Coronavirus (SARS-CoV-2 / COVID-19) and Tinnitus

[linearb]

If an official states that researchers are looking into developing a procedure that would allow the doctors in the future to use X to treat Y, and some people go ahead and use X by itself (and not as part of the procedure and not under the supervision of a doctor), then any deaths that follow are on those people and not on the official.

yeah -- again --- you're comparing an academic presentation from a specialist intended for a group of people with an academic level of knowledge, to a statement in mass media from the President of the United States (who does not have a remotely academic level of knowledge and was spouting misinformation). If you don't see why I think this is a ridiculous and unreasonable stretch, there's not much else to discuss there.

You don't really seem to like Trump very much from a lot of your other posts, so it is perplexing that you're so hellbent on defending him on this one tiny point, especially when it's so clear his original statements were made out of confusion and his habit of babbling ideas out loud or repeating the last thing he heard without understanding it. This is probably not even the fifth most stupid thing his admin has done in the last 2 weeks.

 

[Bill Bauer]

you're comparing n academic presentation from a specialist intended for a group of people with an academic level of knowledge, to a statement in mass media from the President of the United States

Are you saying that because the video I chose to illustrate my point was an academic presentation? Make it:

If an official ADDRESSING THE PUBLIC states that researchers are looking into developing a procedure that would allow the doctors in the future to use X to treat Y, and some people go ahead and use X by itself (and not as part of the procedure and not under the supervision of a doctor), then any deaths that follow are on those people and not on the official.

 

[david c]

@Bill Bauer . Every one of your answers shows to me that you understand absolutely none of the issues involved in shielding the vulnerable and supporting carers. Let alone the issues of how you are meant to protect all people with underlying health conditions from Covid (in the USA for example that amounts to about 60 million people) without having social distancing measures in place.

I gave you examples of countries which have managed Covid well. They include Germany, South Korea, Czech Republic, Denmark, Taiwan, New Zealand. Pretty much they have handled Covid well by doing the same things - going into lockdown early, having effective social distancing measures in place, mass testing for Covid and contact tracing. As a result these countries are starting to be able to ease lockdown early - which actually means that in the long term they will also be economically less hard hit. You have yet to cite a single example of a country which you think has handled Covid well by following the approach you suggest except Sweden, a country which has had around two to three times the number of Covid fatalities as comparable countries. For me that isn't a success.

 

[linearb]

Are you saying that because the video I chose to illustrate my point was an academic presentation? Make it:

I think this whole take and metaphor is outlandish; you're free to disagree, but I've said all I have to say on it. We are not looking at the world through the same prism, at least in this one specific regard, and trying to find common ground here, or a change in either of our opinions, looks to me to be a waste of time.

We seem to be far more divided on this one particular little faucet of one set of comments and how the media portrayed it, than we are on the overall issues of uncertainty surrounding our current status and the pros & cons of various different ways of moving forward. So, I'm not trying to dismiss this simply out of convenience, but because I think it's becoming a distraction from more prescient issues.

 

[Bill Bauer]

I think this whole take and metaphor is outlandish; you're free to disagree, but I've said all I have to say on it. We are not looking at the world through the same prism, at least in this one specific regard, and trying to find common ground here, or a change in either of our opinions, looks to me to be a waste of time.

We seem to be far more divided on this one particular little faucet of one set of comments and how the media portrayed it, than we are on the overall issues of uncertainty surrounding our current status and the pros & cons of various different ways of moving forward. So, I'm not trying to dismiss this simply out of convenience, but because I think it's becoming a distraction from more prescient issues.

I had been hoping to get to the bottom of what assumption/interpretation is the cause of this disagreement, but I guess it is not to be.

 

[Bill Bauer]

Sweden, a country which has had around two to three times the number of Covid fatalities as comparable countries. For me that isn't a success.

