Machu Peach

A good amount of the discussion here is just that. We certainly have a whole sub-forum dedicated to improbable hypothetical scenarios. How much of the Hader thread is tongue-in-cheek, though, I don't know! I meant there's a lot of "concern in society about the moral and ethical effects of the choices people are currently making in real life" in this very thread, but I think you may have known that.

Think of the moral and ethical effects of such a policy. Think of other circumstances where similar logic can be applied (or misapplied). I would hope anyone would shun such a society. Would that there would be as much concern in society about the moral and ethical effects of the choices people are currently making in real life on the other people around them. I view that as more serious than an improbable tongue-in-cheek hypothetical scenario posted on a baseball message board. A good amount of the discussion here is just that.

Think of the moral and ethical effects of such a policy. Think of other circumstances where similar logic can be applied (or misapplied). I would hope anyone would shun such a society.

I don't see where Jesse Goodman, a professor of medicine and infectious diseases at Georgetown University, states the need for a larger study. Does Professor Goodman have an additional quote where he talks about study size? Am I misunderstanding your statements about needed a larger study?

Oh, I would agree completely that longer term results would be very useful to have. It becomes something of an ethical problem. Do you hold back a potentially lifesaving therapy to wait for an ideal data set? Normally a vaccine study would be followed for years before approval, but in this case that could possibly cost millions of live worldwide. However you mentioned the need for a larger study and I haven't seen that the study is underpowered. I'm not saying that the study isn't underpowered or anything (I don't have access to the data), but I haven't seen anything saying it is.

It's confusing to me how this evolved to "Masks don't protect you but do protect others." This may be debating semantics a bit, just IMO. To be fair "masks don't protect you but do protect others" seems to be a very common viewpoint and I'm in no way trying to single you out for saying so. I would say that the difference between "masks don't protect you" and "masks do protect you, just not as much" is more than semantics, but we can agree to disagree as I think everyone's thoughts are apparent. My inquiries are requests for information, there's no need to try to interpret a hidden meaning.

I've never heard of a internal review being referred to as an independent review in biotech, but maybe they do in other places (in biotech). Our major projects all have something called an External Scientific Advisory Board (ESAB). This a panel of independent experts that are not associated with the organization. I think that's pretty much the industry standard, though I don't know if it's a requirement (or even a standard) for big pharma/biotech. Peer review is the industry standard for publishing papers. It is not required for FDA review or approval. The FDA standards are usually much higher and more detailed. Why do you think it needs a larger sample size? Is it stated that the study in underpowered somewhere? An emergency use authorization would allow for public use. It is not full authorization so you'll see language like "May be effective to prevent COVID". Edit: clarity

The article states "The results, which were evaluated by an independent committee of experts..." The FDA will also review the results once they officially receive them and the FDA is free to audit the trial at any time. Yeah, I wasn't trying to disparage the results. Based on how the article was written, it sounded like the independent committee was still under Pfizer's employment. Thus the comments about other independent review. If that's the case it's pretty sleazy to call them an "independent committee of experts." Why do you think this is the case? I believe Pfizer has stated that they'll file for an FDA emergency use authorization before the end of Nov.

It's confusing to me how this evolved to "Masks don't protect you but do protect others." Generally, recent studies (October) have been favorable in both cases, with surgical/comparable cloth masks about 67% effective in protecting the wearer:https://www.nature.com/articles/d41586-020-02801-8 Thank you for the link. However this isn't a scientific study, it's just the author's opinions/thoughts occasionally supported by citations. The citation the author uses for the 67% claim doesn't seem to include the 67% claim. Am I just missing it?

The article states "The results, which were evaluated by an independent committee of experts..." The FDA will also review the results once they officially receive them and the FDA is free to audit the trial at any time. In vaccine development we'll look at people who were infected, survived, and now have sterilizing immunity. Specifically we'll look at the various components of the memory immune response and determine which components are more common in those with sterilizing immunity than those without. Often a hard cut will be identified; "anyone with a anti-spike protein IgG titer over ____ug/ml will have protection." We call this a "correlate of protection." We say it's a correlate of protection, because we can't be sure that it's actually what's causing the protection, but we know that we is present in all people with protection. Thus it's correlates with protection, but may or may not be what's causing protection. For the majority of viruses the main correlate of protection is either neutralizing or non-neutralizing antibodies. The correlates of protection for COVID are currently not well established. However we do know that people who have had COVID are (with rare exceptions) protected from reinfection (for at least a certain period of time) and we also know what their anti-COVID immunity response. Thus it was decided that for a vaccine candidate to pass from phase II to a phase II trial they had to have a log fold higher COVID-specific antibody titer than patients that had recovered from the disease. So yes, they've have been and will continue to look at the immune response generated by the vaccine. However, that's very a much secondary analysis. If a vaccine protects against the disease and is safe it's a good vaccine, even if the correlates of protect don't match. If vaccine does not protect against the disease, it's a bad vaccine even if it otherwise looks great.

