> He attributes this to the presence of more-infectious variants.
I still think facemasks are selecting for more infectious strains and likely won't be effective enough in a few years unless vaccines bring us to herd immunity fast enough or the virus mutates into something less severe.
Face masks couldn’t be doing that because they don’t work to slow transmission whatsoever. The whole theory of face masks - even before accounting for real world usage - rests on the assumption that the primary transmission mode is respiratory droplets and not aerosols which is not the case. They’re just medical security theater, except worse because they have obvious negatives. I advocate instead for performing rain dances; they’re no less effective but provide a bit of exercise to boot.
Anyway, on a related vein, non-infection-protecting vaccines can do exactly what you’re saying and select for more virulent/pathogenic strains. Take a look: https://journals.plos.org/plosbiology/article?id=10.1371/jou.... Because all the COVID/19 vaccines do not prevent infection nor transmission (they reduce it but don’t fully block it), our incredibly shortsighted mass vaccination campaign is likely to select for more pathogenic strains. Go science!
> Could some vaccines drive the evolution of more virulent pathogens? Conventional wisdom is that natural selection will remove highly lethal pathogens if host death greatly reduces transmission. Vaccines that keep hosts alive but still allow transmission could thus allow very virulent strains to circulate in a population. Here we show experimentally that immunization of chickens against Marek's disease virus enhances the fitness of more virulent strains, making it possible for hyperpathogenic strains to transmit. Immunity elicited by direct vaccination or by maternal vaccination prolongs host survival but does not prevent infection, viral replication or transmission, thus extending the infectious periods of strains otherwise too lethal to persist. Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts.
we should be pushing for N95 masks to be cheaper and more available. those masks block aerosols when they're properly fitted (and we should make them easier to fit.)
I would love for N95 usage to become more widespread, but that is hampered by the dogmatic clinging to the belief that cloth masks actually work, unfortunately.
Do N95s work for source control though? They certainly do work for self infection but I haven’t personally read any N95 studies on source control so am not sure.
the ones without exhalation valves do. the barrier is bidirectional. the ones with valves bypass this which is why those shouldn't be used for source control but are popular for wildfires etc.
Thanks. That was my thinking but glad to see it confirmed.
Kind of ironic that you’re not allowed to wear an N95 with an exhale valve, but are encouraged to wear a surgical mask, bandana, cloth mask, or dirty T-shirt, none of which provide any source control.
Again, the elephant in the room is respiratory viruses in general, and SARS-2 in particular, spread via aerosols. Non-N95 face coverings cannot block aerosols. Indeed mask wearing leads to deeper breaths to maintain homeostasis (this has been studied), therefore lead to a greater net volume of air, therefore lead to increased aerosol emission before even accounting for the potential to nebulize large droplets into a shower of tiny aerosol particles. But I digress.
A surgical mask, bandana, cloth mask, or dirty T-shirt over a particulate mask (e.g. N95) is typically allowed. There are serious benefits to the wearer to having an exhaust valve. Wearing a second, less effective face covering over the particulate mask retains the benefits of the particulate mask and exhaust valve while maintaining the same level of source control as without the particulate mask.
Sure, cloth masks were widespread for about a year but by now usage of FFP2 masks is becoming extremely widespread, especially since the supply is by now overwhelming.
Cloth masks work better than no mask, so they made sense early on when surgical masks couldn't be found. There are certainly better options now though.
There is no RCT that shows cloth masks work any better than no mask. You’re relying on mechanistic studies at best (or crappy associative studies).
Masks incur costs; at a minimum you must admit they alter risk appraisal if nothing else.
Anyway, nobody in this thread has addressed the point that masks don’t even work in theory if aerosol transmission is the dominant transmission mode. That’s before accounting for the incredible cross contamination and misuse of masks that you see in the community.
In Germany, you are required to use surgical or FFP2/(K)N95 masks (in 2 states surgical ones are not allowed) to enter any store. At least in my city, the majority of people wear FFP2 masks.
If cloth masks don't work, they aren't doing much for source control either. They don't magically filter better in one direction than the other.
If everyone was wearing a particulate mask (e.g. N95), source control wouldn't matter as much. Masks with an exhaust valve are significantly more comfortable and comfort is the reason the CDC is currently citing in regard to their recommendation for people not to wear particulate masks.
If your protection plan relies on everyone else doing something complicated correctly, you have already lost. I think controlling the spread of a virus in the general population using source control is not something our species is capable of.
To be clear, I agree. I think the whole concept of source control is silly. Actually I’ll go one step further and say I think the whole concept of trying to artificially slow transmission of SARS-2 in the general population is a bad idea period.
And my wife can't find ones small enough to fit her face properly. In her home country masks come in all sizes and shapes, in Europe there seems to be only a single size. At least every type I've looked at is the same size as all the others.
I found one with an amazing fit from China that was large enough. Then I googled the name and found out it’s listed under the fake/mislabeled category on the CDC site [0] with filtration efficiency between 8 and 94% (over 2 ten sample test runs):(
I 100% agree that the conversation should shift to how we can get more particulate masks into people's hands. That said, N95 masks are not the gold standard many people claim they are.
N99 and P100 masks typically include a gasket which improves the seal dramatically. They also come with the bonus of filtering substantially more fine particles. Given than the size of the aerosols in question are less than 5 microns and that the ratings are in relation to 0.1 microns, getting a higher rating is probably a good idea.
Even better still is a silicone mask which is trivial to leak test by covering the filter cartridge inlets (negative pressure) or exhaust valve (positive pressure).
PAPRs (powered air purifiying respirators) would be far more effective and efficient, especially on a long-term basis. People who are at risk of becoming severely ill from a respiratory infection (i.e. Pneumovax 23 recipients), especially in the developed world, should be able to have their national/public/private health insurance pay for a PAPR. After the pandemic, this really should be the case. There are also more compact, more convenient, and better designed PAPRs coming out, such as the Optrel Swiss Air [1] and the CleanSpace Halo [2]. Most PAPRs do not require fit tests to ensure the seal, while N95/N99/P100 masks do. The PAPRs I list can easily be adapted, either formally or informally, to have source control (covering of the exhaust valves).
There has been a large push for N95 masks in Germany. They are now mandatory when doing grocery shopping.
You're allowed to use a "surgical mask" instead, however. I think those offer few less protection to the wearer.
The only RCT ever performed for self infection of SARS-2 in the community failed to reach significance. No RCT of community masking for SARS-2 transmission has ever been done, probably because it’s unfeasible (translation: we’ve constructed an unfalsifiable hypothesis).
Can you point me to a non mechanistic non associative study that demonstrates that face masks work to prevent community transmission of SARS-2?
EDIR: I can’t reply to the child comment about condoms (does HN have a nesting limit?) but suffice to say we only have 1 RCT on SARS-2 so playing the significance game is silly. You can’t point to a single RCT showing an effect because it doesn’t exist. That’s the problem. We’re mandating an intervention that is unproven to work and rests on theoretical assumptions that are now known to be false.
You can go look at non-SARS-2 RCTs if you want but those also look abysmal. For example go read Macintyre’s cluster-randomized controlled trial of cloth masks in healthcare workers. It’s not encouraging.
> The only RCT ever performed for self infection of SARS-2 in the community failed to reach significance.
Do condoms work against sexually transmitted diseases? 5 out of 10 RCT studies reported statistically significant effect. Do condoms work against unwanted pregnancy? 0 out of 4 RCT studies reported statistically significant effect.
> Face masks ... don’t work to slow transmission whatsoever
and when pushed on it, you imply that this is true because there’s been no trial on it, which is not how implication works.
You then also try and suggest the presence of an unfalsifiable hypothesis which you don’t try and explain, and seems suggestive that you don’t know what the term means?
It’s unfalsifiable because it requires studying a whole community and sequencing every SARS-2 infection to attribute “blame” to the source of the infection. That is very difficult to do and that is why such an RCT does not exist. And yet most of the world is performing this intervention anyway.
