While I think this is most likely due to masking, distancing and staying home when sick, which were all far more effective against the flu than against SARS-CoV-2, I wonder how much this was affected by some of the deep cleans that cities were doing at the beginning of the pandemic where they basically sprayed entire cities with disinfectant trucks. Does anyone with more expertise have any thoughts about that?
You realize those « deep cleans » are mostly comms operations for governments to look like they are doing stuff, right? Virus live (mostly) in people, not on sidewalks.
One of the most ridiculous example: the Thai government went to the extent of spraying disinfectant in the forest next to the Burmese border, and got pictures published in newspaper to show their great work. Comical! [1]
The flu is global, yes? How many cities did your "deep cleaning" (I've heard it for the first time)? Out of a total of how many cities? I decline your notion on those grounds alone.
AFAIK fomite transmission on public streets and other places sprayed by such "deep cleans" isn't a common spread vector for any widespread disease, so eliminating it can't make a meaningful difference.
Even fairly small changes can be significant with exponential feedback loops. That’s not to say they actually had any impact, just that you can’t always tell what was important.
For example it’s possible but unlikely that some other pandemic was accidentally prevented.
Ehh... most viruses really don't live on surfaces very long. Unless they were continuously spraying the whole pandemic on a weekly basis I don't see how it could do much at all. And even if they were doing it every week... most of us get viruses from handled (by humans) surfaces.
Virus exist everywhere and is the most common entity on earth. In a tablespoon of seawater there can be ten million of them. Most are not dangerous to man, about 600 is known. They are also very good to survive on their own without a host and can live in most hostile environments.
Viruses aren't alive, and they certainly can't reproduce without host cells, so saying that they survive on their own doesn't seem like a terribly accurate statement. Trying to extend the metaphors of life "alive or dead, surviving" to viruses only generates misconceptions, instead "viable or inactivated" is a better way of looking at it.
Flu is an influenza virus not a coronavirus - it's literally in the name.
Additionally, varying levels of contagiousness and mechanisms of spread absolutely make actions more effective for some diseases and less effective or not effective at all for others. This is not a controversial statement despite your dramatic insistence on ignorance.
“Basic statistics” like occasionally wearing a mask and putting up signs to distance despite massive contrary evidence like mass protests and spring break? your numbers are a joke.
If 90%* wear masks and the R-factor of the "flu" is is low enough it "disappears". But if the R-factor for covid is high enough it still spreads even if 90%* wear masks (10% don't).
It's mindboggling how simple simple thinking can evade people.
The median R value for seasonal influenza(aka flu) was 1.28 (IQR: 1.19–1.37), whereas the R rate for COVID without any protection is much higher. It means people staying at home, reducing visits and social distancing might be enough to lower the R rate below one for influenza, however, not necessarily for COVID as the R rate is higher.
Whoa, crossing into personal attack and flamewar comments like you did here, and elsewhere in this thread, is totally not cool on HN, no matter how wrong someone else is or you feel they are.
We ban accounts that post like this, because it's so destructive of the community we're trying to have here. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and sticking to the rules, we'd be grateful.
> Schools have been surprisingly rare causes of COVID outbreaks
I can clearly remember that multiple countries closed schools within weeks of the first reopening because the virus was spreading there like wildfire, in the age group with the highest rate of asymptomatic(aka invisible until it's too late) cases.
The low symptom rate corresponds to a low transmission rate. The worse your case of COVID, the more likely you will transmit it to others in the same situation. This is the obvious mechanism of the fact that kids, who very seldom have bad cases of COVID and so frequently do not show symptoms, are not usually major spreaders of the virus.
This all is one of the really unusual things about COVID compared to other communicable diseases.
Or -- I bet a lot more likely -- the handwashing etc. prescriptions that turned out to be pretty meaningless for COVID but that are important to the transmission of flu and many other diseases.
Obviously personal action is harder to reproduce than government-sponsored trucks, so it's less useful if it was a main cause.
> While I think this is most likely due to masking, distancing
I give it 5 years from now when it is no longer politically intolerable that studies will come out and admit that masks and social distancing did absolutely nothing to slow or prevent infection.
That advice was intentionally deceptive. It was based on not having a mass run on PPE needed by healthcare workers, not medical science or safety.
It also likely led to more deaths due to the revelation that it was a lie, and people treating any further advice (which was actually medically sound) with the same kind of cynical skepticism used for liars. Rejection of masks wasn't much of a thing before this happened.
Thanks! This is good information. I would imagine that ~4% less flu infections at the start of a flu season would be enough to slow down the season a bit, in theory, but not to the point flu has been slowed down now.
The author lied about his affiliation with Stanford, and the paper was retracted.
> Jonathan Davis, a spokesperson for Elsevier, told Reuters via email that Medical Hypotheses has since retracted the article after concluding it was misleading due to “a broader review of existing scientific evidence” showing that masks “are an effective prevention of COVID-19 transmission” and said that the article contained several misquotes and unverified data. Davis said that the author himself had submitted the affiliation with Stanford Medicine.
> As reported here by Forbes, Medical Hypotheses has previously published articles such as “Is there an association between the use of heeled footwear and schizophrenia” (here) and “Ejaculation as a potential treatment of nasal congestion in mature males” (here).
There's a reason it's titled "Medical Hypotheses".
I'm saying "trash publication" because I had experience working with Forbes. Once again, one can publish at Forbes whatever the hell they want. It costs a few hundred bucks.
From the "Medical Hypotheses" journal the Forbes article is criticizing for poor editorial control, and citing those as examples. At least read the claim you're attempting to debunk.
> Once again, one can publish at Forbes whatever the hell they want. It costs a few hundred bucks.
Apparently that's also true for the "Medical Hypotheses" journal.
I read the Reuters fact-check article. In fact, there are no facts. It says that the publication has been retracted, but from what I can see, that's not true. CDC's current response on masks is positive, however their initial response was negative. Same for WHO. All in all, Reuters rely on a single source – Nature. Nature.com is indeed a legitimate source, however the article is massive, so I can't say for sure if relying on that single source is good enough to make a conclusion.
Nope. Reuters is still a great source of truth. In fact, Reuters is my favorite publication agency. But, it doesn't mean they are saint and won't ever bullshit.
> I'm sorry, you'll base your beliefs on an article in "Medical Hypotheses".
I haven't made any conclusions yet. I'm still analyzing. Both you and Reuters try to belittle the significance of an entity based on its name or the titles of their publications. While it's possible that the publication is pure crap, "belittling" is one of those crappy techniques one can rely on to defend their arguments.
That source is awful, just an opinion piece, largely. "Wearing facemasks has been demonstrated to have substantial adverse physiological and psychological effects. " It's literally the opposite. Pure garbage, that link.
Why did the flu also disappear in the states that had effectively no covid restrictions?
This is a serious question and not an attempt at rhetoric. I really am curious. Was flu never a problem in Florida? Was voluntary compliance so widespread that heavy handed government policy had no marginal anti-flu effect? Something else?
The likely explanation is that, because the flu is significantly less transmissible than COVID, even states with "no restrictions" were able to knock it out because enough people took enough measures to protect themselves from airborne/surface communicable disease in general.
In other words, you can probably beat back the flu significantly by having enough of the population mask up, wash/sanitize their hands, etc.
Not sure what the case is overall, but apparently in North Dakota, where flu cases were 1/65 of what they were the year prior, flu vaccinations are only up 5%: https://kfgo.com/2021/04/29/319613/
> The likely explanation is that, because the flu is significantly less transmissible than COVID
But why is it less transmissible? One obvious explanation is because we've lived with it all our lives, and most people already have some level of pre-existing immunity to most flu strains they're exposed to. Both due to natural infections, and vaccines.
> In other words, you can probably beat back the flu significantly by having enough of the population mask up, wash/sanitize their hands, etc.
If pre-existing immunity is why it's less transmissible, those measures will result in fewer flu infections, and thus lower levels of pre-existing immunity. Which in turn, may make the flu more transmissible, leaving us where we started. Worse, if pre-existing immunity is decreasing the severity of the infections we do get, the net effect may actually be more deaths due to fewer, but more deadly, infections.
Flu vaccines are notoriously ineffective, with a typical year being just 50% effective, and bad years being as little as 19%. They're probably the least effective widely used vaccines by a long shot (eg the MMR vaccine is about 97% effective). So we can't just assume we'd be able to make up the difference with increased vaccination. Flu vaccine coverage is already quite high anyway, 51.8% or so for the entire US population.
Your link says that flu shot coverage is 51.8% for all people over 6 months of age. The 64% number is for children.
Flu vaccine effectiveness is not great because they have to "guess" which variants of the flu will be most prevalent months ahead of time due to the manufacturing lead times. A lot of experts are optimistic than the mRNA vaccine technology will lead to more effective flu shots.
> A lot of experts are optimistic than the mRNA vaccine technology will lead to more effective flu shots.
We will see. Influenza is unusual in its ability to evolve new variants that resist existing antibodies. It's also not clear that we even can give people repeated mRNA vaccine shots year after year. People quite often develop antibodies to glycol, which makes up the nanospheres used to get the mRNA into cells. Repeated shots may lead to severe side effects, and/or the nanospheres being destroyed before the mRNA can be delivered, rendering the vaccines ineffective.
Incidentally, this is also a problem with the new adenovirus technology used in the Astra Zeneca and Johnson & Johnson vaccines: your immune system develops antibodies to the carrier virus as well as the target proteins. Subsequent shots with the same adenovirus can be destroyed prior to being able to get into cells and express the desired protein; there isn't an infinite supply of suitable adenovirus strains. The Sputnik V vaccine actually uses a different adenovirus for the first and second shots for this reason.
There obvious explanation is that different diseases have different levels of infectiousness. It just so happens that the symptoms the flu causes make it less virulent than covid-19.
> But why is it less transmissible? One obvious explanation is because we've lived with it all our lives
Haven't we lived with different types of coronaviruses all of our lives as well, though? It seems at least equally as plausible that COVID is more transmissible due to actual physical qualities of the virus with respect to replication rate, particle size, and other factors that cause more virus to be expelled from the body in different ways. It could be that the flu is more transmissible by fomites than through aerosols, or that less flu virus tends to be expelled by the body, or that the flu virus has a more difficult time in infecting our cells compared to SARS-CoV2.
Of course, this is pure speculation on my part, but from what I can tell we lack data for anyone to be drawing any firm conclusions on this point.
Transmissibility (or Basic Reproduction Number - R0) is an intrinsic characteristic of a disease.
Measles is at least 3 times more transmissible than flu [1].
We have a very effective vaccine against measles and a mildly effective one against flu, so people get flu and not measles but let them circulate among people without any protection and measles will get them sooner than flu. And it's also much deadlier [2]
> Transmissibility (or Basic Reproduction Number - R0) is an intrinsic characteristic of a disease.
I'm not talking about the theoretical R0, which assumes an immunologically naive population. I'm talking about the real world reproductive ratio, R, including existing immunity. Estimates of real world R for influenza are are even lower than the 2-4 your source quoted. Eg, this paper estimates a median of just 1.3 for a typical year's seasonal influenza: https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471...
Re: measles, note that pre-vaccine, almost everyone got infected with measles at some point in their life, usually as a child. You actually see this in how effective the early childhood measles vaccination programs were: even though only children were being vaccinated, a small % of the total population, measles rates dropped dramatically(1) almost immediately. The adults had already gotten it and were already immune. So to wipe it out, we just needed to protect those who hadn't been infected: the new, uninfected, children born every year. The measles vaccine is attenuated live measles after all. So by vaccinating, we just get the inevitable infection over with in a controlled way, with the odds rigged _enormously_ in your favor.
I haven't been keeping up with it, but that's the lowest estimate I've seen yet. Back when it was still only known to be in China it was estimated at 5-6, but quickly went down to 3-4 for the first several months or so of last year, then some estimates brought it back up to 5-6..
I remember it not being a huge deal to have a bunch of people at work come with flu-like symptoms. "It's just something going around." Work gave out flu shots every year but that isn't 100%. It wasn't even considered much of a faux pas to show up to work feeling a little ill. Now, showing up to work with flu-like symptoms could put you in the hot seat with HR. Having a bunch of people fall ill in the office now results in it being closed for the day for cleaning. It won't stay this way forever but it's going to be a while until most people go back to being lax on contagious diseases. Imagine companies forcing employees and schools forcing students to mask up during flu season.
One time I was really sick at an airport McDonalds. Fever, sneezing, the whole thing. But you're in an airport, and you have to eat something.
I had to explain almost pedantically why they should allow me to order verbally instead of using their touchscreens, for the safety of the other customers.
I think today, they'd have a protocol to accommodate people who are obviously sick so they don't have to touch anything. In fact, they probably don't even let healthy people use touch screens, if I had to guess.
So, in your expert medical opinion, given years after the fact without any understanding of the illness in question... You think that your advice that "you should just have washed your hands" is such amazing advice that you think it's worth writing here?
What are you hoping to gain? And even if you were right, as I said, I had a high fever. It's not like I was thinking clearly. Are you trying to feel morally superior to someone who was in gravely ill?
I really, really hope that "coming to work sick" is considered bad form from now on, or even outright against policy.
It's always been dumb: at best they're just getting more people sick (some of whom will need to take time off, negating any supposed benefit of the sick person not just staying home in the first place), and at worst it's spreading a flu that eventually results in someone dying.
On top of that, a massive number of companies have just proven remote work is possible, even during entirely non-ideal conditions (lockdowns, virtual school, high stress, etc).
Every fall, winter and spring, I was able to watch as colds and the flu spread around indoors. People would be chastised for staying home with "the sniffles", too.
Not wearing masks is a hill many people have chosen to literally die on, so while I hope that there is a culture change, I expect that anyone wearing masks after the pandemic is over will be demonized.
But the flu has always been here, even when our country was significantly less populated, when we were significantly more rural, and when people were significantly less connected in many ways. Like, how did we get flu pandemics in the 1700s? Weren't we less connected back then, even after you account for all the social distancing that was done this year?
The flu (influenza) has been linked to solar radiation and electricity.
-- quote --
In 2001, Canadian astronomer Ken Tapping showed that the influenza pandemics over the previous three centuries correlated with peaks in solar magnetic activity, on an 11-
year cycle. It has also been found that some outbreaks of influenza spread over enormous areas in just a few days – a fact that is difficult to explain by contagion from one person to another. Also, numerous experiments seeking to prove direct contagion through close contact, droplets of mucus or other processes have proved fruitless.
From 1933 to the present day, virologists have been unable to present any experimental study proving that influenza spreads through normal contact between people.
All attempts to do so have met with failure.
5gexposed.com is not really a reputable source. Anyway,
> Also, numerous experiments seeking to prove direct contagion through close contact, droplets of mucus or other processes have proved fruitless.
> From 1933 to the present day, virologists have been unable to present any experimental study proving that influenza spreads through normal contact between people. All attempts to do so have met with failure.
Large indoor gatherings, indoor restaurants, bars, were shut down for months. Grocery stores enforced or at least encouraged their own mask policies. What’s more in Florida, those few steps covered almost all the ways people really interact there. Like much of the US, there is almost zero spontaneous sharing of space outside of bars, restaurants, stores and churches.
I personally dislike the isolation of extreme car culture, but it does help in situations like this.
> states that had effectively no covid restrictions?
This isn't really true anywhere, some places had fewer state mandated restrictions, but effectively everywhere had significant changes in terms of breadth and depth of person-to-person contacts.
I was in Florida two weeks ago--Orlando and Sarasota. I'm a Massachusetts resident. In Florida, I observed around 90+% mask usage in grocery stores. In a random ColdStone creamery, I saw maybe 70%, Five guys was probably 80% except while eating.
In Massachusetts, usage is certainly higher, but maybe in practicality, not enough to make a difference compared to other factors?
Interesting. Do people still associate indoors in large numbers, or is that unchanged as well? As in, could behavioral change be a driver?
I also wonder, with far less numerical opportunity to spread and mutate, if the flu wasn't able to "grow" a good candidate with good evolutionary fitness this year, so distancing and mask usage affect countries even where they aren't practiced.
No, we have other restrictions and recommendations resulting in various degrees of social distancing. Definitely less than countries that did lockdowns but it's probably as you say a combination of our own measures and other countries' more rigid restrictions (including masks) killing off the international transmission routes. So we should be thankful that other countries took this more seriously if that's the case.
You seem to be implying that Florida had no restrictions, but this just isn't the case. Even when I went a couple of months ago, masking indoors was the norm and most places still had capacity restrictions.
Queues at popular sites were socially distanced outdoors as well.
Apart from what others said. Flu is seasonal and (most of the time?) starts in Asia. With very restricted international travel flu simply has less possibilities to come over.
Flu disappeared globally. With no incoming cases, it would have had to spread simply by internal transmission, which by definition would be less than usual.
Also, there were probably minor restrictions people took upon themselves, like staying home when they had flu-like symptoms, or shunning people that coughed.
Flu is seasonal, and there are large pushes to get people vaccinated against flu each year. Sometimes those vaccinations are more effective, and sometimes you get more people vaccinated. This season it appears both are true.
It's only seasonal because of increased indoor/outdoor humidity permitting longer micro-droplet aerosol suspension. If everyone were wearing masks that trap micro-droplets, then flus and colds effectively die out. It's the no maskers and chin-guarders that cause infectious agents like SARS-CoV-2, flu, and colds to proliferate.
The notion that horizontal interdiction is responsible for this suppression is absolutely, positively absurd and will never stand up to scrutiny.
On the other hand, this patterns very neatly with previously observed and well-documented phenomena of viral interference, specifically with respect to influenza. Here's a good paper to start a journey of research on this topic: https://academic.oup.com/jid/article/212/11/1690/2911897
1. All places had COVID responses, even places that didn't have state-wide rules. I doubt that there were any real number of Americans -- even in isolated communities -- whose lives were not impacted by public health stuff during COVID.
2. Having flu outside your border be rarer means less flu coming in.
A single data point: I didn't get flu once since I went self employed and started working from home most of the time in 2006. Less public transport, less open space offices, less restaurants at lunch time. Maybe a coincidence but if people had less chances to meet other people, maybe because those other people kept social distancing, then they had less chances to get flu. It's way less contagious than covid to start with.
Behavioral change. Flu is generally less infectious than covid, so it will take less voluntary behavioral change to get the flu R-number below 1 than the covid one.
Also, the whole hand-sanitiser-everywhere thing, while in retrospect probably not super effective against covid, would be expected to be quite effective for the flu.
There are a bunch of contributing factors (most schools, indoor public places, and workplaces encouraging or requiring masks, and many workplaces remote), but one thing that I'd expect to help with flu much more than it does with COVID-19 is sick people staying home.
Asymptomatic spread is a much larger risk with COVID-19 compared to the flu. A simple behavior change of "If I feel sick, I don't go to work/school/grocery shopping" isn't enough to stop COVID, but could cut flu spread a ton by itself.
Just speculating here, but maybe because of false positives where flu cases get labeled as Covid? I've heard that PCR tests were not meant to be used for large scale virus detection.
EDIT: The PCR test quote was fact checked and deemed to be misleading, but it still sounds like they are not very accurate [0].
You don’t deserve the downvotes. There’s long been speculation that flu cases may be getting reported as COVID and vice-versa because of the symptom overlap.
Hum, I think I've only heard of this speculation coming from people who deny covid is a big deal and not that that position should be dismissed out of hand, but the overwhelming evidence is that the strong version of it at least is wrong.
I'm also struggling to understand how symptom overlap would lead differences in the number of confirmed cases with PCR tests. These aren't cases confirmed by doctors talking to you and running through a checklist, these are tests that with a great degree of accuracy confirm if you have flu or covid in your system
Perhaps the corona virus is asymptomatic for some people (as is known to be), and the effects they are feeling are from the flu. How many people get a false positive (or true positive that would otherwise be asymptomatic) while also being positive for the flu?
Maybe corona virus is an enabler of some other disease, like a particularly virulent flu or some other respiratory infection.
This questions are inconvenient, so they'll go unasked by the media, let alone answered.
> This questions are inconvenient, so they'll go unasked by the media, let alone answered.
Literally an infinite number of questions go unasked by the media. Often because they're a pointless waste of time.
I'd say if leading virologists around the world looked at it in a lab and agree it's not some mystery illness, most media will go with that. At least the reputable ones not fishing for cheap attention from paranoid conspiracy theorists.
Leading virologists said not to give people anti-inflammatories at the beginning of the pandemic and probably killed a bunch of people.
> At least the reputable ones not fishing for cheap attention from paranoid conspiracy theorists.
We're not talking about paranoid conspiracy theories here, we're talking about the inexplicable disappearance of influenza globally, when it should have the same transmission characteristics as corona virus. Corona might spread more rapidly, but it should spread in the same manner.
It's entirely possible that the bulk of people with symptoms actually have a concurrent infection (eg, the flu). We already know the vast, vast majority of deaths have a 'comorbidity.'
> when it should have the same transmission characteristics as corona virus. Corona might spread more rapidly, but it should spread in the same manner.
That's just like not true. Different diseases spread differently. It seems like covid will spread better through smaller droplets for example. And even if it were you just said that covid spreads easier. Disease transmission isn't linear so if interventions were enough to dip Flu's reproduction rate below 1 we'd see more or less what we've seen. Very little spread. Even if we ignore all of that and pretend you're right and really this year of horror has just been Flu cases, the health care system almost collapse in Italy, NYC, LA, and now India is still a huge deal. Hugely more people are dying this year than do in an average year. People died, literally dies in all of these places because they weren't able to get into a hospital. I don't care if it was actually covid (it was) or not killing them
> the health care system almost collapse in Italy, NYC, LA, and now India is still a huge deal.
This I can agree with. But our way of dealing with the problem hasn't solved that going forward whatsoever. Are we going to ignore the fact that NYC has been shutting down hospitals for decades[1]?
> Hugely more people are dying this year than do in an average year.
Not according to the numbers I've seen.
> People died, literally dies in all of these places because they weren't able to get into a hospital.
What are the death rates for people in hospitals compared to people dying with covid outside of hospitals? What interventions are hospitals providing to most patients that are conclusively saving their lives? At first, it was ventilators, but that has quietly become not recommend for most patients.
I happen to be close friends with someone that worked on the covid floor in a major regional hospital. Most people in the hospital were being treated for pneumonia, some of them were on supplemental oxygen. The hospital was never overrun, only a small portion was dedicated as a covid wing.
My friend never contracted covid, nor did anyone else they worked with.
I mean the first one is possible. I think it has been thought of though, we do random testing sometimes and at least some covid samples are also tested for flu.
The second just seems wrong. Like it could have been true a year ago, but it really would be known by now and there really isn't any reason it would be inconvenient for any sort of narrative. Diseases that weaken your immune system enough for some other disease to be killing loads of people are still worrying and big deals. We would still be calling for lock downs regardless of if covid is directly or indirectly causing extra deaths
There's lots and lots of samples being tested for flu. Is the theory then that there is some bias where the hidden cases don't get tested for flu at all and only mistakes are sent for testing?
This speculation has also been long debunked with a look at the mortality per week/month compared to the same time period in 2019. Which revealed that at least in early 2020 a ton of deaths were unaccounted for, due to limited Covid-19 testing as well as deaths indirectly caused by Covid-19(delayed surgery thanks to overloaded hospitals etc.)
This is the problem with "presumptive positive." If you call the physician and he says "sounds like covid, call me if you develop serious breathing problems" and that never happens, like in most cases, now were are not counting anything, or worse, counting one as the other.
Depends, different countries (and sometimes states) have different standards there. And those reporting standards also sometimes changed over time. Which is why numbers are not completely comparable internationally and from different periods of the pandemic without a lot of additional interpretation.
I'd also like to see the data normalized by number of flu tests administered. Maybe people are just not getting tested for flu to avoid a possible covid exposure.
The test detects "viral material" and "does not indicate that the virus is fully intact and infectious, i.e. able to cause infection in other people."
The fraud is not in the test itself, but in the reporting of test results. When a PCR test comes back positive, more often than not it is assumed the patient is infected with COVID (which may not be the case) - and cases of infected people are reported widely using these PCR test results.
It may even be the case that fewer people are seeking medical care for symptoms that they (correctly) think are just the flu. The lack of smell that COVID often causes is very distinct; easy to imagine people who are sick with the flu, but have not lost their sense of smell deciding to stay home both out of fear of covid, and because accessing medical care during a pandemic is less convenient.
Some people may also be worried that they do have covid (or will get a false positive), and don't want to get a positive test due to quarantine requirements, embarrassment, etc.
For all of the weird things my country Sweden has done (and perhaps more importantly - not done) in the past year, shaming and financially punishing people with covid is not one of them.
The flu didn't happen here either according to the long standing sentinel testing program.
Summary: 145k people were tested (1.4% of the total population), 29 people tested positive for an influenza variant during the winter season 2020/2021. Typical numbers for previous years are in the thousands.
Most people (with flu-like symptoms) don't contract influenza in a given year, and the number of cases the CDC puts out each year are comprised mostly of 'suspected' cases.
Between the flu and covid, case reporting numbers are wildly unreliable.
One might ask, what incentives are there to over report a given illness at any given time?
Yes, that's the hypothesis of the "There's no Covid-19" crowd that will disappear whenever hospital corridors are filled with dead bodies.
On the other hand PCR test are not inaccurate at all, at least regarding false positives. There are detailed articles and even Youtube videos on the process and if you take a look, you will understand why it's quite accurate.
In essence, they create a reaction that will mass produce specific parts of the virus gene until it's detectable with a sensor. They run the reaction multiple times and then the sensor looks for luminance if I recall correctly.
Because you can't accidentally produce Covid-19 genes, the tests are very accurate. However, you might not get enough virus material when taking the sample from the patient(which can fail your reaction or you might need more cycles than usual to create a detectable amount) or it could be the case that there's a mutation in the gene that you are attempting to multiply, therefore you can get a negative test for an infected person.
between 0.8% and 4% false positive rate according to that, making them completely unsuitable for mass testing. On top of that BBC's panorama did a program pointing out the sloppy standards at centers where the tests are processed.
How did you decide that this range exactly is unsuitable enough that we are better off we simply assume that the reality is the one that suits our agenda? IMHO that's a pretty good accuracy, significantly better than the "I feel like", "I want to believe that", "what if it's all about" or the "It's suits me better if" methodologies.
I'm not being snarky, I simply want to outline the alternatives I'm aware of.
I respect the accuracy of the PCR, it can literally tell us why people in India are dying off on the streets right now in thousands and we even cannot see the assailant through optical magnification. It can also tell us that it's the same thing that caused the exact same situation in NY and Italy.
It's amazing, much more intriguing than any other explanation that I came across.
I’m not the OP, but the rest of the paragraph that the quote above was linked to reads as follows (note the last 3 words in the quote):
* This rate could translate into a significant proportion of false-positive results daily due to the current low prevalence of the virus in the UK population, adversely affecting the positive predictive value of the test.2 Considering that the UK National Health Service employs 1·1 million health-care workers, many of whom have been exposed to COVID-19 at the peak of the first wave, the potential disruption to health and social services due to false positives could be considerable.*
At the height of the "second wave" here, it was estimated that around 0.8% of the population was infected at the time. That means that if you were randomly tested there was a greater chance that you would have a false positive than an actual infection.
That would be unfortunate to all those prevalence studies where the difference between 1.1 and % 0.3 means the world for them. They may never know if it was %0.5 or %0.8 of the people infected.
On the other hand, it's a pretty good accuracy when you have a hospital full of sick people. Sure, you may end up recommending 14 days of staying at home every now and then when it's not necessary.
See, the PCR test is just one of the clues that is used to diagnose people. Negative test with clearly Covid-19 symptoms and medical image of the lungs showing spots gets you a bed and treatment in the hospital. Positive test and no symptoms gets you stay at home and wear a mask recommendation.
Nevermind the fact that as we find more people positive we see an increase in hospitalizations and mortality shortly afterwards, why in these charts[1] did Alberta get so many sub 0.8% 7 day rolling averages then?
> On the other hand PCR test are not inaccurate at all, at least regarding false positives.
PCR tests work by selectively amplifying DNA. Each PCR test cycle approximately doubles the amount of the selected DNA. (for SARS-CoV-2, an RNA virus, the RNA is first converted to DNA)
Since each cycle approximately doubles the amount of selected DNA present, PCR tests can be extraordinarily sensitive if enough cycles are used. In theory, just a single fragment of RNA could result in a positive test. As Health Canada says:
Hospitals are testing pretty much everyone who comes in the door for COVID-19. The fact that people can test positive long after they were actually infected should obviously raise questions about the accuracy of our statistics with regard to COVID-19 hospitalization and death rates.
Additionally, contamination is a potential problem. For example, the BBC's undercover reporting found significant cross-contamination between samples at one testing lab: https://www.bbc.com/news/uk-56556806
Contamination could be showing up as a multiplier on true positives: as positive % increases, opportunities for contamination also increase. Since PCR tests work by replicating DNA, they also have the unusual property that the testing process itself creates large quantities of potential contamination. Good lab practice will eliminate that problem. But that's hard to guarantee when testing volume is increased enormously in a short period of time.
That's not PCR's but the sample processing error rate. It's not inherent to PCR but the specific organisation that runs the mass testing efforts. If UK's has these issues the maybe they should improve their quality standards.
I know in our region they aggressively and specifically checked for flu and found none this year, so it is definitely not for a lack of testing. I have no idea why people are so uncomfortable with the idea that what worked to deter COVID had an even greater effect on the flu.
The inventor of the PCR test himself, Kary Mullis, was very critical of Fauci and the way that PCR is being used today [1]. Are there any rebuttals or counterpoints to his statements on PCR?
Kary Mullis also doubts that HIV causes AIDS, believes in astrology, and once saw a fluorescent talking raccoon. Clearly a brilliant guy, but not someone whose advice should directly determine clinical practice.
See my other comment here for the reasons why I believe almost all SARS-CoV-2 PCR positives are true positives (as to whether the patient is or was very recently infected; the kernel of truth is that they don't necessarily indicate that the patient could infect others right now).
That's an ad-hominem argument. You might as well say Isaac Newton also believed in astrology, so we should throw out all his work on math and physics. As a non-religious person, astrology and religion are no different to me, so then you might as well throw out any knowledge innovated by like 99% of people who have ever lived.
I have no stake or attachment to Kary Mullis, whether he's wrong or right is irrelevant to me. I just find it interesting that the creator of PCR, which has a lot of attention these days, had opinions that don't get a lot of attention these days. I'll give your comment a look, but am also curious if anybody else has a counter to Mullis' claims.
And yours was an argument from authority. You gave no explanation of or support for Mullis's arguments, and you gave no reason to believe his conclusion except a positive aspect of his reputation (i.e., his discovery of PCR in the first place).
In that case, negative aspects of his reputation (i.e., the fluorescent raccoon; or, closer to the domain in question, his belief on HIV and AIDS) are surely also relevant. They don't mean what he's saying is false, but they'd cause a reasonable person to approach his unsupported statements with more care.
For convenience, I'm linking my other comment below. This is a detailed explanation of why I believe almost all patients who test positive by PCR are (or were very recently) infected with SARS-CoV-2, fully referenced. It has so far received zero interaction.
If you think I'm wrong, please explain why, and I'll reply. If you think I'm right, then I'd also appreciate a reply. The belief that coronavirus cases are grossly over-diagnosed is a common element of claims that no precautions against it are necessary, which cause real harm; so I hope you don't want to falsely spread that belief.
ETA: And for completeness, here's a paper discussing the ability to culture virus from PCR-positive samples. I believe that's the real point Mullis was alluding to in his comments, that people who test PCR positive aren't necessarily shedding replication-competent virus; but that's a separate question from whether they are (or very recently were) infected.
> These tests, called “home brews,” are not commercially available, and there are no good estimates of their error rates.
