COVID COVID-19 Coronavirus Containment Efforts

[kadiot]

Herd immunity, if achieved, is theoretically a great thing. Theoretically. This is what we’ve been saying all along. No one can be sure of things, of their theories, especially that this pandemic has not run its full course and the virus is still unraveling. We can’t test our theories on the general population, the risks are simply too high. Prudence and caution are the way to go. We don’t even know for sure where it came from (Is it a chimera between two or more viruses? Did they come together naturally or were they engineered? If it’s the latter, to what end?), we’re still figuring out what it does to the body (New clinical presentations are documented months into the pandemic; it attacks different people differently; it’s not a respiratory illness as it attacks several other organs, too), and we’re still figuring out its possible correlations with blood type, ethnicity (genetics), existing maintenance medications or preexisting conditions, and even past vaccinations. There’s a lot we don’t know. Never be sure about a novel virus until and unless an overwhelming scientific consensus is formed taking into account every conceivable variable. It’d not only be embarrassing but it could cost lives if you’re proven wrong.

https://www.businessinsider.com/coronavirus-antibodies-study-herd-immunity-unachievable-spain-2020-7

 

[mfb]

A link between COVID-19 and brain damage
Similar news

There is also a phenomenon of happy hypoxia: People with a blood oxygen saturation so low you would expect them to be unconscious - happily using their phones, talking to people and so on.

----------------

The latest study I saw showed HCQ does work but it needs to be started early and it works best not by itself but in combination with zinc and another drug. Six weeks to work doesn't sound correct. Also, people with O type blood seem to get less severe infections.

That study is nonsense. The group getting HCQ is much younger on average, and they also have a big difference in other medication. Not randomizing the groups or adjusting for absurdly obvious confounding factors is an error you wouldn't accept even from an undergrad report.

Off-topic...

Again I ask.
Why China, again?

https://edition.cnn.com/2020/07/06/...YMCJ6OeOJ8Cza5ypLIdG5Sg-d7y7Br8Iti8SpbuYvqeVU

Because you picked the news report about a disease in China. You could have picked a news report about a disease elsewhere, but you chose not to. The real question is: Why did you pick China, again?

Herd immunity, if achieved, is theoretically a great thing.

If it doesn't come from a vaccine then it's the worst-case outcome.

This is what we’ve been saying all along.

Yes, and people have told you that you are wrong every time you mention it.

 

[bhobba]

The latest study I saw showed HCQ does work but it needs to be started early and it works best not by itself but in combination with zinc and another drug. Six weeks to work doesn't sound correct. Also, people with O type blood seem to get less severe infections.

I did a search to confirm that and they all said 6 weeks or longer eg:
https://rheumatology.org.au/patients/documents/Hydroxychloroquine_2016_008.pdf

My reading of the latest studies is the following:
https://www.sciencemag.org/news/202...roxychloroquine-can-treat-or-prevent-covid-19

My Rheumatologist admitted it may work as a preventative, and I did see a study that showed it was 50% effective, but he wanted to see the study design before commenting.

Thanks
Bill

 

[mfb]

Sweden Has Become the World’s Cautionary Tale
Shorter version: Sweden 'literally gained nothing' from staying open during COVID-19, including 'no economic gains'
Key aspects they find:

• Sweden's soft approach killed more people
• Their economy is as damaged as the economy of the neighbors
• Sweden's rules are now stricter than the (relaxed) rules of its neighbors. Norway in particular is expected to have a faster economic recovery

But Sweden’s grim result — more death, and nearly equal economic damage — suggests that the supposed choice between lives and paychecks is a false one: A failure to impose social distancing can cost lives and jobs at the same time.

There is also this interesting comparison to the US:

Collectively, Scandinavian consumers are expected to continue spending far more robustly than in the United States, said Thomas Harr, global head of research at Danske Bank, emphasizing those nations’ generous social safety nets, including national health care systems. Americans, by contrast, tend to rely on their jobs for health care, making them more cautious about their health and their spending during the pandemic, knowing that hospitalization can be a gateway to financial calamity.

I can't say I am surprised. This is what I wrote early April:

It's not like we have a choice "economy or people". The economy will see a recession either way, and no one knows reliably how much in any scenario. But we do know that an unstopped pandemic will kill many people while a stopped pandemic will have a very limited death toll.

 

[bob012345]

That study is nonsense. The group getting HCQ is much younger on average, and they also have a big difference in other medication. Not randomizing the groups or adjusting for absurdly obvious confounding factors is an error you wouldn't accept even from an undergrad report.