That’s the brilliance of “my mask protects you”. It’s not feasibly falsifiable. “My mask protects me” is very easy to falsify. That’s why we have one RCT that studied exactly that and failed to reach significance.
Again, the theoretical MoA of masking only makes sense if SARS-2 spreads via respiratory droplets. If it spreads via aerosols, the sub-micron aerosol particles stay aloft for minutes-hours and bypass the comparatively giant holes of the mask with ease. The sightly altered directional flow is largely irrelevant. You can watch any of the many videos of someone vaping with a mask on/off to see what I’m talking about. Imagine that every time you exhale.
The theory behind universal masking rests on early studies which indicated a possibility of asymptomatic spreaders.
This has mostly been falsified in at least one controlled study [1].
The Danish study is the closest thing we have to RCT on masking [2] which found no statistically significant result from universal masking.
Wearing a mask while symptomatic seems like a good idea though, if you're unable to stay home for some reason, though that's good advice for most airborne contagious illnesses. I appreciated the culture of doing this when I was in Japan - if for no other reason than it told me who to keep my distance from.
Washington [0], Vermont [1], and Maine [2] all got mask mandates last summer. These states have had half the number of cases [3] as other northern-US states.
Masks reduce respiratory disease transmission in hospitals. They work outside of hospitals, too. Covid-19 spreads like any other respiratory disease.
If you don't want to wear a mask, then stay at home. I have the right to participate in society without catching a dangerous disease from you.
If your mask is uncomfortable, then try some different ones. I use masks made by Burlway [4]. They are very soft. They fit my face perfectly and haven't stretched or shrunk. I have 10 of them. I keep clean ones in a drawer near the door. My going out ritual is now "keys mask phone wallet."
No, this individual is stating that no matter what, people (including the disabled) have to go out in society to things like doctor’s appointments. Everyone has the right not to catch a potentially deadly disease.
“Freedom” does not extend to not wearing masks during a pandemic. Your freedom stops when you are a potential asymptomatic/symptomatic spreader of a potentially deadly disease to others.
Therefore, masks should be required for everyone.
Also, I am disabled and I agree with this poster’s comment. It was definitely not ableist at all. It was 100% in support of masks when out in public.
Is knowingly exposing someone to an STI without their consent in fact uniformly legal everywhere? Have you ever heard of anyone suggesting it be illegal before?
I'm not expressing an opinion here; I'm trying to understand why you would take for granted that everyone thinks such behavior is ok or inevitably legal, setting aside the specific context of COVID and current partisan conflict.
What I'm pointing out it is that, whether people acknowledge it or not, they're treating everyone as though they're infected.
So something like masking is required even if someone seems healthy. It's a regime of constant anxiety and latching onto any and every doom scenario.
So with the same logic, we should be assuming every sex partner has an incurable STI. Especially with the emerging threat of antibiotic-resistant strains, the most risk-avoidant with respect to SARS-CoV-2 would only be consistent by likewise being in favor of extreme measures like mandated condoms, quarantining, forced testing, etc. with something like STIs.
I don't agree with this at all - but it's clear that there's a fixation with COVID that doesn't get applied to other large aspects of society.
If we care about people's health - why don't we lock up fat people and force feed them a strict diet until they're a healthy weight? It's hard for me to see anything under the current public health/political regime that wouldn't justify this.
I guess a lot of people (extrapolating somewhat from myself) feel like wearing a mask when you go in a building other than your home is not extreme nor has it been enforced in an extreme way, contrasting with your hypotheticals.
From what I read on the internet, it's long been a custom in many places in the far east to wear a mask whenever one has or might have the cold or flu or whatever.
At this point, I'm thinking why shouldn't we westerners adopt that, going forward?
It appears that wearing masks drastically reduced flu transmission, which seems logical given that it's much less contagious than covid-19. That presumably saved many lives.
And the common cold is not worth developing an advanced vaccine against, but what would we be losing if we prevent its transmission?
So I don't see why masks are a bad thing even if covid vanished tomorrow. There are so many measures we take to mitigate things that have substantial known and unknown risks, so it's mysterious to me why people are so vehemently against one with no downsides.
Some people think that knowingly exposing someone to HIV should be a serious crime (I don't know if it presently is in any jurisdiction; I'm fairly certain there have been attempts to pass such laws at least).
Is this an example of the positive right that you say never existed and leads to all manner of evils?
Do you think the proponents of it are uniformly politically aligned with the people in favor of masks for COVID?
In the context of COVID we’re actually talking about unknowingly exposing someone to a virus. So I don’t think it’s directly comparable.
Anyway, I don’t believe in throwing someone in jail for such an act. Some people do.
But I don’t think that invalidates the point that such a right does not exist, because “spread disease” is a superset of “knowingly spread disease”.
Ironically here in California it is legal to knowingly spread AIDS to someone, because democrats, yet that same political faction thinks that you are responsible if you unknowingly spread COVID-19 to someoen. (As an aside the absurd “infecting Grandma in the grocery store” doesn’t happen anyway because that’s not really where COVID spreads but I digress)
https://www.acpjournals.org/doi/10.7326/m20-6817 - Only community RCT of masking for SARS-2 ever performed. Failed to reach significance, bounds are from (in plain english) “slight-moderate worsening” to “moderate+ improvement” in transmission. Endpoint was self infection not source control. No RCT of source control for SARS-2 exists, and yet everyone in this thread besides me is advocating for usage of this unproven intervention, how curious.
https://bmjopen.bmj.com/content/5/4/e006577?fbclid=IwAR1eSyc... - cluster-randomized controlled trial of masking in hcw. Compared cloth masking to “standard practice”, not a no-mask control, but results caution against usage of cloth masks due to abysmal filtration efficiency and the
increased infections in the group relative to standard practice
I’d have to cite like 10 different studies to show the full story on aerosol transmission and I’m on mobile so I’ll leave that as an exercise to the reader for now. But I’d like someone to at least answer this:
If you take it as fact that SARS-2 primarily spreads through aerosols, what does that imply about the efficacy of masking for source control of SARS-2? There is a reason that the health authorities advocating community usage of masks (which they never did for any respiratory pathogen pre-COVID btw) maintain that SARS-2 spreads through large respiratory droplets. It’s because otherwise the whole concept of community masking is absurd.
I think a review of the relevant literature shows that it quite obviously is, but I’m about to go to sleep and don’t want to fight that battle thus why I’m trying to direct your attention to the actual point.
So let’s try again:
If you take it as a given that SARS-2 primarily spreads via aerosols, what does that imply about the efficacy of strapping a warm, damp piece of cloth over your breathing holes?
That masking wearing is virtue signaling, showing that you care. Which is not necessarily a bad thing, but you might as well wear a t-shirt with a message.
> There is a reason that the health authorities advocating community usage of masks...maintain that SARS-2 spreads through large respiratory droplets. It’s because otherwise the whole concept of community masking is absurd.
But why would they keep saying it? Maybe they are effective. Maybe it's the politician's syllogism. Maybe they're worried that back-peddling would hurt their credibility. Maybe they create enough of a sense of both safety and fear to keep society functioning.
That’s study says “Immunity elicited by direct vaccination or by maternal vaccination prolongs host survival but does not prevent infection, viral replication or transmission, thus extending the infectious periods of strains otherwise too lethal to persist.”
Is this your concern with the covid vaccine? That a strain which would have killed someone unvaccinated, that person will now instead stay alive and spread it?
The viruses used and discussed in that study had between a 60% and 100% fatality rate. This is pretty different than covid 19
Right but imagine the same study but performed on 1 billion people for a much less lethal virus. That’s what we’re doing with this mass global vaccination campaign.
So yes, that is my concern. But I mainly mention it because it’s a handy counter to the utilitarian collectivist argumentation without having to argue against the ethics of collectivism itself.
Your logic is flawed because additive risks like that cannot be compared to exponential risks (like the spread of a virus). There's an asymmetry in the outcomes and the potential upside is enormous; especially when your stated risks are minimal to (say the least), like acne or in some cases, have been proven to be wrong by data (re: psychological "discomfort"--suicide rates decreased last year).
