There’s a pandemic of more than just COVID-19 right now. There’s also a pandemic of pseudoscience, misinformation, disinformation, and just plain bad science. There’s also a pandemic of armchair epidemiologists confidently spouting off about infection rates and case fatality rates, people who self-assuredly say, “I’m not an epidemiologist or infectious disease expert, but…” and then proceed to make opine about the incidence, prevalence, and treatment as though they were experts. Personally, whenever anyone starts out by saying, “I’m not an infectious disease expert or epidemiologist, but…” I respond, “You should have stopped after ‘I’m not I’m not an infectious disease expert or epidemiologist.” The problem, of course, is that estimating, for example, prevalence of exposure to COVID-19 and case fatality rates is very difficult in the middle of a pandemic in which there is insufficient testing, case numbers are still climbing, and the antibody tests likely have high false positive rates, and if you don’t have any training you don’t even know what you don’t know. That applies to physicians, too, most of whom have no training in epidemiology or virology. It goes double for the Bakerfield duo who’ve become the darlings of Fox News and COVID-19 deniers, Drs. Dan Erickson and Dr. Artin Massihi. Their toxic Dunning-Kruger ignorance is spreading via news stories like California urgent care doctor questions stay-at-home orders: ‘You can get to herd immunity without a vaccine’, Tucker Carlson: New Evidence Means The Coronavirus Far Less Deadly Than We Were Told, and Frontline doctors who administered 5,000 coronavirus tests want to reopen, say COVID-19 similar to flu, all based on this video, originally posted featuring Drs. Erickson and Massihi a week ago or so:
The original 52 minute video was removed from YouTube for violating its terms of service, but unfortunately you can find it everywhere, even elsewhere on YouTube, plus this 12 minute part 2:
Based on their “study” Drs. Erickson and Massihi have found themselves falsely elevated to the status of “experts” in the right wing COVID-19 denying crankosphere. They are in fact pseudoexperts. For one thing, from what I’ve been able to tell, although Dr. Massihi is a board-certified in emergency medicine, Dr. Erickson, who does all the talking in the first video, can’t even be viewed as an expert in emergency medicine, as he appears not to be board-certified in it based on my searches. For purposes of discussing epidemiology, it doesn’t really matter if Drs. Erickson or Massihi are boarded in emergency medicine anyway. In fact, Erickson and Massihi’s video, it turns out, is a slick mix of statements, made by doctors in that are mostly true mixed with misinformation and bad science thrown together to give a message that is probably true (COVID-19 likely has a case fatality rate considerably lower than estimates made early in the pandemic) but exaggerated (it’s as low as influenza), all in service of a political message (“we should reopen America because COVID-19 is not that dangerous”).
Erickson starts out by describing how the focus on COVID-19 means that a lot of people with other medical problems, such as heart attacks and the like, are afraid to come to the hospital (or their urgent care clinics) and may be dying at home or recovering without treatment that might have minimized the damage. This is true. Erickson also notes that we should quarantine the sick and not the people who are well, which is, of course, the way we will eventually have to remove the restrictions, while dismissing the current approach of in essence “quarantining” everyone with shelter-in-place orders as overkill. The problem is that to be able to quarantine the sick and allow the well to go about their business with lesser restrictions, we need accurate testing, a lot more accurate testing. Absent a lot of testing, and the robust ability to trace the contacts of those identified as having COVID-19, the only option was the one that most nations and most states in the US chose: Shelter-in-place orders of varying strictness. While Erickson is correct that a more targeted approach to quarantine is desirable, he barely mentions what is needed to achieve that.
At this point, Erickson states that Accelerated Urgent Care centers have tested 5,213 people and that 340 of them were positive, which he characterizes as “6.5% of the population” of the Central Valley in California, their cachement area around Bakersfield. He then mentions that 12% of the tests in California were positive and 39% in New York were positive, after which they make a really brain dead extrapolation. Based on California’s population of 39 million people, if 12% tested positive then 4.5 million people in California might have had COVID-19. This is, of course, utter nonsense. Similarly, Erickson extrapolates from his observation that 6.5% of their COVID-19 tests were positive that 6.5% of the people in Bakersfield have or have had COVID-19; i.e., about 58,000 cases, far more than the 700 confirmed cases in the area thus far. He then makes the argument that hospitalization and case fatality rates should be based on these numbers, estimating the COVID-19 case fatality rate to be around 0.02%, arguing that it’s five times less lethal than the 0.1% case fatality rate due to the flu. There is no facepalm large enough for this boneheaded claim, but this one comes close:
Finally, based on the “analysis” by himself and Dr. Massihi, Erickson identifies a number of economic and political implications, the most prominent of which is, unsurprisingly, echo the COVID-19 diminishment and denial machine’s call to “reopen America” based on the argument that the shutdown is doing more harm than good. (They also make a really brain dead claim about the harm shelter-in-place is supposedly doing to our health. More on that later.)
Perhaps the best deconstruction of this particular claim can be found here:
The point is that the assumption that the population served by these doctors’ urgent care centers is representative of the general population. As I said, this is Epidemiology 101 stuff, a mistake so egregious that it isn’t even worthy of being called a rookie mistake. I’ll quote Dr. Kasten fairly extensively:
Their fatal, immediate, obvious, rookie mistake is that their 5213 people are in NO WAY REPRESENTATIVE of the population at large. Although we don’t know how many (because the data was not that thorough)- we can assume a decent chunk of these people had symptoms of COVID, sought care, and were tested. Their urgent cares had the lion’s share of COVID tests for the entire Central Valley (which is awesome). So ANYONE in Bakersfield who felt worried would go there. Presumably doctors referred patients there whom they felt needed testing.
Walk around an ER on a Friday night. If 4 out of 50 patients had broken legs, and another 10 had heart attacks, you can’t assume 8% of the city fell off a ladder when drunk that night and a full quarter were clutching their chest in an armchair as we speak. In epidemiology terms, that’s selection bias- bias introduced by a non-random sample.
So, essentially their calculations are entirely invalid. If they could somehow prove that the 5213 were an entirely random sample of people which was perfectly representative of the age, sex, pre-existing conditions, ethnic background and degree of symptomatology of the Central Valley, that would be different.
Characterizing their mistake as a “rookie mistake” is too generous.
Echoing this analysis is Michael Falk:
This kind of thought process would be like I run an emergency room and tonight 10% of the people have a stroke. Then I extrapolate that to mean that 10% of the world is having a stroke tonight. That’s obviously ludicrous. The sample of people coming to the ER is not representative of the entire population.
What is the selection bias? Who comes to urgent care clinics and get a COVID-19 test? Obviously, it’s those who were worried that they had been exposed to COVID-19 or who had COVID-like symptoms, such as cough, fever, and shortness of breath. Far more of their patients at their urgent care centers would be likely to have COVID-19 than the general population. We also don’t know the time frame during which they were doing these tests; so the percentage of the population with COVID-19 could have been rapidly increasing. Someone also pointed this out to me:
Which linked to this video from March 17, in which they announced that, having opened three new locations, their Accelerated Urgent Care centers would begin testing for COVID-19 because they had procured a lot of tests.
This TV news report could easily have spurred anyone with symptoms or concerned that they had been exposed to someone with COVID-19 to head on over to an Accelerated Urgent Care center location to be evaluated and tested. And guess what? In that video, they state that only symptomatic patients would be tested. Is it any wonder that they observed a high percentage of COVID-19 positive tests?
There are a number of other flagrant errors of science in the video, too. For instance, Erickson claims to have looked at the numbers in Sweden (at the time, with 1,765 deaths) compared to Norway (182 deaths) and claimed that this was statistically insignificant. As Michael Falk pointed out, that’s BS. Clearly, Drs. Erickson and Massihi are not statisticians, either. Erickson repeatedly claim to be “following the science.” What they’re doing is cherry picking and misanalyzing the science in order, in essence, to lie with statistics.
There are a number of other nonsense claims, such as dismissing academic physicians as not having seen a patient in 20 years. This, too, is utter nonsense and betrays an ignorance of the current state of academic medicine. The MD who can support himself through research grants alone has become so rare as to be an endangered species these days. Nearly every academic physician must bring in a certai amount of clinical revenue, their clinical productivity judged by a measure known as RVUs (Google it if you’re curious; for purposes of this post how RVUs are calculated doesn’t matter). If their RVUs are too low, their salary goes down. If they generate a lot of RVUs, they get bonuses. Indeed, if these “entrepreneurs” knew academic medicine, they’d know that the dependence on RVUs has made it very difficult for academic physicians to find the time to do research. Similarly, Erickson claims that “no one” does in-house testing. Actually, almost every major hospital now does in-house testing. The hospitals where I have privileges have been doing in-house testing at least three weeks now, for instance, and were doing it when this video first dropped.
The part at around 18 minutes is where this not-so-dynamic duo talk about the supposedly harmful effects of quarantine. Guess what? Like a quack, Erickson claims that it harms the immune system to shelter in place. Particularly amusing is the part where hes brag about all the experience and study in microbiology and immunology that he and Dr. Massihi have. As far as I can tell, though, they haven’t done any study beyond what a typical medical student would undertake in those areas, which means that they likely know as much as the average doctor about these topics, nothing more. That is not true “expertise.”
In any event, Dr. Erickson goes on about how the immune system develops through exposure to antigens. That is, of course, true. I’ve spoken about “immune amnesia” caused by the measles virus, wherein the measles virus erases a subset of memory cells providing immunity to antigens previously encountered, partially “resetting” the immune system so that it no longer has immunity to some previously encountered antigens. So, yes, exposure to antigens is important. Invoking “Immunology and Microbiology 101,” Erickson then goes on to claim that staying at home is bad for the immune system because one doesn’t encounter enough antigens. Too bad it’s also “Immunology and Microbiology 101” that there are trillions of bacteria in your home and yard. As Falk puts it:
Unless you live inside a bubble, your home and your yard have TRILLIONS of pathogens. No amount of lysol and handwashing is going to remove pathogens that you breathe in and touch all the time. Your own mouth has billions of microbes. Your skin is teeming with microbes. Fungal spores and viruses in the air. Your immune system will 100% not be weaker by being at home. Your immune system might get weaker if you stay home, don’t exercise and eat candy all day but the fact of being home in an of itself will not harm your immune system.
I’ll also quote Dr. Kasten, because I love her all-caps line:
UNLESS YOU LIVE INSIDE AN AUTOCLAVE, YOUR HOME IS PLENTY PATHOGEN-RICH
The world is absolutely teeming with microbes. You’re coated in them, your house is coated in them, they enter your body with every breath you take and everything you eat. Your immune system is getting a perfectly adequate workout. You’re just restricting your exposure to a handful of things (respiratory pathogens) for a very short period of time.
I’d add that, even an autoclave can be a place where pathogens grow when it hasn’t been used in a day or two. Seriously, Erickson and Massihi don’t understand even “Immunology and Microbiology 101.”
There’s a lot of other nonsense in the video, so much so that I skipped over some parts. For instance, Erickson claims that doctors are being pressured to add COVID-19 to diagnoses, implying that we’re overcounting COVID-19 cases. In fact, the evidence is very strong that, due to insufficient testing, we’re undercounting cases and deaths due to COVID-19. Indeed, all-cause mortality statistics rose dramatically during the early weeks of the pandemic, suggesting a lot of excess deaths beyond what is normally expected at the same time of year, very likely the majority from COVID-19, that aren’t showing up in the statistics. In fact, case and death counts have likely been undercounted by quite a lot.
Then there’s Erickson’s claim that COVID-19 doesn’t kill people, but rather their pre-existing conditions do. At that point, I wondered: Is this guy really a physician? How can he be so obtuse? Of course, pre-existing comorbidities and age increase one’s risk of developing severe disease and dying from COVID-19, but COVID-19 has also killed young otherwise healthy people without significant comorbidities.
I could go on, but why bother? These are the key pieces of misinformation promulgated in this video. I can’t help but note, however, that Dr. Massihi, at least, appears to be a big fan of President Trump:
I also noted that Massihi also had at least one video by antivaccine leader Del Bigtree posted on his Facebook page, but he appears to have either deleted the post or made its access not public. Meanwhile, both have been appearing all over Fox News and right wing media sites pushing their bad science:
Amusingly, this not-so-dynamic duo of armchair epidemiologists always appear wearing scrubs emblazoned with the logo of their urgent care centers. In this, they remind me of Dr. Mehmet Oz, who always used to show up on Oprah’s TV show in scrubs, or Dr. Travis Stork, who frequently wears scrubs in his role as part of the panel on The Doctors, dressing up in a way that screams, “I’m a doctor! I have authority! Listen to me!” It’s a costume—and, make no mistake, for purposes of TV, wearing scrubs is a costume, even for doctors—that I frequently laugh at.
Meanwhile, the American College of Emergency Physicians and the American Academy of Emergency Medicine issued a devastating statement:
The American College of Emergency Physicians and the American Academy of Emergency Medicine provided a scathing rebuke of comments made last week by Accelerated Urgent Care Drs. Daniel Erickson and Artin Messihi.
The statement, in part, says, “As owners of local urgent care clinics, it appears these two individuals are releasing biased, non-peer reviewed data to advance their personal financial interests without regard for the public’s health.”
“COVID-19 misinformation is widespread and dangerous,” it continues. “Members of ACEP and AAEM are first-hand witnesses to the human toll that COVID-19 is taking on our communities. ACEP and AAEM strongly advise against using any statements of Drs. Erickson and Messihi as a basis for policy and decision making.”
The full statement is here.
I’ll conclude by quoting something that Dr. Erickson said that I actually agree with, “It takes work to understand this stuff.” It absolutely does take work to understand this stuff. The reason Drs. Erickson and Massihi owe me another irony meter is because they clearly haven’t done the work necessary to “understand this stuff.” Instead, as I said above, they’re fake experts, armchair epidemiologists who don’t even know enough to know what they don’t know. None of that has stopped them from being embraced by political forces that very much like their message and see their fake “results” as evidence that they can use to promote that message. Unsurprisingly, Drs. Erickson and Massihi appear to be very much enjoying their 15 minutes of fame and using it to promote their business and brand.
ADDENDUM (4/29/2020): I apparently misattributed Michael Falk’s post. He was quoting someone named Steve Lee, whose original post is here.
ADDENDUM #2 (4/30/2020): I see that over the past couple of days this post has resulted in a traffic to this blog 10-12X higher compared to the usual traffic this blog draws on an average Tuesday and Wednesday, as well as an influx of new commenters, some of whom appear to be Dr. Erickson and Dr. Massahi fans and/or people who take issue with what I wrote in this post. So I thought I’d just say a word to the newbies commenting about how things work around here.
If you’ve never commented on this blog, your first comment will automatically go to moderation. After I release the first comment, you can comment freely without moderation before the comment goes live. (After the comment is posted is another matter.) The reason for this feature is to cut down on comment spam. So, no, you’re not being “censored,” and if it’s several hours between your first attempt at commenting and your comment appearing on the blog, it’s usually because I was busy working or sleeping. If you’re interested, here is my comment policy.
435 replies on “Drs. Dan Erickson and Artin Massihi: Promoting dangerously bogus pseudo-epidemiology about COVID-19”
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Admit it Jacky you’re just jealous!
Why would I be envious of a couple of grifting fools?
they are doctors and you’re a weeb? did you go to school for PR ? I bet you replied to that ad “[email protected] $ 5-0-0!! A DA!Y FR0M H0m3”
Well, Charlie, if I were you I should try to find out who Orac is, which is the worst kept secret on the internet. If you can’t find this out on your own, I consider you the ignorant one
Oddly enough, commenter “mike” had the same problem today.
These doctors are clearly microbiologists with a lot of experience. they stated facts based on their own research. Nothing they said was dangerous nor fake. We all go to the store and buy stuff. What is the difference between going to Costco and interacting with people and things, but you can’t go to the beach. Makes no sense. As they say, something else is going on here. Fear is what you are promoting. Not facts, just fear. You have an underlying agenda. they don’t.
They’re doctors who run a chain of urgent care clinics in Bakersfield. One of them isn’t even board certified in emergency medicine. They are not microbiologists. They are not epidemiologists. They have no relevant qualifications.???♂️
Does charlie know what a weeb is? Does Orac like anime?
Costco is a place to go to buy food. Humans need food to live.
The beach is a place to go to get sand in your shorts. Humans do not need sand in their shorts to live.
I’m with Gary Hemminger on this one. They should not be closing off outdoor spaces. Part of the crowding problem is that other nearby beaches may still be closed. It is the same here with the beer store. They shut down the state-controlled ‘liquor’ stores but not the Windmills — Tons of unmasked old, nasty Jim Beamers and Coors lighters coming in from three counties around.
Shouldn’t it be enough to enforce face coverings, small groups or minimum distances out in the open? Use drones to get in peoples’ faces and chastise them like in they did in China, or something. Oh, yea: How many realize that there are 15 states in ‘merica where face coverings are outlawed? Facial recognition doesn’t work? Can’t tell if the guy is black so cops don’t know who to shoot at a traffic stop?
This spotty draconian stay inside stuff is just creating scenes like this “everybody cough in my face! Do it!”
Beats Michelob Ultra (my host was given a sack of this sort of stuff from a former client).
Well, there are ‘niches’ Narad. Michelob fits in the InBev niche. I’m sure that it is not the nastiest in that class; Maybe even vying for tops in the sweat-flavored piss style offerings.
I don’t remember which comedian said it but “amongst construction materials, concrete is favored as a dessert topping”.
why would you eat your own children because you disagree with medical opinions in a community not relevant to your own? and since we’re on the subject of “not experts” where do your two columns on immunity, and editorial license give you free reign to libel over a press conference?
to be more specific. the “facts” in question and the context you spew here are just as half cocked. no point in having a discussion that is Aspberger’s AF over what appears to be your issue with doctors advertising. It’s clear your line of patients and who gets tested is way better.
“Shouldn’t it be enough to enforce face coverings, small groups or minimum distances out in the open?”
I have no idea. I’ll go ask an actual expert.
I don’t spent lot of time on beaches, but my little experience and pictures seem to indicate that beaches can be a bit crowded in Summer time, regardless of how many are available. They are like shelves in your flat. You can have as many as you want, they will always end up fully packed.
