Reasonable precautions here were likely to be proper masking from visitors and adequate air filtering in the room. Not something too hard to expect from people visiting a sick person.
It's not like those "reasonable precautions" are guaranteed. I know a couple people who were absolutely terrified of getting Covid, such that they always masked with N95s and literally only would meet with people outside, 6 feet apart (probably the only time they were inside was with others at the grocery store, and when stores were enforcing masking) and they still got it.
I see this as an example of confusion between population-level and individual protection. Widespread use of N95s is great at keeping the hospitals from overcrowding, but if somebody is serious about personally avoiding COVID, 95% percent filtration seems rather low (and there's leakage around the sides too.) If they were truly serious about avoiding COVID, they'd use an elastomeric half-face respirator at the minimum (which has the bonus feature of being more comfortable to wear).
The N95 guarantees a minimum of 95% filtration at the worst possible particle size, which airborne virus particles are not.
The 3M 9210s I’ve been wearing since 2021 have been independelty tested as having >99.5% filtration efficiency at the relevant particle size, and that’s with physical testing so stuff like ability of the make to seal is also being tested.
They would never list healthcare on the general purpose version anyway, since there is a separate specific certification for that. The only difference is better fluid protection, which is irrelevant to the given threat model. They do indeed sell that.
"This healthcare N95 particulate respirator and surgical mask has comfortable inner materials and helps provide respiratory protection against certain airborne biological particles. The individually packaged, flat-fold design allows for convenient storage prior to use.
Fluid-resistant surgical masks help reduce your exposure to blood and body fluids. Cleared for sale by the Food and Drug Administration (FDA)."
> I recommend you to make IgG test for covid antibodies. Most likely you already have some
I've had Covid at least twice since this nightmare started, most recently in November 2023.
After both a chest x-ray and a CT scan in hospital eventually a Covid PCR test[0] came back positive and at that point the mood lightened and the doctors told me that a positive Covid test was "the good news" and to go home and rest.
I appreciate Covid is still a threat to some elderly and/or sick people. To the majority of us, it isn't ... and wasn't ... ever [1][2]
[0] Unwitting comedy moment from the (otherwise friendly and apparently competent) student doctor. Took my history very thoroughly, felt my glands, examined ears and looked down throat. All without her wearing any kind of mask. Then late on she decided to take a Covid swab, so left the small room that we'd been in together for 10+ minutes to retrieve swab and FFP mask, which she donned to swab my nostrils. Am afraid I giggled when I saw her go get the mask, had to tell a lie to avoid exposing the utter nonsense of fetching one at that stage :)
[1] https://twitter.com/d_spiegel/status/1241297511287046144?lan...
[2] https://twitter.com/d_spiegel/status/1271696043739172864
"Sir David John Spiegelhalter OBE FRS [..] is a British statistician and a Fellow of Churchill College, Cambridge. From 2007 to 2018 he was Winton Professor of the Public Understanding of Risk in the Statistical Laboratory at the University of Cambridge [..] He is currently Chair of the Winton Centre for Risk and Evidence Communication in the Centre for Mathematical Sciences at Cambridge"[0] He was invited to join SAGE[1] in April 2020 as a "scientific expert"[2]
I'm afraid at this point I'm obliged to quote Keynes: "When the facts change, I change my mind - what do you do, sir?"
Even if we assume that this paid blog is a legitimate alternative to peer reviewed research (it is not), the first article you cite starts with the below disclaimer, which seems to refute your claim.
> Note added 2nd May 2020. Some people seem to be interpreting this article as suggesting that COVID does not add to one’s normal risk. I should make it clear that I am suggesting that it roughly doubles your risk of dying this year.
The author, who you seem to consider an authority, has also written an entire book on COVID statistics. It's central theme seems to be contrary to your point.
The book is titled "Covid by Numbers: Making Sense of the Pandemic with Data". I've only skimmed it, but it seems to be well regarded.