Suicide rates are not the same thing as discomfort.
Calling the risks minimal to acne makes no sense. It’s one of the worst contributors to acne in any person’s daily life.
Even if I agreed with your exponentiality argument the whole point is that I’m saying masks don’t reduce spread. You seem to think there’s only possible upside, but there is equally downside wrt xmission; that is, masks run the risk of worsening transmission.
Yes, but they are a pretty good proxy for psychological discomfort levels/rates. And my point was that you can't really compare acne to covid as the latter is much worse (let me emphasize that you _don't_ have to agree with me on this, all you need to agree with is the fact that exponential risk >>>>>>> additive).
Furthermore, there is nothing to suggest that masks run the risk of worsening transmission. I see from your other comments that you're familiar with the mask clinical trials (presumably you're referring to the Danish study). That study was inconclusive (also note that it was _severely_ underpowered), and considering that _nothing_ in our previous knowledge suggests that they worsen infection rates, your reasoning is once again flawed.
I’ve already outlined in another comment why they could increase transmission.
They increase net volume of air exchanged, therefore all else equal they increase the release of aerosols. There’s furthermore a strong chance that they actively nebulize respiratory droplets into fine aerosols; ie they incresse the relative aerosolization and therefore the absolute aerosols.
They make convo partners stand closer together or speak louder.
They alter risk appraisal.
It is foolish to rule out any downsides. At best you’re advocating for a condom full of holes. At worse you’re advocating for a condom that magically worsens STI transmission.
Nothing in our previous understanding suggests that they increase release of aerosols or aerosolization. Multiple previous studies have shown that they don't (see Asadi, S., Cappa, C.D., Barreda, S. et al. Efficacy of masks and face coverings in controlling outward aerosol particle emission from expiratory activities. Sci Rep 10, 15665 (2020), for one example; there's also older studies but you can look them up yourself).
The other arguments are of the "seatbelts cause more accidents" variety, which honestly aren't worth refuting. But I'll just note that social distancing has much weaker evidence of affecting virus transmission than even masks (there is no real justification for the 6 feet number and mostly unlikely it makes much of a difference). Hell, social distancing is even much more difficult to comply with than wearing masks so your argument makes no sense at all.
Fair question. We've never done this before to this extent, so there just aren't studies, and this is just a hypothesis. It reminded me a lot of antibiotic resistance, though.
None of the virus build resistance to masks. what exactly is the hypothesis? Masks just reduce the transmission rate, so it shouldn't have any correlation with virality. A 10x more viral variant will still be 10x more with masks, just that overall transmission for all variants will be reduced by 90%
I've had thoughts on similar lines to the top level comment, by the following line of reasoning:
In US and Europe, policies and behavior (such as mask-wearing and social distancing) have become stricter as the number of cases rise and more lenient as the number of cases fall. This means that the reproduction number hovers around 1.
If we imagine that R_0 for Covid-19 is 2.0, no measures are taken, and a variant which is twice as infectious appears when there are 10^6 cases (in a population of 10^9), then the variant will have only infected ~10^6 people by the time we have herd immunity (a very rough estimate).
On the other hand, if measures halving the spread rate are imposed when 10^6 cases are reached and the variant appears, then the variant will still spread exponentially while the original strain is curtailed, resulting in most people catching the highly infectious variant.
I have no background in medicine or epidemiology, so I'm keen for people to point out flaws.
Edit: I am not advocating that no measures to stop or slow the spread of Covid should have been taken.
Due to massive population and relatively sparse testing centers available, IMV, numbers might have been off even the first time. Even this time, I think the numbers are far off.
In my home, during the first wave, all family members caught fever. All of us took an antiviral medicine. We were already isolated, in the peak of lockdown. Took all precautions and avoided contact with anyone else. The doctor who we consulted, our regular family doctor, did not recommend for testing and in any case, testing was not easily accessible.
I suspect a lot of such instances are there and the real infection numbers might be around 3 times the reported figures.
If that is true, what is remarkable is the low death rate.
> If that is true, what is remarkable is the low death rate.
Not sure what the implied IFR of your scenario is, but FWIW John Ioannidis has the global IFR at .15%. Furthermore SARS-2 is so incredibly age stratified wrt risk (something we conveniently ignore in public health mandates) that non-1st-world countries can have incredibly low death rates since fewer people survive to old age (and there is relatively less prevalence of diseases of modernity). Whereas the data I’ve seen for the increases in global poverty, child starvation, missed medical appointments and missed [non-COVID] vaccinations is staggering. Yet another cost of a one-size-fits-all approach taken across the globe.
Take a look through a dataset of COVID deaths and you’ll notice something that gets lip service but isn’t talked about nearly enough:
Literally wrote one of the most famous evidence-based papers in the world about why most interventions don’t work.
But Gibbon1 said he’s not a credible source because he doesn’t like his conclusions even though he works with the WHO to publish global SARS/2 IFR research. Got it, I’ll perform a bayesian update with this new info.
...Hmm, weird, my posteriors didn’t change at all.
Ioannidis has made claims of very low IFRs throughout the pandemic. If you go look at hard hit areas though, the population fatality rate is higher than his infection fatality rate. Just as one example, New Jersey has close to a 0.3% population fatality rate. If Ioannidis were correct, that would imply that every person in New Jersey had been infected twice.
Ioannidis may have had some very interesting ideas, but his data analysis on COVID has simply been shown to be incorrect.
You’re comparing global IFR to a specific region. Not the same claim. US mortality is worse because of our extensive diseases of modernity and decent proportion of elderly.
Furthermore you are assuming that the excess deaths are solely attributable to COVID-19. The truth is not even close.
Ioandis' original study was in Santa Clara County, CA, where they estimated 0.17%. I don't see how New Jersey, for example, materially differs in a relevant way in terms of population statistics from Santa Clara.
I would also note that New Jersey STILL has a high COVID case rate, even with 47% of the population vaccinated. They did not achieve herd immunity with their 0.3% death rate, because far less than 100% of the population has gotten COVID, so the IFR is very obviously significantly higher than 0.3%.
They made a prediction, the prediction was wrong. It's clearly motivated reasoning, because the authors on these studies have had policy prescriptions since the very beginning that depend on COVID not being very dangerous.
Unfortunately reality is not required to adhere to a particular set of political views, and arguing with a virus is not effective.
> Ioandis' original study was in Santa Clara County, CA, where they estimated 0.17%. I don't see how New Jersey, for example, materially differs in a relevant way in terms of population statistics from Santa Clara.
I doubt it emerged early enough for this to be specifically relevant to the study in question, but something like the more-transmissible-but-less-deadly California variant would be a pretty big differentiator between California and New Jersey.
Your suspicion may be right, the actual maybe off by a large factor. Sero survey whose results were available early February statistically indicated about 270 million exposures (as indicated by presence of antibodies) till February [1] (assuming a population of 1300 million).
India is relatively young country - that might explain the low death rate. It would be interesting to see statistics by age groups compared to countries like Italy.
I also suspect that, in general, Indian people are exposed to more pathogens on a daily basis compared to developed countries. It might be due to factors such as lax regulation in food and restaurant sectors (street food is highly popular among the young and old, and its generally not too hygienic).
There might be more faster and stronger immunological responses due to this increased exposure.
Please stop saying this "we may be more immune because we are exposed to more viruses". Doctors have repeatedly clarified that this is not true and this immunity does not help in COVID's case. This is an argument used by antivaxxers all across the country. This also pushes people to false medicines like Ayurveda/Homeotherapy
I don't think there are many antivaxxers in india. The group who are in Ayurveda are more likely to take the vaccine and continue using Ayurveda thats from my experience.
Unfortunately, there are plenty of antivaxxers in India, especially in the upper middle classes who copy talking points from crunchy western folks. Its not as high as that in, say, California but it is a non negligible fraction.
