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CR: COVID-19 --Political Talk


Mrs Whiggins

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There wouldn’t be black lives matter protests going on during a pandemic if governmental policies didn’t disproportionately kill black people during said pandemic. Not only was it made very clear that many governments didn’t give a shit about covid when they realized it disproportionately killed black and brown people, the cops couldn’t even put their murdering black people thing on pause.

Given all that, it’s indicative of the incredible patience of black Americans that only one police precinct has been torched.

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8 minutes ago, mdmost said:

What a strange thing to try to fixate on or take up as a hypothetical issue. Most people still get that Covid is a threat but this isn't something that can wait until after people are given the all clear. 

My problem is that these medical professionals who sent out the letter supporting these protests are selectively, uh, selecting which mass gatherings are OK to violate social distancing (and risking lives, which is what we've been told for the last 3 months) and which mass gatherings aren't.

Two weeks ago, the media and medical professionals widely lampooned the Open Up the Economy protests across the state - to them, those protests were stupid and not worth violating social distancing orders.  Same thing with churches.  Religion is unimportant, so gotta stay home.

But now, they say that police brutality against minorities is such an immediate threat, that it's OK for tens of thousands of protesters to mass gather like a pack of sardines going on 2 weeks now and put their loved ones and the loved ones of others at great risk.   or so we've been told for the last 3 months.

I like Fauci's approach - basically a caveat emptor - it is a just cause, just know that these mass events are likely to spread the virus to your family and others.  And basically this - 

And if there is a second wave thanks to these protests or a resurgence in the Fall??  Good luck getting ANYBODY to stay home.

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4 minutes ago, Message Board User said:

My problem is that these medical professionals who sent out the letter supporting these protests are selectively, uh, selecting which mass gatherings are OK to violate social distancing (and risking lives, which is what we've been told for the last 3 months) and which mass gatherings aren't.

Two weeks ago, the media and medical professionals widely lampooned the Open Up the Economy protests across the state - to them, those protests were stupid and not worth violating social distancing orders.  Same thing with churches.  Religion is unimportant, so gotta stay home.

But now, they say that police brutality against minorities is such an immediate threat, that it's OK for tens of thousands of protesters to mass gather like a pack of sardines going on 2 weeks now and put their loved ones and the loved ones of others at great risk.   or so we've been told for the last 3 months.

I like Fauci's approach - basically a caveat emptor - it is a just cause, just know that these mass events are likely to spread the virus to your family and others.

He'srightyouknow.gif

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9 minutes ago, Message Board User said:

My problem is that these medical professionals who sent out the letter supporting these protests are selectively, uh, selecting which mass gatherings are OK to violate social distancing (and risking lives, which is what we've been told for the last 3 months) and which mass gatherings aren't.

The protests (actually astroturfed) a month ago were *about the stay at home orders*. They were allegedly protesting the stay at home orders, themselves. Staying at home objectively had saved lives and was necessary because of the rampant and unchecked spread of the virus. Those protests were lampooned because it was about “reopening” in an unsafe and not scientifically supported way. 
 

Surely you can see the difference why a medical professional would oppose the “reopen” protests. 

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1 minute ago, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

Damn Bama.  I am sorry to hear that. Fuck this virus.  

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2 minutes ago, Pig Bellmont said:

The protests (actually astroturfed) a month ago were *about the stay at home orders*. They were allegedly protesting the stay at home orders, themselves. Staying at home objectively had saved lives and was necessary because of the rampant and unchecked spread of the virus. Those protests were lampooned because it was about “reopening” in an unsafe and not scientifically supported way. 
 

Surely you can see the difference why a medical professional would oppose the “reopen” protests. 

Massive protests with 10's of thousands of people in some cases, often yelling and chanting and singing. OK.

Church service with more than 10 people in attendance. Not OK.

There is a value judgement baked into that.  Whether you agree with it or disagree, an honest discussion needs to acknowledge it. 

 

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2 minutes ago, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

Jeez - wasn't it just a week since the symptoms started?  Terrible.  Sorry to hear it.

 

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46 minutes ago, ruitxn said:

I guess it depends on just how much you value freedom from discrimination, equal  justice, and love and care for all individuals.

Who’s chairing the Gathering Justification and Approval Committee?

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41 minutes ago, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

so sorry to hear that, bama. 

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47 minutes ago, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

Very sorry to hear about your friend, Bama Chick.  

