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

[Bill Bauer]

I'd put money on the overall mortality risk here being at least an order of magnitude higher across all age groups excluding 0-15, because I think the data overwhelmingly supports that.

If that data were to exist, you would know about it, and you wouldn't have to bet on it supporting a certain level of mortality risk. In fact, it is suspicious that this data hasn't been reported to us yet. This alone seems to imply that the mortality risk is embarrassingly low.

My strong suspicion is that weird and scary side effects mid to long term will likewise end up being more common than with flu, because I think that's where the early evidence points, but whether that means "10% of people have long term problems" or ".01% of people have long term problems", I am not qualified to assess.

All we know is that there is anecdotal evidence of those side effects, just like there is such evidence for the flu. If those cases for COVID-19 were to be more common than those cases for the flu, it would be easy to use stats to determine that. The fact that we haven't seen this stated clearly means that the fraction is close to that of the flu, which would make it harder to distinguish between the two, and lead to a lack of reports about it.

Beyond that, I won't make any bets, but to me that means "avoid exposure at all reasonable costs" until more of these unknowns are in focus.

When avoiding exposure has a low cost (i.e., the cost of a mask), of course it makes sense to avoid the exposure.

 

[linearb]

If that data were to exist, you would know about it, and you wouldn't have to bet on it supporting a certain level of mortality risk. In fact, it is suspicious that this data hasn't been reported to us yet. This alone seems to imply that the mortality risk is embarrassingly low.

We do have access to this data and low estimates put this at 10x plus flu mortality for all age groups besides 0-15.

I think that's the floor of the possible range that can be easily supported by the current data, some of which is fairly well compiled in that Atlantic article and all of which is very easy to find. I don't know what you're suspicious of.

All we know is that there is anecdotal evidence of those side effects, just like there is such evidence for the flu.

I believe this is also wrong; there's nothing anecdotal in either case. In the case of the flu prevalence numbers are more reliable (and exceedingly low) because we have 100 years of data instead of 6 months. In both cases we have massive general medical agreement though; everyone treating C19 agrees it has massive vascular effects in both serious and some "not serious enough that the person sought treatment" cases, we just don't know exactly how to quantify that risk, and won't for quite a while. I am happy to let others be the guinea pigs for that.

Unless you're wearing an n100, masks are significantly more protective of others in the case you're sick, than vice versa. So it's a good idea that should be a necessity but doesn't keep you safe unless society is playing along.

 

[linearb]

to be clear, I took this to mean

do we know how common it is with COVID?

To be related to "weird, novel side effects" such as neurological damage from strokes, cardiovascular damage, etc. We know these things are happening, and the degree to which there is widespread reporting of them from basically every country that's reporting any COVID hospital data at all, implies it's not an insanely uncommon occurrence. I haven't tried to crunch numbers, but I would expect that we probably do have enough data to say "novel side effects from COVID is more common than post-influenza encephalopathy", but we have 100 years of good data on the latter and it's a tiny sliver (ex: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5982813/ --

Mean seasonal incidence of IAE cases among children and adults (aged ≥18 years) was 2.83 and 0.19 cases per 1000000 population, respectively

Getting to that same level of certainty on any specific COVID complication is going to take years of follow-up.

As far as overall case fatality rate, while it will likewise take years to pin down with the exact CFR in each affected region and city was, and what all the variables are... well, in 6 months we have basically the equivilent of 5 years worth of flu data, in terms of overall case counts, hospitalizations, etc. So, even though there's still a big degree of blurriness in exactly where the needle is going to fall, suggesting "10x the mortality of flu in all age ranges besides pediatric" as the floor of what's possible seems entirely reasonable to me, because there's a ton of different glimpses at CFR from different countries and locales and essentially none of them are outside of that range.

