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Thread: Disease and pandemics thread (because it's science)

  1. #2851
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    Quote Originally Posted by Copernicus View Post
    I wrote a novel once. While doing that, I realized how phenomenally humans can make up stories or try to cover their tracks. People want to believe in what they want to believe. This is one of the reasons I don't believe in some of the things I used to believe in.
    Worobey was one of the people who pushed strongly for proper investigation of the "lab escape hypothesis" back in May, so he's hardly pushing an "anti-leak" agenda.
    If you have an issue with his paper, he's actively and calmly discussing it on Twitter. Maybe you could raise it with him there and have your concerns addressed.

    Otherwise, to quote the man himself:
    There is enough of this sort of "I'll-believe-what-I-want-to-believe-in-the-face-of-all-evidence-to-the-contrary" going around these days for it not to leak further into scientific discourse.
    Grant Hutchison
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    Quote Originally Posted by Copernicus View Post
    More information that Covid-19 is airborne. https://phys.org/news/2021-11-covid-...lta-virus.html
    That's a model of how Covid might spread if it's travelling in aerosols, presented at a meeting about high-performance computing. It has yet to be tested in the real world.

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    Quote Originally Posted by Copernicus View Post
    I wrote a novel once. While doing that, I realized how phenomenally humans can make up stories or try to cover their tracks. People want to believe in what they want to believe. This is one of the reasons I don't believe in some of the things I used to believe in.
    I would like to pick up the word “want”. Beliefs are very hard to change from within even it you want to. The clash between current experience and what a belief would expect to experience is the cause of epiphany or other crisis. I try to avoid all belief but it’s very hard.

    In this situation we do have lots of evidence now. Knowledge can prevail over beliefs, or we can hope so.
    Last edited by profloater; 2021-Nov-23 at 10:42 AM.
    sicut vis videre esto
    When we realize that patterns don't exist in the universe, they are a template that we hold to the universe to make sense of it, it all makes a lot more sense.
    Originally Posted by Ken G

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    Quote Originally Posted by profloater View Post
    I would like to pick up the word “want”. Beliefs are very hard to change from within even it you want to. The clash between current experience and what a belief would expect to experience is the cause of epiphany or other crisis. I try to avoid all belief but it’s very hard.

    In this situation we do have lots of evidence now. Knowledge can prevail over beliefs, or we can hope so.
    Nature did a nice summary of the pros and cons of the lab-leak hypothesis back in June. I don't think much has changed since then, apart from Worobey's exhaustive detective work, previously referenced, which has un-muddied a lot of waters around the early epidemiology, shifting the balance of that evidence strongly towards a patient zero associated with the animal market rather than the lab.

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    Quote Originally Posted by Copernicus View Post
    Covid is now airborne. Distance and masks are not the protection that they used to be. Vaccination for vulnerable people is the best option. The virus is emitted by just talking now. Even the vaccinated get sick and emit virus. The vaccinated just don't get nearly as sick, on average.
    Every day we release thousands of droplets into the air that are invisible to the naked eye just by uttering the words: 'stay healthy'.
    Once out of our mouths, many large droplets will quickly land on nearby surfaces while smaller droplets remain suspended in the air for hours and will be inhaled by someone. And the ability to filter airborne particles of masks like N95 and FFP-2 respirators is very high.

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    A University of Cambridge fluid dynamics study by an engineering group concludes that 2-meter "social distancing" is an "arbitrary measure of safety."

    A new study has shown that the airborne transmission of COVID-19 is highly random and suggests that the two-metre rule was a number chosen from a risk Ďcontinuumí, rather than any concrete measurement of safety.

    A team of engineers from the University of Cambridge used computer modelling to quantify how droplets spread when people cough. They found that in the absence of masks, a person with COVID-19 can infect another person at a two-metre distance, even when outdoors.

    The team also found that individual coughs vary widely, and that the Ďsafeí distance could have been set at anywhere between one to three or more metres, depending on the risk tolerance of a given public health authority.

    The results, published in the journal Physics of Fluids, suggest that social distancing is not an effective mitigation measure on its own, and underline the continued importance of vaccination, ventilation and masks as we head into the winter months in the northern hemisphere.

    Despite the focus on hand-washing and surface cleaning in the early days of the pandemic, itís been clear for nearly two years that COVID-19 spreads through airborne transmission. Infected people can spread the virus through coughing, speaking or even breathing, when they expel larger droplets that eventually settle or smaller aerosols that may float in the air.

