Covid-19 Diary : Sunday 31 January, 2021

 

I spent several days this week in what seemed like a different world.  Masks were almost entirely absent, people shook hands, interactions and socializing was normal.  This was primarily in Lincoln County, WA, and Valley County, ID.

In Lincoln County, it seemed all businesses had signs on their doors saying (I’m paraphrasing)

The governor says you must wear a mask unless you have a specific medical exemption.  Due to the HIPAA health privacy laws, we can’t ask you about your medical conditions, so if you are not wearing a mask, we will assume it is for medical reasons and not ask you about it.

A very cynical and slightly amusing way of flouting the state mandate on mask wearing.  I’m a great believer in masks, and this came as quite a shock, particularly because in the Seattle area, people are very compliant with mask wearing.  I felt uncomfortable and awkward, not sure whether I should wear a mask or not.

I was curious to see how this non-mask wearing reflected in their level of virus impact.

The result was surprising.

CountyCounty Cases per millionState Cases per million
Lincoln Co, WA28,77041,323
Valley Co, ID64,31091,034
National average80,530

Now, let’s think about what this means and what it does not mean.  Anti-maskers will rush to delightedly proclaim that statewide virus case rates are 50% higher than in the counties where mask wearing is minimal, and claim that proves that masks are not only of no value but may be harmful.

That is most definitely not a conclusion I could support.  The data provided is insufficient to draw any conclusion at all, and there are very many more differences between these two counties and the larger states they are part of.  There are almost certainly other lifestyle factors influencing the numbers.

Maybe if we waved a magic wand and made these two counties become 100% mask wearing for a couple of months, we could then see if there was a relative decline in new case numbers compared to those accumulated so far.  While we see low case rates currently, maybe they could be (should be) even lower if masks were worn.

So, an interesting but perhaps meaningless pair of data points, and surprising to see such community-wide mask refusals.

This is the 173rd article I’ve written about the virus over the last year.  During that time, my focus has shifted from an initial attempt to understand everything, to a series of changing perspectives on the key issues of the day as they seemed at the time.  I realized, earlier this week, that my focus is becoming once again clearly targeted on a specific issue – and that is the continued willful failure of our political, medical, and opinion leaders to acknowledge and deploy low-cost safe treatments to reduce our terrible mortality rates, and to allow more people avoid any hospitalization at all.

With now 452,000 deaths, in less than a year, and recent death rates of over 4,000 in a single day, hopefully the fools who blithely told us there was nothing to worry about and Covid was less impactful than the annual ‘flu are now abjectly silent.  (The annual ‘flu kills about 30,000 – 50,000 a year.)

The terrible tragedy – surely a crime against humanity – is that many/most of these deaths would have been prevented if we’d been quick to deploy first hydroxychloroquine, then subsequently ivermectin as it became better understood as a great defense against and treatment for the virus, too.  Doctors, who are supposed to be helping us, are instead killing us.

Even now, we get supercilious articles such as this one in the NY Times that states without attribution and while ignoring the over 200 positive studies, 171 of which are peer reviewed,  “it turned out that the drug [HCQ} provided no benefit — and might even do harm”, and then goes on to say about ivermectin that it is “another drug is becoming popular before there’s strong evidence that it works: the parasite-killing compound ivermectin”.  The article doesn’t explain what size trial might be needed, apparently considers 35 trials so far (all positive) as insufficient, and also fails to mention one trial of enormous size involving tens of millions of people (ie Peru, as per this article).

If trial size and number was the only measure of approvals, the single trials supporting the emergency vaccine approvals would all be rejected, too.

Furthermore, the entire “burden of proof” is misplaced.  An already proven-to-be-safe drug that is inexpensive and easy to administer shouldn’t need a massive series of formal trials before it is used for a new purpose.  The outcome is simple.  If it works, that’s a win.  But if it doesn’t work, there is no harm, and no sacrifice.  If a few simple short trials suggest it works, isn’t that enough to allow broader access?

Remember also that the FDA has said it will give emergency use approvals to any vaccine that is as little as 50% effective.  Why won’t it give emergency use approvals to treatments that are as high as 90% effective?