When I was a kid the big slogan was "Reduce, reuse, and recycle." We were taught that the three Rs were listed in order of importance. Reduce your consumption/waste where possible. If you can't reduce, then reuse when possible, and if you can't reuse then recycle. However it seemed to me at the time that "recycle" got the most attention. I think that something similar may be happening with COVID. Masks get all the attention, however social distancing is the most important/effective. Masks to used where avoiding contact is not possible. Just like recycling doesn't make ok to be wasteful, wearing a mask does not make it ok to avoid social distancing where possible. ...at least that's what makes sense to me. I've also seen it mentioned many times that masks don't protect the wearer, but do protect others. Does anyone know of a study that looks at this? Specifically, I'm looking for a scientific study that demonstrates that 1) masks don't protect the wearer and 2) do protect others.

So I looked into it a bit more. From what I hear, the vaccine will be packaged in a temperature monitored cooler filled with dry ice at the distribution facility and then directly sent to the end user facility. Protocol says the cooler can be opened twice a day to remove vaccine and restock dry ice for a max of 15 days (I'm not sure if this if 15 days total or 15 days on top of the first 10 days). Protocol allows the vaccine to stay at 4C for up to 5 days. The current plan is to ship directly to clinics, pharmacies, and specific community vaccine centers. There's no need for a -80C freezer at any point in the distribution process and I'm not clear if they can be used where available. I'm also not 100% certain on any of that and it doesn't sound like the plans are fully finalized, so please don't hold it against me if that proves to be partially or completely wrong. I'm doing a ton of reading-between-the-lines and it's really just my best guess.

Pretty much all biomedical research labs have at least one -80C freezer. My lab has six. Back of the envelope math... If one where to assume a single dose packaging and larger vials (both very inefficient space-wise) a single -80C could hold 15,000-60,000 vials. That means my lab could hold 90,000-360,000 vials. One could add space for another 15,000-60,000 vials or so if we include our -196C storage. A -80C takes up roughly the same amount of space as a large refrigerator and requires a power outlet. They don't need any sort of special space; most labs keep them in the hallway. I can see why your standard pharmacy wouldn't have access to a -80C, but there's no reason why every hospital shouldn't have one (or be able to easily procure one). In the absolute worst case scenario one could use a camping/picnic cooler and make a trip to Walmart every 2-3 days to pick up $30 worth of dry ice and easily maintain -80C.

Mayo can store things much much colder than -70C. I assume you have a typo with "-70 F" The author is flat out wrong. I have no idea what the virologist quoted is talking about.

It looks like roughly 2% of the population of NYC, about 170,000 people, may have been COVID seropositive on March 1st. Their lockdown didn't start until March 22nd. Almost 20% of the population, 1.7 million, was COVID seropositive by mid April. Notably, NYC only has roughly 270k confirmed infections total; less than 16% of the likely total infections were actually ever detected. https://www.nature.com/articles/s41586-020-2912-6

There's also a specific physical trait that limits one's ability to produce Vitamin D via sun exposure (though it's less common in the upper midwest ). As a result I've taken a vitamin D supplement daily since moving from the sunbelt; perhaps SunnyD is a missed opportunity.

50-90% of Vitamin D is produced from sunshine exposure on skin. The rest comes from diet. Something like 3 million people in the US suffer from clinical-level vitamin D deficiency. Subclinical vitamin D deficiency is estimated to be much higher, with some estimates up to 50% of people worldwide. The main clinical symptoms of a vitamin D deficiency is bone density problems and muscle weakness. On a mechanistic level, vitamin D plays a role in several parts of the immune system, most notably immune tolerance. Vitamin D deficiency could absolutely be playing a role in COVID severity. Whether it actually does and to what extent needs more research, but I'm certainly not comfortable writing it off.

