually infected with the virus and it doesn’t actually get to be a severe case. Even in the event someone got severely sick with the virus, you have no evidence that the CD4 T cells they already have in their blood will contribute to a cytokine storm. You have just created a stink based on BS. Why don’t you see if you can get that paper retracted, clown? Now keep it up. Keep lying. You will be very influential here.

      • Re: “Ah, yes it is true that no CD4 T cells in the plasma.”

        Congratulations on moving away from a treatment that might have harmed patients. And you were therefore wrong to bring up the plasma point as if it rebutted what I said on CD4+ T cells; i.e. you offered a red herring.

        Just to be clear, Don: I’m not responding to you for your benefit; I think you’re a lost cause. I’m responding to link people to these comments later so they can learn something and see how a lot of you right-wing ideologues distort science.

        Re: “The point is that according to those researchers many folks who never had COVID 19 have been found to have CD4 T cells that might give them some level of immunity to the CoV virus. I said that is encouraging. That’s my opinion.”

        It’s as worthless + baseless as your opinion that plasma therapy included CD4+ T cells, for the reasons I already explained to you in this thread and in the other one here:

        https://judithcurry.com/2020/05/06/covid-discussion-thread-vi/#comment-917332

        Re: “You keep harping on cytokine storm which is totally irrelevant if those folks are not actually infected with the virus and it doesn’t actually get to be a severe case.”

        And you still don’t grasp that the presence of pre-existing CD4+ T cells could predispose the patient to a cytokine storm, given the role of CD4+ T cell place in inflammation (ex: their production of inflammatory cytokines, their activation of other cells to cause those cells to produce inflammatory cytokines, the fact that they can be activated to an inflammatory state by other cytokines to promote a positive feedback loop that results in cytokine storm, etc.)

        Re: “Even in the event someone got severely sick with the virus, you have no evidence that the CD4 T cells they already have in their blood will contribute to a cytokine storm.”

        CD4+ T cells produce cytokines involved in cytokine storm. That’s immunology 101, so of course you don’t know it. Ironically, I already cited a paper to you on this, though you likely neither read nor understood it, given your lack of knowledge + lack of genuine interest in the scientific topics you’re misrepresenting (hint: IL-6 is a cytokine, is a major player in cytokine storm, is produced by CD4+ T cells, and is known to help push T cells into the inflammatory phenotype seen in cytokine storm):

        “In another study, it was shown that CD4 T cells of ICU patients with COVID-19 produced more IL-6 and GM-CSF than those not requiring ICU, although the numbers, powers, and statistical treatments were not reported.”

        Click to access s11357-020-00186-0.pdf

        “IL-6 can be produced by almost all stromal cells and immune system cells, such as B lymphocytes, T lymphocytes, macrophages, monocytes, dendritic cells, mast cells and other non-lymphocytes, such as fibroblasts, endothelial cells, keratinocytes, glomerular Mesangial cells and tumor cells [16].
        […]
        In addition, IL-6 is a pro-inflammatory regulator of T cells. IL-6 can promote Th17 cell lineage and function, inhibit the induction of regulatory T cell (Treg), and promote the development of self-reactive pro-inflammatory CD4 T cell response. IL-6 combined with TGF-β can promote the development and function of Th17 cells, while Th17 cells are related to the occurrence and development of many self-inflammatory diseases, such as rheumatoid arthritis, systemic lupus erythematosus and so on [31], [32], [33]. “
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118634/

        Re: “But if you are an immunologist you should know that plasma from recovered COVID 19 patients has been infused into a lot of patients with active disease.”

        What a ridiculous claim for you to make, especially given your screw-up on CD4+ T cells being plasma. I already knew what plasma therapy was; that’s why I was immediately suspicious of your laughable claim that they were transferring plasma containing CD4+ T cells. Also, being an immunologist does not mean you already know every treatment that’s being used for every condition, including newly discovered conditions. Finally, I already cited plasma therapy research to you before you made your reply above. Next time, learn to actually read what you’re responding to, Don.
        ;)

  68. I wish to congratulate the American people. Texas recorded it’s highest number of new cases Saturday. You will be amazed at what you will see whin I get today’s post posted.

    • That should be expected after distancing is relaxed. The purpose of distancing was to slow, not to stop the virus. Distancing can’t be maintained.

    • Robert Clark: I wish to congratulate the American people. Texas recorded it’s highest number of new cases Saturday.

      885 new cases (per worldometers), and 32 new deaths; bringing its total so far to 46 deaths per million.
      Florida was roughly similar: 673 new cases, 47 new deaths, raising its total so far to 91 deaths per million.

      New York is down a bit: only 2083 new cases and 172 new deaths, bringing its US-leading and world-leading(?) total to 1446 per million.

      Yes. Watching the trends in the diverse states as they substitute totally voluntary social distancing for decreed lockdowns will be informative. As the autoworkers in America’s geographically dispersed auto factories and parts factories go back to work, will their celebrated grandmothers (Whoopi Goldberg mentioned these just the other day) start dying at a higher rate than they have been? Will the rates be the same in CA, MI, SC and AL? Will the death rates be inflated by the expected (based on experience) number of deaths during elective surgeries, which are slowly resuming nationwide, and will these death rates be the same nationwide?

      Atomsk’s Sanakan and VeryTallGuy amazed me day before yesterday (I am still experiencing the effects of eating crow), so I look forward to your amazing me and the rest of us. Don’t disappoint.

    • Thanks, Robert. We should have listened to the geniuses who would continue draconian lock down, until economic and social intercourse is stomped out and no more viruses exist.

    • I hope there is at least someone out there understands how the chart below shows the AMERICAN PEOPLE have succeded

  69. Accepted for publication:

    https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2930610-3

    “Importantly, we detected SARS-CoV-2-reactive CD4* T cells in 40-60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating ‘common cold’ coronaviruses and SARS-CoV-2.”

    https://www.biorxiv.org/content/10.1101/2020.05.14.095414v1

    “Pre-existing and de novo humoral immunity to SARS-CoV-2 in humans

    Using diverse assays for detection of antibodies reactive with the SARS-CoV-2 Spike (S) glycoprotein, we demonstrate the presence of pre-existing immunity in uninfected and unexposed humans to the new coronavirus. SARS-CoV-2 S-reactive antibodies, exclusively of the IgG class, were readily detectable by a sensitive flow cytometry-based method in SARS-CoV-2-uninfected individuals with recent HCoV infection and targeted the S2 subunit.”

    Bad news for the SARS cheerleaders.

    • PS: second one is a pre-print

    • Wow Don, That’s incredibly good news and explains a lot about why virtually everywhere the curve has peaked and is going down. If 40% – 60% of unexposed individuals are already immune, that means New York City has reached effective herd immunity. We could be almost out of the woods!! :-)

      • Don Monfort

        I think we need to see some more research, before we can conclude that
        “Importantly, we detected SARS-CoV-2-reactive CD4* T cells in 40-60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating ‘common cold’ coronaviruses and SARS-CoV-2.” means that those folks have significant immunity against being infected with COVID 19. But it’s encouraging.

      • Potentially very good news. Could mean that deliberately infecting people with other coronaviruses could confer some level of immunity – as a step prior to vaccines. Given the high levels of infections we’ve seen – particularly in restricted communities like Bergamo, Italy, Chelsea, MA, prisons, meat packing plants, etc., – it seems rather doubtful that “40%-60% of unexposed individuals are already immune.” But hey, I’m no scientist like David.

        On the other hand, scientists seem to have some questions about some potential downside to this finding, as in maybe preexisting antibodies along those lines could be negative – contributing to an immune system “storm,” or can “skew the initial response and cause injury.”

      • David –

        > That’s incredibly good news and explains a lot about why virtually everywhere the curve has peaked and is going down.

        I see that unlike our scientists friends here, Kevin is appropriately very cautions about speculating.