I disagree. I don't think it's wise to just dismiss a large study done by medical professionals.

https://khn.org/morning-breakout/study-finds-positive-results-for-hydroxychloroquine/

 

[chemisttree]

Now Bloomberg television is showing the Boston Pops 4 July celebration. Indoors with people without masks singing loudly standing next to others on and off stage. This I cannot fathom.

What don’t you understand?

 

[Astronuc]

I disagree. I don't think it's wise to just dismiss a large study done by medical professionals.

https://khn.org/morning-breakout/study-finds-positive-results-for-hydroxychloroquine/

Kaiser Health News reports "Summaries of health policy coverage from major news organizations"

From the Henry Ford Health Systems - Treatment with Hydroxychloroquine Cut Death Rate Significantly in COVID-19 Patients, Henry Ford Health System Study Shows
https://www.henryford.com/news/2020/07/hydro-treatment-study

In a large-scale retrospective analysis of 2,541 patients hospitalized between March 10 and May 2, 2020 across the system’s six hospitals, the study found 13% of those treated with hydroxychloroquine alone died compared to 26.4% not treated with hydroxychloroquine. None of the patients had documented serious heart abnormalities; however, patients were monitored for a heart condition routinely pointed to as a reason to avoid the drug as a treatment for COVID-19.

However, those with certain heart conditions or heart disease are more susceptible to COVID-19, cannot be treated with Hydroxychloroquine, since it is potentially fatal. The study is contradicted by other studies that show no effectiveness, or adverse effects. Dosage is critical factor.

Many deaths from COVID-19 also involve one or more comorbidities, including cardio-pulmonary disease.

Also from Henry Ford Health Systems - DETROIT – "Researchers at Henry Ford Health System in Detroit say early diagnosis of a life-threatening blood clot in the lungs led to swifter treatment intervention in COVID-19 patients. "
https://www.henryford.com/news/2020/06/pulmonary-embolism-study

However, this requires folks to have symptoms and get tested. Pulmonary embolism is a concern throughout the circulatory system. Blood clots in capillaries starve tissue from blood flow, which leads to hypoxia leading to anoxia, which leads to tissue damage or necrosis, and nerve or organ damage.

 

[bob012345]

Kaiser Health News reports "Summaries of health policy coverage from major news organizations"

From the Henry Ford Health Systems - Treatment with Hydroxychloroquine Cut Death Rate Significantly in COVID-19 Patients, Henry Ford Health System Study Shows
https://www.henryford.com/news/2020/07/hydro-treatment-study
However, those with certain heart conditions or heart disease are more susceptible to COVID-19, cannot be treated with Hydroxychloroquine, since it is potentially fatal. The study is contradicted by other studies that show no effectiveness, or adverse effects. Dosage is critical factor.

Many deaths from COVID-19 also involve one or more comorbidities, including cardio-pulmonary disease.

Also from Henry Ford Health Systems - DETROIT – "Researchers at Henry Ford Health System in Detroit say early diagnosis of a life-threatening blood clot in the lungs led to swifter treatment intervention in COVID-19 patients. "
https://www.henryford.com/news/2020/06/pulmonary-embolism-study

However, this requires folks to have symptoms and get tested. Pulmonary embolism is a concern throughout the circulatory system. Blood clots in capillaries starve tissue from blood flow, which leads to hypoxia leading to anoxia, which leads to tissue damage or necrosis, and nerve or organ damage.

It's funny. Doctors have been routinely prescribing HCQ for what 70 years now to people without bothering to screen them for heart conditions. HCQ was always considered a safe alternative to CQ. Now, all of a sudden its highly dangerous. I'm skeptical. I think that's because different kinds of doctors are involved now and the legalities are far more scary with endless lawsuits.

 

[Astronuc]

Doctors have been routinely prescribing HCQ for what 70 years now to people without bothering to screen them for heart conditions.

Please provide the evidence that demonstrates this claim.

I know someone who takes Plaquenil (by prescription) for a condition. The doctor considered effects on the heart, eyesight, and other potential adverse effects.

