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Anastasis

Certifiably Surly
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Posts posted by Anastasis

  1. 4 minutes ago, BradInATX said:

    Unless one of the vaccines that they're already pre-producing a ton of hits.

    Pre-approval production set-up has a substantial impact, but we still have to manage distribution, prioritization and safety surveillance.  And prioritization includes at individual level as well as worldwide prioritization.  I'll stick with return to normal 2022-2023 time frame and will be happy if I am wrong. 

    NYT has a piece on this with some interesting infographics. 

    https://www.nytimes.com/interactive/2020/04/30/opinion/coronavirus-covid-vaccine.html

     

    • Like 2
  2. 15 minutes ago, BradInATX said:

    I'm not necessarily saying you're wrong. It could end up endemic, but so far the vaccine trials are promising, and some of what you're saying is a bit off. Covid isn't the same type of virus as influenza, so you can't really use the flu as a comparison. And nobody is really trying for a SARS/MERS vaccine because they fizzled out on their own, so that doesn't mean much of anything.

    There are no certainties but early results from vaccine trials are good. 

    Yeah, perhaps it is just unfounded optimism, but I see no reason that a vaccination program should be able to get this under control.  The initial data from non-scrubs (basically non MRNA companies) has been pretty good, but it is early information.

    But vax approval is just the first step.  We have to be thinking about what a vaccine roll out program looks like.  Production, distribution, how do we prioritize vaccination to high risk individuals, what kind of safety surveillance system do we have in place, what are the contingency plans if something goes wrong. Seems to me like the R&D component is the most well understood part of this whole thing.  All those other things still need to be articulated. 

    I think that we need to come to grips with the fact that, given that effective vaccines come out of the development program, it will take many months, perhaps a year+ after successful trials to roll out. We aren't going to get back to anything approaching pre-COVID normal until 2022-2023 imo.   

  3. 1 hour ago, Prepuce of Doom said:

    Yesterday's Shithead of the Day has been identified, fired, etc. - details in thread below. 

    (Former) insurance agent, apparently. 

     

     

    Does that guy look like he is printing a concealed weapon on his hip @ the waist band?

    • Like 1
  4. 17 minutes ago, JSB said:

    Fuck I want to contribute to this thread. I've got my eyes out for a decent price on a restored convertible V-8 with a stick and 4 seats. I lean Mustang, but can be talked into something else. I plan on going to Mecum in September in Dallas Corona willing, and have been looking through online ads. If anyone sees something, let me know. 

    Keep an eye of BaT, if for no reason that to get a sense of values...they've had a number of mustangs recently, including a manual convertible. 

    https://bringatrailer.com/ford/mustang-1965/

    https://bringatrailer.com/ford/mustang-1967-1968/

     

  5.  

    4 minutes ago, The Royal We said:

    Seems reasonable.  Although I do think it could become more statistically impactful in the future if multiple negative tests are required before someone can participate in an activity - seems like that would drive more positive tests.

    It also seems like counties should have the ability to keep track the number of positive individuals vs. tests in the numbers they are reporting to the state.  At least the smaller counties, it could be more challenging for Harris, Dallas, Tarrant, etc.

    Yeah, I think it could have impact if policy was crafted to require serial testing. 

    I would agree that the ability to report out person-level should be straightforward. Seems to me that information should be integrated into the contact tracing platform, which I would assume are more sophisticated in larger counties. I don't really know the answer, just speculating. 

  6. 11 minutes ago, The Royal We said:

    Yea, I don't think it would be statistically significant, but I'd like to find a trustworthy source that says the case count is individuals, not positive tests - found that for NC and GA, but not for TX.  Been digging around on the TX DSHS website with no luck so far - not mentioned in the FAQ.

    I think that that kind of reduction to individual level counts vs. test level counts would have to occur at the county level. My assumption would be that test level counts are what is being provided, but there may vary well be variability from county to county, and there would likely be some errors introduced in the process.  None of which I think would actually have a meaningful impact on the numbers. 