Here’s a great article on the topic of the passive non-response by the NIH and Dr Fauci.  (More about Dr Fauci, below…..)

A reader sent in a link to a YouTube video about the virus, the vaccines, and various other treatments – this is a presentation by a doctor who is also the head of the Americas Frontline Doctors group.  Generally I hate videos, because they are so “slow” and can’t be skimmed through, but because I knew/respected the reader, I started to watch it, and ended up watching the entire video.

It is compelling, particularly the part where the lady doctor described how she was fired from her hospital for prescribing HCQ to patients – not due to any medical reason, but because a big pharma company told the hospital it didn’t want the hospital to support HCQ use.  Now that’s a headline the NY Times should be publishing, rather than making groundless claims that HCQ is dangerous and ineffective.

Are you comfortable where big pharma companies can freely pressure hospitals to fire doctors for prescribing a competing medication that is cheaper and better than the ones they offer?

The speaker – Dr Simone Gold – also has some critical comments about the vaccines currently being offered in the US.  She points out there are potential longer-term problems for people who have been vaccinated, and also talks about a known possibility where a person might actually have a worse rather than better reaction to the virus after being vaccinated.

Ah, you might say, but that’s what all the pre-approval testing was about – to ensure the safety of the vaccines.  Maybe, but do you know how many people actually were infected after being vaccinated?  Eight for one of the two vaccines, eleven for the other.  That’s right – these still-experimental vaccines (remember, they are not fully approved vaccines, they have only received emergency use approval, because they haven’t been properly and completely tested) are based on the observed reactions of eight people in one case and eleven in the other.

I’m not saying “don’t get vaccinated” – and neither is Dr Gold.  But she is saying – and I understand and agree – that there are as yet unknown but possibly measurable downsides to these vaccines that we don’t know enough about yet, and so, for now, you should only get vaccinated if you’re in a high-risk group.

Another vaccine is nearing approval; one developed by Johnson & Johnson.  It is 66% effective overall, but that’s not the number you’ll see quoted in the headlines, which generally say 85% (for example, here).

The vaccine was 66% effective overall at preventing moderate and severe disease, a result that covers a wide range of variation depending on geography: it was 72% effective at protecting against moderate to severe illness in the United States, but it was 66% effective in Latin America and 57% effective in South Africa, where concerning variants have taken root.  In other words, the vaccine is less effective than ivermectin.

The good news is this is a single dose vaccine, although trials are ongoing to see if a second dose would boost its effectiveness further.  Its lower-than-95% effectiveness (also a factor with the likely-to-be-approved AstraZeneca vaccine, which has an effectiveness level that is pretty much anyone’s guess due to the mess of their testing) gives further reason to why we still need to have treatments as well as vaccines.  We know that not everyone can be vaccinated for some time to come, and we also know that not everyone will ever want to be vaccinated, and now we know that not all vaccines are fully effective.

Here’s another article on the stunning incompetence that pervades our healthcare system.  This time it is the CDC’s inability to oversee the development of the vaccine data system that was supposed to coordinate getting the vaccines rapidly deployed.  It awarded a no-bid contract to Deloitte, starting in May last year, to develop this system, at a cost of $44 – $48 million.  It is so useless that some states are urgently developing their own systems instead, or forced to use paper records.

A reader wondered who signed off on the system.  My guess is that it is almost certainly (and deliberately) a “non-accountable decision” that was made by a committee, with no single person at fault.  My own question though is slightly sharper.  Who will lose their job over this?  Probably, yet again, no-one.  Why not fire the entire committee and everyone else involved?

How can we expect these organizations to improve when there is no accountability and no negative consequences for such devastating displays of incompetence?

Current Numbers

No appreciable changes in the US, just some swaps in the lists.  Similarly, some only minor positional changes in the other lists.