Side Effects
Nausea, vomiting, loss of appetite, diarrhea, dizziness, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: slow heartbeat, symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), mental/mood changes (such as anxiety, depression, rare thoughts of suicide, hallucinations), hearing changes (such as ringing in the ears, hearing loss), easy bruising/bleeding, signs of infection (such as sore throat that doesn't go away, fever), signs of liver disease (such as severe stomach/abdominal pain, yellowing eyes/skin, dark urine), muscle weakness, unwanted/uncontrolled movements (including tongue/face twitching), hair loss, hair/skin color changes.

https://www.webmd.com/drugs/2/drug-6986/plaquenil-oral/details

Additional rare reports of changes in the heart rhythm have been reported with the use of hydroxychloroquine, particularly in combination with other medications. While monitoring for this risk is not typical in the office setting, it has been indicated in hospitalized and critically ill patients to evaluate for interactions with other medications.

https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Hydroxychloroquine-Plaquenil (Side Effects)

A baseline ocular examination is recommended within the first year of starting PLAQUENIL. The baseline exam should include: best corrected distance visual acuity (BCVA), an automated threshold visual field (VF) of the central 10 degrees (with retesting if an abnormality is noted), and spectral domain ocular coherence tomography (SD-OCT). For individuals with significant risk factors (daily dose of hydroxychloroquine sulfate greater than 5.0 mg/kg base of actual body weight, subnormal glomerular filtration, use of tamoxifen citrate or concurrent macular disease) monitoring should include annual examinations which include BCVA, VF and SD-OCT. For individuals without significant risk factors, annual exams can usually be deferred until five years of treatment. In individuals of Asian descent, retinal toxicity may first be noticed outside the macula. In patients of Asian descent, it is recommended that visual field testing be performed in the central 24 degrees instead of the central 10 degrees. It is recommended that hydroxychloroquine be discontinued if ocular toxicity is suspected and the patient should be closely observed given that retinal changes (and visual disturbances) may progress even after cessation of therapy. Cardiac Effects, including Cardiomyopathy and QT prolongation: Postmarketing cases of life-threatening and fatal cardiomyopathy have been reported with use of PLAQUENIL as well as with use of chloroquine. Patients may present with atrioventricular block, pulmonary hypertension, sick sinus syndrome or with cardiac complications. ECG findings may include atrioventricular, right or left bundle branch block. Signs or symptoms of cardiac compromise have appeared during acute and chronic treatment. Clinical monitoring for signs and symptoms of cardiomyopathy is advised, including use of appropriate diagnostic tools such as ECG to monitor patients for cardiomyopathy during PLAQUENIL therapy. Chronic toxicity should be considered when conduction disorders (bundle branch block/atrio-ventricular heart block) or biventricular hypertrophy are diagnosed. If cardiotoxicity is suspected, prompt discontinuation of PLAQUENIL may prevent life-threatening complications.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/009768s037s045s047lbl.pdf
https://www.fda.gov/drugs/drug-safe...oroquine-covid-19-outside-hospital-setting-or

NIH halts clinical trial of hydroxychloroquine
Study shows treatment does no harm, but provides no benefit
https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine

COVID-19 Hydroxychloroquine Treatment Brings Prolonged QT Arrhythmia Issues
https://www.dicardiology.com/articl...eatment-brings-prolonged-qt-arrhythmia-issues
Two studies from 2013 and 2016 regarding adverse effects of HCQ on QT arrhythmia are cited.

Hydroxychloroquine cardiotoxicity presenting as a rapidly evolving biventricular cardiomyopathy: key diagnostic features and literature review (Numerous studies cited back to the 1980s)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760572/

From Yogita Rochlani, Mohammed Hasan Khan, Behram Mody, Anthony Fuisz, Howard Cooper and Alan Gass, "HYDROXYCHLOROQUINE (PLAQUENIL) CARDIOTOXICITY: AN UNCOMMON COMPLICATION OF A COMMON MEDICATION", Journal of the American College of Cardiology, Volume 71, Issue 11 Supplement, March 2018 DOI: 10.1016/S0735-1097(18)32936-X https://www.onlinejacc.org/content/71/11_Supplement/A2395
"Hydroxychloroquine (HCQ), a common anti-rheumatic medication, can be cardiotoxic and cause systolic or diastolic heart failure (HF)."

Now, all of a sudden its highly dangerous.

No, not all of sudden, based on cited studies going back to the 1980s and FDA warnings, and no one has claimed "highly dangerous". However, it has been recognized over at least 30-40 years, that there can be adverse cardiotoxicity in some persons. Dosage is a key factor.

 

[bob012345]

Please provide the evidence that demonstrates this claim.