      • Re: “Wow Don, That’s incredibly good news and explains a lot about why virtually everywhere the curve has peaked and is going down. If 40% – 60% of unexposed individuals are already immune, that means New York City has reached effective herd immunity. We could be almost out of the woods!! :-)”

        Nowhere does either article imply that 40 – 60% of people would already immune. Only someone utterly uninformed of immunology would claim that. So again you and Don misrepresent a topic you don’t understand to suit your ideology, just as you do on climate science. Actually read the articles. Then you would have noticed stuff like this:

        “There is also great uncertainty about whether adaptive immune responses to SARS-CoV-2 are protective or pathogenic, or whether both scenarios can occur depending on timing, composition, or magnitude of the adaptive immune response.”
        https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2930610-3

        As people have repeatedly explained to you (ex: https://judithcurry.com/2020/03/14/coronavirus-discussion-thread/#comment-914377 ), COVID-19 complications often result from an overactive immune system, as per cytokine storm. That was one of the central rationales for using immunosuppressive agents such as hydroxychloroquine and tocilizumab to treat COVID-19. Two of the very things hydroxychloroquine does is cause apoptosis of T cells and limit T cell activiation. It’s therefore amazing to me that 2 people who previously cheerled hydroxychloroquine treatment are now happily contradicting one of the mechanisms it’s supposed to operate via in COVID-19.

        So having pre-existing, cross-reactive CD4+ T cells before infection may not be a good thing. In addition to the hyper-reactivity point, there’s the issue of whether the cells are at sufficient levels to prevent disease, whether they’re of the appropriate sub-type so as not to exacerbate disease (ex: Th1 vs. Th2 vs. Th17 vs. Treg), etc. Given these and other points, it would baseless to infer that 40 – 60% of people having detectable levels these T cells implies 40-60% of people are immune. Hence the paper not making that implication, while you do, dpy.

        And the non-peer-reviewed article doesn’t imply 40 – 60% immunity either:

        “A possible modification of COVID-19 severity by prior HCoV infection might account for the age distribution of COVID-19 susceptibility, where higher HCoV infection rates in children than in adults […], correlates with relative protection from COVID-19 […].
        Public health measures intended to prevent the spread of SARS-CoV-2 will also prevent the spread of and, consequently, maintenance of herd immunity to HCoVs, particularly in children. It is, therefore, imperative that any effect, positive or negative, of pre-existing HCoV-elicited immunity on the natural course of SARS-CoV-2 infection is fully delineated.”

        Click to access 2020.05.14.095414v1.full.pdf

        So that article is compatible with HCoV already being factored in in terms of the skewing of more deadly infections towards older people instead of younger people, instead of it being some new phenomena that will make more people resistant than previously thought.

        Enough with your misrepresentations of immunology, dpy, just to serve your ideologically-motivated pre-conceptions.

      • Wiley Coyote, You now lie about what I said. I said “If 40%-60% unexposed individuals are already immune, New York City has already effectively reached herd immunity” My statement is 100% accurate. I didn’t read most of your anonymous rant because you have no qualifications and because you mostly cherry pick to “prove” someone else wrong when they are right.

        You did that above concerning your silly citing of outdated papers on IFR. That enables you to “select” older studies with smaller datasets and bigger errors and ignore later studies with better datasets. And then you have the gall to cite some stupid commentary on the importance of peer review.

      • verytallguy

        “I didn’t read most of your anonymous rant because you have no qualifications…”

        What relevant qualifications do you claim in virology, immunology, epidemiology or related fields dpy?

        Or do you recommend your posts are ignored?

      • @dpy6629

        Sensible people can clearly see you wrote this:

        “Wow Don, That’s incredibly good news and explains a lot about why virtually everywhere the curve has peaked and is going down. If 40% – 60% of unexposed individuals are already immune, that means New York City has reached effective herd immunity. We could be almost out of the woods!! :-)”

        So no, you did act as if the paper explained why “everywhere the curve has peaked and is going down”, as a result of 40 – 60% of people being immune. The paper supports no such conclusion, as I explained to you, and could just as easily be taken as evidence on why SARS-CoV-2 is so dangerous. And you can call what I said a “rant” all you want; it’s just a cover for the fact that you lack the expertise and knowledge needed to address what I said. You’re again commenting on topics in which you are out-of-your-depth, and then making up excuses when you’re caught. It’s actually funny to watch you try this; like watching someone who doesn’t even know algebra try to bluff their way through calculus.

      • VTG, I don’t claim qualifications in virology. But I am capable of evaluations the track record of someone like John Ioannidis and I’ve read lots of stuff over the last month. I can also do simple math. Based on that you can ignore my comments if you want.

        It is absolutely 100% guaranteed that Ioannidis and his scores of collaborators over the last 2 months are vastly more reliable than you and Wiley Coyote. I would suggest you spend some time reading up on his work instead of taking my word for it. You might learn something.

      • Wiley Coyote doubles down on his lie. What I said is 100% correct. You don’t know how I “acted” because you didn’t see me. You are reading into my comment something that was not there in order to attack me. School yard bullying by you and you get to wear a hood while doing so. Is your hood white with a red cross?

      • Re: “It is absolutely 100% guaranteed that Ioannidis and his scores of collaborators over the last 2 months are vastly more reliable than you and Wiley Coyote.”

        It ain’t just a river in Egypt.
        :D

        “A Stanford whistleblower complaint alleges that the controversial John Ioannidis study failed to disclose important financial ties and ignored scientists’ concerns that their antibody test was inaccurate.”
        https://www.buzzfeednews.com/article/stephaniemlee/stanford-coronavirus-neeleman-ioannidis-whistleblower

        “A recent study by Bendavid et al. claimed that the rate of infection of COVID-19 in Santa Clara county was between 2.49% and 4.16%, 50-85 times higher than the number of officially confirmed cases. The statistical methodology used in that study overestimates of rate of infection given the available data.”

        Click to access 2020.04.24.20078824.full.pdf

        “Our data suggest that the use of serological tests for large-scale prevalence surveys (or to grant “immunity passports”) are currently only justified in hard-hit regions, while they should be used with caution elsewhere.”

        Click to access 2020.05.03.20084160.full.pdf

      • verytallguy

        “Based on that you can ignore my comments if you want”

        Your proposal is acceptable.

      • This is really childish Wiley although more or less standard with our corrupt and partisan media and the internet.

        1. Very well respected researchers embark on a new study on a politically charged topic.
        2. They form a large research team and carry out the research. Initial results anger those who view this lockdown as an “opportunity.”
        3. There is a leak of information intended to discredit the research and the researchers. Leakers can and often do “select” their material to show the worst picture possible by being dishonest.
        4. There is as yet no counterpoint by the maligned scientists. So far as we know everything was reasonable and above board and in context nothing is wrong.
        5. Anonymous internet personas spread the word with no first hand knowledge of anything but an intent to smear the scientists.

        It’s really school yard bullying where the bullies get to wear hoods.

        Ioannidis is a very respected scientist. He is one of the most cited in his field. He is humble and thanks those who offer serious criticism. He says he is not political and has no political motive. You should be ashamed of your baseless smear.

        Both sides of this story will eventually come out. Right now noone knows including you.

      • Don Monfort

        New Yorkers are acting as if they have reached herd immunity. They aren’t listening to the doom and gloom of the pointy headed little Eppididdlymologist for Dummies clowns, like those who drop in here to spread their pro-virus propaganda. The lock down is over. FAct is there was never a lock down in NY. Except for the patients in nursing homes, who weren’t able to escape those death traps created by the pro-virus Cuomo-DeBlasio syndicate:

        https://nypost.com/2020/05/16/people-flock-to-nyc-area-bars-beaches-as-quarantine-fatigue-intensifies/

        They’re partying like it’s 2019.

        Lockdown-weary New Yorkers ditched the distancing to get social instead this weekend — transforming parts of the Big Apple into a raucous, late-season Mardi Gras.

