COVID19

[Doobs]

Wednesday is on a Wednesday this week.

It seems we have a new health secretary, so we have had to endure some comparisons with flu and overexaggerated mental health problems and some nonsense about how we can have more operations by letting the virus rip (or something like that).  Only a matter of months until we get to hear him to talking about the great rest if he follows the trajectory of Clare Path, Nick Hudson and Ivor.  It seems they may have achieved what seemed impossible and found someone worse than Hancock at this.

Deaths were up 25% on the week to over 100 a week, hospitalisations up 30% or so on average to 400 a day and cases were up over 50% on the week.  Vaccinations have been falling noticeably recently too.

So none of these indicators is slowing down, and if anything, they appear to be accelerating.  There are some signs that there is a recent slowdown (Zoe reported it the other day), but it stlll seems likely that we do get more casdes per day than in wave 2.  As an indication of the new Covid World, 100,000 cases a day is going to translate to 2,000+ hospitalisations a day, which isn't that far from the last peak. 

James Ward has done a recent thread which forecasts possible deaths and hospitalisations based on more current information. 

https://twitter.com/JamesWard73/status/1412182736572399623

It seems clear that the NHS could suffer worse than before under the worst scenarios but deaths should still be lower. 

I'd add that if the patients are younger than average then deaths at half the levels seen in wave 2 isn't clearly going to be a better result than wave 2 either (is the death of a 50 year old worse than the death of an 80 year old?  We don't know the long term effects of Covid on our children).

I am probably less optimistic than I was, if that isn't clear.

 

Another Wednesday and still not much sign of a slow down.

For those that have long memories (well a few months), this Wednesday update was a follow up to some comparisions that were made between real deaths in England and forecast deaths in the Spectator.  Well this week, we have reached a milestone, the projected deaths on all those previous projections were zero by now.  So from now on we are above the very worst projections each week!  I must be clear that I don't think we have had as many "wave 2" deaths as we did in many of those projections, but thought it was interesting and it just shows how hard it is to model many months in advance.

Anyway onwards:

Deaths are probably increasing by over 30% a week (and were last week after correcting for lag).  We are up near 150 a week in England.  This is massively down on the wave 2 peak, but we likely have at lest 5 more weeks of 30% plus growth.  The growth may well increase by more than this going forward as restrictions aren't getting stronger.

Hospitalisations.  These are up another 50% or so, and we are now hitting close to 600 a day.  Wave 2 peaked at 4,000 a day or so, if we carry on at this rate we get there in about 5 weeks.  Because these people are younger, they are less likely to end up in ICU, but that still seems to suggest that we should be keeping some more measures in place?  If the aim of the measures was to save lives then we have probably done very well, but if the aim was to protect the NHS and clear the massive backlog, we seem to be going very much in the wrong direction.

Cases.  There may be some hope here, as the rate of increase may well be slowing.  They were probably up around 40% on average over the week to 7 July.  This may seem a lot, but it was 70% the week before.  I am hoping this is genuine and not an issue with hitting testing capacity in some places, or because many are avoiding testing for various reasons.

Vaccinations.  First vaccinations are now way down on the peak, with less than 100,000 vaccinated each day since the 4 July (peak was over half a million).  Second vaccinations are holding up better, but still down more than half from the peak.     

I am less pessimistic about the UK than mostly everywhere else.  If we can't slow down the case growth much in this wave, what hope does that give those with populations that have far lower rates of vaccination? 

[Doobs]

Good news for balance.

Death rates during Q2 in the UK lower than any previous year.  I assume this does mean all time, even though not shown, as before Covid the age adjusted mortality was falling.



https://twitter.com/ActuaryByDay/status/1415029238961430533

[Marky147]

Craziest thing over the last few weeks, is watching the migration of Anti-Lockdown folk, right over to Anti-Vaxxer, in order to keep their grift going.

[Doobs]

Craziest thing over the last few weeks, is watching the migration of Anti-Lockdown folk, right over to Anti-Vaxxer, in order to keep their grift going.

Yep, the arrow has gone round to the summer casedemic on Ivor's wheel of nonsense.   Obviously this is the reason few people are dying here and nothing to do with the vaccine take up.   

35,000 PCR false positives a day now.  Presumably they are much more likely when the temperature heats up?  Funny how the hospital beds start filling as the PCR tests become less accurate...   Almost as if the false positive test result is so damaging to people's mental health that they start struggling to breathe...

[Marky147]

I can't see anything of his, but imagine he's losing the plot now things are going back to normal

Better hope they're as thick as he thinks they are, or his grift is up soon enough.