While this is true about people who follow Ayurveda,
Many people thought covid was not a big deal from because how easy the first wave went through. The vaccine slots were mostly free till a month back when the crunch started.
It was not a easy first wave. The cases were rising very fast from june till october. Then suddenly it came down. It did not go up during following festivals nor during winter. I don't think there has been put forward a very good explanation on why the cases went down. Now in peak summer it going up though way more rapidly than before. Question would be will it come down like before without much understanding of why it went up or down.
I have never seen anti-vaxxers in the majority of the population.
Credit goes to successive governments from various parties, who have largely not politicized the issue.
It also helps that the previous and current generation have seen the effects of non-vaccination, like polio afflicted ones.
In general, the population goes by the word of the medical establishment and there are no nonsensical opposing voices.
What is happening in USA is puzzling to me. Just goes to show that you can have all the wealth, infrastructure, research and qualified personnel in the world and still be beholden to crackpot ideas and conspiracy theories.
I have read some peer reviewed research that suggested that exposure to other coronaviruses (including SARS from 2003) do give some level of immunity to Covid 19
Coronaviruses are common, and India is also in the region where this nasty one originated.
For all we know, a worse one swept through the population 3000 years ago and inferred some genetic immunity. Or they have cross immunity from recent infections.
It’s weird this never gets talked about, considering how all of the countries near China did quite well (relatively).
As I understand it around 1 in 4 colds are caused by coronaviruses. The Diamond Princess cruise ship only ever had 20% of the passengers that tested positive, implying a fair bit of previous immunity.
I have eaten street food in India. It may not look especially hygienic, but most of it is deep fried and that is going to kill off most pathogens pretty effectivley. Steamed (as opposed to fried) momos in Northern India seemed to be the thing that gave most people a bad stomach form anecdotal reports.
The death rate is not low. Its falsified [1]. People are dying by the thousands and the govt is hiding it. Please look at the indian twitter struggling to find beds, oxygen tanks and drugs for their loved ones.
I also wonder if the virus could be spreading fast through India's extremely dense urban areas, and would naturally slow down in rural areas. Since 2/3 of Indians live in rural areas, that would be another reason to hope for a low death rate for the country overall.
> If that is true, what is remarkable is the low death rate.
Death count is also very much under reported.[1] I am not able to find the reference but only testing count is reliable, positive case and death counts are highly under reported.
I think population size is incredibly underappreciated. It's hard to comprehend large numbers.
More to the point, 1.3 billion people. On par with China. Those are the two most populous nations in the world. Third place is the United States. With 334 million people, which is 1/4th in size compared to India or China.
To put that in perspective: the world population today is 7.7 billion. Those 3 countries together constitute about 37% of the global population.
273.000 cases on april 18th, that's 0.021% of India's population.
To be clear: I do not intend to diminish the amount of suffering. 273k a day is an insane number of people who require specialized healthcare.
India is also a microcosmos unto itself. It's an incredibly complex and diverse society due to it's sheer size. That's also something which is underappreciated if you live across the world. Even in this day and age, it's worth being aware of the fact that news from India tends to be condensed in a few terse paragraphs published on, predominantly western, ephemeral online outlets. In the process, the complexity of India is easily lost.
Why is that important? Because many readers of the news will tend to compare that to their own frame of reference.
When people argue about the accuracy of numbers from PCR testing, hospital admissions, deaths,... it's easy to forget that this pertains to a 1.3 billion people across a diverse continent, having conditions which aren't at all equal regardless of where you travel.
My point here is this: the vastness and the complexity of the continent compared with a rapidly unfolding event make it hard to observe and comprehend what is going on.
This isn't a new issue. It was, and to an extent still is, an issue when one tries to assess the exact impact of the Spanish Flu in India:
The number of deaths caused by Spanish Flu in India is an estimate as well ranging from 12 million to 17-18 million on Wikipedia. And that's during a time when the population was vastly lower then it is today: the 1921 census states recorded a population of 318 million.
What historians do have asserted is the social and political impact of the pandemic on the Indian sentiment regarding the then colonial rule, and, in the long run, triggered a long rally towards independence. Even though exact data are hard to come by.
Even in this day and age, the fact that everyone - scientists, data experts, policy makers - are puzzled and wildly speculating about what's going on in India is also a reflection of the limited capabilities of modern technology as well. Even in an era of digitization it's still extremely hard to gather data from a complex, rapidly involving context and being able to ask relevant questions which will yield to a more accurate explanation.
Rather then enless speculating about the exactness of data, the big question for Indian policy makers on all administrative and governmental levels would be: how to respond? how to save lives? how to protect the country's infrastructure? And how to do all that in a flexible, transparent, effective manner which can capture / cater to the complexity of the Indian nation.
I think this surge in India is being underestimated, if anything. It’s impossible to get a place in a hospital right now for love or money in most major Indian cities, not just the states that are reporting high numbers of cases. All states are suffering but some aren’t testing or attributing deaths to Covid.
> A Financial Times analysis also points to under-reporting of deaths. Local news reports for seven districts across the states of Gujarat, Uttar Pradesh, Madhya Pradesh and Bihar show that while at least 1,833 people are known to have died of Covid-19 in recent days, based mainly on cremations, only 228 have been officially reported. In the Jamnagar district in Gujarat, 100 people died of Covid-19 but only one Covid death was reported.
All those states are run by one party. They are cooking the books so they look good compared to the other parties.
You can pick and choose data if it helps your beliefs. EVERY state is doing this. Every state government is afraid to let he public know the real numbers. Same story in my state not ruled by "the one party".
Yeah cause they will direct the entire to attack states who are reporting real numbers, as failures and will work ferociously to overturn the govt. We are witnessing this live with the Maharastra govt.
The amount of real deaths now is in thousands per day and yet "the party" does not give a shit about anything and is focused on winning elections. So please dont come at us with childish arguments. Also try saying this in a public place in those heavily affected states. Then you'll know if people are in sync with you or not
> Also try saying this in a public place in those heavily affected states.
Not 100% sure what the insinuation is here, but just because the general public may respond negatively (perhaps angrily) to a particular viewpoint, does not indicate anything about the truth value of that viewpoint.
Every state isn't doing this. Karnataka/Kerala are better in this regard than Gujarat/UP. These are among the states where I am directly aware of the information collection. It isn't just BJP vs non-BJP either, Karnataka is a BJP state. Some states have better infrastructure and better reporting, e.g. Kerala, which ironically makes things look worse because their numbers are more honest. Ironically, on a per capita basis, the best performing state is Bihar, followed by UP. For anyone familiar with India, you can draw your own conclusions. For anyone looking to run their own analysis, this [1] has a comprehensive data source with APIs to pull data.
In Germany there is a agency for statistics [1]. It is regulated by a law (BStatG). "Cooking" statistics can be done of course, but is illegal and can get you in big trouble. The selection of data to use in Government press releases is free for the government to choose though. But one can go to the agency source.
Contrary e.g. to the US many top government positions are not political and not changed with every election.
i know indians who had corona before and also who already got the first vaccine shot but got it still with strong symptoms in this current wave. everything points to mutants being more resistant and also the first wave partial immunity to already go away in big parts of the population. this is extremely worrisome. worst case: when the world just has some decent vaccine coverage later in the year we start all over again with a completely new epidemic.
"The vaccines prevent illness, but maybe not infection. Covid vaccines are being authorized based on how well they keep you from getting sick, needing hospitalization and dying. Scientists don’t know yet how effective the vaccines are at preventing the coronavirus from infecting you to begin with, or at keeping you from passing it on to others. (That is why vaccinated people should keep wearing masks and maintaining social distance.)"
Maybe there is a flu virus going around as well. I don't think anywhere is actually testing for it any more, just making assumptions that it is corona.
Aren't we too focused on PCR-test results? The article is talking about infections but most of the times this means positive results of PCR-tests.
A PCR-test only shows if you carry RNA of the virus. Not if you are sick of that virus, not if you are contagious.
The following scenario is true and happens often: Someone gets infected by Covid-19 but the body does break down the virus and the person does not get sick and was never contagious.
