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Covid, vaccines and public health

Here’s a talk that I found extremely interesting and I think will also resonate with some of the other posters here. It’s a broad look at the current state of affairs with Covid and the various different public health responses.

I definitely have some problems with the data presented - some of the numbers seem wrong to me, and I need to go and have a think about them - but overall I feel like it is an interesting and compelling alternative view on our current global crisis, and our individual and social attitudes to health and wellness.

Please don’t share this link away from this forum, and I would encourage any of you who are interested, to consider becoming a member of the Scientific and Medical Network.

Cheers
PP

This is one of the most useful discussions I’ve seen yet in the whole covid stampede. Thanks Pontius! I suggest these people need to get a lot more heed for what they’re doing. It’s the wave of the future, when the Long Descent has battered the globalising gics a good way down from where they are now, with the scams that they’ve been running to monetise and power-grab this - alleged - epidemic towards more world-control.

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Welcome. As I said the are a few parts where he didn’t quite carry me, but overall I thought he was very current cogent and compelling. I now have a few things to think about.

I thought the q&a was pretty good too

NOTE: See how easy it was to edit that spelling mistake? Joy!

Just picked this up from a btl poster on Off-G. “No covid patients AT ALL (!) in any of the three main Devon hospitals”, says nurse working there. Empty wards doing nothing, despite all the people needing help for other problems who’ve been turned away:

And btw, see the vid of the Spanish doctor offing the whole covid hysteria, from which the above link was culled:

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Posted this in the ‘Covid Misniformation’ topic. But it should be here too. It will become clear as you listen that they are a group of mainly conservative-minded US doctors. But never mind the messengers, hear the message. Dynamite! Covid gone in a month, with this approach. So they insist:

Thanks Rhis.

I watched a chunk yesterday, and will watch more later. The host immediately raised my hackles by calling this the “China virus” and a doctor referring to “loony lefties” didn’t improve my mood :wink:

I’m guessing they might not be the most unbiased crowd eh?

However, as you say, the message is more important than the messenger, and I think it’s crazy to ignore the mountain of different kinds of evidence that is slowly being amassed.

I will say one further thing though. Despite this evidence, it does remain true that there are very few (none the last time I really looked) truly well performed randomised controlled trials on the early use of HCQ+Azithromicin+Zinc. The main published studies are retrospective or non randomised or given late (up to when a patient is in ICU already!) Or missing zinc etc etc etc.

I can understand why those with a desire to disprove the effectiveness set up studies that don’t meet the protocol, but I don’t understand why those who are proponents (Didier - I’m looking at you!) don’t try and settle this matter once and for all by doing the correct study with the correct protocols?

Come on guys!

Too busy up to the elbows curing the sick - and at the same time fighting off the political whores who are trying to trash you and your work, because it can’t be milked for big ackers, perhaps P? Certainly describes Didier’s case. And it’s worth copying here a question that I posted in the 'Vaxxed/Vaxxed II topic:

" Which leads to another nagging question: Why are RCTs - randomised controlled tests - the only gold-standard tests of the true impact of a drug? How many constantly-repeated anecdotals does it need before we recognise that that sort of evidence is at least as potent as RCTs in the overall estimation of a drug’s effect? (Just as front-line doctors, in the thick of a big sickness, use anything that seems to work, and report their non-RCT anecdotals about actual clinical outcomes, until it’s clear beyond reasonable doubt that they’re onto an empirical cure…)"

yes, that might be a good response. However things have calmed down somewhat, Didier is the head of his very own institute, and the overall good such a study would do would be monumental.

I wish he would get some of his underlings to do it. He could go a long way towards ending this otherwise endless debate!

I think one problem is that a RCT by Raoult and co would not settle it.
It’s predictable that vested interests will go on about RCTs as if they are the be-all and end-all.
RCTs might be ‘gold standard’ when other requirements of a good study are met. The fact that a study is a randomized controlled trial has less importance when (eg) the treatment dose is off the scale, the study is stopped too early rendering it too small, the results are misreported or the patients are too sick for the interpretation to be ‘early treatment’ - ie, when the fiddle factor is high (I’ll try to link these criticisms to particular studies soon).

A ‘well performed’ trial implies a big one, which means that if the treatment is effective, some who are allocated the placebo instead of the treatment will go on to die. That is Raoult’s stated reason. No doctor who believe their treatment is essentially a cure can ethically do this.
If the main science or medical community insists that a RCT is necessary then it falls on them to do one, and see that it meets the standard. As long as they fail to do this there can be no excuse for not examining the non-RCT evidence in the dozens of other positive studies. Currently a big majority of HCQ studies (about three quarters a couple of weeks back) are positive, a proportion that gets higher when early treatment is specified. These trials amount to thousands of patients.
Here is a very good place to look https://c19study.com/, which aims to catalogue all the HCQ studies.