Also, a difference between Costco and beaches is that most people don’t feel like making new acquaintances while shopping.
So you’re saying injecting bleach isn’t good for you? WTF??? So many mixed messages.
Don’t you EVERuse Asperger’s as an epithet you obnoxious prick!
Someone diagnosed as Asperger’s over 20 years ago.
Oh, I missed this one yesterday. Is the tally up to five who can’t figure out the worst-kept secret now?
Just curious is orac a microbiologist virologist or epidemiologist?
Cameron says: “Just curious is orac a microbiologist virologist or epidemiologist?”
Just curious… has Cameron bothered to check the menu options at the top of this page? Especially the link that starts with “Who is..”
Because they were right according to CDC numbers, May 22, 2020.
Except that the CDC model has been widely criticized as being way too optimistic. As one epidemiologist pointed out. For that estimate or be accurate, everyone in NYC would have to have been infected to have seen the number of deaths the city’s seen so far.?
Dear boy, Orac ( and many of his followers) studied medicine, life science, psychology and yes, subjects that explain how PR and advertising work as well as how charlatans operate. In fact, that last one is our hobby. If he ( or many of us) wanted to bilk people with phony treatments. products or counselling: we could as we know the ropes. But we instead choose to expose how these prevaricators fool clients. IN DETAIL.
Yep, I’d be rich, rich, rich if I lacked a conscience.
With this video it’s actually a lot of work to get to the errors in the arena of microbiology/immunology. Along the way you have to slog through a crapload of basic statistical errors, that even students in non-medical fields would be able to spot right away if they’d had Stats 101. I’ll let the medically trained folks comment on the medical science issues. But, as someone who has taken quite a few statistics classes en route to the Biology Ph.D., these 2 urgent care clinic operators are just plain lousy at statistics and sampling design. I mean, REALLY lousy.
Yep. Fortunately, I wrote about them last week. https://www.respectfulinsolence.com/2020/04/28/erickson-massihi-bogus-epidemiology-covid-19/
Yep, you’re a right charlie, charlie.
Damn, you’re making me feel old. I thought that expression had passed into the mists of time several decades ago. Next you’ll tell me that jackanapes has been revived and is all the rage.
Priceless article. The author states more testing is needed to get the actual numbers, but outright dismisses doctors presenting their data and professional conclusion. The part where the author dismisses their extrapolation based on their data and New York’s data by stating “This is, of course, utter nonsense.” The author makes a conclusion after he/she states we need more testing, but presents an opinion without any data. The author even fails to mention other data sets that suggest the Kern County data may be supported by the New York state data, Santa Clara and Los Angeles County data. The author is doing the same thing. Just complaining. As a scientist, you present no new data and only opine. If you do NOT have your own controlled experimental data to refute their data, perhaps you should not armchair quarterback and follow your own advice…“You should have stopped after ‘I’m not I’m not an infectious disease expert or epidemiologist.” with actual data of my own, just opinion. (You know what they say about opinions) That’s actually how peer reviewed science works.
Sorry Banter Jackson – your view on how peer reviewed science work is plainly wrong. Have you ever done it? Peer reviewing scientific work is never about presenting data of your own – it is about picking apart the data and methods in the work you are reviewing. If the conclusions drawn don’t add up from the data and methods presented, they cannot merit full scientific value. As a one-time pretty busy reviewer for a handful of journals I feel pretty confident in stating that scientific peer review is a lot about opinions – opinions on whether data and methods use gives enough support for the conclusion. Almost exactly as in the blog post at hand…
Mr Jackson, why wouldn’t you go to a covid ward in a hospital, test everyone in it and extrapolate general population infection rates from the results?
That would be like going to a cardiac ICU, testing those patients, and extrapolating results about cardiac disease for the general population. ? Would you want guidelines about whether or not we should all get to eat red meat extrapolated from the data collected and findings extrapolated from this very biased test group? Would you want two vegan cardiologist “experts” who have personal financial conflicts of interest in charge of this study and the resulting recommendations?
That is exactly what NumberWang wants. She/He/Some infinitum of gender identities is fooling you and you don’t like it.
Banter Jackson, it’s clear you have no clue what you are talking about. As someone who is rather adept at statistics and have taught such at undergrad level, it is clear that they have no clue what they are doing. Due to the extreme shortage of tests in the US, only the sick have been tested. To get proper numbers EVERYONE has to be tested!!!!!
Orac HAS brought forward a lot of information – statistics is not as easy as counting 1,2,3. Technique is also very relevant. You have to know how to count to get the proper numbers and rates, how to watch for things that mask the true causes, which he has mentioned. For instance, no one actually dies from cancer per se – cancer doesn’t do the killing. What it does is damage the body so other disease processes can do the actual killing – things like blood clots, and strokes. COVID-19 does the exact same thing, it damages the body’s ability do processes required for life by causing blood clot cascades and severe respiratory distress. As an example, my own mother died from blood clotting caused by her 15 year fight with breast cancer. Her death certificate states cancer as a direct cause of her death. Erickson and Massihi would say my mother’s death was not due to the cancer processes that triggered the clots. The truth is death by COVID-19 IS UNDERCOUNTED.
The two doctors are only worried about their return on investment, having expended large amounts of cash to open up 3 clinics that now are not seeing nearly enough patience to cover the rent. BTW, who were my worse students in my stats classes – Pre-meds, because they didn’t want to understand, They only cared about getting the grades to get into med school. Erickson and Massihi fit that bill perfectly.
Ha ha… you feekin’ hot shots are a riot!
Truth? Do YOU KNOW the truth? God rot it, you DON’T, you poser!
The Major inference to be made by all the number diddling, and posturing by supposed experts and politicians is that NO ONE KNOWS the truth, but all have grabbed the tiger, and are fighting to hold on….
The author of this has forgotten that the CDC’s numbers cannot be trusted, the WHO’s numbers cannot be trusted, China’s numbers etc.
These two ER docs suppositions are as good as anyone else’s. And before you go off… the ‘fact’ pool is so contaminated that even MY suppositions are damn near as good! 🙂 🙂 :))
any peer reviews of the statements made by these “urgent care” bozos would be greatly appreciated. But wait bozos are their peers I guess that wouldn’t work either, I mean to get to anything really scientific!
Maybe in our dysfunctional, fragmented, for-profit health care system, by ending physical distancing, they may simply be drumming up business? After all, emergency physicians are usually the first to treat potential COVID-19 cases.
Check out: Elizabeth Rosenthal’s “An American Sickness.” Book details just how much, even more than I imagined, our health care system prioritizes profits over people. Extensive footnotes.
They don’t actually care. A slice of Glaxo’s 100 billion dollar PR campaign this year goes to these goofballs when they post
You should check what a billion dollar means. Glaxo’s revenues are less than 100 billion
Be a good boy and get on to the accounts department, being as you seem to be so well informed about these things, and chivvy them to send my cheques on, will you?
Ta very muchly, ‘cos I’m not going to carry on this shill-ing for nowt.
As with all science. You cannot extrapolate facts from the opinion of one (or two) professional in the field. You have to take into account the collective scientific consensus on a topic. Most doctors with the same or similar credentials as these two do not agree with them. Just like we don’t have 100% consensus on climate change.
A. I haven’t been able to find a Dan Erickson, with that spelling licensed in California as a physician. There’s a Daniel Erikson – spelled differently – whose license was cancelled.
B. Just as a point of interest, in public health law we teach the distinction between isolation and quarantine as being that we isolate people who are infected; quarantine is for people who are healthy but have been exposed. There’s actually a meaningful legal difference: people who are isolated (and sick) are entitled to medical treatment. Just as a point of interest.
California has a separate board for D.O.’s. License 20A9426, NPI 1982787412.
Ah, thank you!
Also, searching the board certification website, I see that Dr. Massihi is board certified in emergency medicine, while Dr. Erickson is not and is apparently not board certified in any specialty.
Thank you for your article.
“The point is that the assumption that the population served by these doctors’ urgent care centers is representative of the general population. As I said, this is Epidemiology 101 stuff, a mistake so egregious that it isn’t even worthy of being called a rookie mistake.”
Always said so. The trick is that it also goes the other way round: it is not because a syndrome is rare, even relative to other syndromes or diseases, that it automatically implies that the prevalence or burden in a hospital setting is proportionate to this rate, even comparatively to other syndromes or diseases. My 2 cents.
I am a statistician. What these doctors did from an extrapolation standpoint if fine. If they got 3-4% of a random sample with the disease, then it is fine statistically to then extrapolate this to the population of the target area. That is fine statistically. Nothing wrong with that. It is like a poll. It has a % of error based on the sample size. But to say this is wrong statistically shows no understanding of statistics. I would say that it is likely someone that makes this claims has no experience in statistics or mathematics.
I call bullshit on you being a statistician, because a qualified statistician would realize that you can’t accurately extrapolate from a biased sample. Even if you are a statistician you’re not an epidemiologist. ?
If this person read the post he would realize that this is not a representative sample.
… And yet MSNBC, CNN, take a sampling from their viewers in a poll….. You trust polls?
Because polling is done with representative samples, following established methodology…something these “doctors” appear to know little to nothing about.
“… And yet MSNBC, CNN, take a sampling from their viewers in a poll….. You trust polls?”
Do you understand anything about sampling and/or polling? I’m guessing not.
How do they report a biased sample if they reported everyone who was tested? You okay? ?♂️
The sample is not representative of the general population; so it doesn’t matter if they reported every test. Their results are not generalizable. ???♂️
As explained in the post, people going to urgent care to be tested are not the general population – these are people that have grounds to think they may have COVID-19, because of symptoms or exposure.
So they are likely to have higher rates than in the general population.
Well, they didn’t, so I guess that takes care of that.
@ Gary Hamminger
“If they got 3-4% of a random sample with the disease”
Did I read the word “if”?
Even television news informs us that the recent estimates of positive Covid antibodies in NYC/ NY state were acquired only from people who went grocery shopping THEREFORE not everyone- not a representative sample
pandorasbox:~ asshole$ racket
Welcome to Racket v7.6.
Yep. It was a conditional statement. Glad I figured this one out… Phew!
Dorit is absolutely right, it isn’t a representative sample, Statistics is only as good as the accuracy and source of the data.
@ Gary Hemminger @ Joel
Meet the Cramér-Rao bound.
It isn’t clear why you bring up that lower bound absent — I’m not sure how you think it applies here, without any details on your thoughts.
In a bayesian context, it makes sense. There is a bayesian version of the Cramér-Rao bound. And while too specific a statement I made, it does convey the message in the presence of unreliable data.
The statement does not fully apply here, but the underlying reality it conveys is the right one. Maybe I’ve gone down the rabbit hole of trying to adapt information geometry to a bayesian context, but the key concept of information geometry is Fisher’s metric, of which the Cramér-Rao bound is a byproduct.
Joel’s statement was: “Statistics is only as good as the accuracy and source of the data.” The Cramér-Rao bound in an inferential context assumes accuracy of the data and gives a bound on the accuracy of estimators. Bayesian statistics allow you to reason in the context where you allow yourself to probabilise the accuracy of the source data itself (probabilities on the prior knowledge you have, including the accuracy of the source). But in essence, the same idea underlying Cramér-Rao’s bound can be developed.
The Cramér-Rao bound in an inferential context assumes accuracy of the data and gives a bound on the accuracy of estimators.
I am aware of what it is, and its limitations: it only applies to unbiased estimators and is linked to the Fisher Information of the modeled (assumed) distribution.
So it doesn’t seem to me to have any link to the discussion here without a lot more context.
“it only applies to unbiased estimators”
“The Cramér–Rao bound can also be used to bound the variance of biased estimators of given bias. In some cases, a biased approach can result in both a variance and a mean squared error that are below the unbiased Cramér–Rao lower bound; see estimator bias.” — Wikipedia
Ok, there’s the word “given” in “given bias”, but still, bias can be incorporated into the bound.
“linked to the Fisher Information of the modeled (assumed) distribution.”
That’s why I specified “bayesian” in the subsequent post. I’d rather use three words than long periphrases to highlight an idea.
“So it doesn’t seem to me to have any link to the discussion here without a lot more context.”
The link is that if there’s one result about the accuracy of statistical accuracy and its limitations, it’s that one. Then it can be declined in other contexts. One shouldn’t be afraid of highlighting an idea through it’s archetypal example on the grounds that the context doesn’t entirely fit with the historical formulation. If we were, we would never be able to generalize any mathematical result because of an enduring orthodoxy of interpretation. And that’s the kind of things I like to do in my spare time.
Two men were on a balloon once and got lost. They yelled down to a guy on the ground and asked him where they were. He yelled back that they were in a balloon. The guy on the ground was a statistician, clearly. His answer, while correct, was useless and lacked context to solve the problem at hand.
No, it is not fine to “extrapolate” anything. There is selection bias. There is surveillance bias. There are other biases at hand. I suggest you drop the statistician act.
Sincerely, an epidemiologist/biostatistician.
lol!! no extrapolation modelling allowed!
Oh, I’m pretty sure that it is, vis-à-vis the next thing that’s likely to spurt from your keyboard.
“He yelled back that they were in a balloon. ”
The way I heard it, the guys in the balloon knew instantly that they were by the Microsoft building as the answer was 100% correct and totally useless.
I think I’ve heard variations of that joke a hundred times. We old people remember it being IBM.
In the version I know……
……you must be an engineer.
I am. How did you know?
Because every thing you told me is technically correct but, at the same time, no use at all.
You must be in management.
I am, how did you know?
You got in this situation by way of massive amounts of hot air and no forethought but now its somehow my fault.
@ René F. Najera, DrPH
I love your comment about statistical and balloon.
The rest of your comment makes a lie of that statement. People presenting at urgent care clinics are not a random sample of the population.
But it is not a random sample based on the discussion in the article. That is the point.
You’re either lying about being a statistician or you’re not a very good one. You absolutely can’t extrapolate their “data” to the general population. The BEST you could do would be to extrapolate it to those showing symptoms suspicious for COVID-19. You know, that PART of the population which is similar to the patients in their sample. To do otherwise would be wrong. To do otherwise with an agenda would be purposefully misleading.
It’s not a random sample. It’s a sample of symptomatic individuals.
I don’t believe your statistical credentials claim gary: did you see how poorly the “sample” was obtained? There is nothing reliable to learn from it.
Saying it is perfectly fine to generalize from it shows no understanding of the way proper statistics is done. My sophomores would know better.
@charlie; The entire sample size was 3000 people for the entire state of New York. There are individual apartment buildings in New York City that house more than 3000 people. The sample wasn’t representative of New York State by age, race, social habits, socioeconomic status,or any other criteria other than they were at grocery stores. What about the people who get their food from Peapod or DoorDash?
We’ve had drive-up testing for a while, but who tests the people that don’t drive?
No way are you a statistician.
I am a statistician
And I am Marie of Romania.
The Medical Board of California should take a closer look at their licenses. It’s not just the glaring dilettantism these guys exhibit – the Hippocratic Oath is also violated.
“Remember your hippopotamus oath!” — Homer Simpson
I commented on Orac a lot on the old days; with the current crisis you may hear more from me from time to time. Orac is a wonderful resource in this crisis, because he knows and understands a whole lot of relevant stuff.
Well, just as I was cutting eye-holes in a new paper bag to put over my head that link to the ACEP-AAEM statement about these two pseudo-epidemiologists really, really impressed me! I forwarded the link to my State’s AAP representative in the vain hope that it provides an example of what responsible medical specialty governing groups can do to members that spread dangerous misinformation. Here’s looking at you, Dr Bob.
Maybe I’ll send paper bags to the Dean’s of The College Of Osteopathic Medicine Of The Pacific (Erickson) and Loma Linda University School of Medicine (Massihi); I’m sure those Deans can use the bags right about now…
There has always got to be that one guy; And today it is was Mike Meme Man Face Pence.
Did he really have to fake ask the question? Isn’t it clear and he is flaunting it? I would really like him to roll up his sleeves (and probably by this point, his socks to get a look at those destroyed herculean veins of his — He likely doses dinurally, like a vampire, because his body has yet to be trained on making those anti bodies itself. Otherwise, how is it possible for #2 to just not have any fucks to give and defy his own panel’s recommendations?
It seems that Mr. “I don’t have to show you any stinkin’ mask” Pence (according to https://www.bbc.com/news/world-us-canada-52465172) is protected by being tested regularly, as well as those around him. I guess there must be no chance of his either picking up or passing along any infection, then. It’s good to know that is able to get such great access to great healthcare and doesn’t feel like he needs to worry or even pretend to set an example. Nothing like having privileges.
It appears to me that he didn’t wear a mask because the “president’ doesn’t wear one. Whatever Trump does or doesn’t, there’s Mike Pence doing or not doing right along with him.
Trump: “What kind of sycophant are you, Mike?”
Pence: “What kind of sycophant do you want me to be?”
I’m not 100% sure, because English isn’t my first language, but if I understood properly what he said there is one more problem in their logic.
He took the number of fatalities in given population and divided it by this population size. Thus he calculated mortality.
Then he took this number and said that it is the chanse of dying if you will get covid-19.
So he has interpreted mortality ratio like if it was case fatality ratio.
Am I right?
Or I missheard what he said?
Thanks for doing this, Orac.
I’m back to my old ways of doing roundup posts on my blog. You can find it here:
[…] Dr. Dan Erickson and Artin Massihi: Promoting dangerously bogus pseudo-epidemiology about COVID-19 […]
Dr. Erickson goes on about how the immune system develops through exposure to antigens
So the immune system is a kind of muscle? It gets stronger if you exercise it, and goes all floppy otherwise?
Dr Erickson needs to exercise his brain more; it has gone weak from disuse.
@ Smut Clyde
The immune system doesn’t get “stronger”; but the acquired/adapted immune system, B-cells and T-cells, do develop memory cells to the specific antigens we are exposed to so that upon re-exposure, instead of taking 2 – 3 weeks to rev up to full strength for repelling an invader, the memory cells can both rev the system up super fast and at a higher level. In many case, resulting in stopping an invader cold before we even experience symptoms.
Though I’ve read several 850 page undergraduate immunology texts, audited courses, and read almost every article for past 30 years on immune system in Scientific American, the best book that I always recommend is only 160 pages, well-written and easy to understand: Lauren Sompayrac’s “How the Immune System Works” now in 6th edition. I’ve bought and read every edition. Just got the 6th edition.