  7. 18 minutes ago, jimmyjazz said:

    Maybe old people just lie more.  (Semi-serious:  I would expect someone 40 or older to be more aware of the social contract related to wearing masks and social distancing than a teenager, and to feel more shame for not participating.)

    There certainly may be some either conscious or subconscious bias towards giving the "correct" response among older folks. All I can say is that those data tend to agree with my observations.  A HS aged kid wearing a mask and practicing social distancing is a unicorn. #pongfest 

  8. 6 minutes ago, Bama Chick said:


    It’s a right wing talking point.

    Alabama Department of Public Health had to actually put out a statement debunking it because actual elected were spouting it off too.

     

     

     

     


    I would imagine Texas is the same but unless someone asks for clarification the information may not be floating around.

     

     

     

     

    That's antibody testing vs. diagnostic testing.  The way that I read the quoted test was how were cases where an individual had multiple diagnostic test come back as positive treated.  Not sure the answer to that, but even if they are double counting I don't think it should have a meaningful impact on the trends we are seeing in cases. 

  9. 18 minutes ago, BigHorn'13 said:

    Completely out of context but if I have to hear about "the young people not taking this seriously" I'mma cap a boomer.

    All generations seem to be not taking this shit seriously so why is it on the young people to do everything? At what age do adults acceptably return to acting like children? Asking for a friend...

    Agree that there are examples of all generations shitting the bed, but at least on social distancing measures there does appear to be a relationship with age.

     

    ETA: SCAN survey results from 8097 respondents from King County for masking and distancing behavior while in public. Survey respondents were asked how often (always, sometimes, never) they did each of the following in the past seven days: “wear a face mask in public to protect others from getting sick?” and “try to stay six feet away from people who don’t live with you?” Image courtesy Public Health Insider

     

    22053389_web1_News-PHI-Mask-Survey-ECH-2

  10. 38 minutes ago, GRHorn said:

    Anecdotal note here, but the first doc I know in SA that was positive, caught it on a ski trip over spring break to Colorado. At one surgery center where they periodically check she just came back with no antibodies. 
     

    I haven’t really dug into immunology since med school days, but I have a hard time thinking that if she was exposed to Covid again today that she wouldn’t have a much milder course of illness. So how is that likely mediated? T cells, NK cells? Are the tests just missing different antibodies to the same virus? 
     

    When I combine that story with the study showing 5% seroprevalence in Spain, it really makes me question how many people have been exposed in Spain and elsewhere and how much immunity the community has.

    Article on Derek Lowe's blog about this today.  His blog is regularly updated with timely information and is worth a follow.

    More on T Cells, Antibody Levels, and Our Ignorance

    By Derek Lowe 7 July, 2020

    https://blogs.sciencemag.org/pipeline/archives/2020/07/07/more-on-t-cells-antibody-levels-and-our-ignorance

    I wrote here about the reports of rather short antibody persistence in recovering coronavirus patients, and what’s been coming out in the two weeks since then has only made this issue more important. In that post, I was emphasizing that although we can measure antibody levels, we don’t know how well that correlates with exposure to the virus nor to later immunity from it, and that T cells are surely a big part of this picture that we don’t have much insight into.

    T-cells-etc-1024x938.jpeg

    This Twitter thread by Eric Topol is exactly what I mean, and this article that he references is an important read. Its schematic at right (see also here) will help make clear that antibody levels are only one aspect of the immune response to the infection – it’s an important one, but we’re making it look even more important than it is because it’s by far the easiest part of the process to measure. The T-cell response (much harder to get good data on) is known to be a key player in viral infections, and is also known to be highly variable, both between different types of pathogens and among individuals themselves. The latter variations are also beginning to be characterized among patients in the current pandemic. We have to get more data on it across a broader population of patients in order to make sense of what we’re seeing.