A month later the same person is infected by the Rhino-virus and this time it is causing a cold.
The person is tested and the PCR-test shows a positive result for covid-19. Which is true from a month earlier.
Since the article says that they estimate 50% of the population came in contact with the virus in Januari, it is to be expected that there are a lot positive tests. But the article is unclear about what this means for the healthcare system. Do a lot of people get sick, or is there just a lot of focus on positive tests?
As far as I know the only way to identify covid-19 with a PCR-test is a positive test and to know in wich order of symptoms occurred.
You are right, this is the correct counter-argument to oppose here. However, I wonder to what extent overwhelmed hospitals reflect relatively low hospital capacity, especially in crowded cities.
Are they normally overwhelmed to this extent in April?
I’ve never heard of mention of it before when I’ve been in Delhi talking to locals at this time of year in the past, but open for figures like hospital occupancy etc.
I don't think they are. What I'm saying is that overwhelmed hospitals could be a less dramatic signal (or an earlier signal) of the epidemic taking off.
I don’t know much about India’s situation, but hospitals are overloaded everywhere. In the Bay Area everyone that wants it can get a vaccine tomorrow and we are about to fully reopen, but icu capacity is still pretty bad and full of Covid patients.
There is nowhere in the world that was prepared for this virus and had anywhere close to enough icu beds.
The other thing to explain is why deaths with people testing positive for covid lag people testing positive for covid by 2 weeks.
If people tested positive because of say extra tests, and it was just a general factor, then surely those deaths would increase at the same time, not 2 weeks later.
The rough covid pattern for someone who dies of severe breathing difficulties while testing positive for covid seems to be globally:
True, but in most countries every year hospitals get overloaded around this time of year (2018 was also very bad world wide).
I believe testing works but only to see how many people came in contact with covid-19. It is not possible to tell how many people got sick from covid because the symptoms are the same.
I am not saying people don't get sick from covid. It's clear a new virus is going around the world. But it's a fact that we are unsure how many people really get sick from covid (alone).
And about the massive surge in India: my guess is that bad air quality in the big cities is not helping.
Where? They were overwhelmed, but coped for around 6 weeks around April 2020 here in Spain. Everything since then has been paranoia based on PCR test results.
Meanwhile thre were videos of the full hospitals in the UK being empty at the height of the second wave, while we were being told they were overwhelmed.
The PCR-test is the best test we currently have to test the population in a useful and generally reliable way.
While it is true that the test can remain positive after a few weeks after the infection or onset of symptoms, the percentage is close to 0 after about 6 weeks. [1]
So as it's the end of April, the January infections will not have any false-positive influence on the current wave.
> The person is tested and the PCR-test shows a positive result for covid-19. Which is true from a month earlier.
PCR tests detect viral DNA in a specimen. To have viral DNA in a specimen requires an active infection as DNA from dead viral particles doesn’t sit around for a month in the patient’s respiratory system. As the immune system responds and eliminates the infection repeated PCR tests will eventually show a negative result. Perhaps you’re thinking of antibody tests?
You are correct since they use RT-PCR specifically for SARS-CoV-2. However, the number of cycles used in the process is key, <= 24 cycles produces very few false positives for active infection. The OPs explanation for the increased rate doesn’t match this fact.
I heard once a person has been vaccinated, for the next 24 hours, chances of others around that person getting infected rises. This might have contributed to the surge in cases.
My information comes from the fact that my colleague who got vaccinated 2 days ago, now has her 12 year old daughter exhibiting symptoms. The daughter is having 101-103.5 fever since yesterday afternoon.
My colleague told me whatever I said in previous comment.
With >300k reported and many more unreported cases, her daughter may have got it from anyone or it may be a seasonal fever of April. This is a simple confirmation bias.
Even if we assume that you somehow can be infected by a vaccine that doesn't contain the virus, if your colleague got infected 2 days ago, it's relatively unlikely a contact person would already have gotten infected from them and be showing symptoms.
You are repeating what your colleague said. In effect, you are telling me that you will listen and believe what anyone (or at least your colleague says around you. If this is not the case, you don't really answer my question.
Ironically situation in india for time being is worrisome and adding to our worry is this new report [https://www.indiatoday.in/coronavirus-outbreak/story/coronav...]
Millennials are the group of people who have to leave homes for earning and by seeing the declining numbers there became bit lenient and stopped following appropriate covid-19 behavior and the new mutants which were detected added fuel to the fire and things messed up and we are seeing massive surge now.
There is one thing which is clear now that we haven't had so called 'herd immunity'. In fact there have been lot of cases being reported where people are already being vaccinated [https://www.ndtv.com/india-news/shashi-tharoor-covid-positiv...] be it pfizer or Covishield or any other vaccine, but i am just hoping that it will atleast moderate the impact of the Covid virus.
Jammu and Kashmir is a 12 million strong popluation cluster and has a grand total of 2620 covid dedicated hospital beds and a total of 248 ICU beds.
Just for the record, yesterday the daily new cases reached 2204 with new daily deaths of 13.
What can you imagine these 248 beds will do? How much can they help ?
Even if the occupancy rate of hospital beds is low, that figure can shoot up in a matter of hours and then what? Its not like its China and the government can build a hospital in 10 days so yeah, pretty fucked.
The simplest explanation is that the seroprevalence data was badly collected and analyzed. Selection effects could have favored participants that wanted to know if they had been infected or otherwise biased the sample. Adjustment for sampling effects could have led researchers to arbitrarily increase their estimates of seroprevalence (which certainly happened in the studies in Brazil claiming they had hit herd immunity). And then antibody tests which aren't specific and cross react with other coronaviruses could have further inflated the data. And then 20% is just not enough, particularly with variants that have higher R0 values and more transmissibility.
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[ 3.1 ms ] story [ 234 ms ] threadI still think facemasks are selecting for more infectious strains and likely won't be effective enough in a few years unless vaccines bring us to herd immunity fast enough or the virus mutates into something less severe.
Anyway, on a related vein, non-infection-protecting vaccines can do exactly what you’re saying and select for more virulent/pathogenic strains. Take a look: https://journals.plos.org/plosbiology/article?id=10.1371/jou.... Because all the COVID/19 vaccines do not prevent infection nor transmission (they reduce it but don’t fully block it), our incredibly shortsighted mass vaccination campaign is likely to select for more pathogenic strains. Go science!
> Could some vaccines drive the evolution of more virulent pathogens? Conventional wisdom is that natural selection will remove highly lethal pathogens if host death greatly reduces transmission. Vaccines that keep hosts alive but still allow transmission could thus allow very virulent strains to circulate in a population. Here we show experimentally that immunization of chickens against Marek's disease virus enhances the fitness of more virulent strains, making it possible for hyperpathogenic strains to transmit. Immunity elicited by direct vaccination or by maternal vaccination prolongs host survival but does not prevent infection, viral replication or transmission, thus extending the infectious periods of strains otherwise too lethal to persist. Our data show that anti-disease vaccines that do not prevent transmission can create conditions that promote the emergence of pathogen strains that cause more severe disease in unvaccinated hosts.
Do N95s work for source control though? They certainly do work for self infection but I haven’t personally read any N95 studies on source control so am not sure.
Kind of ironic that you’re not allowed to wear an N95 with an exhale valve, but are encouraged to wear a surgical mask, bandana, cloth mask, or dirty T-shirt, none of which provide any source control.
Again, the elephant in the room is respiratory viruses in general, and SARS-2 in particular, spread via aerosols. Non-N95 face coverings cannot block aerosols. Indeed mask wearing leads to deeper breaths to maintain homeostasis (this has been studied), therefore lead to a greater net volume of air, therefore lead to increased aerosol emission before even accounting for the potential to nebulize large droplets into a shower of tiny aerosol particles. But I digress.
Sure, cloth masks were widespread for about a year but by now usage of FFP2 masks is becoming extremely widespread, especially since the supply is by now overwhelming.