[Doobs]

Tim Zoe app Spector has done an update

http://www.youtube.com/watch?v=gwUSC6rid4A

Cliffs:
They think cases are peaking.
R=1
May have peaked in the West and London, still rising in the East of UK (NE and East of England).
Unvaccinated cases are falling, but the number of unvaccinated people are falling, and numbers on the Zoe App are small.
Vaccination reduces severe illness
One dose isn't very effective vs Delta.
Cases likely to fall slower than in the past (as restrictions arenit increasing)
Advice for post "freedom" day, eg still wear masks in crowded/badly ventilated places, get 2nd dose, don't assume everyone wants a hug etc.  I'll be following the mask thing indoors until cases have significantly fallen from here.  Seems mad to have been doing so a month or so ago when cases were much lower, and not to do so next week.

I will add that the unvaccinated numbers are small on the App, so there is less certaintly.  He said himself later on twiter that this was the case, and people should look at all indicators and not just Zoe.  I think there are a significant number who don't do Zoe, won't be wearing masks, aren't getting tested, have removed the NHS App so don't check in and won't be taking the vaccine.  So I think there is going to be more uncertainty on number of cases going forward and track and trace isn't ever keeping with cases at this level even if people did do everything properly.  Hospitalisations and deaths should remain reliable.

Finally, love this https://twitter.com/QETalks.  It is like a who's who of those who have spent the last 18 months encouraging people to behave irresponsibly, and the summit is discussing... how we can open reponsibly.   It is hard for them to time this thing worse, UK lockdowns have effectively finished already, cases may well be peaking, and it is going to be a lovely summer's day.  Don't think there is much chance the grift stops soon though.

[Doobs]

And RIP Tess Lawrie's grift

I mentioned back in the day that Tess Lawrie's Meta Analysis relied heavily on one study that looked like a massive outlier from Egypt.  Well it turns out that it was forged.

https://www.theguardian.com/science/2021/jul/16/huge-study-supporting-ivermectin-as-covid-treatment-withdrawn-over-ethical-concerns

Mad that so many people who ignore massive amounts of credible data could have then put so much faith in something that always looked more than a bit dubious.

[Doobs]

And RIP Tess Lawrie's grift

I mentioned back in the day that Tess Lawrie's Meta Analysis relied heavily on one study that looked like a massive outlier from Egypt.  Well it turns out that it was forged.

https://www.theguardian.com/science/2021/jul/16/huge-study-supporting-ivermectin-as-covid-treatment-withdrawn-over-ethical-concerns

Mad that so many people who ignore massive amounts of credible data could have then put so much faith in something that always looked more than a bit dubious.

More here

https://gidmk.medium.com/is-ivermectin-for-covid-19-based-on-fraudulent-research-5cc079278602

[Doobs]

Marky, I am not sure I can watch another Doctor John videos, as I already watched a long one where he didn't appear to challenge her enough.

The Tess Lawrie rapid review is here

https://www.researchgate.net/publication/348297284_Ivermectin_reduces_the_risk_of_death_from_COVID-19_-a_rapid_review_and_meta-analysis_in_support_of_the_recommendation_of_the_Front_Line_COVID-19_Critical_Care_Alliance_Latest_version_v12_-_6_Jan_2021

It seems to rely heavily on two studies due to those two having bigger sample sizes on deaths.

They are Elgazzar et al. here

https://www.researchsquare.com/article/rs-100956/v3

and Niaee et al. here

https://www.researchsquare.com/article/rs-109670/v1

Elgazzar shows 2 deaths from 200(Ivemectin) vs 20 deaths from 200(comparitor)

The thing that struck me in this one, is that the comparitor isn't a placebo, but is hydroxychloroquine.  The WHO found that hydroxychloroquine increased deaths vs a placebo, and this effect was worse for people with prior heart disease.  So that leapt out as not the same as comparing vs a neutral placebo.  Then I looked at the evidence, and Ischemic heart disease was present in 5 of the patients in the Ivermectin group and 12 of the patients in the hydroxychloroquine group.  So you should definitely worry about whether this was a fair comparison, and comparing 2 deaths in the Ivemectin group and 20 with a placebo is not correct.  But looking at the rapid review 2 and 20 are the numbers used.

The Iranian study (Niaee et al) seems to have better split of groups and claims to compare genuine placebos with Ivermectin.  There is definitely one weird thing in that only 50% of the placebo group had a positive PCR test vs 80% in the treatment groups.  I was left wondering how they diagnosed Covid (were many of this lot at deaths door so didn't need a test?) and why so many of them had then died (11 from 60 people, of which only 30 had positive Covid tests).  That is way higher than you'd expect from Covid given some of them were listed as mild and all were getting other treatments at the same time.  In addition a separate site lists this study as having a high risk of bias (see http://www.metaevidence.org/viewPathology2.aspx?exposition=684&comparator=649&pathology=87&domain=12).  This seems very much at odds with the Tess Lawrie conclusion that this study has a low risk of bias. 