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    Quote Originally Posted by schlaugh View Post
    A University of Cambridge fluid dynamics study by an engineering group concludes that 2-meter "social distancing" is an "arbitrary measure of safety."
    I love it when physicists get a paper and a press release out of something that medics have understood for years.
    In other news, "five portions of fruit and veg per day" is a round number plucked arbitrarily out of a continuum of nutritional benefit, "brush your teeth for two minutes" is a round number plucked arbitrarily from a continuum of incremental plaque removal, and "wash your hands for twenty seconds" is a round number plucked arbitrarily from a continuum of progressive viral lysis.

    On a serious note, the hint that there is no absolute clinical cut off has always been there in the fact that different countries have set different "social distance" thresholds on the basis of the same evidence. So it's not just the case that "the ‘safe’ distance could have been set at anywhere between one to three or more metres, depending on the risk tolerance of a given public health authority", that's what actually happened. These numbers are always about balancing risk, benefit, compliance and feasibility, and different people and different societies weight these differently.

    Grant Hutchison
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  8. #2858
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    Quote Originally Posted by grant hutchison View Post
    Quote Originally Posted by schlaugh View Post
    A University of Cambridge fluid dynamics study by an engineering group concludes that 2-meter "social distancing" is an "arbitrary measure of safety."
    I love it when physicists get a paper and a press release out of something that medics have understood for years.
    In other news, "five portions of fruit and veg per day" is a round number plucked arbitrarily out of a continuum of nutritional benefit, "brush your teeth for two minutes" is a round number plucked arbitrarily from a continuum of incremental plaque removal, and "wash your hands for twenty seconds" is a round number plucked arbitrarily from a continuum of progressive viral lysis.

    On a serious note, the hint that there is no absolute clinical cut off has always been there in the fact that different countries have set different "social distance" thresholds on the basis of the same evidence. So it's not just the case that "the ‘safe’ distance could have been set at anywhere between one to three or more metres, depending on the risk tolerance of a given public health authority", that's what actually happened. These numbers are always about balancing risk, benefit, compliance and feasibility, and different people and different societies weight these differently.

    Grant Hutchison
    Just to pile on to what Grant said, I would have been shocked if it was otherwise ("They were 1.9 meters apart; if only they had increased it to 2.1, they might have survived!").

    Even in harder sciences there are almost no hard limits or absolutes, especially when what you are trying to do or prevent is dependent on multiple (often uncontrolled) variables, and you are judging them by probabilities of an event happening (or not happening).

    Take something like the pressure limit on a high-pressure reactor. The rating might be to 300 bar, but it doesn't mean it will explode at 301, nor is there zero risk of failure at 299, especially given a lot of other variables beside pressure.
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    When it comes to computer simulations of clinical problems, I once attended a lecture on that topic which began with a slide that read: "To the extent computer simulations according with clinical observation, they are superfluous; to the extent they do not accord with clinical observation, they are wrong."
    (The presenter went on to point out a broad middle ground in which simulation suggests useful new lines of clinical enquiry, or solves clinical puzzles.)

    One thing the Covid pandemic has brought us, though, has been illustrations of the extremes suggested by that opening slide.

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    Quote Originally Posted by grant hutchison View Post
    When it comes to computer simulations of clinical problems, I once attended a lecture on that topic which began with a slide that read: "To the extent computer simulations according with clinical observation, they are superfluous; to the extent they do not accord with clinical observation, they are wrong."
    (The presenter went on to point out a broad middle ground in which simulation suggests useful new lines of clinical enquiry, or solves clinical puzzles.)

    One thing the Covid pandemic has brought us, though, has been illustrations of the extremes suggested by that opening slide.

    Grant Hutchison
    Agreed! At best, when a situation is, statistically, fully understood, there is a probability density of chance.
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    Some more information on social distancing and masks and protection from the corona virus. https://medicalxpress.com/news/2021-...ion-masks.html
    Study shows the maximum risks of COVID infection with and without masks
    The moment an instant lasted forever, we were destined for the leading edge of eternity.

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    Quote Originally Posted by Copernicus View Post
    Some more information on social distancing and masks and protection from the corona virus. https://medicalxpress.com/news/2021-...ion-masks.html
    Study shows the maximum risks of COVID infection with and without masks
    Finally, one of these simulation exercises gets around to looking at the airflow around the sides of the mask, instead of pretending that forward trajectories are the only ones of interest. That's only taken eighteen bleedin' months to happen, despite the fact clinicians have been aware of it for forty years, at least. Also (surprise!) if you use the malleable nose wire properly it cuts down leakage. That's why the nose wire is there in the first place, of course. What did people imagine it was for?
    It's been a massive failure of public health messaging in many countries, that people have been instructed to wear essentially random masks, without adequate instruction in how to wear them properly. Norway is the only country I'm aware of which included the necessity for proper and widespread public instruction in their deliberations about whether or not to introduce a mask mandate. As a result they held back for a long time, both because they were achieving low prevalence through other means, and because they were unconvinced that the demonstrable hazards of improper mask use outweighed the benefits likely to be achieved by an untrained public. We've been lucky, in that regard.