US Best and Worst States

RankCases/MillionDeaths/Million
A week agoNowA week agoNow
1 BestVT (17,681)HI (18,259)HI (242)VT (279)
2HI (17,766)VT (19,175)VT (272)HI (290)
3ME (27,226)MEAKAK
4OR (32,759)OR (33,766)MEME
5WA (39,855)WA (41,364)OR (446)OR (464)
47RI (103,586)TN (106,581)MS (1,939)MS (2,031)
48TN (103,778)RI (108,025)RI (1,966)RI (2,033)
49UT (104,931)UT (108,119)MA (2,050)MA (2,115)
50SDSDNY (2,179)NY (2,246)
51 WorstND (127,046)ND (128,113)NJ (2,359)NJ (2,419)

 

Top Case Rates Minor Countries (cases per million)

RankOne Week AgoToday
1Andorra (123,476)Andorra (128,488)
2Gibraltar (117,738)Gibraltar (122,132)
3MontenegroMontenegro
4San MarinoSan Marino
5LuxembourgLuxembourg
6SloveniaSlovenia
7PanamaPanama
8LithuaniaIsrael
9IsraelLithuania
10Liechtenstein (63,917)Liechtenstein (65,275)

 

Top Case Rates Major Countries (cases per million)

RankOne Week AgoToday
1Czech Republic (87,462)Czech Republic (91,858)
2USA (77,392)USA (80,590)
3Portugal (62,496)Portugal (70,783)
4Belgium (59,549)Belgium (60,920)
5Spain (55,671)Spain (60,525)
6NetherlandsNetherlands  (57,030)
7Sweden (53,988)UK (56,057)
8UK (53,570)Sweden (55,934)
9FranceFrance
10BrazilBrazil
11Argentina (41,101)Argentina (42,414)
12Italy (40,834)Italy (42,262)

 

Top Death Rate Major Countries (deaths per million)

RankOne Week AgoToday
1Belgium (1,784)Belgium (1,813)
2UK (1,438)UK (1,559)
3Czech Republic (1,338)Czech Republic (1,521)
4Italy (1,415)Italy (1,465)
5USA (1,293)USA (1,362)
6Peru (1,197)Spain (1,247)
7Spain (1,186)Peru (1,229)
8Mexico (1,149)Portugal (1,226)
9France (1,118)Mexico (1,219)
10Sweden (1,086)France (1,164)

I Am Not a Doctor, But….

When asked if he was investing in drug stocks, Dr Fauci enigmatically said “I’m a government employee, I get a government salary.”  The implication was this meant he was unable to spend much on anything other than the basic essentials of life and nothing more.

The truth – and, as he has said himself, he likes to reveal the truth in small steps to make the ultimate reality more acceptable, is that he is the highest paid employee in the entire US Federal Government, being paid more than his various bosses, more than the President, and more than any else.  He gets $417k/year, plus of course, the generous raft of government benefits that the rest of us can only envy.

So, Dr Fauci.  What drug companies have you invested in?  (Not that there’s anything wrong with doing so – it makes sense to invest in industries you understand, just so long as there’s no danger of either favoritism or insider benefits, of course.)

How is it that Dr Fauci came to be the highest paid government functionary?  That’s a very good question.  This article points out that it certainly wasn’t due to demonstrating any unusual talent or achieving anything out of the ordinary – indeed, it goes as far as to blame him for a series of disappointments and (some would say) disasters over the last 37 years.

As for his recent brilliance when it comes to combatting Covid, what exactly has he done special there?  Would it be his ridiculing President Trump when Trump said there would be vaccines developed by the end of the year (2020)?  Or his laughing at the thought of everyone wearing masks, and saying there was no need for that at all?  Or maybe his total disinterest in any type of off-the-shelf drugs being repurposed to fight Covid, including incorrect criticism of HCQ and, as far as I can tell, a total silence on IVM.

And then there was his rush to embrace remdesivir, a drug that has increasingly been understood as being of less and less value whatsoever and now is even recommended against by WHO.  Meanwhile, other drugs are showing massively more promise, like this one which is showing initial results 100 times better than remdesivir.

Instead, here’s an example this week of the type of brilliance that has generated such consistently gushing praise.  His insight into what will happen with the pandemic into the future, stated in five words.  “It potentially could get worse”.  Is that really the best value he can offer in return for his $417k/year salary?  “It potentially could get worse”.