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13 minutes ago, Bama Chick said:


Yeah - he was hospitalized on Saturday but his wife said he’d been feeling run down for 4-5 days before he went to the ER.

He was at the club pool and started hallucinating and having trouble breathing so they took him to the hospital.

He coded early Sunday morning and it took them 37 minutes to get him back so he’s really been gone since - he never regained consciousness. His body just finally caught up today.

Turns out he had some signs of very early CHF but it wasn’t effecting his daily life or causing him symptoms at all but that probably made it harder for him to fight against the virus. He was also 20 odd pounds overweight but nothing out of the ordinary for a middle aged guy.

I never would have thought of him when worrying about at risk people or people with health issues.

He wasn’t a triathlete and he wasn’t an obese scooter person. Just your very average man in his late 40s with the normal health stuff for someone his age.

I bet many of the people that post here are very much like he was and don’t think of themselves as at risk.

This virus is very serious. And most of America is acting like it’s no big deal and it’s hurting other people.

Those other people are vibrant human lives with friends and wives and daughters and mothers and sisters. It’s easy to see it as just another abstract danger until it robs you of someone.

Be safe y’all. And be kind to one another.

I am very sorry to hear this. You are out there seeing how the virus is ravaging our country on a daily basis and now you've lost a friend. Grieve how you want to and for as long as you want to. God Bless you, your friend's family and all that counted him as a friend.

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1 hour ago, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

roll tide

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Massive protests with 10's of thousands of people in some cases, often yelling and chanting and singing. OK.
Church service with more than 10 people in attendance. Not OK.
There is a value judgement baked into that.  Whether you agree with it or disagree, an honest discussion needs to acknowledge it. 
 


My impression is the virus load potential in an indoor space may legit be more risky than a mass protest outdoors. Singing may make it much worse.

That said, I didn’t go to our local protest last night as I don’t want to be near a bunch of yelling people even outdoors as we’re pretty sure that also increases load potential, particularly if the air is calm.
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Sorry to hear about the loss Bama.  I fear many of us are going to experience the loss of someone close to this virus. Glad we have this space to share with each other when it happens and thank you for telling us about your friend, he sounded like I guy I would have partied with in college. Thoughts are with you. 

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3 hours ago, Bama Chick said:


Yeah - he was hospitalized on Saturday but his wife said he’d been feeling run down for 4-5 days before he went to the ER.

He was at the club pool and started hallucinating and having trouble breathing so they took him to the hospital.

He coded early Sunday morning and it took them 37 minutes to get him back so he’s really been gone since - he never regained consciousness. His body just finally caught up today.

Turns out he had some signs of very early CHF but it wasn’t effecting his daily life or causing him symptoms at all but that probably made it harder for him to fight against the virus. He was also 20 odd pounds overweight but nothing out of the ordinary for a middle aged guy.

I never would have thought of him when worrying about at risk people or people with health issues.

He wasn’t a triathlete and he wasn’t an obese scooter person. Just your very average man in his late 40s with the normal health stuff for someone his age.

I bet many of the people that post here are very much like he was and don’t think of themselves as at risk.

This virus is very serious. And most of America is acting like it’s no big deal and it’s hurting other people.

Those other people are vibrant human lives with friends and wives and daughters and mothers and sisters. It’s easy to see it as just another abstract danger until it robs you of someone.

Be safe y’all. And be kind to one another.

Sorry Ma'am. Living in a small Texas town I am seeing the lack of caring. It hurts to know we are losing friends and loved ones when we could have prevented so much of it. 

RIP Bama Chick's friend.

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4 hours ago, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

I'm sorry to hear that and send prayers.

My younger brother, whom I live with, tested positive for COVID today.  He started feeling sick on Monday night and Tuesday woke up with a fever and decided to go get tested here in SA.  My brother would never go anywhere at the beginning of this and only recently after seeing everybody keep going out and starting to resume normalcy did he start going a couple places.  He went to the gym with a facemask a few times and hung out with a couple friends a handful of times.  He feels a lot better today and has no fever and a minor cough.  He's been self-isolating since tuesday and I really hadn't had much interaction this past weekend because he went out of town until Monday.  He has to wait until he has 2 negative tests before he can go to the office.  He mainly feels guilty now about anybody he could've possibly gotten sick even though he attempted to be as considerate as possible.

