On 2020-04-19 05:26:28, user chalkful wrote:

You can talk about selection bias, and that’s valid. But nit-picking every part of this study down to the assumptions made about manufacturer specifications seems ridiculous and very hypocritical when similar assumptions were made with RT-PCR tests that were rushed to market with questionable, if any, validation, and which are relied upon to make public policy decisions which dictate the lives of millions, even billions.

Did you apply precisely the same level of detailed, critical analysis and nitpick every minute inconsistency in all the other COVID-related “peer reviewed” studies which were rushed to print, and which were gloom-and-doom?

Why choose to write off all conclusions drawn by a study with such a substantial effect size because of minor statistical errors? As a non-academic, the study appears largely methodologically sound, despite a few flaws, and it is not logical to throw the baby out with the bath water. Even assuming the infection rate is half of what is concluded, that is still significant and the first study, and conclusion, of its kind.

I suspect that, with as with most things COVID-related, much of this is due more to politics than pure intellectual rigor, and that the conclusions drawn by the study shake the foundation of what many believe, which scares them.

On 2020-04-23 17:52:02, user Fiona Mulvey wrote:

Belgium is counting suspected cases of COVID-19 in official records even if it's not confirmed by tests, Sweden is not. I think probably New Zealand and Taiwan are good examples of record keeping.

On 2020-04-19 00:58:33, user dixon pinfold wrote:

If you read between the lines of the final paragraph of the Discussion, you can perhaps guess at some of the motivation behind the study.

No other antibody seroprevalence studies had been started in the US prior to this one, and the study's authors may have thought that it was high time, somewhat-dubious antibody tests and barriers to random sampling be damned.

On rare occasions, owing to a sense of urgency, the farmer may think it necessary to plant a crop despite the ground not really being prepared.

If others are white-hot with indignation at the very idea, it's their right, and from their side of it they are probably correct. For my part, I'm less than sure.

On 2020-04-18 14:03:13, user Richard Davis wrote:

Could you guys make the data and code available for other researchers to try and replicate, now that the paper is out there?

On 2020-04-20 18:43:59, user A. J. wrote:

Advertisement for this study found on Reddit:<br /> "FREE COVID-19 Testing --needed to calculate prevalence of disease in Santa Clara County<br /> What? Get tested. FDA approved antibody test for Coronavirus. To test the prevalence of disease in our county, we need 2500 residents. The antibody test differs from the swab test that measures infectious patients actively carrying the COVID-19 RNA in their nasal passages. The serum antibody test determines whether your immune system has fought off the virus and created antibodies to protect you from future exposure. Since the first cases appeared in November/December in Wuhan, China until the U.S. banned flights from China, an estimated 15,000 residents of Wuhan would have traveled to the U.S. so the disease likely entered the California in December (based on 2019 travel data). <br /> Who? HEALTHY volunteer who lives in Santa Clara County. ONE PERSON per household. 2500 people to be tested.<br /> When? APRIL 3rd and 4th. THIS WEEK. 7AM-5PM. <br /> How? (link)<br /> Why get tested? (1) Knowledge - Peace of mind. You will know if you are immune. If you have antibodies against the virus, you are FREE from the danger of a) getting sick or b) spreading the virus. In China and U.K. they are asking for proof of immunity before returning to work. If you know any small business owners or employees that have been laid off, let them know-- they no longer need to quarantine and can return to work without fear. If you don't want to know the results, we don't need to send you the results. (2) Research - Contribute to knowledge of the prevalence of virus spread in Santa Clara County. This allows researchers to plan hospital bed needs and forecasting where to allocate public health resources. This will help your neighbors and family members."

On 2020-04-18 22:21:57, user derp wrote:

Age distribution of Diamond Princess was not even remotely close to the age distribution for general population, and you would need to do is perform serological tests on all 4000 passengers to know how many more than 700 people were actually infected with the virus at some point.

Taking those things into account yes its likely somewhere around 0.2% mortality in general public. Although age is such a huge factor, I think it's misleading to even give a single mortality rate for the virus.

On 2020-04-19 02:31:07, user Mortal Wombat wrote:

Yes, and the German study came up with a 0.37% infection mortality rate -- 2 to 3 times the rate this study came up with. Likely because this study is overestimating the infection prevalence due to its non-random sampling techniques, allowing for heavy oversampling of people with symptomatic histories which the authors here chose not to adjust for.

On 2020-04-28 19:17:58, user outdoorgirl0814 wrote:

This point does not counter my point. It is a fact that presumptive COVID cases are now scored as COVID, and any death in a COVID positive patient is counted as a COVID death. If mortality numbers are increased by a number that exceeds COVID deaths by two-fold (which isn't evident as an overall situation by the CDC data but nonetheless, if it were true in Santa Clara county), then I would presume they died with other symptoms or from other causes. There are substantial measures in place to avoid undercounting of COVID deaths. I do not see how your referenced numbers are direct proof of such.

On 2025-02-21 05:09:57, user Evan Stanbury wrote:

Re "Serological evidence of recent Epstein-Barr virus (EBV) reactivation was observed more frequently in PVS participants". EBV causes glandular fever, which often leaves sufferers with a Post-Viral syndrome similar to Long COVID (and the sick cohort). This is not directly attributable to the vaccine.

On 2020-07-17 04:24:05, user Bruce Conklin wrote:

I wrote the authors on July 12, asking if they had data on troponin levels. The authors have not responded. I tried to download the supplementary data, but found none. Investigation into direct tissue effects of the virus on tissues would be warranted to back up the claim that the disease is only immunological.

On 2023-01-15 02:42:48, user Peter lange wrote:

I agree with the other commenters. The description of training is inadequate to determine if the dogs are detecting acute and chronic stress, which canines have been trained to do with high reliability. Without further information the conclusions are unsupported by evidence presented.

On 2020-06-04 00:20:18, user wbgrant wrote:

It would be useful now or in further studies, what baseline and achieved 25OHD concentrations were. <br /> It is not clear in the text how many were given DMB prior to April 6, how many after April 6. Those given DMB prior to April 6 would be the less severe cases, thereby biasing the study.

On 2021-01-24 08:54:43, user ad4 wrote:

Can the authors please provide a list / file of all input parameters (with error intervals) used in the model and make all code publicly available.

On 2021-12-15 03:22:39, user Sean Bearly wrote:

A study of children born during the pandemic means a study of children less than two years old. It is preposterous to think we can come to consensus about the results. We might as well do studies of children born during Obama presidency vs the Trump presidency. Also, I believe our desire to get children into public indoctrination as early as possible has resulted in a desire to show that missing early in-person indoctrination is the worse thing that can happen not just to children but to the parents who then have to deal with the little monsters. Many home schoolers chose that route based on multiple studies of early childhood development which showed that a child that enters school at the 6th grade level, even with no previous home schooling, quickly comes up to speed and often outpaces the other children within one school year. There are many reasons for this but anyone interested can find that information.

The Obama administration did a study of the effectiveness of early education and promised to stop funding for the Head Start program if data showed that it wasn't money well spent. The study showed that Head Start gave most children an initial boost in education, but that it was lost within a few years and Head Start graduates by the third grade were no smarter, better behaved, etc. than the children who did not go into the program. Head Start was not cancelled though because of several reasons, one being parents had learned to depend on the program for child care, and also because the teacher's unions fought to keep the program.

This pandemic for certain has been difficult for many. But this is not the worse thing that can happen to a child. Children have weathered much worse without losing 20 points on their IQ score. I am reluctant to believe that kind of drop can even be measured in children under 2.

On 2023-12-10 17:31:49, user Scott Lear wrote:

I have several serious concerns with the study and manuscript:

1. This is an observational study and despite what is written in the manuscript, an observational study cannot lead to the clear conclusions the authors suggest the results indicate. The authors should temper their interpretation of the results and take into account the below.

2. The authors do not address their findings in the context of the 1000s of other observational studies indicating activity (and at high levels) has consistently been associated with reduce risk for premature mortality.

3. The authors state previous studies have not robustly adjusted for other lifestyle measures. This is untrue. Many of the existing observational studies have robustly adjusted for the measures the authors of this study say weren't done (and have done so for decades). Here are a few:

https://pubmed.ncbi.nlm.nih...<br /> https://pubmed.ncbi.nlm.nih...<br /> https://pubmed.ncbi.nlm.nih...

All of these studies (there are many more) had more robust adjustment than the present one and found that high levels of activity either provided further risk reduction or a plateau but no reduced risk reduction. The last study had 30 years of follow-up and 15 points of LTPA assessment- a point that the authors of the current study infer that their study is the only study to have a long follow-up.

1. Self-reported questionnaires to assess LTPA are not as accurate as the authors indicate. While questionnaires are used in many studies, they tend to overestimate activity levels compared to objective measures such as accelerometers (plenty of studies to support this). They also are not accurate in distinguishing different levels of intensity of activity which is also pertinent to consider. Lastly, the study only assessed leisure time activity ignoring occupational, household and transport activities. Given the surveys were done in 1975, 1981 and 1990, this is likely to be a substantial amount of activity missed (as all jobs were more active back then, than now). There is no indication in the Methods how the participants were put into the four activity groups (sedentary to highly active).

2. The biological ageing was based only on a sub-sample of 5% of the study population. There is no description in the methods how this sub-sample<br /> was selected. Was it random, and thus possibly representative of the larger cohort, or was a convenience or selective sample that could introduce bias?

3. BMI was self-reported, and again, there is ample literature to indicate self-reported BMI underestimates true BMI and this is greatest in those with higher BMI. In addition, if one is looking to assess the true affect of LTPA, BMI should not be adjusted for as it is in the causal path between LTPA and mortality.

4. We have good quality randomized trials from the 1980s in cardiac rehab that indicate the benefit of structured exercise on <br /> reducing early death (and leading to greater lifespan) in people with heart disease. While the authors quote a single study (#5) stating RCTs <br /> have not shown activity to result in longer life, the study quoted is not a real study but rather a commentary. The advantage of the RCTs from the 1980s is the lack of pharmacological management of participants in usual care because statins and anti-hypertensives where either not around or readily prescribed at the time. More recent RCTs have control groups that are optimally medically managed.

On 2021-06-21 19:30:04, user Edward Sheppard wrote:

It's a poor graph. What should have been compared in this chart is survival after 10 days for each group. Just eye balling the data, it looks like 67% of the non-treatment group survived 10 days. In the end about 28% of those survived. That's compared to 59% of the treatment group. Still, a quite sizeable effect.

Ideally we should consider everyone though. IOW, go from day zero but consider the treatment group to include those who would have been in this treatment group but died before day 10.

On 2021-06-15 20:42:31, user Joe Grane wrote:

Wasn't the "VA" study just a review of health records without the all of the dosing analysis in this, Smith, et al. study.

Some of the main points in Smith, et al are that you have so many obese patients. Doses of HCQ and AZT need to be weight dependent.

"no Covid study has examined the effects of these differences in weight on response to HCQ therapy or HCQ adverse effects."

Furthermore they noticed that the cumulative dose had a big effect on the outcome. They explain that HCQ has a long half-life but it also takes a long time to get optimal amounts into the lungs.