> a legitimate alternative to peer reviewed research
I'm not sure that peer-reviewed research deserves to be put on a pedestal. I've worked in a research lab, I have a couple of [tedious and uninteresting] published papers. It's not a holy grail. We still employ humans to do this stuff, and they come with flaws. We also need funding for this stuff, and with it comes with warped incentives.
> the first article you cite starts with the below disclaimer, which seems to refute your claim
Why would it refute the claim?
If you double a very tiny risk, to all intents and purposes it may still be "very tiny", and irrelevant compared to other more significant risks (such as the increased risk of dying due to not having been able to attend your screening appointment because all non-critical healthcare in your area has been cancelled to "save lives", while achieving the opposite).
We can and should trust doctors at an individual level, but at planet scale we need to listen to statisticians too. That didn't happen during the pandemic.
It's pretty unfortunate if a "cure" ends up killing more people than the disease... and yes, there were people mentioning this concern already in early 2020, but apparently no-one was listening:
"A fierce debate is under way between those who believe that the current lockdowns in place across much of the world are an overreaction, and those who believe it would be barbaric to do anything other than try to avoid as many coronavirus deaths as possible. Those in the first camp [..] point out things like [..] the collateral damage from the lockdowns will end up causing more harm than coronavirus itself; and that the amount of money we are effectively spending on saving each life is completely out of whack with what we would normally consider reasonable."
> "I appreciate Covid is still a threat to some elderly and/or sick people. To the majority of us, it isn't ... and wasn't ... ever "
The fact that it doubled everyone's risk of dying disproves that.
I understand that it's unlikely for a young, healthy person to die in any given year but they should still wear seatbelts, or stop smoking if doing those things doubles their likelihood of death.
>I'm not sure that peer-reviewed research deserves to be put on a pedestal.
I'm unaware of any better alternative. Twitter and blog posts certainly aren't it.
>It's pretty unfortunate if a "cure" ends up killing more people than the disease
It would be pretty bold to make that claim. Do you have any reliable source to indicate that it was? I'm aware that many people speculated to that effect, often loudly. I've never seen any evidence though.
That said, the fact that this is Financial Times article kind of gives it away. It's reasonable (if a bit monstrous) to say that you think your income is more important than other peoples lives, but if that's what you mean you should state it plainly.
> We can and should trust doctors at an individual level, but at planet scale we need to listen to statisticians too.
I'm not sure I would agree with that statement. Statistics are like bikinis. What they display is important, but what they conceal is vital. To me, statements like this feel like another way of saying "There are things more important than human life."
> The fact that it doubled everyone's risk of dying disproves that.
It really doesn't.
> It would be pretty bold to make that claim. Do you have any reliable source to indicate that it was?
"Pandemics kill people in two ways, said Chris Whitty at the start of the Covid outbreak: directly and indirectly, via disruption.
He was making the case for caution amidst strong public demand for lockdown, stressing the tradeoffs.
While Covid deaths were counted daily, the longer-term effects would take years to come through. The only real way of counting this would be to look at ‘excess deaths’, i.e. how many more people die every month (or year) compared to normal.
That data is now coming through."[0]
EDIT - adding:
"COVID-19 lockdowns were “a global policy failure of gigantic proportions,” according to this peer-reviewed new academic study. The draconian policy failed to significantly reduce deaths while imposing substantial social, cultural, and economic costs.
“This study is the first all-encompassing evaluation of the research on the effectiveness of mandatory restrictions on mortality,” according to one of the study’s co-authors, Dr. Lars Jonung, professor emeritus at the Knut Wicksell Centre for Financial Studies at Sweden’s Lund University, “It demonstrates that lockdowns were a failed promise. They had negligible health effects but disastrous economic, social and political costs to society. Most likely lockdowns represent the biggest policy mistake in modern times.” "
and
"The Herby-Jonung-Hanke meta-analysis found that lockdowns, as reported in studies based on stringency indices in the spring of 2020, reduced mortality by 3.2 per cent when compared to less strict lockdown policies adopted by the likes of Sweden
This means lockdowns prevented 1,700 deaths in England and Wales, 6,000 deaths across Europe, and 4,000 deaths in the United States."
and
"The research concludes that, unless substantial alternative evidence emerges, lockdowns should be ‘rejected out of hand’ to control future pandemics."