I went and did one of those short turnaround tests here at the Tex Med Clinic across the street and thankfully came out negative.  Not sure how reliable those are but figured they have to be a little bit reliable but I'll go get another one on Monday.  Even then, I still have to self isolate and can't go to work this week and probably the following week either.  I didn't realize I'd have to change all my shit and it kinda sucks man.  I guess its good I'm studying for the bar exam and can be forced to study all day 

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15 minutes ago, LonghornSean said:

 

That graph appears to have a mislabeled axis and doesn’t really demonstrate a rebound in cases. It appears to show fluctuation in positivity rates vs number of tests conducted. 

Edited by Anastasis
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9 hours ago, Anastasis said:

I agree with this.  On attesting to access to and accuracy of the data, the Lancet disclosure does not appear to include this, but I have signed a number of agreements where this was explicitly required of at a minimum the first author.  Some require an attestation of some form in the actual article. They don't get a pass on this. 

Here is text from the Lancet article that has been retracted:

The corresponding author and coauthor ANP had full access to all the data in the study and had final responsibility for the decision to submit for publication.

And here is text from the NEJM article, also retracted, from the same research group:

All the authors reviewed the manuscript and vouch for the accuracy and completeness of the data provided.

 

Here are the JAMA guidelines for comparison:

Data Access, Responsibility, and Analysis

For all reports (regardless of funding source) containing original data, at least 1 named author (eg, the principal investigator), and no more than 2 authors, must indicate that she or he "had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis."7 This exact statement should be included in the Acknowledgment section at the end of the manuscript. Modified statements or generic statements indicating that all authors had such access are not acceptable. In addition, for all reports containing original data, the names and affiliations of all authors (or other individuals) who conducted and are responsible for the data analysis must be indicated in the Acknowledgment section of the manuscript. If the individual who conducted the analysis is not named as an author, a detailed explanation of his/her contributions and reasons for his/her involvement with the data analysis should be included.

 

 

There is no excuse for this. The authors should be held accountable for the role they played in this shit show. If they got duped by Desai, fine, but their should not be allowed to hide behind a "well, I only provided interpretation of the results" screen. There are policies and procedures in place to prevent this sort of thing.  I would be surprised if their affiliations (Harvard, Zurich, Utah, etc.) did not have some SOPs related to this sort of stuff to protect the credibility of their institutions. 

Obviously I don’t know the extent of your first hand experience in the peer review and data interpretation process, but you seem to know more than just about anyone on here.
 

How much time does it actually take to do a review of such a large set of data? Also, how long does it take to review and put your approval on someone else’s interpretation?

 

Im just trying to gauge the necessity and the effect of “rushing out studies without peer review”. Like how much time would it take to just wait and get it done?

Edited by GRHorn
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23 minutes ago, GRHorn said:

Obviously I don’t know the extent of your first hand experience in the peer review and data interpretation process, but you seem to know more than just about anyone on here.
 

How much time does it actually take to do a review of such a large set of data? Also, how long does it take to review and put your approval on someone else’s interpretation?

 

Im just trying to gauge the necessity and the effect of “rushing out studies without peer review”. Like how much time would it take to just wait and get it done?

I wouldn't claim to be an authority on it, and there are some other posters who don't anchor as much of their time in the CR who may be better to ask.

I don't know how to answer the question of how long would it take it vet a novel dataset.  What I can say is that even when using well characterized data that we have ready access to, in my shop we're talking ~9 months to execute an observational study, maybe a year in total before it would go to print. And that's considered to be moving relatively fast in the grand scheme of things. 

If you put a gun to my head, gave me unlimited resources (programmers) and streamlined statistical analysis plan development, I could see compressing that 9 month project down to maybe two months. Start running some things in parallel while the data continues to accrue, maybe even a month or shorter. It could be done if you have well characterized data as a starting point (e.g., VA EMR HCQ study took just under two weeks from data lock to pre-print).   

The urgency of COVID related research absolutely is impacting the quality of the related medical research being conducted right now.  Even the well designed RCTs are dealing with certain realities outside their control, for example testing availability early on made lab confirmation of cases challenging, so you had people using symptom-based case definitions in addition to lab confirmed cases (see HCQ post-exposure prophy study). There are a good number of infectious disease experts who have been spending the last couple months bashing the pre-print paradigm that has evolved during the current pandemic, and the god amount of garbage research being picked up and ran with in various settings, including the lay press. That the garbage also filtered through major tier 1 medical journals like Lancet and NEJM without being sniffed out just shows that the problems are not limited to pre-prints.     