For someone in my own particular demographic, age wise, my risk of death from COVID appears to be ~0.5% on the low end, and 2.5% on the high end. That's a 500% spread from the low end to the high end, but that's "only" a half order of magnitude, and, more importantly, the low end is still vastly, vastly higher than influenza for my age group. That's without thinking about any potential for complications or reduced life quality after recovery.

 

[Bill Bauer]

We do have access to this data

Why did you say that you were going to bet on a certain outcome, if the outcome is known?

low estimates put this at 10x plus flu mortality

Is this after we account for
https://www.washingtonpost.com/health/2020/06/25/coronavirus-cases-10-times-larger/
I bumped into the article above, when I attempted to find a very similar article about Canada that I've seen several days ago. Unfortunately I couldn't easily find it, but that would surely explain it.

I will have to read the rest of your message tomorrow.

 

[linearb]

Why did you say that you were going to bet on a certain outcome, if the outcome is known?

It's a figure of speech? Also, the outcome is far from known; we have some ceiling and floor values at different confidence intervals.

Additionally -- that's actually exactly the kind of data set gamblers do bet on (lower confidence of predicting exact value, decent grasp on possible spread). So, the figure of speech fits, even if I myself am not a gambler.

Is this after we account for
https://www.washingtonpost.com/health/2020/06/25/coronavirus-cases-10-times-larger/

Yes, absolutely. 10x the number of known cases as a reasonable guess for actual infection has intermittantly seemed like a reasonable guess (depending on number of tests performed). That would put the total number of infected in the US at around 20million which is in line with other estimates I've seen, or within a half order of magnitude.

If we just assume that number is correct and extrapolate from there, and also make the more dubious assumption that immunity persists for some significant period and herd immunity becomes a factor at 70% infected, then we need to get to 231,000,000 infected in the US, which means we need to get another 211,000,000 infected. Assuming a 1% CFR (which is in line with the lower bounds here, but likely optimistic) then that will require another 2 million people to die before we get there.

That sounds like a bad plan to me, and this is assuming that we are in fact missing 90% of cases and can attain 1% CFR

 

[Bill Bauer]

Yes, absolutely. 10x the number of known cases as a reasonable guess for actual infection has intermittantly seemed like a reasonable guess (depending on number of tests performed). That would put the total number of infected in the US at around 20million which is in line with other estimates I've seen, or within a half order of magnitude.

Since there is a lot less uncertainty about the number of people who die from COVID-19 (although that number is likely an overestimate, as hospitals have an incentive to report deaths as COVID-19 deaths), when the total number of infected grows, the mortality rate falls. Specifically, if the number of infected is 10 times of what has been reported, the mortality rate is 1/10th of the original mortality rate, in line with the mortality for the regular flu, which this is starting to look like.

 

[Bill Bauer]

we need to get to 231,000,000 infected in the US, which means we need to get another 211,000,000 infected

The only way out is through.

 

[linearb]

in line with the mortality for the regular flu, which this is starting to look like.

Nah, did you read that Atlantic article? That's a strong summary of where we are math wise but we blew through flu numbers a long time ago.

My 1% guess was based on a 90% underreporting, plus the lag between case count rising and the death count following 4-6 weeks later (which we're only barely seeing the beginning of now, but because of how badly cases have gotten out of control, it's inevitable that there next few weeks are and will continue to be bloodbaths over there coming weeks as we get back over 1000 deaths / day)

If we're not at substantial underreporting and we've had 140k deaths on 3m infected that's 5% CFR; 1/10 that would be 0.5%. that's both dramatically more optimistic then any actual epidemiologist estimate I've seen, and also still 5x as lethal as flu, which has better understood and seemingly far more uncommon long term problems associated with it.

edit: I just looked up the 2019 flu stats, and CDC says we had 34k deaths from 35m cases, so there's our "normal" .1%. To put that in perspective, even if we're undercounting Corona cases by 90% that would still give us 140k dead from roughly the same number of cases -- and that's a 12 month flu year, vs the 7 months of Corona we're looking at. (And, sadly, the 12 month corona number will be substantially worse than where we are now, no matter what people start doing right now).