So this is about clinical use of an uncharacterized test. Why is that relevant to the test for SARS-CoV-2, which has probably now been run more times than any other PCR test in history, including on large populations with extremely low test positivity (e.g., most of Australia, <0.1%), which bounds the specificity (e.g., to >99.9%)?
Seriously, engage with the evidence. There are still zero replies to my detailed explanation linked above. Did you read it? What did you think?
I read to the end of the article. They even developed a better (though still not perfect) PCR test that excluded most of the initial false positives!
> Its scientists also did additional P.C.R. tests on samples from 116 of the 134 people who were thought to have whooping cough. Only one P.C.R. was positive, but other tests did not show that that person was infected with pertussis bacteria.
It's absolutely possible to develop bad PCR tests, and that's why it's necessary to characterize them on large populations to determine their specificity and sensitivity. It seems the Dartmouth team didn't do that before using the test clinically, and that was their problem; but the SARS-CoV-2 tests are the most intensively-studied PCR tests in human history, and the evidence I've seen looks quite good.
So again, did you read my detailed explanation? Do you understand it? If you're just looking to knowingly spread baseless doubt, there's far more effective places to do it. So why not engage with the actual science?
I did read your linked explanation, I did not get a chance to read your sources however but I will when I get a chance. You don't need to be so condescending. Are you in the medical field by chance? Anyhow my concerns around the virus aren't so much with the tests but with the lack of data on the long term effects of the new vaccines. Since I am not in an elderly age group, I am reluctant to take the vaccine without at least waiting a few years to observe if there are any other effects.
Please do read the sources. My background is math/CS, though I've done statistical work for life sciences. Evidence like the excess mortality requires zero medical knowledge though, just the ability to count deaths and compare that count year over year. Whatever the PCR test is doing, PCR-confirmed COVID deaths track reasonably well with excess deaths in regions hard enough hit for the excess deaths to be statistically distinguishable:
In fact excess mortality usually exceeds COVID deaths, suggesting there are more false negative PCR tests (at least on dead/dying people) than false positive.
The vaccine is an entirely different topic. There's certainly a higher risk that the SARS-CoV-2 vaccine will have unforeseen long-term effects than for other, longer-studied vaccines; but there's also a higher risk that SARS-CoV-2 itself will have unforeseen long-term effects than for other, longer-studied diseases. I'm not elderly, but I've placed my bet on the vaccine.
I don't mean to be condescending. I'm just frustrated that I've spent considerable time explaining why I believe the PCR test for SARS-CoV-2 is almost always accurate, and received zero engagement with any of that. The evidence is there for anyone willing to invest the effort to understand it.
> And yours was an argument from authority. You gave no explanation of or support for Mullis's arguments, and you gave no reason to believe his conclusion except a positive aspect of his reputation (i.e., his discovery of PCR in the first place).
Nice try but your tit for tat doesn't quite work. I explicitly said I have no attachment to Mullis or his claims. I didn't make an argument myself. I was asking "the creator of PCR made this claim, what are the counter-arguments?"
Then, and now again, you gave your irrelevant ad-hominem points. I don't care if he believed in voodoo or saw pink elephants in the sky, because they're irrelevant to my question. And as I already said, Newton believed some outlandish things, yet I still believe in physics. I'm interested in what the counterpoints to his argument, not his reputation, are.
I also read your comment, and it's also not relevant to my question. You seem upset that it's gotten zero interaction, and I'm not sure what I'm supposed to do about that. But I'm not looking for info on why PCR tests are true positives, I'm looking for arguments on Mullis' claims
So to be clear, do you agree that almost all positive PCR tests for SARS-CoV-2 are true positives (i.e., that almost all patients testing positive are truly infected)? If yes, then what do you think (or think Mullis thinks) is wrong with "the way that PCR is being used today"?
The comment you replied to was speculating about "false positives where flu cases get labeled as Covid". Mullis's comments are not too coherent, but I read them as a claim that PCR tests will result in false positives, and I assumed that was why you thought they were relevant. At least one other user seems to have read them the same way, since user theclap responded with a link to a different article explicitly about PCR false positives. Do you read them as something else?
I don't agree with anything; I don't have an opinion or stance, I've said that from the beginning. I'm looking for someone _else_ to give _their_ opinion or evidence. I don't know how many different ways I can rephrase the same point.
Here's a quote from another reply to my original comment:
> > Kary Mullis: I think misused PCR is not quite ... I don't think you can misuse PCR. No, the results, the interpretation of it. See if you can say, if they wanted, if they could find this virus in you at all, and with PCR if you do it well you can find almost anything in anybody. It starts making you believe in the, sort of buddhist notion, that everything is contained in everything else. Right, I mean because if you can amplify one single molecule up to to something that you can really measure which PCR can do, then there's just very few molecules that you don't have at least one single one of them in your body. Okay, so that could be thought of as a misuse of it just to claim that it's meaningful. It is, there's very little of what they call HIV and what's been brought out here by Phil ... the measurement for it is not exact at all, it's not it's not as good as our measurement for things like apples. An apple is an apple. You know, you can get something that's kind of like, if you've got enough things that look kind of like an apple you stick them all together you might think it as an apple. And HIV is like that. Those tests are all based on things that are invisible, and they are the results are inferred in a sense. PCR is separate from that, it's just a process that's used to make a whole lot of something out of something that's why it's not, it doesn't tell you that you're sick and it doesn't tell you that the thing you ended up with really was going to hurt you or anything like that.
An example of what I'm looking for info on is this in particular:
> PCR is separate from that, it's just a process that's used to make a whole lot of something out of something that's why it's not, it doesn't tell you that you're sick and it doesn't tell you that the thing you ended up with really was going to hurt you or anything like that.
I don't have an opinion myself and I'm just looking for someone informed to comment on how today's use of PCR for diagnosing covid aligns with the inventor of PCR's comments that it isn't useful for diagnosing illness. Not whether or not today's covid tests are false or true positives
The PCR test is being used clinically in two major ways. First, people with a positive test are advised to isolate themselves, to avoid infecting others. As I noted in my very first reply, a positive PCR test doesn't necessarily mean that the patient is shedding viable virus (i.e., that the patient could infect others), and that's the kernel of truth behind Mullis's statements. I posted a link above to a paper that attempted to culture virus from PCR-positive samples:
> It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, <3% of cultures are positive.
So it's absolutely true that some of the people who test positive by PCR would never have infected anyone else, and there was no need for them to isolate. But it's hard to distinguish who--the viral culture takes too much time to run for each patient, and no one really knows how sensitive that is anyways. So to be conservative, they just advise everyone to isolate.
People have talked about advising isolation only if Ct is less than some lower cutoff, since there's a clear correlation between Ct and positivity in culture. But since a patient early in the infection might have high Ct now but lower Ct later, public health authorities haven't done so.
The second way that PCR tests are being used is to diagnose the cause of illness--a patient comes in sick, and the doctor is trying to find the cause. At this point, we already know that the patient is sick, because they're coughing, complaining that they feel terrible, etc. The PCR test isn't what tells us that they're sick, but rather what tells us that the cause of their sickness is SARS-CoV-2. The alternative hypothesis is that people are dying of some different disease, and by coincidence the excess mortality due to that different disease correlates strongly with SARS-CoV-2 test positivity (which e.g. is why that's high in the USA, and low in Australia; you can also see the correlation within a single region if you look at the time series). That would be a pretty strange coincidence, and no one has proposed any mechanism for that.
So do the above clinical uses seem reasonable to you? Or is there some other clinical use that seems unreasonable to you in light of Mullis's comments?
Perhaps this confusion comes from the definition of "illness" or "sick". In a certain sense, if I don't feel sick, then no test can tell me otherwise. For example, was Typhoid Mary "sick"? Is an HIV patient with no symptoms? Kary Mullis says no:
> A man with gray hair and a goatee raises his hand. He says he's been HIV-positive since 1984, that he took the anti-AIDS drug AZT for a couple years but stopped. Now, he says, his T-cell count -- the number of a kind of white blood cell that is killed by HIV -- has gone way down.
> Mullis interrupts him: "Change doctors!"
> The man continues. His T-cell count is down to 150, which is usually thought of as dangerously low. He asks Mullis for advice.
> "I would say there is no evidence that I can find in the scientific literature that you should worry about HIV or your T-cell count," Mullis tells him. "If you'd stop worrying, maybe you'll be all right. You look pretty healthy to me."
> Reporter: .... misuse PCR to estimate all these so supposedly free viral RNAs that may or may not be there?
> Kary Mullis: I think misused PCR is not quite ... I don't think you can misuse PCR. No, the results, the interpretation of it. See if you can say, if they wanted, if they could find this virus in you at all, and with PCR if you do it well you can find almost anything in anybody. It starts making you believe in the, sort of buddhist notion, that everything is contained in everything else. Right, I mean because if you can amplify one single molecule up to to something that you can really measure which PCR can do, then there's just very few molecules that you don't have at least one single one of them in your body. Okay, so that could be thought of as a misuse of it just to claim that it's meaningful. It is, there's very little of what they call HIV and what's been brought out here by Phil ... the measurement for it is not exact at all, it's not it's not as good as our measurement for things like apples. An apple is an apple. You know, you can get something that's kind of like, if you've got enough things that look kind of like an apple you stick them all together you might think it as an apple. And HIV is like that. Those tests are all based on things that are invisible, and they are the results are inferred in a sense. PCR is separate from that, it's just a process that's used to make a whole lot of something out of something that's why it's not, it doesn't tell you that you're sick and it doesn't tell you that the thing you ended up with really was going to hurt you or anything like that.
The test positivity in lightly-affected areas is very small, for example <0.1% in much of Australia. This includes both true and false positives, so it bounds the specificity of the test.
A Lancet article cited below references a paper that estimates much worse specificity of PCR tests for SARS-CoV-2 based on the specificity of tests for other RNA viruses (original SARS, MERS, influenza, etc.):
But why would anyone do that, when we have direct experience with the actual test for the actual virus?
Of course the false positive rate in heavily-affected areas may be higher, due to sample contamination--with more true positive patients, there's more opportunity for one true-positive patient to contaminate multiple samples. But such cross-contamination can occur frequently only if there are actually lots of true positive patients.
For another sanity check, the sensitivity of antibody tests is established on a sample of patients who tested positive by PCR, who are assumed to all be true-positive. So any PCR false-positive among those patients will show up as an antibody false-negative, so that bounds the apparent sensitivity of those antibody tests. But antibody tests show sensitivity around 85%:
So even if the antibody tests were perfect, at most 15% of their positive sample was false-positive. (Note that this is a different quantity from the PCR specificity, and can't be translated into such without knowing the true prevalence in the population that the sample was drawn from.) Of course the antibody tests also aren't perfect, and I'd guess that 15% is almost entirely antibody false-negatives rather than PCR false-positives.
You can also compare reported COVID deaths (which are generally established by PCR) with year-over-year excess mortality. The agreement isn't perfect, but it's pretty close.
The vast majority of patients who test positive by PCR are or were infected by the virus. That's a different question from whether a positive test indicates the presence of replication-competent virus (i.e., whether the patient could infect others right now), since RNA from dead virus can trigger the positive too; but that dead virus had to come from somewhere.
"With PCR, if you do it well, you can find almost anything, in anybody"
"If you can amplify one single molecule up to something that you can really measure - which PCR can do - then there's just.. very few molecules that you don't have at least one single one of them in your body"
"It doesn't tell you that you're sick"
My interpretation is that Kary Mullis did believe it was at least possible to "misinterpret" the results of a PCR test. It doesn't seem such a stretch to believe that you could be sick with the flu, while also having a single molecule of a coronavirus gene present in your nasal cavity (triggering a positive coronavirus test).
Note: I know this is an inflammatory topic. The views of Kary Mullis are not necessarily my own. I am posting this here because I think it is interesting.
Every COVID test I took included a separate influenza test. Not sure if that was the case everywhere though. But at least in my case flu would get labeled flu.
I read somewhere (I think Bill Bryson's "At Home") that they were almost wiped out at one point in the 20th century, but have recently started making a comeback which seems to correlate with the rise of energy saving low temp wash cycles that aren't as effective at killing them.
Possible the higher instances are related to the fact that schools no longer do routine screening for lice. No more school nurse and no more chopsticks checks monthly means that they have a chance to spread amongst the kids before anyone notices.
There are sporadic outbreaks of head lice in my children’s preschool. It doesn’t seems to have change much since I was in that age myself soon fifty years ago.
Indeed they are. We battled the lice on multiple occasions with our two girls (in Canada). Pre-COVID, there was nothing we wanted to see less than a letter from the daycare or school about a lice case in the room. Lice are a pain in the butt.
I'm going to guess most people here had short hair while in elementary school...you're all so lucky!
I've always had clean thick long blonde hair, which happens to be lice's favourite hair type. Every time there was a lice outbreak in school, I got it. Its very much a thing in Canada still.
I grew up in a rural area in a second-world country, during the 90ies when the economy went from shitty to complete shit, and many people had to subsist on grazing, so to speak: I helped to plant (and then gather) potatoes, tomatoes and other vegetables in our backyard. But even then, lices were mostly something out of WW2-era stories, or something you'd get if you hanged out with local "wandering folk", I guess; I don't remember any lice cases in my school although we did have our hair checked in the elementary.
Then things generally improved and life is now much better; so what about the lices? According to the 2019 statistics, there were 200 cases of headlice per 100'000 children that year. Quite a number, but not a huge one, really.
So that's why I asked--if in a poor second-world country lices were almost a non-issue, then surely that means the rich first-world countries have managed to completely get rid off the lice, and much earlier, too? Right?
The seedy airbnbs by the drinking areas have been making money hand over fist this pandemic among the "refuse to subscribe to reality" crowd, which has been empowered over the last few years.
I thought lice were found in the environment and not human reservoirs only. Obviously sterilizing the Earth coukd technically solve it but going full War of the Worlds Martian would be a terrible idea.
You always fight the last war. Covid measures started as flu measures, and to a great extent still are even though we now know (and knew fairly early) that the transmission modes differ significantly.
Flu has significant fomite transmission, both direct and from emissions, where CoV-2 basically has none. Aerosol transmission is present in flu, but nowhere near as strong as CoV-2. There are definitely some overlaps, like direct large droplet transmission (which make measures like masks work for both.)
Sanitation and "social distancing" work for flu, but coronavirus is mainly about ventilation.
An alternative explanation is that of "viral interference"[1,2], i.e., the most transmissible virus boosting up viral immunity in the population, and precluding transmission of the less transmissible/fit virus
It's strange to call this an "alternative explanation", since it's the one that expert infectious disease researchers, nearly without exception, are pointing to.
The (let's face it, silly) notion that masks and distancing suppressed all respiratory pathogens except one is a theory with very little traction, and which will almost certainly not stand up to serious scrutiny.
There’s nothing silly about a novel virus having greater abilities to overcome barriers when compared to other pathogens that humans have had years decades and centuries to develop defenses again.
At the end of the day it’s likely gonna be the result of a combination of all these factors.
> There’s nothing silly about a novel virus having greater abilities to overcome barriers when compared to other pathogens that humans have had years decades and centuries to develop defenses again.
Agreed! What you are describing is viral interference: population-level immune responses to one respiratory pathogen causing suppression of others.
We've seen selective suppression of influenza and all of the other four endemic coronaviruses, while SARS-CoV-2 has thrived. This is true throughout the world, including places where stringent horizontal interdictive measures were taken, in places where no such measures were taken, and in all places in between.
> At the end of the day it’s likely gonna be the result of a combination of all these factors.
I think it's very unlikely - almost impossibly so - that interdiction has played a meaningful role in population-level suppression. I don't think it will be a combination; I think it will be explained by the same clearly observed phenomenon which has been responsible for similar outcomes in the past.
Sure, viral interference, yes; but I didn’t go inside a restaurant for 13 months. You’re saying that (and masking, and social distancing in general) didn’t affect influenza transmission?
Yeah, and even in places with no mandatory measures, people would widely take voluntary measures against SARS-CoV-2 that would also be effective against other respiratory viruses.
Whether lockdowns/restrictions are "effective" is somewhat conjecture, but likely had an effect. It's also likely that given the global and nearly total nature of this observed phenomenon that other forces are at play such as the competition and immunity stimulus mentioned in OP.
Although COVID-19 is definitely more virulent than influenza, it doesn't seem reasonable to just jump to the conclusion of saying "it must be the restrictions". That's definitely part of the equation, and maybe it will turn out to be the entire equation, but we don't know.
> During the study period, states allowed restaurants to reopen for on-premises dining in 3,076 (97.9%) U.S. counties. Changes in daily COVID-19 case and death growth rates were not statistically significant 1–20 and 21–40 days after restrictions were lifted. Allowing on-premises dining at restaurants was associated with 0.9 (p = 0.02), 1.2 (p<0.01), and 1.1 (p = 0.04) percentage point increases in the case growth rate 41–60, 61–80, and 81–100 days, respectively, after restrictions were lifted (Table 2) (Figure). Allowing on-premises dining at restaurants was associated with 2.2 and 3.0 percentage point increases in the death growth rate 61–80 and 81–100 days, respectively, after restrictions were lifted (p<0.01 for both). Daily death growth rates before restrictions were lifted were not statistically different from those during the reference period, whereas significant differences in daily case growth rates were observed 41–60 days before restrictions were lifted.
This is one hell of a virus, but if what we are seeing is that it still spreads quite rapidly even with all the restrictions, yet the flu, which is also quite virulent, manages to disappear, then I don't think we really have all the facts as to why it has gone away. Maybe it is just that simple?
I guess what I'm saying is that it's a bit concerning just how fast people here are willing to jump to conclusions.
> There’s nothing silly about a novel virus having greater abilities to overcome barriers when compared to other pathogens that humans have had years decades and centuries to develop defenses again.
This isn't really quite accurate though. Before SARS-CoV-2 ever emerged, our immune systems already had defenses against it. This is because of the already-extant circulating hCoVs.
This is why something like 80% of blood samples taken before SARS-CoV-2 emerged showed T-cell cross-reactivity. From the perspective of our immune system, it was never a "novel" virus. It was novel to scientists and politicians but not to the human immune system.
Blasphemy! Anyone paying attention can see that every person with the flu was labeled as having “Covid” but everyone who “follows the science” will perform all kinds of mental gymnastics to avoid seeing what is obvious.
> every person with the flu was labeled as having “Covid”
I got a cold a few weeks ago. Got tested, it wasn't Covid. Where mental gymnastics are needed is in ignoring hospitalization and excess mortality statistics.
> The (let's face it, silly) notion that masks and distancing suppressed all respiratory pathogens except one is a theory with very little tracti
Are you familiar with the concept of "R0" and that one virus may be more transmissible than another?
Flu has an R0 of about 1.5, and whatever covid's is, it's higher (last I saw was 2.5).
If we postulate that masking and distancing and similar measures act to reduce these numbers across the board, say by 0.6, that brings flu down to 0.9 and covid to 1.9. Outbreaks don't tend to stay around when their R0 is below 1, which would explain why there's hardly any flu this year and plenty of covid.
In this admittedly over-simplified model, beta is (per wiki) "the average number of contacts per person per time, multiplied by the probability of disease transmission in a contact between a susceptible and an infectious subject".
Social distancing reduces the average number of contacts, masking reduces the probability of transmission, and both act to reduce beta. You reduce beta, you reduce R0, you win.
Not necessarily. COVID might be so transmissible that the entire world has been exposed to it enough to trigger an immune response but only establishes itself and becomes an infection in those who get a large enough viral load over a short enough time period.
It wouldn't produce an immunity, it would just keep the innate immune response active enough to prevent the average small cluster of COVID or flu viruses from replicating and growing into a full blown infection. This wouldn't even give the adaptive immune system a chance to develop an immunity to either of them.
If someone went to the COVID or flu ward and had someone cough in their face, they'd still get infected because that kind of exposure is generally too much for the innate immune system to catch.
The lack of Flu infections in the population that did not contract COVID cannot be explained by viral interference. Viral interference would only explain a decreased influenza infection rate among those exposed to COVID.
Combination between efforts to avoid COVID and viral interference of those who were exposed would drastically reduce the ability to spread. Could it perhaps have reduced it enough to have stopped a flu season from developing?
That's pretty much my belief: efforts to avoid COVID also avoid the flu. Viral interference, theoretically, is part of that picture, but does not fully explain the observed data and has not, to my knowledge been tested itself: references to the phenomena as an explanation for flu decreases are based on research for other viruses. Given the HN community frequently criticizes research or reporting on research for overstating it's claims, I am surprised that so many people here have latched on to an extrapolation from research not directly related to COVID.
It seems far simpler, in the Occam's Razor sense, to begin with the idea that staying away from people makes it harder to get sick from other people.
Unfortunately, COVID restrictions and social distancing have become so politicized that many resist the idea that staying away from people reduces the chance of getting the flu from them, because the implication is that those measures might also have been effective in reducing COVID cases. This contradicts a political point of view and therefore some would like to dismiss it out if hand.
For example I've notice that many of those who believe precautions violated their personal liberty want to diminish the effectiveness of those precautions, which isn't necessary from a logical point of view. It is not logically inconsistent to believe these precautions violated civil liberties even if they were highly effective. It just requires a person to believe that many deaths were a reasonable price to pay.
If a large portion of the people who contracted COVID are removed from the set of people who could have potentially exposed me to the flu, doesn't that decrease the likelihood of me contracting the flu regardless of whether I contracted COVID?
Removing those people removes, relatively, an extremely small portion of the population. You are removing roughly 10% of the population in the U.S., or 2% worldwide. This does not explain the magnitude of the decrease observed for the flu.
Is it that hard to believe that not being around other people limits the chance of getting sick from other people?
The first, "alternative explanation" the statistician in me wants to mention is perhaps the way influenza data is gathered has changed.
"Only people who get tested for influenzalike illnesses—typically about 5 percent of individuals who fall ill—are tallied."
If there were a change in the way these tests were administered, for example a blaring medical bias toward another disease, that would present a significant sampling problem. That same statistician also wanted me to mention the simplest and most boring answers are usually closest to the truth.
A bias towards testing for Covid wouldn't explain fewer cases of the flu unless those cases of the flu were coming back as Covid falsely instead of so further diagnosis was stopped. If you have a bad enough flue to seek treatment, then once you get that Covid test and it says "negative", you would move on to the next step for treatment. (Consistent with past years - nobody was getting flu tested just cause they had a runny nose in 2019, it was just the people who needed treatment).
There could be other explanations, such as: a desire to avoid Covid causes people to avoid seeking treatment, so more flu cases self resolve. OR: a fear of Covid causes more people to get tested when they're sick, and some of them may then go for flu testing before they would otherwise after coming back negative for Covid...?
Seems like the simplest answer is just "actions that have reduced the spread of one disease have also reduced the spread of another, that's historically less widespread already."
> Seems like the simplest answer is just "actions that have reduced the spread of one disease have also reduced the spread of another, that's historically less widespread already."
This is not the simplest answer, and the evidence that the measures have really slowed spread is extremely low except in places like New Zealand and Australia which are small islands in Oceania.
---
> A bias towards testing for Covid wouldn't explain fewer cases of the flu unless those cases of the flu were coming back as Covid falsely instead of so further diagnosis was stopped.
Exactly this. I'm partial to the viral interference hypothesis, but what you don't seem to realize is that if you get infected for SARS-CoV-2 and recover in 7-14 days, you will still test PCR+ for months after. This goes into the widespread mistuning of the cycle threshold. Case in point: They tested George Floyd's corpse for COVID-19 and he was PCR+, despite having recovered from COVID-19 a couple months before. The test hit on the remnant viral debris from his long-gone infection.
> This is not the simplest answer, and the evidence that the measures have really slowed spread is extremely low except in places like New Zealand and Australia which are small islands in Oceania.
Have you ever heard of this small Asian country called CHINA?
With a lot of people getting tested for COVID "just in case" and hypochondriacs constantly checking in with their doctors, I'd guess that the percent of flu cases tallied might actually be a little bit higher than usual due to COVID
I wouldn't be surprised if there was more flu testing this year. I've never intentionally taking a flu test, but some of my COVID tests also screened for influenza a/b at the same time.
Those links don't allege what you are saying at all... the second expressly disclaims any such conclusions given the size of the error bars, and the first talks about the protective effect of an active infection, not a simultaneous epidemic. Needless to say, only a tiny fraction of humanity has been actually infected with covid at any one time over the past year.
Do you have a link to someone alleging this for covid? I'm worried this is spin that you picked up from a source that has an interest in opposition to covid mitigation practices.
I thought exactly the same. I recently had a lengthy discussion about viral interference here on HN only to learn that the person didn't want to see evidence that the mitigation measures (i.e. associated human behaviour change!) are effective - not only for SARS-Cov-2, but for a broad range of viral (and non-viral!) infectious diseases.
When Covid goes away, we can assume masking, distancing, and staying home will also go away. In that case, all communicable diseases are likely to increase, from the common cold to STDs.
This is why a tiny fringe of epidemologists has been calling for social distancing to continue for the next several years at least, even after COVID, because they see this as a chance to wipe out other common illnesses. If a person hyperspecializes in a field like epidemology, there is the risk of the person expecting all government policy to revolve around their specific concerns. Sometimes in interviews those epidemologists simply seem oblivious to the effect this will have on live music, theatre, cafes and restaurants, etc., other times they say that we simply cannot allow ourselves those things any more, because saving lives is more important.
You know they do covid tests if they think your flu is covid.
I think you are mixing up half-facts. People were saying that deaths with co-factors were being lumped as covid related deaths and different countries were classifying things differently for political reasons. No one is mislabeling the flu as covid and not giving you a covid test to detect the strain.
A covid tests doesn't test if you have something else. A covid test would not detect the flu or a broken leg and label it as covid. Depending in the type of test 1/3 could be false positive. If your theory was false positives are because of flu I'm not sure there is any proof to that theory but I would like to hear more.
All flu occurrences were not diagnosed before, this year or will be in our future lifetimes. Your doctor telling you its the flu and to get rest vs getting a positive for a influena A or B test and the percentage that a lab might make a mistake on those tests vs the % of time your doctor is wrong are two very different ways to think about your question. Usually the words 'AlWAYS' and 'ONLY' fail in a big population set.
In most developed countries, some sort of flu surveillance is operated. In some countries, those surveillance operations are seeing _no positive cases at all_. They are, however, seeing some flu-like symptoms and picking up some rhinovirus (and covid).
If I caught the flu, how would the government/scientists studying this stuff even know I got it? If you're anything like me you probably just take some time off and get over the illness without ever seeing a doctor or taking a flu-test. How do they measure such things? I suspect they use some elaborate statistical model to try and generalize the results to the whole population.
Of course, but I would say that most people who get the flu don’t experience bad enough symptoms to go to the doctor.
I am not sure what your point is with the assuming everyone is healthy. No one is saying that the flu can’t be deadly. The entire thread is about how you calculate how many people got the flu in a year. Some people suffer severe symptoms from the flu, go to the doctor, and are recorded in the statistics as having had the flu. Many people, however, don’t have bad enough symptoms and therefore don’t go to the doctor and are not tracked in the statistics as having had the flu.
The question is how do they figure out the actual rates when a large portion of cases are never recorded.
What does my own health or the fact that the flu kills many people have to do with that question?
I'm not OP but no, I work from home and only see the people I live with since this started. Knowing if its covid vs the flu wouldn't really matter much to me and either way my behavior would be the same. Frankly it would be worse for public health if I left the house while sick to satisfy my curiosity.
I can imagine that many others in my situation would come to a similar conclusion.
im in your situation: didnt need to leave my house and minimally interacted with people outside of my bubble. I felt sick recently and got the covid/flu test.
Exactly. The only result from covid testing it delaying your own civil liberties. The vast vast majority of people wont ever get covid and a tiny remainder will have symptoms, an even smaller number will need to go to bed, a smaller number will need to go to hospital and people who were going to die this year may die from it. Dont take my word for it, this is the opinion of the UKs chief medical officer:
>But that doesn’t mean you can get away from the fact that if we did not do anything, if we let this virus to run, we would be back in a very serious situation that would threaten many lives and threaten the NHS.
You are arguing from an a prior position that "do nothing" would have the same result of "stay home & other precautions".
When you start from that position, you are already assuming your point of view is correct, and then using the correctness of that point of view in a circular manner to support your point of view.
"the Centers for Disease Control and Prevention estimated there were roughly 22,000 deaths in the prior season and 34,000 two seasons ago." -- emphasis added
Estimation usually involves gathering data and applying some statistics to the data. The question was about the details of that process. "They estimated" isn't telling us anything new.
I don't know where you live but in Canada we have programs like FluWatchers which send sample groups a survey every week asking about flu-like symptoms, flu vaccinations (and COVID now) and such every flu season. They can also request a voluntary sample from you to help track these things.
I was in university when the Ontario Health Study began and they were giving out Amazon gift cards for participating so naturally a ton of students signed up. They send out questionnaires to participants every few months.
In the province I'm familiar with the Provincial government has canceled all testing for the common Flu unless your in the hospital. This is being misconstrued as the flu disappearing in my province which is obviously true because it's not being test for.
It's not being tested for because they are prioritizing COVID-19 testing, unless your hospitalized.
**Please note for all dashboards that as of March 12, community samples are no longer being routinely tested for non-COVID respiratory pathogens including flu.
You'll see they don't have any test information for Influenza.
I may be misunderstanding this as it is hard to make sense how the governments statistics show no testing and that news article you mentioned with the chief medical officer for the province saying otherwise.
They never post how many tests were done on that dashboard, you can look at past years and see the same results. That data regarding testing doesn't doesn't seem available yet on the sites, but I see no real reason to doubt the CMO's claim, do you?
Well except for the link that I posted that specifically said : *Please note for all dashboards that as of March 12, community samples are no longer being routinely tested for non-COVID respiratory pathogens including flu.
And that they at least show non zero results for past years.
In the USA, we have a few organizations that try to keep track of the flu. I think they are mostly private companies pushing drug ads though.
Before covid hospitals, and doctors, didn't test for the flu viruses. Maybe in severe cases?
I know for certain private practice doctors didn't. All you saw was a chart on the wall differentiating a cold, from the flu.
In the USA, the government tries to target the upcoming flu vaccine, but is usually wrong on the strain.
Personally, I think Americans have been dying for years of SAR viruses, and the government has been blaming the flu virus?
We had a family Thanksgiving in my grandmother's house in '98. My sister brought her two very sick kids to the holliday. By the next morning (12-16 hrs after exposure) we were all sick, with the exception of my brother. 5 people who never felt so sick in their lives. I could't even muster the energy to take my slacks off before dropping into bed. 7 days later my grandmother died. I was always under the impression the incubation period was longer than a half day? Whatever that virus was, I will never forget it for a lot of reasons. And of course, my grandmothers cause of death was "complications of the flu", and probally should have been on a respirator, and not sent home so soon?
> In 2018, providers completed between 35 million and 40 million flu tests in the U.S., including RIDTs that use immunoassay technology and molecular tests, flu testing company executives said.
Anecdotally, my kids' pediatrician does them any time flu-like symptoms are present. Same for strep tests. Both have rapid, in-practice tests that require just a swab.
In any of the places I've lived, I've never been to a doctor with suspected flu and not been given a flu test of some sort. Sure, I've gone in with something and been told "this is almost definitely not the flu so we won't test" but every doctor my family has seen over the years has done flu tests when suspected.
There's intensive community monitoring for flu. Flu's a big deal, which is why there are internationally coordinated programs to monitor which strains are circulating, and then to create and distribute vaccines.
By have a sophisticated surveillance network and testing people. To quote from the above page, there have been 931,726 specimens collected since 9/2020, and only 0.2% have been positive.
Compare that number to the previous season (13.0%):
There is literally an entire industrial complex setup to fight the flu on an annual basis, including massive testing & tracking. This is how we have data on annual flu infections. If anything, this year would have been an excellent year to find more flu infections as many people who got sick didn't simply stay home and get over the illness, they went & got tested.