        Yet the city’s COVID-be-damned attitude was nothing compared with the scene in Belmar, NJ, a beach popular with Staten Islanders and Brooklynites.

        Huge crowds waited shoulder-to-shoulder on the boardwalk for their turn to buy beach badges.

        “The line for beach badges was like four non-socially distanced blocks long,” tweeted Jarrett Seidler, who described the boardwalk as “obscenely packed.”

        Outside popular bars on the Upper East Side, the Upper West Side, the East and West Villages and in Greenpoint, Brooklyn, The Post found booze hounds arriving for the takeout cocktails and then staying — and staying — to sip drinks on packed sidewalks and soak up the lively scenes.

        “How are you going to drink with a mask on?” one reveler, hairdresser Akeem ­Kelley, told The Post.

      • VTG, You should really read some of Ioannidis’ work. He is really a hero for trying to improve medicine by removing biases. His work is bearing fruit too as more and more places are requiring pre-registration of trial measures and outputs.

      • Don Monfort

        The clown says:”That was one of the central rationales for using immunosuppressive agents such as hydroxychloroquine and tocilizumab to treat COVID-19. Two of the very things hydroxychloroquine does is cause apoptosis of T cells and limit T cell activiation. It’s therefore amazing to me that 2 people who previously cheerled hydroxychloroquine treatment are now happily contradicting one of the mechanisms it’s supposed to operate via in COVID-19.”

        That’s not a rationale that I ever mentioned, or believed to be central. I am with the advocates for HCQ, who believe that anti-viral activity is the central rationale, because once the virus has replicated to the point it is causing a cytokine storm, it’s too late to do much good. You are with the virus.

      • Don Monfort

        After all the jibber jabbering and running down rabbit holes of the epididdlymologist, the bottom line is:

        “Importantly, pre-existing SARS-CoV2-crossreactive T cell responses were observed in healthy donors, indicating some potential for pre-existing immunity in the human population.”

        https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2930610-3

      • I will point out how truly disappointing it is to see Ioannidis attacked by so many people who can’t hold a candle to his excellent research record. He is a very mild person who carefully states his views without political statements of any kind. Even Gavin Schmidt smeared him on twitter. Medical research has nothing to do with climate science. It just I guess shows what a completely partisan and decency free atmosphere we live in.

        He’s kind of a hero for leading the charge to find ways to clean up medical research. That’s not an easy role.

      • Re:” He is a very mild person who carefully states his views without political statements of any kind. Even Gavin Schmidt smeared him on twitter. Medical research has nothing to do with climate science.”

        Your hero-worship is so quaint. But have you forgotten what Ioannidis actually said, despite you being told many times? Of course not; you’re just pretending again, like always.
        ;)

        https://judithcurry.com/2020/03/19/coronavirus-uncertainty/#comment-911457

        “Many fields lack the high reproducibility standards that are already used in fields such as air pollution and climate change.
        […]
        Moreover, they have not used science as much as they should. This is particularly worrisome when the evidence is strong, yet governments have not acted forcefully enough. […] It is a scandal that we continue to allow companies to make money from selling tobacco products, despite expecting about 1 billion tobacco-related deaths in the next 100 years, a Holocaust equivalent of lost lives repeated every year. It is a scandal that the response of governments to climate change and pollution has not been more decisive.”

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933781/

        Humans causing climate change is on about the same level of certainty as the idea that smoking is killing people:
        17:17 to 18:30 : http://rationallyspeakingpodcast.org/show/rs-174-john-ioannidis-on-what-happened-to-evidence-based-med.html
        http://hwcdn.libsyn.com/p/f/8/9/f89584694d653aa6/rs174.mp3?c_id=13577443&cs_id=13577443&expiration=1584648769&hwt=736ba1cc30e54af900f17b584b4685ec

      • Sanakan, Is it possible for you to make a comment without a gratuitous insult? It is childish.

        Of course I know about what Ioannidis said about climate change. It doesn’t decrease my high view of his science. I don’t totally agree completely however. “Doing something” about climate change that actually works is going to be really really difficult. Further we still don’t have a good handle on how costly the problem itself is going to be.

        Part of the problem in climate science is exactly the bias that Ioannidis has done great work documenting in medicine. That’s why its pretty silly to do the kind of proof text quoting you do from papers selected to support whatever your current diatribe is about.

      • @Don Montfort

        Re: “After all the jibber jabbering and running down rabbit holes of the epididdlymologist, the bottom line is:
        ““Importantly, pre-existing SARS-CoV2-crossreactive T cell responses were observed in healthy donors, indicating some potential for pre-existing immunity in the human population.”””

        Note the word “potential”, Don. Actually, of course you won’t note it, since you have no genuine interest in understanding that topic; you’re just an non-expert ideologue. The presence of pre-existing cross-reactive T cells could just as easily be evidence of a potential predisposition to a pathogenic immune response to SARS-CoV-2 (ex: cytokine storm), especially given that those of us who read research on how COVID-19 works, Don (so not you), know the role of cytokine storm in its immunopathology. Again, not that you would know, since you grasp immunology about as well as I did in kindergarten.

        “There is also great uncertainty about whether adaptive immune responses to SARS-CoV-2 are protective or pathogenic, or whether both scenarios can occur depending on timing, composition, or magnitude of the adaptive immune response.
        […]
        Immunopathogenesis in COVID-19 is a serious concern (Cao, 2020; Peeples, 2020). It is most likely that an early CD4+ and CD8+ T cell response against SARS-CoV-2 is protective, but an early response is difficult to generate because of efficient innate immune evasion mechanisms of SARSCoV-2 in humans […]. Immune evasion by SARS-CoV-2 is likely exacerbated by reduced myeloid cell antigen presenting cell (APC) function or availability in the elderly […]. In such cases, it is conceivable that late T cell responses may instead amplify pathogenic inflammatory outcomes in the presence of sustained high viral loads in the lungs, by multiple hypothetical possible mechanisms […]. Critical (ICU) and fatal COVID-19 (and SARS) outcomes are associated with elevated levels of inflammatory cytokines and chemokines, including IL-6 […].”

        https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2930610-3

        “Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe COVID-19 patients”

        Click to access nwaa041.pdf

      • Re: “Sanakan, Is it possible for you to make a comment without a gratuitous insult? It is childish.”

        I’m sure that verytallguy, and anyone else familiar with your posting history, is probably thinking ‘it’s the pot calling the kettle black.’ If you can’t take it dpy, then don’t dish it out, especially given your persistent use of ridiculous nicknames for me, as evidenced in this very comment thread.
        Don’t pretend Ioannidis avoids political claims, when he clearly makes them. Don’t pretend Ioannidis agrees with your tripe, when he actually doesn’t. And don’t use your hero-worship of him to dodge his screw-ups on research.

        Do better.
        :P

        Re: ” That’s why its pretty silly to do the kind of proof text quoting”

        I’m not going to fall for your usual dodging of people citing sources, by you calling it “proof text quoting”. Get over it, and learn how to competent address sources, for once in your life.