Assuming I understand your point correctly, I would argue that it's likely the oppose. Existing factors, such as obesity prevalence, don't change over a 12 month period (or even over years), so there isn't reason to assume they would have a larger impact early. Similarly, I would think the effects of a lockdown would be strongest early when disease prevalence is lowest and lockdown compliance is highest. Once the disease is ubiquitous and compliance wanes, lockdowns would likely be less effective. The data reporting issue are likely an issue, but overall I don't have a major problem with the paper's methodology or conclusions. Given the data limitations at the time I think it's quite good overall. ...and just on the chance that someone is planning on to tell me that it 'seems like' I'm arguing against lockdowns, let me be clear that I'm not making any overall statements about lockdowns either way

You wouldn't see any sign until it is accepted/published, though one should be EXTREMELY skeptical (10x so for COVID related papers) of all preprints unless the authors are very well established. I don't have a major issue with the title, though if I were a reviewer I would ask that they phrase it "_____ analysis shows full lockdown policies...". The other criticisms are quite valid. Why do you find that less than surprising?

That makes sense. Usually I hear that phrase used when referring to how two subjects interact, not three. ...though, can't they be both? Can't the restrictions be the result of COVID and the cause of business failings?

I'm confused by the subject of "Restrictions are a result, not a cause." Are you arguing that restrictions are the result, but not the cause of business failures? Or are you arguing that restrictions are the result, but not the cause of COVID? If the latter, think of it this way. COVID results in restrictions. Restrictions results in lost income and business failures. A results in B and B results in C. Therefore A results in C. ...but that doesn't mean that B doesn't result in C too.

I think your point is valid, though perhaps an overly optimistic view of society as a whole. I'd agree wholeheartedly with your view if people had drawn a conclusion based on their own review of data and reputable sources. Sadly, I believe that views on this are largely derived from what 'their side' tells them to believe/think, and subsequently how to act, and is often based on inaccurate or blatantly misleading 'reporting' on social media, cable news channels du jour, etc. I actually thing OSS has made one of the better arguments at this point that I've been presented with regarding the state of things- there's literally nothing we can do to prevent up to 45% of the population from acting in a risky, dangerous way. Are we better to just let them Darwin themselves at this point and open back up while those that take a different view duck and cover and try to avoid being collateral damage? You still have an ethical dilemma with those that have to work in the industries that can't allow people to themselves to be safe and have other people making that choice for them, but that's the only real counter-argument I have. I refuse to believe that 45% of the population are irrational lemmings. If that make me overly optimistic I am completely fine with that. I, personally, would likely be chronically unhappy if I thought that about roughly half the population.

A couple things that could be helpful to keep in mind... There's a difference between voluntary lockdowns and mandated lockdowns. Both have occurred. Region to region comparisons are difficult. Straight up, single variable comparisons (such as comparing the effects of lockdowns between two countries or states while looking at no other variables) are mostly useless from a scientific point of view. A multivariable statistical analysis could be useful, but it's difficult to acquire a good enough data set to do so. Confirmed case numbers are not a very good stat to use when comparing different regions or the same region during different time periods. Testing protocols are different everywhere and evolve over time. Mortality rate may be a better option. It's very helpful to mention what geographical area one is talking about when they make statements about viral spread. I understand that most people here are from WI and therefore are going to be highly interested in discussing WI, but for the sake of clarity it would be helpful to add "in WI" or "in the US" somewhere in statements. It's also usually not a good idea to question the motives of the person you're interacting with. The overwhelming majority of the humanity doesn't want people to die or businesses to close. Play the odds and assume you're interacting with a decent human being that has reached a different conclusion than you. ...and if it 'seems like' you're interacting with a dirtbag at least be open to the idea that you're misunderstanding their point.

Can you provide studies that show this data from reputable sources? We'd all like to see the backing of this claim. Keep waiting. For people who need facts on how lockdowns work look at Australia. The federated state of Victoria where Melbourne is has been in a long lockdown - just ended yesterday actually. Melbourne alone is almost the same size as Wisconsin. They just posted a day with ZERO new cases! They have had 50 or less daily for almost two months. Wisconsin had 5,000 plus yesterday. An island nation entering its summer season on the other side of the world probably isn't a good comp for WI.

I assume you mean 115 new cases per 100k. Is that correct?