No idea on the technical answer, but the healthcare logistics answer is that because it's not all that likely, a positive flu test was a decent stand-in when COVID tests weren't widely available.
Say 1 in 10 people have flu and 1 in 10 have covid. In a population of 100, 9 have just flu, 9 have just covid, and 1 has both. Those 19 people present similar symptoms, and anyone among them has roughly a 53% chance of having each disease. They take a flu test and it comes up positive. Now they're either one of the 9 with just flu, or the one unlucky person with both, so there's only a 10% chance they have covid.
The impact of this effect changes if has-flu and has-covid are correlated, but it's still there unless it's a 100% correlation.
The technical term is "explaining away". If a burglar alarm goes off, you can be pretty sure someone triggered it. If there also was an earthquake at the same moment, you can be pretty sure of the opposite. Even though both events can happen at the same time.
Not in the UK. My cousin just had a bad dose of something. It's not covid (negative test, he's vaccinated and he had covid a few months ago) and it's not life-threatening so, quite reasonably, nobody cares what it is.
Don't know how widespread it was, but for my wife who had bi-weekly Covid tests for work they also started testing the samples simultaneously for the flu.
I went to the hospital a few months ago for something that could have been covid-19 and they did test the various influenza strains as well as the covid one. Not sure how representative that is though. I don't think the covid-19 swab or gurgle tests automatically test for the flu as well.
I've never known a doctor actually run a test for flu. You couldn't even get a test for Covid either for much of last year, even if the symptoms were blatant. I know a few people who simply stayed home with Covid symptoms and never ventured out to a doctor - and thus were never counted in the statistics.
I had bad flu last year and because of home working, I went back to "work" once I reached the number of days after which I needed a doctor's note. In normal times I'd have gone to the doctor to get a sick note rather than infect my colleagues.
Your awareness on flu testing is an indication of the limits of your knowledge, not a lack of testing. Others in this discussion have provided links with hard data on testing from the CDC for the US. For a world-wide picture, FluNet w/ GISRS also provide data on testing.
These form the basis of overall infection estimates. If you are interested in the methodology of those estimates, here is the CDC overviews, complete with citations for the primary research that informed the creation of their models: https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm#e...
Flu experts generally look at hospitalizations and deaths, as those metrics are more damaging to individuals and society, and also much easier to measure. There have been studies via random sampling of mucosa, sick time used, Google search trend studies, twitter symptoms analyses...many ways to gain a glimpse outside of medical data.
They probably know how many flu cases end up in the hospital or urgent care, then extrapolate from that number. They have historical data and also geographic, and census data, so they can make pretty good statistical estimates.
It's kinda the same math that hardware stores use to figure out how many shovels to stock in a given store each week. Nothing is a mystery if you have data.
Not in that business, but normally you expect certain types of shovels to be seasonal. E.g. snow shovels probably sell more in winter, gardening shovels more in summer. Add to that you can usually look at weather data and refine the seasonal estimates, since in a warm winter people buy fewer snow shovels, in a cold spring, people buy fewer gardening shovels.
Just put all that into some simple regression models and you probably get a fairly good estimate.
The trickiest thing is figuring out how out of stock you are. How many shovels would you have sold if you hadn't run out of stock. So usually you have to be more careful with data points when you might have not registered customers that didn't get what they want in your store.
Huh, it's funny, I never thought about it, but if you are selling something, the best number of unsold inventory you want to have is 1, not 0. Cause if it's zero, you have no idea how many sales you lost, if it's one, you pretty much stocked perfectly.
Exactly. If you renamed flu to FLU-21, did extensive testing for the flu (doesn't really matter how reliable the tests are), you'd have a pandemic every year.
Well, the flu only used to kill like 34k people a year in the US. Covid killed over 10 times more, in a population where a significant portion of it was doing social isolation, wearing masks, etc. So yes, maybe you can call flu a pandemic, but don't compare it to Covid after everything the world as seen in the past year.
The definition for a flu epidemic is two standard deviations above the expected cases for influenza that year, as estimated by a Serfling-type regression model using a negative binomial distribution.
Influenza just doesn't breach that barrier for more than a few weeks most years, and rarely in widespread geographic areas at once.
Compare that to SARS-CoV-2, where the expected number of cases is zero.
"Epidemic" isn't "Is a disease bad?". It's "Is this disease occurring at a level above expected?"
You can have very serious endemic diseases - malaria is one example. But "Occurring to a level above expected" is an important piece of information all its own - for example, five cases of Smallpox, while only five cases, is something of an emergency, whereas five cases of influenza is not a serious crisis.
This is absolutely wrong. Labs in all the largest cities in the US, simply stopped accepting samples for anything other than COVID. Source: wife is RN working as triage nurse and interacting daily with the largest testing sites in NY, CA, NJ, IL, etc.etc.etc.
> And the decline has not been because of a lack of testing. Since late September, 1.3 million specimens have been tested for influenza, more than the average of about one million in the same period in recent years.
My wife is also an ER doctor and agrees that there were times that they didn't perform many/any flu tests--mostly in the spring of 2020 and after none of the flu tests were returning positive for a while. But this past winter people have definitely been tested for the flu. Rapid influenza tests are also usually performed first, only sending to labs when confirmatory testing is desired.
Hmmm, interesting. Wonder what the source of this 1.3 million flu tests is. It makes no sense. Why would doctors send off flu labs to such a statistically higher degree, in a year when they're not seeing any flu?
We have extensive sentinel surveillance systems and reporting physicians that, you correctly guess, are used to inform population-level estimates. Flu surveillance is probably the most comprehensive and robust disease reporting system we have in the U.S. outside the things that are mandatory reports (and even likely some of those).
You're probably thinking of the common cold. If you actually had the flu there's a decent chance you'd go to the hospital or at least a doctor who would run a test
Every community has a baseline mortality rate during "normal" times. During abnormal times like pandemic, famine and war, more people die than usual, but often the cause isn't known.
If you subtract baseline mortality from actual mortality to get excess mortality, that's often a better estimate of the casualties from pandemic, famine and war than the death certificates for every person who died.
Excess mortality in most countries shows that Covid deaths are significantly under-reported.
And if there are fewer deaths from flu, and fewer from suicide [1], then excess mortality itself is under-reported and Covid killed even more than we thought.
> And if there are fewer deaths from flu, and fewer from suicide [1], then excess mortality itself is under-reported and Covid killed even more than we thought.
The majority of covid deaths are those that on average had very few months left to live. There is a likely a high chance these people were going to die to the next "flu" that came around.
How do you account for this? It seems like adding flu deaths on top of covid is incorrect - both would only have a subset of people that are going to die from it, and while covid's is probably more than the flu (depending on the flu strain - we've had some pretty bad flu years), since they both share the same pool I don't think you can add flu deaths in.
On top of that, we had a relatively light flu season preceding covid. This would also need to somehow be accounted for, but I'm not sure how. There was likely a "dry tinder" effect.
10 years earlier than they would have been expected to die without catching COVID. From anything, not just the flu. All-cause mortality includes flu deaths, yes, if that's what you're asking?
If they only had a few months left to live, we should see a spike in the opposite direction for excess mortality. You can monitor this yourself for some countries here: https://www.euromomo.eu/graphs-and-maps/
Sorry for the awful formatting. Odd things in the prelim 2020 data that surprised me:
All leading causes of death were statistically unchanged; COVID just shoehorned itself into the #3 spot below heart disease and cancer, above unintentional injuries.
I was expecting a huge drop in the "Influenza and pneumonia" category, but there was not.
I was also expecting a noticeable increase in the suicide category, but there was not.
Unlikely/impossible to kill off all strains. Enough will survive that it will come back, just it will likely take longer to transmit due to greatly-reduced numbers of infected hosts.
Coronavirus: How the common cold can boot out Covid
Think of the cells in your nose, throat and lungs as being like a row of houses. Once a virus gets inside, it can either hold the door open to let in other viruses, or it can nail the door shut and keep its new home to itself.
Influenza is one of the most selfish viruses around, and nearly always infects alone. Others, such as adenoviruses, seem to be more up for a houseshare.
If rhinovirus and Sars-CoV-2 were released at the same time, only rhinovirus is successful. If rhinovirus had a 24-hour head start then Sars-CoV-2 does not get a look in. And even when Sars-CoV-2 had 24-hours to get started, rhinovirus boots it out.
"Sars-CoV-2 never takes off, it is heavily inhibited by rhinovirus," Dr Pablo Murcia told BBC News.
He added: "This is absolutely exciting because if you have a high prevalence of rhinovirus, it could stop new Sars-CoV-2 infections."
It's very much disputed how much 'viral interference' was or is an influence in the current pandemic, and this effect (to my knowledge) has been only studied in animal models and human tissue [1], paper from the article [2].
Or to put it another way, the influenza season was already under way when SARS-Cov-2 hit in Feb 2020, but there is no indication the influenza virus slowed the SARS-Cov-2 pandemic.
The exciting thing about viral interference is that no genetic similarity between the viruses is needed, however, the effect is only temporary (days to weeks) and limited.
Unfortunately viral interference is also being misused as an 'alternative explanation' by folks that do not want to see the evidence that non-pharmacological interventions (hygiene, social distancing, quarantine, masks, large gatherings etc.) are effective against a whole host of respiratory diseases.
It seems possible. Timing would need to be right though so you would probably need to purposely infect that person with the dangerous one at the right time.
> They are lytic in nature and are among the smallest viruses, with diameters of about 30 nanometers. By comparison, other viruses, such as smallpox and vaccinia, are around ten times larger at about 300 nanometers, while flu viruses are around 80–120 nm.
Different virus sizes, different mask effectiveness.
Anecdotally, my kids are in middle school, and every winter we get several colds. None this year.
>Different virus sizes, different mask effectiveness.
Not necessarily - when speaking and otherwise spreading aerosols they start out much larger than any virus particles contained within them and quickly dry out and shrink if in air (i.e. not caught in a mask) [1, 1um - 500um, between Table I & Fig 11].
If they were on their own, the small 'nanoparticle' regime (1-100nm) shows fairly good filtration in a variety of media [1st image in 3] thanks at least in part to the diffusion of particles through filter media. It's not the same by size by any means (with smaller often being the most passed particle size) but it varies with filter construction and treatment [3].
The larger point: You should not "expect" two different classes of viruses to act the same given a specific mitigation, as there can be substantial differences between them.
I mean, if you look at May 2019 vs 2020 for the enterovirus/rhinoviruses on that chart, that's a drop from ~25% to ~3%; September went from 35% to 21%. So it's still a pretty solid decrease. I think it just wasn't nearly eradicated like influenza was because the prevalence is so high.
I got a cold about two weeks ago and I'm only now almost recovered. I work at a hospital so got a COVID test to be safe, even though I'm fully vaccinated. They ran a respiratory panel as well. They called me with the results and I almost had to change my pants because they informed me I had "Coronavirus OC43.... which is essentially the common cold".
Each virus can only interact with certain cells of your body. COVID and influenza interact with lower respiratory cells. You have to inhale a viral load to be infected, or at least this is the consensus belief right now (and is contrary to all of the concern about fomites early on).
Many cold-like viruses infect mucous membranes (you have a number over your body). A glancing touch is enough to be infected.
I'm not sure the source of that chart. The viruses contained in the Coronavirus category aren't even the SARS-CoV-2 that we call COVID. They list 4 strains, all of which are the regular circulating strains of coronavirus. I'd say this is not accurate at all.
This is stupid. Both my wife and I got sick and luckily it wasn't Covid. When we were tested, that's all everyone cared about so I'm sure they didn't mark us as having the flu even though we obviously had something.
Family member had same experience. Classic flu symptoms. No breathing problems. Dr. Wrote down Covid symptoms in his notes which they did not have and had not complained of. They ordered a covid test, which was negative. I actually feel like they got WORSE care than they would have otherwise. The Dr. wasn't even interested in treating anything that wasn't covid, let alone diagnosing it.
Just because you weren’t tested for the flu at your local doctor’s office, that doesn’t mean that the flu isn’t systematically monitored or that infection rates haven’t plummeted.
The headline is hyperbolic (the article says it’s dropped to “minuscule levels”) but it’s entirely possible to determine that by sampling a small portion of the population.
In the meantime, public health measures like masking and distancing will work against both viruses. If people become reluctant to socialize because of covid (whether or not there be legal restrictions), they will also not spread the flu.
As a broad conclusion, if public health measures reduce the effective reproduction number of Covid to about 1 (stabilizing exponential growth), they will also reduce the effective reproduction number of the flu to something substantially below 1. Since the flu would have also had a low baseline prevalence in the summer of 2020, it is no wonder that we failed to see a flu season.
Non virologist naive question, if we apply all these measures targeting SARS-COV2 and it also creates a massive negative pressure on flu viruses, is there a risk that this applies an adaptive pressure to select for a future uber infectious new flu strain?
I don't see any reason to expect it would. Summer months, for example, already apply a strong negative pressure on the flu virus (that is, we have a flu season), yet we have not seen a year-round flu.
Diseases always face selection pressure to spread more easily and rapidly. When that selection pressure is caused by broad factors like "people aren't congregating together," it's hard to imagine how any simple evolution could overcome that barrier.
Covid itself is instructive here. Some of the variants of concern are more transmissible than the originally-distributed variant as of March of last year, but those mutations don't uniquely overcome masks or social distancing. They would have always result in a more transmissible virus (because SARS-CoV-2 appears to be a zoonotic virus not originally perfectly-adapted to humans), and we are seeing them now because each infected person is a new roll of the mutation dice.
Applying that lesson to the flu, the less prevalent the virus the less likely we are to see variations, not more. Alas, for influenza itself we always have the asterisk that we regularly see new variations cross to humans from animal reservoirs, so we're unlikely to eliminate it through only (nonpharmaceutical) human-health measures. (It'd be nice to get a universal flu vaccine, though.)
It's potentially the opposite. Say you have a population of 1000. If one person infects ten others. Then its going to be 3 generations before 1000 are infected and full immunity is reached.
We go for a suppression strategy instead.If 1 person infects 1 other person (as we seem to be trying to achieve with corna) it is going to take 1000 generations before full immunity is achieved. There is going to be far more chance of mutations in 1000 generations of viral replication than in 3 generations.
If everybody has had the disease, what's the purpose of having full immunity?
However, I think this is right in one sense: an implicit or explicit strategy of keeping R0 as close as possible to 1 would be the strategy with the highest risk of significant mutations, as we have seen.
UK government ministers literally stated this to be their strategy.
That is a really interesting thought.
But isn‘t the chance of mutation per viral replication (which happens million-fold in each human per infection) and not per human?
What I meant was that if we contain the virus to only ever get 1% of the population sick then there is a lower chance of mutation than if it gets 70% sick.
Your second paragraph assumes that a suppressed virus will not go extinct. If the suppression is effective, with eg. vaccines it can be done with quickly, with no higher chance of mutations.
Where people weren’t constantly battling the decisions, lockdowns were quite effective. The problem is that without a very strict but short lockdown you will get into this semi-lockdown that is hardly effective and thus just prolongs everything. But the answer never is “just do whatever you want”.
It's unlikely. Most of the major "uber infectious" influenza strains don't emerge via ordinary mutation (antigenic drift) but the reassortment of two viral genomes that have infected the same host (antigenic shift). Given pigs and wild birds aren't social distancing, there's no reason to believe there's a distinctly high amount of additional pressure one way or the other.
Chance of mutation depends mostly on the number of infected —- applying antibiotics is problematic because it is a repeated process, and the net amount of cell divisions is huge with iterating killing and “letting go”. With effective and strict measures, the pandemic could quickly die out with basically minimal chance of a super-mutation.
The current some half of the world somewhat protected, while other parts are breeding grounds is a pretty bad state to be at, with a potential mutation turning up and endangering the protected people as well again.
> This should not come as a surprise, and it was largely predictable from the outset....the flu has a base reproduction number (R0) less than 2....Covid has an R0 in the vicinity of 2.5....In the meantime, public health measures like masking and distancing will work against both viruses....there's really no need for conspiracy theorizing.
Assuming that this is due to "masking and distancing" and the small difference in R0 is crude thinking. It's unlikely to be anything of the sort.
First, R0 is not a fixed constant. It varies by context and location, and we've seen influenza decline everywhere.
Second, R0 is an estimated value. There are big error bars on all of these estimates -- the overlap is far greater than the 0.5 you're using to claim causality.
Third, rhinovirus has not gone away (estimated R0 < 2). Nor has adenovirus (estimated R0 ~2.3) [1,2]
There's something far more interesting going on here, it is surprising, and it isn't a "conspiracy theory" to talk about it. It's science.
(FWIW, my current favored hypothesis is that the closure of schools, and possibly travel, significantly affected the spread of flu. Unlike Covid, kids are a significant vector of spread for influenza. It's one of those little facts about Covid that is...politically incorrect...to acknowledge right now. But I am speculating, and there are problems with this theory as well.)
- More asymptomatic transmission of rhinovirus/enterovirus and adenoviruses than influenza. People often don't notice these illnesses, so wouldn't assume it is COVID and quarantine like they would for influenza.
- More fomite spread than influenza. They may be more stable on surfaces or in food
These are reasonable theories as well. Though the second one would really have to be "SARS-CoV2 has more fomite spread than flu" to explain the observations.
In general though, any sort of explanation that focuses on differences in transmission is more plausible than hand-wavy theories involving R0 and masks. People just desperately want to find evidence that the stuff we did this year made a huge difference.
> People just desperately want to find evidence that the stuff we did this year made a huge difference.
I don't think that's true at all. People have been receptive to the increased evidence that transmission on surfaces is pretty unlikely, for example, despite all the efforts we've put into sanitizing surfaces.
I think most people can appreciate that all the shit we threw at the wall throughout the pandemic eventually comes down to how much effort it is vs how much benefit we get from it. And our understanding of each measure has changed over time. We now know, generally:
Masks indoors are low-effort, medium reward. Masks outdoors are low-effort, low reward.
Cleaning surfaces is medium-effort, low reward.
Staying home is (economically, societally) high-effort, high reward.
To be clear: I'm not making a specific argument about masks vs. sanitizing vs. whatever here.
I'm just saying: responses like the OP immediately leap to the conclusion that influenza went away because of all the stuff we did. It's an error in logic, driven by the emotional desire to believe that the stuff we did must have had a serious impact, and that anything else is not worth serious discussion.
> That said, if the massive reduction in flu cases isn't a result of some or all of our Covid efforts, it'd be a hell of a coincidence.
Mmmm...I wouldn't go that far. Like I said, my current preferred theory involves schools, but other plausible theories involve things like mutual inhibition: infection with one virus somehow interferes with infection by the other.
We have some evidence of this happening in the past. Strains of influenza have abruptly vanished due to this phenomena.
Certainly, I'd agree that this is interesting (which is pretty much where I end up on this, vs. the OP, who thinks the matter is settled.)
more generally, it's likely due to greater (indoor) distancing, of which school closures is a subset. the slight differences in transmission characteristics between flu and covid (also represented as differential r0) likely makes flu relatively more susceptible to reduction by distancing.
and distancing is a first-order mitigation that overwhelms the effects of inferior/ineffective mitigations like cleaning, sanitizing, mask-wearing, extra ventilation, etc. those secondary mitigations can make more of a difference when we want to pack it in, like at a movie theater, but otherwise they don't do much because those circumstances are relatively rare.
folks just don't want to accept such a simple answer because it means there's not much to hang their anxiety on, and that cognitive dissonance is unacceptable, as it always is.
> I'm just saying: responses like the OP immediately leap to the conclusion that influenza went away because of all the stuff we did. It's an error in logic, driven by the emotional desire to believe that the stuff we did must have had a serious impact, and that anything else is not worth serious discussion.
I feel like you're coming down too hard on OP. He makes a valid argument.
> immediately leap to the conclusion that influenza went away because of all the stuff we did
It's not an error in logic. It's a reasonable conclusion to draw based on what we've seen and the links he provided. Whether it's true or not, that's debatable and probably nobody here on HN is going to figure that out definitively.
I'm really not sure why you're so argumentative without actually providing any substantial arguments against OP. It feels more like you're the one arguing from an ideological basis.
2 was published in Feb 2020, so not sure how helpful that is...
1 is not normalized data. It does not account for testing frequency. These percentages are of tests using BioFire. My hospital, for example, does not use BioFire to test for SARS-CoV-2 and so we end up running BioFire much, much less frequently than during a normal year.
Anecdotally non-COVID respiratory infections in hospitalized patients have decreased dramatically. Working on trying to demonstrate this with data.
> 2 was published in Feb 2020, so not sure how helpful that is...
It's a meta-analysis of many other papers. The estimates for the other ILIs have not changed significantly in 2020. Again, this is nitpicking that misses the forest for the trees: the differences in estimated R0 between these viruses is not so precise as to be useful for claiming the effectiveness of something like "masks and distancing".
> 1 is not normalized data. It does not account for testing frequency
This is incorrect. The data is normalized across all samples. Your hospital's non-participation may change the coverage of the sample, but that doesn't really matter when it's just showing you that rhinovirus hasn't gone away.
The FilmArray RP test utilization rate (TUR) metric is defined as the non-normalized number of RP patient test results generated each week across the Trend sites (computed as a centered 3-week moving average). To calculate the pathogen detection rate (as displayed in Figure 2 [second data view] and on the Trend website), we compute the rate for each organism at each institution as a centered 3-week moving average. To adjust for the capacity differences between sites, a national aggregate is calculated as the unweighted average of individual site rates. Only data from sites contributing more than 30 tests per week is included to avoid noise from small numbers of tests. Because the calculation of pathogen detection rate includes results from patients with multiple detections, the detection rate for all organisms can, in theory, add up to greater than one. In practice, this does not occur.
These are rates. This does not account for testing frequency. If they only tested 1 person in the United States tomorrow, and they had rhino/entero, the graph would show 100% (obviously it wouldn't and they won't only test 1 person). That means that if testing decreased, because for example there were less patients with symptomatic viral infections, but the % positive stayed the same, the chart would not appear to change, even though there were fewer cases...
The TUR is not the metric plotted on the website. Read the very next sentence in the section you're quoting:
> To calculate the pathogen detection rate (as displayed in Figure 2 [second data view] and on the Trend website), we compute the rate for each organism at each institution as a centered 3-week moving average. To adjust for the capacity differences between sites, a national aggregate is calculated as the unweighted average of individual site rates. Only data from sites contributing more than 30 tests per week is included to avoid noise from small numbers of tests. Because the calculation of pathogen detection rate includes results from patients with multiple detections, the detection rate for all organisms can, in theory, add up to greater than one. In practice, this does not occur.
The TUR is the the raw number of hits across all sites. They normalize this, which is why they talk about it possibly exceeding 1.0. It's why the Y-axis of the plot is labeled in percentages. The height of the bars is a moving average of detection rates across their network.
Regardless, this is still nitpicking. The point was that these other pathogens have not gone away. They have not. Even if you were right, it wouldn't change the argument.
> and the small difference in R0 is crude thinking.
Given the reproduction number appears as the base of an exponent, I would not consider the difference "small."
If influenza has a typical R0 of about 2, reducing contacts by 50% would make its growth non-exponential. If covid has a typical R0 of about 2.5, doing the same would require a further 20% reduction of contacts, to 40% of baseline rather than 50%. Since population behaviour and legal restrictions have diminishing returns (eliminating casual contacts first at lower cost, then progressively higher-cost and more essential contacts), this could easily correspond to a large difference in effected (necessary) policy.
> Second, R0 is an estimated value. There are big error bars on all of these estimates -- the overlap is far greater than the 0.5 you're using to claim causality.
I have seen no credible evidence that typical (non-pandemic) influenza has an R0 greater than that of SARS-CoV-2. If you have a citation handy to the contrary, I'd be interested in seeing it. In the meantime, I tried to be generous in my estimation of influenza's R0; even your reference [2] places its central estimate at 1.68.
> Third, rhinovirus has not gone away (estimated R0 < 2). Nor has adenovirus (estimated R0 ~2.3) [1,2]
Rhinovirus and adenovirus both have mean-estimate R0 greater than that of influenza in your reference [2], so if policy is going to eliminate any of these disease from general circulation then influenza would be the first.
Furthermore, some analysis does show limited evidence of a reduction of rhinovirus cases (https://www.nature.com/articles/d41586-020-03519-3). A confounding factor here, however, is that we don't really have comprehensive like-against-like monitoring for rhinovirus in the way developed nations monitor for influenza. Adenoviruses as a broad category are also not limited to respiratory transmission, so air-focused restrictions would have less effect on these other routes.
Finally, I reiterate that flu has a pronounced seasonal variation, whereas rhinovirus is somewhat less variable. A set of social responses only needs to prevent the flu season from starting to make it "disappear."
> Given the reproduction number appears as the base of an exponent, I would not consider the difference "small."
The difference in measurement is small, relative to the error in measurement.
Look at the error bars on the R0 estimates in that paper. Influenza runs from 1.06 to 3.4. You are trying to make micrometer inferences from a parameter where our best estimates are measured in libraries of congress.
I'm not a clinician or public health policymaker, so I'm operating on the balance of probabilities rather than a p=0.05 standard.
If you consider the influenza estimate independent of equivalent estimates for covid, then there's a substantially greater than 50% chance that influenza's R0 is meaningfully smaller than that of the flu. If the estimates are partially dependent (i.e. methodology that gives a larger estimate for influenza would also give a larger estimate for covid), then that chance goes up further.
Moreover, we also have evidence in the actual observations of epidemic dynamics. Over the southern hemisphere fall of 2020 (northern hemisphere spring), covid cases increased more rapidly than influenza cases in countries that were entering their flu seasons. That's compelling-to-me evidence that covid in fact has a larger basic reproductive number, whether that be due to a fundamental difference in the virus or just the effects of low baseline immunity.
Now, your idea that the particular set of policy restrictions may be more effective against influenza than covid is very interesting. There's a basic horse sense to it, as well, since policymakers were largely operating from a playbook written for a flu pandemic. However, I do not think that "more effective" is a necessary component of the argument; "at least as effective" will do just as well given influenza's low baseline prevalence (out of season).
Remember, my original point upthread was not to explain every bit of the relative epidemic curves, but instead to claim that we really ought not be surprised by the difference. I see little need to resort to specialized theories to explain the broad outline, even though I'm sure they will be helpful in the details.
> we also have evidence in the actual observations of epidemic dynamics. Over the southern hemisphere fall of 2020 (northern hemisphere spring), covid cases increased more rapidly than influenza cases in countries that were entering their flu seasons. That's compelling-to-me evidence that covid in fact has a larger basic reproductive number
Yes, we know that SARS-CoV2 increased, and influenza went away. That's trivially observed. We don't know why flu went away.
To turn that observation around and say "Covid grew faster than flu, and therefore it has a higher R0, and therefore, the flu went away because {insert your favorite NPI} was just good enough to stop it" is begging the question.
It could just as easily be any number of other factors that you're not accounting for. There's also a number of other faulty assumptions inherent in your logic. For starters: there's no particular reason, a priori, that a person couldn't have both flu and SARS-CoV2 in the same year.
> I have seen no credible evidence that typical (non-pandemic) influenza has an R0 greater than that of SARS-CoV-2. If you have a citation handy to the contrary, I'd be interested in seeing it.
Even if the difference in R of influenza and SARS-Cov-2 was only 0.1 (and there is no evidence suggesting the average difference is that small) and assuming both pathogens spread in a similar fashion [1], then over time SARS-Cov-2 will fluctuate around the meta-stable point of 1.0 and as a result influenza will decrease exponentially.
I am not dodging it. As the parent noted in their own post, the best mean estimates we have for SARS-CoV2 are a fraction of a unit away from the best mean estimates we have for influenza or rhinovirus.
Trying to use this tiny relative difference in fuzzy estimates of empirical parameters to make a complex causal arguments about...well, anything...is folly.
Sorry to be harsh here, but that's exactly what I meant by dodging: Parent asked for evidence that the R0 of influenza is higher on average than the R0 of SARS-Cov-2.
If there are no studies to show, refer to an opinion of an epidemiologist or any other expert in the spread of infectious diseases.
You seem to argue against a vast field of computer scientists, mathematicians, physicists, biologists, medical experts that do nothing else but study the spread of infectious diseases.
> Sorry to be harsh here, but that's exactly what I meant by dodging: Parent asked for evidence that the R0 of influenza is higher on average than the R0 of SARS-Cov-2.
Burden is on the parent to prove their claim, not for me to disprove claims advanced without evidence.
All current estimates for R0 have wide, overlapping confidence intervals that make it impossible to differentiate them from other viruses. The best anyone can say is that Covid and influenza have similar mean R0 estimates.
> If there are no studies to show, refer to an opinion of an epidemiologist or any other expert in the spread of infectious diseases.
> Burden is on the parent to prove their claim, not for me to disprove claims advanced without evidence.
Multiple people have cited many papers that all generally agree with the trend that influenza has a lower r0. You've discounted those by making what are ultimately statistically unsound claims.
> I cited just such a paper. Please refer to it
The paper you cited supports the other person's contention: that r0 of influenza is lower than that of covid.
> The paper you cited supports the other person's contention: that r0 of influenza is lower than that of covid.
As "the other person[1]," I'd like to point out for the sake of accuracy that the paper you mention here does not in fact study covid. While published in February 2020, the "SARS-CoV" it talks about was SARS 1, not the virus behind the current pandemic.
[1] -- Who is also leaving the argument. We've both made our points well enough for others to form their opinion, and I don't think there's much unexplored territory.
Last spring COVID was managing to achieve rapid spread at the same time that the flu season naturally ended. Despite the challenges in measuring R0 for both, this is pretty direct evidence that R0 is higher for COVID than for the flu.
R0 is not static. As people become immune to the current strains and the virus mutates, people will still have partial immunity to the new strains. Some people will be fully immune depending on their antibody response and the mutations.
Next year it is entirely possible that the R0 of covid drops below influenza.
If you introduced influenza to a naive population (i.e. native americans) you would get massive death.
<<Experts believe that as much as 90 percent of the American Indian population may have died from illnesses introduced to America by Europeans>>
Europeans did bring back disease they weren't immune to:
Europeans brought deadly viruses and bacteria, such as smallpox, measles, urope. Europeans brought deadly viruses and bacteria, such as smallpox, measles,
typhus, and cholera, for which Native Americans had no immunity (Denevan, 1976). yphus, and cholera, for which Native Americans had no immunity (Denevan, 1976).
On their return home, European sailors brought syphilis to Europe. Although less n their return home, European sailors brought syphilis to Europe. Although less
deadly, the disease was known to have caused great social disruption throughout eadly, the disease was known to have caused great social disruption throughout
the Old World (Sherman, 2007)
It is one of the major points from Guns, Germs and Steel. Most of our major diseases have transferred from domestic animals. For example both measles and smallpox (the two most deadly diseases for Native Americans) come from cows.
Europeans successfully domesticated animals, Native Americans did not. So Europeans had diseases that Native Americans were not adapted to.
I believe the theory is that Europeans kept various domesticated animals and Native Americans had far fewer, and that those animals were frequently sources of new diseases. Europe was also more interconnected, so diseases may have spread farther while Native diseases died out.
Small but important correction: nothing can make epidemiological spread non-exponential. Driving base reproduction below one additional infection per infected patient means the exponent is less than one, so the incidence of the disease rapidly decreases. This decrease is also exponential by definition: infection is simply an exponential process, and an exponential equation doesn't stop being what it is when the exponent is less than one.
The steady state is exactly 1, which is like balancing a pencil on its point.
It's plausible that two things happened here: the various local restrictions reduced the R0 of flu below 1, and the border closures kept mutations from traveling: and influenza is notoriously mutation-prone.
These can combine to practically extirpate influenza. Unfortunately, the effect is temporary, and the next flu season is likely to be a real doozy.
Which will be "fun" because our societies now have a hyperactive immune system, and there will be considerable political pressure to "do something" about the next flu wave. This must be resisted but I'm not optimistic.