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    So, a good year for mask makers, and getting better. A recent statistical study (Australia IIRC) found mask wearing reduced case numbers with no comment about causes. With only a slight understanding of politicians, I would have thought there were votes in mask supply, but then some people object and even protest about that. If thought to be a good thing, I can see why a study of effectiveness could be delayed, it could only muddy the waters of understanding that seep through the barriers of prejudice, (to mix metaphors horribly). Time was I knew no obviously infected people, now I know several vaccinated and infected, but none of them seriously worse than we expect in winter. Sadly I knew a few more, unvaccinated and now dead.
    sicut vis videre esto
    When we realize that patterns don't exist in the universe, they are a template that we hold to the universe to make sense of it, it all makes a lot more sense.
    Originally Posted by Ken G

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    The best data so far are from a cluster randomized trial in Bangladesh, which has just passed through peer-review and into publication. They produced a modest decreasing in symptomatic seroprevalence overall, but quite a striking reduction in symptomatic seroprevalence among the over-60s, which is interesting. As usual, it's difficult to tease out a pure signal, because their intervention not only increased "proper" mask use, but increased social distancing, too. (Which is reassuring in that Bangladeshi villagers, at least, don't seem to indulge in the sort of risk compensation behaviour that was initially feared, and which I observe regularly around town in these parts.)
    But their intervention was quite complex, and rather underscores my point about the "fire and forget" mask mandates that are tediously prevalent around the world--essentially telling the public to wear masks, threatening them with sanctions if they fail to comply, and then pretty much leaving them to their own devices. As the authors describe, Bangladesh was operating under such a mask mandate at the time of the experiment, but compliance had steadily declined.
    After piloting, we settled on a core intervention package that combined household mask distribution with communication about the value of mask-wearing, mask promotion and in-person reminders at mosques, markets, and other public places, and role-modeling by public officials and community leaders. We also tested several other strategies in sub-samples, such as asking people to make a verbal commitment, creating opportunities for social signaling, text messages, and providing village-level incentives to increase mask-wearing
    They even have a section entitled "In-person reinforcement is crucial to our intervention".

    On the more significant effect on older people, the authors have a number of speculations.
    There are several possible theories for why we might observe a larger reduction in COVID-19 cases for older adults. We did not directly measure age during surveillance, but mask-wearing could have increased more for older adults. A second theory is that older adults are more susceptible to infections at viral loads preventable by masks. A third theory is that older adults have fewer social connections, so that reducing transmission through any one connection is more likely to prevent infection by severing all transmissible routes. A fourth theory is that people exercised more care and were more likely to wear masks when proximate to the elderly.
    To what extent an intervention package that works on villages in Bangladesh is transferrable to other societies is another matter, of course.

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    Quote Originally Posted by grant hutchison View Post
    When it comes to computer simulations of clinical problems, I once attended a lecture on that topic which began with a slide that read: "To the extent computer simulations according with clinical observation, they are superfluous; to the extent they do not accord with clinical observation, they are wrong."
    (The presenter went on to point out a broad middle ground in which simulation suggests useful new lines of clinical enquiry, or solves clinical puzzles.)

    One thing the Covid pandemic has brought us, though, has been illustrations of the extremes suggested by that opening slide.

    Grant Hutchison
    It seems to me that both simulations which accord with the data and those which do not could be useful tools for developing better computer simulations.
    Cum catapultae proscriptae erunt tum soli proscript catapultas habebunt.

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    Quote Originally Posted by Trebuchet View Post
    It seems to me that both simulations which accord with the data and those which do not could be useful tools for developing better computer simulations.
    For sure. The vexatious aspects are when the simulators claim to have "discovered" something that's already well-known in clinical medicine, or claim to have made a dramatic "discovery" which is in fact completely incompatible with the clinical ground-truth. There used to be a steady trickle of that sort of activity before the pandemic, but it has really kicked off big-time since the start of Covid.

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    Quote Originally Posted by grant hutchison View Post
    For sure. The vexatious aspects are when the simulators claim to have "discovered" something that's already well-known in clinical medicine, or claim to have made a dramatic "discovery" which is in fact completely incompatible with the clinical ground-truth. There used to be a steady trickle of that sort of activity before the pandemic, but it has really kicked off big-time since the start of Covid.

    Grant Hutchison
    An old adage comes to mind garbage in garbage out.

