Paul Alexander, ‘the man in the iron lung’, has died
bbc.com
bbc.com
As somebody with a medical condition since birth, this line really hit home. I'm not speaking for Mr. Alexander, but for myself "used to it" is such a great way of putting the odd experience of living with frequent and cumbersome medical intervention.
On the one hand you have no choice so it is quite easy. You just do it. On the other hand there are often periods here and there through your life where you wrestle with the treatment, complain about it, explore other options, etc. But then a new option does come around every so often and, well, some times you stick with what you know even though there are "better" options.
"used to it" is such a disarmingly accurate way of putting it. It is simultaneously the most difficult and easy thing to do.
Requiem aeternum Paul Alexander.
That conversation stuck with me because I found it horrifying.
Mechanical ventilation is very complex and has come a long way since the 1990's. The lung is an exceedingly complex organ, and breathing itself is an exceedingly complex bodily function that we largely take for granted until something goes wrong.
Suction devices also have their own horrifying outcomes. Someone told me a story once in the context of maximum vacuum limits of an EMT that was suctioning debris and fluid from an open brain injury and had the vacuum up so high they were vacuuming a person's brain tissue.
He worked for free, or next to nothing, taught the curriculum he wanted to (can’t afford to fire him!). Apparently he brought high end audiophile speakers to school and played classical music on them when not lecturing. The kind that cost half a year’s salary for a teacher.
I knew a humanities professor that taught a heavy course load for years, and he and his wife lived off her paycheck serving food in the university cafeteria.
Sometimes getting an unpaid adjunct position can still be extremely competitive and hard to get. Academia is pretty weird.
Yet everyone I've ever spoken to that happened to has a simple answer: "not difficult at all. It isn't there". One put it like "I'm also not a tiger and can't jump 8 meters high. It's similar".
Very strange how adaptable humans are sometimes.
If you are born without sight, it only exists as an abstract concept for you.
But I remember asking him when we were teens and he me gave a really good answer about how he's learnt to interact with the world as a blind person so for him to be able to see it would a huge hinderance to him at this point – perhaps as much as me being blind.
He'd would need to read and write again. He would need to learn how to use a computer again. He might not like how his girlfriend looks. He would need reorganise his life and activities around the fact he can now see. Would he still be interested in doing the same things if he could see? Might he want to play video games instead of piano in his spare time if he could?
I think in a lot of cases it's not even just not knowing what you're missing, but it's also not worth hassle. If you're content as is then why change things?
> My best friend as a kid was blind
How did you meet him? Were you in the same class at school? Or a neighborhood friend?
Just as sighted people take for granted a lot of things about their sight, I'm not surprised some blind people take many things for granted about their lack of sight -- even when they are negative, frustrating things.
While accessibility has come a long way, it still seems like it would be objectively more difficult to navigate the world blind than sighted.
> One put it like "I'm also not a tiger and can't jump 8 meters high. It's similar".
This makes a lot of sense, even if it's an imperfect analogy. Sometimes, if you have no experience with something, you won't mind not being able to do it, even if you know that a lot of other people can.
But if you look at it the other way: imagine a tiger with mobility issues that can't jump at all. Likely their life will be pretty limited, compared to most tigers.
I'm glad it seems there are (at least in your experience) a lot of people who are blind but don't consider it that big a hindrance. Ultimately what matters in life is that people are happy, and I imagine feeling like your life is constantly difficult due to something like blindness would reduce your happiness.
This happens for medication too. If you're on a specific drug for your whole life, it may be disruptive to switch to a different medication even if it's notionally better. I take a pill every morning, and will for the rest of my life, would I prefer one I took every other day? Not really, it sounds like I'd just miss days sometimes. If it had fewer side effects? I haven't noticed any effects now, despite the list in the leaflet so "fewer" doesn't sound like a meaningful improvement.
In the first few days maybe even weeks of taking it I'd have been open to any improvements, but now I've settled into a habit, so any change needs a serious justification.
No, it's nothing as serious as chronic medical conditions and I certainly do not intend to make light of them, but the underlying motives are the same.
Also see: https://xkcd.com/1172/
There are also enormous social pressures to stay in abusive relationships: people feel free to tell you you should stay in a relationship, that it can be fixed, etc. Very few people are willing to tell someone they should leave a relationship. So, what you hear is everyone thinks it should be fixed rather than ended.
There are many practical difficulties in ending a relationship too: financial, legal.