> The steady state is exactly 1, which is like balancing a pencil on its point.
At exactly one, it's indeterminate; you could see a subexponential growth or decay. With no exponential terms remaining, lower-order terms that are ordinarily hidden by exponential growth become the dominant observables. (Since epidemic spread is also random, you're much more likely to see the stochastic terms show up in the overall statistics in these cases. You really can be lucky or unlucky with Rt ~= 1, but there's no persistent luck with Rt >> 1.)
This is also important before community spreading sets in, and it is the mechanism by which contact tracing can work. Rather than change the general susceptibility of the population to the disease (changing the effective reproduction number), contact tracing tries to operate at the level of individual cases in ways that cannot be scaled to uncontrolled community spreading (even if Rt is close to 1).
> and the border closures kept mutations from traveling: and influenza is notoriously mutation-prone.
Perhaps, but are influenza mutations an important effect within a single flu season? I know the determination of to-be-dominant strains has a great effect on the composition of each season's flu vaccine, but as far as I am aware we don't see declining flu vaccine efficacy over a season.
By the way, now that we are already talking about R ~= 1 ...
Over pretty much the last year you could observe, in different countries all around the world, that the reproduction number was 'magically' floating around 1.
Only recently did I learn that this effect was puzzling for epidemiologists as well and was only solved around 2012 (?) in a model that assumes a network of information about the disease in parallel to the network of disease transmission. The resulting feedback loops lead to the meta-stability of R=1. Super interesting how society acts as this distributed information processor, similar to 'the market' in economics.
A well-known Norwegian economic commentator pointed this out in a newspaper article a few weeks ago. You'll eventually be forced to maintain an R~=1 no matter what you do, so it's best for everyone if your cases have a low baseline when that happens. The measures will be the same, but the baseline risk can either be terrible or okay.
You can almost see the phenomenon in real time during this pandemic. Countries that have low trust in authorities will still freak out when the epidemic hits biblical proportions, and do various forms of impromptu distancing measures which will bring the R number down. Then when the signs of panic subside, they'll loosen them. And so on.
Societies with high trust in authorities will still pressure their authorities to loosen up when things feel safe, with predictible results, leading to further lockdowns.
The economic deviation caused by governments over reacting is your biggest pressure. Unless you shut down all travel, bars, restaurants, schools, universities and dating.
Then all of this will come back in the future and kick you in the teeth. Either we're going to have to accept this as a way of life, which is more detrimental. Or we're pushing off the inevitable.
No one has overreacted, unless you accept an outcome that both leads to improvised individual social distancing and the even worse worse economic devastation that follows.
This was uncertain to most people last year, but now we’ve seen so many examples that it really shouldn’t be so controversial any longer. But if it wasn’t, we wouldn’t be discussing it.
The covid virus is evolved to fit exactly into the niche of societal behavior where it will be a big fucking problem but not so bad that it’s immediately obvious to enough people.
We're not talking about a single flu season, effectively we're talking about skipping an entire flu season.
Influenza is pretty promiscuous. In normal conditions, very few people aren't exposed to it: either their existing immune resistance (vaccinated or otherwise) is up to the job, or it isn't.
Mutation is therefore the primary driver of flu, year upon year. This is why vaccines are continually reformulated for a best-guess at what strains are going to be dominant.
We had just concluded a northern-hemisphere flu season when travel restrictions started to kick in. This was followed by at least a 90% reduction in international travel, and for most of what remained, it was mandated that new arrivals isolate for long enough to eliminate any influenza they might have carried.
Lockdowns would mean less mutation to begin with, since it happens in human hosts. And such mutations as did present are going to have a tough time jumping oceans, and even when they do arrive, spreading through the populace is substantially inhibited.
Ironically, the universal mask mandates are likely to be more effective against flu than against COVID. Like it or not, masking has minimal effect on spreading aerosols, although using a "real" mask, and being pretty careful to wear it right, can mitigate inhaling those aerosols.
Influenza is believed to be spreadable through aerosols, but the primary vector is droplets, while the opposite appears to be true for SARS2. Bog-standard cloth masks are fairly good at keeping droplets off people and surfaces.
People don't inhale 1 or 0 covid particles they inhale n particles where reducing the value of n makes transmission less likely. Keeping more of your spit to yourself reduces chance of transmission even if masks are imperfect.
> The overwhelming majority of transmission of SARS-CoV-2 is via large respiratory droplets as conclusively demonstrated by contact tracing studies, cluster investigations, the lack of infection spread in hospital settings with universal masking protocols and the low estimated R.
> The principal mode by which people are infected with SARS-CoV-2 (the virus that causes COVID-19) is through exposure to respiratory droplets carrying infectious virus.
From what I can tell, you may have your flu/covid mixed up. Covid is spread through respiratory droplets, the spread of which is reduced by wearing a mask.
Both those sources may be out of date now (July and October). While there is limited experimental evidence for airborne transmission except in animals, there is even less evidence for fomite & respiratory droplet transmission.
The claim that "lack of infection spread in hospital settings" rules out airborne transmission due to masking is also questionable. The opposite seems true. As I understand it, infections in hospital settings have been routinely documented throughout the pandemic despite masking, contact protocols, etc. - which implicates airborne rather than droplet/fomite transmission.
This is a really good article in the Lancet recently which solidified my opinion on this. It offers 10 items of evidence for airborne transmission being the primary driver of the pandemic.
> Second, long-range transmission of SARS-CoV-2 between people in adjacent rooms but never in each other's presence has been documented in quarantine hotels.7
> Sixth, viable SARS-CoV-2 has been detected in the air. In laboratory experiments, SARS-CoV-2 stayed infectious in the air for up to 3 h with a half-life of 1·1 h.12 Viable SARS-CoV-2 was identified in air samples from rooms occupied by COVID-19 patients in the absence of aerosol-generating health-care procedures13 and in air samples from an infected person's car.14 Although other studies have failed to capture viable SARS-CoV-2 in air samples, this is to be expected. Sampling of airborne virus is technically challenging for several reasons, including limited effectiveness of some sampling methods for collecting fine particles, viral dehydration during collection, viral damage due to impact forces (leading to loss of viability), reaerosolisation of virus during collection, and viral retention in the sampling equipment.3 Measles and tuberculosis, two primarily airborne diseases, have never been cultivated from room air.15
> Seventh, SARS-CoV-2 has been identified in air filters and building ducts in hospitals with COVID-19 patients; such locations could be reached only by aerosols.16
> Eighth, studies involving infected caged animals that were connected to separately caged uninfected animals via an air duct have shown transmission of SARS-CoV-2 that can be adequately explained only by aerosols.17
> Tenth, there is limited evidence to support other dominant routes of transmission—ie, respiratory droplet or fomite.9, 24 Ease of infection between people in close proximity to each other has been cited as proof of respiratory droplet transmission of SARS-CoV-2. However, close-proximity transmission in most cases along with distant infection for a few when sharing air is more likely to be explained by dilution of exhaled aerosols with distance from an infected person.9 The flawed assumption that transmission through close proximity implies large respiratory droplets or fomites was historically used for decades to deny the airborne transmission of tuberculosis and measles.
>> there will be considerable political pressure to "do something" about the next flu wave. This must be resisted
Why on earth does it make sense to resist sensible public health measures to reduce the influenza to R0<1?
The measures would not need to be nearly as drastic as those for COVID ("normal" R0 of 2 vs 2.5+), so more handwashing (good to minimize a broad spectrum of pathogens), masks (already culturally ordinary in many countries), and especially better indoor ventilation systems would be a long-term benefit to everyone.
I'm mostly hoping that the success of better sequencing, mRNA vaccine technology, and the rapid development deployed for CV-19 will also be applicable to influenza and help minimize or practically eliminate it.
"so more handwashing (good to minimize a broad spectrum of pathogens), masks (already culturally ordinary in many countries), and especially better indoor ventilation systems"
Let's not forget a substantial portion of the population working from home, using less public transportation (choosing to travel by car when traveling at all), a huge decrease in tourism and large public gatherings, much less eating out at restaurants, contactless food delivery becoming the norm, etc.
So many factors figure in to why much of the (wealthy, developed) world is a lot more resistant to contagious pathogens today than it was a year ago.
Politicians have shown themselves throughout this pandemic to be opportunistic authoritarians who obviously don't believe in their mandates since they break them themselves so frequently. There's no reason to expect that these sociopaths won't jump at the opportunity to drink more from the fountain of power again given the chance. Since they've gotten away with so much this time, they might even be tempted to go even further next time.
If anything, politicians have vastly under-managed the situation, timidly afraid of offending constituents' offense at any inconvenience, and only partially at best following sound science.
In states that did issue orders for masks and stay-at-home, the orders were weak, late, and lifted early, resulting in multiple waves that only abate now because of the rapid deployment of vaccines.
Most importantly, there was very little and late funding to cover the costs of those who should most have been shut down, group travel, entertainment, dining, etc. - should have been fully shut down immediately, and everyone's costs covered.
6-10 weeks of hard shutdown, while standing up a full masking, test/trace/isolate protocol would have handled it, yet few countries did it.
A few countries did implement early, strong, and effective measures, such as New Zealand. They also then opened up many months earlier than the rest of the world with near-normal life.
Where are the politicians "drunk with power" who are restarting lockdowns for their own gratification?
Where is the advantage for such a "drunk on power" politician? What could they possible gain by unnecessarily implementing measures that are seen at best by the smart ones who understand it as a necessary inconvenience, and by the rest as an assault on them?
Even flat-out authoritarians do no such thing. E.g., China, who is unashamed to run literal concentration camps for Uyghur minorities, and who did hard lockdowns at the start, is not opening up as soon as scientifically feasible.
Unless you can show some citations of evidence, this looks a lot less like a real phenomenon, and more like a pseudo-libertarian teenager's trope.
This is basically a fantasy. Public health measures that restrict freedom are unpopular even when they are justified. More than anything else your least favorite lawmaker wants to remain employed and to do so they will eventually bow to the will of the people even when the people are ignorant.
Public health measures that you disdain aren't popular where they are because your neighbors want to step on your neck they are popular because people who know more than you do know they on net save lives.
When there is nothing to be gained by such measure support will blow away like dust in the wind. There is no battle for you to fight.
Those measures are not entirely different from the measures previously suggested, though.
Obviously your quoted poster’s concerns are less about “hand washing”, “wear a mask if you have symptoms”, and “stay home” while you recover, and instead are about an overreaction in which entire businesses are forced to shut down, children without symptoms are forced to wear masks even as they run and play, and people are forcibly prevented from leaving their homes “just because it’s flu season”.
This may be necessary, at times, for COVID-19, but as you recognized, not for the normal flu.
Given the spotty record of both public and private policy with regards to using actual science as a driver, these are not invalid concerns.
Or put differently, rather than presuming that anyone against “doing something” is against “common sense” measures, perhaps we should be supportive of making sure that we do something, AND that the “something” that we do remain in the realm of common sense, to assuage the very real concerns that “doing something” could mean something more harmful than good.
The normal flu can be pretty bad. In 2018 the spike in total deaths in TX and surrounding states were between a third and a half of the covid spike in those regions. Masks might have been a good idea in 2018 and I hope they become part of our culture at least when you think you might be coming down with something. You know, that first day of a cold when you are telling yourself its allergies or drainage. Shutting down stores makes less sense.
How about a culture and social support system where you can just stay home and rest if you feel something's up? Probably a lot more efficient than a mask, and would probably help with lots of other problems as well.
Plenty of people, hourly, gig, and self-employed people don’t get paid if they don’t work. You might be able to force some of those to be paid while sick-not-working, but the last category will be very difficult to address without either missing a lot of folks or creating tons of fraud and grift risk (and represent a lot of interactions with the public).
I think this goes under culture and social support system. Perhaps worth a thought that giving more support for everybody can help everybody. This interaction is quite apparent in e.g. epidemics, but probably has similar effects for many phenomena.
Of course it falls into the category of social support system, but what the specific design choices are matter in terms of driving behavior.
If I (salaried) take a sick day, I get paid the same amount from the same source; there’s next-to-no economic incentive for me to risk the health of others by working when sick: problem is solved.
We could more or less force the same by law for scheduled hourly workers. It’s a little more difficult for gig. It’s basically impossible (as I see it) to put self-employed people at the same outcome as if they worked without substantial risks of under-comping some and over-comping others.
But sometimes it is allergies, and you feel fine and want to get some work done. Masks aren't a big deal, I forget I have mine on, and I wear it all day. Maybe some people have more difficulty? If I vwas in construction or something more physical vthan typing I might vfeel differently.
People who are subject to allergies know they are so and allergies doesn't cause most of the same symptoms. You could probably differentiate most cases of sickness by simply taking your temperature.
I think only 1 in 6 or 7 are allergic to anything if you mean seasonal allergies to pollen what most people seem to mean when they say they feel poorly from allergies its only half as prevalent.
That is to say most people don't have allergies to confuse with illness and although you might wake up feeling poorly for a number of reasons flu sufferers are liable to suffer from one or more distinguishable symptoms for example for myself when I've contracted the flu I always get a really shitty body ache.
It's possible to get a cold without also having a fever. You are absolutely correct about that but even in that instance the majority are liable to be able to know when they are ill. They just don't stay home because the social pressure has been in favor of bringing your sickness to work as if you were doing everyone a favor by showing up and making your cohorts sick.
7.8% of Adults suffer from hay fever. *1 Around 50 million out of around 330 or about 15% suffer from any sort of allergies according to the AAAAI *2 which references data from the CDC
1 Hay fever, or allergic rhinitis, is a common condition with symptoms similar to those of a cold. There may be sneezing, congestion, runny nose, and sinus pressure. It is caused by an allergic response to airborne substances, such as pollen.
2 The American Academy of Allergy, Asthma & Immunology (AAAAI) is the most prominent membership organization of more than 7,000 allergists / immunologists (in the United States, Canada and 72 other countries) and patients' trusted resource for allergies, asthma and immune deficiency disorders. This membership includes allergist / immunologists, other medical specialists, allied health and related healthcare professionals—all with a special interest in the research and treatment of allergic and immunologic diseases.
WebMD's doesn't actually seem to actually source their data at all despite styling it like a link for some reason and since their is a disparity between what the CDC and AAAAI say I strongly suspect they are full of shit
I only think I have very occasional allergies by observing my health during the pandemic. I have no clue what it's from. I just assumed they were colds before, though I certainly had less illness of any kind this last year.
Depends on what you want to achieve. If you like a increase of infection, you do it like here in germany and close down hardware stores etc. multiple times on short notice, without telling when they will open again - so people try to storm them before they close, all coming closely together by doing so, which they would not have otherwise.
This particular type of unintended consequence has been repeated multiple times during the crisis, it's puzzling.
For example here in order to avoid contamination in public transports they limited the hours of service. Consequence: same number of people took transport but in less time, increasing density and contact.
Similarly with the curfew forcing shops to close earlier in the day, more people gather in less time.
We will be lucky if we can normalize washing your hands more and staying home when you are sick. The idea that we are going to react to flu with fanatical zeal and need to prepare to resist public health measures is a fantasy promoted by those who are preparing to fight a war that exists only in their own heads.
We've had, in the past year, at various times, public policies that have prevented grocery stores from selling "non-essential" items such as towels and blankets (while allowing alcohol), halted critical health services such as cancer treatments, and led to people from the same household being verbally and physically assaulted for not distancing or wearing masks - after a period of time in which people were verbally chastised for wearing masks when the official stance was not to.
We've sorted a lot of this out over the past year, but there is an all time distrust of institutions surrounding both policymakers and the public health recommendations informing them, and there's a reason for it.
We can either help assuage people's fears (whether you see them as founded or unfounded) by empathizing with their concerns and experiences and addressing them while ensuring that any measures enacted remain rooted in science that we can trust...
OR we can be part of the problem for why there's so much distrust, by ignoring anyone who may have real experiences that have caused them to lose trust in our science and health institutions, and telling them that it's all in their head.
OR we can shutdown social media. A lot of the misinformation has been spread through social media - it has a tendency to amplify extremism by providing 'echo chambers' people can select into to reinforce their preconceptions.
At a super fundamental level, epidemics take place on a social graph. In a well connected graph spread will be exponential, but depending on graph shape it could be something else.
In particular you could imagine that if people never venture outside their own block that the social network is an euclidean graph. In an ideal case where people are evenly spaced in the plane and only interact with neighbors, the disease would spread as a circle expanding outwards, so total infections would be proportional to ~ t^2, and current infections ~ t.
I'm perplexed as well. That the perfect mixing models most people think of for infectious diseases are an imperfect approximation of the actual dynamics on a graph is well known in epidemiology.
>>Small but important correction: nothing can make epidemiological spread non-exponential.
“Exponential with R varying over time” and “not exponential” differ only in interpretation imposed by an observer.
> infection is simply an exponential process
No, in the hyperidealized perfect mixing scenario, its a logistic process, like most other resource constrained processed that look exponential when analyzed over a dhort period.
In the real world, its neither exponential nor even perfectly logistic, even before considering changes to the environment in which the disease spreads (including those induced by the disease, including people’s response to knowledge of it.)
> Which will be "fun" because our societies now have a hyperactive immune system, and there will be considerable political pressure to "do something" about the next flu wave.
So, do something by taking a flu vaccine like is already available and recommended for annual use by the CDC?
The flu vaccine isn't hugely effective at the best of times, and with flu disappearing worldwide and global travel locked down I don't see how they'll even be able to figure out what strains to target for the next one.
Flu causes fever, which is one of the signs of covid, causing people to isolate. Whereas colds like the rhinovirus have different symptoms and are less likely to cause fever and so they 'fly under the radar' as it were.
Most of the Europe didn't close schools either or very short periods when numbers where out of the roof. School closure is American teachers union thing really, vast majority of the countries do whatever possible to send kids to school as it takes the priority above everything.
For clarity: are you genuinely claiming that you believe school closures prevent influenza transmission but that you think other related mitigation strategies like mask-wearing, restaurant closures, work-from-home, etc... don't?
Did we even test for the flu? Or did we just presume that flu cases were COIVD because the symptoms are so similar?
The idea that the flu just 'disappeared' despite world trade continuing just sets off my bullshit detectors. Between all the countries that did little or nothing initially, and the people who refused to wear masks and didn't lock down...there's just no way it dropped to zero. Less? Sure. But gone? I simply don't believe it.
Yes, everyone with ILI symptoms (influenza-like-illness) who goes to one of the clinics or hospitals participating in the surveillance program gets tested for about 30 pathogens. That's how we know what's going on with all those critters.
None of that has changed in the era of COVID, although the pattern of who goes to clinic for what may have. If there were flu out there we'd be detecting it is the bottom line.
The WHO has the FluNET program and they constantly test a fixed set of people with respiratory symptoms for flu, all around the world.
FluNET is precisely why we know flu dropped so much, and hence the large chunk of people with respiratory symptoms have been COVID-19 or otherwise, but certainly not flu.
Yes. They didn't just stop testing for flu when someone shows up with influenza-like illness (i.e. flu, covid). Maybe in some places where medical systems were already struggling in normal times, but not in developed nations certainly.
Indeed, most flu patients don’t even see a doctor.
So, at the outset, the flu stats are coming from a very specific category of patients: in-patients and people with great insurance who have the time and money to get tested for the flu (even though it won’t make a bit of difference what the test says as it’ll be over in a couple weeks anyway.)
This second-category may be skewing things.
The personality-type that has a ‘need’ to know whether they have the flu was instead focused on Covid. They’d have the sniffles, go through a drive-through Covid testing site, get their negative result and breathe a sigh of relief. They would NOT however make an appointment with their doctor as they perhaps would have in years past as (a) they wanted to avoid sources of Covid, and (b) the doctors were discouraging appointments but for emergencies (and flu-like symptoms plus a negative Covid test, would not, in the patient’s mind, amount to an emergency.)
I doubt this explains all of the decrease in flu-positive tests. But, perhaps some of it.
> Unlike Covid, kids are a significant vector of spread for influenza
Kids are significant spreaders of both influenza and Covid (after school reopenings, in many countries kids become one of the top sources of inter-household Covid spread). They just tend to have mild or absent Covid symptoms and didn’t require regular testing for work etc., and therefore did not get consistently tested in most parts of the world. In some places parents deliberately avoided testing their kids for fear positive tests would interfere with their in-person schooling or extracurricular activities.
Repeated claims that kids don’t spread Covid were politically motivated and based largely on junk science.
Admittedly doing good studies was extremely difficult in places like the USA where spread was wildly out of control and contact tracing was completely overwhelmed.
The study isolated SARS-CoV-2 samples from every positive case, sequenced genome of virus, and tracked the mutation patterns. So, that will avoid a lot of the errors that improper qPCR usage can result in.
First things first, age and viral susceptibility:
> Of the 564 children under the age of 10 years in the targeted testing group, 38 (6.7%) tested positive, in contrast to positive test result in 1183 of 8635 persons who were 10 years of age or older (13.7%). In analyses involving participants up to 20 years of age, we observed a gradual increase with older age in the percentage who tested positive (Fig. S5).
> Children under 10 are less likely to get infected than adults and if they get infected, they are less likely to get seriously ill. What is interesting is that even if children do get infected, they are less likely to transmit the disease to others than adults. We have not found a single instance of a child infecting parents.
> There is an amazing diversity in the way in which we react to the virus.
---
(I recognize I only presented one study here - there's only so much time in the day :P - but the other high-quality studies I've seen confirm this. Mechanistically it makes sense if you look at the enormous T-cell cross-reactivity in those age groups. And BTW, data on school closures for Influenza (which children seem to transmit much more readily) showed that school closures were ineffective anyway because they would just spread it more outside of school)
Interesting that this was getting downvoted. Obviously relates to what the poster above was saying about it being "politically incorrect."
We may disagree on what the science implies, but downvoting someone for sharing research means that people are refusing to listen to anything that disagrees with their preconceived notions.
(I guess perhaps the implicit assumption is that anyone pushing articles that show that kids are at less risk, or that kids don't spread Covid as well, must also be pushing for all kids to be running free and socializing?)
Edit: And now this comment is getting downvoted. Folks who disagree, why not speak up about what's wrong with the study, instead of just downvoting?
To be fair, that implicit assumption is pretty strong. There is an absurd bias to push kids back in schools so parents can get back to work.
Still, your points stand that there are some good studies showing kids are not necessarily the major spreaders. It is somewhat surprising to me, but it is data.
There is an absurd bias to push kids back in schools so parents can get back to work.
Why is that absurd? Millions of Americans (mostly women) have had to work less or leave their jobs entirely in order to take care of their children, which is a major hit to both their finances and careers. It's a huge cost.
It is somewhat surprising to me
It shouldn't be if the media had been doing their jobs, but due to either incompetence or bias they haven't. People really don't seem to realize that schools have been open in large parts of the US (and many other countries) for months, and it hasn't led to mass infections of students or teachers or parents.
I'm far enough on the liberal end that a living income makes sense to me. Raising your kids is a job. And it is of value to society that one can do that well. Juggling low paying jobs is not beneficial.
As a parent of a 6 year old and 8 year old, I'm thankful for this cutoff. Many studies define child as <= 18 or < 20, and I'm not sure how relevant they are for our particular situation.
I think it’s entirely reasonable to believe that individual kids are more resistant to spreading COVID, but closing schools is a powerful intervention. Schools have _lots_ of kids in them, in close proximity, and _every_ child lives in a household with at least one, but on average more than one, other person.
This is not the only study implying closing schools was a sensible step:
I'm going to lift one part of your quoted material, because this should get more eyeballs:
> We have not found a single instance of a child infecting parents.
That is a really strong claim. It also goes against common logic.
Children are more likely to be asymptomatic. Fine. They tend to resist the virus better, and avoid severe cases even when they do get it. Yup, all good so far. They are less likely to infect others around them. Still makes sense.[ß]
What doesn't make sense is that transmission probabilities in the list are all above zero. From a purely mathematical perspective, transmission probability of "infected child -> parent" should not be zero. I am not stupid enough to dispute scientific finds, but I strongly suspect there are more factors in play.
Also the cynic in me notes that "infected child -> parent" is NOT the same as "infected child -> adult".
ß: Recent news indicates that the latest variants do spread more aggressively among children and teens, and are more likely to show up with symptoms in them. I haven't seen anything about increased mortality among the same groups, though.
It should be an internet rule that whenever someone calls something scientific or trashing something as poor science, they should provide scientific references. I'm referring to you here.
This makes sense. I've always caught a flu or cold in the tube or in the office, usually from an infected parent. Last year many parents were enjoying a flu-less life while the schools were closed, only to catch it again a week after opening the schools again. I don't have kids, so last year, for the first time in my life, I didn't spend a single day sick.
I live in a country where schools have stayed open and our 2 kids have been going to daycare normally throughout the whole pandemic.
Our kids have also been eerily free of colds/flus this winter, after the previous winter where it seemed like they had fevers weekly and so much snot they'd choke on it while asleep.
I live in Europe and never experienced such a thing. Perhaps to be more specific: I grew up in Spain and now live in the UK. To the best of my knowledge, children keep catching the flu every year and passing it on to their parents, who instead pass it on to their colleagues in the office (or used to, before 2020).
> This should not come as a surprise, and it was largely predictable from the outset....the flu has a base reproduction number
I feel like you constructed a straw man by snipping this out from the parent comment:
> work against both viruses. If people become reluctant to socialize because of covid (whether or not there be legal restrictions), they will also not spread the flu.
You can socialize from 6 feet and with a mask. I took the parent to include staying home in their assessment and I have no clue why anyone would think otherwise. It's peak social distancing.
From the CDCs tips for social distancing:
> Choose Safe Social Activities: It is possible to stay socially connected with friends and family who don’t live in your home by calling, using video chat, or staying connected through social media.
>FWIW, my current favored hypothesis is that the closure of schools, and possibly travel, significantly affected the spread of flu. Unlike Covid, kids are a significant vector of spread for influenza. It's one of those little facts about Covid that is...politically incorrect...to acknowledge right now.
You say "unlike covid". Maybe I'm biased because half of my family was infected with covid by a 6 year old(everyone's fine now) . Also here in Poland all 3 of our covid "waves" came few weeks after kids went back to schools (no masks are required at schools here, because feelings). It is obvious kids at schools are a very significant spread factor second only to spread at the workplace (also no need for masks at the workplace for some stupid reason unless you are public facing).
It is infuriating that tens of thousands of people have to die, because idiot politicians make policy based on stupid factors. For example, it would be inconvenient for everyone at workplaces to have to wear masks so let's tell them to ensure desks are 1.5m apart and everything is fine despite the fact they are not. There was even a local study done recently that estimated 40% of all covid cases were infected at the workplace. This info was major news for few days, then nothing changed and everyone forgot about it.
Also, the pinnacle of stupid (bordering on malice - hopefully it will be prosecuted eventually) is making covid treatment policy based on expected drug availability not on what works. It has been proved recently(9th of April) in Lancet corticosteroids given early on lower the incidence of hospitalisation a lot. However, despite many letters from the public "official medical guidelines" in PL still say the exact opposite using an irrelevant study as justification.
* The study is irrelevant because they measured efficacy of those steroids on people that are already hospitalised,it found no impact on death rate of already intubated people. The study authors also extrapolated their research of hospitalised intubated people to people pre-hospitalisation and for some reason wrote in their abstract corticosteroids given early actually have detrimental effect (no proof of this assumption in their study whatsoever).
Then the second study comes out that measures efficacy of (inhaled) corticosteroids in real early covid patients.It finds it significantly lowers development of symptoms that require hospitalisation. Everyone ignores it. Meanwhile we have over 80 thousand "extra" deaths in a country one tenth the size of US.
Oh, and my claim is that people making decisions on covid policy are perfectly aware of their wrongdoing because transcripts of their meetings are mysteriously unavailable.
It's conspiracy theory by definition if it falls outside the official narrative. So even science can be a conspiracy theory.
In fact, real science has a tendency to be viewed (by non-scientists, it should go without saying) as conspiracy theory insofar as it challenges the official narrative, and invokes complicated explanations, rather than a nice simple answer.
No, a conspiracy theory "by definition" requires collaboration between several human agents.
In this overall thread, the idea that the "disappearance" of flu is driven by political desire to label all respiratory illnesses as covid cases would be an example of a conspiracy theory.
Another commenter brings up the idea of 'viral interference.' This is not an example of a conspiracy theory, but I do not give the idea great credence on Occam's Razor grounds.
While I may personally agree the viral interference comment is not (in my definition) a conspiracy theory, it is regarded as a conspiracy theory in many (again, non-scientific) contexts.
The conspiracy is not the collaboration, it is the belief.
> the idea that the "disappearance" of flu is driven by political desire to label all respiratory illnesses as covid cases would be an example of a conspiracy theory.
You’d also have to claim that mislabelling was done deliberately for it to be conspiratorial.
I don’t think politically motivated distortions of perception are conspiratorial if those who are prone to mislabel things due to their belief system do so without realizing.
Not saying that’s an applicable explanation for the disappearance of flu, as it seems way too universal, just going further into semantics.
>In the meantime, public health measures like masking and distancing will work against both viruses
That's not necessarily true. COVID appears to be aerosolized, whereas typical flu is not. That means that masks will work to catch viral flu particles in ejected fluids (talking, coughing, sneezing, etc), but the same cannot be assumed for COVID, given that viral particles are orders of magnitude smaller than pores in cloth and surgical masks. And this assertion is supported by at least two studies (one Danish I believe) which showed negligible effect of mask wearing on COVID spread.
> How can you explain people getting covid but not the flu when nothing changed when places started opening up?
Covid starts from a higher baseline level of cases, and it has a higher transmission rate. When societies "open up" (resume social contacts; it's more than just government lockdowns), then we'd expect to see covid cases climb before flu cases. In fact, seeing the opposite would be very surprising.
The CDC doesn't accurately measure flu deaths. It's largely done by assessing death certificate data rather than positively identifying a flu infection. Deaths by pneumonia during the designated flu season months are counted in the tally of annual flu deaths. It is very likely that a portion of deaths attributed to COV19 over the winter were in fact from flu.
Flu is largely suppressed in summer anyway, with outbreaks moving from the northern to southern hemisphere, in time for winter, and back again.
So, it feels unsurprising that flu is relatively easy to suppress, since its spread is already fragile in normal times.
The combination of summer suppression and (continuing) hygiene measures has resulted in historic low levels of flu globally, which would need time to grow exponentially to even reach baseline levels.
Covid appears to spread much more readily through the air, why the influenza virus spreads much more significantly through fomites (touch and surfaces).
All that sanitizing and hand-washing, as well as not going into the office and school, cut that way down.
Meanwhile, Covid continued to spread fine in public transportation, stores, restaurants, etc.
Where's all the people that were saying Covid is a completely separate thing from the flu?...and every "Covid Death" was a separate death on top of the normal flu death rate?
Occam's Razor: Covid isn't a "pandemic", it's a strong flu
covid might not be more infectious, it might just be less people have any existing partial resistance to sars-cov-2. Each year the flu mutates but it still has overlap with prior variants.
As sars-cov-2 mutates seasonal covid might end up less bad than the seasonal flu. Though there is no way to tell.
That said, even if it was, a "very strong flu" with global transmission and impact _is_ a pandemic -- see the 1918 Flu Pandemic.
The death rate in 2020 in the US also surpassed that during the 1918 pandemic.
What I think we've learned is that the same measures used to slow the spread of COVID-19 are staggeringly effective against the flu, and that we now know how to prepare for the next particularly aggressive influenza variant.
Covid is a completely separate thing from the flu, and this study shows that the excess death rate is not in fact on top of the normal flu, but that because of covid related precautions there were almost no flu deaths. So covid killed alot more people than the excess death rate would indicate.
Covid is caused by a coronavirus, not an influenza virus. They have similar transmission methods and symptoms, but they are still different things. Like cats and dogs are both of similar size, both carnivores, both kept as pets and both can bite you, but they are still different kinds of animals.
