Sunday Nite Coronavirus Meanderings

I must say it is discouraging to see so much bad science and bad interpretation of data being pushed for the obvious political reason of protecting those Governors who made horrendous, panicked decisions to shut down economies and schools.  One line of this “research” is to try to say that lockdowns saved a bazillion lives, another, not completely consistent, is that because we were too slow to respond, we killed a bunch of people we didn’t need to.  (STAT Article)   I am still waiting for the study that says if we had just delayed the lockdowns we would have saved a bunch of deaths that are occurring and will occur for years because of the lockdowns.  In any event this nonsensical article completely avoids two obvious facts.  One is that every model was premised on the notion that mitigation measures only saved lives if health care resources were over-run; otherwise deaths were just delayed.  I have not seen one report suggesting that a single death occurred in the US because of inadequate health resources.  So don’t count a single death in that category.  The second is that everywhere in the US, the true count of deaths among residents of long-term care facilities and other persons over 80 accounts for at least 70% of deaths.  Many of those people had advance directives–they didn’t want to be treated.  The average life expectancy was likely around 6 months.  So unless you are going to specifically talk about that population, I don’t know what you are talking about.  And these authors don’t talk about that, they just make some sweeping generalizations about other countries.  Complete garbage.

Here is yet more evidence that the epidemic actually began last fall and the virus was probably circulating on several continents before 2020, based on Italian sewage analysis.  (ZH Story)   Retesting of collected samples found virus residue in December.

The fear-monger, its terrible camp keeps writing stories about how the coronavirus death toll must be higher than reported, as in this NY Times story, (NY Times Story), while others try to say its exaggerated.  At this point, any deaths being reported probably had a confirmed positive test.  I don’t think there is much of an undercount.  And while I think it is a fair point that the death of a frail old person with a lot of diseases is hard to attribute to coronavirus, as long as we get accurate counts of the number of long-term care resident deaths, and the amount of pre-existing conditions, I think we all can see what the impact of this impact really is, and it isn’t in the general population.

I don’t know what to make of this.  The Ontario Civil Liberties Association must have a bee in its bonnet about mandatory mask wearing.  (Mask Study)   I think it is an exaggeration to say masks don’t work.  I don’t think they work as well as promoted, I think people ought to be given a choice about wearing them, but I also suspect that in many situations they do limit transmission.  If you are paranoid about getting infected, wear one, just don’t tell everyone else they have to do so as well.  And I am pretty sure that some day soon we will be reading stories about bad health consequences for some people from wearing masks, especially in warm weather.

Here is another mask study, this one published by the CDC and relating to influenza.  (Mask Study)   Looking at 14 randomized trials relating to hand hygiene and masks, the authors found that there was limited evidence for effectiveness in controlling transmission.  Maybe coronavirus is different, maybe not.

And speaking of transmission control, as we have noted with other research, there is no true experimental basis for 6 foot (or two meter in metric countries) social distancing, it is just completely made up.  (CEBM Study)   Lancet recently published a review purporting to support the rule, but these authors, from the Center for Evidence-based Medicine, said they could not replicate the results of the studies and pointed out other problems with the review, suggesting it should be retracted.  Ooops.

Here is a study from a group called Swiss Policy Research on the prevalence of infection.  (SPR Report)   The immunologists who led the study were examining antibodies in the blood and upper respiratory tract mucus linings.  (I just want to say again that people should also be looking for Tcell responses, given what we now know.)  They were looking at health care workers and at patients with a range of illness.  One type of antibody was more commonly found in patients with mild disease and in their mucus membranes, but that antibody is very effective against the virus.  Because most tests don’t look for this antibody, the prevalence of infection has likely been underestimated and the authors believe there may be five times more infections than reported.  They also believe the respiratory tract antibodies may explain why children don’t get infected as often.

Finally, another study in the evolving line of research finally exploring how the immune system defends us against the virus.  This should have been a first thought of epidemiologists and immunologists–that there might be cross-reactivity or general immune defenses protecting many people.  (Medrxiv Paper)   The authors first generated a set of Tcell receptors to antigens derived from the current strain of coronavirus, using 7 infected patients and five controls.  They then tested these to see if they were cross-reactive with other viruses, and found that it was cross-reactive with a common segment of influenza virus.  Yet another possibility for a source of pre-existing virus defense.