You are right, Sweden has had 138 deaths per million, whereas Denmark has had 58 deaths per million on the same day. This means that the difference is 80 deaths per million. The deaths are no longer growing exponentially anywhere, including Sweden(!), but let's be generous and say that eventually this difference is going to get to 150 cases per million. There are 328 million people living in the US. So this means that there would be an additional 150*328 = 49,200 cases. Note that most (as in over 50%, but probably higher than that) of those cases are people who would have died over the next year or two if not for this epidemic (so we expect the mortality to be lower in 2021 and 2022). But even if that weren't the case, the monetary cost of the lockdowns could have paid for saving many more lives than that if the money were to be spent in a smarter way than financing a lockdown. And we are not even counting the countless lives that got broken as a result of the lockdown.

 

[david c]

You are right, Sweden has had 138 deaths per million, whereas Denmark has had 58 deaths per million on the same day. This means that the difference is 80 deaths per million. The deaths are no longer growing exponentially anywhere, including Sweden(!), but let's be generous and say that eventually this difference is going to get to 150 cases per million. There are 328 million people living in the US. So this means that there would be an additional 150*328 = 49,200 cases. Note that most (as in over 50%, but probably higher than that) of those cases are people who would have died over the next year or two if not for this epidemic (so we expect the mortality to be lower in 2021 and 2022). But even if that weren't the case, the monetary cost of the lockdowns could have paid for saving many more lives than that if the money were to be spent in a smarter way than financing a lockdown. And we are not even counting the countless lives that got broken as a result of the lockdown.

Sweden current deaths 2355. Denmark current deaths: 434. Even if we say Denmark is smaller than Sweden and so double the death rate to 868 that would still mean 1487 people have died in Sweden who wouldn't have died if they'd been following Denmark's strategy. That is a lot of deaths - though not nearly as many as the 30,000 or so people who have died in the UK mainly because we were so slow to lockdown.

But as well as your medical arguments being empty Bill, so are your economic arguments. Because the countries whose economies are going to be least hard hit are the ones who did the sensible thing: locked down early, had strong social distancing, tested and traced and as a result got to grips with the virus. New Zealand which did all of those things has now pretty much eradicated Covid-19.

In contrast the countries which locked down late or didn't lock down at all are going to be economic basket cases because the most damaging thing to people going out and spending money is actually an out of control and dangerous virus.

 

[Daniel Lion]

Sweden current deaths 2355. Denmark current deaths: 434. Even if we say Denmark is smaller than Sweden and so double the death rate to 868 that would still mean 1487 people have died in Sweden who wouldn't have died if they'd been following Denmark's strategy. That is a lot of deaths - though not nearly as many as the 30,000 or so people who have died in the UK mainly because we were so slow to lockdown.

But as well as your medical arguments being empty Bill, so are your economic arguments. Because the countries whose economies are going to be least hard hit are the ones who did the sensible thing: locked down early, had strong social distancing, tested and traced and as a result got to grips with the virus. New Zealand which did all of those things has now pretty much eradicated Covid-19.

In contrast the countries which locked down late or didn't lock down at all are going to be economic basket cases because the most damaging thing to people going out and spending money is actually an out of control and dangerous virus.

The head of the Swedish experiment, policy, said the death tolls will be the same, it's just a matter of "timing". It will happen first in Sweden then will slow down as herd immunity is achieved, and other countries locked down will catch up with their mortality numbers. Read that yesterday. The doctor also admitted to doing a shit job protecting elderly, all countries will need to focus on this Now. If countries with resources and money want to protect their old, they will have to develop systems for carers and protections to mitigate and deal with the virus. If we can fight wars on multiple fronts, surely this is an achievable goal if the will is there.
As far as large countries with big cities and more carnage, I don't know, can the Swedish model or Brazil approach work? Do we have a choice? Are we just deferring the inevitable?
New Zealand is an island with a small population. Eventually they will have to open up. Laos where I live, has miraculously succeeded in locking down and having no cases, they will have to open up too. Laos is bordered by 5 countries and is poor... it needs trade.

Testing... affordable, reliable testing. Is that the way out?

No new cases here for over two weeks. I want my kids back in school, running and playing ASAP.