        “Antibody surveys suggesting vast undercount of coronavirus infections may be unreliable”
        https://www.sciencemag.org/news/2020/04/antibody-surveys-suggesting-vast-undercount-coronavirus-infections-may-be-unreliable

      • Your usual evasions aren’t going to work on me, dpy (ex: ‘stop citing sources I don’t have the wherewithal to address; that’s proof-texting!). It just shows you can’t competently address criticism of your heroes work, as per your willfully uninformed hero-worship. You’re out-of-your-depth when it comes to medical research (especially immunology-related medical research) and it shows. Next time, don’t argue with an immunologist about a topic he understands better than you ever will, just to suit your ideology.
        ;p

        “I think the authors of the above-linked paper [Bendavid et al.] owe us all an apology. We wasted time and effort discussing this paper whose main selling point was some numbers that were essentially the product of a statistical error.
        I’m serious about the apology. Everyone makes mistakes. I don’t think they authors need to apologize just because they screwed up. I think they need to apologize because these were avoidable screw-ups. They’re the kind of screw-ups that happen if you want to leap out with an exciting finding and you don’t look too carefully at what you might have done wrong.”

        https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-stanford-study-of-coronavirus-prevalence/

      • Wiley Coyote throws out a couple of content free insults and then quote mines from blogs and twitter, two impeccible sources of accurate science. And he cherry picks from Gelman to mislead. Gelman also said:

        “I’m not saying that the claims in the above-linked paper are wrong. Maybe the test they are using really does have a 100% specificity rate and maybe the prevalence in Santa Clara county really was 4.2%. It’s possible. The problem with the paper is that (a) it doesn’t make this reasoning clear, and (b) their uncertainty statements are not consistent with the information they themselves present.

        Let me put it another way. The fact that the authors keep saying that “50-85-fold” thing suggest to me that they sincerely believe that the specificity of their test is between 99.5% and 100%. They’re clinicians and medical testing experts; I’m not. Fine. But then they should make that assumption crystal clear. In the abstract of their paper. Something like this:

        We believe that the specificity of the test used in this study is between 99.5% and 100%. Under this assumption, we conclude that the population prevalence in Santa Clara county was between 1.8% and 5.7% . . .

        This specificity thing is your key assumption, so place it front and center. Own your modeling decisions.”

        You seem to have a problem with cherry picking a couple of sentences you like and ignoring other important statements.

      • Oh, and dpy, don’t worry: I already know you’re not going to competently respond to longer discussions of evidence (ex: ‘proof-texting!’, ‘too much for my attention-span’, etc.). But I’m not posting for your benefit.

        Anyway, on recent seroprevalence work from Spain, showing a higher infection fatality ratio (IFR):

        “Covid-19 optimists have pointed to a couple of flawed studies from California, both of which suggested that infection has been much more widespread than commonly assumed, and that consequently, the virus is much less lethal than commonly assumed.
        The new Spanish survey (which is still underway) has a much higher-quality research design, and unfortunately, it has a much less reassuring result at this point: Only about 5 percent of people in the study have tested positive for Covid-19 antibodies, suggesting that just 5 percent of the Spanish population has had the coronavirus.
        […]
        The Spanish data suggests about 1.15 percent of those who got infected in Spain ended up dying. Spain has a significantly older age profile than the US, so Americans might be better off.”

        https://www.vox.com/2020/5/16/21259492/covid-antibodies-spain-serology-study-coronavirus-immunity

        (It’s annoying when press sources conflate the virus SARS-CoV-2 with the disease it causes, COVID-19. There are SARS-CoV-2 antibodies; no need to call them “Covid-19 antibodies”.)

        The study:

        Click to access 13.05130520204528614.pdf

        But that’s Spain. How about more recent seroprevalence work in the United States? Even there one still ends up with a higher-end IFR that’s larger than in Ioannidis’ co-authored research:

        “Preliminary results from a scientific study aimed at measuring the spread of the novel coronavirus in Indiana show a general population prevalence of about 2.8 percent of the state’s population.
        […]
        IUPUI scientists estimate the infection-fatality rate for the novel coronavirus in Indiana to be 0.58 percent, making it nearly six times more deadly than the seasonal flu, which has an infection-fatality rate of 0.1, according to the U.S. Centers for Disease Control and Prevention.”

        https://news.iu.edu/stories/2020/05/iupui/releases/13-preliminary-findings-impact-covid-19-indiana-coronavirus.html

        That press piece actually messed up their flu calculation, since it’s the flu’s case fatality ratio (CFR) that’s ~0.1%; seasonal flu’s IFR is about 0.02% – 0.05%, if not lower. So these results actually show SARS-CoV-2-induced COVID-19 to be at least 10 times deadlier than the seasonal flu, contrary to Ioannidis’ co-authored, non-peer-reviewed research:

        https://www.coronavirus.in.gov/2393.htm [ http://archive.is/qczAN ]

        But one might complain that those are non-formally-peer-reviewed sources. And peer review is important, since even informal peer review by experts online eviscerated Ioannidis’ non-formally-peer-reviewed pre-print, to the point that the authors needed to edit the pre-print. Even Ioannidis likely understands the importance of peer review, at least on some level:

        “Ioannidis also pointed out that it was a preprint, not a published study, and therefore subject to further revisions.”
        https://www.buzzfeednews.com/article/stephaniemlee/stanford-coronavirus-neeleman-ioannidis-whistleblower

        So here’s a list of IFR estimates in peer-reviewed journals, as of May 13, 2020:

        0.9% , 2.4% (Beijing, China as a whole) : “Estimating the infection fatality rate among symptomatic COVID-19 cases in the United States”
        1.3% (0.6% – 2.1%) : “Estimating the infection fatality rate among symptomatic COVID-19 cases in the United States”
        0.8% (0.5% – 1.3%) : “Using early data to estimate the actual infection fatality ratio from COVID-19 in France”
        0.7% (0.4% – 1.0%) : “Estimating the burden of SARS-CoV-2 in France”
        0.7% (0.4% – 1.3%) : “Estimates of the severity of coronavirus disease 2019: a model-based analysis”
        (0.5% – 0.8%) :
        “Real-time estimation of the risk of death from novel coronavirus (COVID-19) infection: inference using exported cases”
        0.6% (0.2% – 1.3%) : “Estimating the infection and case fatality ratio for coronavirus disease (COVID-19) using age-adjusted data from the outbreak on the Diamond Princess cruise ship, February 2020”
        (0.3% – 0.6%) : “The rate of underascertainment of novel coronavirus (2019-nCoV) infection: estimation using Japanese passengers data on evacuation flights”
        (0.05% – 0.134%) : “Estimating the COVID-19 infection rate: Anatomy of an inference problem”

      • Re: “You seem to have a problem with cherry picking a couple of sentences you like and ignoring other important statements.”

        You seem to have a problem understanding what “specificity” and “under-estimating the rate of false positives” mean. Again, that’s not surprising, since you don’t grasp medical science at even a basic level. Once again:

        “Our data suggest that the use of serological tests for large-scale prevalence surveys (or to grant “immunity passports”) are currently only justified in hard-hit regions, while they should be used with caution elsewhere.”

        Click to access 2020.05.03.20084160.full.pdf

        “A recent study by Bendavid et al. claimed that the rate of infection of COVID-19 in Santa Clara county was between 2.49% and 4.16%, 50-85 times higher than the number of officially confirmed cases. The statistical methodology used in that study overestimates of rate of infection given the available data.”

        Click to access 2020.04.24.20078824.full.pdf

        Re: “Don you are right about the total lack of intellectual or moral integrity. Perhaps in future Judith will want to moderate this stinker.”

        Oh, you want moderation to protect you from criticism you’re not competent enough to address. How precious.
        :D

      • Wiley Coyote, You have already posted this. Perhaps like any propagandist you think repetition will fool people. The Santa Clara study is controversial. The authors are in the process of addressing the issues. Your transparent attempts to smear its authors before the verdict is in is really vile.

        Perhaps Judith will put you in moderation in the future. You deserve it.

      • @Don

        Re: “Read it, you pointy headed rascal.”

        I already did; I also explained why you saying it displays your fundamental lack of understanding of both COVID-19 and the immune system. You don’t grasp the role of hyper-active CD4+ T cells in the pathogenesis on COVID-19 (ex: cytokine storm), so you falsely think that the presence of pre-existing cross-reactive CD4+ T cells is necessarily “encouraging.” It isn’t. Combine that ignorance with a lack of integrity, and there’s the explanation for why you still can’t address what I said to you. Oh well.