And of-fucking-course it's a pandemic. What do you think that word means?
It's disappointing to see this type of misinformation being spread on HN. All you need to do is look at all-cause mortality in 2020 compared to previous years to easily disprove this:
Not the Parent but the orignal numbers come form the CDC but I'm not sure where the graph is from. Here are links to the last two years of data, embedded in a comment I made on HN recently:
From the CDC: In 2019, a total of 2,854,838 resident deaths were registered in the United States—15,633 more deaths than in 2018.
In 2020, approximately 3,358,814 deaths occurred in the United States (Table). The age-adjusted rate was 828.7 deaths per 100,000 population, an increase of 15.9% from 715.2 in 2019.
If we're using the WHO definition of a pandemic it's a pandemic.
If we're using the dictionary definition of a pandemic "(of a disease) prevalent over a whole country or the world."
it's a pandemic.
If we're using the colloquial definition of a pandemic "a disease that spreads around the world killing lots of people" it's a pandemic.
If you want you can consider seasonal flu on the list of pandemics, fine, but you're simply wrong to consider covid not a pandemic and if you are trying to downplay how deadly covid is I'd say you're behaving in an ethically wrong manner too.
Influenza is a specific thing. I'm not sure why you're trying to argue that COVID-19 is influenza when that's observably factually incorrect. Perhaps you're not aware that "the flu" is a specific thing and not just a way people say "people who get sick all at once from a thing"?
We were warned of bad outcomes if precautions weren't taken. Precautions were taken, and the worst outcomes were avoided. This doesn't invalidate the prior warning.
I don't want to assume bad intentions on your part but I'm not really sure what you want us to conclude from these posts... elaborate?
That it wasn't predictable or obvious flu cases would go to near zero. These news stories are not about how if we do X then flu cases will go to near zero, and most operate under the assumption flu season is coming and will likely be a "twindemic" that needs to be mitigated/lessened. It didn't come and now we are pretending it was clear it was never coming.
Just tired of people using selective memories to pretend that the last year wasn't chaotic and full of many wrong predictions, from experts and novices alike. Some humility would be appreciated.
You're lumping the poster in with all the experts and novices. They're one person, saying one thing. You need a link to _them_ saying the opposite to substantiate your criticism of their statement.
> That it wasn't predictable or obvious flu cases would go to near zero.
How could it not be predictable? I get the cold/flu when I or someone in the family is exposed to someone sick and it gets passed on.
If we're all staying in the house and not going anywhere for a year, by what mechanism could we possibly get sick? Seemed predictable to me.
In any case, it's been so awesome to not be sick in over a year. With elementary school kid, it used to be I was sick every few weeks all year long. Not looking forward to going back to that kind of normal.
And yet I really don't remember any discussion at all about how flu season was going to be nonexistent this winter in the media. No discussion about how if we socially distance flu deaths would drop almost 97% (22000 -> 600).
I guess no one decided to write a news story about it cause it was so predictable, dog bites man and all.
Why would the conclusions drawn from the post indicate bad intentions?
The warnings you're referring to were predicated on a pretty generic and nondescript need to get people vaccinated. This was a widespread messaging campaign in the media, heavy on the threats but not specificity.
Instead of what was threatened all summer, what actually happened was that flu disappeared AND people were being chastised for poor compliance with local ordinances and vaccination.
Shills drawing in from every side. ITT watch someone post examples of contrary information presented as fact by the press, to be slandered as spreading misinformation.
How much do they pay the child commenters, or do they really do it because they drink the kool-aid?
For the reasons listed above, there were 3 potential outcomes, depending on the success of the public health measures to contain the spread of COVID:
1. A high number of COVID cases and a high number of flu cases.
2. A high number of COVID cases but low number of flu cases.
3. A low number of COVID cases and a low number of flu cases.
If flu and COVID were independent, there would be a fourth potential outcome (high flu cases and low COVID cases). Majromax is saying that it was largely predictable that this fourth outcome would not happen.
The thing that the news articles are warning about is outcome #1 which, if it had transpired, probably would have been quite bad. Note that the experts in the articles are warning about something that could happen, not saying that it will definitely happen. And the reason it didn't happen is at least in part due to the warnings that were issued.
I actually told people at the outset of the covid lockdowns, “at least we won’t have a flu season this year.” Then later on I saw people online floating this as some kind of conspiracy and I thought, “wait, this wasn’t obvious to everyone?”
I’m not lying you know. I did say this, and everyone I said it too either said that they had also had the same thought, or if they hadn’t, they still agreed after thinking about it for a moment. That includes conservatives. Anyone could have seen it coming, and many did. It was only after that fact that the conspiracy memes started going around.
Or....(and without any conspiracy theories - never mind MOST conspiracy theories of the last 30 years have entirely become true - conspiracy TRUTHS).
Everything that was flu was labeled as COVID since doctors, hospitals and medical professions were PAID a bounty on COVID.
Multiple this by PCR testing being 99% fraudulent due to high cycle counts which enable cold viruses and even flu viruses to to test positive because you've reached the "noise floor" of the test at 10-15 cycles (most testing was done with 30-40 cycles). This helped "fulfill" the bounties and take all the attention away from conventional diseases both infective and others like heart disease, cancer, etc. (which got counted as COVID as well, just like traffic accidents and other definitely-not-COVID deaths that occurred).
The same bounty system shut down the entire surveillance system for flu as well as because non-essential workers included anything not COVID related or providing shallowly defined "essential" services.
No mask, public transports, restaurant, schools open, etc
doesn't matter if even 20% of the population (which is a very high estimate) use some of these measures. You can't explain that the evolution is exactly the same as a Norway...
I believe there’s been placebo controlled studies that show that masks to not stop the spread of influenza . I haven’t read the papers, just something I’ve seen mentioned on medcram.
The problem with this logic is the presumption that wearing masks was a widespread phenomenon. As someone who traveled a lot this year I can assure you that there a many states and areas that mostly ignored the lockdowns happening in the city areas.
For these places, we would expect the flu to continue on as normal. Instead it’s disappeared.
I remember reading a conspiracy theory back in ~ April 2020 that said "what happened to the flu" / "why are flu cases down so sharply?"
It was literally so stupid that it took me a minute or two to understand that the implication was that conspiracy theorists think flu cases were being categorized as covid.
Could you explain why this is "literally so stupid" when this appears to be what is happening?
If lockdown measures, social distancing, mask wearing, etc. were the true cause of the massive reduction in flu cases, we would expect to also see that countries and US states that failed to enact measures would be reporting high flu numbers to the WHO.
This doesn't appear to be happening. Instead, "the drop-off in flu numbers was both swift and universal." (article quote)
This universality suggests a data problem to me rather than an environmental change.
> we would expect to also see that countries and US states that failed to enact measures would be reporting high flu numbers to the WHO.
I don’t think so. Even without government policies in place, people become much much more vary of hygiene - that alone could account for a serious drop in new flu cases. The other factor as others mentioned is that someone with a weaker immune system who would have a pretty bad case of flu, had now a much higher chance of getting covid instead (due to covid quickly overtaking the number of cases due to its higher R number), so in a way covid being more infectious, sort of suffocated the flu.
> In the meantime, public health measures like masking and distancing will work against both viruses.
This argument does not make sense because of the timing of the disappearance of the flu.
For example, NYS was having a really bad flu season before the Covid panic hit[1]. I am posting a link to my screenshot first because NYS flu tracker[1] is one of the stupidest web pages out there. Click on the "compare with previous seasons" heading on the page to get the current table.
The noteworthy part is the drop in flu cases between the 6th and 7th weeks during what seems like an exceptionally bad flu season.
Note also "Regulation for Prevention of Influenza Transmission by Healthcare and Residential Facility and Agency Personnel"[3]:
> As of December 5, 2019, influenza is prevalent in NYS.
> At this time, Section 2.59 of the New York State Sanitary Code (10 NYCRR § 2.59) requires all health care and residential facilities and agencies regulated pursuant to Article 28, 36, or 40 of the Public Health Law to ensure that all personnel, as defined in the regulation, not vaccinated against influenza for the current influenza season wear a surgical or procedure mask while in areas where patients or residents are typically present.
> This page will be updated when the status changes.
which apparently has not been updated since December 5, 2019.
I find the downvotes interesting. Do you think the web page is actually well done? Or do you disagree with the observation that the drop between weeks 6 and 7 in 2020 (in the midst of a bad flu season) looks different?
What caused flu cases to start falling in mid-February _before_ so called "public health measures"?[1]
> The acceleration phase of a pandemic is complex and requires a multifaceted and rapidly adapting public health response. During a 3-week period in late February to early March, the number of U.S. COVID-19 cases increased more than 1,000-fold. Various community mitigation interventions were implemented with the aim of reducing further spread and controlling the impact on health care capacity.
So, between CDC weeks 7 to 10, the a bad flu season disappears while COVID-19 cases increase 1,000-fold. What are the "public health measures" that explain this divergence?
March 21, 2020[2]:
> "To be clear, the state has the legal authority to overrule any locality's decision to issue an order of mass quarantine or shut down. No locality will be closing down. The mass transit system is not shutting down. These rumors, caused by undue anxiety, are just that - rumors."
March 7, 2020[3]:
> During a briefing on the novel coronavirus, Governor Andrew M. Cuomo today declared a state of emergency to help New York more quickly and effectively contain the spread of the virus.
February 29, 2020[4]:
> "We'll start testing immediately here in New York, so we can handle more tests, more volume, turn them around faster, and we are ready to go and literally we can start testing immediately We have mobilized for emergencies before, and we're going to do it again."
February 27, 2020[5]:
> Governor Andrew M. Cuomo today announced the total number of flu cases in New York State has eclipsed the record number of seasonal cases since the New York State Department of Health began tracking flu cases during the 1998-99 season.
Some of this is actually a surprise - we don't have a good handle on how influenza seasonality works, and some of the "Just So" stories for it should have promoted influenza transmission, like increased indoor crowding above even the usual levels in the winter.
The dynamics of influenza could have been expected to change, and I would have put money on they decreasing, but it is never the less not pre-ordained nor attributable to an obvious cause (for example, one of the original reasons people didn't push mask orders is the limited suggestion that they were effective for flu).
I'm really excited to see this thread on HN because I've got a question about flu vs COVID, and I feel like this is my only (slim) chance to get a non-politicized answer to it.
It's a simple question. Flu deaths in the US have dropped precipitously. This past flu season resulted in (very roughly) ~1% of the deaths of previous seasons. It seems obvious that this is primarily due to social distancing efforts as you say. To naive little me, this implies that COVID deaths are also likely to have been reduced to ~1% from what they would have been without said measures. In the US, that implies that we may have steered into 500K deaths instead of a stunning potential 50M deaths.
Based on my admittedly naive calculations, I'm sure this is inaccurate, but I don't even know in which direction, could have been potentially even more. Did we really avert 50M deaths by social distancing?
That extrapolation only works if the flu is equally as contagious as covid and also has identical methods of transmission (for example, it may be that covid transmits through the air more readily than the flu). But we know that covid is actually quite a bit more contagious, so you can't really make a linear extrapolation like that.
All else being equal, mitigation efforts are going to have less effect on the more contagious disease. 6 feet social distance with a mask might be plenty to nearly eradicate the flu while it only somewhat reduces covid. Washing your hands frequently may have a very profound effect on the flu but very little effect on covid since it seems to transmit more through the air.
> Did we really avert 50M deaths by social distancing?
No, not even close.
> this implies that COVID deaths are also likely to have been reduced to ~1% from what they would have been without said measures
I don't think it implies that. There is nothing that says that the anti-COVID measures are about as effective at preventing spread of COVID as spread of flu.
> 500K deaths
Closer to 600k :(
This is among 32MM cases reported to the CDC, probably more like 80MM cases total.
Ignoring lots of factors, our ceiling for COVID is more like 4-10x what we've experienced, not 100X.
I feel like you misunderstand the meaning of "implies", which is to suggest without explicitly saying. I think it is reasonable to assume that social distancing measures would have a similar effect, and in the absence of other data, the best estimate might be to assume they are proportional.
Fortunately there are a couple of other answers in thread that answered this at a level of detail that I could understand.
32.8 million Americans have had confirmed positive tests for COVID-19 as of April 26[1], and the current US population is 328.2 million, so at a minimum 10% of the people in the US have gotten COVID. A maximum of 100% of the people in the US could be infected[2], so that implies an upper bound of 10x worse or 5M deaths averted by all interventions combined. US CDC estimates that about 3 - 3.5x as many people have contracted as have tested positive[3], so a more realistic upper bound is that COVID-19 would have been 3x worse without any intervention (assuming that 100% of people would have been infected without intervention).
So that gives you an upper bound. I'm not sure how to get a lower bound but it might be possible for someone with sufficient statistical know-how.
There are a bunch of stuff that make this hard to calculate. One is that cases are undercounted, while deaths are almost certainly not. Another is that deaths are correlated to available healthcare. 3x cases would mean that the standard of care goes down, which means more deaths. More deaths would probably also mean increased "protective" measures. Risk tolerance (and risk of infection) is elastic. Seeing 3x more deaths would certainly mean at least some people would take it more seriously, which reduces risky behavior and slows down cases, etc.
So you're right, if worst case everyone in the US gets infected, we're in for a lot more deaths, but aside from an apocalyptical R=100 type disease, not everyone is getting infected. The more infections there are, the more preventative measures are taken, etc.
This calculation does not take into account a collapse of the medical system. The problem with covid is the speed of its spread. We see this in India right now. There are not many cases per capita but their limited health care system could not handle this and people suffocate to death.
This is very wrong because as another comment mentioned, we are constantly on the verge of collapse of the health care capacity. I have friends who work in hospitals and the measures a government in Europe seems to take seems to always have as loose as possible measures while keeping the health care system at near maximum strain. Many people recover from covid in the hospital and even bigger problem is that if many more people are sick from covid, the people with other unrelated issues are lacking health care attention. One number I've heard is that we will see an increase in deaths from unrelated health problems which would usually get detected on time but since it's hard to get an appointment
The difference might be in flu deaths being confounded by C19 deaths in vulnerable populations. An example might be a person with a weakened immune system. In an alternate timeline without C19 they would have died of flu. In the real world they caught C19 first and died of that instead.
I would not claim that it accounts for all flu avoidance, but some nontrivial portion of missing flu deaths.
Additionally I would not be surprised if flu deaths remained lower for several years since C19 appeared to be more severe than flu in vulnerable populations. Future flu deaths were likely preempted by C19.
Paralleling the term herd immunity, this would be called culling the herd.
> To naive little me, this implies that COVID deaths are also likely to have been reduced to ~1% from what they would have been without said measures.
No, unfortunately this is not true. While the flu season disappeared entirely, covid obviously did not -- it grew significantly. As it stands, the United States has seen just shy of 100,000 confirmed cases per million people; if that represented 1% of a "status quo" infection rate then you'd have to expect everyone in the US to have covid 10 times over.
Instead, you have to think about the logistic model of infectious disease growth. As a very rough back of the envelope calculation, Covid has an R0 of about 2.5. It will spread throughout the population until about 60% is immune/recovered (which roughly matches the critical vaccination level seen in Israel, providing a reasonable check on this number).
That implies that absent public health measures (i.e. where covid quickly spreads to a level that gives herd immunity), the United States would have seen about 200 million cases (330m0.6), or 600,000 cases per million.
What that implies about deaths* depends on your estimates of how comprehensive case identification has been. If you think that we've tested and identified the vast majority of cases, then the "worst case" would be about 6x the current rate of infection and a similar increase in the total death rate. If on the other hand you think we've vastly undercounted cases, then maybe the US has in fact come close to that herd immunity level already, and the public health restrictions only succeeded in "flattening the curve" without changing the cumulative outcome much.
Working at this from another angle, the CDC estimates (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena..., case 5) give an infection/fatality ratio of about 0.25% when you apply their demographic estimates to the US population writ large. If you back-fit an estimated number of covid cases from the currently-observed 500,000 deaths, you end up remarkably close to 200m total cases -- but you can also quibble here by noting that seniors' homes suffered a disproportionate share of infections and deaths, especially early in the pandemic.
This model greatly depends on the rate of actual infection.
Assuming a perfectly oblivious population, for example, where there are absolutely no protective measures in place† and people just act 100% as usual††, then the infection rate would have skyrocketed in a very short time and the death rate would have been much, much higher because of the healthcare system completely collapsing. You'd have people dying from tetanus because nobody would have been available to give them shots. People dying from easily stoppable bleeding, etc. So in this extreme case I think the total death rate caused by the pandemic could have easily been in the low millions.
† Self distancing, masks, etc.
†† Which would be quite irrational and hasn't actually happened even in places which otherwise ignored the pandemic: a certain percentage of the population self-isolated due to the survival instinct.
Has anyone given the consideration that many of the positive tests have been common coronavirus colds or other things that may resemble flu and be diagnosed as such in a ICD10/CPT data dump ?
If that is the case, expect to see it here in the antipodes first. In NZ we had a almost cold and flu free season last winter, just six confirmed cases in a country of 5 million [1], and are heading into winter now with looser border restrictions (relatively looser, Australians can now enter without being put into a managed isolation facility for two weeks).
With Australia being effectively Covid free we've already started to see much stronger cases of the flu.
Local doctors in my City (Canberra) told multiple people I've talked with that the extra protective steps taken last year meant our bodies weren't as well positioned to handle the standard flu when we caught it.
If a more infectious variant surfaced, it might spread. But a lower absolute prevalence of flu (because of masks, social distancing, and lockdowns) means that low probability events - like a more virulent strain emerging - are less likely, and might not occur at all.
Contrariwise this (beside basic humanity) is why the current out of control situation in India or Brazil is everyone's problem. High absolute prevalence means events that are one in a billion chance get to happen. And spread.
Diseases have no trouble spreading through ordinary intimate social interactions with friends and family. In fact, you're far more likely to get sick from someone you are close to and spend hours with than someone you just pass by in a retail store. Lockdowns and mask policy are not neatly correlated with lower infection rates or death counts. Simple counterfactual example is Florida vs. California. Same results, vastly different policies. One has been open with no masking, no limits on indoor capacity, etc for over 9 months, and one has tightly restricted public congregation. Same results. Disproves the hypothesis.
Unless of course you look at the city level, where different policies and different levels of compliance correlate quite clearly with cases: look at San Francisco or San Jose compared to Miami or Los Angeles.
Not at all, you can cherry pick cities and that proves nothing, they all have vastly different demographics, different density, different climates, etc. For example, New York City is one of the worst performing metros on the planet despite harsh restrictions (and high compliance) at the city and state level and in neighboring states. There's no discernible pattern in the data.
Okay, but then why doesn’t the “vastly different demographics, different density, different climates” apply to comparisons between states, if you’re claiming those comparisons “disprove the hypothesis” (let alone the fact that SF has much higher density that the others and a colder climate)? As far as cherry picking, why does me picking four cities count as cherry picking but you picking two states doesn’t?
Also for the specific NYC case, a crucial difference is that when the restrictions started which was after there were many infections already (thanks in part to disagreement between the city and state early on and different legal powers of the city to effect them compared to elsewhere). I’m also not sure what neighboring states with high compliance you’re referring to for New York. Their most populous neighbor (PA) has consistently had very low compliance and fluctuating levels of restrictions.
Not sure about in other areas, but where i am from the hospital systems rarely checked for flu. During the pandemic anyone symptomatic was told to stay home. People who visited a health clinic were typically first given a covid test. My guess is quite a few people who had the flu over the last year likely did not get an official flu test since it was difficult to get into a hospital or health clinics during the pandemic.
I can't speak for everywhere, but I know that from what I'm told here (was actually talking about the lack of flu with some nurses who worked in local clinics and hospitals in the area), those who had covid-like symptoms were usually given the covid test no matter what. But, if flu would have normally been suspected and there wasn't a strong indication it was covid (loss of smell/taste, known exposure to a covid-positive person, etc.), they usually also got a flu test just in case.
I look forward to the day when the standard practice is to test for every common respiratory pathogen at once when someone has cold/flu symptoms. The technology exists now for personalized, data-driven medicine to take off.
I know someone who works for a company who produces such tests at the same cost as a single test today, but often insurance companies and providers don't know how to bill for them, so you see stories in the news about "irresponsible doctors who should never have ordered 20 tests" that were really a single test billed incorrectly.
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[ 2.2 ms ] story [ 343 ms ] threadOne of the most ridiculous example: the Thai government went to the extent of spraying disinfectant in the forest next to the Burmese border, and got pictures published in newspaper to show their great work. Comical! [1]
[1] https://twitter.com/thainewsreports/status/13819185863488225...
Yes, but it must have had some effect on fomite transmission of some viruses, right?
For example it’s possible but unlikely that some other pandemic was accidentally prevented.
I would be very surprised if doing this is a good idea, even if it kills covid and/or flu.
so maybe not so efective.
Covid - a coronavirus that is absolutely rampant because insufficient masking, distancing, and hygiene controls
How you rationalize that hypocrisy so easily in your head is beyond me.
Additionally, varying levels of contagiousness and mechanisms of spread absolutely make actions more effective for some diseases and less effective or not effective at all for others. This is not a controversial statement despite your dramatic insistence on ignorance.
Who knew defeating flu was this easy all along!
https://news.ycombinator.com/newsguidelines.html
Flu shots be damned.
The smugness of such stupidity..
If 90%* wear masks and the R-factor of the "flu" is is low enough it "disappears". But if the R-factor for covid is high enough it still spreads even if 90%* wear masks (10% don't).
It's mindboggling how simple simple thinking can evade people.
*numbers made up for illustration purposes only
https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471...
We ban accounts that post like this, because it's so destructive of the community we're trying to have here. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and sticking to the rules, we'd be grateful.
This makes a lot of sense. Schools have been surprisingly rare causes of COVID outbreaks, but are constant epicenters for flu outbreaks.
I can clearly remember that multiple countries closed schools within weeks of the first reopening because the virus was spreading there like wildfire, in the age group with the highest rate of asymptomatic(aka invisible until it's too late) cases.
The low symptom rate corresponds to a low transmission rate. The worse your case of COVID, the more likely you will transmit it to others in the same situation. This is the obvious mechanism of the fact that kids, who very seldom have bad cases of COVID and so frequently do not show symptoms, are not usually major spreaders of the virus.
This all is one of the really unusual things about COVID compared to other communicable diseases.
Obviously personal action is harder to reproduce than government-sponsored trucks, so it's less useful if it was a main cause.
I give it 5 years from now when it is no longer politically intolerable that studies will come out and admit that masks and social distancing did absolutely nothing to slow or prevent infection.
It also likely led to more deaths due to the revelation that it was a lie, and people treating any further advice (which was actually medically sound) with the same kind of cynical skepticism used for liars. Rejection of masks wasn't much of a thing before this happened.
[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121424/
Edit: if you downvote, please, comment why. I could be wrong, so would love to know your arguments.
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680614/
https://www.reuters.com/article/factcheck-stanford-masks/fac...
The author lied about his affiliation with Stanford, and the paper was retracted.
> Jonathan Davis, a spokesperson for Elsevier, told Reuters via email that Medical Hypotheses has since retracted the article after concluding it was misleading due to “a broader review of existing scientific evidence” showing that masks “are an effective prevention of COVID-19 transmission” and said that the article contained several misquotes and unverified data. Davis said that the author himself had submitted the affiliation with Stanford Medicine.
> As reported here by Forbes, Medical Hypotheses has previously published articles such as “Is there an association between the use of heeled footwear and schizophrenia” (here) and “Ejaculation as a potential treatment of nasal congestion in mature males” (here).
There's a reason it's titled "Medical Hypotheses".
Edit: also, quoting Reuters is fine. However, quoting Forbes is not. Forbes is a trash publication, getting published there costs a few hundred bucks.
https://pubmed.ncbi.nlm.nih.gov/15325026/
https://pubmed.ncbi.nlm.nih.gov/18434036/
Studies demonstrating mask efficacy are just as easily Googleable.
You might not want to be throwing around "trash publication" slams here, given your cite.
I'm saying "trash publication" because I had experience working with Forbes. Once again, one can publish at Forbes whatever the hell they want. It costs a few hundred bucks.
From the "Medical Hypotheses" journal the Forbes article is criticizing for poor editorial control, and citing those as examples. At least read the claim you're attempting to debunk.
> Once again, one can publish at Forbes whatever the hell they want. It costs a few hundred bucks.
Apparently that's also true for the "Medical Hypotheses" journal.
Edit: also, _nobody_ gives a crap about masks in Florida. However, death rates are the same as in California: https://apnews.com/article/public-health-health-florida-coro...
I'm sorry, you'll base your beliefs on an article in "Medical Hypotheses", but conclude that Reuters is making up an Elsevier spokesperson?
I thought "quoting Reuters is fine"; now they're fake news?
> I'm sorry, you'll base your beliefs on an article in "Medical Hypotheses".
I haven't made any conclusions yet. I'm still analyzing. Both you and Reuters try to belittle the significance of an entity based on its name or the titles of their publications. While it's possible that the publication is pure crap, "belittling" is one of those crappy techniques one can rely on to defend their arguments.
Here's some quality sources:
https://www.pnas.org/content/118/4/e2014564118?fbclid=IwAR0j...
https://www.sciencedirect.com/science/article/pii/S2666142X2...
https://www.medrxiv.org/content/10.1101/2020.08.12.20173047v...
That is, as a parent, I was far less prone to sickness before I had kids of school age. From all I have ever heard, I am far from unique in that.
This is a serious question and not an attempt at rhetoric. I really am curious. Was flu never a problem in Florida? Was voluntary compliance so widespread that heavy handed government policy had no marginal anti-flu effect? Something else?
In other words, you can probably beat back the flu significantly by having enough of the population mask up, wash/sanitize their hands, etc.
But why is it less transmissible? One obvious explanation is because we've lived with it all our lives, and most people already have some level of pre-existing immunity to most flu strains they're exposed to. Both due to natural infections, and vaccines.
> In other words, you can probably beat back the flu significantly by having enough of the population mask up, wash/sanitize their hands, etc.
If pre-existing immunity is why it's less transmissible, those measures will result in fewer flu infections, and thus lower levels of pre-existing immunity. Which in turn, may make the flu more transmissible, leaving us where we started. Worse, if pre-existing immunity is decreasing the severity of the infections we do get, the net effect may actually be more deaths due to fewer, but more deadly, infections.
Flu vaccines are notoriously ineffective, with a typical year being just 50% effective, and bad years being as little as 19%. They're probably the least effective widely used vaccines by a long shot (eg the MMR vaccine is about 97% effective). So we can't just assume we'd be able to make up the difference with increased vaccination. Flu vaccine coverage is already quite high anyway, 51.8% or so for the entire US population.
edit: fixed %
https://www.cdc.gov/flu/fluvaxview/coverage-1920estimates.ht... https://www.cdc.gov/vaccines/vpd/measles/index.html https://www.cdc.gov/flu/vaccines-work/effectiveness-studies....
Flu vaccine effectiveness is not great because they have to "guess" which variants of the flu will be most prevalent months ahead of time due to the manufacturing lead times. A lot of experts are optimistic than the mRNA vaccine technology will lead to more effective flu shots.
> A lot of experts are optimistic than the mRNA vaccine technology will lead to more effective flu shots.
We will see. Influenza is unusual in its ability to evolve new variants that resist existing antibodies. It's also not clear that we even can give people repeated mRNA vaccine shots year after year. People quite often develop antibodies to glycol, which makes up the nanospheres used to get the mRNA into cells. Repeated shots may lead to severe side effects, and/or the nanospheres being destroyed before the mRNA can be delivered, rendering the vaccines ineffective.
Incidentally, this is also a problem with the new adenovirus technology used in the Astra Zeneca and Johnson & Johnson vaccines: your immune system develops antibodies to the carrier virus as well as the target proteins. Subsequent shots with the same adenovirus can be destroyed prior to being able to get into cells and express the desired protein; there isn't an infinite supply of suitable adenovirus strains. The Sputnik V vaccine actually uses a different adenovirus for the first and second shots for this reason.
There obvious explanation is that different diseases have different levels of infectiousness. It just so happens that the symptoms the flu causes make it less virulent than covid-19.
Haven't we lived with different types of coronaviruses all of our lives as well, though? It seems at least equally as plausible that COVID is more transmissible due to actual physical qualities of the virus with respect to replication rate, particle size, and other factors that cause more virus to be expelled from the body in different ways. It could be that the flu is more transmissible by fomites than through aerosols, or that less flu virus tends to be expelled by the body, or that the flu virus has a more difficult time in infecting our cells compared to SARS-CoV2.
Of course, this is pure speculation on my part, but from what I can tell we lack data for anyone to be drawing any firm conclusions on this point.
Measles is at least 3 times more transmissible than flu [1].
We have a very effective vaccine against measles and a mildly effective one against flu, so people get flu and not measles but let them circulate among people without any protection and measles will get them sooner than flu. And it's also much deadlier [2]
[1] https://transportgeography.org/contents/applications/transpo...
[2] https://academic.oup.com/jid/article/189/Supplement_1/S4/823...
I'm not talking about the theoretical R0, which assumes an immunologically naive population. I'm talking about the real world reproductive ratio, R, including existing immunity. Estimates of real world R for influenza are are even lower than the 2-4 your source quoted. Eg, this paper estimates a median of just 1.3 for a typical year's seasonal influenza: https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471...
With COVID-19's R0 estimated at 2-3, it could easily be the case that our measures are sufficient to completely wipe out the flu. But not COVID-19: https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
Re: measles, note that pre-vaccine, almost everyone got infected with measles at some point in their life, usually as a child. You actually see this in how effective the early childhood measles vaccination programs were: even though only children were being vaccinated, a small % of the total population, measles rates dropped dramatically(1) almost immediately. The adults had already gotten it and were already immune. So to wipe it out, we just needed to protect those who hadn't been infected: the new, uninfected, children born every year. The measles vaccine is attenuated live measles after all. So by vaccinating, we just get the inevitable infection over with in a controlled way, with the odds rigged _enormously_ in your favor.
1) https://ftp.historyofvaccines.org/index.php/content/graph-us...
I haven't been keeping up with it, but that's the lowest estimate I've seen yet. Back when it was still only known to be in China it was estimated at 5-6, but quickly went down to 3-4 for the first several months or so of last year, then some estimates brought it back up to 5-6..
I had to explain almost pedantically why they should allow me to order verbally instead of using their touchscreens, for the safety of the other customers.
I think today, they'd have a protocol to accommodate people who are obviously sick so they don't have to touch anything. In fact, they probably don't even let healthy people use touch screens, if I had to guess.
Besides, I would think shooting mucus debris in their direction by talking is worse than using a cleaned knuckle on a screen far away from them.
What are you hoping to gain? And even if you were right, as I said, I had a high fever. It's not like I was thinking clearly. Are you trying to feel morally superior to someone who was in gravely ill?
It's always been dumb: at best they're just getting more people sick (some of whom will need to take time off, negating any supposed benefit of the sick person not just staying home in the first place), and at worst it's spreading a flu that eventually results in someone dying.
On top of that, a massive number of companies have just proven remote work is possible, even during entirely non-ideal conditions (lockdowns, virtual school, high stress, etc).
Germ theory of disease didn't exist back then.
-- quote --
In 2001, Canadian astronomer Ken Tapping showed that the influenza pandemics over the previous three centuries correlated with peaks in solar magnetic activity, on an 11- year cycle. It has also been found that some outbreaks of influenza spread over enormous areas in just a few days – a fact that is difficult to explain by contagion from one person to another. Also, numerous experiments seeking to prove direct contagion through close contact, droplets of mucus or other processes have proved fruitless.
From 1933 to the present day, virologists have been unable to present any experimental study proving that influenza spreads through normal contact between people. All attempts to do so have met with failure.
-- end quote --
source: https://www.5gexposed.com/wp-content/uploads/2019/04/English...