Masks incur costs; at a minimum you must admit they alter risk appraisal if nothing else.
Anyway, nobody in this thread has addressed the point that masks don’t even work in theory if aerosol transmission is the dominant transmission mode. That’s before accounting for the incredible cross contamination and misuse of masks that you see in the community.
There has not been a surge of new cases.
Throughout 2020, Broken Bow, OK received millions of tourists, it was the #2 short-term vacation rental destination in the country, according to VRBO.
It's a small town with crowded bars. Very few locals or visitors wore masks.
There was not a significant rise in severe Covid cases, and schools mostly kept masking optional.
If everyone was wearing a particulate mask (e.g. N95), source control wouldn't matter as much. Masks with an exhaust valve are significantly more comfortable and comfort is the reason the CDC is currently citing in regard to their recommendation for people not to wear particulate masks.
If your protection plan relies on everyone else doing something complicated correctly, you have already lost. I think controlling the spread of a virus in the general population using source control is not something our species is capable of.
Not to mention make versions for unusual face sizes (big and small). I cannot find one large enough for my face.
[0]: https://www.cdc.gov/niosh/npptl/respirators/testing/NonNIOSH...
N99 and P100 masks typically include a gasket which improves the seal dramatically. They also come with the bonus of filtering substantially more fine particles. Given than the size of the aerosols in question are less than 5 microns and that the ratings are in relation to 0.1 microns, getting a higher rating is probably a good idea.
Even better still is a silicone mask which is trivial to leak test by covering the filter cartridge inlets (negative pressure) or exhaust valve (positive pressure).
[1] Optrel Swiss Air: https://industrial.optrel.com/fileadmin/optrel/redaktion/pdf...
[2] CleanSpace Halo: https://cleanspacetechnology.com/wp-content/uploads/2019/11/...
Can you point me to a non mechanistic non associative study that demonstrates that face masks work to prevent community transmission of SARS-2?
EDIR: I can’t reply to the child comment about condoms (does HN have a nesting limit?) but suffice to say we only have 1 RCT on SARS-2 so playing the significance game is silly. You can’t point to a single RCT showing an effect because it doesn’t exist. That’s the problem. We’re mandating an intervention that is unproven to work and rests on theoretical assumptions that are now known to be false.
You can go look at non-SARS-2 RCTs if you want but those also look abysmal. For example go read Macintyre’s cluster-randomized controlled trial of cloth masks in healthcare workers. It’s not encouraging.
Do condoms work against sexually transmitted diseases? 5 out of 10 RCT studies reported statistically significant effect. Do condoms work against unwanted pregnancy? 0 out of 4 RCT studies reported statistically significant effect.
https://jech.bmj.com/content/65/2/100
Forgive my tone but...just wow.
So is the mentioned mask RCT study. They should be quite comparable.
> Face masks ... don’t work to slow transmission whatsoever
and when pushed on it, you imply that this is true because there’s been no trial on it, which is not how implication works.
You then also try and suggest the presence of an unfalsifiable hypothesis which you don’t try and explain, and seems suggestive that you don’t know what the term means?
That’s the brilliance of “my mask protects you”. It’s not feasibly falsifiable. “My mask protects me” is very easy to falsify. That’s why we have one RCT that studied exactly that and failed to reach significance.
Again, the theoretical MoA of masking only makes sense if SARS-2 spreads via respiratory droplets. If it spreads via aerosols, the sub-micron aerosol particles stay aloft for minutes-hours and bypass the comparatively giant holes of the mask with ease. The sightly altered directional flow is largely irrelevant. You can watch any of the many videos of someone vaping with a mask on/off to see what I’m talking about. Imagine that every time you exhale.
That’s not what that means.
This has mostly been falsified in at least one controlled study [1].
The Danish study is the closest thing we have to RCT on masking [2] which found no statistically significant result from universal masking.
Wearing a mask while symptomatic seems like a good idea though, if you're unable to stay home for some reason, though that's good advice for most airborne contagious illnesses. I appreciated the culture of doing this when I was in Japan - if for no other reason than it told me who to keep my distance from.
[1] https://www.bmj.com/content/371/bmj.m4695
[2] https://www.acpjournals.org/doi/10.7326/m20-6817
Masks reduce respiratory disease transmission in hospitals. They work outside of hospitals, too. Covid-19 spreads like any other respiratory disease.
If you don't want to wear a mask, then stay at home. I have the right to participate in society without catching a dangerous disease from you.
If your mask is uncomfortable, then try some different ones. I use masks made by Burlway [4]. They are very soft. They fit my face perfectly and haven't stretched or shrunk. I have 10 of them. I keep clean ones in a drawer near the door. My going out ritual is now "keys mask phone wallet."
[0] https://www.governor.wa.gov/news-media/inslee-announces-stat...
[1] https://vtdigger.org/2020/07/24/scott-orders-mask-mandate/
[2] https://www.newscentermaine.com/article/news/health/coronavi...
[3] https://ig.ft.com/coronavirus-chart/?areasRegional=uswa&area...
[4] https://www.amazon.com/gp/product/B08DXY4TBS
You're essentially saying that the disabled (illness is a disability) should be excluded from society.
Shun the unclean and diseased?
You have the option of staying inside if you're afraid of mingling with certain people.
“Freedom” does not extend to not wearing masks during a pandemic. Your freedom stops when you are a potential asymptomatic/symptomatic spreader of a potentially deadly disease to others.
Therefore, masks should be required for everyone.
Also, I am disabled and I agree with this poster’s comment. It was definitely not ableist at all. It was 100% in support of masks when out in public.
I guess condoms must be mandated since antibiotic-resistant STIs are almost inevitable right now.
I guess we have to outlaw unprotected sex.
I'm not expressing an opinion here; I'm trying to understand why you would take for granted that everyone thinks such behavior is ok or inevitably legal, setting aside the specific context of COVID and current partisan conflict.
So something like masking is required even if someone seems healthy. It's a regime of constant anxiety and latching onto any and every doom scenario.
So with the same logic, we should be assuming every sex partner has an incurable STI. Especially with the emerging threat of antibiotic-resistant strains, the most risk-avoidant with respect to SARS-CoV-2 would only be consistent by likewise being in favor of extreme measures like mandated condoms, quarantining, forced testing, etc. with something like STIs.
I don't agree with this at all - but it's clear that there's a fixation with COVID that doesn't get applied to other large aspects of society.
If we care about people's health - why don't we lock up fat people and force feed them a strict diet until they're a healthy weight? It's hard for me to see anything under the current public health/political regime that wouldn't justify this.
From what I read on the internet, it's long been a custom in many places in the far east to wear a mask whenever one has or might have the cold or flu or whatever.
At this point, I'm thinking why shouldn't we westerners adopt that, going forward?
It appears that wearing masks drastically reduced flu transmission, which seems logical given that it's much less contagious than covid-19. That presumably saved many lives.
And the common cold is not worth developing an advanced vaccine against, but what would we be losing if we prevent its transmission?
So I don't see why masks are a bad thing even if covid vanished tomorrow. There are so many measures we take to mitigate things that have substantial known and unknown risks, so it's mysterious to me why people are so vehemently against one with no downsides.
Humans have millions of years of evolution searing into their DNA the impulse to socialize with other humans.
I think you're underestimating the effect of completely obscuring the face - how people indicate subtle social cues, emote, and communicate.
This ignores that masking is a nuisance, I don't care what other people say: they're virtue-signalling, Stockholm syndrome victims in my opinion.
Breathing fresh air, unabated, is one of the greatest pleasures in life.
Nobody has this right. This positive right has never existed. And for good reason. It leads to all manner of evils taken to the extreme.
Is this an example of the positive right that you say never existed and leads to all manner of evils?
Do you think the proponents of it are uniformly politically aligned with the people in favor of masks for COVID?
Anyway, I don’t believe in throwing someone in jail for such an act. Some people do.
But I don’t think that invalidates the point that such a right does not exist, because “spread disease” is a superset of “knowingly spread disease”.