It's not my claim, I heard doctors discussing it on TV a couple of months ago. I listened to what they said. They were aghast at the attitude of 'new' doctors without the extensive experience they had with the drug.

 

[bhobba]

HCQ was always considered a safe alternative to CQ.

According to my Rheumatologist HCQ is perfectly safe when prescribed by a doctor trained in its use eg it's contraindicated if you have psoriasis and regular blood tests are generally required. It is used in Lupus and sometimes other autoimmune diseases (of course not psoriatic arthritis) as well as Malaria. But many of the Malaria carriers around the world have developed resistance to it so is only of value in certain countries these days. CQ however is another matter - it can be dangerous, but my doctor knows of nobody that ever uses it - he certainly has never prescribed it.

Thanks
Bill

 

[jim mcnamara]

@bob012345
It's not my claim, I heard doctors discussing it on TV a couple of months ago. I listened to what they said. They were aghast at the attitude of 'new' doctors without the extensive experience they had with the drug.

Not acceptable. You need a refereed paper or at least a case study. These kinds of 'I saw/read/heard something somewhere somewhen' do not fly on PF. And if HCQ and CQ were not politicized, we would probably not be 'debating' them like this. They are fine anti-malarial drugs and have an off label history for some auto-immune problems. They do have serious side effect and interactions.
This is what is accepted, content reviewed by MD's:
https://www.webmd.com/drugs/2/drug-5482/hydroxychloroquine-oral/details

 

[bob012345]

I've suspected for a long time powerful commercial toilets are very dangerous. I remember during the SARS outbreak they warned the virus could be inhaled from aerosol droplets ejected by toilets.

https://www.nytimes.com/2020/06/16/...tion=click&module=RelatedLinks&pgtype=Article

 

[bob012345]

Not acceptable. You need a refereed paper or at least a case study. These kinds of 'I saw/read/heard something somewhere somewhen' do not fly on PF. And if HCQ and CQ were not politicized, we would probably not be 'debating' them like this. They are fine anti-malarial drugs and have an off label history for some auto-immune problems. They do have serious side effect and interactions.
This is what is accepted, content reviewed by MD's:
https://www.webmd.com/drugs/2/drug-5482/hydroxychloroquine-oral/details

My comments may have been too strong but they were based on what I heard. And I am not saying there are never any side effects. I can try and dig up the video comments if that's acceptable but since you correctly pointed out that opinions on this drug have been politicized, perhaps we just should not discuss it here. Thanks.

 

[morrobay]

What don’t you understand?

Your question. The past reruns of the Boston Pops 4 July show that I assumed to be a live broadcast showed very risky behavior.

 

[bob012345]

Your question. The past reruns of the Boston Pops 4 July show that I assumed to be a live broadcast showed very risky behavior.

I believe from this we can conclude from this PR information about the show that the program was a mix of past performances and new virtual performances. There may have been a 'live' host (certainly a living one...) but I do not believe the audience was live. The same was done with PBS's A Capitol Fourth show last week. They may have seamlessly created the illusion it was all live.

A Boston Pops Salute to Our Heroes celebrates the everyday heroes among us through music, shouts outs, and a pre-recorded fireworks display.

The program will feature previous musical performances from recent years including Andy Grammer, Leslie Odom Jr., Rhiannon Giddens, Brian Stokes Mitchell, Arlo Guthrie, and more. Rita Moreno and Amanda Gorman contribute moving narration and poetry accompanied by the masterful Boston Pops. The three-hour show also includes several newly-created recorded virtual performance pieces by Boston Symphony and Boston Pops players as well as the Middlesex Country Volunteer Fifes and Drums. Many friends of the Boston Pops also share special video messages to commemorate our nation’s birthday. Leading the celebrations is Boston Pops conductor Keith Lockhart joined by Bloomberg’s Kim Carrigan, Janet Wu, and Joe Shortsleeve.

 

[mfb]

I disagree. I don't think it's wise to just dismiss a large study done by medical professionals.

I'm not "just" dismissing it, I'm dismissing it because of a ridiculously flawed protocol used by the study, one you can easily verify yourself. This study might have some use in some aspects, but the conclusion "HCQ is useful" (which is heavily implied by the paper, and blindly reported by people using this study as last straw to save their blind belief in the drug) cannot be drawn from it, because the groups they use do not allow such a comparison.

If you give 60 year old patients red socks and 30 year old patients yellow socks, will you come to the conclusion that yellow socks are a valid treatment for COVID-19? Yeah, me neither. But if you use HCQ instead of sock colors it's good enough to be cited, apparently.