"We found that when the cumulative doses of two drugs, HCQ and AZM, were above a certain level, patients had a survival rate 2.9 times the other patients...HCQ cumulative dose > 80 mg/kg works substantially better. "

"Patients receiving >3g HCQ/>1g AZM had 3.26 times lower risk of mortality than those who did not receive these doses [HR = .307,95% CI = 0.183 – 0.516, p < .001]. Patients receiving TOZ had 2.00 times lower risk of death than patients who did not receive the medicine [HR = .50, 95% CI = 0.36 – 0.69, p < .001].

Their statements about patient EKGs were striking. They were particularly critical of the FDA's April 2020 warning on the issue.

"there was no correlation between HCQ cumulative dose and QTc delta (r = -0.170).... No patient experienced torsades de pointes...given the data presented here, the studies reporting HCQ’s effect of QTc intervals need to be reevaluated."

Apparently Smith, et al were looking for ways to make HCQ helpful to Covid patients--a seemingly unusual interest.

In contrast Boulware, et al concluded HCQ was not beneficial for post exposure prophylaxis when started within 4 days. However several other groups reanalyzed the data and concluded HCQ was beneficial when started within 3 days. <br /> https://www.medrxiv.org/con...<br /> https://arxiv.org/ftp/arxiv...<br /> https://www.longdom.org/ope...

On 2021-09-12 11:36:46, user 4qmmt wrote:

Read the Kentucky study carefully. It is loaded with bias. <br /> 1) It is a CDC sponsored study. i.e. conflict of interest is significant.

2) The sample sizes are very small. They admit that, "Additional prospective studies with larger populations are warranted to support these findings."

3) Determination of previous infection was limited to a Positive NAAT test or antigen test. Positive NAAT (PCR) tests have significant potential for false positives. Why didn't they only use the antigen test?

All case-patients (reinfected) and control participants (not reinfected) had previous SARS-CoV-2 infection documented by positive NAAT or antigen test results during March–December 2020. Reinfection was defined as receipt of positive NAAT or antigen test results during May 1–June 30, 2021.

Another way to interpret their data is that they found a significant number of people who were considered previously infected for whom the Positive test was false, since they were later "re-infected" or truly infected for the first time. It would be very interesting to see what the results are for cohorts made up of only antigen test Positive cases, both first and second infection.

3) They admit they don't really know if these were "re-infections."

First, reinfection was not confirmed through whole genome sequencing, which would be necessary to definitively prove that the reinfection was caused from a distinct virus relative to the first infection.

Also,

Although in some cases the repeat positive test could be indicative of prolonged viral shedding or failure to clear the initial viral infection (9), given the time between initial and subsequent positive molecular tests among participants in this study, reinfection is the most likely explanation.

The report also states

persons who have been vaccinated are possibly less likely to get tested. Therefore, the association of reinfection and lack of vaccination might be overestimated.

On 2021-08-28 19:52:31, user Catriona wrote:

“ individuals who were previously infected with SARS-CoV-2 and given a single dose of the BNT162b2 vaccine gained additional protection against the Delta variant.”

I’m confused. Didn’t your study show no significant difference for symptomatic infections in previously infected individuals with or without a single vaccination dose? Or did I get that wrong? The table says the previously infected and vaccinated odds ratio for symptomatic infection is 0.65 but confidence intervals were 0.34-1.25 and P value was 0.194.

In which case, exactly what were they protected against? Is there some sort of clinical significance regarding a positive PCR in the absence of any symptoms? Or are you implying that individuals can have atypical symptoms that can cause them health problems but aren’t recorded as symptoms? The study didn’t look at infectivity.

Are you claiming the vaccinated individuals were healthier in some way because they had fewer positive PCRs? Or are you claiming they did not pass on the Delta variant as often? Or was there something else that you meant by “additional protection against the Delta variant?”

Would love some clarification on these issues.

On 2021-09-03 13:37:28, user bgoo2 wrote:

More research? What is your point? 98.7% of the hospitalizations in Ontario are unvaccinated or 1-dose. Here's more for you.... Sep 2.... Ontario's numbers are even HIGHER. 865 confirmed cases. 692 of those cases are unvaccinated or 1 dose. That's 80% of the cases.

And Ontario's positivity rate holds at 3%. One of the most vaccinated population centres on planet Earth. Sep 2... 83% of citizens 12+ have 2 doses. Hmmmm... what a coincidence. So there are your facts.

The vaccines dramatically reduce transmission and hospitalizations. Nothing has changed since my original post.

And let's forget Alabama. You're correct. Let's head over to Alberta. 4.3 million people.

Sep 2.... 10.9% positivity rate. 487 in hospital. 114 in ICU.

But please... go have another shot of bourbon and another giant plate of pasta and avoid your vaccine. Since you know what is best for you....

...Against the advice of all sane health care providers across the planet.

Clearly working out well for 95% of the people who lost the Covid lottery and have a tube jammed down their throat.

On 2021-08-30 21:19:29, user Disintigrator wrote:

Did you read the study? It sounds like you didn't, because it says multiple times that the data was adjusted to rule out socioeconomic factors, geographical areas, or underlying health problems playing any part to change the results.

The only factor to make a difference was age >60, which is logical and expected due to the natural decline in our immune systems as we age. ... If anything, those aged>60 who fought off CoVID-19 and gained natural immunity should be weighted to give greater influence over the results - because despite their declining immune systems they were 13x better at resisting CoVID-19 reinfection than those who received the so-called mRNA "vaccines". (Which according to the CDC only suppresses the viral symptoms and do not stop you from catching or spreading it).

On 2019-09-30 05:24:02, user Guyguy wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 25 SEPTEMBER 2019

The epidemiological situation of the Ebola Virus Disease dated September 25, 2019

Thursday, September 26, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,178, of which 3,066 confirmed and 112 probable. In total, there were 2,126 deaths (2014 confirmed and 112 probable) and 981 people healed.

• 483 suspected cases under investigation; <br /> • 3 new confirmed cases, including: <br /> • No cases in North Kivu; <br /> • 3 in Ituri, including 2 in Mandima and 1 in Mambasa; <br /> • 4 new confirmed deaths, including; <br /> • 1 community death in Ituri in Mandima; <br /> • 3 deaths of confirmed cases in North Kivu, including 2 in Katwa and 1 in Beni; <br /> • 1 person cured out of CTE in North Kivu in Butembo; <br /> • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths. <br /> NEWS <br /> Six people from Mambasa cured of Ebola Virus Disease out of Komanda CTE in Ituri * <br /> • The Ebola Treatment Center (ETC) in Komanda, Ituri province, unloaded on Thursday, September 26, 2019, six people cured of Ebola Virus Disease, all from Mambasa; <br /> • For the director of the Komanda CTE, Claude Banga Lonema, this treatment center receives patients from the Nyakunde and Komanda health zones, as well as from Mambasa well before the construction of its CTE, which has become functional for almost a week; <br /> • For the director of the CTE of Komanda, Dr. Claude Banga Lonema, all these cures are the work of a whole team, including medical and paramedical staff, psychosocial teams, nutritionists and hygienists and guards, to whom he is grateful for all their efforts in this day-to-day treatment center, as well as dedication and their apostolate; <br /> • The coordinator ai of the Subcommittee on Response and Chief Medical Officer of the Komanda Health Zone, Dr. Faustin Singo Ngozo, said on this occasion that the success and success of Ebola Virus Disease is an asset for everyone in the response. This success must be shared, because if surveillance does not work, there will always be notification of deaths. The presence of cures at the Komanda CTE shows that epidemiological surveillance has been successful in detecting cases in a timely manner and has enabled the care physicians to have sufficient time to treat these patients. To this end, he recommended mutual support among all the teams in the response to push him out of the way to harm the epidemic, which he said has lasted too long, to continue working with the same momentum. He also asked the six healings to help the response in sensitizing everyone in his respective environment. Military healing, he said, is a resource that can educate his colleagues to end this epidemic; <br /> • Among the Mambasa healers who were discharged from the Komanda Treatment Center were an 8-year-old girl, a man in uniform, including the Armed Forces of the Democratic Republic of the Congo, and the village chief of Makoko II, a village in strong resistance. The latter two promised to raise awareness about Ebola Virus Disease in their respective communities; <br /> • This triumphal exit from the six healings of Mambasa, an area still showing resistance against EVD, was made in the presence of the few partners, namely the delegates of WHO and UNICEF: <br /> • Beginning with the prayer, this ceremony also ended with prayer and a family photo between the cures and the teams of the response in this ETC; <br /> • Immediately after, their exits from the CTE of Komanda, the cured were accompanied by the teams of the response to Mambasa, their respective health zone, where a festive atmosphere awaited them; <br /> • The Komanda CTE is located in the Mangiva Health Area, precisely in Makayanga village in the health zone of Komanda, 100 km from the Mambasa health zone.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding). <br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

VACCINATION <br /> • Expanded ring vaccination around 2 confirmed cases in the Mataba Health Area in Kalunguta, North Kivu. In addition, two other vaccination rings, in the same health zone, are waiting to be opened in Lisasa and Kabasha Health Zones; <br /> • Since the beginning of vaccination on August 8, 2018, 228,430 people have been vaccinated; <br /> • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS <br /> • Since the beginning of the epidemic, the total number of travelers checked (temperature rise) at the sanitary control points is 98,818,462; <br /> • To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

LEXICON <br /> • A community death is any death that occurs outside a #Ebola Treatment Center. <br /> • A probable case is a death for which it was not possible to obtain biological samples for confirmation in the laboratory but where the investigations revealed an epidemiological link with a confirmed or probable case.

On 2019-10-17 18:36:39, user GuyguyKabundi Tshima wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS OF OCTOBER 15, 2019

Wednesday, October 16, 2019<br /> Since the beginning of the epidemic, the cumulative number of cases is 3,227, of which 3,113 are confirmed and 114 are probable. In total, there were 2,154 deaths (2040 confirmed and 114 probable) and 1038 people healed.<br /> 530 suspected cases under investigation;<br /> 3 new confirmed cases, including:<br /> No cases in North Kivu;<br /> 3 in Ituri in Mandima;<br /> 1 new confirmed death, of which:<br /> 1 community death in Ituri in Mandima;<br /> No confirmed deaths;<br /> 2 people healed from the CTE in Ituri in Mambasa;<br /> No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.

NEWS

The state of play of the response at the center of an interview in Goma between the Technical Secretary of the CMRE and the United Nations Emergency Coordinator for Ebola<br /> - The Technical Secretary of the Multisectoral Committee on Epidemic Response to Ebola Virus Disease (ST / CMRE), Prof. Jean Jacques Muyembe Tamfum, granted a hearing on Wednesday, October 16, 2019 in Goma to the United Nations Emergency Coordinator for Ebola;<br /> - During their meeting, the two personalities discussed the state of play of the response to the 10th Ebola Virus Disease outbreak and the security situation in the areas affected by this epidemic;<br /> - It should be noted that the 10th Ebola epidemic has been taking place in the Democratic Republic of the Congo in areas of armed conflict, particularly in the provinces of North Kivu and Ituri, for more than a year;<br /> - Some time before this meeting, the technical secretary of the Multisectoral Committee for the Response to the Ebola Virus Disease Epidemic (ST / CMRE), Prof. Muyembe Tamfum, who is currently staying in Goma, North Kivu to inquire about the evolution of the response, chaired the morning meeting of the general coordination of the Ebola response to the epidemic.