Ironically here in California it is legal to knowingly spread AIDS to someone, because democrats, yet that same political faction thinks that you are responsible if you unknowingly spread COVID-19 to someoen. (As an aside the absurd “infecting Grandma in the grocery store” doesn’t happen anyway because that’s not really where COVID spreads but I digress)
There is overwhelming evidence that the virus is spread by fine aerosols: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
It is widely reported (and noted in the article above) that cloth masks are not effective against such particulates.
One of the only studies on the topic found that cloth masks were penetrated by ~97% of such particles: https://bmjopen.bmj.com/content/5/4/e006577
https://bmjopen.bmj.com/content/5/4/e006577?fbclid=IwAR1eSyc... - cluster-randomized controlled trial of masking in hcw. Compared cloth masking to “standard practice”, not a no-mask control, but results caution against usage of cloth masks due to abysmal filtration efficiency and the increased infections in the group relative to standard practice
I’d have to cite like 10 different studies to show the full story on aerosol transmission and I’m on mobile so I’ll leave that as an exercise to the reader for now. But I’d like someone to at least answer this:
If you take it as fact that SARS-2 primarily spreads through aerosols, what does that imply about the efficacy of masking for source control of SARS-2? There is a reason that the health authorities advocating community usage of masks (which they never did for any respiratory pathogen pre-COVID btw) maintain that SARS-2 spreads through large respiratory droplets. It’s because otherwise the whole concept of community masking is absurd.
Is that actually a fact though?
So let’s try again:
If you take it as a given that SARS-2 primarily spreads via aerosols, what does that imply about the efficacy of strapping a warm, damp piece of cloth over your breathing holes?
But why would they keep saying it? Maybe they are effective. Maybe it's the politician's syllogism. Maybe they're worried that back-peddling would hurt their credibility. Maybe they create enough of a sense of both safety and fear to keep society functioning.
Is this your concern with the covid vaccine? That a strain which would have killed someone unvaccinated, that person will now instead stay alive and spread it?
The viruses used and discussed in that study had between a 60% and 100% fatality rate. This is pretty different than covid 19
So yes, that is my concern. But I mainly mention it because it’s a handy counter to the utilitarian collectivist argumentation without having to argue against the ethics of collectivism itself.
Worsening rosacea
Difficulty communicating with the hard of hearing, language learners, etc
Reduced ability to convey info via facial expressions
Altered risk appraisal
Having to stand closer or speak louder to convo partner
Psychological discomfort
Bacterial pneumonia
Cross-contamination (hand to mask, mask to hand, hand to face)
Mild negatives from uncomfortable pressure on ears
Sends a message of societal fear that there is something to be afraid of (you might consider this a positive, I don’t personally)
Encourages viewing the wearer as just a vector for disease
Increased CO2 buildup
Calling the risks minimal to acne makes no sense. It’s one of the worst contributors to acne in any person’s daily life.
Even if I agreed with your exponentiality argument the whole point is that I’m saying masks don’t reduce spread. You seem to think there’s only possible upside, but there is equally downside wrt xmission; that is, masks run the risk of worsening transmission.
Furthermore, there is nothing to suggest that masks run the risk of worsening transmission. I see from your other comments that you're familiar with the mask clinical trials (presumably you're referring to the Danish study). That study was inconclusive (also note that it was _severely_ underpowered), and considering that _nothing_ in our previous knowledge suggests that they worsen infection rates, your reasoning is once again flawed.
They increase net volume of air exchanged, therefore all else equal they increase the release of aerosols. There’s furthermore a strong chance that they actively nebulize respiratory droplets into fine aerosols; ie they incresse the relative aerosolization and therefore the absolute aerosols.
They make convo partners stand closer together or speak louder.
They alter risk appraisal.
It is foolish to rule out any downsides. At best you’re advocating for a condom full of holes. At worse you’re advocating for a condom that magically worsens STI transmission.
The other arguments are of the "seatbelts cause more accidents" variety, which honestly aren't worth refuting. But I'll just note that social distancing has much weaker evidence of affecting virus transmission than even masks (there is no real justification for the 6 feet number and mostly unlikely it makes much of a difference). Hell, social distancing is even much more difficult to comply with than wearing masks so your argument makes no sense at all.
In US and Europe, policies and behavior (such as mask-wearing and social distancing) have become stricter as the number of cases rise and more lenient as the number of cases fall. This means that the reproduction number hovers around 1.
If we imagine that R_0 for Covid-19 is 2.0, no measures are taken, and a variant which is twice as infectious appears when there are 10^6 cases (in a population of 10^9), then the variant will have only infected ~10^6 people by the time we have herd immunity (a very rough estimate).
On the other hand, if measures halving the spread rate are imposed when 10^6 cases are reached and the variant appears, then the variant will still spread exponentially while the original strain is curtailed, resulting in most people catching the highly infectious variant.
I have no background in medicine or epidemiology, so I'm keen for people to point out flaws.
Edit: I am not advocating that no measures to stop or slow the spread of Covid should have been taken.
In my home, during the first wave, all family members caught fever. All of us took an antiviral medicine. We were already isolated, in the peak of lockdown. Took all precautions and avoided contact with anyone else. The doctor who we consulted, our regular family doctor, did not recommend for testing and in any case, testing was not easily accessible.
I suspect a lot of such instances are there and the real infection numbers might be around 3 times the reported figures.
If that is true, what is remarkable is the low death rate.
Not sure what the implied IFR of your scenario is, but FWIW John Ioannidis has the global IFR at .15%. Furthermore SARS-2 is so incredibly age stratified wrt risk (something we conveniently ignore in public health mandates) that non-1st-world countries can have incredibly low death rates since fewer people survive to old age (and there is relatively less prevalence of diseases of modernity). Whereas the data I’ve seen for the increases in global poverty, child starvation, missed medical appointments and missed [non-COVID] vaccinations is staggering. Yet another cost of a one-size-fits-all approach taken across the globe.
Take a look through a dataset of COVID deaths and you’ll notice something that gets lip service but isn’t talked about nearly enough:
https://datacatalog.cookcountyil.gov/widgets/3trz-enys
Diseases of modernity.
Not a credible source.
...Hmm, weird, my posteriors didn’t change at all.
The man is a total and complete embarrassment.
https://sciencebasedmedicine.org/what-the-heck-happened-to-j...
Ioannidis may have had some very interesting ideas, but his data analysis on COVID has simply been shown to be incorrect.
Furthermore you are assuming that the excess deaths are solely attributable to COVID-19. The truth is not even close.
Ioandis' original study was in Santa Clara County, CA, where they estimated 0.17%. I don't see how New Jersey, for example, materially differs in a relevant way in terms of population statistics from Santa Clara.
I would also note that New Jersey STILL has a high COVID case rate, even with 47% of the population vaccinated. They did not achieve herd immunity with their 0.3% death rate, because far less than 100% of the population has gotten COVID, so the IFR is very obviously significantly higher than 0.3%.
They made a prediction, the prediction was wrong. It's clearly motivated reasoning, because the authors on these studies have had policy prescriptions since the very beginning that depend on COVID not being very dangerous.
Unfortunately reality is not required to adhere to a particular set of political views, and arguing with a virus is not effective.
Yea clearly a science-minded person wouldn't be able to find a plethora of different variables between populations on opposite sides of the country.
Let's just assume they're homogeneous. /s
I doubt it emerged early enough for this to be specifically relevant to the study in question, but something like the more-transmissible-but-less-deadly California variant would be a pretty big differentiator between California and New Jersey.
The esteemed internet silhouette Gibbon1 informs us that the credentialed expert John Ioannidis is not credible.
[1] https://www.businesstoday.in/latest/trends/over-21-indians-a...
I also suspect that, in general, Indian people are exposed to more pathogens on a daily basis compared to developed countries. It might be due to factors such as lax regulation in food and restaurant sectors (street food is highly popular among the young and old, and its generally not too hygienic).
There might be more faster and stronger immunological responses due to this increased exposure.