So, to all the people who worship at the shrine of St Tony, I have a question for you.  Why?  What has he actually, personally, done to help us fight our Covid battle (and, as you consider the question, keep in mind we’re the second worst country in the world for virus case rates, and the fifth worst in terms of deaths)?

It is good to see the CDC becoming more assertive at the need to wear masks, now making them mandatory for all public transportation.

It should come as no surprise to everyone who is doubtful of the benefits of big government to learn that the EU has not done a great job of coordinating its access to vaccines.  But it might be surprising to some to see, as explained in this story, that the two heroes of the story are probably the UK, thanks in part to Brexit, and the US, thanks in part to the Operation Warp Speed plan.

While the US has had some colossal failures in its response to the virus, its handling of vaccine development and deployment – even with all the CDC vaccine management program problems, and the Biden administration’s “loss” of 20 million doses last week – is among the best in the world.

Vaccine News

Here’s a fairly heavy-going but compelling paper about the unknown risks and issues associated with the current vaccines for Covid.  The authors – all doctors – make the point that surely a higher standard of safety needs to be associated with giving something to a currently healthy person to hopefully keep them healthy, as compared to giving something to an already sick person to hopefully cure them.  But while there have been trials and studies galore proving beyond any shadow of a doubt the efficacy of ivermectin and hydroxychloroquine, these vaccine trials have incredibly small numbers of people involved.

You might think “there were tens of thousands of people in the trials” and that is true, but the focus shouldn’t be on the total people (half of whom of course didn’t get vaccines anyway – they got placebos) but rather, when trying to ascertain some of the possible effects of the vaccines, study needs to be focused on the 19 people who actually still got the virus after being vaccinated.  What happened to them?

There are many other excellent points too, and overall, it is a group of sincere doctors pointing out all the alarming things that have been overlooked or glossed over in a race to create new vaccines using untested technologies (or, worse, technologies that, whenever used in the past, have always ended up with severe problems).

Timings And Numbers

RT, RIP.  The excellent rt.live site ended its daily updating on Monday.  I’m trying to decide on a new data series to use instead.  For now, how about this :

The map, from epiforecasts.io, is hopefully self explanatory, and shows only one state (PA)with increasing rates of new virus cases.

Who Should Pay

People who are singularly blessed with the ability not to consider the real world have been advocating that passengers should be required to be tested for the virus before being allowed to fly domestically.

There are several problems with that idea.  The first is that virus testing is surprisingly unreliable, and limited only to reporting on a person’s status at the instant of the test.  It doesn’t determine if a person is “safe” to be on the flight, nor does it reliably indicate if a person might be bringing a new case of the virus to another location.

The second is that, at least at airports, and at many other places when asking for a “bonus” test for travel purposes, rather than a test formally prescribed by a doctor due to credible fear of having the virus, you can easily pay $100 – $200 for the test.  These prices are of course outrageously marked up, and we desperately need fairly priced tests (ie $10 – $20/test).  But, taking say a cost of $150 per test, would you accept the hassle of getting tested twice, and a $300 cost, in order to be able to fly roundtrip somewhere in the US?  You’ve probably close to doubled the cost of the airfare by adding on the cost of two tests.

A bonus third reason is that we probably don’t have the testing capacity.  We’re testing about 1.5 million people a day at present.  Testing all domestic passengers would add another almost 700,000 tests to that – a jump of almost 50%.

The airlines understand that very few people would welcome this added cost and unpleasantness, and so are keen to prevent the measure from becoming a reality.

Talking about expensive measures, how about Canada and its about C$2000 cost for a three day hotel stay and a virus test.

Lastly, it has been interesting to see the isolation and quarantine lengths New Zealand has to go to for arriving people from other countries in order to keep its virus case count at zero.  Or, perhaps, it is better to say it is interesting to see the problems that arise in enforcing these measures.  Some problems are medical.  Other problems are, ahem, “personal”.  Adds a whole new dimension to the concept of (un)safe sex….

Please stay happy and healthy; all going well, I’ll be back again on Thursday.

 

 

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