I think we may just have different assumptions buried in the heart of our respective worldviews.
To me it is axiomatic that the value of a human life is not something that can be measured in dollars. All lives that can be saved, should be saved unless doing so would cost more lives.
To the "Institute of Economic Affairs" it's probably axiomatic that a humans only value is in their economic worth. The elderly that died therefore had little value in the first place. Their loss would mean little to that worldview.
When I see statements from the article like the ones below I see it as absolute proof that we made the right decisions, or at least something close to the right decisions. When the authors saw it they concluded that these lives were too expensive. A concept I find completely alien.
>Shelter-in-place (stay at home) orders in Europe and the United States reduced COVID mortality by between 1.4 and 4.1 per cent;
>Business closures reduced mortality by 7.5 per cent;
>Gathering limits likely increased COVID mortality by almost six per cent;
>Mask mandates, which most countries avoided in Spring 2020, reduced mortality by 18.7 per cent, particularly mandates in workplaces; and
>School closures resulted in a between 2.5 per cent and 6.2 per cent mortality reduction.
> If you were put in charge, how would you formulate policy for managing a resource-constrained health system?
I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own.
It is a big, complicated subject and just being generally clever isn't enough to qualify someone for that type of thing.
> Have you seen the excess deaths data for Europe 2020-2022?
I had not, and it's concerning.
I don't think it automatically counts as proof that covid interventions did more harm than the disease though. For example, I've seen other papers that suggest excess deaths are actually proof that covid deaths were wildly underreported, especially early on.
That and the paper you linked earlier are certainly enough to suggest we need more research to determine which interventions worked, and which didn't, with greater certainty. This won't be the last pandemic.
I may fully read the book by the statistician you cited earlier. I think he touches on the subject of those excess deaths a bit.
> I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own.
Like the UK NHS's NICE?
"The UK’s National Institute for Health and Care Excellence (NICE) is responsible for conducting health technology assessment (HTA) on behalf of the National Health Service (NHS). In seeking to justify its recommendations to the NHS about which technologies to fund, NICE claims to adopt two complementary ethical frameworks, one procedural—accountability for reasonableness (AfR)—and one substantive—an ‘ethics of opportunity costs’ (EOC) that rests primarily on the notion of allocative efficiency."[0]
"NICE’s use of ICERs, quality-adjusted life-years (QALYs) and the cost-effectiveness threshold as its preferred tools for decision-making, with some allowance for relevant social and ethical values, has been consistent since the institute’s inception"[0]
and as Karol Sikora said: "QALY [is] not a perfect metric, but it’s the best we’ve got"
"[NICE] guidelines are based on the best available evidence. Our recommendations are put together by experts, people using services, carers and the public"[1][2]
Sounds not unlike what you suggested ... and yet they've consistently used 'value for money' measures such as QALY.
Systems like this are necessary primarily because these programs are given lower priority than other government spending. If I were in charge the queen would've been buried in a pine box, and the money wasted on her funeral would've gone towards life saving medical treatments.
Any system that prioritizes anything above human health is fundamentally broken, and that's not the SME's fault.
That said, the world is finite and tough decisions do still need to be made. In those cases I would defer to the SME's. If they still thought a system like the above was necessary after being fully funded I would accept that, despite it being distasteful to me.
Cause of deaths is not described. If vaccines works, why productive population still dies in high numbers during winters? Why elders are dying in same numbers?