The point here is that in Erickson’s magical thinking, developing immunity to antigens (and pathogens) A and B means that your immune system will respond more rapidly to unrelated pathogen X.
Thanks for the reading tip.
“Dr. Erickson goes on about how the immune system develops through exposure to antigens…”
This is one of the favorite arguments of the anti-vaxxers. If those kids had just been exposed to measles, they wouldn’t have contracted measles.
@John, wrong. A we select against pathogens, then only the remaining successful pathogens propagate, so essentially we drive their evolution. They constantly become more lethal. So if you do not gain immunity to the current ones, you ARE more likely to die later from MORE lethal ones. If you were to be kept in a bubble as a child, you would never be able to leave it. You would quickly die if you left the bubble as an adult. But that is NOT an argument against vaccinations at all. Vaccinations are the equivalent to getting the disease. The argument against vaccinations containing mercury or eggs is when some children have allergies to mercury or eggs, and mercury and eggs to not have to be used.
Apparently, the marlaria-causing Plasmodium spp. didn’t get the memo.
It depends how you apply the selective pressure. Preventative measures tend to select for more sneaky and less lethal germs. In part, because they don’t draw out attention so we don’t devise antibiotics and vaccines against them. Or simply, because we don’t put the diseased in isolation.
The more lethal a germ is, the less time it has to propagate. Because, obviously, once the host is not mobile anymore, the germ will have some troubles getting to new hosts.
Conversely, a germ with rarely-lethal side-effects can piggy-back and take its time to jump from host to host.
Last time I checked, we are not all dead from Ebola or some super-polio/super-measles.
Thank you Doctor.
This morning in the comments on an article on the CBC website, someone actually directly said that the immune system is like muscle and needs exercise to keep is strong. He is an anti-vaxxxer, uses a picture of Palmer of chiropractic fame as his avatar and calls himself B… Palmer
Of course you need an invasion of something in order to develop an immunity, and that immunity then is retained against similar attacks in the future. The invasion does not have to be a viable threat, but can be only a vaccine. That is the whole point of why vaccinations have value. And if you do NOT get immunity to COVID-19 now, then you will be more likely to die when a more lethal strain comes around next year. All pathogens tend to become more lethal over time, and once a pathogen has crossed over to human hosts, it never goes away, only becomes more lethal.
“All pathogens tend to become more lethal over time.” Where the fuck did you get that bit of nonsense?
It is not a great strategy for a virus to get more lethal. The more lethal, the less chance of spreading itself. That is what Covic-19 makes such a succes. It can spread easily over the world, because people who carry the virus are still able to travel, so they can spread it to others. Dead people don’t travel that much.
Yup. The reason most new viruses tend to evolve to become less, rather than more, deadly is because if a virus is too deadly, it doesn’t spread as efficiently. It’s one reason why, although there are outbreaks of Ebola, Ebola never developed into a pandemic. Its outbreaks tend to burn themselves out before the virus can spread widely. That being said, none of this means that COVID-19 will evolve to become less deadly. For one thing, it can already spread very efficiently as it is now, because a large percentage of the infected have mild disease or even asymptomatic disease. More importantly, it can spread from an infected person quite easily during the days before that person develops symptoms. Given how efficient SARS-CoV-2 is already at spreading already, there probably aren’t any significant selective pressures on it to become less lethal.
I see that Mr. Augustin is a formidable intellect.
While there’s no pressure for it to become less lethal, there’s also no pressure for it to become more lethal, since more people with serious symptoms would probably reduce its spread, as people stayed home, in bed. (Even the “mild” cases are apparently really sucky).
It’s time to leave your mother’s basement. Go out and enjoy the beautiful world.
As I’m not a doctor and don’t trust just anything I read without researching opposing views I came to this site because others I trust find trust in trust this site. I was looking for an honest and sober counterpoint to what I saw as a measured set of statements from a pair of frontline medical professionals. Not knowing anything about this forum I couldn’t get through the first paragraph without knowing that this author lacks the ability to deliver on the “sober counterpoint” expectation. The petty ad hominems, appeals to authority, and guilt by association fallacies all occur before the reader can get a sense of the author’s actual concerns; setting the tone for what was to come. It didn’t get any better as the article progressed. It’s a darn shame. Readers need good unbiased information, sited sources, and NOT dialog that wouldn’t be more at home in a adolescent’s Twitter thread. Please…do better.
Guess how I react to tone policing??
I completely understand your desire to read my comments as addressing your “tone” rather than your “style”.
That said, it was completely my fault coming into this blog expecting more. Perhaps I was thrown off by the “Respectful” part of the title. My expectations were too high. As you continue to mature in the hopes of one day being a public influencer of merit perhaps you will start to reflect on the impressions of audience members you could have gained but instead…turn off. As it stands today this is a missed opportunity to do even more “good”.
But as they say, “your blog; your rule”. Please consider this no more than a completed customer feedback card.
Clearly you misunderstand irony. All is explained here. https://www.respectfulinsolence.com/who-is-orac/
“Clearly you misunderstand irony”
Not at all, I quite love irony. As I said the fault was mine in that my going in expectations were incorrect. Clearly you have a style that many enjoy. I’m not your target audience. I prefer authors that steel man their opponents instead of straw manning. I am however enjoying reading some of your back and forth interactions with your commenters; the ones that are substantive…
“Straw man”? You keep using that word. I do not think it means what you think it means. I “straw manned” nothing.
You can strawman someone with perfect politeness and steelman someone with the most foul language. Doesn’t change the fact that steelmaning loons puts you in a rather comfortable position: you just have to let them speak and show that their own statements contradict themselves or are utterly based on fabrications or foolishness. The only thing you have to watch out for is their rhetorics.
But acting in a most posh passive-aggressive fashion or like Machete is up to personal taste.
Ever tried to stonewall flat-earthers?
Uh, I would guess …. poorly?
As well you should. This kind of BS requires an appropriate response. And an appropriate response is demolition of their bogosity, derision, and ultimately, righteous anger. Kudos, and cheers.
“Man stunned to discover site called ‘Respectful Insolence’ is insolent. News at 11.”
“I’m not wearing any pants … film at 11!”
Hippo: “The Medical Board of California should take a closer look at their licenses. It’s not just the glaring dilettantism these guys exhibit – the Hippocratic Oath is also violated.”
Since misapprehensions about the Hippocratic Oath grate on me, I’m going to note that only about half of medical schools in the most recent survey I can find (from 2000) still administered the Hippocratic Oath, while others reported graduates adhering at least in principle to the Declaration of Geneva, the Oath of Maimonides and various other oaths including ones drawn up by students and faculty. I can’t remember exactly what my graduating med school class swore to, but it was not the Hippocratic Oath.* So I can pretty much do what I want. 🙂
Whatever oath med school graduates take is not binding in any way and not enforceable by state medical boards.
*I would’ve enjoyed taking the original Hippocratic Oath, which involving swearing by Apollo, Hygieia, Panacea and all the gods and goddesses**. Apparently that stuck in the craw of modern-day Christians and so the Oath was strategically rewritten.***
**a medical practice that would’ve appealed to Dionysus might land the practitioner in hot water.
***modern versions also have deleted other parts, including the one about not using pessaries to induce abortion.
I was also going to mention that osteopathic schools apparently all administer an Osteopathic Oath, so Dr. Erickson likely took that instead of the Hippocratic Oath.
We do (see what I did there?) and he probably took it. Although, I would argue that he is more in direct violation of our Code of Ethics, Section 7: “Under the law a physician may advertise, but no physician shall advertise or solicit patients directly or indirectly through the use of matters or activities which are false or misleading.” What purpose does bringing this kind of attention to oneself serve other than advertisement? Regardless, it was false and misleading. Section 18 might also apply: “A physician shall not intentionally misrepresent himself/herself or his/her research work in any way.” Sadly, he may just be dumb enough to think he had a “Eureka!” on his hands. My more cynical perspective is that he wanted to come out as some kind of “Competing expert” in the public discourse.
In my training I encountered a couple guys like this – people who either did a “Traditional year” and nothing more or who have a license but no specialty because they passed COMLEX Level 3 and did no other training. They all shared two themes. 1) they were very limited in what they could do outside of a clinic they opened on their own dime. 2) They repeatedly failed to gain training positions (Match or otherwise) and just gave up. Which brings me to intent…what is his intent in this situation? Summarized simply? He can’t get a legitimate clinician job so he’s hosed until his UC business ramps back up. I don’t blame the guy for finding a workaround for his lack of specialty training but he crossed the line in a big way with this stunt.
Either way I hope this information might make anyone reading think twice before considering this guy an expert in anything other than referring cases to the ED.
Markku Peltonen publishes epidemiological data at Twitter (@MarkkuPeltonen). Sweden really sticks out.
They’re in Bakersfield. I would expect no less. Or any more.
I’m not an infectious disease expert or epidemiologist, so perhaps people here can clarify the herd immunity thing. I often see on this blog numbers of 90%+ being posited for effective herd immunity to other diseases, but for Covid I feel I keep seeing (in other places) 60% as the figure touted. Any reason for that? As stated I have no medical knowledge, but I do have some theoretical knowledge about networks and so forth – including some simple epdiemiological models, and I’m finding it hard to see 60% as anything more than a slowing of spread effect – certainly in highly connected conurbations, maybe its big enough for rural areas. Anyway, I don’t know so any clarification gratefuly received.
I think you are right, I have also seen people using the 60% figure and wondered at it, but I’m not an infectious disease specialist or an epidemiologist either.
I think it might be that given the R0 when we were all walking around doing our thing, 2.2 or so, it is the proportion of the population that would have to be immune to make R0<1. However, that doesn’t really look like what I would call herd immunity, it is also a fragile place to be because very marginal increases in connections pop R0 over 1 (ie the extra people out on a sunny day), so its not like suddenly at 60% its all over. Also, humans arent cows – in any analysis of herd immunity cows are fungible but humans are not – some have vastly more connections than others – people in housing projects and mutiple generations in their family and are therefore more susceptible. In other words, if the 60% was evenly distributed, then those tightly bound communities would still have a local R0 >>1. Thats (even distribution) unlikely though, whats more likely is that to get to the 60% requires a kind of equilibrium (still working on what exactly ;), where actual immunity rate has to be much higher for those communites (and therefore lowere for the luckeir half). We might find that the poorest say 20% of the population have ALL had it and lived or died by the time the general population gets to 60%.
It’s based on the R0 (reproduction number – on average, how many other people one infected person passes the disease to).
Herd immunity threshold = 1 − 1/R0
Although we aren’t totally sure of the R0 for SARS-COV2 yet, it’s definitely lower than e.g. measles, so its herd immunity threshold is also lower.
@Rose Yes your formula is what I said it was. If you’re saying its some kind of offical definition of herd immunity – the proportion of immune st given other things being equal R0<1 – then I'll guess I'll just have to lower the significance I attach to the term, I had thought it meant R0<>1 in the densest areas, and that ultimately to reach that level in the whole population means some subpopulations having much greater infection rates.
Thta means you can’t have ‘achieving herd immunity’ as your exit strategy (though it may end being the actual exit) without implicitly dooming your least fortunate citizens to maximum pain. Having said that, I’m not aware that anyone both sensible and powerful is actually currently suggesting that as an explicit strategy, except in Sweden, which does have one of the most equitable societies on Earth and therefore morally can maybe live with it.
[…] ● NEWS ● #respectfulinsolence #covid19 #science #coronavirus ☞ Drs. Dan Erickson and Artin Massihi: Promoting dangerously bogus pseudo-epidemiology about COVID-19 https://www.respectfulinsolence.com/2020/04/28/erickson-massihi-bogus-epidemiology-covid-19/ […]
Just curious, what makes you so qualified to write this article calling them wrong? You blame them for grifting, yet all you’re doing is fearmongering.
Working out who uses the pseudonym “Orac” really isn’t difficult.
In fact, it’s so easy that just a little clicking around on the blog will find it and the origin of the pseudonym.?
So that’s three in what, two days?
These two doctors were a bit sloppy in their presentation, but their message rings true for this man.
At the beginning of this pandemic we were warned of mortality rates of over 10%, then 7%, then 3.4%, then 2.6%, then one to 2%, and now we are seeing, based on the most reliable data we have, mortality rates between 0.4% and 1%.
We were then warned by a consensus of expert epidemiologists and talking heads that no matter what we did, we were going to see our hospitals swamped by a tsunami of covid-19 patients. The word “tsunami” came from a very dear friend of mine who’s a general practitioner in the United Kingdom. He told me it was coming six weeks ago, and the wave has never materialized.
On March 12th, here in Ohio, we were told by our government’s top epidemiologist and our Governor’s personal expert, Amy Acton, that there were no less than 100,000 cases of coronavirus already existing in the state at that time. Two and a half weeks later Ohio had a grand total of 25 deaths from the Coronavirus. At that time we were told that the mortality rate was 3.6%. If this were true, we would have seen 3600 deaths on March 29th, not 25.
Recent serology tests from California and New York indicate that the number of extant cases of virus outnumbers the number of confirmed cases by a factor of 50 to 85. You claim that it is likely that there are many false positives on these antibody tests, but you give no evidence for that. Are you just guessing because that’s where your confirmation bias leads you? And you correctly state that there are problems with the sampling in these surveys. This may be true, but it’s the closest thing we have yet to a random sampling. Either way it’s better data than we had the day before.
The Marion Correctional Institution houses 2,500 prisoners in north central Ohio, many of them older with pre-existing health conditions. After testing 2,300 inmates for the coronavirus, they were shocked. Of the 2,028 who tested positive, close to 95% had no symptoms. That means 101 inmates, or 5% did display symptoms. The report doesn’t give details on the mortality rate from that survey, but if we can assume the majority of symptomatic patients had mild symptoms, which our experts are telling us is usually the case, and that the majority of people with severe symptoms survived, the death toll must have been very low indeed.
According to the Pennsylvania Department of Health, fully 50% of covid-19 deaths occur in nursing homes. We might forgive the average person for suspecting that many of those patients were in their last days or weeks of life anyway.
According to the Ohio Department of Health, 49% of Covid-19 deaths occur in patients over 80 years old, and 75% of the deaths occur in patients over 70 years old. Virtually all of them displayed comorbidities in addition to their advanced age.
You cite examples of young and healthy people dying from this disease. While true, there’s a ring of dishonesty to your argument. The number of young, healthy adults who died from a coronavirus infection is so vanishingly small as to be statistically insignificant. I have read reports that suggest that the incidence of death in young healthy adults due to a cytokine storm brought on by the coronavirus is no higher than the incidence brought on by influenza. Some people just have immune systems that will overreact to viral Invaders.
At every step, we have trusted the experts and at every step we have found the experts have either knowingly or unknowingly exaggerated the danger of the situation. As new information comes in daily, anyone who is paying attention can see the obvious trend. And that trend has shown no indication of changing. It seems to be showing us that there’s virtually nothing to fear for the average person, that the vast majority of people who catch the virus will experience no symptoms, that the majority of people who do have symptoms will recover fully, and that many of the people it does claim were already in danger of dying from other factors. This virus is simply not having the impact that our government used to justify killing the economy and seriously harming tens of millions of people.
So please forgive the general population when we make people like these two young and handsome doctors internet sensations for speaking the truth as we were seeing it. It’s regrettable that their message was diluted buy some inconsistencies, but on the whole I think they were hitting the mark.
You do yourself no favors or your cause when you begin your article by essentially saying that no one who is not an epidemiologist can possibly understand what is happening here. Insulting your audience and attacking these two doctors with withering condescension, name-calling, snarky memes and sarcasm only serves to increase the divide one would hope you are trying to close.
That’s nice, but “ringing true” doesn’t mean anything in science.
That’s what happens in a pandemic. Why? Because early on, only the sickest patients get tested, making the denominator artificially small and the apparent case fatality rate artificially high. As test availability increases and more widespread testing occurs, we get closer to the “true” case fatality rate. We still don’t know for sure what the “true” COVID-19 case fatality rate is is, but it’s pretty certain that it is not less than seasonal flu, certainly not five times less, as these clueless wonders have estimated based on their biased sample. We likely won’t know the true case fatality rate for many months, after the pandemic has abated. Moreover, case fatality rates vary based on geography, population, quality of available medical care, and time. For instance, the case fatality rate will be higher in hard-hit areas as the medical services there are overwhelmed, and triage becomes necessary, than in areas that are not medical resource constrained.
Wrong. They have not. COVID-19 has killed nearly 60,000 Americans in just two months, over 50,000 in just 30 days, and that was IN SPITE OF the massive mitigation of shutting down nonessential businesses and sheltering in place. Think of it this way. More Americans have died of COVID-19 over 2-3 months than died during the entire Vietnam War, which took place over more than a decade. Comparisons to the worst flu seasons we’ve had recently, with 60,000 deaths, show that this is much worse than flu, too. After all, those 60,000 deaths in a flu season took place over 8-9 months. We’ve lost over 50,000 in just the last 30 days.That is almost certainly a gross undercount of the true number of COVID-19 deaths thus far. Recent data for total deaths per week from the CDC show an huge increase in the number of deaths in late March compared to the same time during the previous five years. It’s very striking, and there’s been nothing like it in a very long time. Guess what? The vast majority of those extra deaths are almost certainly COVID-19 deaths. https://www.nytimes.com/interactive/2020/04/28/us/coronavirus-death-toll-total.html
There’s an old saying about intervening in a pandemic from Dr. Fauci: “…if it looks like you’re overreacting, you’re probably doing the right thing.” Then, of course, epidemiologists are in a no-win situation as far as public relations. If their estimates are underestimates, they’ll be trashed. If, however, the death counts are much lower than predicted, they’ll be accused of having exaggerated the severity of the pandemic. No, my Dunning-Kruger friend, the reason death counts aren’t in the hundreds of thousands is because social distancing works.
That’s not quite what I said. I said that no one who isn’t an epidemiologist should be making claims based on their testing data, the way Drs. Erickson and Massihi are. They made very obvious mistakes that an Epidemiology 101 student could point out and would probably laugh at because the mistakes were so bad. As I said before, they have no relevant qualifications to analyze their data, and clearly don’t know enough about epidemiology to know even what they don’t know.