Pygmies at Mahombo camp in Mambasa territory in Ituri pledge to fight Ebola Virus Disease

• The pygmies residing in Mahombo camp located more than 30 minutes walk from the main road from the village Nyangwe in the territory of Mambasa in ITURI, pledged Tuesday, October 15, 2019 to fight against Ebola by raising alerts with teams of the response;<br /> This commitment is the result of awareness raising by the Community Risk and Commitment (CREC) teams for 79 pygmies about the generalities of the Ebola virus disease, its methods of prevention and contamination;<br /> Pygmies have, for this purpose, asked for hand washing kits to break the chain of transmission of the Ebola virus in their respective communities.

VACCINATION

• Since vaccination began on 8 August 2018, 238,700 people have been vaccinated;
• The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS

• The Governor of North Kivu, Carly Nzanzu Kasivita accompanied by a strong delegation, visited Maboya Control Points (PoCs) in Kalunguta and Kangote in Butembo in North Kivu Province;
• The providers of the Mususa Point of Control (PoC) in Butembo, North Kivu, in collaboration with the Ndondo Primary School and the Kyambogho School Complex, participated in a mass sensitization session (travelers and riverside population) under the theme " All Eliminate Ebola Virus Disease "on International Handwashing Day;
• Since the beginning of the epidemic, the total number of travelers checked (temperature rise) at the sanitary control points is 106.625.956 ;
• To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2020-11-06 05:07:01, user Schneide Fu wrote:

Not sure they got the dosage correctly, as Nitazoxanide has a half life of 2.9 hrs. Should have been on divided doses, several times a day.

On 2020-05-25 11:34:54, user Rogelio Macías-Ordóñez wrote:

Even after countless revisions prior tu submission to medRxiv we found a minor mistake in the sentence (lines 375-378):

"A group of five countries (Brazil Fig 4, México, India, Peru and Russia) with IFR values below 1% and an already high death toll (above 1,000) may experience a high number of casualties if, as our estimates suggest, they experience 68-82% more deaths in the next 23 days."

It should say "...64-82% more deaths in the next 23 days." since 64% is the lowest value (for Brazil) among those countries in Table 1.

On 2020-07-11 23:36:55, user Monil Majmundar wrote:

Study showed corticosteroid was associated with lower risk of Icu transfer, intubation, mortality and higher probability of discharge.<br /> Corticosteroid was associated with 85% lower risk of primary outcome that is composite of icu transfer, intubation and death. 84% lower risk of icu transfer, 69% lower risk of intubation and 47% lower risk of mortality. 3.65 times higher probability of discharge.

On 2021-07-25 17:46:53, user Ullrich Anton Schuler wrote:

I recommend to reduce percentages to 3 significant digits. E.g. "33.76% of SARS-CoV-2 exposed children" means with 548 children: 1% is 5 children, 0,1% represents 0,5 children, 0,01% means 1/20th of a child. Therefore two digits after the decimal point in my opinion are nonsense (as it is the case in very many situations!). The unnecessary question arises as to whether the authors have a sensible feeling for numbers and sizes.

On 2021-09-21 11:11:33, user 4qmmt wrote:

Would any of you agree that rate of myocarditis/pericarditis due to the vaccine in youth is a) unknown and b) higher than the available data suggest?

On 2021-09-11 13:17:40, user Adam Carmack wrote:

Except vaccination doesn't prevent infection, it only limits the severity of the infection, which is already so low among children

On 2021-09-12 23:03:02, user Irl Smith wrote:

I didn't see anything in the original paper suggesting such an extreme peak in the myoc incidence; the first paragraph in the "Design" section seemed to me to indicate that case counts were for five and a half months (1/1 – 6/18). Do you have unpublished data which shows that the myoc occurred so shortly after the vaccination?<br /> What would have helped clarify the strength of the conclusion would be to apply a Bayesian analysis with an assumed prior incidence as found in Arola. It would also have helped if you kept the denominator constant throughout the paper (i.e., not switching between per-100k and per-million).<br /> I apologize if I am not using the correct terminology; I am not an epidemiologist.

On 2021-09-10 09:53:32, user Christopher McMaster wrote:

This paper uses an interpretation of VAERS data that is not supported by the literature or HHS. I suggest the authors familiarise themselves with the VAERS guidance (https://vaers.hhs.gov/data/... "https://vaers.hhs.gov/data/dataguide.html)") and avail themselves of the many publicly available educational materials on pharmacovigilance research (e.g. Uppsala Monitoring Centre educational materials).

On 2020-04-01 21:11:32, user V. Cheianov, Esq. wrote:

Below I post a link to a recent publication by the Russian Institute for Economic Analysis <br /> (a typical Russian think tank, not an academic institution), which arrives at similar conclusions.

There are some methodological differences.

At the moment the publication is only available in Russian.<br /> The results are published in the form of a blog post

https://aillarionov.livejou...

On 2020-04-02 17:08:35, user Yaira Ca Ce wrote:

Interesting correlation BUT... Is it strong enough the correlation of data from countries in different stages? Being from Mexico makes me think of the lack of detection in my country. The tests haven't been applied massively, and there are MANY cases of atypical pneumonia and flu. Interesting isn't it? It might be that a low morbility and mortality is due to under developed countries in their first stages or there's not a massive testing. Still interesting to consider it. At the end it will be more realistic to make a comparison.

On 2020-05-16 22:05:44, user Chris Bagshaw wrote:

Everyone seems to be quoting the death rates in various countries but my country is placing COVID19 on death certificates for people dying from other causes "following government guidelines" so how can anyone calculate the true infection / mortality rates when the actual numbers being quoted are fatally flawed by manipulation?

On 2020-07-21 21:41:59, user Alfred_Packer wrote:

This research was done very early, and has the imperfections inherent in such an early effort- but they appear to have been pretty close to the actual IFR. At the time it was seen as impossibly low and a dozen researchers beat this study up. So how did such a flawed study get the right answer, basically?

On 2021-01-25 15:10:24, user Chip Hughes wrote:

Thank you all for this great research. It will really help OSHA target enforcement to the highest risk sectors and job classifications so that we can hope to reduce deaths among frontline workers with the highest level of COVID19 exposures on the job. Chip Hughes, USDOL-OSHA DAS

On 2023-01-07 03:30:19, user loki4loki wrote:

The authors have a new definition of effectiveness. I thought a vaccine was effective if it prevented hospitalization and death. Now they have changed the goal posts. No wonder the Browns are having a bad year.

On 2023-01-02 11:42:16, user Lance wrote:

It seems that the authors indulged in the pharma-friendly practice of starting the clock on exposure 7 days post-exposure:

"Individuals were considered bivalent vaccinated 7 days after receipt of a single dose of the bivalent COVID-19 vaccine... Curves for the non-vaccinated state were based on data while the bivalent vaccination status of subjects remained “non-vaccinated”. Curves for the bivalent vaccinated state were based on data from the date the bivalent vaccination status changed to “vaccinated”. "

This is particularly egregious given the potential for these vaccines to increase infection risk in the period immediately following vaccination. What little VE is reported here for the bivalent could itself be an illusion, disappearing upon proper treatment of the data.

On 2020-04-20 11:54:22, user Larry Knight wrote:

Agreed. Usually viral load is connected to symptoms.

On 2020-04-18 20:15:52, user Tere mius wrote:

How are these results helpful if the analysis is conducted on nasopharyngeal swabs? We know that in asymptomatics the majority of viral load is present only in the upper respiratory tract, or am I not understanding what was reported in other papers? <br /> Furthermore, part of the symptoms are caused by the immune system itself, so a higher viral load will cause a different reaction anyway, am I right?<br /> Thanks if anyone can clarify this for me.

On 2021-07-16 05:35:56, user Altamir Gomes Bispo Junior wrote:

Hi, I'm one of the authors of [49].

I will make the following suggestions:

1- I see that medical doctors in several countries (India, China, South Korea etc.) are repurposing drugs and nutraceuticals and they are making huge strides on COVID-19 treatment guidelines. It will for sure be interesting to inform the general public about these possibilities, even if these possibilities are not currently acknowledged by organizations such as the WHO.

2- Many of the current COVID-19 vaccines are not sterilizing and thus cannot block transmission efficiently. Virus spread may vary due to different vaccine platforms.

3- Vaccines for respiratory viruses are known to have lower immunogenicity on older age cohorts and to have also a vanishing protection against infection and symptomatic infection. This could be added to the model.

On 2020-04-29 16:03:06, user Eugene Kutsin wrote:

1. comparing flu to covid death based on a hand-picked interval is misleading. The peak of flu distribution based on 2017-2018 CDC data comes in January and is not included in the statistics. based on 2017-2018 data, 34% of death fall into the interval, while covid peak is included, meaning that at least 50% of deaths is accounted;
2. excess death is calculated based on 2017-2019 (I guess average or mean). Based on country wide CDC data (https://www.cdc.gov/nchs/da... "https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf)") making adjustment for New York we see deaths count fluctuates in tens of thousands. So the 13K falls into marginal error. This makes measure "excess deaths" as computed not usable;
3. statement "number of COVID-related deaths [based on excess number] is in fact greater ... as trauma and even heart attacks, appears to have decreased during the shelter-in-place period of the pandemic" is a speculative one. while it's probably true that trauma related deaths would go down during lockdown, number of death related to cases when people are not getting adequate medical help by avoiding visits or lack of resources;

On 2021-06-14 19:15:42, user Alhaji Abubakari Sadiq wrote:

Can i please get the vaccine acceptance scale for my study. I will validate it anyway. Maybe provide some information about the it for me

On 2021-08-04 20:52:35, user johns1956 wrote:

I don't see Supplemental Table 4, can you please provide it if you have it?

On 2020-07-03 19:26:50, user Jun Wan wrote:

Dr. Anthony Fauci warned this Tuesday (https://www.youtube.com/wat... "https://www.youtube.com/watch?v=m5l5UGS9ngc)") that a new strain of the coronavirus was found to be dominant around the world which was published the past Sunday by the Cell (https://www.cell.com/action... "https://www.cell.com/action/showPdf?pii=S0092-8674%2820%2930820-5)"). The new strain G614 they referred is the exactly same as what this paper identified associated with the mutation A23403G (group A). In addition to the mutation on Spike (614), another mutation C14408T on ORF1ab (P4715 changed to L4715) was also reported by this paper which co-occurred with the mutation on Spike (614). Both can become the features of these strains. Indeed, the paper combined both together to name them as strain GL (G614+L4715) or DP (D614+P4715). Their results suggest "that the GL strain of SARS-CoV-2 might become much more stable and prevailing than DP identified from Wuhan-Hu-1 after 6-month evolution and transmission." Actually, when you read the paper carefully, you may find more novel interesting findings discussed in their work.

On 2021-06-09 19:49:55, user Emily Russell wrote:

It's important to note that a null statistical finding does not indicate that there is no evidence of association. With only 1,359 individuals who were previously infected and unvaccinated, I question that this study has enough statistical power to support the bold claims in the discussion. I would like to see a power analysis as part of the final published work.