> Also, numerous experiments seeking to prove direct contagion through close contact, droplets of mucus or other processes have proved fruitless.
> From 1933 to the present day, virologists have been unable to present any experimental study proving that influenza spreads through normal contact between people. All attempts to do so have met with failure.
This is just demonstrably false. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682679/
Where are you getting this take? Life in the US in 2020 is dramatically different than it was in 2019.
I personally dislike the isolation of extreme car culture, but it does help in situations like this.
This isn't really true anywhere, some places had fewer state mandated restrictions, but effectively everywhere had significant changes in terms of breadth and depth of person-to-person contacts.
In Massachusetts, usage is certainly higher, but maybe in practicality, not enough to make a difference compared to other factors?
I also wonder, with far less numerical opportunity to spread and mutate, if the flu wasn't able to "grow" a good candidate with good evolutionary fitness this year, so distancing and mask usage affect countries even where they aren't practiced.
Queues at popular sites were socially distanced outdoors as well.
Also, there were probably minor restrictions people took upon themselves, like staying home when they had flu-like symptoms, or shunning people that coughed.
On the other hand, this patterns very neatly with previously observed and well-documented phenomena of viral interference, specifically with respect to influenza. Here's a good paper to start a journey of research on this topic: https://academic.oup.com/jid/article/212/11/1690/2911897
2. Having flu outside your border be rarer means less flu coming in.
Also, the whole hand-sanitiser-everywhere thing, while in retrospect probably not super effective against covid, would be expected to be quite effective for the flu.
Asymptomatic spread is a much larger risk with COVID-19 compared to the flu. A simple behavior change of "If I feel sick, I don't go to work/school/grocery shopping" isn't enough to stop COVID, but could cut flu spread a ton by itself.
EDIT: The PCR test quote was fact checked and deemed to be misleading, but it still sounds like they are not very accurate [0].
[0]: https://www.reuters.com/article/uk-factcheck-pcr-idUSKBN2442...
I'm also struggling to understand how symptom overlap would lead differences in the number of confirmed cases with PCR tests. These aren't cases confirmed by doctors talking to you and running through a checklist, these are tests that with a great degree of accuracy confirm if you have flu or covid in your system
Maybe corona virus is an enabler of some other disease, like a particularly virulent flu or some other respiratory infection.
This questions are inconvenient, so they'll go unasked by the media, let alone answered.
Literally an infinite number of questions go unasked by the media. Often because they're a pointless waste of time.
I'd say if leading virologists around the world looked at it in a lab and agree it's not some mystery illness, most media will go with that. At least the reputable ones not fishing for cheap attention from paranoid conspiracy theorists.
> At least the reputable ones not fishing for cheap attention from paranoid conspiracy theorists.
We're not talking about paranoid conspiracy theories here, we're talking about the inexplicable disappearance of influenza globally, when it should have the same transmission characteristics as corona virus. Corona might spread more rapidly, but it should spread in the same manner.
It's entirely possible that the bulk of people with symptoms actually have a concurrent infection (eg, the flu). We already know the vast, vast majority of deaths have a 'comorbidity.'
That's just like not true. Different diseases spread differently. It seems like covid will spread better through smaller droplets for example. And even if it were you just said that covid spreads easier. Disease transmission isn't linear so if interventions were enough to dip Flu's reproduction rate below 1 we'd see more or less what we've seen. Very little spread. Even if we ignore all of that and pretend you're right and really this year of horror has just been Flu cases, the health care system almost collapse in Italy, NYC, LA, and now India is still a huge deal. Hugely more people are dying this year than do in an average year. People died, literally dies in all of these places because they weren't able to get into a hospital. I don't care if it was actually covid (it was) or not killing them
This I can agree with. But our way of dealing with the problem hasn't solved that going forward whatsoever. Are we going to ignore the fact that NYC has been shutting down hospitals for decades[1]?
> Hugely more people are dying this year than do in an average year.
Not according to the numbers I've seen.
> People died, literally dies in all of these places because they weren't able to get into a hospital.
What are the death rates for people in hospitals compared to people dying with covid outside of hospitals? What interventions are hospitals providing to most patients that are conclusively saving their lives? At first, it was ventilators, but that has quietly become not recommend for most patients.
I happen to be close friends with someone that worked on the covid floor in a major regional hospital. Most people in the hospital were being treated for pneumonia, some of them were on supplemental oxygen. The hospital was never overrun, only a small portion was dedicated as a covid wing.
My friend never contracted covid, nor did anyone else they worked with.
1: https://indypendent.org/2014/04/nycs-vanishing-hospitals/
The second just seems wrong. Like it could have been true a year ago, but it really would be known by now and there really isn't any reason it would be inconvenient for any sort of narrative. Diseases that weaken your immune system enough for some other disease to be killing loads of people are still worrying and big deals. We would still be calling for lock downs regardless of if covid is directly or indirectly causing extra deaths
Why are some people to be weakened and not others? Maybe that's what we should be investigating.
https://www.cdc.gov/flu/weekly/index.htm
It says right on the page that Covid makes the data difficult to interpret, the thing I'm pointing to is the 900,000 samples tested.
The fraud is not in the test itself, but in the reporting of test results. When a PCR test comes back positive, more often than not it is assumed the patient is infected with COVID (which may not be the case) - and cases of infected people are reported widely using these PCR test results.
What other method would you suggest in replacement to verify if a person is possibly infectious?
Some people may also be worried that they do have covid (or will get a false positive), and don't want to get a positive test due to quarantine requirements, embarrassment, etc.
The flu didn't happen here either according to the long standing sentinel testing program.
https://www.folkhalsomyndigheten.se/folkhalsorapportering-st... (Swedish, published today)
Summary: 145k people were tested (1.4% of the total population), 29 people tested positive for an influenza variant during the winter season 2020/2021. Typical numbers for previous years are in the thousands.
Graph comparing winter seasons: https://www.folkhalsomyndigheten.se/contentassets/a9433fcecd...
(X-axis: week number, Y-axis: number of cases.)
Between the flu and covid, case reporting numbers are wildly unreliable.
One might ask, what incentives are there to over report a given illness at any given time?
It allows the government to create fear and panic and pass broad sweeping bills with huge budgets. All in the name of "Covid Relief" etc.
On the other hand PCR test are not inaccurate at all, at least regarding false positives. There are detailed articles and even Youtube videos on the process and if you take a look, you will understand why it's quite accurate.
In essence, they create a reaction that will mass produce specific parts of the virus gene until it's detectable with a sensor. They run the reaction multiple times and then the sensor looks for luminance if I recall correctly.
Because you can't accidentally produce Covid-19 genes, the tests are very accurate. However, you might not get enough virus material when taking the sample from the patient(which can fail your reaction or you might need more cycles than usual to create a detectable amount) or it could be the case that there's a mutation in the gene that you are attempting to multiply, therefore you can get a negative test for an infected person.
https://www.thelancet.com/journals/lanres/article/PIIS2213-2...
between 0.8% and 4% false positive rate according to that, making them completely unsuitable for mass testing. On top of that BBC's panorama did a program pointing out the sloppy standards at centers where the tests are processed.
I'm not being snarky, I simply want to outline the alternatives I'm aware of.
I respect the accuracy of the PCR, it can literally tell us why people in India are dying off on the streets right now in thousands and we even cannot see the assailant through optical magnification. It can also tell us that it's the same thing that caused the exact same situation in NY and Italy.
It's amazing, much more intriguing than any other explanation that I came across.
* This rate could translate into a significant proportion of false-positive results daily due to the current low prevalence of the virus in the UK population, adversely affecting the positive predictive value of the test.2 Considering that the UK National Health Service employs 1·1 million health-care workers, many of whom have been exposed to COVID-19 at the peak of the first wave, the potential disruption to health and social services due to false positives could be considerable.*
On the other hand, it's a pretty good accuracy when you have a hospital full of sick people. Sure, you may end up recommending 14 days of staying at home every now and then when it's not necessary.
See, the PCR test is just one of the clues that is used to diagnose people. Negative test with clearly Covid-19 symptoms and medical image of the lungs showing spots gets you a bed and treatment in the hospital. Positive test and no symptoms gets you stay at home and wear a mask recommendation.
https://www.alberta.ca/stats/covid-19-alberta-statistics.htm...
PCR tests work by selectively amplifying DNA. Each PCR test cycle approximately doubles the amount of the selected DNA. (for SARS-CoV-2, an RNA virus, the RNA is first converted to DNA)
Since each cycle approximately doubles the amount of selected DNA present, PCR tests can be extraordinarily sensitive if enough cycles are used. In theory, just a single fragment of RNA could result in a positive test. As Health Canada says:
"There are numerous studies that demonstrate prolonged detection of SARS-CoV-2 RNA that extends beyond the resolution of COVID-19 symptoms and can persist for several weeks or months." https://www.canada.ca/en/public-health/services/diseases/201...
Hospitals are testing pretty much everyone who comes in the door for COVID-19. The fact that people can test positive long after they were actually infected should obviously raise questions about the accuracy of our statistics with regard to COVID-19 hospitalization and death rates.
Additionally, contamination is a potential problem. For example, the BBC's undercover reporting found significant cross-contamination between samples at one testing lab: https://www.bbc.com/news/uk-56556806
Contamination could be showing up as a multiplier on true positives: as positive % increases, opportunities for contamination also increase. Since PCR tests work by replicating DNA, they also have the unusual property that the testing process itself creates large quantities of potential contamination. Good lab practice will eliminate that problem. But that's hard to guarantee when testing volume is increased enormously in a short period of time.
Thankfully we don't have to stop with a PCR test.
https://www.cbc.ca/news/canada/edmonton/alberta-nears-end-of...
1: https://www.youtube.com/watch?v=X0aMow7FrZo
https://www.mcgill.ca/oss/article/technology-history/man-who...
See my other comment here for the reasons why I believe almost all SARS-CoV-2 PCR positives are true positives (as to whether the patient is or was very recently infected; the kernel of truth is that they don't necessarily indicate that the patient could infect others right now).
I have no stake or attachment to Kary Mullis, whether he's wrong or right is irrelevant to me. I just find it interesting that the creator of PCR, which has a lot of attention these days, had opinions that don't get a lot of attention these days. I'll give your comment a look, but am also curious if anybody else has a counter to Mullis' claims.
And yours was an argument from authority. You gave no explanation of or support for Mullis's arguments, and you gave no reason to believe his conclusion except a positive aspect of his reputation (i.e., his discovery of PCR in the first place).
In that case, negative aspects of his reputation (i.e., the fluorescent raccoon; or, closer to the domain in question, his belief on HIV and AIDS) are surely also relevant. They don't mean what he's saying is false, but they'd cause a reasonable person to approach his unsupported statements with more care.
For convenience, I'm linking my other comment below. This is a detailed explanation of why I believe almost all patients who test positive by PCR are (or were very recently) infected with SARS-CoV-2, fully referenced. It has so far received zero interaction.
https://news.ycombinator.com/item?id=26984429
If you think I'm wrong, please explain why, and I'll reply. If you think I'm right, then I'd also appreciate a reply. The belief that coronavirus cases are grossly over-diagnosed is a common element of claims that no precautions against it are necessary, which cause real harm; so I hope you don't want to falsely spread that belief.
ETA: And for completeness, here's a paper discussing the ability to culture virus from PCR-positive samples. I believe that's the real point Mullis was alluding to in his comments, that people who test PCR positive aren't necessarily shedding replication-competent virus; but that's a separate question from whether they are (or very recently were) infected.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
https://archive.ph/ugiWQ
I wonder if the same mistakes are being repeated.
> These tests, called “home brews,” are not commercially available, and there are no good estimates of their error rates.
So this is about clinical use of an uncharacterized test. Why is that relevant to the test for SARS-CoV-2, which has probably now been run more times than any other PCR test in history, including on large populations with extremely low test positivity (e.g., most of Australia, <0.1%), which bounds the specificity (e.g., to >99.9%)?
Seriously, engage with the evidence. There are still zero replies to my detailed explanation linked above. Did you read it? What did you think?
> Its scientists also did additional P.C.R. tests on samples from 116 of the 134 people who were thought to have whooping cough. Only one P.C.R. was positive, but other tests did not show that that person was infected with pertussis bacteria.
It's absolutely possible to develop bad PCR tests, and that's why it's necessary to characterize them on large populations to determine their specificity and sensitivity. It seems the Dartmouth team didn't do that before using the test clinically, and that was their problem; but the SARS-CoV-2 tests are the most intensively-studied PCR tests in human history, and the evidence I've seen looks quite good.
So again, did you read my detailed explanation? Do you understand it? If you're just looking to knowingly spread baseless doubt, there's far more effective places to do it. So why not engage with the actual science?
https://jamanetwork.com/journals/jama/fullarticle/2778361
In fact excess mortality usually exceeds COVID deaths, suggesting there are more false negative PCR tests (at least on dead/dying people) than false positive.
The vaccine is an entirely different topic. There's certainly a higher risk that the SARS-CoV-2 vaccine will have unforeseen long-term effects than for other, longer-studied vaccines; but there's also a higher risk that SARS-CoV-2 itself will have unforeseen long-term effects than for other, longer-studied diseases. I'm not elderly, but I've placed my bet on the vaccine.
I don't mean to be condescending. I'm just frustrated that I've spent considerable time explaining why I believe the PCR test for SARS-CoV-2 is almost always accurate, and received zero engagement with any of that. The evidence is there for anyone willing to invest the effort to understand it.
Nice try but your tit for tat doesn't quite work. I explicitly said I have no attachment to Mullis or his claims. I didn't make an argument myself. I was asking "the creator of PCR made this claim, what are the counter-arguments?"
Then, and now again, you gave your irrelevant ad-hominem points. I don't care if he believed in voodoo or saw pink elephants in the sky, because they're irrelevant to my question. And as I already said, Newton believed some outlandish things, yet I still believe in physics. I'm interested in what the counterpoints to his argument, not his reputation, are.
I also read your comment, and it's also not relevant to my question. You seem upset that it's gotten zero interaction, and I'm not sure what I'm supposed to do about that. But I'm not looking for info on why PCR tests are true positives, I'm looking for arguments on Mullis' claims
The comment you replied to was speculating about "false positives where flu cases get labeled as Covid". Mullis's comments are not too coherent, but I read them as a claim that PCR tests will result in false positives, and I assumed that was why you thought they were relevant. At least one other user seems to have read them the same way, since user theclap responded with a link to a different article explicitly about PCR false positives. Do you read them as something else?
Here's a quote from another reply to my original comment:
> > Kary Mullis: I think misused PCR is not quite ... I don't think you can misuse PCR. No, the results, the interpretation of it. See if you can say, if they wanted, if they could find this virus in you at all, and with PCR if you do it well you can find almost anything in anybody. It starts making you believe in the, sort of buddhist notion, that everything is contained in everything else. Right, I mean because if you can amplify one single molecule up to to something that you can really measure which PCR can do, then there's just very few molecules that you don't have at least one single one of them in your body. Okay, so that could be thought of as a misuse of it just to claim that it's meaningful. It is, there's very little of what they call HIV and what's been brought out here by Phil ... the measurement for it is not exact at all, it's not it's not as good as our measurement for things like apples. An apple is an apple. You know, you can get something that's kind of like, if you've got enough things that look kind of like an apple you stick them all together you might think it as an apple. And HIV is like that. Those tests are all based on things that are invisible, and they are the results are inferred in a sense. PCR is separate from that, it's just a process that's used to make a whole lot of something out of something that's why it's not, it doesn't tell you that you're sick and it doesn't tell you that the thing you ended up with really was going to hurt you or anything like that.
An example of what I'm looking for info on is this in particular:
> PCR is separate from that, it's just a process that's used to make a whole lot of something out of something that's why it's not, it doesn't tell you that you're sick and it doesn't tell you that the thing you ended up with really was going to hurt you or anything like that.
I don't have an opinion myself and I'm just looking for someone informed to comment on how today's use of PCR for diagnosing covid aligns with the inventor of PCR's comments that it isn't useful for diagnosing illness. Not whether or not today's covid tests are false or true positives
> It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, <3% of cultures are positive.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid...
So it's absolutely true that some of the people who test positive by PCR would never have infected anyone else, and there was no need for them to isolate. But it's hard to distinguish who--the viral culture takes too much time to run for each patient, and no one really knows how sensitive that is anyways. So to be conservative, they just advise everyone to isolate.
People have talked about advising isolation only if Ct is less than some lower cutoff, since there's a clear correlation between Ct and positivity in culture. But since a patient early in the infection might have high Ct now but lower Ct later, public health authorities haven't done so.
The second way that PCR tests are being used is to diagnose the cause of illness--a patient comes in sick, and the doctor is trying to find the cause. At this point, we already know that the patient is sick, because they're coughing, complaining that they feel terrible, etc. The PCR test isn't what tells us that they're sick, but rather what tells us that the cause of their sickness is SARS-CoV-2. The alternative hypothesis is that people are dying of some different disease, and by coincidence the excess mortality due to that different disease correlates strongly with SARS-CoV-2 test positivity (which e.g. is why that's high in the USA, and low in Australia; you can also see the correlation within a single region if you look at the time series). That would be a pretty strange coincidence, and no one has proposed any mechanism for that.
So do the above clinical uses seem reasonable to you? Or is there some other clinical use that seems unreasonable to you in light of Mullis's comments?
Perhaps this confusion comes from the definition of "illness" or "sick". In a certain sense, if I don't feel sick, then no test can tell me otherwise. For example, was Typhoid Mary "sick"? Is an HIV patient with no symptoms? Kary Mullis says no:
> A man with gray hair and a goatee raises his hand. He says he's been HIV-positive since 1984, that he took the anti-AIDS drug AZT for a couple years but stopped. Now, he says, his T-cell count -- the number of a kind of white blood cell that is killed by HIV -- has gone way down.
> Mullis interrupts him: "Change doctors!"
> The man continues. His T-cell count is down to 150, which is usually thought of as dangerously low. He asks Mullis for advice.
> "I would say there is no evidence that I can find in the scientific literature that you should worry about HIV or your T-cell count," Mullis tells him. "If you'd stop worrying, maybe you'll be all right. You look pretty healthy to me."
https://www.washingtonpost.com/archive/lifestyle/1998/11/03/...
Do you think he gave tha...
- On HIV and PCR: https://www.youtube.com/watch?v=V__Zx0qS7uI&t=101s - On Fauci and PCR: https://www.youtube.com/watch?v=5aISPlTLbJo
> Reporter: .... misuse PCR to estimate all these so supposedly free viral RNAs that may or may not be there?
> Kary Mullis: I think misused PCR is not quite ... I don't think you can misuse PCR. No, the results, the interpretation of it. See if you can say, if they wanted, if they could find this virus in you at all, and with PCR if you do it well you can find almost anything in anybody. It starts making you believe in the, sort of buddhist notion, that everything is contained in everything else. Right, I mean because if you can amplify one single molecule up to to something that you can really measure which PCR can do, then there's just very few molecules that you don't have at least one single one of them in your body. Okay, so that could be thought of as a misuse of it just to claim that it's meaningful. It is, there's very little of what they call HIV and what's been brought out here by Phil ... the measurement for it is not exact at all, it's not it's not as good as our measurement for things like apples. An apple is an apple. You know, you can get something that's kind of like, if you've got enough things that look kind of like an apple you stick them all together you might think it as an apple. And HIV is like that. Those tests are all based on things that are invisible, and they are the results are inferred in a sense. PCR is separate from that, it's just a process that's used to make a whole lot of something out of something that's why it's not, it doesn't tell you that you're sick and it doesn't tell you that the thing you ended up with really was going to hurt you or anything like that.
https://covidlive.com.au/report/positive-test-rate
A Lancet article cited below references a paper that estimates much worse specificity of PCR tests for SARS-CoV-2 based on the specificity of tests for other RNA viruses (original SARS, MERS, influenza, etc.):
https://www.medrxiv.org/content/10.1101/2020.04.26.20080911v...
But why would anyone do that, when we have direct experience with the actual test for the actual virus?
Of course the false positive rate in heavily-affected areas may be higher, due to sample contamination--with more true positive patients, there's more opportunity for one true-positive patient to contaminate multiple samples. But such cross-contamination can occur frequently only if there are actually lots of true positive patients.
For another sanity check, the sensitivity of antibody tests is established on a sample of patients who tested positive by PCR, who are assumed to all be true-positive. So any PCR false-positive among those patients will show up as an antibody false-negative, so that bounds the apparent sensitivity of those antibody tests. But antibody tests show sensitivity around 85%:
https://journals.plos.org/plosone/article?id=10.1371/journal...
So even if the antibody tests were perfect, at most 15% of their positive sample was false-positive. (Note that this is a different quantity from the PCR specificity, and can't be translated into such without knowing the true prevalence in the population that the sample was drawn from.) Of course the antibody tests also aren't perfect, and I'd guess that 15% is almost entirely antibody false-negatives rather than PCR false-positives.
You can also compare reported COVID deaths (which are generally established by PCR) with year-over-year excess mortality. The agreement isn't perfect, but it's pretty close.
The vast majority of patients who test positive by PCR are or were infected by the virus. That's a different question from whether a positive test indicates the presence of replication-competent virus (i.e., whether the patient could infect others right now), since RNA from dead virus can trigger the positive too; but that dead virus had to come from somewhere.
The relevant quotes from Kary are:
"With PCR, if you do it well, you can find almost anything, in anybody"
"If you can amplify one single molecule up to something that you can really measure - which PCR can do - then there's just.. very few molecules that you don't have at least one single one of them in your body"
"It doesn't tell you that you're sick"
My interpretation is that Kary Mullis did believe it was at least possible to "misinterpret" the results of a PCR test. It doesn't seem such a stretch to believe that you could be sick with the flu, while also having a single molecule of a coronavirus gene present in your nasal cavity (triggering a positive coronavirus test).
Note: I know this is an inflammatory topic. The views of Kary Mullis are not necessarily my own. I am posting this here because I think it is interesting.
US: https://trends.google.com/trends/explore?date=all&geo=US&q=l...
Interesting to see the graph starting to drop dramatically in early 2020 after a decade of growth/high numbers.
I've always had clean thick long blonde hair, which happens to be lice's favourite hair type. Every time there was a lice outbreak in school, I got it. Its very much a thing in Canada still.
Then things generally improved and life is now much better; so what about the lices? According to the 2019 statistics, there were 200 cases of headlice per 100'000 children that year. Quite a number, but not a huge one, really.
So that's why I asked--if in a poor second-world country lices were almost a non-issue, then surely that means the rich first-world countries have managed to completely get rid off the lice, and much earlier, too? Right?
Sanitation and "social distancing" work for flu, but coronavirus is mainly about ventilation.
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5489283/
[2]: https://www.thelancet.com/journals/lanmic/article/PIIS2666-5...
The (let's face it, silly) notion that masks and distancing suppressed all respiratory pathogens except one is a theory with very little traction, and which will almost certainly not stand up to serious scrutiny.
At the end of the day it’s likely gonna be the result of a combination of all these factors.
Agreed! What you are describing is viral interference: population-level immune responses to one respiratory pathogen causing suppression of others.
We've seen selective suppression of influenza and all of the other four endemic coronaviruses, while SARS-CoV-2 has thrived. This is true throughout the world, including places where stringent horizontal interdictive measures were taken, in places where no such measures were taken, and in all places in between.
> At the end of the day it’s likely gonna be the result of a combination of all these factors.
I think it's very unlikely - almost impossibly so - that interdiction has played a meaningful role in population-level suppression. I don't think it will be a combination; I think it will be explained by the same clearly observed phenomenon which has been responsible for similar outcomes in the past.
Why would it not?
https://www.cdc.gov/mmwr/volumes/70/wr/mm7010e3.htm?s_cid=mm...
Although COVID-19 is definitely more virulent than influenza, it doesn't seem reasonable to just jump to the conclusion of saying "it must be the restrictions". That's definitely part of the equation, and maybe it will turn out to be the entire equation, but we don't know.
> During the study period, states allowed restaurants to reopen for on-premises dining in 3,076 (97.9%) U.S. counties. Changes in daily COVID-19 case and death growth rates were not statistically significant 1–20 and 21–40 days after restrictions were lifted. Allowing on-premises dining at restaurants was associated with 0.9 (p = 0.02), 1.2 (p<0.01), and 1.1 (p = 0.04) percentage point increases in the case growth rate 41–60, 61–80, and 81–100 days, respectively, after restrictions were lifted (Table 2) (Figure). Allowing on-premises dining at restaurants was associated with 2.2 and 3.0 percentage point increases in the death growth rate 61–80 and 81–100 days, respectively, after restrictions were lifted (p<0.01 for both). Daily death growth rates before restrictions were lifted were not statistically different from those during the reference period, whereas significant differences in daily case growth rates were observed 41–60 days before restrictions were lifted.
This is one hell of a virus, but if what we are seeing is that it still spreads quite rapidly even with all the restrictions, yet the flu, which is also quite virulent, manages to disappear, then I don't think we really have all the facts as to why it has gone away. Maybe it is just that simple?
I guess what I'm saying is that it's a bit concerning just how fast people here are willing to jump to conclusions.
Well, the CDC/WHO have kind of conditioned them, no? The CDC, at least, is starting to realign their guidelines with the data.
This isn't really quite accurate though. Before SARS-CoV-2 ever emerged, our immune systems already had defenses against it. This is because of the already-extant circulating hCoVs.
This is why something like 80% of blood samples taken before SARS-CoV-2 emerged showed T-cell cross-reactivity. From the perspective of our immune system, it was never a "novel" virus. It was novel to scientists and politicians but not to the human immune system.
I got a cold a few weeks ago. Got tested, it wasn't Covid. Where mental gymnastics are needed is in ignoring hospitalization and excess mortality statistics.
Can you explain what is obvious? You seem to allude to something, but I'm not sure what that is.
Are you familiar with the concept of "R0" and that one virus may be more transmissible than another?
Flu has an R0 of about 1.5, and whatever covid's is, it's higher (last I saw was 2.5).
If we postulate that masking and distancing and similar measures act to reduce these numbers across the board, say by 0.6, that brings flu down to 0.9 and covid to 1.9. Outbreaks don't tend to stay around when their R0 is below 1, which would explain why there's hardly any flu this year and plenty of covid.
Source: I was trained as a mathematical biologist and did a bunch of work with compartmental models: https://en.wikipedia.org/wiki/Compartmental_models_in_epidem...
In this admittedly over-simplified model, beta is (per wiki) "the average number of contacts per person per time, multiplied by the probability of disease transmission in a contact between a susceptible and an infectious subject".
Social distancing reduces the average number of contacts, masking reduces the probability of transmission, and both act to reduce beta. You reduce beta, you reduce R0, you win.
If someone went to the COVID or flu ward and had someone cough in their face, they'd still get infected because that kind of exposure is generally too much for the innate immune system to catch.
It seems far simpler, in the Occam's Razor sense, to begin with the idea that staying away from people makes it harder to get sick from other people.
Unfortunately, COVID restrictions and social distancing have become so politicized that many resist the idea that staying away from people reduces the chance of getting the flu from them, because the implication is that those measures might also have been effective in reducing COVID cases. This contradicts a political point of view and therefore some would like to dismiss it out if hand.
For example I've notice that many of those who believe precautions violated their personal liberty want to diminish the effectiveness of those precautions, which isn't necessary from a logical point of view. It is not logically inconsistent to believe these precautions violated civil liberties even if they were highly effective. It just requires a person to believe that many deaths were a reasonable price to pay.
Is it that hard to believe that not being around other people limits the chance of getting sick from other people?
These numbers seem way too low if you're talking about the prevalence of people that have been exposed to SARS-CoV-2.
"Only people who get tested for influenzalike illnesses—typically about 5 percent of individuals who fall ill—are tallied."
If there were a change in the way these tests were administered, for example a blaring medical bias toward another disease, that would present a significant sampling problem. That same statistician also wanted me to mention the simplest and most boring answers are usually closest to the truth.
There could be other explanations, such as: a desire to avoid Covid causes people to avoid seeking treatment, so more flu cases self resolve. OR: a fear of Covid causes more people to get tested when they're sick, and some of them may then go for flu testing before they would otherwise after coming back negative for Covid...?
Seems like the simplest answer is just "actions that have reduced the spread of one disease have also reduced the spread of another, that's historically less widespread already."
This is not the simplest answer, and the evidence that the measures have really slowed spread is extremely low except in places like New Zealand and Australia which are small islands in Oceania.
---
> A bias towards testing for Covid wouldn't explain fewer cases of the flu unless those cases of the flu were coming back as Covid falsely instead of so further diagnosis was stopped.
Exactly this. I'm partial to the viral interference hypothesis, but what you don't seem to realize is that if you get infected for SARS-CoV-2 and recover in 7-14 days, you will still test PCR+ for months after. This goes into the widespread mistuning of the cycle threshold. Case in point: They tested George Floyd's corpse for COVID-19 and he was PCR+, despite having recovered from COVID-19 a couple months before. The test hit on the remnant viral debris from his long-gone infection.
Have you ever heard of this small Asian country called CHINA?
Do you have a link to someone alleging this for covid? I'm worried this is spin that you picked up from a source that has an interest in opposition to covid mitigation practices.
1) most flu cases are being mislabeled as covid
2) most people who have a mild flu are not going to the doctor
3) the easiest way to test this will be when covid goes away and the flu suddenly reappears.
Influenza will likely never be eradicated from the earth completely, but in the most recent flu season worldwide, it was essentially missing.
When has government willingly relinquished emergency powers?
I think you are mixing up half-facts. People were saying that deaths with co-factors were being lumped as covid related deaths and different countries were classifying things differently for political reasons. No one is mislabeling the flu as covid and not giving you a covid test to detect the strain.
There have been 33 million positive coronavirus cases and 444 million tests-- are you sure you want to assert the following is true 100% of the time:
1) all covid diagnoses are ONLY covid
2) all flu occurrences are diagnosed, and when they are diagnosed, they are always ONLY diagnosed as flu
All flu occurrences were not diagnosed before, this year or will be in our future lifetimes. Your doctor telling you its the flu and to get rest vs getting a positive for a influena A or B test and the percentage that a lab might make a mistake on those tests vs the % of time your doctor is wrong are two very different ways to think about your question. Usually the words 'AlWAYS' and 'ONLY' fail in a big population set.
Perhaps we should continue this way.
Because people outside the US actually see their doctors when they get sick? Or people who are otherwise older/younger/immunocompromised etc.
Don't just assume that everyone is a young healthy person like yourself.
I am not sure what your point is with the assuming everyone is healthy. No one is saying that the flu can’t be deadly. The entire thread is about how you calculate how many people got the flu in a year. Some people suffer severe symptoms from the flu, go to the doctor, and are recorded in the statistics as having had the flu. Many people, however, don’t have bad enough symptoms and therefore don’t go to the doctor and are not tracked in the statistics as having had the flu.
The question is how do they figure out the actual rates when a large portion of cases are never recorded.
What does my own health or the fact that the flu kills many people have to do with that question?
I can imagine that many others in my situation would come to a similar conclusion.
https://www.youtube.com/watch?v=TzriCFzM5Ys
https://imgur.com/a/OZzPVuY
When you start from that position, you are already assuming your point of view is correct, and then using the correctness of that point of view in a circular manner to support your point of view.
From the article:
"the Centers for Disease Control and Prevention estimated there were roughly 22,000 deaths in the prior season and 34,000 two seasons ago." -- emphasis added
So the data is there :-)
https://www.ontariohealthstudy.ca/
It's not being tested for because they are prioritizing COVID-19 testing, unless your hospitalized.
https://www.660citynews.com/2021/04/13/zero-cases-of-seasona...
https://www.albertahealthservices.ca/influenza/Page14481.asp...
**Please note for all dashboards that as of March 12, community samples are no longer being routinely tested for non-COVID respiratory pathogens including flu.