Who’s insulting his audience? Not me. I was, however, pointing out how unqualified, arrogantly ignorant, and utterly incompetent at analyzing epidemiological data these two publicity-seeking doctors are. I stand buy it.
Liar, it does not matter what the infection number is because we know the infection rate has peaked and that can ONLY happen from increased immunity. Sure there are 50k deaths, but out of 330 million people, so the death rate is only 0.015.
Any HONEST person would admit that lock downs do not save a single life but only slow down the infection rate. And in the case of an airborne pathogen with such a low death rate, the slower the infection rate, the more deaths. What we should be doing instead is accelerating the rate to achieve herd immunity by deliberate inoculation of healthy volunteers with the least lethal strain.
What exactly makes you believe the infection rate has peaked? Wanting to believe is not data.
The death rate is calculated by the number of deaths over the number of cases, not population. People not infected are not part of the equation.
And there are quite a few people in the hospital. Even if you wanted to convince yourself nobody else is getting infected – and there’s no basis for that – not all of them are going to make it. In other words, we don’t have death rates.
The fact that people don’t blindly accept your beliefs doesn’t make them liars.
Love it when you get grumpy.
Kirk, if it helps you understand, people aren’t interested in their overall chance of getting knocked down and killed by a car (your death rate), they want to know how dangerous playing in the road is (the true death rate for people who play in the road).
The fact that the overall death rate suits your agenda is no justification for wilful ignorance.
So if I turn up at your UK doctor with an illness that could kill me, they give me pills and I libve, does he then deduce that I didn’t need the medicine? Not only was there a wave in London at least, but without the sd undertaken there would have been a tsumani. Its called cause and effect – tell that doctor about it.
I had a friend who recently called the 27 excess deaths in March in NHS workers ‘negligible’ (usually 1000 or so NHS workers die per month). As I told him then what is ‘neglible’ or ‘insignificant’ is not a property of the numbers, it is an interpretation of them given a context – personally I find any death significant!
And finally, I’m seeing a lot of very bad Utilitarions nowadays.If you’re suggesting that because old people might have say 1 year left to live anyway, so we shouldn’t sacrifice the younger people for that, then when your doing your calculations remember to make that multiplier everywhere – ie multiply all death rates for age groups by their life expectancy, then see the actual cost of ‘insignificant’ deaths’ – by your own measurment,
“The number of young, healthy adults who died from a coronavirus infection is so vanishingly small as to be statistically insignificant. ”
What is your p value for “statistically insignificant”? What is your n? What is your statistical test?
Maybe Orac thinks his readers pay some attention to coronavirus news, and/or might think to Google “antibody tests false positives” before whining. Which yields, among other citations:
Unless the viral infection rate is known, the infection fatality rate cannot be determined. If the infection fatality rate cannot be determined, the true virulence of the organism cannot be determined. The second question is the true case mortality rate. To determine this we need to know how many people were infected with the virus and had symptoms. Headlines numbers such as number of deaths or number of cases, without specifying the denominator are meaningless.
The advice to consider all deaths of patients WITH the virus are due to the virus is a travesty. There is a background death rate. As the majority of victim are over 65, and the largest cohort over 85 (and or in nursing homes), this only leads to a gross inflation of the numbers.
A reasonable question at this point is whether the corona virus, nothwithstanding the dramatic presentation of the ARDS, is not much more than a very bad flu season. People with influenza A also die from ARDS.
And the realization that high blood sugar accelerates the development of the cytokine storm, due to loss of IRF5 suppression, allows us to determine who is at risk.
This is grossly incorrect. There is no evidence that the COVID-19 death toll is being “grossly inflated.” Quite the opposite, in fact. If anything, the death toll from COVID-19 is being grossly undercounted. https://www.nytimes.com/interactive/2020/04/28/us/coronavirus-death-toll-total.html
That is a lie. The CDC reaction about under counting was BEFORE the virus death rate peaked, and before they were even counting COVID-19 deaths at all because there was insufficient test. Now that there is testing, any death testing positive is being attributed to COVID-19 regardless if they died from something else entirely, including car accidents.
Actually, you’re statement is a bold-face lie.
Krik, that’s an easy claim to prove, and yet… you don’t. I look forward to proof that car accident deaths are being counted.
The overall death rate for the country is about 800/100,000. All ages. All cases. However the death rate for those over 65 but less than 74 is about 1000/100,000. The overall death rate for those 74 to 85 is about 4,400/100,000. The overall death rate for those over 85, is about 12,500/100,000. For those over 65, death from cardiovascular disease, pneumonia (any cause, including influenza A), and complications of diabetes, and cancer accounts for the vast majority.
For the country, about 13% of the population is over 65. Those over 65 have about a 28% diabetes type II rate. About 10% of hte population overall has diabetes type II. Diabetes type II is a very significant risk factor for death from both COVID-19 and influenza A. In both cases, the virus kills by initiating an immune hyper-reaction called a cytokine storm. A cytokine storm is to a standard immune reaction what a hurricane is to a thunderstorm. This is because hyperglycemia (the hallmark of diabetes type II) interferes with the function of IRF5. IRF5 activation is necessary to suppress the cytokine storm.
Therefore the COVID-19 death rate needs to be normalized against the background death rate as a certain portion of the population over 65 will die from another cause. If they have SARS and COVID-19, then it may be the cause, it may be component of the cause, or it may be an innocent bystander. It is difficult to say in any particular case, but we know at a population level, that many of these cases must either be a component of the cause of death or an innocent bystander.
We also know from autopsy studies that even when a patient dies from pneumonia, there usually isn’t one pathogen. There is usually a panoply of pathogenic viruses and bacteria.
We also know that in the era of PCR, many organisms traditionally considered to be pathogens, are carried asymptomatically by patients. One common one is C. difficile This carrier state has confounded many physicians in determining whether a patient’s symptoms are due to C. difficile or C. difficile is merely an innocent bystander.
By not normalizing against the background death rate for age and co-morbid status, the virulence (case fatality rate) is overstated.
Be glad that you don’t live with the fellow who is renting me a room for $500 a month and expecting me to clean his dishes while raving that women should not be let out alone by themselves.
^ Sorry, forgot context: He’s also on the “misattribution of deaths to COVID-19” bandwagon. I just have to grit my teeth and try to come up with the money. At least being an errand boy as well gets me outside, not that there’s much to see in Chicago’s Uptown other than that seemingly half of the population has some sort of leg deformity.
But, can’t you rave at the women to help you clean dishes and then afterwards accompany them outside? Just a thought.
What women? They are abstractions in this case.
@Path coin, By your logic, if, for example, people over 85 died when the WTC towers went down, but it didn’t raise the death rate over the general trend, then they shouldn’t be counted in the death rate from Sept. 11, because they would have died anyway.
“The advice to consider all deaths of patients WITH the virus are due to the virus is a travesty. “
If they were counting people who died in a car accident on the way to treatment, you might have a point. But, generally, that people might have died from something else anyway if they hadn’t gotten COVID-19 doesn’t change that they did die from COVID-19.
I’m not an epidemiologist or infectious disease expert, but I am an educated citizen asking those who are to present their evidence and teach me, which I find incredibly easy to do in my own profession to those who aren’t. So far, the real epidemiologists and infectious disease experts aren’t doing all that well at that task, including this article.
First, the article to its credit gives a number of examples where these two doctors’ viewpoint is correct. Second, from what I can discern from my non-expert view, there does seem to be a distinction to dying “with” Covid and dying “from” it, although I’d be happy to learn if that is only a distinction without a difference. If there is a real difference, that would seem to implicate different responses.
Third, even if these doctors are the dunces they are made out to be, what’s missing is the “correct” information. I’d have liked the author to present the unassailable evidence as to exactly how many Americans have been infected and the true mortality/recovery rates per infection so that we can actually determine how dangerous is the disease and how to respond to it.
Fourth, where is the cause and effect unassailable proof that one response to the virus is the best, and does that apply to every geography. So far, I see that Hong Kong, South Korea, Sweden, and New Zealand are getting response praise. All that tells me, but I’m not an expert, is that it seems a quarantine is easier to effectuate if one governs an island surrounded by a huge moat or on a peninsula “surrounded” by zero or few neighbors. But is that transferable to a Continent-spanning nation such as the U.S. or the Russian Federation? For instance, New York and Florida are the same in that each is internally very diverse. The two states reacted very differently to the virus. Yet, New York hit the tubes, and Florida is doing ok. Maybe Florida just hasn’t climbed the stairs to the tubes yet, or maybe something else is to “blame.” Perhaps it is that Florida has a total of 1 old bus (a prop at Disney World) for its entire public transportation system, and New York is paying the price for an otherwise useful mass transit system. I don’t know, I’m not an expert. But could a real expert tell us the exact best plan for the entire USA in whole and in parts, backed up by facts that can’t be dispute, please. Because so far, assuming for the sake of argument that these two doctors are semi-charlatans, I don’t see the “real” experts presenting anything more than their own speculation, although I do see a lot of ostensibly praiseworthy caveats like it’s “too early to tell” which means that it was too early for the expert to speak.
Finally, what this article ignores are the political implications. Like everything else, this public health battle soon turned into just a single–and the only acceptable expert opinion left in America–that Donald J. Trump must be opposed. I open CNN’s website every morning first thing so that I can get my daily vitamin headline (usually a few such headlines), each one now related every known fact about Covid to the fact Donald J. Trump is a murderous idiot. Thus has it been with every matter of public concern for the past 3.5 years. Maybe Donald J. Trump is a murderous idiot. But that correlation does not prove that his condition causes more Covid 19 deaths. And what it does not prove is that Nancy Pelosi’s walking the Streets of San Francisco pitching for more tourism as the virus took off, or Governor Cuomo’s advocacy of flooding nursing homes with sick Covid patients, or that the Presidential candidate late of his basement who said restricting travel in the face of Covid 19 was just another Trump racist ploy would have done any better.
I’m for real,provable, science. On all Covid 19 issues, I’d like to see real, provable numbers, and real, provable cause and effect policies. So far, it seems to me we have a lot of plausibility and few public policy actual proofs.
Perhaps the author can enlighten us all without any caveats, maybes, or the merely plausible.
Wow, what a bunch of malarky. For one, I can open up the Fox News site & immediately be hit with stories of how “Democrats” are responsible for all the ills in the world.
It’s factual to state that the Trump Administration constantly downplayed the possibilities of a mass COVID outbreak in the US for months, at the same time, refusing to take steps to establish the kind of testing program which would have limited the need for the nationwide “stay at home” orders we’ve been faced with.
And let’s talk about the Administration’s decision to bring back thousands of Americans from Europe, through 13 airports, put both the sick, the maybe sick, and the healthy next to each other in long lines, in crowded terminals, and test not one single person.
If you wanted to spread COVID across the US, that was the perfect way to do it. So, when we criticize the current administration, we’re doing it because almost every decision made, from the top down, has been entirely incorrect.
So, go pound sand.
it’s not “factual” that Trump did nothing. To the contrary, there has never been a greater response to the spread of a disease than the resources marshaled by Trump.
However, just because that is true, does not mean that Trump’s response was perfect.
Many others can take blame.
The Obama Administration cut the protective gear/mask budget the last three years it was in office and the stock was low.
But that wasn’t Obama’s fault. It was actually the entire Congress’s fault. Because Congress can’t do its job and pass a budget, they went to an automatic system that more or less ensured these cuts. Both Democrats and Republicans agreed to that and it was a mistake not only politically, but came back to bite us during Covid.
But your post only proves my point. The purpose of Covid “science” today by a large portion of the media and its followers such as yourself is to enlist the science to remove Trump from office just as every human endeavor and thought has been enlisted for that purpose by Trump’s opponents.
What you have failed to do is to put forth your own evidence showing what I asked–I never took a position on what was “true”–for purposes of education. What are the correct answers to all the public’s questions about Covid infection rates, death rates, percentage of cases without symptoms, you name it. It’s not enough to say the doctors are wrong. My post assumes they are wrong. Now, tell us the truth, but no hedging.
And what you also don’t even attempt to show is that Nancy Pelosi (she of the wiping her nose and then the podium in the House recently) who pleaded with people to come to Chinatown in March, or Governor Cuomo whose ventilator shortage never arrived and was putting elderly Covid patients in nursing homes and rehabilitation centers, or Joe Biden in his basement who was against restricting travel would have cured this thing for sure in a minute or two. And all those Democrats vehemently disagree with Trump suspending immigration. Now, I’m in favor of generous immigration. But I don’t know, maybe it’s a good thing and logical that I have to lock myself up in my house, but immigration bringing new people to the country at this particular time should proceed unabated. What for, so they can lock up themselves, too?
I’m not fighting for non-science. I’m just insisting on science all around.
So where are your numbers and where is your scientific proof that A-Z should have happened, still should happen, and how many cases you’ll prevent and how many lives you’ll save?
And I’ll go you one better. Prove that my questions are improper questions and you can skip the proof of the rest.
But be forewarned: proof is tough thing to show.
Actually, it’s true. Trump didn’t do “nothing.” He spent two months denying the severity of the coming pandemic, saying cases would rapidly go down to zero, and actively hampering the ability of career public health officials in the government to respond effectively. Basically, as far as the pandemic went, Trump did worse than nothing.
That is the understatement of the century.
@ Keevan Morgan
“The purpose of Covid “science” today by a large portion of the media and its followers such as yourself is to enlist the science to remove Trump from office just as every human endeavor and thought has been enlisted for that purpose by Trump’s opponents.”
The media are being a bit unfair at times with Trump the man (not with Trump the administration), but there’s such a backlog of nonsensical statements of his that it’s hard to blame the media every time they Raise Their Hands To The Sky Imploring A Divine Intervention to pour some sense of sense into Trump’s mind. But personally, being a foreigner, I just enjoy watching him on Youtube spouting crazy statements and backpedalling by incriminating the media, who in turn naturally double down in the face of his crazy statements. Good show. I’d be really curious too to know what the Chinese audience thinks of Trump’s Youtube performance and tweetomania…
“I’m not fighting for non-science. I’m just insisting on science all around. So where are your numbers and where is your scientific proof that A-Z should have happened, still should happen, and how many cases you’ll prevent and how many lives you’ll save?”
Science per se is not about saving people. It’s about getting things right. Including getting things right concerning the state of knowledge of what you do know and do not know. So, assuming there is no science, assuming that What You claim Is True, then that would be the state of the science: ignorance. And if such were the case, any arrogant fool making wild crazy statements on things nobody could know anything of would be just that: an arrogant fool.
Being right is not about saving people. But good luck trying to save people by being wrong, or by being right by accident like a brocken clock is right on time twice a day.
That’s not exactly how sequestration went down.
He also put in place incomplete and non-helpful traveling bans to China and Europe.
The frustrating thing is that there are still things the federal government can do that would really help, if it would only do them. It’s doing some things, but not anywhere near enough.
And Keevan Morgan says, “proof is tough thing to show” [sic]? Well, it only took him those 25 or less words above to prove he’s both dumber and funnier than Larry The Cable Guy. Keep Gittin R Done Keevan!!
You want proofs go talk to a mathematician.
You talk to biologists (epidemiologists, biostatisticians, immunologists, virologists, etc) you’re going to get probabilities because that is how the universe works. It has nothing to do with what anyone wants, and everything to do with how the world is.
“You want proofs go talk to a mathematician.”
It will take an awful long time to get this category mistake fixed in the minds of people…
And here I was all disappointed with the same old same old trolls. There’s a lot of entertaining crazy out there newly attracted here. If you’re running low on popcorn blame the hording of a certain short alphabetic sequence.
The explanation is likely that this post must have been posted to some popular Facebook pages. Traffic yesterday was 10X my usual daily average traffic, nearly all of it to this post. Today’s traffic is on track to be roughly the same. The blog has been opened to a new influx of readers, many of whom likely are fans of these two doctors. Naturally, they’re not happy.
In addition, these two doctors may have got new fans recently because their video/ audio has been featured and applauded at Del’s place and at PRN. So, they hear about the two brave mavericks and then find that someone is opposing their “science”.
Hmm. Perhaps, Perhaps. My gut tells me that what you have here is a failure to communicate a bunch of well-instilled Fox’n’Fools zealots known as ‘Freepers’. This kind of gives it away:
The article is clearly lying. All a lock down can do is slow an infection spread, and by doing so, slows down getting herd immunity, so then causes MORE deaths. If 200 million healthy volunteers were to be inoculated with the least lethal strain, then the virus would disappear in 14 to 20 days. Anything else is murder. The lock down is murder. It can not possibly do any good, and every single doctor knows it.
“If 200 million healthy volunteers were to be inoculated with the least lethal strain…”
Well hello, Dr. Mengele!
@rs, that is a stupid remark because the death rate of COVID-19 is only 0.015%. Do the math. With only 50k deaths out of 330 million, it is a lower death rate than seasonal flu. And if you select the least lethal strain, and only inoculate healthy people, you might be able to innoculate 200 million without a single death. The ONLY way to protect the elderly and compromised is for the healthy to get immunity. You should stop supporting more deaths. You are essentially assisting murder.
A. You don’t calculate the death rate of a disease out of the general population when most of the population was not exposed. That doesn’t work.
B. Flu season is over 6 months in the U.S.. This disease killed over 50,000 in less than two, with strong stay-at-home measures in place. That’s not the same.
“Least Lethal Strain?”
And which one would that be?
And would you be willing to volunteer to select the 50 – 100K people, individually, who would die in your scenario?
Lastly, we aren’t even sure at this point if “herd immunity” is even possible with COVID.
Stop talking out of your ass.
@ Kirk Augustine
Besides the death to cases ratio is actually around 5%, that is, where we have data on how many infected, simple numbers should tell a reasonable person that we have had over 50,000 deaths in the past couple of months over the usual number and hospitalizations of severe respiratory disorders, many needing ventilation, far above anything we have experienced over a number of years. Maybe you think all these people are just hypochondriacs???
And, as Orac says, yep, we could build herd immunity by exposing almost everyone; but if this is as dangerous as experts believe, e.g., learning more and more, for instance, damage to heart, central nervous system damage, blood clots to organs, all in younger people, then, yep, those surviving, at least those without permanent damage, will create herd immunity. The question is just how many are you willing to sacrifice, e.g., seniors and/or comorbidities? Are diabetics expendable? How about asthmatics? How about someone who has worked hard entire life, retired, enjoying life and grandkids? How about young, healthy person who survives with disabilities?
