COVID Stupid

AG_PhamD

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Ït will be 10 years in March. I didn’t start the statin until about 1-2 years ago. It seems the Letrozole increases cholesterol. I’m just surprised it took that long.

Congratulations! That’s great news.

Ahh yes, indeed aromatase inhibitors can increase cholesterol for some, especially after years of treatment.
 

mac_in_tosh

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Re: Pharmaceutical companies, there is always reason to be skeptical of their reporting given their conflict of interest. The government has cracked down significantly on companies hiding clinical data with much greater oversight. And given numerous controversies, it’s not surprising the public is skeptical. And I’m not telling you to inherently trust them.
Yes, I will remain skeptical. Having been caught and prohibited from certain underhanded practices doesn’t give confidence they won’t try others. Too much money involved.

I think this discussion has reached the “agree to disagree” stage. It started when I commented that many drugs seem to have a barely statistically significant benefit. You brought up statins as an example of an effective drug and I cited results of a six year study in which 5% of untreated people had an adverse incident compared to 4% for those treated, with 2% of the treated group experiencing side effects. You indicated these are usually short lived and usually not serious, but there is a long list of them, some more serious than others and some, such as fatigue, may linger.

The American Heart Association seems to think these outcomes are something to brag about. In fact, one doctor jokingly suggested that statins be added to the water supply. And a friend told me that despite no indication of need, his doctor told him that he “might as well” get started on statins because, you know, they are so wonderful and he was eventually going to take them. Glad to hear that you are not in that camp.

The type of statistics drug companies tout would be unacceptable in other areas. I doubt NASA would brag if changes made led to only 4% of their manned flights resulting in disaster instead of 5%. Or consider an analogy with an investment club with 100 members where during every six year period 5 members go bankrupt based on a poor allocation among the investments discussed. The rest do about average. They hire an investment advisor who gives individual advice to members for the next six years with the result that 4 members went bankrupt, everyone else continued to do about average as before except for two members who did below average. I doubt anyone would consider this advisor’s guidance to be valuable.
 

Herdfan

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Pretty sure a lot of us have been saying this since the beginning:


Here is the original WaPo article. I don't have a sub, but for those who do:

 

SuperMatt

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Pretty sure a lot of us have been saying this since the beginning:


Here is the original WaPo article. I don't have a sub, but for those who do:

Hey look I found 1 person who agrees with me. I knew I was right!

Meanwhile in China, they’ve taken the stance that you are taking. Which has resulted in what would be a comical undercount, if death were funny.


They claim, in a country of a billion people, only 5,258 died from COVID since the pandemic began. Since they reduced COVID restrictions in December? They say only 37 people died. Yeah... and monkeys might fly out of my butt.

If you prefer to listen, here’s a good story about how drastic their undercount is, and how many are trying to figure out reality vs the Communist Party lies. There is a 2-month backlog on getting a cremation, and families only get 2 minutes to say goodbye because of the long line for the next corpse.


There is probably no 100% way to tell in some cases whether the person would have died if they didn’t have COVID or not. I’m sure there are some cases where it was the primary factor, some where it was a secondary factor, and on down to some where it was a non-factor. But this reductive thinking where you look for the first article you find that says “we overcounted by millions” and then say you knew you were right? Come on, man. I know you nearly died of suffocation from wearing a mask into Home Depot once, but get real.

Now that we’ve reached a high level of vaccination and less-deadly variants of the virus have become prevalent, perhaps some find it amusing to say “I told you there was nothing to worry about!” But for those whose family members died and for those who are still getting sick and dying, it’s pretty sad that some people are still acting like spoiled toddlers about sensible public health measures.
 

Eric

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Roller

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Pretty sure a lot of us have been saying this since the beginning:


Here is the original WaPo article. I don't have a sub, but for those who do:

"A lot of us." As in you and medical experts based on your analysis?

But, more importantly, what's your point?

Do you think that hospitalization and death are the only metrics by which COVID's adverse effects should be gauged? Tell that to the millions of people who are suffering from post-acute symptoms, so-called long COVID. Truth is, we don't yet know the incidence or causal mechanisms, which may take years to elucidate, nor do we have effective treatments. In the meantime, it seems prudent to adopt a stance between the extremes of restricting all activities to reverting to pre-pandemic practice, which may vary depending on circumstances.
 

AG_PhamD

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Yes, I will remain skeptical. Having been caught and prohibited from certain underhanded practices doesn’t give confidence they won’t try others. Too much money involved.

I think this discussion has reached the “agree to disagree” stage. It started when I commented that many drugs seem to have a barely statistically significant benefit. You brought up statins as an example of an effective drug and I cited results of a six year study in which 5% of untreated people had an adverse incident compared to 4% for those treated, with 2% of the treated group experiencing side effects. You indicated these are usually short lived and usually not serious, but there is a long list of them, some more serious than others and some, such as fatigue, may linger.