I think the US has sort of chosen one of the worst possible paths here, because political obstinance on the mask issue dramatically undermines the utility of distancing measures. More or less, these things only work when people can all agree to play along. So, we slowed but did not at all actually reduce the spread of the virus in critical areas. Some damage to the service industry in the face of this was unavoidable, but we appear to be headed towards a housing crisis during a pandemic that's still unfolding, against the backdrop of schools being forced to make their own arbitrary decisions about how to proceed, lacking any competent national guidance. Hold my beer.

 

[Bill Bauer]

Nah, did you read that Atlantic article? That's a strong summary of where we are math wise but we blew through flu numbers a long time ago.

My 1% guess was based on a 90% underreporting, plus the lag between case count rising and the death count following 4-6 weeks later (which we're only barely seeing the beginning of now, but because of how badly cases have gotten out of control, it's inevitable that there next few weeks are and will continue to be bloodbaths over there coming weeks as we get back over 1000 deaths / day)

If we're not at substantial underreporting and we've had 140k deaths on 3m infected that's 5% CFR; 1/10 that would be 0.5%. that's both dramatically more optimistic then any actual epidemiologist estimate I've seen, and also still 5x as lethal as flu, which has better understood and seemingly far more uncommon long term problems associated with it.

edit: I just looked up the 2019 flu stats, and CDC says we had 34k deaths from 35m cases, so there's our "normal" .1%. To put that in perspective, even if we're undercounting Corona cases by 90% that would still give us 140k dead from roughly the same number of cases -- and that's a 12 month flu year, vs the 7 months of Corona we're looking at. (And, sadly, the 12 month corona number will be substantially worse than where we are now, no matter what people start doing right now).

I wonder what the numbers would look like once we were to correct for the deaths incorrectly classified as COVID-19 deaths due to the incentives involved.

 

[linearb]

I wonder what the numbers would look like once we were to correct for the deaths incorrectly classified as COVID-19 deaths due to the incentives involved.

this is a talking point that's not happening: https://www.factcheck.org/2020/04/hospital-payments-and-the-covid-19-death-count/

https://www.denverpost.com/2020/05/20/coronavirus-covid-medicare-payments-hospitals/

actually we are almost certainly undercounting:

https://www.forbes.com/sites/tommyb...-official-tally-studies-suggest/#63be4d3b1d76

https://www.cnbc.com/2020/07/01/off...unt-of-actual-tally-new-yale-study-finds.html ;

https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm ;

https://www.scientificamerican.com/article/how-covid-19-deaths-are-counted1/ ;

https://www.washingtonpost.com/poli...bluntly-coronavirus-deaths-are-undercounted/;

 

[Bill Bauer]

this is a talking point that's not happening: https://www.factcheck.org/2020/04/hospital-payments-and-the-covid-19-death-count/

Jensen said he did not think that hospitals were intentionally misclassifying cases for financial reasons.

Just because Jensen doesn't think that, doesn't mean it isn't happening.

Nobody is arguing that the hospitals Aren't getting paid more when they declare a death to be related to COVID-19. This is all we need to know - the incentive is there. People respond to incentives. If you pay more for X, you will get more X.

As for the evidence, I have seen a number of articles about numbers having to be revised as a result of hospitals getting caught. Keep in mind that the amount of evidence we will get to read about depends on people's (nonexistent) incentives to find and report those instances of hospitals misclassifying deaths.

 

[Bill Bauer]

Berenson said revenues appear to be down for hospitals this quarter because many have suspended elective procedures, which are key to their revenue, forcing some hospitals to cut staff.

This makes the incentive stronger.

Berenson and others we spoke with also said that hospitals have profound disincentives for "upcoding," which can result in criminal or civil liabilities, such as being susceptible to being kicked out of the Medicare program.

