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    Quote Originally Posted by mcbob View Post
    Know what you're doing before trying to use it, use only as directed, etc etc.
    Yes, the animal version of Ivermectin is not meant for human consumption.


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    Quote Originally Posted by TheDingo View Post
    Yes, the animal version of Ivermectin is not meant for human consumption.
    Neither are Milk-Bones, but pair them with an ice-cold Miller.......


    I KEED, I KEED. Seriously, don't dose yourself with swine ivomec.
    Pudgy bearded camera guy
    http://mcbob.tv


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    Would love to hear people's thoughts on this article:

    https://www.wsj.com/articles/well-ha...il-11613669731

    Dr Makary has said a lot of cautious things that agree with expert consensus over the past year (at least AFAIK), so I'm more prone to be curious about his thoughts. In some ways it seems he is talking about the obvious idea that as the virus spreads more naturally + vaccination were on an accelerated trajectory towards herd immunity, and on the other hand it feels like there’s some “great Barrington declaration, revision 2.0” vibes going with an overly optimistic and non-data driven approach. It seems that some of his hypothesis rests on some rather precarious logic, and that a spark notes version could be "cool hypothesis... it's not based on any data."

    I also think it could give people a false sense of hope, or create a self fulfilling anti-prophecy; but then, we're all learning as we go. What do you see as the holes in Dr. Makary's hypothesis, or do you think it squares?


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    Senior Member ahalpert's Avatar
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    Your link doesn't work on my phone, so I googled wsj makary and got this - https://www.google.com/amp/s/www.wsj...il-11613669731

    Amid the dire Covid warnings, one crucial fact has been largely ignored: Cases are down 77% over the past six weeks. If a medication slashed cases by 77%, we’d call it a miracle pill. Why is the number of cases plummeting much faster than experts predicted?

    In large part because natural immunity from prior infection is far more common than can be measured by testing. Testing has been capturing only from 10% to 25% of infections, depending on when during the pandemic someone got the virus. Applying a time-weighted case capture average of 1 in 6.5 to the cumulative 28 million confirmed cases would mean about 55% of Americans have natural immunity.

    Now add people getting vaccinated. As of this week, 15% of Americans have received the vaccine, and the figure is rising fast. Former Food and Drug Commissioner Scott Gottlieb estimates 250 million doses will have been delivered to some 150 million people by the end of March.

    There is reason to think the country is racing toward an extremely low level of infection. As more people have been infected, most of whom have mild or no symptoms, there are fewer Americans left to be infected. At the current trajectory, I expect Covid will be mostly gone by April, allowing Americans to resume normal life.
    There are 2 things I agree with and 1 big thing I think he's missing.

    I agree that there is a large number of naturally immune recovered patients that give us a head start to herd immunity, although the figures I've seen quoted were lower than his estimates.

    I also agree that the end of this pandemic may happen more abruptly (in rich countries) than people realize because the vaccine will quickly put an end to it but we've conditioned ourselves to bad news and have overadjusted our expectations about the virus after initially thinking we were invulnerable.

    But there's 1 big thing he's missing - and it's that covid cases started dropping exactly 2 weeks after christmas. Which suggests to me that a big cause of the build-up late last year was all the end-of-year social activities. And because people (at least in my state) are more likely to hunker down come January and venture out less (which is even more true right now with all this snow), there is probably a lot more natural quarantining and social distancing going on right now.

    Which doesn't mean that he's wrong, just that he might be reading too much into how fast cases are declining is and assuming that we're reaching herd immunity maybe a month or two earlier than we actually do. If I'm right.

    One cool thing - wsj also reported that Pfizer is pretty effective after a single dose and can last a couple weeks in a regular freezer.
    Last edited by ahalpert; 02-19-2021 at 09:11 PM.


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    Quote Originally Posted by ahalpert View Post
    I also agree that the end of this pandemic may happen more abruptly (in rich countries) than people realize because the vaccine will quickly put an end to it
    The poor countries will really get screwed. The Gates Foundation is doing some great work, but that's one institution...

    Quote Originally Posted by ahalpert View Post
    covid cases started dropping exactly 2 weeks after christmas.
    I read that's a documented thing- the holiday bump and subsequent decline that's just started.

    Quote Originally Posted by ahalpert View Post
    One cool thing - wsj also reported that Pfizer is pretty effective after a single dose and can last a couple weeks in a regular freezer.
    And there could be good news with the J&J vax- modest refrigeration needs, long shelf life, and there's a good chance a double dose will improve their efficacy numbers.


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    Quote Originally Posted by ahalpert View Post
    Your link doesn't work on my phone
    Apologies, here is the article text:

    Dr. Makary is a professor at the Johns Hopkins School of Medicine and Bloomberg School of Public Health, chief medical adviser to Sesame Care, and author of “The Price We Pay.”