And if you look at the 2020 - 2021 dashboard
https://www.albertahealthservices.ca/influenza/influenza.asp...
You'll see they don't have any test information for Influenza.
I may be misunderstanding this as it is hard to make sense how the governments statistics show no testing and that news article you mentioned with the chief medical officer for the province saying otherwise.
And that they at least show non zero results for past years.
Before covid hospitals, and doctors, didn't test for the flu viruses. Maybe in severe cases?
I know for certain private practice doctors didn't. All you saw was a chart on the wall differentiating a cold, from the flu.
In the USA, the government tries to target the upcoming flu vaccine, but is usually wrong on the strain.
Personally, I think Americans have been dying for years of SAR viruses, and the government has been blaming the flu virus?
We had a family Thanksgiving in my grandmother's house in '98. My sister brought her two very sick kids to the holliday. By the next morning (12-16 hrs after exposure) we were all sick, with the exception of my brother. 5 people who never felt so sick in their lives. I could't even muster the energy to take my slacks off before dropping into bed. 7 days later my grandmother died. I was always under the impression the incubation period was longer than a half day? Whatever that virus was, I will never forget it for a lot of reasons. And of course, my grandmothers cause of death was "complications of the flu", and probally should have been on a respirator, and not sent home so soon?
This is simply false.
https://www.modernhealthcare.com/patients/providers-switchin...
> In 2018, providers completed between 35 million and 40 million flu tests in the U.S., including RIDTs that use immunoassay technology and molecular tests, flu testing company executives said.
Anecdotally, my kids' pediatrician does them any time flu-like symptoms are present. Same for strep tests. Both have rapid, in-practice tests that require just a swab.
See this for an example of the work involved in the UK: https://assets.publishing.service.gov.uk/government/uploads/...
> How do they measure such things?
By have a sophisticated surveillance network and testing people. To quote from the above page, there have been 931,726 specimens collected since 9/2020, and only 0.2% have been positive.
Compare that number to the previous season (13.0%):
https://www.cdc.gov/flu/weekly/weeklyarchives2019-2020/Week0...
The impact of this effect changes if has-flu and has-covid are correlated, but it's still there unless it's a 100% correlation.
I had bad flu last year and because of home working, I went back to "work" once I reached the number of days after which I needed a doctor's note. In normal times I'd have gone to the doctor to get a sick note rather than infect my colleagues.
These form the basis of overall infection estimates. If you are interested in the methodology of those estimates, here is the CDC overviews, complete with citations for the primary research that informed the creation of their models: https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm#e...
It's kinda the same math that hardware stores use to figure out how many shovels to stock in a given store each week. Nothing is a mystery if you have data.
Just put all that into some simple regression models and you probably get a fairly good estimate.
The trickiest thing is figuring out how out of stock you are. How many shovels would you have sold if you hadn't run out of stock. So usually you have to be more careful with data points when you might have not registered customers that didn't get what they want in your store.
The definition for a flu epidemic is two standard deviations above the expected cases for influenza that year, as estimated by a Serfling-type regression model using a negative binomial distribution.
Influenza just doesn't breach that barrier for more than a few weeks most years, and rarely in widespread geographic areas at once.
Compare that to SARS-CoV-2, where the expected number of cases is zero.
"Epidemic" means something more than "Lots".
You can have very serious endemic diseases - malaria is one example. But "Occurring to a level above expected" is an important piece of information all its own - for example, five cases of Smallpox, while only five cases, is something of an emergency, whereas five cases of influenza is not a serious crisis.
That's all based on the people who would use the technical definition.
Source: https://www.nytimes.com/interactive/2021/04/22/science/flu-s...
My wife is also an ER doctor and agrees that there were times that they didn't perform many/any flu tests--mostly in the spring of 2020 and after none of the flu tests were returning positive for a while. But this past winter people have definitely been tested for the flu. Rapid influenza tests are also usually performed first, only sending to labs when confirmatory testing is desired.
https://seattleflu.org/
If you subtract baseline mortality from actual mortality to get excess mortality, that's often a better estimate of the casualties from pandemic, famine and war than the death certificates for every person who died.
Excess mortality in most countries shows that Covid deaths are significantly under-reported.
And if there are fewer deaths from flu, and fewer from suicide [1], then excess mortality itself is under-reported and Covid killed even more than we thought.
[1] https://www.mercurynews.com/2021/04/08/defying-expectations-...
In any case there were a couple peaks in the USA where deaths from all causes were 25% higher than average.
https://ourworldindata.org/grapher/excess-mortality-raw-deat...
The majority of covid deaths are those that on average had very few months left to live. There is a likely a high chance these people were going to die to the next "flu" that came around.
How do you account for this? It seems like adding flu deaths on top of covid is incorrect - both would only have a subset of people that are going to die from it, and while covid's is probably more than the flu (depending on the flu strain - we've had some pretty bad flu years), since they both share the same pool I don't think you can add flu deaths in.
On top of that, we had a relatively light flu season preceding covid. This would also need to somehow be accounted for, but I'm not sure how. There was likely a "dry tinder" effect.
In England we know covid is killing people on average at least 10 years early.
Year/Cause of death 2015 2016 2017 2018 2019 2020 Total deaths 2712630 2744248 2813503 2839205 2854838 3358814 Heart disease 633842 635260 647457 655381 659041 690882 Cancer 595930 598038 599108 599274 599601 598932 COVID-19 345323 Unintentional injuries 146571 161374 169936 167127 173040 192176 Stroke 140323 142142 146383 147810 150005 159050 Chronic lower respiratory diseases 155041 154596 160201 159486 156979 151637 Alzheimer disease 110561 116103 121404 122019 121499 133382 Diabetes 79535 80058 83564 84946 87647 101106 Influenza and pneumonia 57062 51537 55672 59120 49783 53495 Kidney disease 49959 50046 50633 51386 51565 52260 Suicide 44193 44965 47173 48344 47511 44834
Unless I'm reading that chart wrong it seems like flu went away but viruses that cause cold like symptoms stuck around.
If masks/etc was super effective wouldn't you expect those to go down with influenza?
https://www.bbc.com/news/health-56483445
Coronavirus: How the common cold can boot out Covid
Think of the cells in your nose, throat and lungs as being like a row of houses. Once a virus gets inside, it can either hold the door open to let in other viruses, or it can nail the door shut and keep its new home to itself.
Influenza is one of the most selfish viruses around, and nearly always infects alone. Others, such as adenoviruses, seem to be more up for a houseshare.
If rhinovirus and Sars-CoV-2 were released at the same time, only rhinovirus is successful. If rhinovirus had a 24-hour head start then Sars-CoV-2 does not get a look in. And even when Sars-CoV-2 had 24-hours to get started, rhinovirus boots it out.
"Sars-CoV-2 never takes off, it is heavily inhibited by rhinovirus," Dr Pablo Murcia told BBC News.
He added: "This is absolutely exciting because if you have a high prevalence of rhinovirus, it could stop new Sars-CoV-2 infections."
Or to put it another way, the influenza season was already under way when SARS-Cov-2 hit in Feb 2020, but there is no indication the influenza virus slowed the SARS-Cov-2 pandemic.
The exciting thing about viral interference is that no genetic similarity between the viruses is needed, however, the effect is only temporary (days to weeks) and limited.
Unfortunately viral interference is also being misused as an 'alternative explanation' by folks that do not want to see the evidence that non-pharmacological interventions (hygiene, social distancing, quarantine, masks, large gatherings etc.) are effective against a whole host of respiratory diseases.
[1] https://en.wikipedia.org/wiki/Viral_interference [2] https://academic.oup.com/jid/advance-article/doi/10.1093/inf...
Viruses are not identical.
https://en.wikipedia.org/wiki/Rhinovirus
> They are lytic in nature and are among the smallest viruses, with diameters of about 30 nanometers. By comparison, other viruses, such as smallpox and vaccinia, are around ten times larger at about 300 nanometers, while flu viruses are around 80–120 nm.
Different virus sizes, different mask effectiveness.
Anecdotally, my kids are in middle school, and every winter we get several colds. None this year.
Not necessarily - when speaking and otherwise spreading aerosols they start out much larger than any virus particles contained within them and quickly dry out and shrink if in air (i.e. not caught in a mask) [1, 1um - 500um, between Table I & Fig 11].
If they were on their own, the small 'nanoparticle' regime (1-100nm) shows fairly good filtration in a variety of media [1st image in 3] thanks at least in part to the diffusion of particles through filter media. It's not the same by size by any means (with smaller often being the most passed particle size) but it varies with filter construction and treatment [3].
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061903/ [2]: https://www.tandfonline.com/doi/pdf/10.1080/00022470.1980.10... [3]: https://academic.oup.com/annweh/article/56/5/568/159920
Many cold-like viruses infect mucous membranes (you have a number over your body). A glancing touch is enough to be infected.
https://www.usatoday.com/story/news/nation/2020/09/08/do-you...
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
s/b
The public health measures that slow the spread of the novel coronavirus work really well on FANG earnings.
The headline is hyperbolic (the article says it’s dropped to “minuscule levels”) but it’s entirely possible to determine that by sampling a small portion of the population.
The flu has a base reproduction number (R0) less than 2 (https://www.vdh.virginia.gov/coronavirus/2020/12/07/covid-19...). Covid has an R0 in the vicinity of 2.5 (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...).
In the meantime, public health measures like masking and distancing will work against both viruses. If people become reluctant to socialize because of covid (whether or not there be legal restrictions), they will also not spread the flu.
As a broad conclusion, if public health measures reduce the effective reproduction number of Covid to about 1 (stabilizing exponential growth), they will also reduce the effective reproduction number of the flu to something substantially below 1. Since the flu would have also had a low baseline prevalence in the summer of 2020, it is no wonder that we failed to see a flu season.
There's really no need for conspiracy theorizing.
Diseases always face selection pressure to spread more easily and rapidly. When that selection pressure is caused by broad factors like "people aren't congregating together," it's hard to imagine how any simple evolution could overcome that barrier.
Covid itself is instructive here. Some of the variants of concern are more transmissible than the originally-distributed variant as of March of last year, but those mutations don't uniquely overcome masks or social distancing. They would have always result in a more transmissible virus (because SARS-CoV-2 appears to be a zoonotic virus not originally perfectly-adapted to humans), and we are seeing them now because each infected person is a new roll of the mutation dice.
Applying that lesson to the flu, the less prevalent the virus the less likely we are to see variations, not more. Alas, for influenza itself we always have the asterisk that we regularly see new variations cross to humans from animal reservoirs, so we're unlikely to eliminate it through only (nonpharmaceutical) human-health measures. (It'd be nice to get a universal flu vaccine, though.)
We had. And it may have killed 3% to 5% of the world population in about 2 years: https://en.wikipedia.org/wiki/Spanish_flu
That's also why we are so afraid of this one and constantly monitor it: https://en.wikipedia.org/wiki/Avian_influenza
We go for a suppression strategy instead.If 1 person infects 1 other person (as we seem to be trying to achieve with corna) it is going to take 1000 generations before full immunity is achieved. There is going to be far more chance of mutations in 1000 generations of viral replication than in 3 generations.
However, I think this is right in one sense: an implicit or explicit strategy of keeping R0 as close as possible to 1 would be the strategy with the highest risk of significant mutations, as we have seen.
UK government ministers literally stated this to be their strategy.
Comparing places that didn't lock down to those that did I think its fair to say that the strategy has not been effective.
The current some half of the world somewhat protected, while other parts are breeding grounds is a pretty bad state to be at, with a potential mutation turning up and endangering the protected people as well again.
Assuming that this is due to "masking and distancing" and the small difference in R0 is crude thinking. It's unlikely to be anything of the sort.
First, R0 is not a fixed constant. It varies by context and location, and we've seen influenza decline everywhere.
Second, R0 is an estimated value. There are big error bars on all of these estimates -- the overlap is far greater than the 0.5 you're using to claim causality.
Third, rhinovirus has not gone away (estimated R0 < 2). Nor has adenovirus (estimated R0 ~2.3) [1,2]
There's something far more interesting going on here, it is surprising, and it isn't a "conspiracy theory" to talk about it. It's science.
(FWIW, my current favored hypothesis is that the closure of schools, and possibly travel, significantly affected the spread of flu. Unlike Covid, kids are a significant vector of spread for influenza. It's one of those little facts about Covid that is...politically incorrect...to acknowledge right now. But I am speculating, and there are problems with this theory as well.)
[1] https://syndromictrends.com/metric/panel/rp/percent_positivi...
[2] https://www.medrxiv.org/content/10.1101/2020.02.04.20020404v...
- More asymptomatic transmission of rhinovirus/enterovirus and adenoviruses than influenza. People often don't notice these illnesses, so wouldn't assume it is COVID and quarantine like they would for influenza.
- More fomite spread than influenza. They may be more stable on surfaces or in food
In general though, any sort of explanation that focuses on differences in transmission is more plausible than hand-wavy theories involving R0 and masks. People just desperately want to find evidence that the stuff we did this year made a huge difference.
I don't think that's true at all. People have been receptive to the increased evidence that transmission on surfaces is pretty unlikely, for example, despite all the efforts we've put into sanitizing surfaces.
I think most people can appreciate that all the shit we threw at the wall throughout the pandemic eventually comes down to how much effort it is vs how much benefit we get from it. And our understanding of each measure has changed over time. We now know, generally:
Masks indoors are low-effort, medium reward. Masks outdoors are low-effort, low reward.
Cleaning surfaces is medium-effort, low reward.
Staying home is (economically, societally) high-effort, high reward.
I'm just saying: responses like the OP immediately leap to the conclusion that influenza went away because of all the stuff we did. It's an error in logic, driven by the emotional desire to believe that the stuff we did must have had a serious impact, and that anything else is not worth serious discussion.
That's ideology, not science.
That said, if the massive reduction in flu cases isn't a result of some or all of our Covid efforts, it'd be a hell of a coincidence.
Mmmm...I wouldn't go that far. Like I said, my current preferred theory involves schools, but other plausible theories involve things like mutual inhibition: infection with one virus somehow interferes with infection by the other.
We have some evidence of this happening in the past. Strains of influenza have abruptly vanished due to this phenomena.
Certainly, I'd agree that this is interesting (which is pretty much where I end up on this, vs. the OP, who thinks the matter is settled.)
and distancing is a first-order mitigation that overwhelms the effects of inferior/ineffective mitigations like cleaning, sanitizing, mask-wearing, extra ventilation, etc. those secondary mitigations can make more of a difference when we want to pack it in, like at a movie theater, but otherwise they don't do much because those circumstances are relatively rare.
folks just don't want to accept such a simple answer because it means there's not much to hang their anxiety on, and that cognitive dissonance is unacceptable, as it always is.
I feel like you're coming down too hard on OP. He makes a valid argument.
> immediately leap to the conclusion that influenza went away because of all the stuff we did
It's not an error in logic. It's a reasonable conclusion to draw based on what we've seen and the links he provided. Whether it's true or not, that's debatable and probably nobody here on HN is going to figure that out definitively.
I'm really not sure why you're so argumentative without actually providing any substantial arguments against OP. It feels more like you're the one arguing from an ideological basis.
1 is not normalized data. It does not account for testing frequency. These percentages are of tests using BioFire. My hospital, for example, does not use BioFire to test for SARS-CoV-2 and so we end up running BioFire much, much less frequently than during a normal year.
Anecdotally non-COVID respiratory infections in hospitalized patients have decreased dramatically. Working on trying to demonstrate this with data.
It's a meta-analysis of many other papers. The estimates for the other ILIs have not changed significantly in 2020. Again, this is nitpicking that misses the forest for the trees: the differences in estimated R0 between these viruses is not so precise as to be useful for claiming the effectiveness of something like "masks and distancing".
> 1 is not normalized data. It does not account for testing frequency
This is incorrect. The data is normalized across all samples. Your hospital's non-participation may change the coverage of the sample, but that doesn't really matter when it's just showing you that rhinovirus hasn't gone away.
The FilmArray RP test utilization rate (TUR) metric is defined as the non-normalized number of RP patient test results generated each week across the Trend sites (computed as a centered 3-week moving average). To calculate the pathogen detection rate (as displayed in Figure 2 [second data view] and on the Trend website), we compute the rate for each organism at each institution as a centered 3-week moving average. To adjust for the capacity differences between sites, a national aggregate is calculated as the unweighted average of individual site rates. Only data from sites contributing more than 30 tests per week is included to avoid noise from small numbers of tests. Because the calculation of pathogen detection rate includes results from patients with multiple detections, the detection rate for all organisms can, in theory, add up to greater than one. In practice, this does not occur.
These are rates. This does not account for testing frequency. If they only tested 1 person in the United States tomorrow, and they had rhino/entero, the graph would show 100% (obviously it wouldn't and they won't only test 1 person). That means that if testing decreased, because for example there were less patients with symptomatic viral infections, but the % positive stayed the same, the chart would not appear to change, even though there were fewer cases...
paper: https://publichealth.jmir.org/2018/3/e59/
> To calculate the pathogen detection rate (as displayed in Figure 2 [second data view] and on the Trend website), we compute the rate for each organism at each institution as a centered 3-week moving average. To adjust for the capacity differences between sites, a national aggregate is calculated as the unweighted average of individual site rates. Only data from sites contributing more than 30 tests per week is included to avoid noise from small numbers of tests. Because the calculation of pathogen detection rate includes results from patients with multiple detections, the detection rate for all organisms can, in theory, add up to greater than one. In practice, this does not occur.
The TUR is the the raw number of hits across all sites. They normalize this, which is why they talk about it possibly exceeding 1.0. It's why the Y-axis of the plot is labeled in percentages. The height of the bars is a moving average of detection rates across their network.
Regardless, this is still nitpicking. The point was that these other pathogens have not gone away. They have not. Even if you were right, it wouldn't change the argument.
When [2] speaks about SARS-CoV, it's referring to the earlier SARS-1, not SARS-2-aka-covid-19.
Given the reproduction number appears as the base of an exponent, I would not consider the difference "small."
If influenza has a typical R0 of about 2, reducing contacts by 50% would make its growth non-exponential. If covid has a typical R0 of about 2.5, doing the same would require a further 20% reduction of contacts, to 40% of baseline rather than 50%. Since population behaviour and legal restrictions have diminishing returns (eliminating casual contacts first at lower cost, then progressively higher-cost and more essential contacts), this could easily correspond to a large difference in effected (necessary) policy.
> Second, R0 is an estimated value. There are big error bars on all of these estimates -- the overlap is far greater than the 0.5 you're using to claim causality.
I have seen no credible evidence that typical (non-pandemic) influenza has an R0 greater than that of SARS-CoV-2. If you have a citation handy to the contrary, I'd be interested in seeing it. In the meantime, I tried to be generous in my estimation of influenza's R0; even your reference [2] places its central estimate at 1.68.
> Third, rhinovirus has not gone away (estimated R0 < 2). Nor has adenovirus (estimated R0 ~2.3) [1,2]
Rhinovirus and adenovirus both have mean-estimate R0 greater than that of influenza in your reference [2], so if policy is going to eliminate any of these disease from general circulation then influenza would be the first.
Furthermore, some analysis does show limited evidence of a reduction of rhinovirus cases (https://www.nature.com/articles/d41586-020-03519-3). A confounding factor here, however, is that we don't really have comprehensive like-against-like monitoring for rhinovirus in the way developed nations monitor for influenza. Adenoviruses as a broad category are also not limited to respiratory transmission, so air-focused restrictions would have less effect on these other routes.
Finally, I reiterate that flu has a pronounced seasonal variation, whereas rhinovirus is somewhat less variable. A set of social responses only needs to prevent the flu season from starting to make it "disappear."
The difference in measurement is small, relative to the error in measurement.
Look at the error bars on the R0 estimates in that paper. Influenza runs from 1.06 to 3.4. You are trying to make micrometer inferences from a parameter where our best estimates are measured in libraries of congress.
If you consider the influenza estimate independent of equivalent estimates for covid, then there's a substantially greater than 50% chance that influenza's R0 is meaningfully smaller than that of the flu. If the estimates are partially dependent (i.e. methodology that gives a larger estimate for influenza would also give a larger estimate for covid), then that chance goes up further.
Moreover, we also have evidence in the actual observations of epidemic dynamics. Over the southern hemisphere fall of 2020 (northern hemisphere spring), covid cases increased more rapidly than influenza cases in countries that were entering their flu seasons. That's compelling-to-me evidence that covid in fact has a larger basic reproductive number, whether that be due to a fundamental difference in the virus or just the effects of low baseline immunity.
Now, your idea that the particular set of policy restrictions may be more effective against influenza than covid is very interesting. There's a basic horse sense to it, as well, since policymakers were largely operating from a playbook written for a flu pandemic. However, I do not think that "more effective" is a necessary component of the argument; "at least as effective" will do just as well given influenza's low baseline prevalence (out of season).
Remember, my original point upthread was not to explain every bit of the relative epidemic curves, but instead to claim that we really ought not be surprised by the difference. I see little need to resort to specialized theories to explain the broad outline, even though I'm sure they will be helpful in the details.
Yes, we know that SARS-CoV2 increased, and influenza went away. That's trivially observed. We don't know why flu went away.
To turn that observation around and say "Covid grew faster than flu, and therefore it has a higher R0, and therefore, the flu went away because {insert your favorite NPI} was just good enough to stop it" is begging the question.
It could just as easily be any number of other factors that you're not accounting for. There's also a number of other faulty assumptions inherent in your logic. For starters: there's no particular reason, a priori, that a person couldn't have both flu and SARS-CoV2 in the same year.
> I have seen no credible evidence that typical (non-pandemic) influenza has an R0 greater than that of SARS-CoV-2. If you have a citation handy to the contrary, I'd be interested in seeing it.
Even if the difference in R of influenza and SARS-Cov-2 was only 0.1 (and there is no evidence suggesting the average difference is that small) and assuming both pathogens spread in a similar fashion [1], then over time SARS-Cov-2 will fluctuate around the meta-stable point of 1.0 and as a result influenza will decrease exponentially.
[1] https://virologyj.biomedcentral.com/articles/10.1186/1743-42...
Trying to use this tiny relative difference in fuzzy estimates of empirical parameters to make a complex causal arguments about...well, anything...is folly.
If there are no studies to show, refer to an opinion of an epidemiologist or any other expert in the spread of infectious diseases.
You seem to argue against a vast field of computer scientists, mathematicians, physicists, biologists, medical experts that do nothing else but study the spread of infectious diseases.
Burden is on the parent to prove their claim, not for me to disprove claims advanced without evidence.
All current estimates for R0 have wide, overlapping confidence intervals that make it impossible to differentiate them from other viruses. The best anyone can say is that Covid and influenza have similar mean R0 estimates.
> If there are no studies to show, refer to an opinion of an epidemiologist or any other expert in the spread of infectious diseases.
I cited just such a paper. Please refer to it.
Multiple people have cited many papers that all generally agree with the trend that influenza has a lower r0. You've discounted those by making what are ultimately statistically unsound claims.
> I cited just such a paper. Please refer to it
The paper you cited supports the other person's contention: that r0 of influenza is lower than that of covid.
As "the other person[1]," I'd like to point out for the sake of accuracy that the paper you mention here does not in fact study covid. While published in February 2020, the "SARS-CoV" it talks about was SARS 1, not the virus behind the current pandemic.
I've taken my prior for covid's R0 from sources such as the CDC (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...), which seem to report a best guess of about 2.5 with some room for variation.
[1] -- Who is also leaving the argument. We've both made our points well enough for others to form their opinion, and I don't think there's much unexplored territory.
Next year it is entirely possible that the R0 of covid drops below influenza.
If you introduced influenza to a naive population (i.e. native americans) you would get massive death.
<<Experts believe that as much as 90 percent of the American Indian population may have died from illnesses introduced to America by Europeans>>
any info about this? very interesting
Europeans brought deadly viruses and bacteria, such as smallpox, measles, urope. Europeans brought deadly viruses and bacteria, such as smallpox, measles, typhus, and cholera, for which Native Americans had no immunity (Denevan, 1976). yphus, and cholera, for which Native Americans had no immunity (Denevan, 1976). On their return home, European sailors brought syphilis to Europe. Although less n their return home, European sailors brought syphilis to Europe. Although less deadly, the disease was known to have caused great social disruption throughout eadly, the disease was known to have caused great social disruption throughout the Old World (Sherman, 2007)
https://www.kellogg.northwestern.edu/faculty/qian/resources/... (Note that I haven't read this whole thing, but wanted to find a source for my little factoid)
Europeans successfully domesticated animals, Native Americans did not. So Europeans had diseases that Native Americans were not adapted to.
See the wiki page: https://en.m.wikipedia.org/wiki/Native_American_disease_and_...
The steady state is exactly 1, which is like balancing a pencil on its point.
It's plausible that two things happened here: the various local restrictions reduced the R0 of flu below 1, and the border closures kept mutations from traveling: and influenza is notoriously mutation-prone.
These can combine to practically extirpate influenza. Unfortunately, the effect is temporary, and the next flu season is likely to be a real doozy.
Which will be "fun" because our societies now have a hyperactive immune system, and there will be considerable political pressure to "do something" about the next flu wave. This must be resisted but I'm not optimistic.
At exactly one, it's indeterminate; you could see a subexponential growth or decay. With no exponential terms remaining, lower-order terms that are ordinarily hidden by exponential growth become the dominant observables. (Since epidemic spread is also random, you're much more likely to see the stochastic terms show up in the overall statistics in these cases. You really can be lucky or unlucky with Rt ~= 1, but there's no persistent luck with Rt >> 1.)
This is also important before community spreading sets in, and it is the mechanism by which contact tracing can work. Rather than change the general susceptibility of the population to the disease (changing the effective reproduction number), contact tracing tries to operate at the level of individual cases in ways that cannot be scaled to uncontrolled community spreading (even if Rt is close to 1).
> and the border closures kept mutations from traveling: and influenza is notoriously mutation-prone.
Perhaps, but are influenza mutations an important effect within a single flu season? I know the determination of to-be-dominant strains has a great effect on the composition of each season's flu vaccine, but as far as I am aware we don't see declining flu vaccine efficacy over a season.
Over pretty much the last year you could observe, in different countries all around the world, that the reproduction number was 'magically' floating around 1.
Only recently did I learn that this effect was puzzling for epidemiologists as well and was only solved around 2012 (?) in a model that assumes a network of information about the disease in parallel to the network of disease transmission. The resulting feedback loops lead to the meta-stability of R=1. Super interesting how society acts as this distributed information processor, similar to 'the market' in economics.
You can almost see the phenomenon in real time during this pandemic. Countries that have low trust in authorities will still freak out when the epidemic hits biblical proportions, and do various forms of impromptu distancing measures which will bring the R number down. Then when the signs of panic subside, they'll loosen them. And so on.
Societies with high trust in authorities will still pressure their authorities to loosen up when things feel safe, with predictible results, leading to further lockdowns.
Then all of this will come back in the future and kick you in the teeth. Either we're going to have to accept this as a way of life, which is more detrimental. Or we're pushing off the inevitable.
This was uncertain to most people last year, but now we’ve seen so many examples that it really shouldn’t be so controversial any longer. But if it wasn’t, we wouldn’t be discussing it.
The covid virus is evolved to fit exactly into the niche of societal behavior where it will be a big fucking problem but not so bad that it’s immediately obvious to enough people.
Influenza is pretty promiscuous. In normal conditions, very few people aren't exposed to it: either their existing immune resistance (vaccinated or otherwise) is up to the job, or it isn't.
Mutation is therefore the primary driver of flu, year upon year. This is why vaccines are continually reformulated for a best-guess at what strains are going to be dominant.
We had just concluded a northern-hemisphere flu season when travel restrictions started to kick in. This was followed by at least a 90% reduction in international travel, and for most of what remained, it was mandated that new arrivals isolate for long enough to eliminate any influenza they might have carried.
Lockdowns would mean less mutation to begin with, since it happens in human hosts. And such mutations as did present are going to have a tough time jumping oceans, and even when they do arrive, spreading through the populace is substantially inhibited.
Ironically, the universal mask mandates are likely to be more effective against flu than against COVID. Like it or not, masking has minimal effect on spreading aerosols, although using a "real" mask, and being pretty careful to wear it right, can mitigate inhaling those aerosols.
Influenza is believed to be spreadable through aerosols, but the primary vector is droplets, while the opposite appears to be true for SARS2. Bog-standard cloth masks are fairly good at keeping droplets off people and surfaces.
[citation needed]
https://www.pennmedicine.org/updates/blogs/penn-physician-bl...
> The principal mode by which people are infected with SARS-CoV-2 (the virus that causes COVID-19) is through exposure to respiratory droplets carrying infectious virus.
https://www.cdc.gov/coronavirus/2019-ncov/science/science-br...
From what I can tell, you may have your flu/covid mixed up. Covid is spread through respiratory droplets, the spread of which is reduced by wearing a mask.
The claim that "lack of infection spread in hospital settings" rules out airborne transmission due to masking is also questionable. The opposite seems true. As I understand it, infections in hospital settings have been routinely documented throughout the pandemic despite masking, contact protocols, etc. - which implicates airborne rather than droplet/fomite transmission.
This is a really good article in the Lancet recently which solidified my opinion on this. It offers 10 items of evidence for airborne transmission being the primary driver of the pandemic.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
For me, the key points are:
> Second, long-range transmission of SARS-CoV-2 between people in adjacent rooms but never in each other's presence has been documented in quarantine hotels.7
> Sixth, viable SARS-CoV-2 has been detected in the air. In laboratory experiments, SARS-CoV-2 stayed infectious in the air for up to 3 h with a half-life of 1·1 h.12 Viable SARS-CoV-2 was identified in air samples from rooms occupied by COVID-19 patients in the absence of aerosol-generating health-care procedures13 and in air samples from an infected person's car.14 Although other studies have failed to capture viable SARS-CoV-2 in air samples, this is to be expected. Sampling of airborne virus is technically challenging for several reasons, including limited effectiveness of some sampling methods for collecting fine particles, viral dehydration during collection, viral damage due to impact forces (leading to loss of viability), reaerosolisation of virus during collection, and viral retention in the sampling equipment.3 Measles and tuberculosis, two primarily airborne diseases, have never been cultivated from room air.15
> Seventh, SARS-CoV-2 has been identified in air filters and building ducts in hospitals with COVID-19 patients; such locations could be reached only by aerosols.16
> Eighth, studies involving infected caged animals that were connected to separately caged uninfected animals via an air duct have shown transmission of SARS-CoV-2 that can be adequately explained only by aerosols.17
> Tenth, there is limited evidence to support other dominant routes of transmission—ie, respiratory droplet or fomite.9, 24 Ease of infection between people in close proximity to each other has been cited as proof of respiratory droplet transmission of SARS-CoV-2. However, close-proximity transmission in most cases along with distant infection for a few when sharing air is more likely to be explained by dilution of exhaled aerosols with distance from an infected person.9 The flawed assumption that transmission through close proximity implies large respiratory droplets or fomites was historically used for decades to deny the airborne transmission of tuberculosis and measles.
Why on earth does it make sense to resist sensible public health measures to reduce the influenza to R0<1?
The measures would not need to be nearly as drastic as those for COVID ("normal" R0 of 2 vs 2.5+), so more handwashing (good to minimize a broad spectrum of pathogens), masks (already culturally ordinary in many countries), and especially better indoor ventilation systems would be a long-term benefit to everyone.
I'm mostly hoping that the success of better sequencing, mRNA vaccine technology, and the rapid development deployed for CV-19 will also be applicable to influenza and help minimize or practically eliminate it.
Are you assuming other measures?
Let's not forget a substantial portion of the population working from home, using less public transportation (choosing to travel by car when traveling at all), a huge decrease in tourism and large public gatherings, much less eating out at restaurants, contactless food delivery becoming the norm, etc.
So many factors figure in to why much of the (wealthy, developed) world is a lot more resistant to contagious pathogens today than it was a year ago.
