OG doc. AMA on COVID-19

mataleo1, any thoughts on seasonal flu? All the reports seem to indicate flu infections are way, way down. Do you think this pandemic will have any lasting effect, or do you expect we will see flu case rates return to a more typical expected level?

I’ve mentioned this on a few occasions.

  1. The flu statistics are true and believable. It’s not a conspiracy as some suggest. A positive COVID test does not result in a positive flu test. We test EVERY patient coming our ER for the flu (for more than 8 months now). The number of positive cases: less than 10 (out of 30-40 thousand). The flu has all but disappeared.

  2. To understand why, you need to know about R0 i.e. how contagious the virus is. A R0 = 2 means for each patient infected, that person will give it to 2 persons. A R0 over 1 means you’ll have growth whereas below 1 means it will be die down.

The R0 of the flu is about 1.5 (vs 5 for COVID)
With distancing and other measures that R0 decreased to about 0.3 meaning cases will not expand.

If I had to bet, I’d expect flu numbers to go back to usual when we stop mitigating measures (next year, as the flu usually disappears around April). Don’t forget that the natural reservoir of the flu virus is poultry and wild birds. This reservoir will always exist.

Right, I think we all know the infection numbers are bullshit. And that’s another thing Osterholm touched upon. What a great job China did because they had so few infections and deaths /eyeroll.

But theoretically, they could have ended up with those low numbers if they had maintained the draconian lockdowns they initiated in the beginning. Basically locking everyone inside their homes.

But that brings up another point. We all saw the pictures and information coming out of Wuhan early on. Doctors and nurses pushed to the limit and images of bodies piling up. Reports of high SO2 levels outside of Wuhan from presumably thousands of bodies being burned. Images of people dropping dead in the streets. And this was WITH the massive lockdowns. Now that there are little to no lockdowns there, none of these reports are coming out now. It’s almost like the virus doesn’t even exist.

So that begs the question, were these reports early on of hospitals being overrun and bodies being stacked in the corner complete propaganda? Were they lying then, or now?

We already know that Iran, Turkey, and Russia falsified COVID numbers. So it’s not a stretch to think China did the same.

And these draconian lockdowns were also imitated elsewhere with nowhere near the same success.

Who the hell knows what’s going on!

We must kill all birds.

But I enjoy fried chicken. Long live the flu

Any updates to ivermectin and colchicine studies?

also, would have any recommendations to offset vaccine symtoms if you are one of the unlucky few who react badly (fever, nausea, vomiting, headache chills? )?

Reminds me of the Animal Control guy from Parks and Rec during the Emergency Response episode lol.

Osterholm is an idiot. Just as much of a stupid blowhard as Fauci.

The most probable scenario is that the virus escaped from the lab. This isn’t conspiracy. It’s just good Bayesian reasoning. Of all the places it could have showed up, the chance it would show up next to a lab studying the same kind of virus yet NOT be connected is small.

If there’s a puddle of water in the desert and it just happens to be next to one of a handful of water pumps in the desert, your best bet is a leaky pump, not rain.

Colchicine: A lot a hype.
Here is the study (not peer-reviewed yet): https://www.medrxiv.org/content/10.1101/2021.01.26.21250494v1
I’m not going to do a statistic dissertation but some points:
-The absolute (not relative) risk reduction is extremely low (1.4%)
-You need to treat 70 patients to prevent 1 hospitalization
-The p-value is P=0.0492 and the upper limit of the confidence interval is 0.99, both meaning they are at the extreme limit of statistical significance (to avoid saying more…)

For Ivermectin, 4 randomized trials have been published, but just 1 big one (others await)

  1. 476 patients, mild COVID, 5-day ivermectin vs placebo. Length of symptoms in both groups: no difference
    Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19
  2. One had 24 patients (…) and showed a difference in self-reporting of anosmia (…)
    https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30464-8/fulltext
  3. 2 studies (32 patients in the first and 72 in the second) looked at viral load (non-clinical)
    https://www.ncbi.nlm.nih.gov/pubmed/33723507
    https://www.ncbi.nlm.nih.gov/pubmed/33278625

As for vaccine:
Hydration before, tylenol (no advil) if fever or pain, rest

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Why is Covid the only thing folks think the government is right on? The same people saying the government can’t do anything right are led around by the ear on covid.

@mataleo1 in places like Los Angeles, they are pretty much opening up, even indoor restaurants, bars, and indoor concerts (limited). What is your opinion on giving the impression that the pandemic is now over since the vaccine seems to be working well. It almost makes it a scenario where IF something went sideways with the vaccine by this fall/winter, it would be logistically/mentally impossible to close things down again. Thoughts?

I’ll give you my opinion, which is likely ways from the truth.

It’s been estimated that herd immunity is likely to occur when 50-70% of a population has been vaccinated or infected.

The big caveats here are:

  1. Length of immunity
  2. Variants

Some experts are betting that herd immunity won’t happen because of constant apparition of variants.
https://www.nature.com/articles/d41586-021-00728-2

Right now, about 20% of the US population has been infected. 30% got at least 1 vaccine dose. This means that we are theoretically close. If infections surge again (especially in States like NY where the total of vaccinated+ infected is about 75%), then we are not going to win this. And that means we can forget about any future lockdowns. I remain hopeful this won’t happen, however, given the spectacular situation we’re seeing in Israel.

Mataleo, why Tylenol over ibuprofen?

I had heard this last year and when I was sick with covid, I took ibuprofen (my preferred nsaid) and it made me feel worse. I promptly tried Tylenol and could feel relief.

2 things here:

  1. There was data last year in March that NSAIDs worsened COVID prognosis, but this was pretty much debunked afterwards.
  2. Regarding vaccination, one study (below) suggests that NSAIDs reduce antibody formation
    https://jvi.asm.org/content/95/7/e00014-21
    The results are very contested and my guess is that NSAIDs are just fine. But given this, if you’re going through the trouble of getting vaccinated, might as well prefer tylenol.

What is going on in Canada? People are claiming the hospitals are full of people who are 45 yrs old and under with some SARS-CoV-2 variant.

I haven’t closely looked at the data in Ontario, but if it’s similar to what we see in Quebec, it’s total fear-mongering crap.

I gave the example on another thread:
December 2020: 50 ICU patients, age over 70y = 32, age under 50y = 7. Percentage of patients under 50 = 14%

April 2021: 20 ICU patients, age over 70y = 11, age under 50y = 7. Percentage of patients under number 50 = 35%

So the number of patients under 50 is exactly the same, but the % is higher (because the older are vaccinated). But the ratio of patients below under 50 has increased: 35/14 = 250%

Media title : “The ICU population in younger patients has INCREASED 250%!!!”

Again, this is only regarding Quebec but I believe Ontario has exactly the same phenomenon.

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I was just going through Toronto’s public records looking for this info and couldn’t find any discernible difference between this wave and the last one with regards to hospitalizations and deaths by age group. The distributions look almost identical. Unless this trend just hasn’t shown up in the numbers yet, I don’t get it.

Yeah I think that’s right unless I’m reading their tables incorrectly, or other ON cities are way different than TO.