    Amid the dire Covid warnings, one crucial fact has been largely ignored: Cases are down 77% over the past six weeks. If a medication slashed cases by 77%, we’d call it a miracle pill. Why is the number of cases plummeting much faster than experts predicted?

    In large part because natural immunity from prior infection is far more common than can be measured by testing. Testing has been capturing only from 10% to 25% of infections, depending on when during the pandemic someone got the virus. Applying a time-weighted case capture average of 1 in 6.5 to the cumulative 28 million confirmed cases would mean about 55% of Americans have natural immunity.

    Now add people getting vaccinated. As of this week, 15% of Americans have received the vaccine, and the figure is rising fast. Former Food and Drug Commissioner Scott Gottlieb estimates 250 million doses will have been delivered to some 150 million people by the end of March.

    There is reason to think the country is racing toward an extremely low level of infection. As more people have been infected, most of whom have mild or no symptoms, there are fewer Americans left to be infected. At the current trajectory, I expect Covid will be mostly gone by April, allowing Americans to resume normal life.

    Antibody studies almost certainly underestimate natural immunity. Antibody testing doesn’t capture antigen-specific T-cells, which develop “memory” once they are activated by the virus. Survivors of the 1918 Spanish flu were found in 2008—90 years later—to have memory cells still able to produce neutralizing antibodies.

    Researchers at Sweden’s Karolinska Institute found that the percentage of people mounting a T-cell response after mild or asymptomatic Covid-19 infection consistently exceeded the percentage with detectable antibodies. T-cell immunity was even present in people who were exposed to infected family members but never developed symptoms. A group of U.K. scientists in September pointed out that the medical community may be under-appreciating the prevalence of immunity from activated T-cells.

    Covid-19 deaths in the U.S. would also suggest much broader immunity than recognized. About 1 in 600 Americans has died of Covid-19, which translates to a population fatality rate of about 0.15%. The Covid-19 infection fatality rate is about 0.23%. These numbers indicate that roughly two-thirds of the U.S. population has had the infection.

    In my own conversations with medical experts, I have noticed that they too often dismiss natural immunity, arguing that we don’t have data. The data certainly doesn’t fit the classic randomized-controlled-trial model of the old-guard medical establishment. There’s no control group. But the observational data is compelling.

    I have argued for months that we could save more American lives if those with prior Covid-19 infection forgo vaccines until all vulnerable seniors get their first dose. Several studies demonstrate that natural immunity should protect those who had Covid-19 until more vaccines are available. Half my friends in the medical community told me: Good idea. The other half said there isn’t enough data on natural immunity, despite the fact that reinfections have occurred in less than 1% of people—and when they do occur, the cases are mild.

    But the consistent and rapid decline in daily cases since Jan. 8 can be explained only by natural immunity. Behavior didn’t suddenly improve over the holidays; Americans traveled more over Christmas than they had since March. Vaccines also don’t explain the steep decline in January. Vaccination rates were low and they take weeks to kick in.

    My prediction that Covid-19 will be mostly gone by April is based on laboratory data, mathematical data, published literature and conversations with experts. But it’s also based on direct observation of how hard testing has been to get, especially for the poor. If you live in a wealthy community where worried people are vigilant about getting tested, you might think that most infections are captured by testing. But if you have seen the many barriers to testing for low-income Americans, you might think that very few infections have been captured at testing centers. Keep in mind that most infections are asymptomatic, which still triggers natural immunity.

    Many experts, along with politicians and journalists, are afraid to talk about herd immunity. The term has political overtones because some suggested the U.S. simply let Covid rip to achieve herd immunity. That was a reckless idea. But herd immunity is the inevitable result of viral spread and vaccination. When the chain of virus transmission has been broken in multiple places, it’s harder for it to spread—and that includes the new strains.

    Herd immunity has been well-documented in the Brazilian city of Manaus, where researchers in the Lancet reported the prevalence of prior Covid-19 infection to be 76%, resulting in a significant slowing of the infection. Doctors are watching a new strain that threatens to evade prior immunity. But countries where new variants have emerged, such as the U.K., South Africa and Brazil, are also seeing significant declines in daily new cases. The risk of new variants mutating around the prior vaccinated or natural immunity should be a reminder that Covid-19 will persist for decades after the pandemic is over. It should also instill a sense of urgency to develop, authorize and administer a vaccine targeted to new variants.