The American Heart Association seems to think these outcomes are something to brag about. In fact, one doctor jokingly suggested that statins be added to the water supply. And a friend told me that despite no indication of need, his doctor told him that he “might as well” get started on statins because, you know, they are so wonderful and he was eventually going to take them. Glad to hear that you are not in that camp.

The type of statistics drug companies tout would be unacceptable in other areas. I doubt NASA would brag if changes made led to only 4% of their manned flights resulting in disaster instead of 5%. Or consider an analogy with an investment club with 100 members where during every six year period 5 members go bankrupt based on a poor allocation among the investments discussed. The rest do about average. They hire an investment advisor who gives individual advice to members for the next six years with the result that 4 members went bankrupt, everyone else continued to do about average as before except for two members who did below average. I doubt anyone would consider this advisor’s guidance to be valuable.

Again, I would point out
1) Most people develop high cholesterol in their 40’s (particularly men) though increasingly it’s people in their 30’s. A 5 year study or even 10 year does not demonstrate the same benefits as a 30-50 year study, which is relevant as high cholesterol’s effects are cumulative

2) Weighing a blanket percentage of side effects is not appropriate if the majority of statins side effects are minor or tolerable or transient. Even in the very rare severe events, it’s not at alll common that this would lead to death or permanent disability. Obviously if people do experience side effects regardless of the drug or dose, then it’s ultimately up to the patient what to do.

I could say X chemotherapy drug has a 30% benefit on 5 year survival, but 100% of people have major side effects- so therefore no one should take chemo.

Plus, it doesn’t make sense not to try the drug because of a small chance of side effects. If you have a 95% chance of not having side effects, would you base your decision off that 5%? Especially when the majority of the side effects are minor and the rare severe events rarely if ever progress to being fatal.

3) If the risk of dying on statins was, then patients would not be prescribed given the risk-reward ratio, even if the drugs prevented 90% of cardiac events. I understand the point you’re making, but the NASA comparison doesn’t make a lot of sense in this context.

Perhaps the better analogy is a tiny investment with a 0.001% chance of losing a lot of money- more than you put in (severe side effect, even though these don’t usually result in death/permanent disability), 5% chance of losing a little money- but you get a refund (minor side effect that goes away upon discontinuation), a 93% chance of gain/losing nothing, or a 2% huge returns worth far more than you invested (with that chance increasing the longer you stay invested). And call the investment $100/year (max) vs a reward of up to 1 million or more if you consider the medical costs of a CV event alone, not including lost productivity and severely degraded quality of life.

——
Ultimately, it’s up to the individual to weigh the risks and benefits of any treatment. I would just be careful not to overweigh the reported side effect profiles of drugs and understand the limitations of studies.
 

Herdfan

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"A lot of us." As in you and medical experts based on your analysis?

But, more importantly, what's your point?

Do you think that hospitalization and death are the only metrics by which COVID's adverse effects should be gauged? Tell that to the millions of people who are suffering from post-acute symptoms, so-called long COVID. Truth is, we don't yet know the incidence or causal mechanisms, which may take years to elucidate, nor do we have effective treatments. In the meantime, it seems prudent to adopt a stance between the extremes of restricting all activities to reverting to pre-pandemic practice, which may vary depending on circumstances.

My point is why were they over-counted? Because it helps keep the panic up and governments in control. Do you think people would have been as compliant if the death numbers touted on a daily basis were lower?

Not sure what long-COVID has to do with the over-counting of deaths.
 

Roller

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My point is why were they over-counted? Because it helps keep the panic up and governments in control. Do you think people would have been as compliant if the death numbers touted on a daily basis were lower?

Not sure what long-COVID has to do with the over-counting of deaths.
First, you cited the article by Leana Wen and the piece in The New York Post to back up a claim that "a lot of us" have been making about COVID-related hospitalization and death, as if you independently came to this conclusion based on your analysis. Here's a contrary view:


But even if your contention were true, it just adds to the narrative that the COVID pandemic is less concerning because fewer people are being hospitalized or dying than we thought. It reminds me of someone whose Tweets I used to read before I blocked him in 2020. He'd comment on any COVID post by quoting extremely high survival figures and saying all the fuss wasn't warranted. Now, I don't think you fall into that camp — I believe you know COVID has to be taken seriously. And certainly we're in a far better position than in 2020, thanks to vaccines, Paxlovid, and other interventions.

However, my point was that evidence regarding the long-term effects of COVID, most of which are poorly understood, should prompt everyone to remain vigilant, stay up-to-date on vaccinations, and take precautions like masking in public spaces.
 