On 2021-07-17 14:00:49, user killshot wrote:

Agree...but some of us informed practitioners were saying this long ago. Do you have a reference re the "those that recovered from COVID were at somewhat higher risk of complications from the shot."?

On 2021-11-19 20:32:12, user Corky Gardner wrote:

https://www.bloomberg.com/n...

On 2024-10-18 20:47:08, user CDSL JHSPH wrote:

First of all, thank you very much for writing this preprinted paper. This article has provided me with a number of ways to assess the duration of treatment with tuberculosis therapy. This paper provides a robust framework for comparing the effectiveness of different approaches through rigorous simulation studies. By carefully modeling a variety of regimen-response relationships and testing various methods under a variety of sample sizes and conditions, the authors provide a comprehensive assessment of the relative strengths and weaknesses of each method, making a valuable contribution to the field of clinical trial design. These findings have the potential to improve the efficiency and accuracy of trials for infectious diseases (especially tuberculosis) and can be generalized to other therapeutic areas. This paper opens up promising new research directions and provides a solid foundation for future work in the field. From my personal perspective, one limitation that needs to be mentioned is the risk of underestimating the Minimum Effective Duration (MED), especially when the sample size is small. If the duration of treatment is underestimated, patients may receive suboptimal treatment, which may lead to higher recurrence rates or incomplete cure.

On 2020-11-05 08:59:04, user Vishal Barot wrote:

Can I have the data of the patient as I would like to perform some prediction based on the historical data?<br /> I have trained certain model using deep learning and would like to contribute for the same.

Thank you

On 2020-12-29 15:21:15, user Claus R wrote:

Please make sure you review the Nov 5 Frontiers in Medicine commentary on the Flaxman paper, https://www.frontiersin.org.... In it, Kuhbandner & Homburg argue (for the UK) that Flaxman et al. ignored that R was already very low at the time when NPIs could have taken effect, something you seem to be confirming with your more extensive analysis here.

• Claus Rinner, Ryerson University, gis.blog.ryerson.ca

On 2022-12-09 22:42:39, user Josipa Domjanovic wrote:

This is an interesting and well-written randomized controlled trial that examined the effect of intradialytic exercise on the survival of patients undergoing treatment with intermittent hemodialysis. The main findings suggest that intradialytic exercise improves survival in this population. The methodology of this study is robust and the results are well-presented, but there are several important constraints that should be acknowledged.

Major remarks:

• Major limitation of this study is a limited sample size, including only 37 patients per group. This is evident in the results including large confidence intervals. The conducted sample size analysis is encouraging, but this is an important study limitation.
• Additionally, exercise time and follow-up was relatively short (6 months vs 1 year) so the long-term effect of intradialytic exercise remains uncertain.
• The Discussion needs elaboration on the clinical implications of this study.

Minor remarks:<br /> - The authors are encouraged to correct the typos and improve the textual flow throughout the manuscript. Paragraphs should be justified.

Nevertheless, this well-organized study warrants publication so it could act as an incentive to start similar ones on a larger sample and with a longer follow-up, which could lead to change in the treatment practice of these patients.

On 2020-06-14 14:46:08, user wbgrant wrote:

It appears that the dose of 1000 IU/d vitamin D is insufficient to raise 25(OH)D concentration significantly. See<br /> Heaney R et al. Human Serum 25-hydroxycholecalciferol Response to Extended Oral Dosing With Cholecalciferol. Am J Clin Nutr. 2003 Jan;77(1):204-10. doi: 10.1093/ajcn/77.1.204.<br /> and<br /> Grant WB, Baggerly CA, Lahore H. Reply: “Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths”. Nutrients 2020, 12(6), 1620; https://doi.org/10.3390/nu1...

On 2020-04-22 23:33:18, user Silander North wrote:

2020-04-20: IHU Méditerranée Infection, Marseille, France: Early treatment of 1061 COVID-19 patients with hydroxychloroquine and azithromycin (PDF)

Quotes:<br /> BACKGROUND: Hydroxychloroquine (HCQ) and azithromycin (AZ) are promising drugs against COVID-19.

METHODS: We conducted an uncontrolled non-comparative observational study in a cohort of 1061 infected patients treated with HCQ+AZ combination for at least three days.

RESULTS: Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < 10-2) but viral culture was negative at day 10. All but one were PCR-cleared at day 15.

A poor clinical outcome was observed for 46 patients (4.3%) and 8 died (0.75%) (74-95 years old).

Mortality was lower than in patients treated with other regimens in all Marseille public hospitals (p< 10-2). Five patients are still hospitalized (98.7% of patients cured so far). Poor clinical outcome was associated to older age (OR 1.11), initial higher severity (OR 10.05) and low HCQ serum concentration. Poor clinical and virological outcomes were associated to the use of selective beta-blocking agents and angiotensin II receptor blockers (P<0.05). No cardiac toxicity was observed.

CONCLUSION: Early HCQ+AZ combination is a safe and efficient treatment for COVID19.<br />

On 2020-05-04 18:15:10, user Dr SK Gupta wrote:

High Dose Chloroquine with Poor patient selection are the culprits- not the drug <br /> Investigators were over enthusiastic in using a higher dose of chloroquine in elderly patients. In China National Health and Care Commission officially included the Chloroquine as medical agent on 19 Feb 2020 to be used in corona virus treatment plan. The dose of 500mg of chloroquine twice a day was decided following in vitro studies EC50 values, PBPK modeling and mice RLTEC data projected on Human beings (1). <br /> The initial recommended dose of 500 mg of chloroquine phosphate salt twice per day can quickly approach danger thresholds with sustained use at the maximum course of 10 days (Total chloroquine base 6gm). The lethal dose of chloroquine base in adults is about 5g. In China, On Feb 26, 2020, the treatment guidelines were revised, shortening the maximum course to 7 days to keep the total dose of chloroquine base 4.2 gm much lower than toxic dose (2). <br /> Elderly population is particularly prone to chloroquine toxicity especially at high doses. It is unfortunate in present study, that a base line ECG was not done to measure the QTc interval because the drug should be avoided if the QTc was more than 500ms especially in patients with severe disease prone to develop myocarditis due to primary disease Covid-19 per se(3). On the contrary we find that the higher dose regimen included Older age population with mean [SD] age, 54.7 [13.7] years vs 47.4 [13.3] years with more heart disease (5 of 28 [17.9%] vs 0) as compared to lower dose regimen. We in India having hige experience of using the drug would refrain from using such high doses.<br /> Gao et al reported results from more than 100 patients demonstrated that chloroquine phosphate is superior to the control treatment: in inhibiting the exacerbation of pneumonia, improving lung imaging findings, promoting a virus-negative conversion, shortening the disease course. Severe adverse reactions to chloroquine phosphate were not noted in the aforementioned patients (4). <br /> Poor patient selection and use of toxic doses of chloroquine seems to have brought disrepute to a promising drug. More studies are required before condemning the drug in present indication of Covid 19<br /> References:<br /> 1. Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020; 30:269–71<br /> 2. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression Dan Zhou, Sheng-Ming Dai and Qiang Tong J Antimicrob Chemother doi:10.1093/jac/dkaa114

1. Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society<br /> Aditya Kapoor, Ulhas Pandurangi,Vanita Arora, Anoop Gupta, Aparna Jaswal et al. Indian Pacing and Electrophysiology Journal, https://doi.org/10.1016/j.i...

2. Gao J, Tian Z, Yang X. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Bioscience Trends 2020; 14:72–3

On 2020-04-17 18:53:10, user Frank Conijn wrote:

A few matters should be noted:

* This study was done with patients with "severe COVID-19". In patients with severe SARS Cov disease, the virus was found to have damaged the heart in 35% of cases, causing "cardiac disease including arrhythmias, sudden cardiac death, and systolic and diastolic dysfunction" (1). So, a fair portion of the patients in the Brazilian study probably already had poorly functioning hearts at the start of the study.

* The dosage in the high-dosage arm was extremely high: 2 x 600 mg of chloroquine per day for 10 days. Chloroquine is stronger and has more side effects than hydroxychloroquine. In comparison, Gautret et al found a substantial beneficial effect with a much lower dosage: 3 x 200 mg of hydroxychloroquine per day for 10 days (2).

* (Hydroxy)chloroquine has always been contraindicated for, or should be prescribed with extra caution to, patients with a cardiac arrythmia. (Which of the two differs per country.)

* It furthermore has a pretty good safety profile. Even in long-term use by patients with diabetes II, who have a high chance of retinopathy (3).

This suggests that (hydroxy)chloroquine could still be used in patients with mild symptoms that do not have a history of cardiac disease (the congenital Long QT Syndrome [LQTS] is a very rare disease). Even by family physicians/general practitioners, if you'd ask me.

Patients with such a history should be referred to a hospital, in which there would be an alternative in the form of remdesivir.

References:

1. https://onlinelibrary.wiley...
2. https://www.sciencedirect.c...
3. https://pubmed.ncbi.nlm.nih...

On 2022-01-30 23:33:36, user Leo Delahunt wrote:

Glad you two had this discussion, the cohort for the Positive SARS-CoV-2 results change the impact of this study quite a bit. I assumed that they had grouped both vaccinated and unvaccinated together, but I think it's probably a vaccinated only cohort.

From the abstract

"...self-controlled case series analysis of 42,200,614 people aged 13 years or more..."

From the Main

"Between December 1, 2020, to November 15, 2021 a total of 42,200,614 people were vaccinated with at least one dose of..."

Data Source

"We used the National Immunisation (NIMS) Database of COVID-19 vaccination to identify vaccine exposure. This includes vaccine type, date and doses for all people vaccinated in England. We linked NIMS vaccination data, at individual level, to national data for mortality (ONS), hospital admissions (HES) and SARS-CoV-2 infection data (SGSS)."

So it appears that the authors started with the vaccination database, then looked through the Hospital admission data and death certificates to identify individuals who had experienced myocarditis or who subsiquently tested positive for covid19. From there myocarditis occurrences were were allocated into categories based on which exposure period the myocarditis occurred.

On 2021-04-09 01:46:20, user Yq Zhang wrote:

Is it possible to make the data public in addition to the code?

On 2020-07-21 15:50:10, user OxImmuno Literature Initiative wrote:

https://www.immunology.ox.a...

On 2020-10-02 00:01:26, user Immunogenetics wrote:

DQA1_509 is not an accurate representation of an HLA allele.

On 2021-10-05 10:08:23, user Samantha Hester wrote:

Members of the trans community are raising questions about your new exclusion criteria that eliminated people who self-identified as unicorns. Unicorns belong to the otherkin community and their responses could be in good faith.

Please review this post from a trans advocacy organization for more details:

https://www.facebook.com/pe...

On 2021-08-27 22:26:34, user Infinite Monkeys wrote:

The number of PhD respondents has decreased from 10,969 in version one of this article to 9,975 in version two, but the number of vaccine hesitant PhD respondents has decreased from ~2,622 (23.9%) to ~1,456 (14.6%). Therefore, 994 respondents were removed, but the number of vaccine hesitant respondents, which should be a subset, decreased by 1,166. As both versions are reporting data for May 2021, there appears to be a discrepancy?

On 2020-04-15 18:26:55, user Archisman Mazumder wrote:

These predictions actually matched.