 

[Bill Bauer]

Sweden current deaths 2355. Denmark current deaths: 434. Even if we say Denmark is smaller than Sweden and so double the death rate to 868 that would still mean 1487 people have died in Sweden who wouldn't have died if they'd been following Denmark's strategy.

Sweden has had 138 deaths per million, whereas Denmark has had 58 deaths per million on the same day.

For every million people 80 more people died in Denmark.

2019 GDP of Denmark was 87 billion dollars. The serious lockdown began on March 13, 46 days ago. Assuming that the GDP fell by at least 30% (the figures below are for the second quarter of 2020 for the US, but let's assume Denmark's decline in the first quarter of 2020 is similar to that in the US)
https://fortune.com/2020/04/20/gdp-us-economy-coronaivurs-pandemic-gross-domestic-product-2020/
the "back of an envelope" calculation cost of the cost of the lockdown over those 46 days is (46/365)(0.3)(87,000,000,000) is about 3,290,000,000 or 3,289,315,068/1487 which is about $2,200,000 per life saved. This is actually less than I expected it to be. It is my understanding that a number below $10 million per life saved is reasonable. Unfortunately this direct cost ignores the indirect cost of all of the lives that ended up being broken by the lockdown (e.g., grad students never having a chance to work in academia, businesses going bankrupt, etc), the cost of the new government debt (the actual interest payments, as well as the reduction in GDP as a result of people anticipating and reacting to higher taxes), etc.

In any case, right now it isn't clear cut whether it was all worth it. However, if we extend these lockdowns for another month, the number of new lives saved will likely be much lower (I am writing this based on the fact that cases are declining everywhere, including Sweden), and the cost per day will be the same or even higher.

 

[Bill Bauer]

the countries whose economies are going to be least hard hit are the ones who did the sensible thing: locked down early, had strong social distancing

The above is a statement. Now please back up the statement - why do you think the above is going to be the case? You seem to be ignoring the actual costs of the lockdown (some of which I listed in my post above).

the most damaging thing to people going out and spending money is actually an out of control and dangerous virus.

The above would be true if we were talking about The Plague. Now it is becoming clear that we are talking about something that kills marginally more people than a flu (3-5 times more?). In 2018 when US had 60,000 deaths it hasn't really even made the news.

By the way, an indirect cost of a lockdown that I forgot to mention in my previous post are all of the postponed surgeries and all of the deaths are wouldn't have happened if not for the lockdown.

I just realized that the biggest argument in favour of Sweden's approach making sense is that the lockdown was supposed to just save the lives lost in case the hospitals become overwhelmed. The rest of the deaths aren't being prevented - only their timing is shifted.

Since Sweden hasn't reported their hospitals becoming overwhelmed, their cost of not having a lockdown was ZERO. More of their people died, but that means that a larger fraction of their population already has immunity, and the exact same number of people will die in the other countries, albeit a couple of months later.

 

[Bill Bauer]

@david c

Now it is becoming clear that we are talking about something that kills marginally more people than a flu (3-5 times more?).

https://reason.com/2020/04/09/preli...infection-fatality-rate-of-about-0-4-percent/

Over the last two weeks, German virologists tested nearly 80 percent of the population of Gangelt for antibodies that indicate whether they'd been infected by the coronavirus. Around 15 percent had been infected, allowing them to calculate a COVID-19 infection fatality rate of about 0.37 percent. The researchers also concluded that people who recover from the infection are immune to reinfection, at least for a while.

For comparison, the U.S. infection fatality rates for the 1957–58 flu epidemic was around 0.27 percent; for the 1918 Spanish flu epidemic, it was about 2.6 percent. For seasonal flu, the rate typically averages around 0.1 percent. Basically, the German researchers found that the coronavirus kills about four times as many infected people than seasonal flu viruses do.

So what we Seem to have is basically the 1957-58 flu with more histrionics.