 

[bhobba]

I can't say I am surprised. This is what I wrote early April:

I am. Like you I thought we would have a recession either way. I did think it would be less if there was not as heavy a lockdown. It really is amazing what the fundamental tenet of science - ie observation trumps theory - turns up. I only hope governments take notice. We are having a second wave in Victoria at the moment and the reimposing of some rather strong lockdown measures across Australia. We are hearing all the time this is going to send many more businesses to the wall and they are pleading to think of them in making these decisions. Looks like whatever the government does it will not make much if any difference to the businesses.

Thanks
Bill

 

[chemisttree]

Your question. The past reruns of the Boston Pops 4 July show that I assumed to be a live broadcast showed very risky behavior.

I see! If you moved past that first minute of the show (I often do) it’s easy to make that mistake.

 

[bhobba]

My comments may have been too strong but they were based on what I heard.

I too have heard all sorts of claims from respected doctors. Some claim it's a wonder cure - especially when combined with a certain antibiotic and Zinc, plus started early. Others claim - do not try it - it will kill you. I just did not know what to make of it. In that situation all you can do is look at the peer reviewed studies. We had the Lancet article that disparaged it - but that was found wanting and withdrawn. We have others like the three studies I posted that showed basically no benefit. We even had some doctors calling other doctors promoting the opposite view quacks - that you virtually never see. There is obviously strong opinions involved here. Only properly run trials can get to the bottom of it. It's why I asked my specialist who prescribes it all the time. He said he finds it very hard to believe because the literature and his clinical experience say it needs at least 6 weeks to work. When I heard that my reaction was I would need strong evidence of its efficacy to believe it is a cure - prophylactic - maybe - but cure looks dubious. Still, used correctly, it's safe so if you get Covid and want to try it, and your doctor agrees, go ahead - but realize some studies did show a slightly higher death rate with it.

Thanks
Bill

 

[Jarvis323]

If you give 60 year old patients red socks and 30 year old patients yellow socks, will you come to the conclusion that yellow socks are a valid treatment for COVID-19? Yeah, me neither. But if you use HCQ instead of sock colors it's good enough to be cited, apparently.

I agree with your point, but you're misrepresenting the study by exaggerating so severely.

Here is the paper:
https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

and relevant table:
https://www.ijidonline.com/action/showFullTableHTML?isHtml=true&tableId=tbl0005&pii=S1201-9712(20)30534-8

Neither HQC or AZM : 68.1 ± 18.9, 71 (56 – 83) mortality 26.4%
HQC alone: 63.2 ± 15.6, 53 (64 – 74), mortality 13.5%
AZM alone: 63.3 ± 17.3, 64 (52 – 76) mortality 22.4%
AZM + HQC: 62.3 ± 15.9, 62 (51 – 74) mortality 20.1%

So you can see the age groups are not that different. (Neither HQC or AZM) looks to have had some older people. It would be nice to see complete breakdown. Where is the actual data? It should be open source. But twice the mortality rate is also a big difference. Still, there are some major limitations.

As far as I know, this is the first study to test early treatment. And they also used safe/recommended dosages (several previous studies used dosages much higher than recommended). So I don't think that the positive result would contradict previous studies. Remdesivir also was found to have no benefit by several early studies.

 

[mfb]

So you can see the age groups are not that different.

The chance to die increased by a factor 2-4 for every 10 years. The "none of these drugs" group is 5 years older. Using the lower estimate, we would expect a factor sqrt(2) for the difference between "none of these drugs" and the other groups, using the upper estimate we would expect a factor 2. The larger standard deviation in the "no drug" range would increase that difference even further as the curve is convex. That range covers the observed differences.

In addition there is a big difference in the use of steroids between the groups. Who knows what their effect was?

It's possible to correct for that. Give the patients weights based on their age to make the comparison fair. It's still not randomized but it's better than nothing. Did they do that? No. Why not? I can't see any explanation that is not fraud or utter incompetence.