On 2021-07-09 12:15:54, user disqus_EnN4OEtF9s wrote:

Numbers for asymptomatic COVID19 cases analyzed for efficacy don't add up. Total said to be 67 while 33 in placebo group and 13 in COVAXIN group. https://twitter.com/das_see...

On 2021-10-21 14:59:55, user Aditya Bhavar wrote:

Hello,<br /> Where to find exact data of adverse reaction occurred during phase-3 trial as on provided preprint publication data is available in very short and I am specifically interested in studies of adverse reaction occurred during trial phase?

On 2021-12-22 14:03:31, user Simone Davies wrote:

I had these symptoms (vibrations for months, muscle twitching for days) after my all 3 of my vaccine shots. I had not had covid before I was vaccinated. Would be interested to know if this is true in others?

On 2021-01-30 22:31:36, user Raghu SN wrote:

It is surprising that the effect of the difference in prevalence of the infection in the general population during the two periods being compared is not accounted for. For example, if the total cases per 100,000 is 40 in the first period and 80 in the second; if 4000 of the inoculated cohort were infected in the first period. It will be statistically expected that without the vaccine 8000 of the cohort would have been infected in the second period. And if actually only 2000 were infected, then the vaccine protected 6000 out of 8000 potential infections, that is 75% efficient. For these numbers, the methodology adopted in the study would calculate only 2000 out of 4000, that is 50%.<br /> Hope my drift is clear, though rustic.

On 2021-06-03 01:36:26, user Ifonly wrote:

The count includes three outbreaks in Queensland. One was from a worker from a hotel, the other two were a doctor and nurse treating patients in hospital. Similarly, one case in NSW was a person transporting a patient to hospital. Regardless of where they are housed when they arrive, we can anticipate still needing to transport and treat the sick to hospitals.

I think it is reasonable to treat differently the best practice approach of current administrations and the the situation in Victoria at the beginning of hotel quarantine.

I believe Queensland had a policy of hospitalising all positive cases. From the Queensland experience, we can expect 2 breaches in hospital per 543 positive cases .37% or 1 in 271. It is not unreasonable to expect a similar figure for dedicated facilities.

In total there has been 3312 positive cases arrive in Australia (excluding the NT), From those there has been 14 breaches, 3 on the way to or in hospital, 2 in Victorian early days leaving 9 breaches for 3312 or .27% or 1 in 368. This of course is not entirely accurate as it includes the 543 in Queensland who spent part of their time in hotels before moving to hospital.

On 2021-10-03 16:42:16, user Luke Yaldo wrote:

The peer reviewed, published version of this article can be found here: https://link.springer.com/a...

On 2020-12-01 14:30:16, user Peter Griffiths wrote:

Published as: Griffiths, P., Saville, C., Ball, J., Culliford, D., Pattison, N., Monks, T., 2020. Performance of the Safer Nursing Care Tool to measure nurse staffing requirements in acute hospitals: a multicentre observational study. BMJ Open 10 (5), e035828.10.1136/bmjopen-2019-035828

On 2021-08-02 17:06:59, user My Pet Ocelot wrote:

You didn't even read the study, they set the Ct to 30.

On 2021-08-15 12:39:25, user Jérémy LLL wrote:

Thank you for the useful work. In your Figure 1, the green trend line does not seem to fit any data on the right half of the plot. Can you explain this? Did you exclude the negative detections (Ct 50) from the fit?

On 2022-03-05 07:28:21, user Kaiser Stobbertus wrote:

A good study!<br /> I just wonder, though, why PEM (Post-Exertional Malaise) was not taken into account - especially given the expectable long-term suffering in patients who might get prescribed excercise?<br /> On topic, see, e.g.:<br /> https://www.ncbi.nlm.nih.go...

On 2020-08-17 22:58:52, user Irene Tosetti wrote:

This is the French RT-Lamp saliva test that I've mentioned, Easycov, validated by Uni of Montpellier https://www.skillcell-alcen...

On 2021-09-08 04:46:33, user Anni wrote:

Quite normal for any vaccine to affect immune responses to unrelated pathogens <br /> https://www.sciencedirect.c...<br /> ... not a bad thing, and Comirnaty has been shown to activate antibodies from past viral infections, all good signs.

Also, Don't forget to check the conflict of interest statement of the study we are commenting on.

The employer, "Trained Therapeutix and Discovery", with the motto "Don't fight the wave, ride it"!! is advertising their treatments to "dampen the ruinous hyperinflammation" in severely ill, hospitalized COVID patients.

It's clearly in their interest to reduce confidence in vaccines, as vaccinated individuals seldom need their treatments, vaccination mostly prevent the aforesaid ruinous hyperinflammation issue ...

Personally, unless you are a pharmaceutical company poised to profit off severely ill covid patients, I'd strongly suggest fighting the wave of infections with a good vaccine.

On 2021-11-08 07:37:42, user Luke wrote:

Did you look at the actual chart - t1:t2, t1:t3 ratio is around maybe 0.7-2.0 <br /> for various tests? Hardly a "it disables and reprograms your immune <br /> system"? The wide scattering in the plots seems to suggest may be dependent on <br /> many factors?

On 2021-12-16 20:52:42, user Chewbacca wrote:

Very thorough analysis. Lots of work behind that study. Well done.

On 2025-06-26 00:25:38, user Pegah Khosravi wrote:

We are pleased to share that this preprint has now been peer-reviewed and published in Biological Methods and Protocols. The final version of the article is available at: https://doi.org/10.1093/biomethods/bpaf032

On 2022-01-21 13:57:00, user Adam Capoferri wrote:

This work is now published in Viruses: https://www.mdpi.com/1999-4...

On 2020-01-25 23:16:22, user White_Runner wrote:

There is another study that puts the R0 value in 1.4 to 2.6, still very high.<br /> However not apocaliptic levels like the one described here.<br /> Also, this R0 value can change in time as long as the adequate restrictions are taken in place.<br /> So, yeah guys, expect the best, have some precautions and happy lunar new year.

On 2021-07-10 13:39:38, user Marco Roccetti wrote:

Final version of this study available on BMJ Open: https://bmjopen.bmj.com/con...

regards<br /> The Authors

On 2020-07-23 20:34:45, user E. Taylor Stone wrote:

Just a note for the authors that in the introduction line 55, OC43 and HKU1 are listed as alphacoronaviruses, but I believe should be listed as betacoronaviruses: https://www.cdc.gov/coronav...

On 2020-11-30 01:00:57, user lbaustin wrote:

Does your hospital not routinely check vitamin D status - 25(OH)D levels? Recent studies have shown that if vitamin D is given early, it can decrease Covid-19 severity, but it is far less effective in severely ill patients.

On 2021-09-29 04:15:27, user Nikki wrote:

I work as an account Escalation Specialist/call center supervisor who takes over Escalated calls. I've never had issues with missing small details which are required to do my job. I caught covid in mid July, had a horrible experience with two weeks worth of severe vertigo, nausea, fever spikes, tons of phlegm, panic attacks. <br /> One month and a half after recovery, I've had 4 major fails which may ultimately end up costing me my job. <br /> My pcp, therapist, and boss appear to disregard this when I try to explain to them about the fogginess. <br /> As a very detail oriented person, I just don't miss those things.... never in my 15 years in callcenter experience.

On 2025-11-26 01:10:16, user Alda wrote:

Congratulations for all the colaborators!! <br /> When will be published ? (perhaps 2026)

On 2020-04-23 17:35:06, user Hugh DeWitter wrote:

PCR test the autopsy lung tissue for M.genitalium DNA. <br /> See @hughdewitter on Twitter for studies in support.

PCR your patients' first void urine, before issuing antibiotics, as a predictor of severe Covid-19. Mgen resistance to macrolides and FQNs seen at 100 and 90%, steals iron (FUR), subclinical, never found by culture, and a retroactive study found that as far back as 1974 it was found in 25% of lungs of a random cohort. Before PCR it tested out as M.pneumoniae, genetically a nearly identical pathogen. Now we only PCR for M.pneumoniae.

Mycoplasma Genitalium thrives in the lung subclinically, especially paired with smoking, pollution, or robust old biofilms. Find that Zn abates symptoms, no one under 14 gets severe disease, vertical transmission, 40pct of infected convert to chronic subclinical carriers after an azithro course, hemolytic anemia from FUR iron theft, adheres to erythrocytes, deposits antigen on erythrocytes, more male carriers/fatalities, sickle cell vulnerability, no increased risk for HIV+ patients (recent antibiotic courses), migrates through tissue, migrates hematogenously, 35 different Mgen isolates, samples vulnerable to dessication, refrigeration causes 27pct PCR false negatives. See the study compilation posted on Twitter @hughdewitter.

On 2020-06-09 13:07:31, user Fahd Al-Mulla wrote:

https://biorxiv.altmetric.c...

On 2020-09-16 17:38:21, user LB wrote:

This Causal Inference paper is brilliant. Why has this not been published?

On 2020-09-07 16:34:55, user A. Baluja wrote:

Hi! The last version for the reference [Baluja et al, 2020] has been finally peer-reviewed and published in:<br /> https://www.tandfonline.com...

The updated version of the preprint:<br /> https://www.medrxiv.org/con...<br /> Thank you for continuing research in such important topic!

On 2021-04-28 21:35:17, user Evangeline Burkholder wrote:

I'd like to know to what actual level was the viral load reduced to?

On 2023-05-05 14:25:04, user David Curtis wrote:

A number of other studies have examined the effects on common phenotypes of rare coding variants identified in exome-sequenced UK Biobank samples.

This paper examines the effect of using different annotation schemes to quantify missense variant pathogenicity, including in GCK, LDLR and PCSK9:

Curtis D. Exploration of weighting schemes based on allele frequency and annotation for weighted burden association analysis of complex phenotypes. Gene 2022 809 146039.

These papers report that rare variants can have large effects on phenotype, again including in GCK, LDLR and PCSK9:

Curtis D. Analysis of rare coding variants in 200,000 exome-sequenced subjects reveals novel genetic risk factors for type 2 diabetes. Diabetes Metab Res Rev 2021.

Curtis D. Analysis of 200,000 exome-sequenced UK Biobank subjects implicates genes involved in increased and decreased risk of hypertension. Pulse 2021 9 17-29.

Curtis D. Weighted burden analysis in 200,000 exome-sequenced subjects characterises rare variant effects on BMI. Int J Obes 2022 46 782-792.

Curtis D. Analysis of 200,000 exome-sequenced UK Biobank subjects illustrates the contribution of rare genetic variants to hyperlipidaemia. J Med Genet 2021.

All these papers seem very relevant and I would have thought that they ought to be cited.

On 2022-01-24 04:45:33, user Isaac Núñez wrote:

This manuscript has been published at Revista de Investigación Clínica, which can be found at the following link: https://www.clinicalandtran... .

On 2020-06-11 14:13:14, user John Mallinckrodt wrote:

The thesis of this manuscript is palpable nonsense. The seven-day cycle is very clearly a reporting anomaly. To suggest that incubation periods, times to death, or any other time associated with the development of the disease could be sharply enough defined to support an explanation like this is simply absurd.

On 2021-01-05 16:49:15, user Ania Lorenc wrote:

Hi, I was wondering - have you excluded known factors contributing to severity - sex + age?