There are also many things in pop culture and media that can encourage it: normalisation of what are actually controlling behaviours, for example. The even "when you are right you are wrong" trope is just one common version of this.
Your profile says "chick" so most likely because people say different things to men and women. In general abusive behaviour by women is not taken seriously - in the UK handbook for the prosecution service it is even classified as "violence against women and girls" (although the text says men can also be victims) . Non violent abusive is not taken seriously even though "coercive control" is technically now a crime.
I used cpap for a while and fitting a mask to your face is just a total pain. The default ones would scab my nose, even with foam ones I had to strap is so hard to avoid leaks that it left red marks on my neck for hours after I woke up. You have the change/clean the masks. You risk problems like the recent Phillips one where a component was disintegrating, going into people's lungs and giving them cancer.
The iron lung not having to go over your face would avoid all of those problems so I'm surprised it completely disappeared.
It is easy to do an at-home nasal swab test when you are infected but before the viral load has gotten to the point of being highly contagious, at which point you think you are negative but really will soon become contagious.
"Reasonable precautions" would have to be very rigorous, and I have to imagine it would be easy to cave and relax precautions as loneliness sets in.
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 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.
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.
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 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.
Zero COVID infections here.
No words about viruses. Also, I recommend you to make IgG test for covid antibodies. Most likely you already have some.
https://www.3m.com/3M/en_US/p/d/v101143973/
And whatta ya know...
"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)."
Notice it's still "just" an N95.
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
*EDIT* Did you just cite a twitter post that links to some dudes blog as if it were a reliable source of medical information?
* EDIT to the EDIT * Did you notice that this dudes blog is PAID, and requires a subscription to access?
Are you ln favor of taking medical advice from Twitter rather than doctors?
Some dude? Really?
"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?"
[0] https://en.wikipedia.org/wiki/David_Spiegelhalter [1] https://www.gov.uk/government/organisations/scientific-advis... [2] https://assets.publishing.service.gov.uk/media/5ed1327f86650...
> 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 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.
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."
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."
[0] https://www.spectator.co.uk/article/sweden-covid-and-excess-... [1] https://iea.org.uk/media/lockdowns-were-a-costly-failure-fin...
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.
That's a laudable view.
If you were put in charge, how would you formulate policy for managing a resource-constrained health system?
> I see it as absolute proof that we made the right decisions, or at least something close to the right decisions
Have you seen the excess deaths data for Europe 2020-2022?
https://pbs.twimg.com/media/Fqb9qDsWAAELo-m?format=jpg&name=...
[EDIT: changed to the English version...]
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.
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.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387327/ [1] https://www.nice.org.uk/about/what-we-do/our-programmes/nice... [2] https://www.nice.org.uk/process/pmg20/chapter/introduction#w...
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.
In winter 2023 triple more deaths in 15-44y than during winter 2020. Overall we have same deaths as during 2021.
Elephant in room.
It also seems to indicate that COVID interventions were effective at preventing excess deaths.
By winter of 23 most of us were done with COVID restrictions and back to operating as if COVID were a bad memory.
My guess is that the end of most COVID countermeasures caused people to die in larger numbers, especially the unvaccinated.
I've also seen recent studies that indicated a serious drop in IQ, even among the otherwise young and healthy.[1]
Both count as a serious threat to me. I am honestly not sure why you world disagree.
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.
Here's the thing... I don't believe you. It's not personal, it's just that you are making claims that are contrary to the evidence and have nothing to back them except an anonymous anecdote on the internet.
If deaths were occuring at that rate it would be devastating and obvious. Nobody could begin to hide it. What you describe are far worse outcomes than COVID itself, but we don't have enough corpses for it to have actually happened. Additionally the timing doesn't work out.
As of March 2023 13 BILLION covid vaccine doses had been given. If it had the same mortality rate as COVID itself (39 per 100,000/ the vaccine would have killed an additional 5,070,000 people, but it didn't. There aren't that many dead, and that's ignoring the disabled completely.
Sooo... If it did have side effects they were less dangerous than the disease itself. It's just math, and not even tough math.
I believe that you believe it, and I can respect that it is important to you, but I prefer science and the consensus among scientists and doctors is that you are wildly off base.
> If people that you disagree with count serious threat for you, you should probably find serious help.
I think I didn't say that clearly. I was saying that the virus doubling the risk of death and making people stupid is a serious threat.