And it isn’t certain if classical herd immunity will work. We still don’t know if someone who has had COVID-19 can be reinfected or not, how long and strong immunity generated from first attack. But, even then, a modified herd immunity will reduce basic reproduction rate, how many an individual can infect and, in general, how many infected; but at what price?
That last point is the most important. Presumably, once someone survives a COVID-19 infection, that person will have some degree of immunity against future infections, but we don’t know that yet. More importantly, even if infection does result in immunity, we don’t know how long lived that immunity will be, if it will be lifelong (unlikely) or much shorter, as in a few months or years, etc. That makes any speculation about herd immunity from COVID-19 premature and not just speculation, but wild speculation.
You wrote “Kirk Augustine”, with an extra “e”.
It may be a coincidence, but this blog did had a visitor called “Augustine”, a decade or so ago. The contrarian type.
I wonder if it is the same person. Last time we saw the other one, they were berating us for “promoting” the anti-HPV vaccines, because we had no evidence it was good at preventing cancer (well, we did had the first studies from Australia coming back good, but never mind that). Since then, there have been a few more very positive studies, I wonder if they saw them…
Augie didn’t capitalize his ‘nym, and also used square brackets for quoting others.
There are different strains now? Oh, wait, it must be encompassed by this:
You are spouting utter nonsense. If you let the virus spread through the population naturally, without slowing its spread, many more will die because medical resources will be quickly swamped. That’s the whole concept behind “flattening the curve” (slowing the spread of the disease sufficiently that the peak number of cases doesn’t completely overwhelm the medical system and lead to more deaths from all causes, not just COVID-19. If you were to inoculate 200 million people with the virus in a short period of time, it might lead to herd immunity but at horrific cost in death and suffering.
@ Kirk Augustin
You write: “The lock down is murder. It can not possibly do any good, and every single doctor knows it.”
“Every single doctor knows it????” Yikes. Besides ignoring almost the entire medical establishment, are you suffering from delusions of grandeur, a knowledge that doesn’t reflect reality? When did you go off your meds?????
As for the virus would disappear in 14 – 20 days, first, it would be impossible to infect 200 million people at once, so it would take months to spread, second, the immune system takes up to three weeks to reach peak strength, so, despite all the suffering and deaths, the virus would be around for many months, etc.
The lockdown does slow the infection so that our health care system isn’t overwhelmed and so that we can test treatments that will work.
I’m just curious, have you ever read anything about infectious diseases, immunology, microbiology, epidemiology. I own half dozen books and well over 100 journal articles on the 1918-19 flu pandemic that killed about 675,000 Americans when our population was around 120 million, translated to today’s population would be around 2 million deaths. And later antibiotics reduced flu deaths from secondary opportunistic bacterial pneumonias; but thanks to the rise of antibiotic resistance, flu deaths will likely rise. And it came in two waves. The first killed more like normal flu; but then the second came back with a vengeance.
So, please, explain how you know more than Orac, me, and others have devoted a life-time to learning the science of diseases?
Oh, Kirk went further. He sent me an email arguing, “In fact, the quickest way would be to ask for 200 million healthy volunteers in the US. With luck, then we could totally eliminate it in 14 to 20 days, without a single death.”
Seriously, he claimed that we could get to herd immunity without a single death from COVID-19. This goes beyond delusional.
Of course like there haven’t been perfectly healthy young people who have died from the virus. So there will defenitly be more deaths if you expose 200 million healthy volunteers (how do you find that many healthy volunteers?). And then there are the people who have to be hospitalised and spend perhaps weeks on the IC units, which is not a walk in the park and which might have some nasty consequences afterwards, so even if most will survive, several of those will suffer the consequences.
But well, I read all kinds of idiotic ideas from people who have no knowledge of diseases and have just read something that fit their view. Like people saying we should open up the economy, because the lockdown (which is relativly mild where I live) is to damaging for the economy. Of course having more people hospitalised and needing lots of healthcare which costs a lot of money is rather bad for the economy as well.
re ” ..all kinds of stupid ideas from people who have no knowledge of diseases..”
Courtesy of PRN.fm today..
” we should only quarantine the sick ” to save the economy
as if we could easily separate ‘sick’ and ‘healthy’ into two discrete categories
he left out asymptomatic, false negatives, people who weren’t tested, those who tested negative but became infected later and weren’t tested a second time etc etc.
How do the clueless survive long enough to be counted as senior citizens?
@ Denice Walter
Today I read, the elderly should quarantaine themselves, so others, who are valuable for the economy, could get back to work.
I don’t know what to say about people who equate “elderly” and “sick” with “useless”.
Just so the people saying this know, my 4.5 year old considers everyone ver 10 “elderly.” You’re not out of the woods.
And just to reiterate: quarantine in public health law is, actually, what you do to the healthy. Isolation is what you do to the sick.
I was surprised when my vet informed me that house cats were considered geriatric at age 7.
“The lock down is murder. It can not possibly do any good, and every single doctor knows it.”
Huh, my aunt is an ER doctor and she’s been praising the whole family for staying home.
So, who’s wrong, the practicing doctor who has seen COVID cases, or someone from the internet?
Gee, now that I think about it my several-levels-up boss is a doctor and we’re all working from home. He doesn’t think it’s murder. My cousin the doctor has also been urging us to stay home. As have all my doctor and nurse friends from school.
So, again, who’s wrong, all of those people, or someone from the internet?
David Gorski you are NOT a epidemiologist. You are fraudulent and paid by the pharmacal industry.
When watching the video of the two doctors they explain that they are ER doctors and simply giving their perspective and data that they have collected.
So I have to question why you (who is not a epidemiologist) would be on a mission to shut down two doctors who are giving their opinion from the experience they have had in the last two months.
The fact that you think your opinion is more important than the two doctors in the video, is mind-boggling to me.
How much money did the pharmaceutical industry pay you to help them shut down those two doctors?
Isn’t that the mission, to shut down anyone who doesn’t have the same opinion of the government and the pharmaceutical companies after all the Pharmaceuticals are going to make billions of dollars from vaccinations for covid. They certainly aren’t going to make billions of dollars if everybody realizes that covid isn’t nearly as bad as with the government’s made it out to be.
These two doctors have never claimed to be anything other than what they are, I watched the video. You on the other hand have all kinds of accusations against you that are completely immoral.
How’s the view from over that petard?
Have you read the article? Because you haven’t addressed any of its points.
Being Michigan then, possibly a k-car FSM (he boiled for our sins, RaMen) bless iacocca.
Where did you learn that Orac is being paid by the pharmaceutical companies? Could you please cite the source? Pay stubs? Transfers of real estate or evidence of who paid for his Maserati?
And what exactly are those “immoral accusations” against him? Could you list the details please? Sources? Thanks. I’ll wait.
Asking the important questions. I figured Orac drove a used Bimmer most of the time; when his Land Rover is not in the shop.
blockquote>who paid for his Maserati?
Maserati?? Not for a Michigan boy – Orac’s Pharma supplied ride is a Ford GT
Nope Orac isn’t an epidemiologist; but a trained scientist who works with epidemiologist, an extremely intelligent individual who has mastered the basics of epidemiology. And I am a retired epidemiologist, never worked for the pharmaceutical industry and have a small 401k that probably has some pharmaceutical stocks. It’s invested in a broad stock and bond fund.
Orac isn’t giving HIS OPINION; but his his articles backs it with science and logic. There are doctors who support homeopathy, water. There are doctors who support chelation therapy for autism, despite that chelation doesn’t cross the blood-brain barrier, so can’t remove mercury from the brain and even if it did, central nervous system cells once killed, don’t revive. And kids have died from chelation therapy. Despite this, parents claim to have immediately seen changes in their kids. Wishful thinking. So, is it wrong of me to, based on what science says about chelation, about what neuroscience says about the brain, and about cases of kids dying from chelation therapy, to point this out?
And your accusation that he is: “fraudulent and paid by the pharmacal industry,” is ludicrous.” You do know that many doctors go to conferences sponsored by pharmaceutical industry, free luncheons, etc. And purveyors of Complimentary and Alternative Medicines make profits, some become millionaires. As for the pharmaceutical industry will make a profit on vaccines, first, vaccines are not all that profitable. Profits are for chronic conditions, drugs used on a daily basis, e.g., insulin, asthma, statins, or used in larger quantities, e.g. chemotherapy. Vaccines are biologics and costly to manufacture and have a one or few time use. And, despite your ignorance, everything is sold for a profit. Making a profit doesn’t determine if something is beneficial, neutral, or harmful. One can criticize how much profit is made on some things, e.g., insulin; but the fact companies make a profit, would you advice someone not to use insulin, conflating profit with its life-saving ability?
As for exaggerating the dangerousness of COVID-19, actually as more and more information comes out, it may be much more dangerous, for instance, they are finding neurological damage, blood clots, etc. in younger people who have “recuperated”/survived. And, perhaps, you don’t care about seniors and/or those with comorbidities; but some of us do. I guess diabetics, asthmatics, people with mild congestive heart failure, etc. are expendable???
If it turns out the COVID-19 is less dangerous, then we have the means to revive our economy, that is, for instance, reduce spending on a military that is way larger than necessary for national defense, stop bailing out wealthy corporations, etc. Congress, for instance, passed bills to fund a new tank and plane that our military made absolutely clear they don’t need and they don’t want. But this enriches a few corporations. However, if everything that experts know about COVID-19 is right on, if we ignore this, we could end up with far more deaths and disabilities, basically overwhelming our health care system, and far more danger to our economy.
But, ignore what ORAC has written over the past few weeks on various aspects of the current pandemic and stick to you baseless ad hominem attacks.
“When watching the video of the two doctors they explain that they are ER doctors and simply giving their perspective and data that they have collected.”
Interesting…. you say they are both ER doctors , yet one doesn’t have ANY speciality. They OWN 3 urgent care clinics where they got their small amount of “data”……. They are not working in an ER…… So far they have exaggerated WHO they are and where they work……any bets that they also exaggerate the results and their meaning as well???
“These two doctors have never claimed to be anything other than what they are,….”
They already did claim to be something they are not – working in a place(ER) they do not…. they work in an urgent care clinic. Many COVID cases rapidly require respiratory or cardiac support which requires an ER/ICU…… they handwave that their numbers are typical of the population in their area, which they are not. They also assume they understand a specialty in depth that they do not have more than a day or so teaching of from their days at med school.
Sorry, Trina, their over-confidence IS immoral. COVID-19 IS worse than what they are making it out to look. I’d rather see an over-exagerration of the rates until we can get sufficient data to calculate the true rates than their gross understatements.
It is obvious this article is not written by a reporter and is deliberately lying. There are dozens of deliberately false statements made by this article that can be sued for under slander and libel laws. Clearly no one with any medical training would ever suggest a lock down with something that is airborn and has only a 0.015 death rate. There is not a single medical professional that says lock down save any lives, and they all admit that they only slow down the infection rate to some degree. The longer you prevent herd immunity, the more deaths you deliberately cause.
Man, people really aren’t capable of doing something as basic as clicking on “Who is Orac?” are they?
It is obvious this comment is not written by a person with a clue about defamation law.
Note that you haven’t pointed out anything incorrect – let alone “deliberately false” – in the article.
So, please share with us your research that shows the exact level which must be reached for “herd immunity.”
Then follow that up with the research which shows that people infected with COVID are unable to get infected a second time.
And then show us the research which shows exactly how long this “immunity” lasts.
Until such time, please stop talking, because you are just exposing your ignorance.
“Until such time, please stop talking, because you are just exposing your ignorance.”
And letting even more ignorant people hold sway?
You seem to have sweet dreams in your fantasy world.
Sorry: read your comment the wrong way. Apologies.
Then you should have no trouble listing the the libellous statements and explaining how they are libellous. Off you go. We’ll wait.
Kirk, Orac is a doctor, not a reporter. (Why do you think he’s a reporter?). He hasn’t made any deliberately false statements and there’s no basis to sue him. And you’re totally wrong that Covid has only a 0.015 death rate. You don’t understand anything about this disease, and appear to be parroting talking points from some misleading right-wing website.
FYI, Michael Falk’s post is a copy of my work 🙂
Yes, I mentioned that in an addendum.
There are other, actual epidemiologists, who disagree with the so-called consensus on this point. Whatever the merits of these two men, you misrepresent the issue by not noting critical voices coming from others whose qualifications are excellent. In the end, the argument from authority is not the same thing as addressing legitimate questions and informed dissenting voices.
With respect to the models, they have been spectacularly wrong even when they accounted for full lockdown and associated protective measures. It’s entirely reasonable to ask for the assumptions and inputs used in the models to be made public, and to question them. It’s also entirely reasonable to ask whether an alternative strategy focusing on only or primarily the most vulnerable would be more cost effective. The fact that models evolve as data comes in is true, but it also does not relieve anyone from doing some basic reality checks on their claims. In the case of the Imperial College Study, the lead modeler, Neil Ferguson, is a physicist by training and has no medical background. He and his team have a track record of massively over-estimating casualties (their estimates of mad cow disease, swine flu, and bird flu were all off by large marings). Moreover, the 2.2M dead with no intervention would have made COVID-19 comparable to the Spanish Flu (adjusted for population). Maybe it is, but it’s a pretty extreme statement and should have been much more rigorously scrutinized. Ironically, the models did not require full lockdown for reasonable mitigation. By your standards, is he an expert or a non-expert?
Throwing the 50K dead in a month versus the flu issue seems to me a strawman. If the virus is especially contagious – and it seems to be – and if it was here much earlier than suspected with many people asymptomatic, then clearly it would have spread widely throughout the population already. Is the current spike in the death rate a reflection of it finally having reached a large enough part of the most vulnerable population to act on them en masse while leaving a large number of people infected but not affected, or is it a trend that will continue at its current rate? That seems to me a reasonable question because if true, then lockdown is not likely doing much to stop the spread. If the spike is just that rather than an indicator of a trend, then comparing it to the more gradual six month (Nov-April) flu season, which is more uniform, is misleading: the area under the curve, so to speak, and thus total deaths may be similar or not.
With respect to the virus being more serious than the flu, it should be noted that it can be just that without it necessarily requiring this type of response. The 1957 and 1968 Asian and Hong Kong flu epidemics killed more than 100K people here without a social lockdown. Adjusting for population, this is close to 200K dead today. Clearly, that’s 3-6x more deadly than the seasonal flu, and the 1968 Hong Kong flu was recognized as being highly contagious, much more so than the seasonal flu. The evidence that COVID-19 is that much more dangerous beyond even those outbreaks needs supporting evidence.
Finally, when you use phrases like COVID-19 deniers or imply right-wing people are simply taking an anti-science position, you do yourself no favors and undercut your argument about sticking to the science. People in all fields and with varying levels of technical, medical, mathematical and scientific knowledge, have raised legitimate questions about the virus without denying its reality or seriousness. As noted above, it can be several or many times more sever than the seasonal flu and yet not require this level of lockdown. That’s an important point because what happens when we have COVID-20, so to speak? What is the trigger for social lockdown? Are we going to do this every couple of years? Note also that when you imply that those on the right raise criticisms irrationally because no reasonable person could disagree with the models, the analysis or the policy, you simply invite the claim that those on the left are taking their stance for political reasons too. This hardly helps find the truth.
Can you link to the epidemiological evidence you have in mind?
And I agree that discussing what level of social distancing we should use and which measures are necessary is important and valuable. I would add that we likely won’t have full data on it until a few years down the line, and there are probably measures that are more or less justified – and we need to learn about this, though we are and will continue to have to make decisions in uncertainty. Providing bad data confidently, as these people did, does not advance that discussion, and can only derail evidence-based decision making.
“There are other, actual epidemiologists, who disagree with the so-called consensus on this point.” And yet you don’t name a single one.
“And yet you don’t name a single one.”
As if I had to show you an invisible pink unicorn to know that they exist! Pffff…. You really do not want to believe, don’t you…
That’s a lot of faux outrage, all politically motivated. Other than the dubious extrapolation from their sample to the population at large (if it’s there; I have not watched the videos), most other examples that Orac is referring to as “bad science” are reasonable. Home environment may teem with microbes but few people keep exercising staying put, and alcohol consumption is through the roof (as confirmed by the stats). Psychological damage is probably huge. Suicides, stress level, domestic violence will all go up, for sure. Economic damage is in trillions. And what, the beloved-by-the-left Swedes are all of a sudden cruel social engineers sacrificing their elderly on the altar of economy?
But yes, even in terms of costs, expending huge resources to save a relatively few lives means many other lives will be lost. If, say, the economic damage from the current approach is ~4 trillion, and a number of incremental lives saved is 50,000, that’s $80 million per life saved. Is it reasonable? Or even half or a quarter of the number? How many lives would be saved by lowering the speed limit to 15 miles? I bet thousands, so why not?
Balance those lives saved with lives lost to social dysfunction and due to less access to the medical system for other conditions, plus lives lost because those trillions will not be invested otherwise, to buy better roads, hospitals, services and for a myriad other reasonable things.
For the Left, this calamity is a god-send: damaging the economy, and particularly small companies and self-employed, while boosting government brings closer their hegemony.
You base your calculations on 50,000 lives saved. During the flu pandemic of 1918-19 the U.S. had over 675,000 deaths in a population of 120 million. Without the lockdown if the COVID-19 is as nasty as it seems, more and more info on damage to heart, liver, and other organs, including central nervous system, and blood clots, then without lockdown we could potentially see deaths approaching one million people, plus many more in long term recovery. And the lockdown stops overwhelming of our medical facilities. If we were inundated during a short period, many would die who could have been saved. Yep, it is the left, not the overwhelming scientific consensus that is driving this lockdown and as I’ve written in other comments, if we didn’t waste monies with weapon systems our military made clear it neither wants nor needs, bailing out crooked bankers, and corporations, lowering taxes on billionaires and corporations (not leading to investments; but corporations buying back their stocks to increase value and billionaire playing the stock market) we would have the means to compensate and rebuild our economy; but lives lost and disabilities developed can’t be undone. I wonder who among your loved ones and friends you are willing to sacrifice.