Nobody is claiming that they classify random deaths as COVID-19 deaths. What they do is classify deaths of anyone who tests positive for COVID-19 as related to COVID-19. They know that COVID-19 wasn't actually the cause of death, but technically they haven't done anything wrong. Good for them.

The CDC guidance says that officials should report deaths in which the patient tested positive for COVID-19 — or, if a test isn't available, "if the circumstances are compelling within a reasonable degree of certainty." It further indicates that if a "definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID-19 on a death certificate as 'probable' or 'presumed.'"

First of all, the above means that if someone gets shot and their test for COVID-19 comes back positive, CDC says it is a COVID-19 related death. Second of all, the above seems to imply that every flu or PNEUMONIA death can be safely classified as COVID-19 (without the need to have a test), as surely it is ok to Suspect that an old person has died of COVID-19.

"If we think it's presumptive … we can go ahead and put down COVID-19," Jensen said, "or even in some situations, even if it's negative." He pointed to the example of a 38-year-old man in Minnesota whose death was attributed to the coronavirus even though he tested negative.

LOL!!!!!! So the fact that false negatives exists gives them the right to classify any pneumonia/flu death they want as COVID-19 no matter what.

FACTCHECK.org: here are some Compelling arguments that there is nothing to see here - CHECKMATE COVID-19 DENIERS!

 

[FGG]

This makes the incentive stronger.
Nobody is claiming that they classify random deaths as COVID-19 deaths. What they do is classify deaths of anyone who tests positive for COVID-19 as related to COVID-19. They know that COVID-19 wasn't actually the cause of death, but technically they haven't done anything wrong. Good for them.

First of all, the above means that if someone gets shot and their test for COVID-19 comes back positive, CDC says it is a COVID-19 related death. Second of all, the above seems to imply that every flu or PNEUMONIA death can be safely classified as COVID-19 (without the need to have a test), as surely it is ok to Suspect that an old person has died of COVID-19.
LOL!!!!!! So the fact that false negatives exists gives them the right to classify any pneumonia/flu death they want as COVID-19 no matter what.

FACTCHECK.org: here are some Compelling arguments that there is nothing to see here - CHECKMATE COVID-19 DENIERS!

What do you attribute the increase in All Cause Mortality to if not COVID-19:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223479/

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767980

 

[Tanni]

[...] the above means that if someone gets shot and their test for COVID-19 comes back positive, CDC says it is a COVID-19 related death.

 

[linearb]

Nobody is arguing that the hospitals Aren't getting paid more when they declare a death to be related to COVID-19. This is all we need to know - the incentive is there. People respond to incentives. If you pay more for X, you will get more X.

Your second point actually isn't how things work in healthcare markets, but your first is wrong. Hospitals do or did in some cases get financial help for handling covid cases. They got nothing specific for deaths, a point already made by two links.

As for the evidence, I have seen a number of articles about numbers having to be revised as a result of hospitals getting caught. Keep in mind that the amount of evidence we will get to read about depends on people's (nonexistent) incentives to find and report those instances of hospitals misclassifying deaths.

Something you "have seen a number of" isn't evidence. If you have articles like that, post them, along with some reasonable rebuttal of the overwhelming chorus of "actually we're undercounting COVID deaths and here's how" articles I've posted, and maybe I'll think about this idea again? Otherwise I think it's a closed book, there is no overreporting of COVID deaths, and there are likely large numbers we have not caught.

You seem to have very selectively parsed the factcheck page and found ways to come to more or less the opposite of the conclusion it's trying to lead you to, and then you're conveniently ignoring five articles explaining why and how we're undercounting COVID deaths, and a great Atlantic article that's putting some hard and scary estimates on the number of deaths we're about to experience in the wave of illness which is happening now.