That said, vaccine scepticism has killed a lot of people. So yes, it is a threat to all mankind.
I don't know where are you from, but you can check statistics about mortality by age in your country.
Speaking about side effects of vaccines, there are plenty studies monitoring it. If you believe in science as you wrote, read it carefuly:
- COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals https://www.sciencedirect.com/science/article/pii/S0264410X2...
- Booster vaccination with SARS-CoV-2 mRNA vaccines and myocarditis in adolescents and young adults: a Nordic cohort study https://academic.oup.com/eurheartj/advance-article-abstract/...
- COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign https://www.cureus.com/articles/203052-covid-19-mrna-vaccine...
- Platelet-neutrophil interaction in COVID-19 and vaccine-induced thrombotic thrombocytopenia https://www.frontiersin.org/articles/10.3389/fimmu.2023.1186...
- Cardiovascular Manifestation of the BNT162b2 mRNA COVID-19 Vaccine in Adolescents https://pubmed.ncbi.nlm.nih.gov/36006288/
- Surveillance of COVID-19 vaccine safety among elderly persons aged 65 years and older https://pubmed.ncbi.nlm.nih.gov/36496287/
- Apparent risks of postural orthostatic tachycardia syndrome diagnoses after COVID-19 vaccination and SARS-Cov-2 Infection https://www.nature.com/articles/s44161-022-00177-8
- To Evaluate the Safety, Tolerability, and Immunogenicity of BNT162b2 Against COVID-19 in Healthy Pregnant Women 18 Years of Age and Older https://clinicaltrials.gov/ct2/show/NCT04754594
- Long-term COVID-19 booster effectiveness by infection history and clinical vulnerability and immune imprinting: a retrospective population-based cohort study https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
- A Comparison of Cases of Autoimmune Hepatitis After Vaccination Against COVID-19 https://journals.lww.com/acgcr/Fulltext/2023/01000/It_Can_t_...
- Massari M. et al: Postmarketing active surveillance of myokarditis and pericarditis following vaccination with COVID-19 mRNA vaccines in persons aged 12 to 39 years in Italy: A multi-database, self-controlled case series study https://pubmed.ncbi.nlm.nih.gov/34849657/
- Lai F.T. et al: Carditis After COVID-19 Vaccination With a Messenger RNA Vaccine and an Inactivated Virus Vaccine https://www.acpjournals.org/doi/full/10.7326/M21-3700?rfr_da...
- Oster M.E. et al: Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021 https://jamanetwork.com/journals/jama/fullarticle/2788346
- Bardosh K.et al: COVID-19 Vaccine Boosters for Young Adults: A Risk-Benefit Assessment and Five Ethical Arguments against Mandates at Universities https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4206070
- Goddard K.et al: Risk of myokarditis and pericarditis following BT162b2 and mRNA-1273 COVID-19 vaccination, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9273527/
- Age and sex-specific risks of myokarditis and pericarditis following Covid-19 messenger RNA vaccines https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233673/
- Epidemiology of Acute Myocarditis/Pericarditis in Hong Kong Adolescents Following Comirnaty Vaccination https://pubmed.ncbi.nlm.nih.gov/34849657/
- Persistent Cardiac Magnetic Resonance Imaging Finfings in a Cohort of Adolescents with Post-Coronavirus Disease 2019 mRNA Vaccine Myopericarditis https://www.jpeds.com/article/S0022-3476(22)00282-7/fulltext
- Vaccine-Associated Myo/Pericarditis in Adolescents: A Stratified Risk-Benefit Analysis https://onlinelibrary.wiley.com/doi/10.1111/eci.13759
- Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection https://www.nature.com/articles/s41591-021-01630-0#Aff1
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.
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).
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.
The Cochrane Review demonstrated this: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
There are also numerous dis-benefits of masking, especially among young children.
Also doesn't claim what people like you says it claims.
Also, look at the history. Date of the original review is 2007. You know what didn't exist in 2007?
Airborne viruses?
It's a meta-analysis of other trials.
>>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?
It has been updated several times. The latest edition was published in January 2023. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...
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.
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".
That’s certainly what I called them only they didn’t seem to like it.
https://www.cidrap.umn.edu/covid-19/commentary-wear-respirat...
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.
In gen pop with patchy adherence to usage not so much.
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.