Covid is not threat for healthy 15-44y individuals. Do we have overcrowded hospitals full of people hooked to oxygen? Did you recently hear about unexpected deaths, rapid cancers, increased suicides or myocarditis among productive generation?
Per statistic in my country, there was 0.16% deaths to my age (mid 30's) with positive PCR test during death (not necessary mean it was cause of death, there was confirmed cases when cause of death was car crash).
I personally don't know anyone, who was healthy and suddenly die because of covid and neither does anyone I ask. Most victims of covid have another comorbidities.
However I know many people (7) injured (including my family) by vaccination and 2 dead. I consulted this anecdotal evidence with my doctor and he observed similar event on his patients (around 2000 people).
- Both count as a serious threat to me.
If people that you disagree with count serious threat for you, you should probably find serious help.
No, I am, first, being supportive of your repeated edits to uncover important details. No trolling -- thank you to dig into those references. Second, I was offering a sarcastic remark about other pseudo-medical topics that are frequently debated on this board. All kinds of Internet randos come out from the woodwork when "inflamation" or "natural foods" are discussed here. This place is great to discuss tech, but the discussions around legal, medicine, and economics are pathetic. All kinds of people trying to apply their nerd programmer knowledge to fields about which they know little.
A properly fitted mask shouldn't leak around the sides. The PFF2 (my country's equivalent of N95) mask I use doesn't leak anywhere when properly adjusted. (Like the sibling comment, it's a 3M, either the 9320+BR or the 9360H; see https://www.3m.com.br/3M/pt_BR/p/d/v000465595/ for its page complete with usage instructions.)
This is exactly why masking isn't as effective as it should be _in aggregate_. N95s aren't foolproof to use even for people who are trying to use them properly, then you have to add in the folks who pull their mask down to cough or to talk.
My favorite was the chin diaper. Particularly because the state I live in (idaho) never really had strict masking requirements so it really never made any sense.
I still occasionally see adults out in public wearing the chin diaper, or with the mask partially or mostly covering the mouth but not the nose at all.
I just don't get it. Why bother? Public outdoor masking rates even here (San Francisco) are anecdotally well under 10%. Why waste the time and effort (and in some places, social consequences) to do something like that completely ineffectively, when nearly no one else is bothering at all?
The "mask on the chin" allows one to quickly pull up the mask to cover the face, at the cost of potentially contaminating the inside of the mask (which then touches the face). The "mask not covering the nose" might be a badly fitted mask slipping down, or it might be the same case as the "mask on the chin" (allowing one to quickly pull up the mask to also cover the nose).
I know this is well known but still worth mentioning again I think. That the "regular" facemasks were primarily so asymptomatic people with covid would spread it less. 100% protection was never possible but anything to delay to spread so that not everybody was sick at the same time was necessary.
I think the global "everyone put on a mask" moment highlighted some large cultural differences.
My Asian friends understood that "not sharing germs" was as important as "not getting sick" mask compliance as much about being kind to others as to yourself. It also helps that lots of them were already socially accepting of masks due to climate, pollution and weather (or what ever you want to call dust out of Mongolia every year).
I think that there is an interesting corollary with PPE culture in general, one that has changed in my life time (safety glasses and seat belts). I think we saw a lot of that same behavior bleed out to normal people (who don't wear PPE at a day job) in action.
All in all there is a cultural aspects at play that are worth looking at.
Against COVID, you would probably get more bang for your buck by protecting the eyes with goggles or by choosing an elastomeric full-face respirator. Anything that lands in the eye ends up in a lacrimal duct, and then in a nasal passage.
If you stick a mask on a dummy in a lab and fire COVID at it, it might show pretty good protection. However, at the population level there is no evidence that masking confers any benefit in preventing the spread of COVID.
People wear N95s to protect against COVID transmission because they work. Yet every time the topic comes up online, someone is always quick to reach for the flawed Cochrane review.
> However, at the population level there is no evidence that masking confers any benefit in preventing the spread of COVID.