 

[russ_watters]

Sweden Has Become the World’s Cautionary Tale
Shorter version: Sweden 'literally gained nothing' from staying open during COVID-19, including 'no economic gains'
Key aspects they find:

• Sweden's soft approach killed more people
• Their economy is as damaged as the economy of the neighbors
• Sweden's rules are now stricter than the (relaxed) rules of its neighbors. Norway in particular is expected to have a faster economic recovery

There is also this interesting comparison to the US:

I can't say I am surprised. This is what I wrote early April:

That article provide a terrible analysis and is way too heavy on spin to be of value. Saying Sweden's unemployment rate "jumped" from 7.1 to 9% whereas Denmark's "edged up" from 4.1 to 5.6% is just an eye-rolling level of spin and that sort of clearly agenda-driven analysis drives me crazy. An increase in unemployment of 1.9% (percentage points) in the midst of what for many countries is the worst recession since the Great Depression is spectacularly good at face value. I'd be more concerned about why their unemployment was 7.1% in March, because that's pretty high. But if that's a structural feature of their Scandinavian Economy, then their increase was actually less significant than Denmark's. Conversely, Denmark's small increase seems impossibly low for a country that shut down, unless closed businesses were still somehow able to keep their employees (more on that below...).

But the real problem with the article's analysis is that it lacks the word "debt". You can fake any economy you want with debt -- for a few months. Presumably, Sweden's economic losses are "real" because without a shutdown, their government wouldn't have had to pour massive amounts of stimulus money into their economy to prop it up. But other countries that shut down, did. GDP numbers and unemployment numbers are largely meaningless without that context because by spending money that you don't have, a government can choose to make them whatever it wants them to be. If you want unemployment to stay low, just give businesses a bunch of money in exchange for not laying-off their employees (which we did). If you want the GDP to look strong, just hand out a bunch of cash (which we did). The damage from those policies (or rather the economic downturn that motivated them) is still real, but it occurs over years or decades instead of months, so it is harder to isolate, and only if you are looking for it.

And yeah, I know, 'debt doesn't matter'. I've heard that plenty in this and the other thread, but it really does matter. It matters a lot, and enough that just 10 years ago it was such a big problem in Europe that it got a capitalized name.

...and I'm setting aside the previously discussed oddity of strictly limiting the comparison of the health impacts to Scandinavian countries (or, oddly, the US).

 

[mfb]

Saying Sweden's unemployment rate "jumped" from 7.1 to 9% whereas Denmark's "edged up" from 4.1 to 5.6% is just an eye-rolling level of spin and that sort of clearly agenda-driven analysis drives me crazy.

Look at the numbers not at the words if you don't like authors avoiding repetitions of words.

An increase in unemployment of 1.9% (percentage points) in the midst of what for many countries is the worst recession since the Great Depression is spectacularly good at face value.

Is it? Germany's unemployment rate increased from 5.1% to 6.1% in the same time frame (and 6.2% in June). In France it increased from 7.6% to 8.1%.
In the Eurozone overall it increased from 7.1% to 7.4%.

More from the same source:
In Australia it increased from 5.2% to 7.1%
In Canada it increased from 7.8% to 13.7%.
The US' increase from 4.4% to 13.3% (down to 11.1% in June) is the outlier here, with Canada being second in the change.

Different countries have different criteria for what counts as unemployed, so absolute comparisons between countries rarely work. Someone can be counted as unemployed in one country but not in another under identical conditions.

I guess we'll need to wait another year until we get data about new debt.

 

[russ_watters]

Look at the numbers not at the words if you don't like authors avoiding repetitions of words.

Oh, come on. That's not just a literary aesthetic of trying to avoid repetition. The meanings conveyed by those words are vastly different. And yeah, I do look at the numbers, but the words matter because they tell me the author's position, which influences what numbers to include and what numbers to exclude. The wording tells me I shouldn't trust this author due to his strong bias.

Is it?

Is what what? The worst recession since the Great Depression? Yes, almost certainly - we're still in the front half of the pandemic, so it's still a projection, but it's looking like it.

[various unemployment rates]
The US' increase from 4.4% to 13.3% (down to 11.1% in June) is the outlier here...

Different countries have different criteria for what counts as unemployed, so absolute comparisons between countries rarely work.

As I said, the bigger problem isn't the country-by-country differences in method/characterization, it's that the numbers themselves aren't real due to the type of economic stimulus given. If someone is at home and not working, but still being paid by their employer, they are "employed" even though they are not working and are not producing any output for the company. As far as I know, that's a type of stimulus that has never happened before, so unless those people can be accounted for, you can't even compare one country's numbers today vs the same country for the 2008-10 recession.

I guess we'll need to wait another year until we get data about new debt.