The problem is - there are RCTs which ‘found’ no effect, albeit by design (eg excessively high doses, late treatment, mis-reporting of results or other surprising omissions like failure to highlight the effect of early treatment, as in Boulware, which I intend to put below). So even if Raoult and co did perform an RCT showing a positive effect it would be played off against those ‘negative’ studies. (Negative meaning inconclusive - an inconclusive study of similar size etc does not cancel out a positive study, but such an interpretation is often used politically to claim ‘mixed’ results).
Hence the crude, seemingly deliberate flaws in these ‘negative’ RCTs need to be uppermost in any serous analysis, whether a proper RCT is done or not.

Cheers

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For those new to these near fraudulent elements of the HCQ picture (the one propagating from western sources, that is) I’ll give one example, the allegedly ‘negative’ Boulware study (most will know of the retracted, fake Lancet study carried out by Surgisphere, which promptly shut up shop once rumbled). The study is here https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

This was an RCT that was widely touted as another nail in the coffin of HCQ. It was claimed to be an early treatment study.

Before appearing in the New England Journal of Medicine (responsible for one retracted study, also by Surgisphere) it was given to the press presumably for the above touting of the false claims and conclusions to take place.

The headlines were duly grabbed around the world.

Even though the study clearly had a host of problems (not least of which being the claimed conclusion didn’t match the data) the worlds press faithfully reproduced the claim (35 outlets the same day showed on NewsNow.co.uk, probably the tip of the iceberg) that the study showed that HCQ treatment was not effective. In fact the study had found a nearly 20% reduction in Covid-19, though the difference did not reach statistical significance.

I posted about this aspect on a media-related site :slightly_smiling_face:, https://members5.boardhost.com/xxxxx/msg/1591228273.html.

Not reaching statistical significance may be because the sample size was too small - and the study was deliberately stopped early. I also posted about all this too

Described as the most rigorous study so far, it was a dogs breakfast with a suspiciously high fiddle factor. With limitations that would have diluted any effect found (I also posted about this - “Always read the limitations”, https://members5.boardhost.com/xxxxx/msg/1591232825.html)

Boulware should very likely have been a positive study.

But there was much more to come, later revealed in a re-analysis . The researchers had not analysed the delays to the treatments following exposure - once this step was taken, there was a slam-dunk correlation between the length of the delay in treatment and whether the patient got Covid-19. The re-analysis by Watanabe is here https://www.nejm.org/doi/full/10.1056/NEJMoa2016638 though I recommend locating it on C19study.com in order to obtain the commentary.

Shown here in a graph, https://c19study.com/boulware.svg

Commentary is here (search for Boulware) shows main points https://c19study.com/.
The full re-analysis paper is here, Efficacy of Hydroxychloroquine as Prophylaxis for Covid-19 https://arxiv.org/abs/2007.09477.
So this was a RCT that was derailed near the end of the line.

Another physician claiming a near 100% success rate for early HCQ treatment is New York’s Dr Zelenko(see bottom), whose HCQ-Azithromycin-Zinc protocol has been followed in many countries. At the heart of this is the idea that treatment has to start before six days of symptoms, otherwise you are essentially treating a different disease. The above re-analysis of the Boulware data matches this time period exactly.

In fact Zelenko was the source of Trump’s endorsement of HCQ; he tried to use Trump to get the message out, which had the unfortunate effect of politicizing the issue along party lines in the US election year.
It’s also noteworthy that Zelenko was having difficulty before the Trump endorsement, due to pharma pressure on doctors.

Zelenko published a study based on his practice results, which can be found in the C19study,com link.
An impressive (and important) interview with Zelenko is here: https://t.co/8KzbKbXZih?amp=1.
(Seems to take a while to load, but it does say will be live in a moment…)

I highlight the following snippet from this interview:
“…Extremely important - based on clinical suspicion, Treated within 1st 5 days of symptoms…I noticed most patients come day 4 or 5. They wait a day or 2 to see, then wait to see a Dr…On about 6 the viral load explodes”. [Hence early treatment]

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Excellent posts. I suppose you’re right that there is an ethics question stopping Raoult from doing an RCT. Although I guess he could also pull the “I’m stopping this early, because the results are too good for those taking HCQ and too bad for the rest” trick too.

More importantly, though, I also think you’re right that a single good study would be played off in the media against the many bad ones in some kind of faux balancing act… The media is already terrible at science reporting even without this extra political dimension.