On 2022-02-01 12:17:22, user Daniel Anthony wrote:

While the primary endpoint may have been missed, the shorter illness course and attenuation of loss of smell and taste is very interesting and warrants further investigation. It also suggests that the mode of action is unlikely to be related to the inhibition of TMPRSS2 to block SPKIE activation.

On 2020-06-05 13:21:52, user Arnar Palsson wrote:

Reference 6. Falconer D, M.T. Introduction to Quantitative Genetics, (London, 1996).

Has two authors, Douglas S. Falconer and Trudy F.C. Mackay

On 2021-10-24 02:36:03, user randy tangang wrote:

The great work in the analysis of how gut microbiome BA dysregulation can increase the risk of immune or metabolic disorders. As it was pointed out in the paper, lifestyle was one of the factors that were left out in this analysis of gut microbes. One factor that I thought was very important was how the environment had an influence on these microbes. The experiment used just 3 countries and all in one continent and as I know, people in different continents are exposed to different bacteria and turn to harbor different bacteria in their guts depending on the environment they live in. someone in the western world (Europe) who has access to clean water and different antibiotics in their food will have a different gut microbiome BA from someone who lives in Africa or South America where people are exposed to many bacteria on daily basis. The paper talks about using this analysis for therapeutic targets in immune or metabolic disorders. And so if the end goal is to use this universally, I recommend studying and analyzing how different environments affect gut microbes BA in different continents.

On 2021-09-27 18:07:42, user DiogenesNJ wrote:

"early attention directed towards identifying SARS-CoV-2 in returning <br /> international travelers may have led to a failure to recognize locally<br /> circulating infections..."

And why were we limited to that? A shortage of testing capability attributable to CDC's insistence on their own test, which turned out to be flawed, and FDA's refusal to allow any of several other tests developed by the private sector or universities to be used during the crucial first months of the pandemic. A classic NIH problem (Not Invented Here, not to be confused with the National Institutes of Health).

Compare and contrast with South Korea, which called in every big pharma company in the country during their New Year holiday, approved a private-sector test in early February, and had massive testing up and running in less than a month (15k tests/day capacity by the end of February).

On 2021-06-04 15:44:32, user maria rescigno wrote:

The paper is now published at JCI: doi: 10.1172/JCI149154

On 2021-08-03 21:07:59, user Everett Nelson wrote:

All-Cause Death Rate Changes are Holy Grail; much more so than "Covid-related" deaths. The reason is that Mitigation Alternatives are complex. For example, the Death By All Cause impact of a Vaccine has legions of variables, because we don't know that adding a vaccine mitigation actually reduces or maintains the existing All-Causes Death Rate. The Vaccine (or say a mask) may afford protection in some good way, but the Mitigation itself may trip things up with side-effects that actually cause death. As one example, consider masks. Is it probable that an old person forgets to take their mask off, gets in their car, starts driving, then removes their mask, gets distracted and creams a kid stepping off the curb? Odds are overwhelming that such an incident involving a mask won't be considered as causing an increase in all-cause Death Rate, but in that case it is! It's the same issue with Lockdowns to "slow the spread". Depression and suicide at increasing rates would increase the All-Cause Death Rate and MUST be measured to assist in understanding whether a given treatment is actually useful or just kills you via side effects that you're not even measuring or capable of measuring.

On 2021-08-04 07:40:42, user Mike wrote:

I'm curious about the HIV infected patients. There were exactly 100 in both vaccine and placebo group. If you look at the co-morbidity tables, no other co-morbidity is balanced in that way. I suppose it's possible that this occurred by chance but it's a very small one if so. Also, why did they include HIV+ patients in the study at all, if they exclude them from all reporting of deaths and adverse events? The HIV+ can lead long lives these days, it's not quite clear to me why they are being treated separately here, especially as it should hopefully be clear if they died of AIDS.

On 2020-09-23 07:52:50, user Subhajit Biswas wrote:

Pleased to see other scientists are supporting with further evidences, the trend we had observed and reported as early as April 2020.

Based on non-overlap of dengue and COVID-19 global severity maps and evidences of SARS-CoV-2 serological cross-reactions with dengue, we proposed that immunization of susceptible populations in Europe, North America and Asia (China, Iran) with available live-attenuated dengue vaccines, may cue the anti-viral immune response to thwart COVID-19.

https://www.preprints.org/m...

Our publications in this area to support our proposition:<br /> 1) COVID-19 Virus Infection and Transmission are Observably Less in Highly Dengue-Endemic Countries: Is Pre-Exposure to Dengue Virus Protective Against COVID-19 Severity and Mortality? Will the Reverse Scenario Be True?

Clinical and Experimental Investigations, Volume 1(2): 2-5.<br /> https://www.sciencereposito...

1. Nath, H., Mallick, A., Roy, S., Sukla, S., & Biswas, S. (2020, June 19). Computational modelling predicts that Dengue virus antibodies can bind to SARS-CoV-2 receptor binding sites: Is pre-exposure to dengue virus protective against COVID-19 severity?. https://doi.org/10.31219/os...

2. This one in medRxiv!

Now, other scientists are observing the same trend in Brazil! Exciting!

See recent publication below and news coverage

1.https://www.medrxiv.org/content/10....

1. Study suggests dengue may provide some immunity against COVID-19.<br /> https://timesofindia.indiat...

Amazing! Nature has its own ways of controlling parasite aggression! Antigenic correlation between a flavivirus and a coronavirus was unprecedented.

Existing and licensed dengue vaccines could be tested in SARS CoV2 animal models and tried in dengue non-endemic countries.

Use in dengue-endemic countries may be problematic as such vaccination can elicit antibody-dependent enhancement of subsequent dengue infections.

On 2020-05-12 18:49:56, user Anne Wyllie wrote:

Hi Sui, thanks for your kind feedback! We are continuing to optimize saliva sampling for SARS-CoV-2 detection and how to increase testing capacity. The results in our preprint are from samples which are often at room temperature for up to 12 hours as they undergo processing so that is already promising to us. We store our samples frozen and even with repeated freeze/thaws for further validation our resulting CTs remain almost identical to when we processed the sample 'fresh'.

On 2021-03-19 11:46:41, user Le Marchand de Venise wrote:

Subjective claims require no debunking; they're no more than personal opinions. Science speaks the language of facts and figures only; no place for hard feelings or personalization. Thanks.

On 2020-10-31 12:07:38, user Scandinavian Journal wrote:

One issue not talked about much is that a normal HCQ dose as per on the package is not considered lethal, has been around for 50 years with good reliability and costs a few dollars for a package. If I caught the virus would I decide that this is useless because some study say so while others say it is effective ? I would of course put myself under this treatment.<br /> If it is useless well what damage did it do. If it was effective it may have saved my life or made the disease progression milder. For a few dollars. Easy choice.

On 2021-09-26 19:41:41, user kdrl nakle wrote:

The whole paper has little valuable information.

On 2020-05-02 07:01:51, user Javier Mancilla-Galindo wrote:

I believe this manuscript is lacking work in the introduction, discussion and conclusions. Authors could try adressing: Why is it useful to have done such a study besides having available local epidemiological data? What are the lessons to be learned form the experience at your center which could be of use to the medical community? What other conditions (structure of the health system, burden of disease, demographics, etc.) make Mexico unique and should be taken into account when using this study to compare to others?

Two of the main highlights of this study are the high extubation rate and low mortality rate. However, the authors have not compared enough these two outcomes to other studies and barely commented on them. It would be important to dicuss further on these topics since it could serve as an example to improve COVID-19 care and patient outcomes in other centers.

Also, further work regarding adequate references is needed. For instance: How does reference number 2 relate at all to the statement the authors are making? "The flow of information from China, Europe and the United States could be used as a basis for our population; however, we must recognise that the Mexican population has very different social and health characteristics.(2)" 2. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:343-346.

On 2021-10-29 19:58:57, user Taylor wrote:

This paper was peer-reviewed and published in PLOS Medicine on 8/31/21: https://journals.plos.org/p...

NIH press release: https://www.nih.gov/news-events/news-releases/common-genetic-disorder-blood-test-reveals-when-benign-tumors-turn-cancerous

WUSTL press release: https://medicine.wustl.edu/news/liquid-biopsies-may-aid-diagnosis-treatment-of-bladder-nerve-tumors/

Journal commentary: https://journals.plos.org/p...

On 2021-02-24 22:37:41, user Sócrates Brasileiro wrote:

There are not two waves. It is the same pandemic, reaching different people. Countries population are more or less constant in one year. This means that infection and fatality rates should be computed by summing up (in the numerator) respective cases during the whole period. And not by splitting the numerator into two waves as if they were cases from different pandemics. If this was done, previous statements by one of the authors, such as "covid is as deadly as driving your car to work", would clearly be wrong, as they are indeed.

On 2020-07-17 16:36:42, user jayded1 wrote:

That is not the recommendation, did you read the conclusion? <br /> "we recommend the use of masks combined with other measures."

On 2021-12-11 13:48:37, user Patrick Gérardin wrote:

The paper has been accepted for publication by Travel Medicine and Infectious Disease. Attached the URL towards the publication: https://www-sciencedirect-c...

On 2022-07-27 11:02:06, user Karen wrote:

The SARS-CoV-2 comparison is flawed.

* You compare cases (testing and reporting-dependent, highly time-variable), not incidence rates (such as ONS estimates)<br /> * You compare cases in the general population, not the paediatric population<br /> * You plot cases on a log scale against hepatitis cases on a linear scale.

This needs revision. Indeed, when you revise it, you find that the conclusion is literally reversed.

On 2020-08-17 09:34:02, user buddinggenetics wrote:

The principal author has stated in media that the cost per test is $10, however in the text the cost is listed as $1.29-4.37/sample. Pricing should be consistently stated to avoid misleading the public and/or scientific community. Also, the text states that the price per sample is low, which is a relative term, and gives no price estimates of other established tests for comparison.

Multiplexing the samples is a fundamental improvement of testing, however there is insufficient evidence to show eliminating the N2 primer set is justified. There needs to be an analysis of how many inconclusive test results (N1 positive and N2 negative/ N1 negative and N2 positive) would now become positive or negative tests as a result of eliminating the N2 primer set. Also, in Supp Fig 2, the data appear irregular with a bimodal distribution when a Gaussian distribution would be expected. The authors do not discuss the reason for this in the text. Furthermore, the failure of the N2, E, and ORF1 sets may be due to the HEX fluorophore. Would they have worked using a different fluorophore? Would the authors have eliminated N1 if they had by chance used HEX on N1?

The Source Data files are not posted.

On 2022-09-28 17:51:37, user Jorge Cruz wrote:

This paper has now been published in Ann Clin Lab Sci July-August 2022 vol. 52 no. 4 651-662

On 2020-03-27 20:04:02, user Sinai Immunol Review Project wrote:

The authors present a digital PCR (dPCR) diagnostic test for SARS-CoV-2 infection. In 103 individuals that were confirmed in a follow-up to be infected, the standard qPCR test had a positivity rate of 28.2% while the dPCR test detected 87.4% of the infections by detecting an additional 61 positive cases. The authors also tested samples from close contacts (early in infection stage) and convalescing individuals (late in infection stage) and were able to detect SARS-CoV-2 nucleic acid in many more samples using dPCR compared to qPCR.