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    Quote Originally Posted by bknight View Post
    An old adage comes to mind garbage in garbage out.
    To be fair to the simulators, that's rarely the problem. It's just that biology is much, much messier than physics, and physicists are not trained in medicine. My Wife The Professor embarked on a few joint medical projects after being contacted by basic scientists or IT specialists who wanted to make a contribution to solving a clinical problem, and she described the first few weeks as being essentially the same conversation on a repeating loop:
    Scientist: "Here's what we're going to do ..."
    Doctor: "Yeah, but ..."
    Scientist: "Seriously? Damn."

    (If doctors ever phoned up basic scientists because the doctor had just had a great idea that might help the scientist out, I'm sure the problem would be much worse than that, of course. It just never happens, because basic sciences contribute to medicine, and not the other way around.)

    Grant Hutchison
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    Quote Originally Posted by grant hutchison View Post
    To be fair to the simulators, that's rarely the problem. It's just that biology is much, much messier than physics, and physicists are not trained in medicine. My Wife The Professor embarked on a few joint medical projects after being contacted by basic scientists or IT specialists who wanted to make a contribution to solving a clinical problem, and she described the first few weeks as being essentially the same conversation on a repeating loop:
    Scientist: "Here's what we're going to do ..."
    Doctor: "Yeah, but ..."
    Scientist: "Seriously? Damn."


    (If doctors ever phoned up basic scientists because the doctor had just had a great idea that might help the scientist out, I'm sure the problem would be much worse than that, of course. It just never happens, because basic sciences contribute to medicine, and not the other way around.)

    Grant Hutchison
    You have reenforced my thought. A simulation can't be effective until all the variables have been accounted for in that coding. In addition, all the correct and pertinent information needs to be input. If all of that hasn't been accomplished then the solution is in question.

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    Quote Originally Posted by bknight View Post
    You have reenforced my thought. A simulation can't be effective until all the variables have been accounted for in that coding. In addition, all the correct and pertinent information needs to be input. If all of that hasn't been accomplished then the solution is in question.
    The problem is generally one of "pertinent information in, interesting information out, relevance to clinical problem slight".
    The aerosol simulation research, for instance, has produced a lot of interesting and (I presume) valid information about the spread of aerosols from coughs and sneezes, but that doesn't get to the nub of the matter for Covid, which is how the virus behaves in terms of getting into these aerosols, surviving in the droplets, and infecting another individual who breathes the droplets in. If the aerosol simulations were all that was relevant, we'd all have caught Covid a hundred times over by now.
    So the aerosol simulations are not garbage, because they can inform, for instance, decisions about effective ventilation. But what they don't do is the thing that they're often purported to do, which is to give a good model of disease transmission.

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    Quote Originally Posted by grant hutchison View Post
    Finally, one of these simulation exercises gets around to looking at the airflow around the sides of the mask, instead of pretending that forward trajectories are the only ones of interest. That's only taken eighteen bleedin' months to happen, despite the fact clinicians have been aware of it for forty years, at least.
    I donít know if this counts or not, but someone at my institute was doing simulations that I think take that into account. Itís the fourth YouTube video in the link below. I think itís due to that thinking that people in restaurants are asked to sit diagonally across from one another.

    https://www.r-ccs.riken.jp/en/fugaku...vid-19/msg-en/


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    Quote Originally Posted by Jens View Post
    I donít know if this counts or not, but someone at my institute was doing simulations that I think take that into account. Itís the fourth YouTube video in the link below. I think itís due to that thinking that people in restaurants are asked to sit diagonally across from one another.

    https://www.r-ccs.riken.jp/en/fugaku...vid-19/msg-en/


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    Masks are pretty leaky around the side. Far from perfect. I am of the opinion that we should try to allow exposure to microbiology, continuously, to build up antibodies, for when the real killers show up. Hopefully, some of the same antibodies will be shared. I also think that many cultural foods, may be protective of disease, for the simple reason that they may have become cultural foods, because the people who ate those certain foods survived past pathogens.
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    Quote Originally Posted by Jens View Post
    I don’t know if this counts or not, but someone at my institute was doing simulations that I think take that into account. It’s the fourth YouTube video in the link below. I think it’s due to that thinking that people in restaurants are asked to sit diagonally across from one another.

    https://www.r-ccs.riken.jp/en/fugaku...vid-19/msg-en/
    That's a nice one, thanks. I haven't seen it before.
    But I did mis-speak somewhat in the post to which you replied. The main "offenders" in regard to ignoring lateral jets have actually been the laboratory experimenters, who looked at the way in which masks moderated the forward projection of droplets and aerosols, but largely ignored all those billowy jets popping out around the mask. While the early modellers seemed to concentrate at first on simulating the spread from unmasked individuals.

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