It’s amazing how similar a scenario like this one is to something like the skripal story or the Syrian white helmets. Almost identical pressures and filters at work in all cases…

It’s almost as if there are inherent biases in how things get reported… :wink:

Cheers

Walter, I hope to god you get to feel at home here on 5F, and stay and continue with your work. Be assured, I and other attack dogs will bite the shit out of anyone who tries to give you the mob-and-slag treatment that you kept getting at TLN. Your persistence there, despite the constant slagging, and the complete absence of any moderation (try that here!! :slight_smile: ) was admirable.

I regard your talent for detailed pursuit of reliable material, and your equally detailed analysis - with added high-quality numeracy - as a crucial asset to any - actually honest and civil - message board. As you say: the devil is in the details. Respect! And keep 'em coming, please! :slight_smile:

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Hi walter
This comment article was published in Nature last year (before the COVID explosion) discussing many of the problems with statistical significance that you raise. It of course triggered a lot of debate which you can find easily if you search for “abandon statistical significance” but I think it raises a lot of important points about how scientists (as well as journalists) interpret and report “statistically significant” results. It also harks back to my previous comments about a desperate need for improved scientific literacy in both the general community and journalists - a problem that is evident in the climate change debate (although anyone would think that climate change had stopped over the past few months) as well as in discussions about COVID19.
https://www.nature.com/articles/d41586-019-00857-9.
Hope you find it of value.
Best wishes
J

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Hi JMC. It’s a very interesting idea, thanks. In statistical theory, any threshold can be set. The fixed threshold that is widely used in practice provides some benefits (objectivity, standardisation, easier to understand conclusions) at the cost of being arbitrary and prescriptive (I’m sure you know all this :slightly_smiling_face: ).
There is no doubt the fixed threshold for a statistical test is abused; it gives a clear target for biased researchers and provides easy (but misleading) wording to steal the headlines in situations of bias. You’re right that it would be much better if journalists, writers, commentators and the public were aware of the mechanics of formal testing. Though I think it’s telling that the western science-reporting world failed to highlight any problem with the study I mentioned.

I looked at some conversations amongst statisticians as you suggested; most of those advocating this change seem to be doing so in terms of scientists “falling prey to misconceptions”. Is this a euphemism? I wonder how many scientists using stats in their work are so untrained in the fundamentals as not to know what the formal conclusion is from a hypothesis test.
If the real problem is bias (in research and reporting of controversial areas of science), would removing the standard threshold help? Researchers could then wave their hands around and draw their own conclusions more freely than they do now. On the other hand, they wouldn’t have access to ready, standard, definitive-sounding spin dressed up as sound science, which allows them to dismiss inconclusive studies that are moderately positive as ‘negative’ or failures. There would have to be a conversation about the inconclusive result.
My own feeling is that there is a lot more wrong than the fixed threshold, and if bias is the real problem it’s probably better to have goalposts - at least that’s something that can’t be moved after the ball is kicked!
I could be wrong and on the ‘other other’ hand, it’s telling that such a large number (800+!) of professional statisticians signed this letter so quickly.
Jury’s out - thanks for the post
Cheers

Thanks Rhis for your kind words. I didn’t mind the close personal attention at TLN per se but answering the flak took so much time that discussions didn’t happen or were derailed by flak at the end, which rendered it a waste of time. Most of the departed said much the same, they couldn’t have proper discussions there.

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ANd just in case anyone takes vaccines seriously, especially the expected Covid vaccine …

LONDON (AP) — The World Health Organization [for the record, says a new polio outbreak in Sudan is linked to an ongoing vaccine-sparked epidemic in Chad — a week after the U.N. health agency declared the African continent free of the wild polio virus.

Holy shit

That’s incredibly bad. And terribly sad for the parents

In rare instances, the live polio virus in the oral vaccine can mutate into a form capable of sparking new outbreaks

Right. So what could possibly go wrong with an un-tested Covid vaccine that’s based on a new DNA editing technique never before used in a vaccine, and rushed out in time for a phony (s)election cycle in the US? An illness that seems to have known effective treatments anyway, if caught early enough…

That can only be good.

Right?

Right?

Not at all. That is just exactly more of the same. The last Kill Gates sponsored polio vaccine killed and maimed thousands (I forget the numbers) but they were black and from African countries so no great shakes.

And another example of vaccine “safety”, is measles. Almost everyone who got measles in the outbreak a few years ago, had had the measles shot!

As you rightly say PP, “what could possibly go wrong with an untested Covid vaccine …”

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