        “The presence of pre-existing SARS-CoV-2-reactive T cells in healthy donors is of high interest but larger scale prospective cohort studies are needed to assess whether their presence is a correlate of protection or pathology.”

        Click to access 2020.04.17.20061440v1.full.pdf

        “In another study, it was shown that CD4 T cells of ICU patients with COVID-19 produced more IL-6 and GM-CSF than those not requiring ICU, although the numbers, powers, and statistical treatments were not reported.”

        Click to access s11357-020-00186-0.pdf

        Re: “[…] then you come along butting into the discussion with a lot of very foolish insults […]”

        The pot is calling someone black again…

      • @Don

        https://judithcurry.com/2020/05/06/covid-discussion-thread-vi/#comment-917401

        @dpy

        Re: “Wiley Coyote, You have already posted this. Perhaps like any propagandist you think repetition will fool people. The Santa Clara study is controversial. The authors are in the process of addressing the issues. Your transparent attempts to smear its authors before the verdict is in is really vile.
        Perhaps Judith will put you in moderation in the future. You deserve it.”

        Yes, I posted two of those sources before (but not the 3rd), and you had no competent response to them then either. No, insulting me is a not a competent response. Nor is hero worship of Ioannidis, evading evidence by calling citation of sources “proof texting”, etc. Their non-formally-peer-reviewed article is wrong and an outlier, both in comparison to peer-reviewed studies and in comparison to more recent seroprevalence research. I already showed that in a comment under moderation. Who knows; maybe Curry will meet your request and block the comment in order to protect you from evidence that shows you’re wrong? As far as I’m concerned (and as far as many other researchers are concerned), their debunked article is unreliable and doesn’t have much merit until it actually goes through formal peer review to better address its numerous distortions.

        “IUPUI scientists estimate the infection-fatality rate for the novel coronavirus in Indiana to be 0.58 percent […].”
        https://news.iu.edu/stories/2020/05/iupui/releases/13-preliminary-findings-impact-covid-19-indiana-coronavirus.html

        https://www.coronavirus.in.gov/2393.htm [ http://archive.is/qczAN ]

      • verytallguy

        dpy

        “Sanakan, Is it possible for you to make a comment without a gratuitous insult? It is childish.”

        This, from a poster whose every other missive includes a childish nickname aimed at their interlocutor, is perhaps the best yet.

        Wonderful stuff, dpy, please do keep it coming.

      • This is childish. Don posts a paper with encouraging news. I make a true statement. Wiley Coyote then turns it into an attack on the Santa Clara study posting endless repetitive proof text quotes with ample references to twitter and blog posts which are in his mind really good sources of science. Then he repeats his IFR spiel which I’ve already responded to.

        As I already said above, the papers you refer to on IFR Wiley Coyote are mostly older work reflecting small early datasets. The more recent work with larger datasets mostly show lower IFR’s; Santa Clara, Los Angeles, Miami Dade, Arizona, German and Danish studies.

        In any case the IFR will vary depending on the age profile of those exposed. It will be higher if a lot of older and ill people are exposed as has happened in many places in the US in nursing homes and hospitals.

        Endless repetition is what propagandists do. In this case the propagandists are wearing hoods to protect their identity and the fact that they have no real credentials. Are your hoods white?

      • My evidence is quite strong and anyone can easily find it online for example at the Arizona department of health or Miami Dade county web site. The Santa Clara and Los Angeles data was widely reported too. Concilience of evidence is important here. Are your hoods white or black?

      • Atomsk’s Sanakan: Oh, and dpy, don’t worry: I already know you’re not going to competently respond to longer discussions of evidence (ex: ‘proof-texting!’, ‘too much for my attention-span’, etc.). But I’m not posting for your benefit.

        Anyway, on recent seroprevalence work from Spain, showing a higher infection fatality ratio (IFR):

        That was another good post. Actually, a series of good posts.

        I’d recommend you drop the insults. It slows reading of the information. For myself I don’t mind: I once likened this weblog process of interchange to sandlot football, and I am prepared. But, as I said, when you insult other people, it slows down my reading.

        But don’t go away.

      • I agree with Matt about leaving out the insults. Just gets in the way.

      • Atomsk’s –

        > I’d recommend you stop conspicuously avoiding saying that to dpy and Don. But hey, I’m already familiar with your double-standards when it comes to your fellow AGW contrarians. So I’m not really interested in appeasing you.

        I suppose I have a double standard as well. I wouldn’t bother asking them to drop the insults because there’s no point in suggesting that they drop the insults. It would have no effect, because there’s no hope they would do so (they are only here to insult), and they offer nothing of value anyway. So for them, dropping the insults wouldn’t have an benefit. Subtracting worthless material would leave nothing but worthless material.

        It isn’t the same with you comments. From my perspective, the insults have zero additive value but lower the concentration of useful information

      • If you looked Josh, you would see that I’ve provided a lot of evidence and some links too. Some of this such as my Miami Dade analysis is something available nowhere else as far as I know. Likewise with Don. He has provided lots of information and links. I think he has medical credentials.

        The issue of credibility really does relate to experience and knowledge. When you are anonymous and do the proof text quoting thing with a very high degrees of bias with regard to climate models for example where I know the literature, it confirms a lack of knowledge or credentials. That’s the case for Sanakan. You can see this on Real Climate.

        If you look at his twitter page, you will see that his purpose is to crush “science denial.” That’s a political purpose and not scientific one and it shows in his biased comments. There is a fine line between quoting papers out of context and actively spreading disinformation. Sanakan’s take on climate models is disinformation and you shouldn’t believe it.

  70. 5/2/2020 34,907 4,814 15.9 286,500
    5/3/2020 31,150 -3,757 -10.7 226,292
    5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829
    5/11/2020 21,122 -3,713 -14.9 540,847
    5/12/2020 19,534 -1,588 -7.5 164,139
    5/13/2020 23,704 4,170 21.3 340,173
    5/14/2020 21,710 -1,994 -8.4 340,721
    5/15/2020 29,276 7,566 25.8 385,164
    5/16/2020 25,812 -3,464 -11.8 433,742
    5/17/2020 20,716 -5,096 -19.7 860,733
    20716 is 2.4% of total tests.
    Lets see if we can raise the numbers every day from now to the 24th.

    • The total tests for the 17th has a problem. At 5:00pm CDT the total test number is less than the 17th ended.at 12:00 CDT.

    • Robert –

      The news on testing is getting just a tad better, relative to other countries.

      Yes, the US still ranks quite highly on the cases per milllion metric – 12th. Not very good, but

      We’re up to 39th on the tests per million metric. Which at least is moving in the right direction.

      Too bad that the richest country in the world isn’t doing better, but we can’t really expect a whole lot when the current leadership is supported by tens of millions of sycophants and toadies (as well represented by many of those we see posting in these threads).

    • Actually reports are coming out that the testing supply vastly outpaces demand. In California they can do 100,000 tests per day and they are actually only managing to perform 40,000 tests. It appears that the public is simply not showing up for voluntary testing. I doubt if required testing would fly either.

      What this shows is that testing is like ventilators. A lot of early whining and demands for massive numbers. In actuality demand turned out to be vastly lower.

      • There are plenty of reasons why, at this point, the supply is outlasting demand…in some places. In some places it still isn’t. I know that for a fact.

        Among the reasons are the months of lying that “anyone who wants a test can get a test,” and the months of restricting tests to only frontline healthcare workers, or then those only with symptoms.

        Among the reasons were failed promised made about the forthcoming availability of testing.

        If people who support this administration had demanded accountability, and demanded an end to the lying, it’s quite possible that the months of failures wouldn’t have been as bad. And it’s quite possible that had that happened, many people would have already been tested.

        We’ll never know. But we do know that plenty of people will line up the excuses for why this administration shouldn’t be held accountable for its failures and the months of lying about tests. What you get when you have tens of millions of sychophants and toadies is an unaccountable government.

        It doesn’t matter which party – with either party that’s how it works.