    Some medical experts privately agreed with my prediction that there may be very little Covid-19 by April but suggested that I not to talk publicly about herd immunity because people might become complacent and fail to take precautions or might decline the vaccine. But scientists shouldn’t try to manipulate the public by hiding the truth. As we encourage everyone to get a vaccine, we also need to reopen schools and society to limit the damage of closures and prolonged isolation. Contingency planning for an open economy by April can deliver hope to those in despair and to those who have made large personal sacrifices.


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    Quote Originally Posted by ahalpert View Post
    I agree that there is a large number of naturally immune recovered patients that give us a head start to herd immunity, although the figures I've seen quoted were lower than his estimates....

    ...But there's 1 big thing he's missing - and it's that covid cases started dropping exactly 2 weeks after christmas. Which suggests to me that a big cause of the build-up late last year was all the end-of-year social activities. And because people (at least in my state) are more likely to hunker down come January and venture out less (which is even more true right now with all this snow), there is probably a lot more natural quarantining and social distancing going on right now.

    Which doesn't mean that he's wrong, just that he might be reading too much into how fast cases are declining is and assuming that we're reaching herd immunity maybe a month or two earlier than we actually do.
    Good thoughts. That sounds reasonable to me. Likewise, I felt a couple weak spot in the article were:

    1. The statement "But the consistent and rapid decline in daily cases since Jan. 8 can be explained only by natural immunity" - that seems like an overreach, especially to state such as fact. As you said, post holiday decline + a lot of news about how bad the virus was getting + possibility of some people pulling back due to immediate hope of an imminent, effective vaccine. The numbers are still as high as they were in late October, simply returning to the pre-holiday spike, and we were all concerned pre holiday. I was also wondering if we are doing less testing due to rolling staff onto vaccination duty? But that is just speculation.

    2. His calculation based on "testing has been capturing only from 10% to 25% of infections" and thus "applying a time-weighted case capture average of 1 in 6.5 to the cumulative 28 million confirmed cases would mean about 55% of Americans have natural immunity." This assumes that behaviors amongst non-COVID tested people mirrors COVID tested people, but it might stand to reason the people coming in for tests are also the people most exposed. So to extrapolate positive test rates from that biased sample slice to all people seems to be an error? Or perhaps the data does account for that and it's more robust?

    In general I think a lot of what is said here is common sense but as you said, perhaps just too accelerated of a timeline - and not accounting for variants. It also stands to reason that our situation is actually rather fragile, many healthcare systems have been on edge, and things could change quickly.


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    Quote Originally Posted by filmguy123 View Post
    2. His calculation based on "testing has been capturing only from 10% to 25% of infections" and thus "applying a time-weighted case capture average of 1 in 6.5 to the cumulative 28 million confirmed cases would mean about 55% of Americans have natural immunity." This assumes that behaviors amongst non-COVID tested people mirrors COVID tested people, but it might stand to reason the people coming in for tests are also the people most exposed. So to extrapolate positive test rates from that biased sample slice to all people seems to be an error? Or perhaps the data does account for that and it's more robust?
    I'm also not sure where he's getting his fatality rate estimate from. But I think that the fatality rate has come down with better treatment, certainly way down from when NYC got torn apart last March.

    So, the final population fatality rate would probably be a weighted average of the fatality rate over time and we would end up higher than his .23% average?

    So yeah, I think some of his numbers may be sloppy and erring on the side of optimism.

    But aside from wild card new variants (and honestly I haven't personally learned much about the UK and South Africa variants out there), I think we'll all be out sneezing in our friend's faces and French-kissing strangers by the end of summer at the latest. Or maybe by May, in time for me to shoot the mother of all wedding seasons.

    PS - haven't seen this one before

    20210222_054544.jpg


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    Haha the Istanbul photo is amazing... perhaps if the variants get really bad this will become new recommendation

    Talked to two different friends who are doctors (not epidemiologists, but very sharp - one a physician and the other a surgeon) and both independently said essentially the same thing: that's not really a complete view of how the immune system works.

    One gave the analogy regarding T-Cells and said something to the effect that the way Makary speaks of T cells here is a bit like reading a manual written on how to put together a computer from a person only looking at RAM and hard drive memory performance, not factoring in how it all works together. A super fast solid state drive is only as fast as the interconnect to the CPU; or, having a lot of RAM (say T cells storing memory) is only part of the equation if the CPU can’t access and handle all of it at once or in enough time. You have to balance the whole system to assess true real world performance. In other words, T cell memory alone is not going to be enough for the body to mount an effective immune response and we simply do not have any data for that, which is a non-trivial concern.

    They also mentioned there's a statement that what he says he is positing this based on XYZ, yet there are no references to what he is referring to either in that article or externally that they could find that mention any such specifics. It's very broad. They both said "the virus may well resolve sooner than later, we are hopeful. But if it does, it won't be for the reasons in that article".


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