Sorry Bill, but either you're not arguing in good faith, or we're fundamentally failing to communicate -- in any case, I wish you well with your tinnitus, I hope you stay safe during this, and I am not interested in discussing it with you any further. If you would like to see this as a victory of some sort, by all means -- to me, it's that I have both been talking at a wall and providing very good fact and evidence based reasons for the picture I am trying to paint on that wall, but just being rebutted with extremely selective reading, tangents, etc.

I think C19 is a real thing, it's happening, it's not a vast global conspiracy, the US response has been poor and not very science based so we're about to experience a bunch of setbacks that will both kill people and be back for the economy; I am worried about the health of my parents and immediate family and vulnerable people in my network.

I need to be not worried any more about trying to understand disagreements with people who are anti-mask, or want to play games with numbers, or think there's some healthcare conspiracy to overstate the seriousness of this. None of that stuff holds water, it can be (and has been) easily and trivially rebutted by widely available data, and when people hold those views but refuse to engage with that data then I just need to move on with life.

Certainly, I have a lot to keep me busy, given that we're likely to be in some kind of hellish childcare-and-economy world for a while, I should probably be out buying more beans and coloring books.

 

[Bill Bauer]

I think C19 is a real thing, it's happening, it's not a vast global conspiracy,

It is real. The conspiracy has to do with making a big deal out of something that a year ago would get a paragraph-long story on page 29 of the newspaper.

Hospitals do or did in some cases get financial help for handling covid cases. They got nothing specific for deaths, a point already made by two links.

There are more cases than there are deaths, so the fact that you pointed out seems to imply that there are even more opportunities to inflate the numbers. Suppose a person comes in with a gunshot wound and the person tests positive for COVID-19. Perhaps that person is even displaying some COVID-19 symptoms. The hospital prescribes the antibiotics they use to treat COVID-19, and then spends several days trying to reverse the consequences of the gunshot wound. Could the hospital use CDC's guidelines to classify it as a COVID-19 case?!

Your second point actually isn't how things work in healthcare markets

What point are you talking about it, and what is it, exactly, that makes this market different?

Something you "have seen a number of" isn't evidence.

You missed my point. If we leave a transparent truck full of cash unguarded on the street, we don't really need empirical studies for us to know that when we come back after a month, the truck will be empty.

 

[PeteJ]

Coronavirus: A Plandemic?

I am just wondering if anyone researched this theory or collection of theories. I will take a wild guess and guess that here, it's 99% to 1% of people who believe the official narrative to those who believe it's an exploitation of a 'flu' to control people (there's many ways to explain or express it).

I don't want to digress too much. I am just wondering if you took any time researching the 'other' narrative?

In my experience, asking people online and in real life, 99% (?) do not.

 

[linearb]

A nice scary twitter thread with RN / NP commentary from Texas where apparently some hospitals are stacking bodies in hallways. Also makes the point that they are already leaning heavily on FEMA staff to replace sick / lost workers; there isn't a bottomless supply of FEMA replacement docs...

The next month is gonna continue to be hellish in wide swaths of the country. As exponential growth continues in places that are ravaged I don't see how we avoid outbreaks other places. The number of hospitals at or approaching 100% capacity in TX, AZ, FL is huge.

This is just one random hospital but this is gonna be a common refrain over the next 4-8 weeks.

 

[Bill Bauer]

Suppose a person comes in with a gunshot wound and the person tests positive for COVID-19. Perhaps that person is even displaying some COVID-19 symptoms. The hospital prescribes the antibiotics they use to treat COVID-19, and then spends several days trying to reverse the consequences of the gunshot wound. Could the hospital use CDC's guidelines to classify it as a COVID-19 case?!

https://cbs12.com/news/local/man-wh...h-counted-as-covid-19-death-in-florida-report

A man who died in a motorcycle crash was counted as a COVID-19 death ...
Dr. Pino tells FOX 35 that one "could actually argue that it could have been the COVID-19 that caused him to crash."

If you are suspect that the above is fake news, he says that at around the 50 seconds mark.