So the tests are good as confirmatory devices. But yeah, it was extremely unserious when they were used to gatekeep public events, etc. The reasonable presumption has always been that transmission of respiratory pathogens will occur at public events (which is a strength: humans are quite good at quickly acquiring community immunity - it's one of the reasons our species is so incredibly robust against respiratory pathogens).
When you say "humans are good at quickly acquiring community immunity", I don't really think we've done that with Covid. Covid is still over 2% of all deaths in the U.S., and it's causing way more disability and injury. We won't truly know what it's done to us for years.
The presence of a particular pathogen (or for that matter, any phenomena) coincident with death is not a meaningful metric.
Nearly 100% of human deaths involve a person with a belly button.
> and it's causing way more disability and injury
While it's important and long past-due that post-infection syndromes are finally getting the attention they deserve, there is no evidence that this particular coronavirus is different from other four endemic coronaviruses (and several other pathogens) in this regard.
This is where Covid is listed on the death certificate as the primary cause of death. Everyone that dies of cardiac arrest or cancer also has a belly button.
> While it's important and long past-due that post-infection syndromes are finally getting the attention they deserve, there is no evidence that this particular coronavirus is different from other four endemic coronaviruses (and several other pathogens) in this regard.
Generally there hasn't been all that much research on post-viral syndromes. To some degree that's because they don't obviously affect so many people. It could very well be that other viruses are the cause of more conditions than is currently appreciated though. Certainly the Epstein-Barr/MS results could be the tip of the iceberg. Regardless of what other viruses do, it's looking to me like Covid is likely to be pretty bad long-term, but we won't know for sure for 30+ years I suppose.
Where are you getting death certificate data for 2023? I can't seem to find it yet.
If you are looking at WISQARS coded deaths, then I imagine you are already familiar with this critique:
https://www.washingtonpost.com/opinions/2023/01/13/covid-pan...
...so I won't go rehashing it.
But in any case, it's a can of worms.
If SARS-CoV-2 disappeared magically tomorrow, do we expect overall mortality to suddenly decrease by 2%? Of course not. The deaths will just go back to being coded with their prior ICD-10 code. For example, multiple myeloma deaths caused by respiratory distress will go back to the C00 series.
But getting back to the broader point: even in the worst reading, even falling to 2% of all deaths for a deadly respiratory pathogen shows pretty good immune robustness. Some influenza is so lethal to some birds that it becomes the only cause of death for an entire flock, causing a 90% mortality rate. No other species communicates immunity across subpopulations as fast as humans.
As far as the mortality data: the change in practice to code deaths as resulting from a particular coronavirus seems like a good evolution in terms of data richness. But to clarify what it means for population mortality, we'd need to do it for other infectious pathogens, not just SARS-CoV-2. To continue the example, if HCoV-HKU1 is the pathogen resulting in lethal respiratory distress for a multiple myeloma patient, than it makes just as much sense to code that death HKU1 as it does for a patient who does from respiratory distress from COVID-19 as COVID-19.
> Everyone that dies of cardiac arrest or cancer also has a belly button.
Many of those also have COVID-19. And of those, some are coded as COVID-19 and some are not. If a person is infected with a coronavirus and dies from cardiac arrest, is it properly understood as a coronavirus death? Prior to 2020, the answer was always "no" (in fact, there was no ICD-10 code available for this (and to my knowledge, there won't be any deaths coded for coronaviruses other than COVID-19 in this year's dataset either)). But now, the answer is "yes" for only one of the five endemic coronaviruses. The data needs to catch up to the reality in order to have an actionable picture of population mortality.
> Generally there hasn't been all that much research on post-viral syndromes. To some degree that's because they don't obviously affect so many people. It could very well be that other viruses are the cause of more conditions than is currently appreciated though. Certainly the Epstein-Barr/MS results could be the tip of the iceberg. Regardless of what other viruses do, it's looking to me like Covid is likely to be pretty bad long-term, but we won't know for sure for 30+ years I suppose.
Hopefully the crazy dearth of research on this topic is something that the COVID-19 pandemic will have changed for the better. It's about time.
> it's looking to me like Covid is likely to be pretty bad long-term, but we won't know for sure for 30+ years I suppose.
Given the unavailability of data on the matter, I'm not sure how you can draw that conclusion. Are people reporting post-viral syndromes following COVID-19? Yes. Are they more frequent than with the other four endemic coronaviruses? We can't know, because we've never tracked this before. But we do know that what we have suddenly started calling "long covid" has been known to science for decades (and can be evinced by searching, for example, "{hku1|oc43|nl61} cardiovascular" on Google Scholar).