Yep, by definition, the debt is a bill you pay later, and you don't even see the full tally until the initial recession is over. I remember from discussions during the 2008-10 recession where people said about stimulus, 'we can't worry about the debt right now, we have to save the economy'. But then came The European Sovereign Debt Crisis. When this is over we're likely to see both a worse recession and a worse debt.
[edit]
Discussion of this issue is quite thin, but here's an article from April about an IMF analysis of the problem:
https://www.ft.com/content/6f9932d4-5bf0-425d-b536-135d834ad20c

 

[StatGuy2000]

Oh, come on. That's not just a literary aesthetic of trying to avoid repetition. The meanings conveyed by those words are vastly different. And yeah, I do look at the numbers, but the words matter because they tell me the author's position, which influences what numbers to include and what numbers to exclude. The wording tells me I shouldn't trust this author due to his strong bias.

Is what what? The worst recession since the Great Depression? Yes, almost certainly - we're still in the front half of the pandemic, so it's still a projection, but it's looking like it.

As I said, the bigger problem isn't the country-by-country differences in method/characterization, it's that the numbers themselves aren't real due to the type of economic stimulus given. If someone is at home and not working, but still being paid by their employer, they are "employed" even though they are not working and are not producing any output for the company. As far as I know, that's a type of stimulus that has never happened before, so unless those people can be accounted for, you can't even compare one country's numbers today vs the same country for the 2008-10 recession.

Yep, by definition, the debt is a bill you pay later, and you don't even see the full tally until the initial recession is over. I remember from discussions during the 2008-10 recession where people said about stimulus, 'we can't worry about the debt right now, we have to save the economy'. But then came The European Sovereign Debt Crisis. When this is over we're likely to see both a worse recession and a worse debt.
[edit]
Discussion of this issue is quite thin, but here's an article from April about an IMF analysis of the problem:
https://www.ft.com/content/6f9932d4-5bf0-425d-b536-135d834ad20c

@russ_watters no one is suggesting that debt does not matter. The questions are the following:

1. Does debt matter right now?

2. To what extent will it matter once the worst of the pandemic has peaked?

#1 is a straw man argument -- the question is if one does nothing, then the pandemic itself will cause greater economic damage. So it is pick your poison -- get into debt to mitigate economic damage now, or do nothing and watch your economy tank (in addition to causing untold damage to the health of your population).

#2 will greatly depend on the degree to which nations around the world will work to stimulate the economy through fiscal and monetary policy, and the degree to which there will be pent-up demand for goods and services that are currently shut down (to varying degrees) due to the pandemic. I (unlike yourself) am actually quite optimistic that once the pandemic passes that the there will be enough robust economic growth to essentially wipe out the past damage and reduce or eliminate the debt accumulated during the pandemic.

 

[Jarvis323]

The chance to die increased by a factor 2-4 for every 10 years. The "none of these drugs" group is 5 years older. Using the lower estimate, we would expect a factor sqrt(2) for the difference between "none of these drugs" and the other groups, using the upper estimate we would expect a factor 2. The larger standard deviation in the "no drug" range would increase that difference even further as the curve is convex. That range covers the observed differences.

In addition there is a big difference in the use of steroids between the groups. Who knows what their effect was?

It's possible to correct for that. Give the patients weights based on their age to make the comparison fair. It's still not randomized but it's better than nothing. Did they do that? No. Why not? I can't see any explanation that is not fraud or utter incompetence.

Here is the description of their statistical analysis.

Multivariable Cox regression models and Kaplan-Meier survival curves were used to compare survival among treatment groups while controlling for demographics (e.g., age, gender), preexisting medical conditions (e.g. CVD, lung disease) and clinical disease severity (mSOFA, O2 saturation). Bivariate comparisons of the 4 medication groups were made using analysis of variance or Kruskal-Wallis tests for continuous variables, and chi-square tests or Fisher exact tests for categorical variables. Additional analysis was performed using propensity score matching to compare outcomes in mortality across treatment groups. A propensity score was created for each patient based on the set of patient characteristics used in the Cox regression model. Subsequently, 1 to 1 matchups of patients given hydroxychloroquine (either hydroxychloroquine alone or in combination with azithromycin) and patients not given hydroxychloroquine based on the exact propensity score were observed. The resulting matched group status was placed into its own Cox regression model as a mortality predictor with a Kaplan-Meier plot summarizing the survival curves of the two matched groups. P values < 0.05 were considered statistically significant. Additionally, median survival times by treatment strata were calculated to approximate prognosis. No imputations were made for missing data.