      • Josh, Decrying people exercising their Constitutional rights and calling them names is an example of why the “elites” are in trouble around the globe. People are free to have the opinion that overall Trump’s administration response has been pretty good. Certainly everyone was slow in February to respond. DeBlasio and Cuomo were actually much worse than Trump. The result was that New York had vastly more deaths per capita than the rest of the country. Based on results comrade DeBlasio and “if I can save 1 life its all worth it” Cuomo weren’t interested in saving lives really.

  71. GO GEORGIA!

    • You made me look, Don Don:

      https://en.wikipedia.org/wiki/Georgia_State_Senate

      We can discuss your innuendo over teh tweeter if you please.

    • Sure, willito. I’ll meet you there. If I’m late, get started without me.

    • No rush, Don Don. There is all the time in the world.

      You might need some practice too.

    • Willard is making it all up again by carefully ignoring the responses.
      Like the first reply to that tweet:

      “This blew my mind so I went to the Georgia department of public health page and the version they have there is chronological. Where was the misleading chart published?”

      It wasn’t.
      Someone re-sorted the chart by something other than chronological and took a screenshot. Because they want to play politics with a virus and they are genuinely sad that people aren’t dying where they want them to die.

      Meanwhile the facts are still stubborn. The dead in New York City alone – just the city limits, not the suburbs – are three times the number of dead in California, Texas and Florida combined.
      Combined.
      You can call this the Urban Flu or the Cuomovirus. Or you can go play games with charts and hope for dead Georgians based on unscientific fantasies.

      • > Like the first reply to that tweet

        That’s how you show having no idea how teh tweeter works, JeffN. First, tweets are not ordered the same way for everyone, and in fact if you return their order may change. Second, you forget the responses to the tweet you fail to cite. Of course the agency corrected their app “glitch” after the MNBC story.

        Nice “but NYC” squirrel, tho.

      • Jeff –

        > Given that you’re still weirdly hoping the latter will one day be as bad as the former- with no reasonable basis for the hope.

        Let’s apply the same logical construct in reverse. It would imply that you are weirdly hoping for more deaths in NY, particularly in nursing homes.

        As much as I disagree with you politically, and as much as I disppprove of your rhetorical style, I wouldn’t ever assume that you are hoping for deaths for the sake of political expediency.

        But I will reiterate – I disapprove of that sort of rhetoric. It’s counterproductive, and actually it disgusts me.

        Maybe you should consider (1) to stop using it and (2) to criticize its use when you see it, even among those you agree with politically?

      • Will wants to watch those wascally wednecks to make sure they don’t get away with anything after they opened up their state and having Georgia’s success be contrasted with the ongoing disaster in NYC. I’m afraid the incompetence and scandals in the Big Apple will go down in history as one of the saddest episodes of this pandemic.

      • Frau Whitmer, Governor of Michigan, just lifted selected restrictions in some northern parts of the state. She realizes that a Yooper living along the banks of the Two Hearted River in the Upper Peninsula in a county of 1912 square miles with 1 case and 0 deaths and has contact with civilization only when visiting Pine Stump Junction on weekends has a different risk profile than a senior with underlying health issues living in a 950 square foot flat in a 7 person, multi generational household with LaGuardiaesque foot traffic in New York City with 633 cases per square mile.

      • Jeff, It’s probably best to not read people’s minds over the internet. It is true that Willard posts mostly marginally relevant stuff from twitter or quote mining. We can stick to that.

      • Here’s your chance to know something about statistics, David:

        Free copy of Regression and Other Stories to the first commenter who comes up with a plausible innocent explanation of the graph. You have to provide enough detail about the software to demonstrate how someone could’ve made this graph by accident.

        https://statmodeling.stat.columbia.edu/2020/05/18/hey-i-think-somethings-wrong-with-this-graph/

      • Matt

        You probably know this but about 50% of deaths in Georgia have occurred in long term health facilities. The high percentage of cases and deaths in such facilities across America is a story in itself. From the start these places should have been a major focus and had stringent regulations in place. When the number of cases is greater than the number of beds, it’s clear in some places they weren’t. Even last week some states were implementing new rules that should have made in early March. When opening up, the analysis of the impact of such decisions should consider what has already been happening at these facilities.

      • Willard: https://www.ajc.com/news/state–regional-govt–politics/just-cuckoo-state-latest-data-mishap-causes-critics-cry-foul/182PpUvUX9XEF8vO11NVGO/

        Thanks for the link.

        There are graphing routines that allow the user to plot counts in order of magnitude ignoring the natural order such as time or longitude. So I can understand how it happened; then someone posted it because it looked pretty. “Cuckoo” is not too strong an epithet for the episode.

      • Matt, Of all the data screwups, why focus on this very small one? Vastly more consequential is that a couple of days ago Colorado lowered its covid death numbers by 25%. New York’s “presumed” covid deaths are also very sloppy. These issues with data have very big implications for how serious this epidemic is.

      • > So I can understand how it happened

        Andrew Gelman will send you his book if you can figure it out.

        Meanwhile, here’s the official story:

      • dpy6629: why focus on this very small one?

        At the start I did not know that it was trivial.

    • “…but rather to create the impression of a decreasing number of cases over time.”
      A motive detector. And an interwebs detective to save us from the Georgia’s bamboolzement. I can sleep better now knowing we are being protected from misleading graphs.
      In other news, When I was young, pictures were taken of the 6 cousins sorted by decreasing height and age. I knew they were up to something.

      • Your motive detector will surely appreciate:

        The state of Georgia was supposed to hold an election Tuesday to fill a seat on the state Supreme Court. Justice Keith Blackwell, a Republican whose six-year term expires on the last day of this year, did not plan to run for reelection. The election, between former Democratic Rep. John Barrow and former Republican state lawmaker Beth Beskin, would determine who would fill Blackwell’s seat.

        But then something weird happened: Georgia’s Republican Gov. Brian Kemp and the state’s Republican secretary of state, Brad Raffensperger, canceled Tuesday’s election. Instead, Kemp will appoint Blackwell’s successor, and that successor will serve for at least two years — ensuring the seat will remain in Republican hands.

        https://www.vox.com/2020/5/19/21262376/georgia-republicans-cancel-election-state-supreme-court-barrow-kemp-blackwell

  72. And now for some not so good news. An update from Jay Bhattacharya

    youtube.com/watch?v=289NWm85eas&t=2521s

    • Ah, you’re citing a vlog (video blog). I remember a certain someone complaining about that sort of thing…

      “And what is a news article about the controversies surrounding serologic testing once again citing blog posts and twitter feeds.”
      https://judithcurry.com/2020/05/06/covid-discussion-thread-vi/#comment-917384

    • It’s good Wiley Coyote but its not a highly technical discussion. You would learn something if you watched it. I know an attention span longer than 5 minutes would be needed.

      If you want to discuss science papers you should at least try to ascertain if your proof text selected quotes are representative, are contradicted elsewhere in the paper or the literature and make sense.

      • You shouldn’t try to extrapolate a national fatality rate from the Santa Clara infection rate.

        Santa Clara is not a representative sample suits le for extrapolating fatality rate.

        But even if we double the infection rate they found in Santa Clara to 6% naturally. At 92k deaths already we’re close to 5x the national fatality rate these researchers said was justified by their Santa Clara research.

        Obviously, they were wrong, just as Ioannidis was wrong in his projections of total deaths.

        You really should just acknowledge their errors and move on. Your refusal to do so suggests you are ideologically motivated not to do so.. That’s OK. We all have ideological motivations. But if they’re pointed out to you, you have the option of just acknowledging your own errors and move in as well.

        5 X.

    • At about 8:30, we find from Bhattacharya that the MLB employees have a lower prevalence than poor people because they “have regular jobs”.

      • Interesting that he notes that poorer people are more likely to get infected, when explaining the 0.7% rate among MLB employees..