In any case, here is an amusing clip:

 

[Bill Bauer]

I think the fact that numerous stage agencies and poison control centers got phone calls from people inquiring about drinking or injecting bleach or hydrogen peroxide, is evidence enough that the comments were ill-conceived and dangerous, without looking any deeper than that.

https://reason.com/2020/04/25/no-po...y-spiking-after-trumps-disinfectant-comments/

 

[Bill Bauer]

I highly recommend the following article, written by a Standford professor of Biomedical Data Science back in March when all of the lockdowns got implemented. The lockdowns were an irrational decision based on hysteria and not science:

https://themyth.net/wp-content/uplo...-making-decisions-without-reliable-data-2.pdf

 

[Bill Bauer]

@david c and anyone else who is still strongly supporting the shutdowns, please read the paper below
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163529/
It's all good, so the quoted text below is just a taste

Some fear an analogy to the 1918 influenza pandemic that killed 20‐40 million people. 18 Retrospective data from that pandemic suggest that early adoption of social distancing measures was associated with lower peak death rates. 19 However, these data are sparse, retrospective and pathogen‐specific. Moreover, total deaths were eventually little affected by early social distancing: people just died several weeks later. 19 Importantly, this year we are dealing with thousands, not tens of millions deaths.

if only part of resources mobilized to implement extreme measures for COVID‐19 had been invested towards enhancing influenza vaccination uptake, tens of thousands of influenza deaths might have been averted.

 

[Ed209]

There are now suggestions that the coronavirus could be linked with a mysterious condition that is affecting children in the UK. Apparently, there are children coming down with something akin to Kawasaki disease.

I just spoke to my cousin on the phone and she said that her friend had lost another uncle to COVID-19. That means that this person has now lost 2 uncles and 1 aunty to the coronavirus and they were all relatively young and healthy. How unlucky can one family get?

My mom is also back in the hospital with a suspected pulmonary embolism. I'm currently waiting for an update. This morning she was coughing up blood and was short of breath. Her Dr told her to go straight to the hospital to rule out a PE where a blood test revealed signs of a clot. They are now doing further tests. There's no end to how shit this year has become.

 

[Bill Bauer]

https://en.wikipedia.org/wiki/Precautionary_principle

 

[Bill Bauer]

I just spoke to my cousin on the phone and she said that her friend had lost another uncle to COVID-19. That means that this person has now lost 2 uncles and 1 aunty to the coronavirus and they were all relatively young and healthy.

Is it the case that they haven't been suffering from any pre-existing conditions?

 

[linearb]

No one's achieved herd immunity from this, so we don't actually know how well that will work out, but it's setting the stage for this to just be a seasonal problem as it becomes endemic (I believe we're past the point where this is avoidable, if it ever were).

That said, the fact that lung scarring has been observed incidentally in asymptomatic cases, and the potential for long term heart or other organ damage which we don't understand yet makes me very willing to keep distancing and sitting pretty until we have more data. If other people want to go expose themselves as part of some experiment, cool, you do you.

If this just settled into the same distribution patterns as the other corona viruses endemic in humans, then over time it becomes ~4% of seasonal colds, and overall longevity will drop because of how badly this destroys the elderly and middle aged.

 

[Bill Bauer]

That said, the fact that lung scarring has been observed incidentally in asymptomatic cases, and the potential for long term heart or other organ damage which we don't understand yet makes me very willing to keep distancing and sitting pretty until we have more data.

Makes sense. That's my plan too - wear a mask and glasses everywhere I go where I might encounter other people, wash my hands a lot, and avoid all unnecessary trips to the store, the doctor, etc. But that doesn't require a complete shutdown of the country.

because of how badly this destroys the elderly and middle aged.

The text "the elderly and middle aged" should Probably be replaced with "the people with serious diseases who likely have less than a year or two left to live". The authorities let us all down - it would have been so easy to avoid if only they were to close the borders and were serious about contact tracing of everyone who had been abroad recently upon realizing that this is a serious disease. Quarantines make sense and are not mind-numbingly costly - locking down the entire country makes sense only with diseases as bad as the plague or worse.

 

[Bill Bauer]

The nature is bouncing back as a result of coronavirus. First the dolphins in Venice canals, and now this:

 

[Bill Bauer]

Unbelievable!!!