With their model, they derive a hazard ratio.

Further, a total of 190 hydroxychloroquine patients exactly matched up with 190 corresponding non-hydroxychloroquine treated patients based on the exact underlying propensity score. Table 3contains a descriptive summarization of these patients within both the unmatched and propensity matched settings, confirming that the propensity matched groups have identical underlying patient characteristics. The Cox regression result for the two propensity matched groups (Table 4) indicates that treatment with hydroxychloroquine resulted in a mortality hazard ratio decrease of 51% (p = 0.009). The resulting Kaplan-Meier survival curves within the propensity matched setting displayed significantly better survival in the hydroxychloroquine treated group, with the enhanced survival persisting all the way out to 28 days from admission (Fig. 2).

To be honest, I don't know how reliable their model is. It may be flawed, and other medications may have made the difference for all I know. And emphasizing the raw results may be misleading. But they did control for confounding factors, and in a more robust way than just weighting by age.

 

[russ_watters]

...and I'm setting aside the previously discussed oddity of strictly limiting the comparison of the health impacts to Scandinavian countries (or, oddly, the US).

On second thought, I don't think I will let that go.

I don't think it's reasonable to compare disease statistics among tight geographic regions or very similar governments only, but I was prepared to let it go because the article is primarily about economic impact, not disease impacts. Since the thesis is that they got zero economic benefit from not locking-down, it doesn't actually matter if they had zero additional deaths or a million.

But the title of the article is "Sweden has Become the World's Cautionary Tale". That has a lot more punch than saying "Scandinavia's Cautionary Tale", but no, I won't accept that literary flair makes the difference acceptable. The article repeatedly applies the thesis globally while providing no economic data for anywhere else but Scandinavia. That's not harmless literary flair, that's flawed analysis.

 

[nsaspook]

By all accounts, Sweden's high rate of Coronavirus deaths was evidence that the country had made a horrendous error. Sweden — which did not impose a strict lockdown — suffered 543 deaths per million of its population, compared to just 105 in neighboring Denmark. The Swedish death toll has been roughly 11 times worse than Norway's, on a per capita basis.

Yet Coronavirus deaths in Sweden have fallen dramatically in recent days, and are now approaching zero. Between June 30 and July 6,

https://www.businessinsider.com/swe...ths-fall-not-mean-lockdown-plan-worked-2020-7

Sweden's Coronavirus death toll is now approaching zero, but experts are warning others not to hail it as a success

What would you call it?

https://www.forbes.com/sites/ericma...-reason-may-be-something-darker/#13b9298069bd

There were also some bright spots in the analysis, however.

“Our study shows that individually driven infection-control measures can have a substantial effect on national outcomes, and we see Sweden as a good example of this case,” said co-auth0r Peter Kasson from the University of Virginia School of Medicine and Uppsala University. “Higher levels of individual action would further suppress the infection, while a complete lack of individual action would likely have led to runaway infection, which, fortunately, hasn’t happened.”

The analysis finds that nearly a third of Swedish residents voluntarily self-isolated.

The result of the unique approach was less catastrophic than many predicted, despite the increased death rate. The country had three times as many deaths per capita compared to Denmark, Finland and Norway as of May 15, but it fared better than the United Kingdom and Spain while also lessening the economic impact of the pandemic.

 

[mfb]

@Jarvis323: That's not what you can find in the abstract or the conclusions, and it disagrees with well-known statistics. And it still doesn't explain why they didn't randomize the groups, and why steroid use is so vastly different but doesn't get mentioned in abstract or conclusions. Well, there is one option that explains all these open questions together neatly: Deliberate manipulation - fraud. It's not the only option, but it does look likely to me.

Is what what?

Is an increase by only 1.9% spectacularly good as you said? It's much larger than the average of the Eurozone. It's only good if you compare it to the US or Canada, but that's telling us more about the US and Canada than Sweden.

But the title of the article is "Sweden has Become the World's Cautionary Tale". That has a lot more punch than saying "Scandinavia's Cautionary Tale", but no, I won't accept that literary flair makes the difference acceptable. The article repeatedly applies the thesis globally while providing no economic data for anywhere else but Scandinavia. That's not harmless literary flair, that's flawed analysis.

By comparing Sweden to similar countries they see that keeping things open longer didn't seem to help the economy. It's a cautionary tale that "we keep things open to help the economy" doesn't have to help the economy, and that tale you can apply worldwide.