As for leftist Sweden, currently they have much higher deaths than Denmark and other neighboring countries because they didn’t impose a lockdown; but a voluntary one with strong suggestion that senior stay home. And, actually, over the past few decades Sweden has, unfortunately, moved to the right. Currently, 23% members in Riksdag belong to a neo-Nazi party (yes a neo-Nazi party where headquarters have had photos of Hitler). On the other hand, all other parties, even conservatives have refused to cooperate with them.
Och jag läser regelbundet Svenska tidningar på internet och håller kontakt med kompisar i Sverige. And I regularly monitor Swedish newspapers on the internet and keep contact with friends in Sweden. In addition, I am on the Swedish Health Departments listserv which sends out regular updates on COVID-19.
But, thank you for adding to the chorus of paranoid conspiracy theorist who don’t even really understand what the “left” is about. Sweden, when I lived there, actually on a per capita basis had more small businesses than the U.S. And also, before the proliferation of for-profit medical journals, when there were fewer journals, had, on a per capita basis, more published medical research. And, for instance, Bernie NEVER called for nationalizing steel industry, auto industry, food industry, which is what socialism calls for. He wanted what economics sometimes calls social or public goods, things that free markets can’t supply in any equitable way, that is health care and education. Despite what our mass media writes, Medicare for All, based on 17 well-done independent studies will cost far less than our current system, the money will go to health care, not for-profit bureaucracies, and profits, and conservatively will save 68,000 lives per year and reduce/prevent 100s of thousands of disabilities. Plus people will be able to choose their doctors and go to them without some for-profit bureaucrat standing in the way. And when our media and pundits criticize his free college education, it was the GI Bill and also when I went to college, Jr. colleges were free and state college tuitions minimal (State of California subsidized higher education by 70%, currently around 17%) and federal housing loans that created our now shrinking middle class. So Bernie is NOT what people like you imagine a socialist to be.
You might find an article I wrote of interest, if you are capable of reading: The Case for a Universal Non-Profit Health Care System at: http://pnhp.org/news/the-case-for-a-non-profit-single-payer-healthcare-system/
As of today, the no-lockdown Sweden’s death rate from the virus is ~230 per million, the US’s 178. Assuming both nations are in the same place on the trajectory, and as many people are yet to die as have, and increasing the US rate to equal that of S., about 500-600 people per million will have died here by the end of the epidemic. This translates to ~150,000 no-lockdown American deaths vs 100,000 on the current trajectory. The difference? 50,000. Your reference to the Spanish flu is arbitrary. Of course, all the assumptions are subject to questioning, but the eventual numbers won’t differ by an order of magnitude.
Health consequences of the condition.
Your lamentations and hypotheticals would be more convincing had you been able to contrast them against the almost universally acknowledged damage from the lockdown. I mean quantify vs pontificate.
On Left’s “compassionate” approach and my hardheartedness.
So OK, we’ve wasted dollars on all those things you disapprove of but that’s been done, no? Kind of, sunk costs? So why deny “the overwhelming scientific consensus” now? It’s a consensus, first and foremost, on the relative damage from the two alternative approaches, and the Left’s policies supposedly are all science-based, are they not? (I discount Marxism, CA anti-vaxers and Fidel as only supported by the academy, not by the sane Left, nor, God forbid, by Bernie). As for whom I’d be ready to “sacrifice” (if you insist on arguing this deep issue), it’s mostly myself, as I am well into the high-risk age group. As are most of my friends. Even the most rational policies help some, “sacrifice” (in different senses) others.
On socialism, Medicare for All, Bernie and such other weighty issues that I do not understand.
We’ve heard that all, many times, and I do not have to imagine anything. I’d lived under this kind of utopia most of my life, before coming here (and very very few of that singed cohort of a couple of million have ever voted Democrat). Public goods can be delivered by the market just fine, just don’t stand in the way, remove perverse incentives to consume those goods with no regard to their real costs, and provide some reasonable safety net. All relatively easily implemented as policies but, of course, not in today’s America.
At least you got to the fail early on. There is no such thing as “the trajectory.”
Apropos of Sweden, do you know this little blog by a Swedish archaeologist?
Coincidentally, he just posted about the Swedish answer to Covid19. He has a few interesting points as to why Sweden didn’t went into full lockdown – in part, because Sweden citizens and politicians trust scientific advisors and don’t need to be told twice to practice social distancing.
But I read it mostly for his ‘pieces of my mind’ and archaelogical stories. Oh, and he is a boardgame geek, like me.
One of the regular commenter is an American working in Hong-Kong. I found his insights from a place on the other side of the planet very interesting.
@citicab Back of the envelope calculations can be useful but one has to filter them through the lense of commonsense to work out what they actually are telling you. Your conclusion is so obviously risible that your calculation is clearly telling you something else. I can easily make a back of envelope calculation that suggests the US would already have reached and breached your end point (150000 deaths) if it had followed milder social distancing policies. So what your calculation is telling you is probably that there are differences between Sweden and the US or UK. For instance, a largely white population (there may be some effect on BAME populations), perhaps a healthier population generally, perhaps more willingness to follow social policy, but to my mind the ability to follow social policy because of the level of urbanisation. People have known since the year dot to leave cities if possible during plagues. You can fit all of Swedens population into the London or New York conurbations for instance. The UK seems to be pretty badly performing by and large – and no doubt the goverment is complicit for not reacting quickly enough. However, the fact that a large portion of the population are rammed into large extensive conurbations is I’m sure a bit of a factor too.
There is too much uncertainty, variation in how various countries seem to be affected and generally unexpalined things with this virus that I personally am making no theory here – I am simply pointing out that your back of enevlope calculation has lead you to a rather silly answer and is probably telling you something different from what you think it is telling you.
This situation is by no means over yet, so we’ll see what actually happens to Sweden and the rest of us, but if Sweden is telling us anything, perhaps its suggesting that in less densely populated areas realtively mild social distancing measures practised diligently by the all the population would be sufficient. That might be a hopeful thing, if treated carefully.
So, are you saying you’re willing to die or suffer life long disability to increase the value of my 401K by a dollar?
Damn R0<<1 I meant..
Does no one else find it surreal enough to be worth comment that Dr. David Gorski, MD, PhD is debating epidemiology on Twitter with Larry The Cable Guy? i mean, it’s one thing for these Bakersfield bone-heads to be boosted by Foxist Newz types like Laura Ingraham and Tucker Carlson, but surely Larry The Cable Guy is the embodiment of the vox populi. /s
I was wondering if Bakersfield is represented by Devin Nunes. It’s not, though his district (CA22) is adjacent. Bakersfield is in CA23, the most Republican in the state, and represented by House Minority Leader Kevin McCarthy.
It’s peak Trump era, I’m afraid.
Lordy. Bunch of Karens stormed in from somewhere and are pounding the inner surface of Orac’s screen demanding to speak to covid-19’s manager.
Here, Karen; A little light reading to pass the time:
Bayesian statistics, based on prior probabilities, is only as good as the prior probabilities. Obviously the two doctors didn’t even consider this. There are situations where Bayesian stats are quite valuable and others where they aren’t. I only had one course in Bayesian stats over 40 years ago and this is what we were taught.
The theory allows you reevaluate the prior. That’s one of the main points of bayesian statistics nowadays (do not know what it was like 40 years ago though…). Anyway, my point was not the one you seem to be making, but rather that thinking in a bayesian way allows you conceptually, not pragmatically, understand how lack of quality of the source, in the form of prior probabilities concerning things like bias and variance of the probabilised quality of the source (in our case, it is bias…) can be incorporated into bounds of statistical accuracy. In essence my point was that bayesian stats allow you to conceptually and theoretically carry over the Cramér-Rao bound.
I wasn’t making a statement about the pragmatics, but about the theory of statistical accuracy.
“There are situations where Bayesian stats are quite valuable and others where they aren’t.”
They are a theoretical superset of regular inferential statistics, so I do not see what the point you’re making is precisely.
Anyhow, my interest in them is related to the combinatorial aspects of all these special functions that crop up when computing posteriors from priors with all these not-so-hidden Mellin transforms lurking everywhere. I have an uncanny obsession with some of their combinatoric properties, and tentative results on factorials that I’m trying to carry over to “double factorials”. Fascinating stuff…
I rather hope teaching of stats has moved on in 40 years then – though I fear not for many social scientists. It can be proved that Bayesian stats is correct in the sense that it (and only it) fulfils all the axioms we would like for a logical inference system. Where frequentist formulations agree Bayesian methods generally are more elegant and explanotory, where they disagree, frequentist formulations are inconsistent. The ‘only as good as the priors’ bit or ‘situations where they aren’t’ are I’m afraid the kind of garbled stuff that people come out with when they are taught that statistical inference is somehow a matter of opinion rather than mathematics and logic. Read ‘Probability Theory’ by E.T. Jaines, which contains the necessary proofs as well as some interesting background on how the whole field of statistical inference got into this woeful position.
“It can be proved that Bayesian stats is correct in the sense that it (and only it) fulfills all the axioms we would like for a logical inference system.”
That’s a very interesting statement given the stuff I’m working on. Do you have references?
(The only problem is that I’m at war with the concept of axioms and axiomatics itself for weird reasons, but I’ll leave it at that…)
@F68.10 I gave the reference mate Probability Theory by E.T Jaynes – misspelled his name but 40 days locked up with an 8 and 4 yrs old brain is mush so sorry!
Got hold of it. Just looking at the table of the contents, it does seem to be a very unique book. Ranging from applications to history of the topic with an interesting twist on Kolmogorov complexity that never gets mentioned in vanilla books on statistics.
Really like that. Specifically the Kolmogorov complexity part, as it’s something I’m quite interested in: Morita equivalent categories have same Kolmogorov complexity. An idea I’ve been toying around for some time (and mentioned cursorily to Narad).
But if you could pinpoint in the 650 pages the place where it supports your claim “It can be proved that Bayesian stats is correct in the sense that it (and only it) fulfills all the axioms we would like for a logical inference system”, I would be most grateful as it would avoid me losing too much time with the book. (Which it seems I’ll eventually have to anyway…)
BTW, you’re an aussie?
I’ll have to dig it out of a pile of books in my garage to get the exact section for that.. Its early on though given that its the foundation for the rest. However, if you’re interested enough in it and capable enough to follow the technical stuff, which it seems you are, then I totally recommend reading it all though. Its an interesting mix of material.
I’m not an Aussie – Scottish actually 🙂
Arrrghhh! Only three chapters in the link I gave! My world is coming to an end!
Anyhow, his argument seems to be summed up in this paper. Need to have a look at it.
F68.10, try this link to the book in the internet archive:
It looks complete but I did not compare to the physical book on my shelf. This is one of the most useful books in my library. I used the ideas and procedures to develop algorithms to analyze sensor data and machine learning in a commercial product years ago. I didn’t jump into it blind since I have a strong education in mathematics and computer science. 😉
Thanks! Love you!
It indeed seems, at first glance, to blend beautifully with the weird stuff I have in mind. But that’ll be a long way down the road…
All the people on RI and elsewhere saying we should expose thousands of healthy people to the virus in order to get herd immunity? I’ve never once seen that sort of comment followed by “I volunteer to be one of those infected.”
Odd, isn’t it?
Well, there was some boss of a team in the Formula I racing class that wanted to expose his stardriver to the virus, so he could gain imunity. It was considered to dangerous, so it wasn’t put into action.
I volunteer. Provided I have the time to wrote a dozen emails and provided my relatives let me…
(Though I believe that the virus is doing a good job on his own and doesn’t need that much help…)
These physicians had the COURAGE to come out and make a public statement on their experience with their patients and give their professional opinion backed by FACTS and YOU ORAC don’t even have the courage to use your real name.
You are a slimy, whimsy little swamp creature with NO BALLS.
You do realize—don’t you—that my real name is pathetically easy to find with just a tiny effort? In fact, it can be found right here on this very blog with a little clicking around.?
Just so you know, the discovery of my true identity is an intelligence test for new commenters. You flunked.
Heck! If he had just read the comments ahead of his, he’d have found it!!! He definitely flunked! He also makes me suspicious that he hasn’t read much of this blog entry……
@ Thomas Tiger O’Keefe
Is “Tiger” your real middle name?
I second what ORAC wrote, his real name is super easy to find, just look at top of page: “Who is Orac”
So, your statement: “You are a slimy, whimsy little swamp creature with NO BALLS.” Besides uncalled for given just how many post not using their real names (people have been harassed/threatened at home and for), shows just what an absolute moron you are AND quite simply I think what you wrote could be construed as based on the psychological defense mechanism of projection, that is, projecting your own negative traits onto others.
Big talk coming from someone with NO BLINKING LIGHTS.
Here’s a hint. Randomly capitalizing words in a comment does not magically convert juvenile ad hominem nonsense to useful commentary.
He clearly stated their “professional opinion” is based on facts. Just misrepresented facts and that their professional opinion is not professional at all. It’s like going to a general practitioner and asking him to perform Brain Surgery. Just because he had classes about the brain doesn’t make him qualified to do brain work. The guys are not Dr’s of epidemiology. Foxnews is speeding America towards its demise. Listen to experts no pseudo experts.
— Donald Trump, probably
Thomas! Can’t you understand? They didn’t use a representative sample. DID NOT use a representative sample. Everything else they say is irrelevant because of this. Not using a representative sample means their mathematics are wrong. I don’t care if your opinion is that the current social policies are wrong. I don’t care if you think that accepting all the additional deaths caused by not following current policies would be worth it. Those are political and moral issues. These doctors were simply incorrect in their statistical extrapolations. The question should probably be, did they do it out of ignorance? Knowingly due to their political leanings? Or money?
I would recommend a read of Ben Goldacre’s book Bad Science. It’s pretty light reading and you’ll learn more about this sort of thing from this one book than you apparently have in your entire life.
All of these long posts from new commenters are completely missing the point. These doctors are statistically wrong. There is no need to supply ‘correct’ figures in place of theirs. This isn’t a competition. There’s no debate. There are no trained epidemiologists who will tell you that extrapolating general results from a non-representative sample is acceptable for accuracy.
No idea how to embed an image (if enabled) in WordPress but what the heck.
As I claim no credentials I’ll ask an honest question about the data…
Can this simplistic view of the data tell a layman anything useful? Besides needing to be hospitalized being VERY bad?
Where’s it from?
The source of the data (Johns Hopkins University) or the source of the image (Photobox)?
If people haven’t seen it yet, the Johns Hopkins portal is now very data rich on the county level for the US. Demographics (including population, ethnicity, poverty, age >65), infrastructure, number tested, current ‘fatality rate’ of positive tests (4.36% for Cook), and comparison with the rest of the state.
This view of the JHU data may be preferred for some.
Photobox creates images all by itself?
Why not have them both?
You’re right…both were on your link. Mine just gets rid of the frame. Dealer’s choice?
As far as I can tell the data is accurate. I’ve seen similar from numerous sources. And i wrote a comment that the death to case ratio was 5%, that is number of deaths to confirmed cases and the chart you link to gives a slightly higher value. Thanks for find it.
But to answer your question, ForThemWhatCares, It is not that great to be in that group, right now. Look on the bright side, You have a 91 to 96 percent chance of not dying mabey depending on where you live (unless you are old where you have a 14-20% chance before any comorbidities.)
But, for the most part, the only ones having been tested are those who are sick (and before that, sick and having been to China or around someone else who was that tested positive — very limited and useless given what is now known about asymtomatic spread). Yes, the overall case fatality is likely to plummet If there were widescale testing but that, as of yet, is not happening. It reminds me of the series Chernobyl where when presenting to Gorbachav the radiation readings: 3.6 not great not terrible; of course, the meters they were using pegged at 3.6. That is where our testing is now.
But don’t be like that covidiot above citing 50,000 deaths over 350,000,000 people means .015 percent overall; And even if you still listen to Rush then do try and recognize his lampshading, gaslighting, and his own pure ignorance.
RUSH: He never said it, never implied it, didn’t ask if this is possible.
Ahh. But Limbaugh was deferencing to Draino:
See how he works???????
From the same link. Day. Fucking. One.
Mega dittos, Rush. I know you got no fucks to give because you golfed with Trump that day and are sitting on liters of other people’s t-cells.
[…] Drs. Dan Erickson and Artin Massihi: Promoting dangerously bogus pseudo-epidemiology about COVID-19 […]
“There’s also a pandemic of armchair epidemiologists confidently spouting off about infection rates and case fatality rates, people who self-assuredly say, “I’m not an epidemiologist or infectious disease expert, but…” and then proceed to make opine about the incidence, prevalence, and treatment as though they were experts. Personally, whenever anyone starts out by saying, “I’m not an infectious disease expert or epidemiologist, but…” I respond, “You should have stopped after ‘I’m not I’m not an infectious disease expert or epidemiologist.””
and you should have stopped there…
And yet you don’t or can’t point out a single error of fact or interpretation in the post.????♂️
Isn’t it interesting how many comments on this post have started that way?
(Immunologist and MPH.)
[…] that we must “FREE AMERICA NOW”, but they’re also praising Bakersfield, California, Drs. Dan Erickson and Artin Massihi as proof that they somehow also have science on their side. Spoiler alert: They still don’t. […]
The so-called Experts have also been wrong multiple times since the beginning of this pandemic, er, before it was a pandemic even. Soooo….. your argument doesnt hold up when you start off with “they are not experts” argument. The immune system part of what they are talking about is correct, thats just common sense.
No, it’s not “common sense,” nor is it science.???♂️
Hi, immunologist here, and no. What they said about the immune system is wrong. That is not how the immune system works. If you immune system had to constantly be reminded of pathogens 1) there would be no such thing as immune memory, which obviously exists and 2) every astronaut coming off the ISS would immediately die of an infectious disease. That doesn’t happen, therefore, these doctor’s statements about the immune system are wrong.
I’ve followed quite closely the current pandemic and you confuse political pronouncement and Fox News, etc. with what real scientists were saying. Early on we were warned of a new deadly pneumonia. Our politicians ignored it. We were warned as more info, including sequencing of the genome, became available, and we ignored it. Trump stopped Chinese from entering country; but didn’t even test nor quarantine for a short time Americans and other Europeans. I guess he and others don’t understand that viruses aren’t picky about who they hop a ride with. And I and others have posted comments concerning the immune system. Common sense doesn’t explain it. I realize that you and all the others who don’t have any background; but still think you know what you are talking about; but once again, I recommend a really great book, only 160 pages, inexpensive from Amazon: Lauren Sompayrac’s “How the Immune System Works (6th edition)”. If you don’t want to spend for the new edition, the 5th edition is more than adequate. Get it and read it if you dare.