Herdfan

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First, you cited the article by Leana Wen and the piece in The New York Post to back up a claim that "a lot of us" have been making about COVID-related hospitalization and death, as if you independently came to this conclusion based on your analysis. Here's a contrary view:


But even if your contention were true, it just adds to the narrative that the COVID pandemic is less concerning because fewer people are being hospitalized or dying than we thought. It reminds me of someone whose Tweets I used to read before I blocked him in 2020. He'd comment on any COVID post by quoting extremely high survival figures and saying all the fuss wasn't warranted. Now, I don't think you fall into that camp — I believe you know COVID has to be taken seriously. And certainly we're in a far better position than in 2020, thanks to vaccines, Paxlovid, and other interventions.

However, my point was that evidence regarding the long-term effects of COVID, most of which are poorly understood, should prompt everyone to remain vigilant, stay up-to-date on vaccinations, and take precautions like masking in public spaces.

I also posted a link to the original article in the WaPo so no one could challenge the source. I don't have a sub so I couldn't make it readable.

How about we simply do our best to count the deaths accurately. Each side has a reason to want them higher or lower. I just want them to be correct.
 

AG_PhamD

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Pretty sure a lot of us have been saying this since the beginning:


Here is the original WaPo article. I don't have a sub, but for those who do:


The COVID overcounting should not really not a surprise to anyone- especially when there is no differentiation between deaths caused by COVID and deaths associated by COVID. This is especially true early in the pandemic when there was nothing resembling standardized reporting. What you consider to be a COVID death can be complicated when you have a patient with other comorbidities.

Here in Mass, less than a year ago, the state concluded they had overcounted COVID deaths by 15%- 4000+ deaths. Here’s how things worked here:
  • 2020-2021- Anyone who died with a previous diagnosis of COVID was counted, even if they died in car accident from obvious trauma.
  • 2021-2021- Anyone who had COVID within 60 days of dying was counted, unless the result of obvious trauma (ie car accidents not counted)
  • **2022+ - Anyone who dies of COVID directly or where COVID contributes to death or who dies of “natural causes” within 30 days of COVID diagnosis (presumptive or lab confirmed Dx). It can also include family members who claim/believe the person died of COVID.
**The last bullet is (my paraphrased summary) of the national standard for COVID reporting. I’m not sure if all states use the CSTE criteria, but many do. As you can see, there is a lot of wiggle room here.

I expect it will take years to sort this out these statistics, as often is the case with epidemics. And there will never be a definite figure.

COVID hospitalizations are also a mess because in many states, anyone hospitalized with COVID is counted as a COVID hospitalization. While the media often did not correctly report these numbers in the correct context, the general sentiment holds true- the more hospitalizations, the more cases among the population, and the more related deaths. I believe the CDC has now made it so only patients receiving treatment for severe COVID are reported.

The least accurate figure by far is the case count. Now that we have at-home rapid tests, there far less reporting on positive results. Most people aren’t going to upload their result per the mfg website or call their doctor to inform them unless they’re really not feeling well.

Over Xmas the state reported case counts around here were stable. But practically 1/3 of people I know got COVID during December… more than I’d ever seen at once. Deaths increased slightly which also suggests a rise. Wastewater virus levels skyrocketed. So I’d say our population-wide case reporting system is pretty useless at this point.

Epidemiology on pandemics/endemic diseases like COVID is tough to track. We’re never going to have anything close to an exact number, only a range of estimates.

Unfortunately any speak of COVID in the mass media either has some underlying political agenda or is interpreted to have one by people who have strong political opinions. I don’t have a WaPo subscription so I can’t make that assessment on the original article. But I don’t think it’s an unreasonable argument. For the sake of public argument though, I’m not quite sure why it matters at this point… aside for people comparing states’ fatality rates with no other variables considered to generate political commentary.

I’m very much over the toxic political BS that has destroyed public health.
 

Roller

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I also posted a link to the original article in the WaPo so no one could challenge the source. I don't have a sub so I couldn't make it readable.

How about we simply do our best to count the deaths accurately. Each side has a reason to want them higher or lower. I just want them to be correct.
I disagree that each side wants them higher or lower, though there are probably some that do. My colleagues and I have always just wanted the numbers to be as accurate as possible. However, as @AG_PhamD said, that's hard to do, even without an agenda.

Our healthcare system is in a much more precarious state than many people know or admit. Many facilities have struggled this winter with the triple threat of COVID, flu, and RSV, and it may not be possible to withstand another major spike. Nurses and other frontline workers are particularly exhausted after nearly three years. We just want people to go along with reasonable public health measures without constantly complaining and ascribing political motives to them.
 

Herdfan

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I’m very much over the toxic political BS that has destroyed public health.