A lot of the other studies are tiny, and I was left wondering if they would all have been published if they had shown that Ivermectin hadn't worked.  Were there another group of doctors who had looked into the effect, but found nothing or just witnessed deaths in their Ivermectin patients?  Presumably there is some survivorship bias in that only those who thought they had seen some positive effect from Ivermectin published anything? 

So in conclusion.

The evidence is nowhere near as comprehensive, or as convincing, as the studies into vaccine efficiacy. 
Ivemectin might well lead to an improved prognosis for Covid sufferers.
There seems to have been plenty of others who have reviewed this evidence and not made the same conclusions as to its reliability.
The often repeated recent claim of a 75% reduction in deaths seems very dubious.   The sample sizes of deaths are very small and the confidence intervals should be large, even if you accept these studies are all perfect.
I'd conclude that Ivemectin is worthy of further investigation and there are several ongoing trials, but do not think it is immoral to not treat people with Ivermectin (which was what Dr lawrie seemed to be claiming in the video I watched).   

It is odd that the very same people who deny the effectiveness of lockdowns and vaccines, despite much better evidence, are then happy to accept that Ivermectin (and usually Hydroxychloroquine) works.  It is good to be sceptical about the intentions of big corporations, but you have to be sceptical about of the alternative claims too.   

This is what I wrote back in March. 

Elgazzar has been shown to be fraudulent, and the Iranian study looked pretty flawed too.  Given those were the two biggest studies in the meta analysis, they had a massive effect on the results.  This was due to a combination of the size of the studies and the significance of the results.  Elgazzar claimed Ivermectin was 900% more effective than the comparitor and had 400 people included.  This is going to drown out several other studies that showed some minor improvement and that were based on a couple of dozen people.  Add in the fact other studies that show no improvement have been simply ignored and this has led to these mad claims that the Ivermectin cures 80% of Covid cases.

Tess Lawrie's gofundme is still live.  https://www.gofundme.com/f/help-us-get-lifesaving-drug-approved-for-covid19?

Clare Craig still promoting her https://twitter.com/AI_Clayton/status/1415971896240349187
   

[Marky147]

Yeah, I've not been watching him much, as it was obvious she managed to hoodwink him, and he's convinced that it's great, too.

Interesting to see what Kory Scott, Bret Wankstein and the likes of Lawrie have to say now.

[Doobs]

Yeah, I've not been watching him much, as it was obvious she managed to hoodwink him, and he's convinced that it's great, too.

Interesting to see what Kory Scott, Bret Wankstein and the likes of Lawrie have to say now.

Bret has already wrongly claimed it makes no difference.  https://twitter.com/BretWeinstein/status/1415835356671348737.  Clearly doesn't understand how much the result affected the conclusion, or how damning all this evidence was.

BTW The Niaee study has been well and truly rubbished in the last 24 hours too.  That was the other big one that the conclusion of the whole meta analysis depended on.   Should have got myself a twitter profile back in March I guess.

Without those two studies you have a result that isn't even close to statistically significane.  So we are back to here iis a drug we use for something else, let's do some more proper studies. 

[Doobs]

and Pierce Kory

https://twitter.com/PierreKory/status/1416080575442587653

IMO: 1) scientific fraud happens and 2) disinformation attacks on scientists with data that runs counter to corporate entities also happens. From Prof. ElGazzar: "This story is fake and is not the actual raw data of my study and I will defend my work"  "It is an unfair attack on the biggest trial of Ivermectin from the enemies of the drug. I found the Guardian e-mail today in junk mail and I will sue them." Numerous other untruths, mistruths in article. Let Prof defend himself first! Then decide on #1 or #2, yeesh.

Not much sign of any doubt there.  Love how a bunch of random stats geeks are in reality corporate entities and enemies of the drug.   

[Marky147]

Weinstein already deleted his post, it appears

Good luck with suing, Pierre.

[Marky147]

Now you have to isolate if you've been to France, even if you're vaccinated 

Who the fuck are the clowns in charge of this?

Wouldn't surprise me if it was Boris and Shapps actually making the decisions.

[Doobs]

Now you have to isolate if you've been to France, even if you're vaccinated 

Who the fuck are the clowns in charge of this?

Wouldn't surprise me if it was Boris and Shapps actually making the decisions.

Think they just do it to piss Ivor off now