1) Several studies from India seem to contradict this and barely had enough statistical power to be useful.
2) The fact that we can't generate a masking study with sufficient statistical power does NOT disprove the hypothesis--either direction.
Citing your source:
"The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions."
This one REALLY grinds my gears. "Well the study said that masks don't work". No, it fucking didn't. It said they couldn't prove they worked given the data and quality of data they had. And the data was lousy as adherence by the general population was terrible.
Things can work and still not be provable--especially when the experiment involves human beings since morally we can't just create two groups and infect one.
Here's your counterexample: take a look at what hospitals are still doing when handling Covid patients. Hospitals get to collect data and enforce adherence. They absolutely do not want to transfer Covid between patients. And they do not want to transfer Covid to their staff as that throws things into disarray. Whatever they're doing seems to be working. I had a stint in the hospital recently, and they had several Covid patients on my floor--they weren't isolated to a specific wing or anything anymore. The hospital managed to not give Covid to me, so something they are doing is working.
So, what that suggests is that procedures and masks work just fine. What seems to be problematic is lack of adherence to said procedures and masks.
Basically, what all of these studies manage to prove is that the general population has enough non-compliant dipshits that active interventions don't work at the population level. Consequenctly, vaccines and other passive interventions that take into account the stupidity of the general population are required.
>>This one REALLY grinds my gears. "Well the study said that masks don't work". No, it fucking didn't. It said they couldn't prove they worked given the data and quality of data they had.
So you admit people were calling for mask-wearing with no evidence. Sounds like we agree.
>>Things can work and still not be provable--especially when the experiment involves human beings since morally we can't just create two groups and infect one.
You don't have to infect one. Just see which one gets infected. This happens all the time with vaccine etc testing of have thought.
>>Basically, what all of these studies manage to prove is that
the general population has enough non-compliant dipshits that active interventions don't work at the population level
It sounds like we're pretty much in agreement here as well. Unless you have some magical solution to ensure perfect adherence.
Of course, you may be super-diligent as an n=1 and nobody ever sneezes on you without warning or anything and you stay free of a disease the CDC says should be treated like the flu.
And the other name for "non-compliant dipshits" is "children".
>>Also doesn't claim what people like you says it claims.
By people like me, you mean people who believe in science? This is what it claims:
"Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate‐certainty evidence. Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks (RR 1.01, 95% CI 0.72 to 1.42; 6 trials, 13,919 participants; moderate‐certainty evidence)."
>>Also, look at the history. Date of the original review is 2007. You know what didn't exist in 2007?
I don't see the point of your comment. You're presenting an anecdotal case where someone who took some precautions which are known for not being 100% effective against airborne diseases ended up contracting an airborne disease.
It makes as much sense as ranting about wearing seatbelts because you can put together an anecdotal case of someone who got hurt in a car accident in spite of wearing one.
What's the point of that sort of argument, really?
The point is that even with reasonable precautions, it is (and was) possible for the man in the iron lung to be exposed to COVID.
The actual precautions necessary to protect him from any exposure at all would have been significantly more stringent than what people tend to believe are reasonable, as GPs anecdote demonstrates.
The problem here is what people believe are reasonable and what is actually reasonable are pretty far apart. COVID will cripple you for the rest of your life if you're unlucky. Chance of that happening increases greatly with each infection. It is not the flu! It's not a cold!
Certainly in any medical context, *everyone* should be wearing N95s (at minimum). This should in particular not be optional for anyone calling themselves a medical professional or working in a medical office. This should not be controversial; it's basic preventative care.
For particularly sensitive people like this gentleman was, more substantial protection should be employed. Facemasks. Superior air recirculation.
The science on this is not controversial. Masks work. Denying that only shows you have fallen for the soundbites and not read the actual studies. For one thing, most of the ones usually cited are testing, with loose controls, surgical style masks for the flu, which has both a different particle size and far lower infectivity than Covid.