Many people thought covid was not a big deal from because how easy the first wave went through. The vaccine slots were mostly free till a month back when the crunch started.
Credit goes to successive governments from various parties, who have largely not politicized the issue.
It also helps that the previous and current generation have seen the effects of non-vaccination, like polio afflicted ones.
In general, the population goes by the word of the medical establishment and there are no nonsensical opposing voices.
What is happening in USA is puzzling to me. Just goes to show that you can have all the wealth, infrastructure, research and qualified personnel in the world and still be beholden to crackpot ideas and conspiracy theories.
For all we know, a worse one swept through the population 3000 years ago and inferred some genetic immunity. Or they have cross immunity from recent infections.
It’s weird this never gets talked about, considering how all of the countries near China did quite well (relatively).
Sandwiches (yummy ones in Pune) are not deep fried or even properly roasted.
Samosas / Mirchi / Jalebi are made and kept out in containers for hours together, until they are cold.
[1] https://threadreaderapp.com/thread/1384782949879517185.html
Death count is also very much under reported.[1] I am not able to find the reference but only testing count is reliable, positive case and death counts are highly under reported.
[1] 4th plot. https://www.ft.com/content/683914a3-134f-40b6-989b-21e0ba1dc...
I think population size is incredibly underappreciated. It's hard to comprehend large numbers.
More to the point, 1.3 billion people. On par with China. Those are the two most populous nations in the world. Third place is the United States. With 334 million people, which is 1/4th in size compared to India or China.
To put that in perspective: the world population today is 7.7 billion. Those 3 countries together constitute about 37% of the global population.
https://www.cia.gov/the-world-factbook/countries/world/#peop...
273.000 cases on april 18th, that's 0.021% of India's population.
To be clear: I do not intend to diminish the amount of suffering. 273k a day is an insane number of people who require specialized healthcare.
India is also a microcosmos unto itself. It's an incredibly complex and diverse society due to it's sheer size. That's also something which is underappreciated if you live across the world. Even in this day and age, it's worth being aware of the fact that news from India tends to be condensed in a few terse paragraphs published on, predominantly western, ephemeral online outlets. In the process, the complexity of India is easily lost.
Why is that important? Because many readers of the news will tend to compare that to their own frame of reference.
When people argue about the accuracy of numbers from PCR testing, hospital admissions, deaths,... it's easy to forget that this pertains to a 1.3 billion people across a diverse continent, having conditions which aren't at all equal regardless of where you travel.
My point here is this: the vastness and the complexity of the continent compared with a rapidly unfolding event make it hard to observe and comprehend what is going on.
This isn't a new issue. It was, and to an extent still is, an issue when one tries to assess the exact impact of the Spanish Flu in India:
The number of deaths caused by Spanish Flu in India is an estimate as well ranging from 12 million to 17-18 million on Wikipedia. And that's during a time when the population was vastly lower then it is today: the 1921 census states recorded a population of 318 million.
What historians do have asserted is the social and political impact of the pandemic on the Indian sentiment regarding the then colonial rule, and, in the long run, triggered a long rally towards independence. Even though exact data are hard to come by.
https://en.wikipedia.org/wiki/1918_flu_pandemic_in_India https://www.censusindia.gov.in/Census_And_You/old_report/cen...
Even in this day and age, the fact that everyone - scientists, data experts, policy makers - are puzzled and wildly speculating about what's going on in India is also a reflection of the limited capabilities of modern technology as well. Even in an era of digitization it's still extremely hard to gather data from a complex, rapidly involving context and being able to ask relevant questions which will yield to a more accurate explanation.
Rather then enless speculating about the exactness of data, the big question for Indian policy makers on all administrative and governmental levels would be: how to respond? how to save lives? how to protect the country's infrastructure? And how to do all that in a flexible, transparent, effective manner which can capture / cater to the complexity of the Indian nation.
Top comment here suggests that india did really good with lockdowns first time around. They just got too confident?
> A Financial Times analysis also points to under-reporting of deaths. Local news reports for seven districts across the states of Gujarat, Uttar Pradesh, Madhya Pradesh and Bihar show that while at least 1,833 people are known to have died of Covid-19 in recent days, based mainly on cremations, only 228 have been officially reported. In the Jamnagar district in Gujarat, 100 people died of Covid-19 but only one Covid death was reported.
All those states are run by one party. They are cooking the books so they look good compared to the other parties.
Not 100% sure what the insinuation is here, but just because the general public may respond negatively (perhaps angrily) to a particular viewpoint, does not indicate anything about the truth value of that viewpoint.
The fact that someone is willing to punch you in the face doesn't make them more correct than if they were unwilling to do so.
[1] https://www.covid19india.org
This party is the ruling party in the federal govt. too. Cooking books wouldn't allow it to escape the wrath of voters, perhaps temper it.
However, I sincerely believe that every govt is cooking books. Politicians are not above that, no matter what party they are from.
Contrary e.g. to the US many top government positions are not political and not changed with every election.
[1] https://www.destatis.de/EN/Home/_node.html
Made worse because it is election season
[1] https://www.forbes.com/sites/siladityaray/2021/04/20/double-...
https://health.economictimes.indiatimes.com/news/diagnostics...
A PCR-test only shows if you carry RNA of the virus. Not if you are sick of that virus, not if you are contagious.
The following scenario is true and happens often: Someone gets infected by Covid-19 but the body does break down the virus and the person does not get sick and was never contagious. A month later the same person is infected by the Rhino-virus and this time it is causing a cold. The person is tested and the PCR-test shows a positive result for covid-19. Which is true from a month earlier.
Since the article says that they estimate 50% of the population came in contact with the virus in Januari, it is to be expected that there are a lot positive tests. But the article is unclear about what this means for the healthcare system. Do a lot of people get sick, or is there just a lot of focus on positive tests?
As far as I know the only way to identify covid-19 with a PCR-test is a positive test and to know in wich order of symptoms occurred.
I’ve never heard of mention of it before when I’ve been in Delhi talking to locals at this time of year in the past, but open for figures like hospital occupancy etc.
There is nowhere in the world that was prepared for this virus and had anywhere close to enough icu beds.
If people tested positive because of say extra tests, and it was just a general factor, then surely those deaths would increase at the same time, not 2 weeks later.
The rough covid pattern for someone who dies of severe breathing difficulties while testing positive for covid seems to be globally:
T+7 test positive for covid
T+14 into hospital
T+21 death
I believe testing works but only to see how many people came in contact with covid-19. It is not possible to tell how many people got sick from covid because the symptoms are the same.
I am not saying people don't get sick from covid. It's clear a new virus is going around the world. But it's a fact that we are unsure how many people really get sick from covid (alone).
And about the massive surge in India: my guess is that bad air quality in the big cities is not helping.
[1] https://academic.oup.com/cid/article/71/16/2249/5822175
PCR tests detect viral DNA in a specimen. To have viral DNA in a specimen requires an active infection as DNA from dead viral particles doesn’t sit around for a month in the patient’s respiratory system. As the immune system responds and eliminates the infection repeated PCR tests will eventually show a negative result. Perhaps you’re thinking of antibody tests?
‘Double Mutant’ Covid Variant: Here’s What We Know As Israel Reports Vaccine Efficacy Against Variant First Detected In India
https://www.forbes.com/sites/siladityaray/2021/04/20/double-...
Another variant that is reason to be concerned is the one from Tanzania. https://www.bloomberg.com/news/articles/2021-03-26/most-muta...
Do you have any citations or reliable sources that advise those taking vaccinations isolate themselves?
My colleague told me whatever I said in previous comment.
Just for the record, yesterday the daily new cases reached 2204 with new daily deaths of 13. What can you imagine these 248 beds will do? How much can they help ?
Even if the occupancy rate of hospital beds is low, that figure can shoot up in a matter of hours and then what? Its not like its China and the government can build a hospital in 10 days so yeah, pretty fucked.
India’s second wave - https://news.ycombinator.com/item?id=26886829 - April 2021 (398 comments)