    Many readers will have seen, for example, this new paper from The Lancet on a large study in Spain. Testing tens of thousands of people across the country continues to show that (on average) only about 5% of the population is seropositive (that is, has antibodies to the virus). There are a lot of interesting findings – such as rather large differences in those positive testing rates in different regions of the country, as well as the realization that at least one-third of the people who now test positive never showed any symptoms at all. But we are still not sure if this means that 95% of the Spanish population has never been exposed to the virus, because we don’t know how many people might have cleared it without raising enough of an antibody response to still be detectable. This paper does show that seroprevalence was about 90% in people 14 days after a positive PCR test, which indicates that most people do raise some sort of antibody response, but we don’t know how many of these people will still show such antibodies at later testing dates. Remember the paper discussed in that link in the first paragraph above, which found that 40% of asymptomatic patients went completely seronegative during their convalescence.

    In other words, the Spanish survey may appear to show that 95% of the country has not yet been exposed to the coronavirus, but that’s almost certainly not true. The authors do mention that cellular immunity is important and not something that they were able to address, but the combination of that factor plus the apparent dropoff in antibody levels with time makes these large IgG surveys almost impossible to interpret. But note that if there are indeed many people who have been exposed but do not read out in such surveys, that we also have no idea how immune they are to further infection. At a minimum, you’d want to know antibody levels over time, T-cell response over time, and (importantly) what a protective profile looks like for both of those. We barely have insight into any of this: the large-scale data are just a snapshot of antibody levels, and that’s not enough.

    We have similar data here in the US: several surveys of IgG antibodies show single-digit seroconversion. You could conclude that we have large numbers of people who have never been exposed – and indeed, the recent upswing in infections in many regions argues that there are plenty of such people out there. But we need to know more. We could have people who look vulnerable but aren’t – perhaps they show no antibodies, but still have a protective T-cell response. Or we could have people who look like they might be protected, but aren’t – perhaps they showed an antibody response many weeks ago that has now declined, and they don’t have protective levels of T-cells to back them up. Across the population, you can use the limited data we have and our limited understanding of it to argue for a uselessly broad range of outcomes. Things could be better than we thought, or worse, getting better or deteriorating in front of our eyes. We just don’t know, and we have to do better at figuring it out.

    • Like 2
  11. 1 hour ago, MC Fresh Breath said:

    I am in no way an anti-vaxxer, but stories like this do give me (an admitted layperson) pause on the current process:

    https://www.reuters.com/article/us-health-coronavirus-moderna-exclusive/exclusive-moderna-spars-with-u-s-scientists-over-covid-19-vaccine-trials-idUSKBN2481EU

     

    The vax situation is a bad setup from a safety perspective in my opinion.  Bunch of companies developing novel vax technologies (not novel in the sense of COVID, novel in the sense the some of the vaccine types are unproven in humans), accelerated development timelines, unprecendented demand for rapid roll out. I don't like it at all. The vax roll out will need to be very thoughtful.    

    • Like 1
  12. https://reason.com/2020/07/06/to-get-americans-safely-back-to-work-and-play-we-need-cheap-and-plentiful-at-home-covid-19-testing/

    To Get Americans Safely Back to Work and Play, We Need Cheap and Plentiful At-home COVID-19 Testing

    Enable people to act responsibly toward their neighbors and co-workers.

    A hand-held 15-minute COVID-19 antigen test has received emergency use authorization from the Food and Drug Administration, announced medical technology company Becton Dickinson (BD) in a press release today. The test works by detecting the presence of coronavirus proteins using specific antibodies embedded on a test strip coated with nasal swab samples, which is then inserted into BD's proprietary cell phone-sized BD Veritor System platform.

    One huge advantage is that the test can detect COVID-19 infections not only in patients showing symptoms but also in pre-symptomatic and asymptomatic people. There are more than 25,000 of the testing machines already located in hospitals, clinics, urgent care centers, retail pharmacies, and doctor's offices around the country.