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Why would someone go out of their way to manufacture a fake medical research paper to discredit the use of a certain drug? That’s pretty fucked up. What if it actually helps (and I’m not promoting this drug it very well could be a nonsense approach) but you actually lied about a study just to make a political point? That’s fucking psycho. 
 

https://www.google.com/amp/s/www.nytimes.com/2020/06/04/health/coronavirus-hydroxychloroquine.amp.html

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1 hour ago, Newy25 said:

Why would someone go out of their way to manufacture a fake medical research paper to discredit the use of a certain drug? That’s pretty fucked up. What if it actually helps (and I’m not promoting this drug it very well could be a nonsense approach) but you actually lied about a study just to make a political point? That’s fucking psycho. 
 

https://www.google.com/amp/s/www.nytimes.com/2020/06/04/health/coronavirus-hydroxychloroquine.amp.html

The first most obvious explanation is to follow the money.  In this case via big pharma.  If the authors of the fake study published by Lancet were acting to serve the interest of big pharma, the intent would be to bury generic HCQ as a safe low cost potentially effective treatment and put in its place a high cost alternative whether effective or not.  In this case all eyes are on Gilead and Remdesivir. 

When you have less than a handful of pharmacologic options, none of which have been able to be subjected to thorough clinical trials for Cov19 amidst a deadly rapid onset pandemic, those few options will be applied in an all out effort to do something to prevent severe illness and death. So if a competitive option can get eliminated due to acute safety concerns when used with Cov19, even an unproven but "safe" alternative will become the default option.  It looks like that is likely what is going on here.  Even if Remdesivir doesn't really offer much clinical benefit to justify the cost, states and hospitals will go with that if there is nothing else, and Gilead wins out over an inexpensive generic alternative to reap large profits.  

Think of the implications if it turns out that aggressive early application of HCQ with or without combining it with other agents reduces the likelihood of illness severity progressing to ICU level of care or death.  We still don't have US study results that examine that question.  But that is exactly what other countries are reporting works well enough to justify continuing.

 

 

 

Edited by triplehorn
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16 hours ago, Anastasis said:

I wouldn't claim to be an authority on it, and there are some other posters who don't anchor as much of their time in the CR who may be better to ask.

I don't know how to answer the question of how long would it take it vet a novel dataset.  What I can say is that even when using well characterized data that we have ready access to, in my shop we're talking ~9 months to execute an observational study, maybe a year in total before it would go to print. And that's considered to be moving relatively fast in the grand scheme of things. 

If you put a gun to my head, gave me unlimited resources (programmers) and streamlined statistical analysis plan development, I could see compressing that 9 month project down to maybe two months. Start running some things in parallel while the data continues to accrue, maybe even a month or shorter. It could be done if you have well characterized data as a starting point (e.g., VA EMR HCQ study took just under two weeks from data lock to pre-print).   

The urgency of COVID related research absolutely is impacting the quality of the related medical research being conducted right now.  Even the well designed RCTs are dealing with certain realities outside their control, for example testing availability early on made lab confirmation of cases challenging, so you had people using symptom-based case definitions in addition to lab confirmed cases (see HCQ post-exposure prophy study). There are a good number of infectious disease experts who have been spending the last couple months bashing the pre-print paradigm that has evolved during the current pandemic, and the god amount of garbage research being picked up and ran with in various settings, including the lay press. That the garbage also filtered through major tier 1 medical journals like Lancet and NEJM without being sniffed out just shows that the problems are not limited to pre-prints.     

Appreciate your response. 
 

Given the attestations and disclosures you cited elsewhere, I don’t see how those that signed off on the study can keep their current positions, no matter how unusual the current circumstances surrounding medical research.  If they do stay on, this kind of job performance gets a tacit stamp of approval from their institutions. 

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On 6/5/2020 at 3:50 PM, Bama Chick said:

My friend died at 1:00 today.

He was 47.

He left behind a wife and 15 year old daughter and hundreds of friends.

He was a rare bird - an Alabama frat boy who was a proud liberal; so we bonded right away. He loved all kinds of music. He kicked all kinds of ass at bar trivia night. He was loud and funny and loved Alabama football.

Roll Tide and Godspeed, S. I hope you’re enjoying some Golden Flake chips and a Coca-Cola with The Bear right now.

