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A Worthy Counterpoint by Emergency Room Doctors
One of my sisters is seeing a drastic slowdown in medical laboratory employment in Washington state. This is a predictable side effect of Dr. Fauci’s “public health” fraud, in which he has consistently misrepresented his unconstrained opinion from a mere slice of the whole field of public health as a fully informed recommendation.* This was simply not the case from Day One, with real public health including suicide prevention, substance abuse treatment and prevention, domestic abuse of every flavor, and prevention and early treatment of lethal diseases, including cancer, diabetes, heart diseases, and stroke. All of these are being predictably aggravated as known side effects of Fauci’s flawed prescription for treatment of the Chinese coronavirus.
We will, indeed, face a public health crisis as the country re-opens, as the healthcare system gets slammed by patients with delayed, worsened conditions at the same that everything from the local lab to the largest hospital scrambles to get staff back to work. Hear it from two ER doctors from California [hat tip to John Hinderaker at Power Line]:
President Trump did not hold a press briefing on Saturday or Sunday. I very much hope he was sent these very popular videos as a needed counterpoint to the “public health” bubble in which Dr. Fauci has wrapped him and the nation. President Trump has been the only one in the White House briefings actually acknowledging real public health includes suicides and substance abuse deaths. He needs credentialed experts to stand up to Fauci, forcing the good doctor to acknowledge that which every medical professional already knows on some level.
* I will back up this very provocative claim in a further post, and will refer to it in the comments here.
Published in General
Jerry is pretty correct here. I’ll admit I don’t understand the math too well, but if a test has a specificity of 99%, then a positive test rate of 1% will be completely meaningless, a test rate of 2% will be highly suspicious, but by the time 5% of your test results are positive, there’s usually reasonable confidence that most of those (i.e. about 80%) are true positives. Of course, the real devil in the details is that specificities aren’t point estimates but 95% CI ranges.
I think Roderic’s point was probably referring to the Santa Clara Study. There, the researchers had 1.5% of their tests positive but extrapolated that through projection magic to “up to 4.2% positive”. So in situations with that much extrapolation to reach the final figures, the entire outcome might indeed be more sensitive to the specificity of the underlying test. This was one of the main criticisms of the Bhattacharya study (especially since they omitted the fact that the manufacturer actually measured a worse specificity than what they cited in their paper).
That’s what I’d call the Apocalypse scenario. Total breakdown of civilization type stuff with War, Famine and Death to follow.
About 2% of the population got infected, and we were already having trouble with food and supply chains. They want to try it with 300 million infected?
This is probably not correct. This is most likely the false positive rate of the test. Antibody tests are seldom more specific than that.
Not saying it’s not true, just pretty unlikely.
We can say that the true prevalence is no higher than a few percent, though.
Roderic, we’re not having trouble with supply chains because of the infections. We’re having trouble with the supply chains because of lockdown orders, and individual coronaphobia. This does not mean that people should take no precautions, or should have no concern. It means that they should avoid irrational fear, and get back to work. Many people seem to want to do this.
The risk to young, healthy people is minimal. I think that this has been adequately established. They need to go about their business, with reasonable but minor precautions.
Marci, I don’t know how quickly we’d reach herd immunity if we opened the country. The prevalence of infection is reportedly around 22% in NYC, so it happened quite quickly even with lockdowns. I would expect the infection to spread most quickly in areas with higher population density, NYC most of all.
I do not agree that opening the country would cause the breakdown of civilization. Continuing the lockdowns might. Based on the best evidence that we have, we’re going to have fatalities in the range of 0.012-0.035% of the population. That range is based on an IFR range of 0.2-0.5%, and an infection rate range of 60-70%.
About 75% of the fatalities will be among people aged 65 and over, who are about 16% of the population. This means that for those 65 and over, 0.56%-1.64% will die, and for those under 65, 0.04%-0.10% will die. The rates will be somewhat higher for men, and somewhat lower for women.
If we did nothing, the economic impact of this would be negligible. The deaths will be tragic, but seem unavoidable to me.
By the way, there is nothing unusual about the death rate being higher for men. Per this table at Statistica of death rates per 100,000 in the US by age and sex, the death rate for men is higher at every age category.
The death rate for those age 65-69 is about 1.5% anyway; for 70-74 it is over 2%, up to a death rate of 13-14% for those 85 and over. Remember that my age 65 cutoff is for ease of reporting, and that the COVID-19 death rates — like all death rates — are consistently higher as one gets older (after age 4).
I don’t cite these numbers because I don’t care about people. I just think that it’s important to understand that about 13-14% of people aged over 85 died each year, before COVID-19. The figures are pretty high for all groups over 65.