 

[Bill Bauer]

it's 99% to 1% of people who believe the official narrative to those who believe it's an exploitation of a 'flu' to control people (there's many ways to explain or express it).

It's usually the case that about 30% of the people think for themselves, actually study, etc, etc. So in this case, my guess is that the group size is about 30%.

 

[FGG]

Looks like mask wearing might be behind a reduction of severity and deaths due to reduced initial viral load:

https://www.npr.org/2020/07/20/8932...suggests-masks-protect-those-wearing-them-too

 

[PeteJ]

It's usually the case that about 30% of the people think for themselves, actually study, etc, etc. So in this case, my guess is that the group size is about 30%.

You think it's that high? I used to think it was higher but now I think it's about 1%. 5% at best if I am wrong.

What makes you think it's 30%. It sure isn't 30% here. Who besides you and I think like this?

The COVID-19 numbers are inflated because people are recorded as dying because of COVID-19 even when it was another health condition as the cause.

Hospitals are getting funds to "fight COVID-19." These two 'situations' make it fairly obvious that something wrong and unethical is going on.

WHO also said even if someone is asymptomatic, it is EXTREMELY UNLIKELY that person will pass it to anyone. There are endless number of facts and information that point to a scam, plan or just contradictory info that doesn't add up and doesn't support the official narrative.

Because I am "reformed" by the judges here, I won't say anything about the 99% except that I feel sorry for them.

https://www.freedomfoundation.com/w...ing-deaths-improperly-attributed-to-covid-19/

https://fox6now.com/2020/05/16/questions-raised-over-accuracy-of-us-coronavirus-death-toll/

https://www.realclearpolitics.com/articles/2020/05/29/us_covid-19_death_toll_is_inflated.html

I think 3 sources are enough to get the picture. Hopefully.

 

[Bill Bauer]

It sure isn't 30% here.

US and Canada aren't free countries, and people are used to keeping their mouths shut.

What makes you think it's 30%.

In my experience, about a third of the population seem to be "normal". The rest are basically Hieronymus Bosch painting characters (on the inside). This notion is conveyed well by the image below.

 

[Bill Bauer]

@PeteJ Are you feeling a little better compared to how you felt six months ago?

 

[linearb]

Per various state reporting we're over 1000 deaths in 24 hours for the first time since 5/24

USA #1, not going to let these upstart countries with worse infrastructure like India and Brazil beat us for worst COVID response without a fight!!

 

[Bill Bauer]

Per various state reporting we're over 1000 deaths in 24 hours for the first time since 5/24

I wonder what it was 3 weeks ago (that's how long this virus takes to kill its victims, right?) that might have caused it... We will probably never know!

 

[PeteJ]

@PeteJ Are you feeling a little better compared to how you felt six months ago?

No. Why?

My frequency and severity of ear pain is slightly lower but tinnitus is still loud volume, screaming tones hell. Is that what you are asking about?

 

[PeteJ]

I wonder what it was 3 weeks ago (that's how long this virus takes to kill its victims, right?) that might have caused it... We will probably never know!

Why reply to people who don't read our posts?

 

[PeteJ]

People are getting assaulted when they don't wear a mask. This clown world is insane. It's really unbelievable to factor in this crazy society and add severe tinnitus and often, severe hyperacusis.

 

[Bill Bauer]

tinnitus is still loud volume, screaming tones hell. Is that what you are asking about?

Yes.

No. Why?

I was hoping that you noticed improvement.

I am More sorry that a decent person like yourself has been struggling with tinnitus, than I am that some other folks [who aren't as decent] have been affected by it (I feel sorry even for them).

Hopefully you will benefit from one of the treatments that are in the pipeline...

People are getting assaulted when they don't wear a mask.

Even in Ontario?

Why reply to people who don't read our posts?

I am sure that lots of people got to read the post. But you are right - nobody is going to change anyone's mind.