        But he was on a national TV campaign to talk about extrapolating from the Santa Clara study – where the median income is way above the national median income.

      • If anything this sampling effect would say that the Santa Clara prevalence would be less (perhaps a lot less) than the prevalence in the country as a whole. That’s good news of course. I think he was surprised at the MLB numbers. I was surprised myself.

      • We know that Bhattacharya is spinning because the SES signal on the infection rate is likely less strong than the SES signal on death rate.

        But even then.,

        The Silicon Valley has more infections per capita than the vast majority of places in the country. Just one of those reasons would be population density, where Santa Clara is more dense than the vast majority of the country, by an order of magnitude.So that’s why it’s a bad sampling for infection rate. So it makes the denominator bigger than for the rest of the country

        But it’s even worse for sampling for fatality rate, as the median income is much higher than the national median income. For that reason it is likely to have a lower per capital fatality rate. It makes the denominator smaller than in the rest of the country.

        So higher infection rate and lower per capita fatality rate than we’d likely find in the rest of the country. In both respects, using it as a sample for determining a national or global fatality rate is putting a thumb on the scale in the same direction. A careful scientist would correct for that in both directions, rather than use it to justify his analysis based on his priors as is evident in the video.

      • Joshua, You just can’t help yourself can you? For you “motivated reasoning” is universal. It is unethical for a health care professional to tell other people what they are “thinking.” For someone who claims to know about ethics in human subjects research…

        The Santa Clara study is not perfect. But it is a good contribution to a continuing story of research. You would do well to accept
        Gelman’s take on it. His is at least a fair critique that the authors take seriously. If you want to contact the authors go ahead, but they will probably not respond to your email. I’m probably the only one who has read your 10,000 word extended essay on the subject spread out over hundreds of comments. It deserves perhaps 100 words. No one else cares and I am about to stop reading as well.

      • The Santa Clara study is a good start. The reason it seems reliable to me is that it agrees pretty much with at least 4 other serologic testing results from around the country. New York is an exception, but there may be reasons for that.

        “A careful scientist would” is a needless attack on them. They are very good scientists. No one is perfect but they have unusually impeccable credentials.

      • Sorry – just noticed re fatality rate…should have been numerator smaller not denominator.

  73. Another “maybe” good news about a vaccine: https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-positive-interim-phase-1-data-its-mrna-vaccine

    Vaccine development is well-known to be an arduous process, so this needs a cautionary warning like everything else, but this looks good for now.

    • Thanks Matt, We do need some good news and this looks promising. All the doom and gloom does get depressing. The Bhattacharya video I posted has some estimates on the very real costs of the lockdown. It’s pretty staggering. From 1.4 million Indians missing their antibiotic treatments for TB to perhaps millions dying from starvation in poor countries, to increases in suicide and addiction, to missed screening medical tests and treatments, to people too scared to go to the hospital when they have a heart attack or stroke. It all adds up and will result in significant excess mortality over time. And these effects will really be “the poor hardest hit.”

  74. 5/4/2020 27,923 -3,227 -10.3 286,179
    5/5/2020 20,731 -7,192 -25.7 319,275
    5/6/2020 25,355 4,634 22.6 252,926
    5/7/2020 26,882 1,527 6 293,203
    5/8/2020 28,765 1,883 7 411,411
    5/9/2020 27,713 -1,052 -5.6 311,965
    5/10/2020 24,835 -2,878 -10.3 287,829
    5/11/2020 21,122 -3,713 -14.9 540,847
    5/12/2020 19,534 -1,588 -7.5 164,139
    5/13/2020 23,704 4,170 21.3 340,173
    5/14/2020 21,710 -1,994 -8.4 340,721
    5/15/2020 29,276 7,566 25.8 385,164
    5/16/2020 25,812 -3,464 -11.8 433,742
    5/17/2020 20,716 -5,096 -19.7 860,733
    5/18/2020 18,631 -2,103 -10.1 576,617
    I guessed the error was +350,000 tests.
    We are still going down. We will see tomorrow.
    Since 5/10 we have removid 159,189 infecteed to isolation. I assume this is less than the virus has made. MORE TESTS! TALK TO YOUR COWORKERS!

    • I ment to say this is more than the virus has made.

      • Robert

        Will more testing change the total numbers who get infected or only change the shape of the curve?

      • Robert Clark

        Back on the 10th I figured there there was about 294,000 infected walking around. More testing just means the few that are left are harder to find. I believe all those self isolating for more than 14 days are clean.

  75. introduction and link to a study on immune responses to SARS CoV-2, along with brief review selected topics in immunology:

    https://blogs.sciencemag.org/pipeline/archives/2020/05/15/good-news-on-the-human-immune-response-to-the-coronavirus

  76. As states begin to reopen and partially reopen, it’s important to analyze the trends in cases and deaths to see the actual cause of any spikes rather than just using statewide averages and assuming the reopening was related to those spikes. For instance, were there changes in any reporting systems? Was there a new, intensified testing program for prisons or nursing homes. If there were expanded testing capabilities in a state, were they in a newly reopened region? Was the outbreak in a specific geographic area that was reopened or in an area still closed down? Was the spike at a facility or factory or processing plant always open and not influenced by the change in policy.

    Can we conclusively establish a chain of causality between the reopening and the increase in cases or deaths? Or will the lazy media just take the easy way out and automatically associate reopening with any increase in infections and deaths?

  77. Nobody seems to have mentioned this peculiarly English news in here yet, so:

    https://CoV-eHealth.org/2020/05/18/why-are-so-many-english-workers-dying-from-covid-19/

    Most disturbing is the comparative story for the 15-64 age group, where England’s relative record in excess mortality in the Covid-19 era is strikingly higher than in the European countries. The 15-64 age group includes the mass of the working age population. At its peak in week 15, it is 2.8 times worse than the weekly peak in next worst country, Spain, around 4 times worse than France and Belgium, and more than 5 times worse than in Italy. Within the UK, excess deaths for this age group are also strikingly worse for England than for the other nations.

    • Yes Jim, I’ve noted that too. It makes me wonder if England’s statistics are dramatically wrong. Or else Englishmen are much much less healthy than counterparts in every other European country. That doesn’t seem likely to me.

      Do you have any idea why this is happening?

      • This is all just “statistics” of course, but….
        Healthcare workers with no or inadequate PPE?
        Drivers of busses crammed with maskless passengers all day?
        Immuno-compromised ticket office clerks being spat at by maskless CovIdiots?

  78. There are only 2 things we know of that stops this virus. They are time and death. 14 days for the body to build up the antibodies. The other is self-explanatory. All we are trying to do is get those infected out of the public while they are contagious. The hospitals are trying to cure the other problems in the body the virus caused.

    • The polititions are bragging about their present testing caapabilities. They say the AMERICAN PEOPLE are not using it to it’s fullest.
      LET ‘S SHOW THEM THEY ARE FULL OF IT!!!

  79. DATE NEW CASES INCREASE % # TE
    5/10/2020 24,835 -2,878 -10.3 287,829
    STS5/11/2020 21,122 -3,713 -14.9 540,847
    5/12/2020 19,534 -1,588 -7.5 164,139
    5/13/2020 23,704 4,170 21.3 340,173
    5/14/2020 21,710 -1,994 -8.4 340,721
    5/15/2020 29,276 7,566 25.8 385,164
    5/16/2020 25,812 -3,464 -11.8 433,742
    5/17/2020 20,716 -5,096 -19.7 860,733
    5/18/2020 18,631 -2,103 -10.1 576,617
    5/19/2020 23,764 5,133 27.5 477,701
    23,764 is 4.9% of total tests. It was 5.9% on the 16th so it is not as scarry as it looks due to the problems of the last few days. This is the only number that counts.