The virus has caused a large number of deaths, and will cause more. I do not think that this can be avoided. If we went about our business, the economic impact would be minimal.
This does not mean that you must agree that we should go about our business. That is a matter for individual risk assessment. I do, I guess, insist that you understand the truth — it is not the virus that could cause economic collapse, civil unrest, war, or famine. It is our reaction to the virus that could cause these things.
The virus will cause a large number of deaths. It has already done so, and I suspect that it will get much worse. Absent the development of some remarkable cure, I currently expect between 400,000 and 1.1 million deaths in the US. Hard as it may be to believe, we can actually weather that without much trouble. About 2.8-2.9 million people died every year in this country, before COVID-19, and many of the COVID-19 deaths are probably among people likely to die of an opportunistic infection, or other injury, in the relatively near term in any event.
I think that there is a significant risk that the overreaction to the virus will cause vastly more harm than the virus itself. This is completely avoidable. Just say no to coronaphobia.
The math is the binomial distribution, which has three variables: the probability of an outcome, the number of trials, and the number of observations. Roderic’s example hypothesizes a 99% specificity (i.e. 1% false positive rate), and an observation that 5% of the trials are positive.
With 100 tests, and a false positive rate of 1%, the chance of observing 5 or more positive test results by chance is 0.3432%. This would be statistical significance above the 99% level.
On the other hand, if the prevalence was lower — say 2% — it would require more tests. Using the same assumption of a 1% false positive rate, it would take about 750 tests to detect a non-zero population prevalence with 99% statistical confidence.
Reality is more complex, because the specificity is not something that we know, but something that we also have to estimate.
Yes the data is worldwide- but US figures were pretty gruesome as well. The US experience of 100K deaths is an eye opener-especially 50-60 years ago when the population was much smaller. While the news of the time didn’t dwell on the pandemic, Americans at the time were more inured to death- WW2 was still fairly recent & the possibility of a war with the USSR was real. But contemporary policy makers were probably aware of the earlier figures which occurred with a new strain of flu- and COVID-19 figured to be worse. While we have improved medical care a great deal in 60 years, precious few of those advances are in the relevant field of virology (except for HIV therapy). Furthermore, the American population was significantly younger 60 years ago & had many fewer co-morbid conditions (except for smoking-which some now claim is protective in COVID-19!) and was therefore less likely to succumb to a virus like COVID-19. All in all, the pandemics of 1958 & 1968 had to sober the medical experts in the federal government-and a new strain of flu is less worrisome than a novel virus that is related to SARS & MERS-both of which had a significant mortality rates. Hence the lockdown & my admonition to quit saying this is just like the flu…..
FWIW, SK is using PCR, or at any rate Seegene, whose test was the first out of the block does.
As you can see, YouTube/Google, deeply compromised by both the Chinese Communist Party and the Democrat (Socialist) Party, has taken down the official video from an actual credentialed television broadcasting station. They are offering the usual direct and indirect lies and evasions. The station itself is directly hosting the video on their website, which we can expect Google to suppress/down-list in search results.
Scott Johnson asks “was it something he said?”
23ABC reports “Video interview with Dr. Dan Erickson and Dr. Artin Massihi taken down from YouTube.”
Roderic, I didn’t even remember the digital appendix. Great memory! That was over a month ago — an Excel file that I looked at for a couple of minutes. Sorry that I didn’t remember. I’ve been looking at a lot of Excel files. The Excel file doesn’t say 60,000. There is a prediction of about 84,000 on the “suppression” page (with no explanation about calculation), and ranges from about 623,000 to almost 2.8 million on the “mitigation page” (again, with no explanation).
Can you tell me where they discuss this in the ICL report? They cite nothing, but seem to just make seat-of-the-pants assumptions about the effect of various measures (they do this in Table 2 on page 6).
I don’t know how you can possibly say that their prediction is accurate. With the mitigation measures we have adopted, it ranged from 623,000 to 1.46 million, which hasn’t occurred (though it may). With “suppression,” which we haven’t done, they predicted about 84,000 deaths — a single point estimate, for some strange reason — and we seem well on our way to surpassing this by a lot.
How many deaths did ICL predict would have occurred through the present? You can’t answer, because they didn’t say. Their darned report is just a black box, as far as I can tell.
It should be left up but widely mocked because the two doctors are totally unqualified to discuss the issue- they own a “doc in the box” for heavens sake! At least one is not board certified and they are DOs in “emergency medicine”- not the draw for the top minds in medicine BTW. Their expertise is in treating minor cuts & STDs and doing sports physicals for high school athletes. People are quoting them as “researchers and experts” while they do not appear to be either. They are the Dr Oz’s of the pandemic-just trying to cash in.