Or you could, you know, give a link.
What most people don’t get about the relationship between pharma industry and the medical profession is that it is a two-way street. As a scientist who has been doing research in drug discovery for several decades (in the service of both big and little pharma), I need to hear from practicing clinicians. I don’t care about selling our drugs to them, but I need to learn about their research and what they need in the clinic.
Over that time, I have not encountered any practicing physician who really knows what it takes to discover and test new drugs. Most academics tend to know a lot about their specialty, but not much beyond it, Being a practicing physician and discovering drugs are two different skillsets.
What many of the critics here and others (see comments to Derek Lowe’s In The Pipeline) have shown is that many people don’t grasp the value in doing the science correctly. That’s understandable for the average person, but is unacceptable in the medical profession. It seems to me that too many doctors have gone full Chicken Little in this pandemic, aided and abetted by poor quality journalism and politicians looking for a quick fix. Those advocating for quick short cuts are not showing courage, just panic.
There’s a good discussion on this at:
Thanks, a superb article. I actually read book by second author, Overtreated (a well-written, well-documented book). And the American Association of Physicians and Surgeons (mentioned in the article), who support hydroxychloroquine, is a fringe group of around 4000 members among over 1 million doctors in United States that has taken positions such as:
human activity has not contributed to climate change, and that global warming will be beneficial and thus is not a cause for concern
that HIV does not cause AIDS.
that the “gay male lifestyle” shortens life expectancy by 20 years.
that there is a link between abortion and the risk of breast cancer.
that there are possible links between autism and vaccinations.
that government efforts to encourage smoking cessation and emphasize the addictiveness of nicotine are misguided
And that the Food and Drug Administration and Centers for Medicare and Medicaid Services are unconstitutional
But, despite the above and more, media quote them. I wonder why media doesn’t give equal time to Flat Earth Society and NASA?
Thanks again for the link
Thanks for the warning about the AAPS! Where can I read more about some of these odd positions you’ve listed as a quick Google search didn’t turn these up?
These quacks statement of a really low IFR are obviously flawed. The real IFR is probably between 0.3%-0.7%, and the best data from NYC says 0.5%. Of course, NYC could have higher average infection doses because of the subway, so the IFR actually could be lower in other places. An infection fatality rate of 0.5% isn’t the end of he world, but it clearly is greater than seasonal flu. Claiming it is less than 0.1% is not only wrong, but it does a big disservice to the political cause they are trying to promote.
So says Gary Hemminger: “they stated facts based on their own research”.
No they did not. Research means investigation. They did not investigate anything, just ran a bunch of tests and drew unwarranted conclusions from them. They didn’t set out to find something. They didn’t set conditions which would test a hypothesis. They didn’t interrogate their data in a way that would tease out statistical significance. Sorry, but all they have is a bunch of anecdotal material, presented in such a way that it offers no way in to develop a hypothesis.
Do the homework. Both of these doctors are Republicans with ties to Big Pharma as well as “Trumpers” who not only want to get their 5 minutes of fame in the media spotlight, but also stand to make big money from opening even more urgent care clinics in their immediate area. This is ALL politically driven–not to mention that their survey results are skewed and totally false. They absolutely should lose their medical licenses over this. Practicing epidemiology without being an epidemiologist is serious. These two should go the way of Dr. Phil–who, unfortunately, continues to make his appearance on national television even though he is a fraud.
Hell is freezing over. Orac and Mike Adams wrote about the same topic and agreed, however, Mike ruined it by spouting about climate science being false.
Dr Anonymous, you blessed us with this gem: “no point in having a discussion that is Aspberger’s AF”
I have Asperger’s syndrome. Your using it as an insult is disgraceful, bigoted, and sickening, on top of which, in your spew of self-righteous disdain, you couldn’t even spell it right.
The following link is for your further edification:
I hope you take the advice you find there.
Looks like bit.ly failed me, and it also looks like the old hand tremors cut off two parts of my nom de ‘net on another post.
Their basic argument makes perfect sense, and you have failed to refute it. You’re part of the problem in society today: believing whatever the “Authorities” tell you.
OK, I’ll bite. Point out a single error of fact, science, analysis, or reasoning in the post.
I wonder what this person thinks the “basic argument” that makes sense is.
These people drew a conclusion from demonstrably – demonstrated in the post – incorrect numbers.
“Point out a single error of fact, science, analysis, or reasoning in the post.”
The second sentence is factually incorrect., Pseudoscience, misinformation, disinformation, and just plain bad science is not a disease. Now, will you let me out of auto-moderation for bravely answering the question?
That’s an interesting argument while sustaining an argument from authority (“These two are ER doctors, they know what they are talking about”).
I’m a bit miffed by all these people telling us we should stop believing what the government is telling us, while the main message of the US government is that the Covid19 pandemic is no big deal, and it’s over anyway.
@ Narad; Don’t insult Michelob Ultra. It’s a fine European-style beer that has been warm-filtered through the kidneys of American beer drinkers.
Ed Yong published an excellent article today.
Note: Yong has a pretty impressive science education (see his Wikipedia entry) but not in epidemiology….yet he has a better grasp of the subject than Drs. Erickson and Massihi.
Thankyou so much thoroughly entertaining as well as educational. My take on it was That these two obviously have a very profitable motive to bend the truth . In my experience that almost always means they will . There are saints who walk amongst us who would resist that temptation but they are as rare as an honest politician .I like to ask questions on a lot of sites which usually leaves me fielding lots of insults and I was impressed by your handling of them .
This is like arguing with a teenager .. there IS no exact science when it comes to COVID as it is a NOVEL virus with a highly variable, barely known clinical history and hardly a shred of epidemiological history that changes literally by the hour.
Everybody .. from Trump to Fauci … is in complete W.AG. mode.
Anybody who says different thinks WAY too highly of themselves.
They will be studying this disease for decades and still won’t have all the answers.
To take anybody medical or not to task for any opinion only confirms one’s overinflated sense of self importance and personal selection bias.
There is a saying we have in medicine that has proven sage advice for many going back a very long way ..
Shut up, watch and learn …
Give it a try scut monkey …. cheers
Can I ask people what happens to high risk people after restrictions are lifted? Yes I have a vested interest.
They are supposed to isolate themselves. At least some people here think that way. Because young people hardly suffer and are very much influenced by the restrictions (yeah right I don’t mind being alone all day and only see my dad, because I care for him and shopping personel if I do some shopping for groceries) they demand more freedom and even some aplause, because they sacrifice so much. Please forgive me if I have to laugh. I hardly live an outgoing life, but my life is influenced very much by this lockdown. No library visits, no occasional restaurant visit, just stay at home.
I’m not sure, but appearently the virus here seems partly to be picked up in Austria in places where young people gathered to have a drink after skiing.
Who is “Orac” and what qualifications does Orac have
Another fail. Try looking.
What, another one? Where do you people come from? To quote our host: “Just so you know, the discovery of my true identity is an intelligence test for new commenters. You flunked.” Have you not even read any of the previous comments, not to mention the original post?
Are you not allowed to use teh googles in Russian troll farms?
Their contract doesn’t leave them the time, and in any case truth isn’t a stipulation. The contract seems to run for no more than 48 hours so they moved en masse to the next job when the time bell rang. What will I do with all the leftover popcorn? Orac needs to run another article to bring them back. It can be about puppies as long as it includes a few trigger words to snare their search algorithms.
More likely the link (and I have it on good authority that it has) has been removed because of ‘blow back’; The ‘faithful’ were getting confused.
[…] urgent care doctors claiming that the COVID crisis is massively overblown. The indispensable Orac dispatches them with ease. Their argument is that since 6% of the people who came into their clinic tested positive for […]
Its basically just the first two chapters. As you noted its a bit of a funny book in style, partly because he died before finishing it -I actually initially had the preprint with large sections marked MORE HERE but now (somewhere) have the hardback. I think this pdf is the same as the print version but not sure.
Its actually 15 years or so since I last read it, my career sadly having diverged from where I actually needed to have some knowledge of this stuff, There isn’t an explcit forumlism of the type ‘given axioms a,b,c then d’ but I think if you read the first two chapters you will see my remarks are justified and they do indeed constitute a proof of my assertion.
If you are in anyway interested in ‘the logic of science’ as he rightly describes it, you will find this book very quirky, stimulating and intellectually satisfying. You will also find that the god of frequentist stats – Fisher – was indeed a genius, but also one transposition away from King Cnut – much to the detriment of the subject.
May have to add it to my lockdown reading list now – once I’ve disposed of Gregory Chaitin – enjoy! 🙂
Sorry that was for F68.10 further up the conversation
“There isn’t an explcit formulism of the type ‘given axioms a,b,c then d’ but I think if you read the first two chapters you will see my remarks are justified and they do indeed constitute a proof of my assertion.”
Sad state of affairs given there is a need for a correct formulation incorporating the epistemological constraints. Will read.
But as I’m trying to use logic programming to encode some kind of general Galois theory using Ehrenfeucht-Fraïssé games not only on well-defined structures coming from mathematics and model theory more generally but on wild data with arbitrary unknown relational structure, I am indeed dealing with the reverse problem of what Jaynes dubbed the Mind Projection Fallacy in the paper I quoted. When running Ehrenfeucht-Fraissé games on arbitrary such structures to probe the internal analogies within the data under permutation of its presentation (these permutations are the Galoisian aspect of the process), you do extract relevant symbolism from the data itself. What Galois indirectly did achieve was indeed to extract, given the roots of an equation (the data), the field of definition of the equation (the symbolism). And such approaches have been generalised to model theory. So you’re trying to solve what Jaynes called the Mind Projection Fallacy this way. But to conceptualise this galoisian probing process, you have to admit that such a logic program is operating under a fog of ignorance of the relational data’s structure, structure which needs to be thought of in terms of Kolmogorov complexity. And to engineer the best Ehrenfeucht-Fraïssé games possible such that such a process is “fast”, you need things like pattern recognition techniques (the better a player of an Ehrenfeucht-Fraïssé game understands/recognises the structure he is playing with, the better he gets at the game). Something therefore a bit better than neural nets, whose theory would not merely be learning paths on information geometry manifolds based on Shannon-like entropy but learning paths on “information” geometry manifolds based on Kolmogorov-like entropy (more like a geometry of axiomatics than a geometry of information, in a sense). In topos theory, analogue results or insights are indeed the special position of Morita equivalences with respect to Ehrenfeucht-Fraïssé games and Kolmogorov complexity. So if Bayesian statistics form a correct logic to probe data, I need to get it right in the general setting to extend it to the context I have in mind.
That’s part of the rabbit hole I’ve been digging recently.
@F68.10 It may be some time before I absorb all that 🙂
It’s going to be much longer for me.
This appears to assume the “reality” of ontology.
“This appears to assume the “reality” of ontology.”
It mostly assumes that given any kind of data (what you call reality), if you can dissociate the internal structure of data itself from the way it is presented to you, then there are more suitable languages than others to talk about the structure of that data. Better languages are those where axioms needed to describe the properties of the data are the densest / most concise. And that there is a somewhat computable yet unpractical way of tackling that language extraction problem from the data itself.
If you have 5 unordered – unordered means that the association of these numbers is dissociated with its presentation to you as data, which presentation is the ordering – random complex numbers, the language in question is what’s called in Galois theory your field of definition (generated by so-called symmetric functions applied to these 5 numbers), and the axiom in that language are given by the polynomial whose 5 roots are these five points. First historical example of the above paragraph.
The Mind Projection Fallacy as defined by Jaynes is assuming that your language is the reality to an extent or another. Acknowledging that it is a fallacy means acknowledging that language is imperfect but that a better language is one that allows you reason on reality. Hence a language that comes bundles with a bunch of axioms. Solving the Mind Projection Fallacy means finding a reasonable way to make language and axioms as precise and simple as possible. You can sacrifice precision for simplicity or simplicity for precision. With algebraic structures, you tend to have the best of both worlds, precise language and simple axioms, which is why they seem real to a mathematician. With random data you cannot have both precision and simplicity of language + axioms, which ties in to the issue of Kolmogorov complexity. Which is why Galois theory first came about with algebraic structures, and why it is so hard to extend the theory the more exotic or wild your structures or data get. But conceptually, it seems that it is possible to do.
Hope it’s a bit clearer.
Just a word to the newbies commenting here. Your first comment goes to moderation. After I release the first comment, you can comment freely. The reason for this feature is to cut down on comment spam. You’re not being “censored,” and if it’s several hours between your attempt at posting and your comment appearing it’s usually because I’m busy working or sleeping. Here’s my comment policy: https://www.respectfulinsolence.com/commenting-policy/
Wonder how long it’ll take antivaxers to go into hysteria mode on hearing that their activities could be seen as a threat to national security.
I’m still puzzling over this attempted simile from AoA:
Oddly enough, I’m reading a history of the Normandy invasion right now. Given that the airborne troupers were supposed to land several miles inland, any soldier landing directly on the beaches would have been way, way off course. So it could mean that Shiva is in the wrong place.
On the other hand, I doubt that AoA is keen on historical accuracy, or accuracy of any sort, so it probably doesn’t mean that.
And hours before the amphibious assault.
I am enjoying the outraged responses from RFK Jnr to Ayyadurai’s shameless attempt at snatching his mantle as Grifter-in-Chief of the antivax movement. Since CMRSI went pear-shaped, there seems to less money sloshing around and people are less inclined to tolerate competition.
Hence the rapid escalation in promotion of conspiracies, as RFK tries to keep one step ahead.
During the recapture of Corregidor in 1945, one of the paratroopers was carried off the island by the wind before he could get out of his parachute and was rescued by one of the landing craft, giving him the dubious distinction of actually invading the island twice in the same day.
So, technically, it’s possible.
Just published and very on topic:
Saturday Morning Breakfast Cereal also did a guest comic on 538 about pandemic modeling that was an interesting read (if lengthy for a comic).
Is fear about Covid-19 just a liberal plot?
According to Del Bigtree ( today’s broadcast, first few minutes- I couldn’t take more) liberal news includes more fear mongering whilst the righties are more realistic, giving examples. AND he used to be a liberal- born in Boulder yet- it must be because they are all in the pocket of Big Pharma, want vaccines etc.
if anyone doubts how deadly the virus is, they should look at graphs of death rates in various locales worldwide for the past 5 years, they seem to vary slightly as graphs do THEN, there are gigantic leaps to huge figures in the past 2 months in all of them
Not only are these people bad at math, they’re bad at reading graphs,
They are channeling articles such as this one.
^That’s the bookends. In the middle is a whole bunch of mortality rates compared to other causes:
They do not point out that those numbers are coming from while the country has been in lock down and that most of those conditions will still become untreated if the system gets swamped.
Wear the mask, freepers. Don’t endanger every one around you and yourselves and your families just to show solidarity for and recognize the stable genius wisdom of that flaming orange narcissist, Donald J. Trump.
Seriously, freepers; Most of Y’all are old as fuck — consider that it would be in your own self interest. What has The Donald or Jim Robnison done for you lately?
There was an article in the Seattle Times today interviewing some of the people who recently protested the stay-at-home order. These people included an anti-vax bartender who doesn’t use hand sanitizer because it contains “toxins” (uh, like alcohol?) and the owners of a chain of tanning salons who don’t understand the difference between a grocery store and a place that give you cancer.
And one person who was very upset her kid couldn’t get an ultrasound promptly. (Kid got the ultrasound, but not before mom went to the protest.)
Yeah, I saw that. I am sorry that I did not have much sympathy for the guy whose business is those skin cancer boxes… also known as tanning beds.
Not to mention that these numbers are in addition to the other numbers of deaths. And that, for those other causes of deaths, there is stuff being done to try to reduce them (vaccines for the flu, dietary advice/treatments for heart disease and diabetes, road and vehicle safety measures for car crashes, etc, etc).
Reminds me on someone who complained dentists were able to get back to work, but hairdressers not.
Another dark thought has occurred to me. That is that the people in these dense protests, sans mask, and shouting, yelling, spraying arm in arm — like the ‘cough in my face guy’ that said “she is even too scared to cough in my face!” — They are spreading this amongst themselves and are gonna get sick first. And will get a bed first; Possibly denying all the others later infected because of their antics.
So. Less of them die than those that didn’t do the stupid. Trump was right. Trust in Trump’s plan.
Why do they go in 3X3 + extended family only to loiter about and come out with one can of cheeze whip and some discount eyeliner?
“I am enjoying the outraged responses from RFK Jr to Ayyadurai’s shameless attempt at snatching his mantle as Grifter-in-Chief of the antivax movement.”
Somehow I’d missed out on the Shiva-RFK Jr. rabid catfight up to now, but it’s bizarre watching their connect-the-dots-capades as they reveal each other to be minions of the Deep State Vax Conspiracy. Shiva may have gotten the last (or latest) word on his website*, but RFK Jr. appears to have scored the most points. There hasn’t been as entertaining a disturbance in Crazy-Land since the Gazillions of Health Freedom Fighters guy took on AoA.
*”Robert F. Kennedy Jr. Vomits BIG LIES When Exposed with Truth! Party Over!”
Shiva is loonier than PatTimmy the Gazillions of Health Freedom Fighters guy. He is just about up there with Gus the Fuss.
I see that Kennedy Jr has hit back on his blog. At the moment I am trying to determine who wants to win the mantle for having the most eye rolling website. Kennedy needs to lift his game.
I am imagining Shiva, the collective Antivaxxosphere, and RFK Jnr in the three roles of the “New girl / Wandering-eyed Boyfriend / Outraged Girlfriend” meme.
Well, @Smut Clyde, this is not what you imagined but just as pertinent, I suppose:
James Corbett of “The Corbett Report” in Japan is concerned, too. https://www.corbettreport.com/can-you-find-this-video/
@ Dr. Anonymous,
As someone who is actually ‘Aspergers AF”; I would prefer you use a more fitting term.