I think there are 2 main reasons for this.

1) The initial response was chaotic. We are the most developed nation in the world and somehow we didn't have detailed plans for this. From Fauci telling people masks weren't needed to "2 weeks to flatten the curve" becoming 6 months to a year of lockdowns. No wonder a lot of people stopped listening.

2) It's settled science. BS There is no such thing. Science is always evolving. If it didn't we would still be using Mercury, bloodletting, and lobotomies. I'm sure at the time, those were settled science.
 

SuperMatt

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Most people think science should magically have all the answers. But they don’t care about the details. So if you tell them the best available information on Monday, and then you find out new information on Friday, they think you lied to them. Hence, all the “Fauci lied” nonsense.

That, paired with Trump making it all political, publicly questioning the nation’s best scientists and doctors, refusing to allow the public health people to handle it without interference, hoarding ventilators, telling people not to test, mocking people who wore masks, making it a badge of honor to defy mask mandates, etc... created a chaotic scene that made everything worse.

A GOOD president would have tried to calm things down and explain to confused people that the scientists and doctors are trying their best and giving the best possible advice based on the data. And let them know things could change as we learn more and if the virus mutates. But people picked a narcissistic turd in 2016, at just the wrong time for a once-in-a-century pandemic.

As for “settled science” - it is truly foolish to claim this doesn’t exist. If nothing were truly settled, we wouldn’t have science textbooks. Sure, we learn new things all the time, but we don’t constantly need to second-guess the speed of light, Planck’s constant, or the gravitational constant. The great thing about science is that one discovery builds on another. Kepler is credited with the discovery of planetary motion. But he relied on Tycho Brahe’s decades of extremely accurate and detailed data on the stars and planets, all without the aid of a telescope. No better way to tell everybody you don’t understand science by constantly calling it all into question for no good reason.

As for counting COVID cases, China is obviously undercounting in a way that is not even close to reality. It’s because they have an agenda. There is no similar agenda for American scientists counting every possible case that involves COVID. As I said before, there is no 100% way to know in every case exactly how much COVID-19 affected the person’s health compared to the other comorbidities. And knowing every death that involved a patient with COVID, whether or not we currently THINK COVID-19 was the primary cause of death, is important. Because we might find correlations between other illnesses or genetic conditions when analyzing the data in the future.

Finally, it should make one think twice if their stance aligns with the Chinese Communist Party on this issue - the ones pushing hardest to undercount, purely for propaganda purposes.

PS - The Washington Post article is not a source of data on COVID-19. It is an opinion piece. If we want to talk about its suggestions, we might consider a 2-level counting system. One that keeps track of every death in which the person had the virus, and those in which the doctor believes it was a factor. Because the data on who had COVID when they died is very important data to have.
 
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Yoused

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… we might consider a 2-level counting system. One that keeps track of every death in which the person had the virus, and those in which the doctor believes it was a factor. Because the data on who had COVID when they died is very important data to have.

I would be inclined to stretch the data even a little harder. Right now, of course, the immediate relevance is gone, but it is nonetheless worth looking at: when it was at plateau, how many people were dying due to not being able to get into a plague-choked hospital? I truly believe those deaths should be attributed to covid.
 

mac_in_tosh

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Most people develop high cholesterol in their 40’s (particularly men) though increasingly it’s people in their 30’s. A 5 year study or even 10 year does not demonstrate the same benefits as a 30-50 year study, which is relevant as high cholesterol’s effects are cumulative
Have there been any such long-term studies? And again, what's particularly vexing about all this is that if the medical profession would strongly advocate simple lifestyle changes a lot of these health issues could be avoided. But in the 5 minutes a lot of them give to each patient encounter, it's easier to just write out a prescription.
I could say X chemotherapy drug has a 30% benefit on 5 year survival, but 100% of people have major side effects- so therefore no one should take chemo.
That's a completely different set of people. We have been discussing having side effects from taking a drug intended to avoid a serious health issue, many of whom will derive no benefit from taking the drug as it only prevents an adverse outcome for 1 out of anywhere from 50 to 100 of them.
I understand the point you’re making, but the NASA comparison doesn’t make a lot of sense in this context.
I was simply trying to demonstrate that the arithmetic used to tout drugs would be unacceptable in other fields.

I'm growing weary of this discussion as perhaps you are also. You've been very patient. I had hoped others would chime in, possibly with their personal experience, but it hasn't happened.
 
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fooferdoggie

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AIUI, this is the former mayor of Baker City Oregon (a place not far from Idaho), and candidate for governor


Being near a vaccinated person puts a woman at risk 😵‍💫🙄🤦🏽‍♀️
if Jab is in there somewhere it is total BS. its amazing How stupid spreads like covid among the right.
 
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