The authors make a strong case for the need for a highly sensitive and accurate confirmatory method for diagnosing COVID-19 during this outbreak and present a potential addition to the diagnostic arsenal. They propose a dPCR test that they present has a dramatically lower false negative rate than the standard RT-qPCR tests and can be especially beneficial in people with low viral load, whether they are in the earlier or later stages of infection.

On 2020-05-10 19:22:45, user 339523 wrote:

what are several ways that would make this clinical trail better?

On 2020-05-28 17:30:13, user RJones1 wrote:

Without a weekly count of the number of new cases each week, by age, this is meaningless data. Keep in mind 8 weeks ago was early April -- a long, long time ago in most of our experience.

Is there a link to that specific data? Thanks.

On 2020-03-23 18:10:30, user Sinai Immunol Review Project wrote:

Summary:<br /> The authors of this study provide a comprehensive analysis of clinical laboratory assessments in 75 patients (median age 47 year old) hospitalized for Corona virus infection in China measuring differential blood counts including T-cell subsets (CD4, CD8), coagulation function, basic blood chemistry, of infection-related biomarkers including CRP, Procalcitonin (PCT) (Precursor of calcitonin that increases during bacterial infection or tissue injury), IL-6 and erythrocyte sedimentation rate as well as clinical parameters. Among the most common hematological changes they found increased neutrophils, reduced CD4 and CD8 lymphocytes, increased LDH, CRP and PCT

When looking at patients with elevated IL-6, the authors describe significantly reduced CD4 and CD8 lymphocyte counts and elevated CRP and PCT levels were significantly increased in infected patients suggesting that increased IL-6 may correlate well with disease severity in COVID-19 infections

Critical analysis:<br /> The authors performed an early assessment of clinical standard parameters in patients infected with COVID-19. Overall, the number of cases (75) is rather low and the snapshot approach does not inform about dynamics and thus potential relevance in the assessment of treatment options in this group of patients.

Importance and implications of the findings in the context of the current epidemics:<br /> The article summarizes provides a good summary of some of the common changes in immune cells inflammatory cytokines in patients with a COVID-19 infection and. Understanding how these changes can help predict severity of disease and guide therapy including IL-6 cytokine receptor blockade using Tocilizumab or Sarilumab will be important to explore.

On 2025-04-28 22:43:18, user Biagio Lucini wrote:

This paper has now published in a book:

https://link.springer.com/chapter/10.1007/978-3-031-48683-8_13

On 2020-10-20 01:41:37, user Karime Kalil wrote:

I congratulate the authors on their paper.

Their main contribution is to reveal that a more diverse microbiome before treatment correlates with better outcomes in paatients with cervical cancer undergoing CRT and to characterize the main bacterial species with which samples from patients with better and worse outcomes were enriched.

Their results raise the hypothesis that the manipulation of the gut microbiome and enrichment with certain bacterial species before treatment may result in better outcomes for locally advanced cervical cancer patients. However, it is still necessary to demonstrate if potentially transient changes in the microbiome using microbiome modifiers would influence response to any anti-cancer treatment.

The main strengths of the paper was that their experiments were well designed and included a robust method for bacterial identification (16S rRNA analysis) and laborious data analysis Besides, because stool samples were collected in five relevant time-points, this research will allow for future analysis of the behavior of the gut microbiome during and after chemoradiation and correlation of the changes with treatment-related adverse events, as well as with response to treatment according to RECIST criteria in the MRIs performed.

On 2021-12-04 11:17:55, user damator1985 wrote:

The model is done with only one parameterset.<br /> A sensitivity analysis shall be added. What is the main study result (r value reduction) if you would change each of the input parameters of your model by +/- e.g. 20%? How does each input parameter influence the r value reduction? Is the r value reduction at the end much lower / higher than expected? Without that it remains fully unclear how significant the result of r value reduction is. But you already understood that the significance of the input parameters is not high. So please add at least 20%-30% uncertainity to all the input parameters listed in the appendix B, not only the matrix S, also in their combination!

Please consider that based on such studies our policy in Germany is desciding on measures against the unvaccinated. You could have some responsibility for these descisions.

On 2021-12-01 18:35:49, user Dr. Kate wrote:

Though I trust your calculations are correct, the way of summarizing the results is extremely misleading. If the vaccine was not showing any effect at all, you would find that 75% of all infections had a contribution from unvaccinated people. In your realistic scenario (Fig. 1b), you find the same number for the current vaccines to be 84%, not much higher than this "base line". What you are not saying is, that, with the same way of summarizing 3 out of 4 categories (u-u, u-v, v-u, v-v), you could also arrive at the conclusion that 62% of infections had a contribution from vaccinated people. Yes, this is lower, as it should be, if you assume the vaccines to not be without any effect. But the effect is much smaller than you make it look, and it raises the question whether you cannot much more easily reach R<1 by eliminating transmission through vaccinated people by testing/quarantine, than to sufficiently raise the number of vaccinations (considering that around 50% of the unvaccinated are children). Or, ideally, advocate doing both instead of publishing this paper with the distorted conclusion that it's almost exclusively the unvaccinated people driving the infections, and leaving everyone with a wrong sense of security and moral superiority over the unvaccinated.

On 2020-11-20 10:16:10, user Saar Wilf wrote:

Thank you for this publication. Given that we already have two successful vitamin D RCTs and dozens of retrospective studies, I believe the null hypothesis is that vitamin D is effective in reducing COVID-19 severity. Therefore the failure of this study is not enough to accept a new hypothesis.

Digging in to the details, the main problem is that the study was extremely underpowered. For example, the probability that it would have found a reduction of 50% in mortality with p<0.05 is only 25%. ICU admission and mechanical ventilation were a bit better with 61%, and 44%, and they indeed showed some effect (despite 1 treatment arm patient admitted to ICU before receiving treatment), although still not significant (as expected).

Sample size was calculated assuming vitamin D would reduce hospital stay from a mean of 7 to 3.5 days. That is extremely unlikely, especially given that bolus vitamin D takes a day or two to be mostly converted to 25(OH)D (and I assume more for 1,25(OH)d. anyone knows how long?).<br /> In essence, the study had a low probability of achieving any of its endpoints..

Patients were recruited 10 days after symptoms, and 90% were already on oxygen. It is possible that improving innate immunity is not very relevant at that point. Whatever effect it may have had, was further reduced due to 62% of patients receiving steroids.

While the study does not show vitamin D is not effective, it does suggest that at a late stage, alongside steroids, it is not *immensely* effective, i.e. does not reduce odds of severe outcomes by 5x or more. Our analysis at Rootclaim suggests that a 5x reduction is a reasonable outcome when vitamin D is administered correctly.

Thanks again.

On 2020-12-01 21:23:17, user NubOfTheMatter wrote:

This trial appears to have been a wasted opportunity.

It is unclear why Vitamin D3 was orally administered to severely ill C-19 patients. It can take a fortnight to be metabolised into Calcifediol, the active, metabolised form required to trigger an immune response. A most unhelpful delay to the effective treatment of severely ill COVID-19 patients.

The RCT conducted at the teaching hospital in Cordoba used Calcifediol, with dramatic results. Compared to the untreated ‘control group’ there was a 96% reduction in the need for Intensive Care Unit admission, and a commensurate reduction in deaths.

One has to ask, therefore, why, in Sao Paulo, it was decided to administer un-metabolised Vitamin D3 rather than Calcifediol to severely ill C-19 patients for whom every day of non-treatment reduces the chance of a good outcome if not survival? Indeed, an experienced physician could have forecast the results obtained without the need for a trial.

On 2021-06-10 10:53:46, user Soshay wrote:

Of course BNT162b2 (Pfizer) and mRNA-1273 (Moderna) would not be detected in breastmilk 4-48 hrs post injection. The biodistribution study follows the lipid nano particle envelope still covering the mrna up to 48 hrs post injection. Follow the ALC - 0315 and ALC - 0159.

On 2020-09-24 14:55:10, user Antonio Cassone wrote:

Enjoyable reading, instructive work, I warmly congratulate with the Authors for this excellent contribution to. this exciting research field of utmost importance.<br /> The Authors may wish to consider for their final peer-reviewed publication our report on D614G mutation in the first wave of Covid-19 epidemic in Italy, a country strongly and early hit by the virus soon after China<br /> (Evidence for mutations in SARS-CoV-2 Italian isolates potentially affecting virus transmission<br /> Domenico Benvenuto Ayse Banu Demir Marta Giovanetti Martina Bianchi Silvia Angeletti Stefano Pascarella Roberto Cauda Massimo Ciccozzi Antonio Cassone<br /> First published: 03 June 2020<br /> https://doi.org/10.1002/jmv... "https://doi.org/10.1002/jmv.26104)")<br /> The change conferred by the D614 mutation in the molecular structure and configuration of the S1 spike protein led us to hypothesize a role of it in enhancing SARS-2-CoV transmission. It was a short, initial communication and we clarified we had, of course, no proof of that supposition (must say, is there any real proof yet?) <br /> Antonio Cassone, MD, FAAM

On 2021-02-06 16:58:04, user Andrew T Levin wrote:

Dear Kailash, the US Scenario Analysis is provided in Supplementary Appendix N of our published paper in the European Journal of Epidemiology (https://link.springer.com/a... "https://link.springer.com/article/10.1007/s10654-020-00698-1)"). We compared two scenarios in which US prevalence reached 20%, and our metaregression estimates indicated that the US death toll would range from 348,000 (with protection of vulnerable age groups) to 867,000 (with uniform prevalence). It now appears that actual US prevalence has indeed reached about 20%, and the actual death toll now stands at about 460,000. That outcome reflects the extent to which the current prevalence among children and younger adults (0-44 years) exceeds 20%, prevalence among middle-aged adults (45 to 64 years) is close to 20%, and prevalence among older adults (65+ years) is about 10%. In effect, the actual US outcome is very tragic but does provide validation for our findings. Best regards, Andrew Levin

On 2021-07-12 23:16:53, user TheSailor wrote:

Did I miss the part where it was confirmed that all were fully vaccinated?

On 2021-07-05 22:52:47, user Robby-D wrote:

Line 108 - the paper cites "five other patients" [testing positive for COVID, beyond the initial patients 0a and 0b]. I believe this should read four?

A more thorough description of total time of the event, what constitutes an "open air tent", and how many other people reported close contact with patients 0a and 0b would be very helpful in assessing the scenario described and the breakthrough cases that occurred. In an open air situation especially, attendees that remain up-draft and far from Patients 0a and 0b should not be included in any denominator for calculating breakthrough percentages.

Condolences to the gentleman who passed and his family and friends.

On 2020-08-07 07:38:40, user kdrl nakle wrote:

"California, Florida, and Texas are each burdened with nearly<br /> 0.5 million cases, which corresponds to 1% infection in their respective populations"

Really? You just pulled 1% of of your ... hat? And also assumed that CDC reported cases would be precisely the number of all infections? Or active infections? Or what?

On 2020-05-23 09:25:08, user Francesca Simonato wrote:

What hydrogen peroxide concentration was used?