 

[Bill Bauer]

people inquiring about drinking or injecting bleach or hydrogen peroxide

https://www.washingtonexaminer.com/...of-arizona-man-who-ingested-fish-tank-cleaner

 

[Ed209]

Is it the case that they haven't been suffering from any pre-existing conditions?

As far as I'm aware, they were all relatively fit and healthy.

My mom is back home now. Her CT scan revealed that there was no clot, but what they did discover is that the coronavirus is still in her lungs. They told her that it was showing up in patches. She's not been well at all and it's been nearly 7 weeks since she started showing symptoms.

 

[linearb]

https://www.washingtonexaminer.com/...of-arizona-man-who-ingested-fish-tank-cleaner

completely different and unrelated story; that one seemed like pretty obvious murder to me from the get go

https://www.fox5atlanta.com/news/officials-2-georgia-men-drank-cleaning-products-to-fight-covid-19

So, on the one hand you do have actual idiots. On the other hand, you have media idiots trying to distort this into a bigger problem than it is:

https://reason.com/2020/04/25/no-po...y-spiking-after-trumps-disinfectant-comments/

I don't think the comments were catastrophic, or, even, probably, the dumbest thing Trump said that week. They were still both irresponsible, and, more worryingly, just unintelligent babble. If you can really watch those clips of him stumbling through inquiries about light and injecting disinfectants and say "yes, there is an intelligent person making reasonable statements about the world around them", then you and I are just living in different realities such that we're never going to agree on this and a number of other things. That was why I said I wanted to drop it -- not because I think you're "wrong", but because there are fundamental and irreconcilable differences in how we are observing and processing things.

As far as I'm aware, they were all relatively fit and healthy.

My mom is back home now. Her CT scan revealed that there was no clot, but what they did discover is that the coronavirus is still in her lungs. They told her that it was showing up in patches. She's not been well at all and it's been nearly 7 weeks since she started showing symptoms.

I am sorry for your losses.

We're not going to start CT'ing everyone, but if we did I think we'd see some worrying stuff from asymptomatic cases, because hospitals that have been CT'ing everyone abroad, report same.

This is a disease I am profoundly interested in not getting, until it's much better understood. Unless we already had it, which we might of, sure would be nice if reliable antibody tests existed!!

 

[linearb]

Makes sense. If not for the noise, I would be ok with the risk of driving on deserted dirt roads at moderate speeds.

A distant relative of mine quit riding motorcycles following getting multiple bones broken in an accident that took place a couple of months after he got his motorcycle license.

I just wanted to revisit this, because the noise doesn't bother me (relatively quiet engine, good plugs) but I was driving on deserted dirt roads at moderate speeds at the beginning of the week, went into a gnarly set of S-curves at a downhill angle which I've blown through a dozen times before, but this time (possibly because I barely have my riding legs for the year yet) trying to make the left coming out of a right, my rear tire just slid ~1' out and I "lowsided", riding my shoulder and knee into gravel as the bike went horizontal.

Oops! The bike is fine (bent handlebar, but I was able to / had to ride it home), and I am just somewhat banged up, and basically this kind of accident is the sort of thing which is probably going to happen sometimes riding on dirt, there's a reason dirt bikes have crash bars and stuff. From a purely math and stats perspective, riding on 2 wheels is the dumbest thing I do by a lot; it's both more dangerous and fundamentally more useless than chainsaw work, for example. Sure, only going 25 there was "smart" and kept this from being life-altering or ending. On the other hand, that road is a bunch of ridges over water and it'd be real easy to just slide off it and suddenly you're 100' up an embankment from the river. Trees would break your fall... and bones, no doubt.

Also, my technical takeaways from this accident: do not even think about brakes when turning on gravel, rely on engine braking only, and be aware that engine braking is still going to make the rear want to slide. Pick straighter lines. Be glad I am not hurt worse, and expect that something like this may eventually happen again if I keep going with this hobby.

 

[Ed209]

I am sorry for your losses.