  80. possible 4.6% seroprevalence in LA County in mid-April:
    https://jamanetwork.com/journals/jama/fullarticle/2766367?guestAccessKey=26ae3f78-2ffa-4e79-9fac-de25c1c2c004&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=051820

    Full paper is downloadable. Of stratified random sample, only half actually showed up for test. Diagnostic error rate estimates are reported.

    • I think that in their press release they estimated the IFR and it was 0.2%-0.4% if my memory serves correctly.

      • In Miami-Dade, they might have had more false positives than true positives. With a base rate of 4. 6%, again, you need a very accurate test to get much out of a seroprevalence survey.

      • I believe they tried to account for that according to Matt’s comment. That’s why there is a range of numbers.

  81. OMG! POTUS Big Orange Fella has announced he is taking that deadly poison hydroxychloroquine, as a prophylatic against the COVID 19. Didn’t he know that his rabid detractors in the press and elsewhere would ridicule his lack of adherence to all that medical science and start speculating about uneducated deplorable deniers following his lead and dying in droves. What was he thinking? I hope he is not sandbagging all those little hysterical varmints

  82. Coronavirus patients who seem to catch COVID-19 twice aren’t infectious 2nd time

    https://fortune.com/2020/05/19/coronavirus-twice-infectious-contagious/

  83. As the President was ending meating his meeting he mentioned we have done about 14 million tests. I checked and we are presemtly at 12.5 million. Is it possible you have done that???

  84. In Minnesota 81% of COVID19 deaths are in nursing homes and long term health care facilities. Seems a natural for no regrets stringent regulations and preventative measures with the first indication of a problem. NYC of the MidWest.

    https://www.startribune.com/minn-nursing-homes-already-site-of-81-of-covid-19-deaths-continue-taking-in-infected-patients/570601282/

  85. Ioannidis meta-analysis if IFR. Shocker, he finds it Lowe than other analyses.

    https://www.medrxiv.org/content/10.1101/2020.05.13.20101253v1

    • This is unreal:

      > For the other studies, healthy volunteer bias may lead to underestimating seroprevalence and this is likely to have been the case in at least one case (the Santa Clara study)19 where wealthy healthy people were rapidly interested to be recruited when the recruiting Facebook ad was
      released. The design of the study anticipated correction with adjustment of the sampling weights by zip code, gender, and ethnicity, but it is likely that healthy volunteer bias may still have led to some underestimation of seroprevalence. Conversely, attracting individuals who might have been
      concerned of having been infected (e.g. because they had symptoms) may lead to overestimation of seroprevalence in surveys.

      So he ignores the ways that the Santa Clara study might have been an overestimation because of the recruitment processes.

      But then he doubles down to ignore the many reason why that Santa Clara would be an overestimate – do to higher median income, lower minority population, etc. with respect to a broader exptrapolation beyond Santa Clara.

      • Sorry – that should have been “some of” the ways that the SC might have been an overestimation because of the recruitment processes…

      • Another example of John’s thumb on the scale:

        >Locations with high burdens of nursing home deaths may have high IFR estimates, but the IFR would still be very low among non-elderly, non-debilitated people.

        He ignores the uncertainty in the other direction; i.e., does Santa Clara have *fewer* long term care facility residents than what would be nationally representative? He consistently looks at the uncertainties only in one direction.

        As someone who has long respected Ioannidis, I am having a hard time understanding how poorly he’s approaching the uncertainties in all of this.

      • I saw absolutely nothing wrong with the Wall Street Journal article. They make the point that there is disinformation about antibodies conferring immunity and that it was political in nature.

    • “Infection fatality rates ranged from 0.03% to 0.50% and corrected values ranged from 0.02% to 0.40%.”

      Much lower than the metaanalysis you posted at Gelman’s. That analysis was very weak anyway and it now appears badly wrong.s

      Exactly agrees with my statements over the last few weeks that serologic studies are finding 0.1% – 0.4%. Will someone admit I was right? I doubt it but I may point this out elsewhere too just for the record.

      • Don Monfort

        I will admit that you are right and the virus cheerleaders are wrong-dishonest cherry pickers, as usual.

    • Really Josh? You expect us to take your cavils over an expert with a fantastic track record. Sorry, but you will need to actually get into technical details rather than just bringing up possible “biases.” If you can find something about the meta analysis let me know.

      The meta analysis agrees pretty well with what I’ve seen on a case by case basis.

    • The rush to characterize seroprevalence has people way out in front of the data. The data are what they are. The problem is trying to extrapolate from those data as Ioannidis is doing.

      Uoannnidis rationalizes the data to match his priors, as in saying that Santa Clara should be an underestimate – how has he quantified his speculated reasons for less prevalence their as compared to relevant factors such as race and ethnicity and SES, and their associated factors such as access to healthcare, comorbidities, likelihood of being an essential worker, prevalence of multi-generational households (and exposing older people to infection) yes, rate of use of public transportation, etc.? It doesn’t appear he has quantified any of that at all. Just speculated away without providing evidence.

      I think it’s bizarre.

      • Joshua, Your comment has no scientific content.

      • Josh, You have no way to know if he is rationalizing or not. As we get more and more data showing much the same thing we get more certain Ioannidis is right.

      • He provides no details, no analysis no data to support his idle speculation about why their surveys undersampled positives.

        Here’s a Baysean analysis that takes on that question.

        https://arxiv.org/abs/2005.08459

        But only to some extent. It doesn’t even deal with the ways that they might have also erred in their category jumping from localized infection rates to national level fatality rates, due to the non-representariveness of their sampling with respect to such key predictors for health outcomes such as SES, and associated metrics such as race/ethnicity, comorbidities, access to healthcare, etc.

      • I’m sure that will come in the full paper later. In any case, Ioannidis is vastly more qualified than you or me to assess these issues. I don’t know what the purpose of speculating is. So far for all of these studies those who don’t like the results only have speculation and no real science. It’s basically a bunch of amateurs speculating like James Annan. If they have anything publish it.

  86. Another possible step forward in antibody development:
    https://www.businesswire.com/news/home/20200518005767/en/Centivax-Antibodies-Neutralize-Pandemic-Coronavirus-Independently-Confirmed

    It’s a press release about in vitro work. Development guided by computational molecular modeling; now to test whether it works in living bodies.

    • In other news, Hospitals still providing limited essential services and some rural ones going out of business. This is all data driven, and follows the science.

      • Ragnaar: Hospitals still providing limited essential services and some rural ones going out of business.

        SD County hospitals started working back toward full time about 2 weeks ago. At that time, reportedly only 2% of hospital beds were in use. But that is one county. Nationwide, …, as you say.

    • > Casino guests will have their temperatures checked at the door and be required to wear face coverings. Employees will also be required to wear face coverings.

      Gambling addicts won’t be deterred by thermometers and masks. Lots o’ money to be milked from addiction.

      • I heard how the Casinos make a science of addictive behavior and optimize their games for it. The profile in MN’s biggest metro area is old people as Casino guests. But they may change in the short term.

    • –snip–

      We identified seasonal human coronaviruses, influenza viruses and rhinoviruses in exhaled breath and coughs of children and adults with acute respiratory illness. Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.

      https://www.nature.com/articles/s41591-020-0843-2

  87. Particles smaller than coronavirus collect on insides of masks – suggesting masks reduce flow of coronaviruses droplets

    https://iopscience.iop.org/article/10.1088/1752-7163/ab433a

  88. I am convinced that masks can reduce significantly potentially infectious droplets flying through the air. Laser light refraction video with and without mask. The videos of this doc are always interesting and informative, but if you have the attention span of a common housefly, skip to 4:40, for the masking test:

    If the link doesn’t work, it’s called;titled;

    Coronavirus Pandemic Update 78: Mask Controversy; Vaccine Update for COVID-19

  89. Good summary of stgatus in US as of yesterday. Nice interactive graph shows effectiveness of the lockdown orders.

    https://thomasglassphd.com/category/daily-briefings/

  90. Retracted

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