On 2020-03-20 16:43:20, user Cathy Gansen wrote:

The final conclusion doesn't seem right based on the reported stats. Or am I reading it incorrectly? Conclusion says: "CONCLUSION People with blood group A have a significantly higher risk for acquiring COVID-19 compared with non-A blood groups, whereas blood group O has a significantly lower risk for the infection compared with non-O blood groups." However, their stat summary is: "MAIN OUTCOME MEASURES Detection of ABO blood groups, infection occurrence of SARS-CoV-2, and patient death RESULTS The ABO group in 3694 normal people in Wuhan showed a distribution of 32.16%, 24.90%, 9.10% and 33.84% for A, B, AB and O, respectively, versus the distribution of 37.75%, 26.42%, 10.03% and 25.80% for A, B, AB and O, respectively, in 1775 COVID-19 patients from Wuhan Jinyintan Hospital." Stats indicate that AB has the lowest, not O. Is this a typo?

On 2021-08-27 17:26:33, user Mohammad Ali wrote:

Please find the published article at BMJ Open here: https://bmjopen.bmj.com/con...

On 2020-07-28 21:14:56, user Dude Dujmovic wrote:

Why not to put the name of the serology test in the abstract instead of requiring a reader to fish it out in the paper?

On 2020-05-22 22:47:23, user Vladislav Isenbaev wrote:

There is no conclusion that HC causes higher risk of death in the article, or am I missing something?

On 2020-04-24 09:57:00, user Philip Davies wrote:

Well, well well,

This pre-print would make a good script for an episode of Columbo.

The retrospective analysis, as presented, leads the reader to just one conclusion in a bazaar of many possible conclusions.

I am even starting to have sympathy with D. Raoult and his team. I note his hot tempered response to this paper, where he lists two enormous factors that should be considered when wrestling with the data: the fact that the HCQ and HCQ & AZ cohorts were a sicker crowd (he lists lymphopenia) and that the sickest of the non-HCQ ventilated patients were then given HCQ (plus AZ in most cases) in a desperate last bid only for most to die.

Raoult's point is certainly valid.

We must remember that for most of the study period the use of HCQ was "ex-license" on a compassionate basis only. This means only the sickest patients got it. Remember also that this is a retrospective analysis, therefore observational. It was not run as a therapeutic trial. On the other hand, the use of AZ was already accepted (hence 30% of the non-HCQ cohort got it anyway).... although do be aware that by this time there had been quite a lot of focus on potentially dangerous QT lengthening when HCQ and AZ were used together in very sick patients.

The HCQ cohort was, across all key determinants, the weakest and sickest group (it had the poorest prospects looking at age, ethnicity, smoking status, congestive heart failure, peripheral vascular disease, cerebrovascular disease (strokes),dementia, COPD, Diabetes (with and without complications)! ... and indeed, the HCQ and HCQ & AZ cohorts did have 100% more lymphopenia than the non-HCQ group.

BUT, the big asymmetric issues become obvious when we look at the pre- and post- ventilator numbers.

In terms of patients discharged without needing ventilation, the "victorious" non-HCQ group performs poorer than the 2 treated groups. This despite having a better prognostic baseline. But the results for this group change dramatically (for the better) when we look at the outcomes of ventilation. 25 ventilated patients came from this group.... but 19 of these 25 patients were then started on HCQ or HCQ & AZ after ventilation was started. It is screamingly obvious that these would be the sickest patients in that group: they were given such compassionate drugs in extremis. So having ejected 19 of 25 ventilated patients into the other cohorts, the non-HCQ group only had 3 deaths from its remaining 6 ventilated patients.

The numbers of ventilated patients in the other cohorts (HCQ and HCQ & AZ) were thus substantially inflated with these new super-sick patients, who mostly died.

There really can be no conclusion at all when looking at a study of this nature without knowing much more about individual clinical conditions and guiding principles behind clinician's decision making. It's still possible to make some reasonable assumptions:

If I were Columbo?... I would say the non-HCQ cohort contained patients of extremes, with the best and worst potential. The worst would have been the very frail (malignancy and or congestive heart failure maybe ... see the stats), who probably were earmarked for 'supplemental oxygen' only from the very start. Such patients would not have been suitable for compassionate use of non proven drugs (remember, most of this came before the "emergency use" edict by FDA). This would explain the number of non-ventilated patients who died in this group (they may have been given AZ only, not being a controversial drug, but otherwise they did not get any significant interventional therapy). These patients would have had significant chronic disease and very poor obs/indices (including lymphopenia). But given that this cohort had, overall, a better starting prognosis than the other two groups, it means that the remaining patients in the group were promising candidates for survival (with better obs/indices). Such patients, not being part of a clinical trial, would not have been offered HCQ on a compassionate basis unless they got dramatically worse .... and of course, the ones who did get worse on the ventilator were started on HCQ (& often AZ as well) and thus swapped into the HCQ / HCQ & AZ cohorts.

If we can understand that, then we might start to think that in fact HCQ & AZ is the best performing cohort with the other 2 vaguely distant. But this is being unfair to the HCQ cohort:

The reason that a sick patient would be given one experimental drug on a compassionate basis (HCQ) but not have a rather less experimental drug further added (AZ), can really only be explained by considering risk versus benefit. A clinician would choose to use HCQ because the patient was particularly sick. The clinician would only add AZ if it was felt that this was worth the risk.... but a particularly sick patient with significant cardiovascular disease (the HCQ contained the most CVD risk) might then die of a more abrupt arrhythmia through adding yet another QT lengthening drug. I dare say the clinicians were tempted to make some "Hail Mary" plays, but we must remember, these patients were not part of an ongoing trial, these drugs were "ex-license" for compassionate use only and clinicians were still accountable for responsible actions. So for those particularly sick frail patients, it wasn't worth the risk.

I am pretty sure that the HCQ cohort (which had pretty good pre-ventilator stats) crashed badly because it was loaded with the sickest patients .... patients that were too sick to risk adding AZ.

So, the findings of this retrospective analysis are, in my opinion, likely to be incorrect.

I believe I can confidently state that:

1. The HCQ cohort started with the sickest patients and had even more of the sickest added during ventilation. Some were too sick to risk the addition of AZ to existing HCQ.
2. The HCQ/AZ cohort also had some very sick patients (again with more additions during ventilation).
3. The Non-HCQ cohort had the best prognosis overall from the very start (although likely a polarized mixture of the most frail and the most promising)... and then its stats got even better when it jettisoned its sickest ventilated patients into the other 2 cohorts.

It is almost impossible to reach a conclusion from all this. BUT, the most likely finding is NOT that adding HCQ delivers a worse outcome than standard treatment. In fact, if we look at the pre-ventilator stats, the addition of HCQ might actually have provided considerable benefit to a particularly sick group of patients. Whether or not the addition of AZ to HCQ adds benefit is also unclear ... although my 'swingometer' is pointing slightly more to benefit than harm.

Once again. I suggest that a robust study into prophylaxis and early treatment (using sensible safer doses adjusted for pulmonary sequestration) will deliver the most interesting results for CQ/HCQ.

Dr Phil Davies<br /> Aldershot Centre For Health<br /> http://thevirus.uk

EditView in discussion<br /> Discussion on medrxiv 3 comments<br /> medrxiv viewer<br /> Philip Davies<br /> Philip Davies 4 days ago<br /> The low dose arm of this study is worth following.

The big problem for this study is comparison. It really has not defined the control population at all. The Italian and Chinese references are entirely different. Even the 2 Chinese populations referenced had massively different outcomes because the populations examined were different.

The Italian mortality rate was actually similar to the overall study average here (but much higher than the low dose arm). The Chinese study involved all patients admitted to the two hospitals ... that included a majority of patients with moderate ("ordinary" as the Chinese class it) disease severity. The patients in this Brazilian study were regarded as severe or critical ... such patients (looking at worldwide stats) would attract a mortality of 30-40% plus.

This is the most important factor. Do not compare apples with pears. So far this study points the "swingometer" in favor of benefit versus harm for the use of HQN in patients with advanced disease.

Once again however, we are looking at the potential impact of an orally administered drug to patients with advanced disease. That's a big ask.

For CQ and HCQ the most interesting results will likely come from studies looking at prophylaxis and early treatment (using safe doses, not silly high doses with added drugs that also lengthen QT). We can't yet guess how they will pan out.

Dr Philip Davies<br /> GP<br /> Aldershot Centre For Health, UK<br /> http://thevirus.uk

On 2021-06-27 17:38:27, user Notbuyingit3337 wrote:

All SE Asian, Oceanic, and African countries had significantly lower deaths per capita no matter what their restrictions were.

On 2021-04-07 23:31:13, user Risham S wrote:

What about therapies like entyvio? Can anyone shed some light on that? Many thanks for the study , a great help for CID patients like me. Appreciate it.

On 2021-11-07 08:53:23, user Mirek Goldberg wrote:

Hi Brian,

I'm keenly interested in the progress of distribution and actual efficacy stats of NVX in inoculated populations.<br /> Very interesting comment of yours!????<br /> Unfortunately, no one in the know has replied yet.<br /> It looks like your keen observation would indicate about a 5-fold higher risk of SAE incidents with NVX than with "similar frequencies" (meaning what - observed occuring with other vaccines?).

Have you tried to ask NovaVax people directly about your finding?

On 2021-01-26 19:45:53, user ingokeck wrote:

The title is misleading, as the data is not about viral load, but instead only on the density of the E gene in the samples. Also, it seems the samples were not normalized to the amount of human dna in the sample. Without that the Ct values can vary by 10 and more just because of differences in the collection, which renders the analysis done in the article useless, unfortunately. Please see Dadouh et al at https://pubmed.ncbi.nlm.nih...

It would be great if the authors could find out if maybe some samples have been normalized and then restrict their analysis to them. The result would still be interesting.

On 2020-04-06 22:21:01, user Spencer Harris wrote:

If the virus can remain as an aerosol for 3 hours how could they possibly recommend people to go outside without a mask???

On 2021-03-10 12:58:49, user Zed wrote:

So it's not working in early treatment, and during hospitalisation (cf: https://www.clinicalmicrobi... "https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(20)30505-X/fulltext)")

On 2021-01-13 11:14:06, user Magnus Brink wrote:

Congratulations to a well conducted and highly interesting study. It seems out of doubt that IL-6 receptor inhibitors can save lives in covid-19. But what about time spent in the ICU? The headline in the prerelease by gov.uk reads: “NHS patients to receive life-saving COVID-19 treatments that could cut hospital time by 10 days”. I would say yes for saving lives but no for cutting time spent in ICU. Table 2 tell us that there are no differences in “Organ failure free days” (OSFD) in survivors; 14 days (IQR 7 to 17) for patients treated with tocilizumab compared to 13 days (IQR 4 to 17) for controls. The conclusion must be that tocilizumab will save lives but unfortunately not un-crowd our ICUs.

On 2019-07-16 21:33:06, user David Ludwig wrote:

One correction and one clarification:

1. There are two errors (slight underestimates) in the upper bounds of the effect sizes in the abstract. The relevant sentence should read: “Estimated energy requirement was higher in the Low vs High group by models involving ITT (ranging from 181 [CI 8-353] to 246 [64-427] kcal/d; P<=0.04) and PP (ranging from 245 [43-446] to 323 [122-525] kcal/d; P<=0.02).” The data in Table 2 are correct.

2. The full database will be publicly posted upon final publication of the manuscript in a peer-review journal.