    Becton Dickinson's testing machines sell for about $300, and the tests themselves are about $20 each. This compares to at-home molecular diagnostic tests that cost more than $100 and take more than two to three days to obtain results from offsite laboratories. The company says that it will roll out up to 10 million tests by the end of September and that it is working toward the capacity to manufacture 2 million a week.

    While BD's new COVID-19 test is certainly a helpful step forward, much more (and even cheaper) antigen testing is needed to control the pandemic and get people back to work, argued an op-ed last week in The New York Times.

    I made exactly the same case back in May: "Testing yourself and your family every day for COVID-19 with a cheap, easy-to-use, 10-minute test could be the game-changer for crushing the epidemic and getting everybody safely back to work and play. Widespread deployment of home antigen testing could make this scenario possible."

    Basically, COVID-19 antigen tests would work much the same way that at-home pregnancy and HIV paper strip tests work now. A fast positive test would enable infected people to voluntarily, quickly self-isolate, and thus break the chains of infection that are fueling the epidemic.

    The Times op-ed suggests that fast at-home tests would enable people to act responsibly to protect themselves, their families, their neighbors, fellow bar patrons, and co-workers from this scourge:

    Would everyone take a paper-strip test every day? Here market incentives will surely help. Once they are provided to all, employers would likely require their workers to take time-dated pictures of their negative test results before coming to work. Colleges would require students to do the same before coming to class. Restaurants could accept reservations only if accompanied by negative-test pictures. In short, everyone will have an incentive to test themselves daily to participate fully in the economy and return to normal life.

    Once paper strips' efficacy is definitively proved and they are cleared by the F.D.A., Congress can quickly authorize the production and distribution, for free, of a year's supply to all Americans. Then we'll have not only a true day-to-day sense of Covid-19's path. We'll also have a far better means to quickly contain and end this terrible plague.

    How much would such testing cost? The good news is that other companies are working to create antigen tests that cost as little as $1. At that price, daily testing for a year by 300 million Americans would amount to roughly $110 billion. However, weekly testing by nearly everybody would probably be more than sufficient to crush the epidemic, and that would cost around $15 billion. That testing price tag would be a bargain when considering that the Congress has already passed legislation authorizing more than $3 trillion in various forms of coronavirus aid.

    • Like 3
  13. I think what is being described is more accurately described as a family structure largely shaped by American values and culture.  I wouldn't call it western per se, in the sense that people coming from a variety of Western cultures, and Mediterranean cultures in particular, tend to have very different social structures and living arrangements.  These family structures imported in the US with the immigration of these people, and in first and many times second generation families these support structures and living arrangements persisted.  Once you get to third generation that family dynamic has largely been replaced with the American cultural norms.  I think that you see the same sorts of trends among asians, middle easterners and non-westerners as well.  At least that is my observation. 

     

    This doesn't really impact the conversation around family structure as it relates to African Americans.  That conversation is infinitely more complex, imo. 

    • Like 4
  14. 1 minute ago, Blotto said:

    I don't know why this shit continues to surprise me, but it does. Lemonade IPO. Basically they are an online insurance company. Insurance is a fairly well understood market, and margins are what they are. 

    Lemonade current market cap ~5 billion. 2019 revenue was $67 million, Net income was -$108 million.

    Aflac current market cap ~26 billion. 2019 revenue was $22.2 billion, Net income was $3 billion. 

    Look, I can understand a little premium based on this being a small company with presumably a lot of growth ahead of it. But holy shit, $5B.... Even in these generally overvalued times, the average insurance company PE is about 20. So based on a market cap of $5 billion, that would translate into a profits of approx $250 million. Based on these financials how likely is that anytime soon:

    image.png.68f6301d18ac9c0ac9e10996c2afb9f8.png

    Their net loss (not shown above, but approximately the same as operating income) seems to increase about 1:1 with increases in revenue. Checks market....up another 30% today. F'n bananas.

     

    LOL financial analysis.  This is fantasy land, get math the fuck out of here. 

     

    • Like 4
    • Haha 1
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