I didn't know them personally, but the family in question are close friends of my cousin. I found it both remarkable and tragic that they lost all those people to Covid-19. I still believe that the viral load one is exposed to is one of the single most important factors as to how ill one might become other than one's age and overall health.

 

[linearb]

I didn't know them personally, but the family in question are close friends of my cousin. I found it both remarkable and tragic that they lost all those people to Covid-19. I still believe that the viral load one is exposed to is one of the single most important factors as to how ill one might become other than one's age and overall health.

yes; I am also wondering the degree to which genetics matter. It makes sense for cases to clump in families in general, but not deaths, and anecdotally yours is not the first story like this I have read and since it appears a big part of the weirder things the virus does may be a result of immune response, then maybe some genes make this more likely to be serious.

 

[Ed209]

yes; I am also wondering the degree to which genetics matter. It makes sense for cases to clump in families in general, but anecdotally yours is not the first story like this I have read and since it appears a big part of the weirder things the virus does may be a result of immune response, then maybe some genes make this more likely to be serious.

I was going to mention genetics in their case as it seems rather extreme for 3 closely related people to die who were otherwise fit and healthy. It could be true for others also. Is there any evidence for this other than anecdotal?

EDIT: So I just found out more information on this. Two of them who died were husband and wife and lived together not far from where I do, so they were not genetically linked. The other one who died lived in Spain and was related to one of the other two.

 

[Lane]

I still believe that the viral load one is exposed to is one of the single most important factors as to how ill one might become other than one's age and overall health.

@Ed209 -- It's seemed obvious to me from the beginning that initial viral load is an important factor. Based on what I'm seeing however, nutritional status seems to be far more important, with Vitamin C, Zinc, Vitamin A, Iodine, and Vitamin D levels among the most crucial. Obviously, there are many others that should be optimal. Regarding Vit. C, I recently learned that "far and away", the highest concentrations of cellular Vitamin C in the body is in the immune system cells (which can apparently become quickly depleted when dealing with an infection).

Below is part of an email I received from Chris Masterjohn (PhD) today which reviews a recent report coming out of Indonesia on COVID-19 infections and Vitamin D status. The numbers are pretty staggering. If anybody is interested in CM's reviews of these kinds of reports, you can subscribe by clicking on this link: -- COVID-19 Research Updates Boldings and underlining below are mine. -- Separately from the below review, here's a link to a lengthy post on EarthClinic I found interesting: -- Nasal Lugol's Iodine Rinse for Protection Against COVID-19

Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study
13 Pages Posted: 30 Apr 2020

The electronic health records of 780 laboratory-confirmed COVID-19 cases from the government hospitals of Indonesia between March 2 and April 24 was searched for data on vitamin D status prior to admission, age, sex, preexisting conditions, and mortality. Vitamin D status was classified as normal (≥30 ng/mL), insufficient (21-29 ng/mL), or deficient (≤20 ng/mL).

The majority of cases (59%) were below age 50, and 83% of them were alive and still in the hospital at the time of writing.
The mean age of those that died was 65, while the mean age those who lived was 46.
Two thirds of those who died were male, while only one third were female.
85% of those who died had preexisting conditions. The specific conditions were not reported.

Just under half (49.7%) of cases had normal vitamin D status, and only 4% of them died.
Just over a quarter (27%) had insufficient vitamin D status, and most of them (88%) died. Just under a quarter (23%) had deficient vitamin D status, and almost all of them (99%) died.

Without adjusting for age, sex, or preexisting conditions, those with vitamin D insufficiency were 12.55 times as likely to die and those with deficiency were 19.12 times as likely to die. After adjusting for age, sex, and preexisting conditions, those with insufficiency were 7.63 times as likely to die and those with deficiency were 10.12 times as likely to die.

 

[Bill Bauer]

Also, my technical takeaways from this accident: do not even think about brakes when turning on gravel

During my latest trip, I had also experienced a serious skid on a gravel road, with the rental car going 90 degrees of where I had been planning for it to go and traveling an unreasonably long distance that way. I got lucky that there was nothing in the way...