I've been away more this week and I missed this. So very sorry, @Bama Chick.

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11 hours ago, Newy25 said:

Why would someone go out of their way to manufacture a fake medical research paper to discredit the use of a certain drug? That’s pretty fucked up. What if it actually helps (and I’m not promoting this drug it very well could be a nonsense approach) but you actually lied about a study just to make a political point? That’s fucking psycho. 
 

https://www.google.com/amp/s/www.nytimes.com/2020/06/04/health/coronavirus-hydroxychloroquine.amp.html

It’s certainly possible that malfeasance is the answer but after reading the article I find it more likely to be incompetence caused by rushing. The doctors used a data source that hadn’t been fully vetted. It appears their conclusions matched with the data, it was just an unverified data source. 

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9 hours ago, Irieguy said:

It’s certainly possible that malfeasance is the answer but after reading the article I find it more likely to be incompetence caused by rushing. The doctors used a data source that hadn’t been fully vetted. It appears their conclusions matched with the data, it was just an unverified data source. 

I certainly will be surprised if no malfeasance is found to have been committed by Surgisphere.  It certainly looks like they are a fraudulent company peddling garbage data.

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1 hour ago, jimmyjazz said:

I certainly will be surprised if no malfeasance is found to have been committed by Surgisphere.  It certainly looks like they are a fraudulent company peddling garbage data.

The relevant parties understand this stuff inside and out.  They know what is legit and what isn't.  What (or who) would motivate a company to produce fraudulent data?  What does a company or person stand to get in return?   

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51 minutes ago, jimmyjazz said:

I certainly will be surprised if no malfeasance is found to have been committed by Surgisphere.  It certainly looks like they are a fraudulent company peddling garbage data.

Agree.  If somebody in the chain was knowingly fabricating data, there was malfeasance. Desai should be on the hook for that. 

That being said, I think that some coordinated Big Pharma Gilead conspiracy is stretching out the tinfoil quite a bit. Might there be some bias, conscious or otherwise, that led the other researchers to accept the results corresponding to their prior expectations and not critically challenge the results? Absolutely. Confirmation bias is a thing, especially when potential conflicts of interest may exist.

Gilead as puppet master coordinating a conspiracy to undermine an effective COVID treatment is not reality based. That is twitter HCQ land conspiracy nonsense.  I would surprised if Gilead had enough time and resources at the moment to focus on half the remdesivir work they have on their plate, much less devoting time and resources running an anti-HCQ campaign. If our friend triple is right in his suggestion however that "Big Pharma all eyes on Gilead" in fact coordinated with Desai, or Harvard Medical School (Len Blavatnik in play, imo), people should hang.  Not just professionally. Like in the public square from gallows.   

There is a third study that used the Surgisphere data that hasn't been discussed as much here. It "found" that ivermectin, a cheap, widely available generic antiparasitic medication originally promoted in India for COVID treatment was effective at reducing mortality.  That led to authorizations and increased use in Latin America especially.  This doesn't fit with the narrative that triple is pushing about Big Pharma trying to "bury generic HCQ as a safe low cost potentially effective treatment and put in its place a high cost alternative".

Far, far more likely, the grift angle here is to use the urgency and chaos around COVID in the medical community to ladder some credibility for a sham company.  Leverage a few academic collaborators from prestigious institutions who are also in their own way grifting the urgency and chaos for their own benefit, and overnight you generate a presence that other companies spend literally decades building.  At that point all you have to do is land a small handful of data license sales at maybe $2-5MM each and you cash out. That's the angle here as I see it. 

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8 minutes ago, triplehorn said:

What (or who) would motivate a company to produce fraudulent data?  What does a company or person stand to get in return?   

 

Just now, Anastasis said:

Far, far more likely, the grift angle here is to use the urgency and chaos around COVID in the medical community to ladder some credibility for a sham company.  Leverage a few academic collaborators from prestigious institutions who are also in their own way grifting the urgency and chaos for their own benefit, and overnight you generate a presence that other companies spend literally decades building.  At that point all you have to do is land a small handful of data license sales at maybe $2-5MM each and you cash out. That's the angle here as I see it. 

Tens of millions of dollars in data license fees.  That's what the company and Desai had to get in return.  

 

It doesn't always have to be a grand conspiracy triple.  Sometime the answer right in front of your face is the right answer. 

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