And sadly, I don't know that we'll really know much better in 30 years. Hopefully we'll understand more about the prognosis, and have some treatments. But distinguishing between the post-infection syndromes of the five endemic coronaviruses might be impossible.
The problem is that people will have symptoms consistent with covid and they're going to visit grandma or whatever, so rather than just cancel, they take a test, the test is negative, and they go do their thing. IMO going just based on symptoms is more reliable at this point unless you're using a molecular test.
It is practically impossible to avoid catching covid in modern society.
'On a long enough timeline everyone's chance of survival drops to zero.'
For the average human going about an ordinary and active life that statement is quite true.
However, the person in question didn't lead an ordinary life. He was confined to a medical device and probably very rarely had in-person contact with random people. Besides, the people who met him personally all must have known about his condition.
Under such circumstances avoiding COVID-19 is actually pretty easy: Have everyone in the room wear high-quality face masks.
Even for the average person during the height of the pandemic, avoiding COVID-19 was still possible, but required significant effort (no lockdowns though, mind you): Basically, it meant wearing such a mask properly in public settings (and changing it at appropriate intervals) as well as frequent testing of everyone you were in touch with regularly.
There's of course still a small chance of contracting COVID-19 in spite of wearing a mask, which is why for society at large masks only slowed down the spread at best. For the individual person by and large the probability for getting infected is negligible, though.
This precisely what those - quite heated - arguments (and pertinent studies) regarding masks being not effective at all were about: Masks are highly effective on a personal level; for preventing community spread their usefulness is limited.
Here, we report on a 62-year-old male hypervaccinated individual from Magdeburg, Germany (HIM), who deliberately and for private reasons received 217 vaccinations against SARS-CoV-2 within a period of 29 months (figure A; appendix 1 tab 1).
Furthermore, HIM had no signs of a past SARS-CoV-2 infection, as indicated by repeatedly negative SARS-CoV-2 antigen tests, PCRs and nucleocapsid serology (figure A; appendix 1 tab 1).that's wild.
https://www.sciencedirect.com/science/article/pii/S0264410X2...
Edit: the quote below (Palahniuk, fight club I believe,) is an actuarial reality.
You can get a antibody (blood) test that will test positive for COVID antibodies even if you were asymptomatic.
So far, is the missing clarifier.
Humans have high variation. It's what keeps the species alive when things like pandemics come rolling in.
Your personal situation doesn't automatically apply to anybody else.
That would be an inconvenient truth though.
Quarantining is very effective but is really inconvenient. You can't get every single person who wants to interact with you to quarantine for 14 days prior unless you are super important.
Also, you may have gotten it, were asymptomatic, and didn't notice. COVID is fun like that.
Also, for all I know you could live in a hut in the mountains so I don't know your exposure.
I assume its medium to high given your implication.
They’re often late with details for this reason.
I’d suggest instead focusing on that this man managed to live a fulfilling and accomplished life in what I would be terrified of being in for even one day.
Rest in peace sir. You are not a cultural war bargaining chip.
When I first saw him, I was rather horrified by his predicament. But then I saw that Paul was always upbeat and positive and accomplished. He seemed to live his life to his maximum. And he accomplished more than the average abled person.
I hadn't seen him the past couple weeks (though my TikTok usage is more cautious morbid curiosity and at an arm's length). I guess this explains it.
His story and positive attitude has had a lasting impact on me in making me appreciate and enjoy life more- and to really work to make the best out of whatever is thrown at me.
WOW -- I just read this:
https://www.theguardian.com/society/2020/may/26/last-iron-lu...
It says he went out with friends, saw movies, and even flew on planes while "frog-breathing", as he called it. He couldn't do it while unconscious so he still had to sleep in the lung.
So, to state it in computing terms, this wasn't a fix for not being able to breathe, it was a workaround. But it seems to have worked really well: at 40, he was "able to spend most of his day outside the machine that still kept him alive".
If this is reported correctly, it would even have been an deliberate choice to not leave more often or entirely.
EDIT: This was seemingly not reported correctly, it seems he only depended on the iron lung while sleeping but could otherwise live without it.
Contracting Covid, unfortunately. :(
Source: https://www.sueddeutsche.de/projekte/artikel/magazin/eiserne...
Source: https://www.nbcnews.com/news/us-news/paul-alexander-polio-su...
Talk about determination