If anything, politicians have vastly under-managed the situation, timidly afraid of offending constituents' offense at any inconvenience, and only partially at best following sound science.
In states that did issue orders for masks and stay-at-home, the orders were weak, late, and lifted early, resulting in multiple waves that only abate now because of the rapid deployment of vaccines.
Most importantly, there was very little and late funding to cover the costs of those who should most have been shut down, group travel, entertainment, dining, etc. - should have been fully shut down immediately, and everyone's costs covered.
6-10 weeks of hard shutdown, while standing up a full masking, test/trace/isolate protocol would have handled it, yet few countries did it.
A few countries did implement early, strong, and effective measures, such as New Zealand. They also then opened up many months earlier than the rest of the world with near-normal life.
Where are the politicians "drunk with power" who are restarting lockdowns for their own gratification?
Where is the advantage for such a "drunk on power" politician? What could they possible gain by unnecessarily implementing measures that are seen at best by the smart ones who understand it as a necessary inconvenience, and by the rest as an assault on them?
Even flat-out authoritarians do no such thing. E.g., China, who is unashamed to run literal concentration camps for Uyghur minorities, and who did hard lockdowns at the start, is not opening up as soon as scientifically feasible.
Unless you can show some citations of evidence, this looks a lot less like a real phenomenon, and more like a pseudo-libertarian teenager's trope.
Public health measures that you disdain aren't popular where they are because your neighbors want to step on your neck they are popular because people who know more than you do know they on net save lives.
When there is nothing to be gained by such measure support will blow away like dust in the wind. There is no battle for you to fight.
Obviously your quoted poster’s concerns are less about “hand washing”, “wear a mask if you have symptoms”, and “stay home” while you recover, and instead are about an overreaction in which entire businesses are forced to shut down, children without symptoms are forced to wear masks even as they run and play, and people are forcibly prevented from leaving their homes “just because it’s flu season”.
This may be necessary, at times, for COVID-19, but as you recognized, not for the normal flu.
Given the spotty record of both public and private policy with regards to using actual science as a driver, these are not invalid concerns.
Or put differently, rather than presuming that anyone against “doing something” is against “common sense” measures, perhaps we should be supportive of making sure that we do something, AND that the “something” that we do remain in the realm of common sense, to assuage the very real concerns that “doing something” could mean something more harmful than good.
If I (salaried) take a sick day, I get paid the same amount from the same source; there’s next-to-no economic incentive for me to risk the health of others by working when sick: problem is solved.
We could more or less force the same by law for scheduled hourly workers. It’s a little more difficult for gig. It’s basically impossible (as I see it) to put self-employed people at the same outcome as if they worked without substantial risks of under-comping some and over-comping others.
That is to say most people don't have allergies to confuse with illness and although you might wake up feeling poorly for a number of reasons flu sufferers are liable to suffer from one or more distinguishable symptoms for example for myself when I've contracted the flu I always get a really shitty body ache.
It's possible to get a cold without also having a fever. You are absolutely correct about that but even in that instance the majority are liable to be able to know when they are ill. They just don't stay home because the social pressure has been in favor of bringing your sickness to work as if you were doing everyone a favor by showing up and making your cohorts sick.
Sometimes my throat is sore but its just allergy drainage. It doesn't help that the things I'm allergic to line up with flu season.
https://www.aaaai.org/about-aaaai/newsroom/allergy-statistic...
https://acaai.org/news/facts-statistics/allergies
1 Hay fever, or allergic rhinitis, is a common condition with symptoms similar to those of a cold. There may be sneezing, congestion, runny nose, and sinus pressure. It is caused by an allergic response to airborne substances, such as pollen.
2 The American Academy of Allergy, Asthma & Immunology (AAAAI) is the most prominent membership organization of more than 7,000 allergists / immunologists (in the United States, Canada and 72 other countries) and patients' trusted resource for allergies, asthma and immune deficiency disorders. This membership includes allergist / immunologists, other medical specialists, allied health and related healthcare professionals—all with a special interest in the research and treatment of allergic and immunologic diseases.
WebMD's doesn't actually seem to actually source their data at all despite styling it like a link for some reason and since their is a disparity between what the CDC and AAAAI say I strongly suspect they are full of shit
Depends on what you want to achieve. If you like a increase of infection, you do it like here in germany and close down hardware stores etc. multiple times on short notice, without telling when they will open again - so people try to storm them before they close, all coming closely together by doing so, which they would not have otherwise.
For example here in order to avoid contamination in public transports they limited the hours of service. Consequence: same number of people took transport but in less time, increasing density and contact.
Similarly with the curfew forcing shops to close earlier in the day, more people gather in less time.
- Paid sick leave. First and foremost.
- Increased flexibility for people WFH as possible if sick or vulnerable.
That's really about it. Maybe masking, though that well has been throughly poisoned.
We've sorted a lot of this out over the past year, but there is an all time distrust of institutions surrounding both policymakers and the public health recommendations informing them, and there's a reason for it.
We can either help assuage people's fears (whether you see them as founded or unfounded) by empathizing with their concerns and experiences and addressing them while ensuring that any measures enacted remain rooted in science that we can trust...
OR we can be part of the problem for why there's so much distrust, by ignoring anyone who may have real experiences that have caused them to lose trust in our science and health institutions, and telling them that it's all in their head.
I strongly hope for the former, myself.
Well, yeah, they can be asymptomatic, spread their sickness to other kids, who then take it home to their parents and grandparents.
In particular you could imagine that if people never venture outside their own block that the social network is an euclidean graph. In an ideal case where people are evenly spaced in the plane and only interact with neighbors, the disease would spread as a circle expanding outwards, so total infections would be proportional to ~ t^2, and current infections ~ t.
“Exponential with R varying over time” and “not exponential” differ only in interpretation imposed by an observer.
> infection is simply an exponential process
No, in the hyperidealized perfect mixing scenario, its a logistic process, like most other resource constrained processed that look exponential when analyzed over a dhort period.
In the real world, its neither exponential nor even perfectly logistic, even before considering changes to the environment in which the disease spreads (including those induced by the disease, including people’s response to knowledge of it.)
So, do something by taking a flu vaccine like is already available and recommended for annual use by the CDC?
[0] https://www.cochrane.org/CD001269/ARI_vaccines-prevent-influ...
That seems a little denialist, honestly.
The idea that the flu just 'disappeared' despite world trade continuing just sets off my bullshit detectors. Between all the countries that did little or nothing initially, and the people who refused to wear masks and didn't lock down...there's just no way it dropped to zero. Less? Sure. But gone? I simply don't believe it.
None of that has changed in the era of COVID, although the pattern of who goes to clinic for what may have. If there were flu out there we'd be detecting it is the bottom line.
Before that it was noted that flu was killing more than coronavirus in summer.
FluNET is precisely why we know flu dropped so much, and hence the large chunk of people with respiratory symptoms have been COVID-19 or otherwise, but certainly not flu.
Also, username-bro.
Indeed, most flu patients don’t even see a doctor.
So, at the outset, the flu stats are coming from a very specific category of patients: in-patients and people with great insurance who have the time and money to get tested for the flu (even though it won’t make a bit of difference what the test says as it’ll be over in a couple weeks anyway.)
This second-category may be skewing things.
The personality-type that has a ‘need’ to know whether they have the flu was instead focused on Covid. They’d have the sniffles, go through a drive-through Covid testing site, get their negative result and breathe a sigh of relief. They would NOT however make an appointment with their doctor as they perhaps would have in years past as (a) they wanted to avoid sources of Covid, and (b) the doctors were discouraging appointments but for emergencies (and flu-like symptoms plus a negative Covid test, would not, in the patient’s mind, amount to an emergency.)
I doubt this explains all of the decrease in flu-positive tests. But, perhaps some of it.
And yes, we test for influenza a lot.
Was one nice perk having kids at home. 9 months of no illness.
6 weeks after going back family had Covid. No it’s back in the routine of mild illness at least monthly.
Kids are significant spreaders of both influenza and Covid (after school reopenings, in many countries kids become one of the top sources of inter-household Covid spread). They just tend to have mild or absent Covid symptoms and didn’t require regular testing for work etc., and therefore did not get consistently tested in most parts of the world. In some places parents deliberately avoided testing their kids for fear positive tests would interfere with their in-person schooling or extracurricular activities.
Repeated claims that kids don’t spread Covid were politically motivated and based largely on junk science.
Admittedly doing good studies was extremely difficult in places like the USA where spread was wildly out of control and contact tracing was completely overwhelmed.
My favorite is this: https://www.nejm.org/doi/pdf/10.1056/NEJMoa2006100?articleTo...
The study isolated SARS-CoV-2 samples from every positive case, sequenced genome of virus, and tracked the mutation patterns. So, that will avoid a lot of the errors that improper qPCR usage can result in.
First things first, age and viral susceptibility:
> Of the 564 children under the age of 10 years in the targeted testing group, 38 (6.7%) tested positive, in contrast to positive test result in 1183 of 8635 persons who were 10 years of age or older (13.7%). In analyses involving participants up to 20 years of age, we observed a gradual increase with older age in the percentage who tested positive (Fig. S5).
That's more about who got it, but there's some discussion of transmission here where the senior author talks about it: https://www.sciencemuseumgroup.org.uk/blog/hunting-down-covi...
> Children under 10 are less likely to get infected than adults and if they get infected, they are less likely to get seriously ill. What is interesting is that even if children do get infected, they are less likely to transmit the disease to others than adults. We have not found a single instance of a child infecting parents.
> There is an amazing diversity in the way in which we react to the virus.
---
(I recognize I only presented one study here - there's only so much time in the day :P - but the other high-quality studies I've seen confirm this. Mechanistically it makes sense if you look at the enormous T-cell cross-reactivity in those age groups. And BTW, data on school closures for Influenza (which children seem to transmit much more readily) showed that school closures were ineffective anyway because they would just spread it more outside of school)
We may disagree on what the science implies, but downvoting someone for sharing research means that people are refusing to listen to anything that disagrees with their preconceived notions.
(I guess perhaps the implicit assumption is that anyone pushing articles that show that kids are at less risk, or that kids don't spread Covid as well, must also be pushing for all kids to be running free and socializing?)
Edit: And now this comment is getting downvoted. Folks who disagree, why not speak up about what's wrong with the study, instead of just downvoting?
Still, your points stand that there are some good studies showing kids are not necessarily the major spreaders. It is somewhat surprising to me, but it is data.
We sent our 6 yo back to (in person) school because computer school was a bad idea.
I have a friend who teaches high school. He is SO relieved to be ending computer teaching.
I think so people want in person school so parents can work, but plenty of people want in person school because it IS better.
I also think in person is better than remote. I can still think the bias to make it look safe to send kids back to school feels forced.
For some kids, lots of data showing some kids thrived and improved while others suffered.
Why is that absurd? Millions of Americans (mostly women) have had to work less or leave their jobs entirely in order to take care of their children, which is a major hit to both their finances and careers. It's a huge cost.
It is somewhat surprising to me
It shouldn't be if the media had been doing their jobs, but due to either incompetence or bias they haven't. People really don't seem to realize that schools have been open in large parts of the US (and many other countries) for months, and it hasn't led to mass infections of students or teachers or parents.
Similarly, nursing homes and any other assisted living makes sense as a category.
This is not the only study implying closing schools was a sensible step:
https://www.nature.com/articles/s41562-020-01009-0
> We have not found a single instance of a child infecting parents.
That is a really strong claim. It also goes against common logic.
Children are more likely to be asymptomatic. Fine. They tend to resist the virus better, and avoid severe cases even when they do get it. Yup, all good so far. They are less likely to infect others around them. Still makes sense.[ß]
What doesn't make sense is that transmission probabilities in the list are all above zero. From a purely mathematical perspective, transmission probability of "infected child -> parent" should not be zero. I am not stupid enough to dispute scientific finds, but I strongly suspect there are more factors in play.
Also the cynic in me notes that "infected child -> parent" is NOT the same as "infected child -> adult".
ß: Recent news indicates that the latest variants do spread more aggressively among children and teens, and are more likely to show up with symptoms in them. I haven't seen anything about increased mortality among the same groups, though.
I live in a country where schools have stayed open and our 2 kids have been going to daycare normally throughout the whole pandemic.
Our kids have also been eerily free of colds/flus this winter, after the previous winter where it seemed like they had fevers weekly and so much snot they'd choke on it while asleep.
Children, in fact, have been hypothesized to be the primary reservoir for influenza.
The implication of this is that it would be much better to vaccinate all children against influenza rather than everybody else.
I feel like you constructed a straw man by snipping this out from the parent comment:
> work against both viruses. If people become reluctant to socialize because of covid (whether or not there be legal restrictions), they will also not spread the flu.
You can socialize from 6 feet and with a mask. I took the parent to include staying home in their assessment and I have no clue why anyone would think otherwise. It's peak social distancing.
From the CDCs tips for social distancing:
> Choose Safe Social Activities: It is possible to stay socially connected with friends and family who don’t live in your home by calling, using video chat, or staying connected through social media.
You say "unlike covid". Maybe I'm biased because half of my family was infected with covid by a 6 year old(everyone's fine now) . Also here in Poland all 3 of our covid "waves" came few weeks after kids went back to schools (no masks are required at schools here, because feelings). It is obvious kids at schools are a very significant spread factor second only to spread at the workplace (also no need for masks at the workplace for some stupid reason unless you are public facing).
It is infuriating that tens of thousands of people have to die, because idiot politicians make policy based on stupid factors. For example, it would be inconvenient for everyone at workplaces to have to wear masks so let's tell them to ensure desks are 1.5m apart and everything is fine despite the fact they are not. There was even a local study done recently that estimated 40% of all covid cases were infected at the workplace. This info was major news for few days, then nothing changed and everyone forgot about it.
Also, the pinnacle of stupid (bordering on malice - hopefully it will be prosecuted eventually) is making covid treatment policy based on expected drug availability not on what works. It has been proved recently(9th of April) in Lancet corticosteroids given early on lower the incidence of hospitalisation a lot. However, despite many letters from the public "official medical guidelines" in PL still say the exact opposite using an irrelevant study as justification.
* The study is irrelevant because they measured efficacy of those steroids on people that are already hospitalised,it found no impact on death rate of already intubated people. The study authors also extrapolated their research of hospitalised intubated people to people pre-hospitalisation and for some reason wrote in their abstract corticosteroids given early actually have detrimental effect (no proof of this assumption in their study whatsoever).
Then the second study comes out that measures efficacy of (inhaled) corticosteroids in real early covid patients.It finds it significantly lowers development of symptoms that require hospitalisation. Everyone ignores it. Meanwhile we have over 80 thousand "extra" deaths in a country one tenth the size of US.
Oh, and my claim is that people making decisions on covid policy are perfectly aware of their wrongdoing because transcripts of their meetings are mysteriously unavailable.
In fact, real science has a tendency to be viewed (by non-scientists, it should go without saying) as conspiracy theory insofar as it challenges the official narrative, and invokes complicated explanations, rather than a nice simple answer.
(of course the modern sense of literal is literally figurative.)
In this overall thread, the idea that the "disappearance" of flu is driven by political desire to label all respiratory illnesses as covid cases would be an example of a conspiracy theory.
Another commenter brings up the idea of 'viral interference.' This is not an example of a conspiracy theory, but I do not give the idea great credence on Occam's Razor grounds.
While I may personally agree the viral interference comment is not (in my definition) a conspiracy theory, it is regarded as a conspiracy theory in many (again, non-scientific) contexts.
The conspiracy is not the collaboration, it is the belief.
You’d also have to claim that mislabelling was done deliberately for it to be conspiratorial.
I don’t think politically motivated distortions of perception are conspiratorial if those who are prone to mislabel things due to their belief system do so without realizing.
Not saying that’s an applicable explanation for the disappearance of flu, as it seems way too universal, just going further into semantics.
That's not necessarily true. COVID appears to be aerosolized, whereas typical flu is not. That means that masks will work to catch viral flu particles in ejected fluids (talking, coughing, sneezing, etc), but the same cannot be assumed for COVID, given that viral particles are orders of magnitude smaller than pores in cloth and surgical masks. And this assertion is supported by at least two studies (one Danish I believe) which showed negligible effect of mask wearing on COVID spread.
It sounds more like poor data reporting more than anything else and I will take that to my grave.
Covid starts from a higher baseline level of cases, and it has a higher transmission rate. When societies "open up" (resume social contacts; it's more than just government lockdowns), then we'd expect to see covid cases climb before flu cases. In fact, seeing the opposite would be very surprising.
"When the Facts Change, I Change My Mind. What Do You Do, Sir?"
So, it feels unsurprising that flu is relatively easy to suppress, since its spread is already fragile in normal times.
The combination of summer suppression and (continuing) hygiene measures has resulted in historic low levels of flu globally, which would need time to grow exponentially to even reach baseline levels.
All that sanitizing and hand-washing, as well as not going into the office and school, cut that way down.
Meanwhile, Covid continued to spread fine in public transportation, stores, restaurants, etc.
That explains all these news stories telling me what to expect:
https://www.nbcnews.com/news/us-news/experts-warn-twindemic-...
https://www.usatoday.com/story/news/health/2020/09/19/covid-...
https://www.scientificamerican.com/article/how-we-can-avoid-...
etc:
https://www.google.com/search?q=twindemic&tbs=cdr:1,cd_min:9...
Occam's Razor: Covid isn't a "pandemic", it's a strong flu
Measures against Covid work against flu.
It’s nice to know that our flu deaths are declining. But our Covid deaths are many times more.
As sars-cov-2 mutates seasonal covid might end up less bad than the seasonal flu. Though there is no way to tell.
Spanish flu killed millions before less deadly strains mutated and became what we now call flu.
I can’t advocate for any measure that kills millions in the short term, _especially_ without data for the long term.
I don't think mainstream virologists and epidemiologists have changed their minds after the past year.
That said, even if it was, a "very strong flu" with global transmission and impact _is_ a pandemic -- see the 1918 Flu Pandemic.
The death rate in 2020 in the US also surpassed that during the 1918 pandemic.
What I think we've learned is that the same measures used to slow the spread of COVID-19 are staggeringly effective against the flu, and that we now know how to prepare for the next particularly aggressive influenza variant.
And of-fucking-course it's a pandemic. What do you think that word means?
https://i.imgur.com/z9RsQ8e.png
From the CDC: In 2019, a total of 2,854,838 resident deaths were registered in the United States—15,633 more deaths than in 2018. In 2020, approximately 3,358,814 deaths occurred in the United States (Table). The age-adjusted rate was 828.7 deaths per 100,000 population, an increase of 15.9% from 715.2 in 2019.
ref: https://www.cdc.gov/nchs/products/databriefs/db395.htm https://www.cdc.gov/mmwr/volumes/70/wr/mm7014e1.htm
https://oronu.wordpress.com/2021/01/29/mortality-statistics/
If we're using the dictionary definition of a pandemic "(of a disease) prevalent over a whole country or the world." it's a pandemic.
If we're using the colloquial definition of a pandemic "a disease that spreads around the world killing lots of people" it's a pandemic.
If you want you can consider seasonal flu on the list of pandemics, fine, but you're simply wrong to consider covid not a pandemic and if you are trying to downplay how deadly covid is I'd say you're behaving in an ethically wrong manner too.
https://www.euromomo.eu/graphs-and-maps/
I don't want to assume bad intentions on your part but I'm not really sure what you want us to conclude from these posts... elaborate?
Just tired of people using selective memories to pretend that the last year wasn't chaotic and full of many wrong predictions, from experts and novices alike. Some humility would be appreciated.
How could it not be predictable? I get the cold/flu when I or someone in the family is exposed to someone sick and it gets passed on.
If we're all staying in the house and not going anywhere for a year, by what mechanism could we possibly get sick? Seemed predictable to me.
In any case, it's been so awesome to not be sick in over a year. With elementary school kid, it used to be I was sick every few weeks all year long. Not looking forward to going back to that kind of normal.
I guess no one decided to write a news story about it cause it was so predictable, dog bites man and all.
The warnings you're referring to were predicated on a pretty generic and nondescript need to get people vaccinated. This was a widespread messaging campaign in the media, heavy on the threats but not specificity.
Instead of what was threatened all summer, what actually happened was that flu disappeared AND people were being chastised for poor compliance with local ordinances and vaccination.
1. A high number of COVID cases and a high number of flu cases.
2. A high number of COVID cases but low number of flu cases.
3. A low number of COVID cases and a low number of flu cases.
If flu and COVID were independent, there would be a fourth potential outcome (high flu cases and low COVID cases). Majromax is saying that it was largely predictable that this fourth outcome would not happen.
The thing that the news articles are warning about is outcome #1 which, if it had transpired, probably would have been quite bad. Note that the experts in the articles are warning about something that could happen, not saying that it will definitely happen. And the reason it didn't happen is at least in part due to the warnings that were issued.
Even if you’re making a loose analogy that’s still a poor comparison.
Looking at two weeks:
- Week of December 5, 2020: 40/22,474 flu tests were positive
- Week of December 7, 2019: 631/1,508 flu tests were positive
Cumulative #s:
- Cumulative through Week 14 2021: 1,739/891,717
- Cumulative through Week 14 2019: 37,155/69,291
So we've been testing wayyy more often with wayyy fewer positives.
https://www.cdc.gov/flu/weekly/pastreports.htm
Everything that was flu was labeled as COVID since doctors, hospitals and medical professions were PAID a bounty on COVID.
Multiple this by PCR testing being 99% fraudulent due to high cycle counts which enable cold viruses and even flu viruses to to test positive because you've reached the "noise floor" of the test at 10-15 cycles (most testing was done with 30-40 cycles). This helped "fulfill" the bounties and take all the attention away from conventional diseases both infective and others like heart disease, cancer, etc. (which got counted as COVID as well, just like traffic accidents and other definitely-not-COVID deaths that occurred).
The same bounty system shut down the entire surveillance system for flu as well as because non-essential workers included anything not COVID related or providing shallowly defined "essential" services.
You what?
Do you actually believe this? Seriously?
Plenty of folks still took them on their own volition.
doesn't matter if even 20% of the population (which is a very high estimate) use some of these measures. You can't explain that the evolution is exactly the same as a Norway...
If you get a disease's R0 below one, it goes away.
Enough people changed their behavior in both countries to make flu go away, because it no longer spread quickly enough to sustain itself.
For these places, we would expect the flu to continue on as normal. Instead it’s disappeared.
How strange.
It was literally so stupid that it took me a minute or two to understand that the implication was that conspiracy theorists think flu cases were being categorized as covid.
If lockdown measures, social distancing, mask wearing, etc. were the true cause of the massive reduction in flu cases, we would expect to also see that countries and US states that failed to enact measures would be reporting high flu numbers to the WHO.
This doesn't appear to be happening. Instead, "the drop-off in flu numbers was both swift and universal." (article quote)
This universality suggests a data problem to me rather than an environmental change.
I don’t think so. Even without government policies in place, people become much much more vary of hygiene - that alone could account for a serious drop in new flu cases. The other factor as others mentioned is that someone with a weaker immune system who would have a pretty bad case of flu, had now a much higher chance of getting covid instead (due to covid quickly overtaking the number of cases due to its higher R number), so in a way covid being more infectious, sort of suffocated the flu.
Yeah but there are numerous studies that show these things don't work. Also, I'm confused why you think someone cannot get both covid-19 and the flu.
This argument does not make sense because of the timing of the disappearance of the flu.
For example, NYS was having a really bad flu season before the Covid panic hit[1]. I am posting a link to my screenshot first because NYS flu tracker[1] is one of the stupidest web pages out there. Click on the "compare with previous seasons" heading on the page to get the current table.
The noteworthy part is the drop in flu cases between the 6th and 7th weeks during what seems like an exceptionally bad flu season.
Note also "Regulation for Prevention of Influenza Transmission by Healthcare and Residential Facility and Agency Personnel"[3]:
> As of December 5, 2019, influenza is prevalent in NYS.
> At this time, Section 2.59 of the New York State Sanitary Code (10 NYCRR § 2.59) requires all health care and residential facilities and agencies regulated pursuant to Article 28, 36, or 40 of the Public Health Law to ensure that all personnel, as defined in the regulation, not vaccinated against influenza for the current influenza season wear a surgical or procedure mask while in areas where patients or residents are typically present.
> This page will be updated when the status changes.
which apparently has not been updated since December 5, 2019.
[1]: https://twitter.com/sinan_unur/status/1368882698966667265
[2]: https://nyshc.health.ny.gov/web/nyapd/new-york-state-flu-tra...
[3]: https://www.health.ny.gov/diseases/communicable/influenza/se... (archived <https://archive.is/wde1c>)
% ch in flu cases between weeks 6 and 7 in NYS
What caused flu cases to start falling in mid-February _before_ so called "public health measures"?[1]> The acceleration phase of a pandemic is complex and requires a multifaceted and rapidly adapting public health response. During a 3-week period in late February to early March, the number of U.S. COVID-19 cases increased more than 1,000-fold. Various community mitigation interventions were implemented with the aim of reducing further spread and controlling the impact on health care capacity.
So, between CDC weeks 7 to 10, the a bad flu season disappears while COVID-19 cases increase 1,000-fold. What are the "public health measures" that explain this divergence?
March 21, 2020[2]:
> "To be clear, the state has the legal authority to overrule any locality's decision to issue an order of mass quarantine or shut down. No locality will be closing down. The mass transit system is not shutting down. These rumors, caused by undue anxiety, are just that - rumors."
March 7, 2020[3]:
> During a briefing on the novel coronavirus, Governor Andrew M. Cuomo today declared a state of emergency to help New York more quickly and effectively contain the spread of the virus.
February 29, 2020[4]:
> "We'll start testing immediately here in New York, so we can handle more tests, more volume, turn them around faster, and we are ready to go and literally we can start testing immediately We have mobilized for emergencies before, and we're going to do it again."
February 27, 2020[5]:
> Governor Andrew M. Cuomo today announced the total number of flu cases in New York State has eclipsed the record number of seasonal cases since the New York State Department of Health began tracking flu cases during the 1998-99 season.
[1]: https://www.cdc.gov/mmwr/volumes/69/wr/mm6918e2.htm
[2]: https://www.governor.ny.gov/news/statement-secretary-governo...
[3]: https://www.governor.ny.gov/news/novel-coronavirus-briefing-...
[4]: https://www.governor.ny.gov/news/video-audio-rush-transcript...
[5]: https://www.governor.ny.gov/news/governor-cuomo-announces-re...
The dynamics of influenza could have been expected to change, and I would have put money on they decreasing, but it is never the less not pre-ordained nor attributable to an obvious cause (for example, one of the original reasons people didn't push mask orders is the limited suggestion that they were effective for flu).
It's a simple question. Flu deaths in the US have dropped precipitously. This past flu season resulted in (very roughly) ~1% of the deaths of previous seasons. It seems obvious that this is primarily due to social distancing efforts as you say. To naive little me, this implies that COVID deaths are also likely to have been reduced to ~1% from what they would have been without said measures. In the US, that implies that we may have steered into 500K deaths instead of a stunning potential 50M deaths.
Based on my admittedly naive calculations, I'm sure this is inaccurate, but I don't even know in which direction, could have been potentially even more. Did we really avert 50M deaths by social distancing?
Other answers on here have convinced me however that 50M is not a reasonable number.
No, not even close.
> this implies that COVID deaths are also likely to have been reduced to ~1% from what they would have been without said measures
I don't think it implies that. There is nothing that says that the anti-COVID measures are about as effective at preventing spread of COVID as spread of flu.
> 500K deaths
Closer to 600k :(
This is among 32MM cases reported to the CDC, probably more like 80MM cases total.
Ignoring lots of factors, our ceiling for COVID is more like 4-10x what we've experienced, not 100X.
Fortunately there are a couple of other answers in thread that answered this at a level of detail that I could understand.
So that gives you an upper bound. I'm not sure how to get a lower bound but it might be possible for someone with sufficient statistical know-how.
[1] https://www.statista.com/topics/6084/coronavirus-covid-19-in...
[2] I'm ignoring reinfections here since, while reinfections happen, they are quite rare relative to first-time infections everywhere I have seen
[3] https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/burd... -- note this is as of January 15, when there were 24.2 million confirmed cases, and CDC estimated that there were about 83.1 million total cases.
So you're right, if worst case everyone in the US gets infected, we're in for a lot more deaths, but aside from an apocalyptical R=100 type disease, not everyone is getting infected. The more infections there are, the more preventative measures are taken, etc.
It's a hard problem.
Additionally I would not be surprised if flu deaths remained lower for several years since C19 appeared to be more severe than flu in vulnerable populations. Future flu deaths were likely preempted by C19.
Paralleling the term herd immunity, this would be called culling the herd.
No, unfortunately this is not true. While the flu season disappeared entirely, covid obviously did not -- it grew significantly. As it stands, the United States has seen just shy of 100,000 confirmed cases per million people; if that represented 1% of a "status quo" infection rate then you'd have to expect everyone in the US to have covid 10 times over.
Instead, you have to think about the logistic model of infectious disease growth. As a very rough back of the envelope calculation, Covid has an R0 of about 2.5. It will spread throughout the population until about 60% is immune/recovered (which roughly matches the critical vaccination level seen in Israel, providing a reasonable check on this number).
That implies that absent public health measures (i.e. where covid quickly spreads to a level that gives herd immunity), the United States would have seen about 200 million cases (330m0.6), or 600,000 cases per million.
What that implies about deaths* depends on your estimates of how comprehensive case identification has been. If you think that we've tested and identified the vast majority of cases, then the "worst case" would be about 6x the current rate of infection and a similar increase in the total death rate. If on the other hand you think we've vastly undercounted cases, then maybe the US has in fact come close to that herd immunity level already, and the public health restrictions only succeeded in "flattening the curve" without changing the cumulative outcome much.
Working at this from another angle, the CDC estimates (https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena..., case 5) give an infection/fatality ratio of about 0.25% when you apply their demographic estimates to the US population writ large. If you back-fit an estimated number of covid cases from the currently-observed 500,000 deaths, you end up remarkably close to 200m total cases -- but you can also quibble here by noting that seniors' homes suffered a disproportionate share of infections and deaths, especially early in the pandemic.
Assuming a perfectly oblivious population, for example, where there are absolutely no protective measures in place† and people just act 100% as usual††, then the infection rate would have skyrocketed in a very short time and the death rate would have been much, much higher because of the healthcare system completely collapsing. You'd have people dying from tetanus because nobody would have been available to give them shots. People dying from easily stoppable bleeding, etc. So in this extreme case I think the total death rate caused by the pandemic could have easily been in the low millions.
† Self distancing, masks, etc.
†† Which would be quite irrational and hasn't actually happened even in places which otherwise ignored the pandemic: a certain percentage of the population self-isolated due to the survival instinct.
Remains to be seen I guess, but this prognosis resonated with me.
[1] https://www.rnz.co.nz/national/programmes/sunday/audio/20187...
Local doctors in my City (Canberra) told multiple people I've talked with that the extra protective steps taken last year meant our bodies weren't as well positioned to handle the standard flu when we caught it.
Contrariwise this (beside basic humanity) is why the current out of control situation in India or Brazil is everyone's problem. High absolute prevalence means events that are one in a billion chance get to happen. And spread.
Also for the specific NYC case, a crucial difference is that when the restrictions started which was after there were many infections already (thanks in part to disagreement between the city and state early on and different legal powers of the city to effect them compared to elsewhere). I’m also not sure what neighboring states with high compliance you’re referring to for New York. Their most populous neighbor (PA) has consistently had very low compliance and fluctuating levels of restrictions.
I know someone who works for a company who produces such tests at the same cost as a single test today, but often insurance companies and providers don't know how to bill for them, so you see stories in the news about "irresponsible doctors who should never have ordered 20 tests" that were really a single test billed incorrectly.
Not sure how much this affects rhe stats. Practically no cases of influenza are recorded, though.