Such as Indoctrinated. Most of those who are high profile in the medical/scientific community are actually not able to think outside of whatever box Fauci, the WHO & the CDC have put in front of them. I bet you that back in January to mid-Febuary, when Fauci was praising the Chinese for ‘their transparency’ & saying that American’s were at little risk & that wearing a mask wasn’t necessary? That they were were right in step with him. And they still are. Lock step.
Orac is not only not Aspergers; his ‘insolent’ blogging’ many times serves to incite his regulars into a frenzied snark attack against parents of vaccine injured children & families of children who succumbed to vaccine fatalities..Although I will admit he does not stoop to that level himself.
I do understand what you MEANT by Asperger’s AF, although sometimes I might actually take pride in that description. Everybody else here actually knows what you meant too, which is why I suggest using the term OBTUSE for his regulars. They know what you meant but you criticized a Box Maker so cue the false outrage.
Rejecting anti-vaccine claims does not make one indoctrinated.
Autism and SIDS are not caused by vaccines, and describing them as “vaccine injuries” is incorrect. Pointing that out is not an attack. It/s a correction.
Scientists change their conclusions according to the data. Anti-vaccine activists do not.
Please stop letting one flap overlap the other when glued together. It makes it terribly obtuse when trying to break them down.
@ Christine Kincaid
Ah, the return of the moron. The moron who knows that the vast majority of scientists around the world are wrong about no association between vaccines and ASD. Yep, as I’ve written numerous times, researchers from many different nations, different cultures, different histories, different economic systems, different educational systems; but all are part of some global conspiracy, all who could care less about their nations children. People like you make me sick.
As for the Chinese. They actually followed U.S. protocols for calling a halt to global travel. After the 2009 H1N1 novel flu which the WHO issued a pandemic warning, the right thing to do as it appeared to be deadly, since it turned out not to be so the WHO Director was forced to resign. And if they hadn’t issued the warning and it was deadly? Damned if they do and damned if the don’t. As for China, the first case was beginning of December. By mid-December they had a few cases of pneumonia deaths of unknown origin. They sent investigators and notified WHO by end of December. WHO put out a bulletin. Trump banned travel from China of Chinese; but Americans were allowed to return, no testing, no quarantine. I have news for you. Viruses are not picky who they hitch a ride with. And now new info that the virus may have been around since November, so, before any deaths it could have traveled around the world. We are finding earlier and earlier evidence for that in U.S.
The U.S. pushed the WHO to limit travel bans several years ago, and WHO did this until it became obvious it was a pandemic and still Trump delayed in acting.
Believe what you want you stupid despicable excuse for a human being; but even if China had issued an alert a week or two earlier, the virus had already spread and Trump still would have delayed. And if they had issued the alert, before they were sure of it spreading, and it turned out to be a false alarm, idiots like you and Trump would still be criticizing the Chinese and WHO.
And you MORON, it was Fauci who early on tried to get Trump to act. Trump got rid of the White House pandemic preparedness team in 2017, he cut funding to CDC and WHO, etc. Yep, you are really STUPID!
And my oldest friend of 63 years was probably Asberger’s (before it was an official diagnosis, he even thought it possible); but he would have done his homework before painting such a false picture.
Please, crawl back under your rock.
What I think he MEANT by Asbergers AF is that we are obsessing over details. What you CK and the moron you quote don’t get is that details are what matters. You appear to belong to the crowd of people who believe that glossing over the cracks and shouting loud enough are the way to establish the truth.
If you and others value the dollar above lives lost then say so. Trying to morally justify it by shouting down anyone who points out errors in your reasoning is just cowardly.
CK, if your opinion could never be changed, no matter what additional data you see, then you are in a box. Has your opinion changed? Or do you still assume that any data counter to your opinion is fraudulent? Do you believe that using the data from their sample can be used reliably to extrapolate data for the entire population? If so why?
Lost lives and lots of people in hospitals and on IC units also costs lots of money, so in the end it not really a choice between money and human lives.
I agree, but I would try to stay open to the arguments about diminishing returns – that in the end run, staying in lockdown will cost more lives, or year-of-life, than re-opening the economy now or earlier.
I am familiar with the concept of medical triage, so I get that hoping to save everybody may not be feasible.
Although so far, the proponents of “this is going too far” have failed to convince me. I find them very overly-optimistic on the consequences of letting the virus go through the population in basically unchecked conditions, with hospitals’ capacities to treat the infected people already overloaded in too many places.
Apparently just counting death, but not the accompanying lesser issues of the infection, like damaged lungs, heart or kidneys Also neurological damages, clotting issues… Every other day, the virus seems to be doing something new and disabling. My mom says that the virus is playing pick-a-boo with us.
(also, funny how antivaxers have the same approach toward “harmless” vaccine-preventable diseases)
Also, the way the “re-open the economy” proponents dismiss the deaths as “just being the elderly” isn’t filling me with confidence with their analysis.
Of course I’m open to the arguments of diminishing returns. I don’t think a lockdown should last forever, But I don’t think now is the right time, considering the amount of people still on IC’s and the presure on the health system and the workers in healthcare at this moment.
“But I don’t think now is the right time”
The problem is that it may not fit the criterion for being the right time for a long time. At some point, one has to cut its losses and take the hit. So it’s not only a question of finding the right abstract criterion for the right time. It’s also a question of how much are we willing to accept that we won’t do better anyway, and then fix the criterion at this level.
In such time-dependent decision problem, there is no relevant concept that could be construed abstractly as “the right time”. It’s also about cutting losses.
Not taking sides, here. Just putting the decision problem in context.
(If I were to take sides, my misanthropy would kick in brutally, so I’d rather stay silent…)
The least one can say is that as long as the normal IC capacity is not enough to serve all patients it might be to early.
I’m glad I’m not the one to decide when restrictions have to be slowly removed. I want them away just as much as most people do. I can live without crowded places, which I tend to avoid, but just doing some normal traveling, visit the library and a restaurant together with my dad, still is something I look forward at.
I’ve lived through more than enough solitary confinement to be able to sympathize. Wish I could.
Well, my life is very solitary. I mostly see just my dad and his neighbour, who sometimes need my care. At this moment it seems the only times I see other people is caring for them.
I don’t really care for sympathy.
Yeah, I agree. Apologies if I was coming as agressive.
In some way, I was mostly writing for myself, as being paralyzed by indecision over taking risk in my normal state.
That doesn’t mean that right now is a good time to open up.
Absent from my earlier comment, things I am wishing every day:
– if we had more hospital beds and accompanying personal and instruments
– if we had accurate tests available in enough quantities
My country, France, will try to unlock in two weeks. That’s going to be interesting days.
No, I didn’t consider your reaction as agressive. I was perhaps a bit annoyed by F….
I also look how things are working in other countries. We have a very mild lockdown, not as mild as in Sweden, but a lot is more or less based on common sense and less on forcing things. Mostly it works, but at some times people tend to take a bit more freedom than desired. But well, if you open shops on Sunday, you might expect people to do fun-shopping (not really my kind of fun), which of course is something that is not wanted.
But in daily life, one can do shopping, though social distancing is advised and mostly done as well, shops letting in a small amount of people at one time. On sunny days my dad takes a walk with his walker in the neighbourhood, which is rather quiet. We don’t need written permissions.
At the other hand, some people are complaining, it takes to long and they want to open-up, especially the owners of pubs. Or young people, complaining they are more the victim of the restrictions, because they miss their social lives, while they consider Covid-19 not really as a big thing, because the consequences are perhaps less serious.
“No, I didn’t consider your reaction as agressive. I was perhaps a bit annoyed by F….”
You have a right to be.
Oh, please. People here had plenty of sympathy for the challenges you face with your son, even if we didn’t agree about the cause, until you made clear the contempt you hold for parents dealing with other special needs, told increasing inconsistent stories and got caught in lies. And, actually, most of us still have sympathy for the challenges, but we dislike you enough that it doesn’t result in us tolerating your nonsense, and you can’t tell the difference between not agreeing with you and an attack.
Indeed. Having disabled children of my own, I am well past Kincaid’s nonsense. Every post of hers I look at, I now start with the explicit assumption that she is completely wrong and will be grandstanding. She has’t disappointed me yet. I sincerely hope she puts on a different persona for her family.
@Chris, agreed. I really hope she doesn’t talk about her son in real life the way she talks about him online. She says she loves her son, and I’m sure she does, but she certainly doesn’t seem to like him, much preferring the hypothetical “normal” child she thinks she should have instead. When faced with challenges, it’s certainly normal to indulge in a bit of “what if,” but her endless fixation on it isn’t healthy.
I’m surprised there’s not more focus on this, but I think the most telling statistical mistake they make (more than one) occurs around the 8:54 mark.
“So, how many deaths do they have? 19,410 out of 19 million people, which is a 0.1% chance of dying from Covid in the state of New York.”
He concludes that you have a 0.1% chance of dying by merely being in the state! (and it’s true, by the numbers). That’s the approximate death rate for the flu IF you HAVE the flu (the case fatality rate and based on estimates), but he’s going to compare it to deaths per capita? By his own “extrapolation” logic, we’d have to assume that 0.1% of the US population has died, but no, 329 thousand people are not dead from Covid (yet).
He then goes on to say, in a very cheery manner, that “And they have a 92% recovery rate, if you are indeed diagnosed with Covid 19, 92% of you will recover.”
I don’t know how he can say that so cheerily; that indicates a nearly 8% death rate! Nothing to celebrate, considering it’s roughly 80 times higher than the flu (P&I at any rate). But it at least is closer to the truth and what he should have been comparing to the flu. He already rattled off the numbers, so there’s no reason he couldn’t have taken 19,410 / 256,272 = 7.6%, so he could honestly compare that to the flu.
I really don’t know how he could honestly make that mistake. Faulty extrapolation aside, I at least understand how that could be done out of naivety, comparing and confusing dissimilar statistics just reeks of deception.
“just a little flu”
@ Dorit, Joel, Chris P, Terie, Athaic, NumberWang, Renate, Tim:
As sound as your statements are, you can’t get through to her. But I know you are also addressing readers who don’t speak up
So will I:
— science and SBM are not boxes because they are not dictatorial systems of obeisance but dynamic interchanges of data and research wherein arguments persist sometimes for long periods of time and schools of thought evolve. Arguments are “won” through replication of results, not preaching.( A current example: do several :miracle drugs” work in ameliorating symptoms of Covid-19? Data is coming) Alt med people like to characterise SBM as such because that is the only way they can comprehend issues- in black and white, not in many shades or levels. A doctoral qualifying exam once asked a question not about whether “Nature or Nurture” was responsible but HOW they were involved because it’s usually an interaction of both..
Reality based people are not following orders but they can read results of studies and see their meaning.
— no serious medical or psychological professionals accept vaccines-cause-autism: it is the realm of quacks seeking money or fame and distraught parents looking for an explanation for their woes
— anti-vaxxers like CK who show up are seeking something other than education; they want to prove themselves right and SBM wrong and a den of vicious vipers at that. It is a futile exercise in attempted therapy just as AoA and other groups are attempts at group therapy/ support groups which seek to reinforce UNrealistic beliefs and UNconstructive means of coping – thus, the converse of good therapy.
In other words, they need professional help- a counsellor, therapist or social worker who is reality based. Which they will never seek out on their own because they don’t recognise their own problems.
That should be Terrie
I don’t think any of us expect her to ever change her mind, not unless someone she cares about dies from a VPD (And even then, she’ll probably find some way to blame vaccines). It’s more not wanting other people to get pulled in by her “Oh, woe is me” shtick.
You are most definitely correct.
Although there are instances when a RL group who challenge unreal ideas or address the need for therapy do get through to a person but I don’t think that that would work here.
One difference between SBM supporters and anti-vaxxers is that agreement amongst the former is arrived at following learning results of research whilst the latter agree based on their feelings and then seek out confirming data from spurious sources. The first group has thousands of sources/ researchers, the second has a few of dubious merit., e.g. the same people present yearly at AutismOne.
@ Denice Walter
“Alt med people like to characterise SBM as such because that is the only way they can comprehend issues- in black and white, not in many shades or levels.”
True. But there are also people who are really disappointed by the behaviour of some doctors, using the word “science” as precisely that: A dictatorial system.
“Science and SBM are not boxes because they are not dictatorial systems of obeisance but dynamic interchanges of data and research wherein arguments persist sometimes for long periods of time and schools of thought evolve.”
That’s precisely the behaviour I wish I could claim I had observed in my life on medical matters. But, alas, no. I did see people using the word “science” as a dictatorial system of obeissance.
That’s why I can’t equate the practice of medicine with science anymore. My whole life has been a refutation of that claim.
And if other people experience the same kind of medical nonsense I did, even to much lesser degrees, it is brain-dead no-brainer that they would reject science altogether. Very bad image, you know… Very very very bad image…
Bottom lights: demanding patient rights is NOT being anti-science. I hope one day that message will be clear. For the moment, it clearly isn’t.
Bottom line. Not “bottom lights”. All apologies.
Believe me, medicine ( and psychology and education) – like all human endeavors- can be an avenue for miscreant actions and profiteering. IN other words, mis-using patients, clients and students. And I believe that you have been subject to abuse.
I also know people personally who haven’t been given the best medical care, had negligent nursing home care and of psychologists who subjected clients to mistreatment and worse ( actually, a prof at my last alma mater).
Like Churchill said of democracy ( paraphrase) “Sure it’s really crap but have you a better system?”
There have been patients’ rights advocates who are NOT Scientologists but concerned citizens who have seen these wrongs happen to relatives or themselves. Some laws have changed. This varies by country.
When I say “SBM” I am of course talking about an ideal and recognising that there are charlatans who publish and doctors who treat people to make money ( Mike Adams tried to link Orac to such a criminal because they both worked in the same city!). Research presented publically is a method to flush out useless, misleading and aberrant treatments and guide better choices as is the case with current speculation about what is effective with Covid-19: Trump’s 2 faves, not so much and an anti-viral, maybe just a little bit for some patients as Orac has explained so well. In only a few weeks, we are learning which treatments are crap and which may work or not work and in which situations. We also see which studies use shitty methodology or may be tied to financial interests. It’s all public and available, even to non-medical people like you, me and news writers.
In contrast, when we discuss woo and woo-meisters, we see that anything goes. They say anything they like, they do whatever they choose and make up data all the day long. There is virtually no oversight in how they mix up potions or supplements, they waltz around restrictions about making claims for their products and how they “cure” people, Their research is especially bald faced and coercive, merely advertisement and PR These business men ( and it’s mostly men) are offering ineffective formulae to treat or prevent Covid-19 right now..
Yet very few of them are subject to sanctioning. Lax laws about supplements and building up legal shields ( by having stables of lawyers) to cover their respective arses. I choose to focus upon their methods rather than the problems inherent in medical care which is above my pay grade . To turn Goldacre’s saying around: ” Just because I write about flying carpets being dangerous doesn’t mean that I think that airplanes are perfect”
@ Denice Walter
“There have been patients’ rights advocates who are NOT Scientologists but concerned citizens who have seen these wrongs happen to relatives or themselves.”
I’m still trying to find such examples. Almost everybody that speaks up on these topic are ridiculed as being precisely that: Scientologists. The eternal return of the Boogeyman…
Nonetheless, I fully understand your perspective and approve of it. Just to be clear.
Yep, CDC stats include pneumonia deaths. The reason is quite simple, if, at the same time, there is an increase in number of hospitalized patients with lab confirmed flu and the number of pneumonia deaths are above the normal number for that particular time of year, then it is highly likely it was a complication of flu. Flu virus damages the epithelials of the lungs exposing the under tissues to opportunist pneumonia causing bacteria. In our current for-profit healthcare system, if one treats pneumonia or someone dies of pneumonia at home, often labs are not done. In addition, if death occurs 1 – 2 weeks after infection with the flu, simple swabs will not find the flu virus, need more expensive labs.
There are hospitals that do carry out labs on almost all patients, so, as they are dispersed throughout U.S we have a good idea when the flu virus is around.
And it isn’t just pneumonia. Someone with mild congestive heart failure who has stopped smoking, begun light exercise, changed diet, may live many more years; but the flu virus could kill them. Same with others with various conditions. Again, if labs find an increase in circulating flu viruses and, at same time, an increase in various deaths over what would be expected, it is a reasonable assumption that the flu contributed to it.
And the latest about COVID-19 finds it, as opposed to the flu, causes blood clots, damage to organs, e.g., heart, liver, kidney, and central nervous system, and those saved by being put on ventilators experience a 30% reduced lung capacity (we don’t know if this is temporary or not), So, the flu, on the whole, is less damaging than COVID-19. Also, the basic reproduction rate (how many one person infects on average) for flu is 1.5 or less whereas for COVID-19 the estimated mean is around 3.28, with a median of 2.79. So many more risk be infected.
The article you cite has at the bottom: “The opinions expressed in this article are solely those of the author and do not reflect the views and opinions of Brigham and Women’s Hospital or Harvard Medical School. As the old saying goes: “opinions are like a-holes, everyone has one” and just because it comes from a degreed person, it is still one person’s opinion, just as some MDs market homeopathy, water!
Or 5.7, depending on how one looks at it.
Do you understand what a mean and median are? Yep, some studies have found as high as 5.7; but I gave the mean and median. Just one more example where you sometimes actually contributed to the discussion and other types just seem to want to irritate people. Don’t you have better things to do? And, one of the things that a scientific approach holds to is not to base positions on what could be potential outliers. Do you know what an “outlier” is?
An outlier is a data point that the experimenter excises because it doesn’t conform to the hypothesis. For some of the less illustrious scientist wanna-bes outliers may comprise the majority of the data set.
Yes, Joel, they do, y’know, teach this in undergrad physics lab courses.
This is a non sequitur.
At least I don’t routinely disgorge paragraph after paragraph tooting my own horn. You’re not the fucking hall monitor.
Yes, Joel. Are you assuming that these numbers follow a Gaussian distribution?
Medians are ordinal data, not Gaussian. So, once more you just post a comment to irritate. So, who is the “fucking” comment poster?
Dear G-d. In other news, one should not censor outliers in a data set unless they can be attributed to specific error.
Gentlemen. You can’t fight in here. This is the War Room!
Seriously. They either need to get over it or get a room. It’s getting exhausting.