Epidemiologists

Predictions

• "We Should Ask the Modellers to Prove Their Models Can Accurately Predict the Future Before Following Their Advice Again,"

24 October 2021, Dr. David Livermore:

As to why these trajectories differ so much, I really cannot say, except for proposing that gonococci biologically ‘like’ being ciprofloxacin resistant whereas cefixime resistance stresses them.

Sometimes, for amusement, I’d ask the modellers why it was possible to write a program to outwit a chess grandmaster but not to reliably predict winners at a race meeting, even a tin-pot one with six nags per race, half of them no hopers. It ought to be easy for modellers to bankrupt bookies, I’d opine. Why don’t they? The answer was that horses were complex and unpredictable. Too many variables again, whereas the moves of chessmen are finite and follow pre-defined patterns. Our modellers lacked the temperament of betting men too, I felt, leastways with their own money. ... Medics, nurses, physios, medical lab scientists, and clinical scientists all must demonstrate competency to be licensed. There is no such regulation for modellers. Yet their advice, adopted by the Government, affects millions whereas a bad doctor can only harm one patient at a time. ... Examine the graph. Then, USING ONLY DATA AVAILABLE UP TO JULY 1891 (i.e., as far into the 1889-94 pandemic as we presently are with COVID) devise a mathematical model (not a qualitative speculation) to account for the peaks up to that date and to predict the size, timing and duration of the two subsequent peaks. Explain why there were no further peaks after 1894. ... In the meantime, let us have no more talk of lockdowns until modellers can prove their skills and competency by showing how the death waves of a previous pandemic could have been predicted accurately. They will find numerous relevant pre-July 1891 articles in the BMJ and the Lancet among other sources.

Expert Lying and Incompetence

• "Why Did It Take So Long to Accept the Facts About Covid?" NY Times, May 7, 2021:

A week ago, more than a year after the World Health Organization declared that we face a pandemic, a page on its website titled “Coronavirus Disease (Covid-19): How Is It Transmitted?” got a seemingly small update.

The agency’s response to that question had been that “current evidence suggests that the main way the virus spreads is by respiratory droplets” — which are expelled from the mouth and quickly fall to the ground — “among people who are in close contact with each other.”

The revised response still emphasizes transmission in close contact but now says it may be via aerosols — smaller respiratory particles that can float — as well as droplets. It also adds a reason the virus can also be transmitted “in poorly ventilated and/or crowded indoor settings,” saying this is because “aerosols remain suspended in the air or travel farther than 1 meter.”

The change didn’t get a lot of attention. There was no news conference, no big announcement.

Then, on Friday, the Centers for Disease Control and Prevention also updated its guidance on Covid-19, clearly saying that inhalation of these smaller particles is a key way the virus is transmitted, even at close range, and put it on top of its list of how the disease spreads.

There was no news conference by the C.D.C. either...

If the importance of aerosol transmission had been accepted early, we would have been told from the beginning that it was much safer outdoors, where these small particles disperse more easily, as long as you avoid close, prolonged contact with others. We would have tried to make sure indoor spaces were well ventilated, with air filtered as necessary...

Initially, SARS-CoV-2 was seen as a disease spread by respiratory droplets, except in rare cases of aerosol transmission during medical procedures like intubation. Countertops, boxes and other possible fomites — contaminated surfaces — were seen as a threat because if we touched them after droplets fell on them, it was believed the virus could make its way to our hands, then our noses, eyes or mouths...

The vast majority of transmission has been indoors, sometimes beyond a range of three or even six feet. The superspreading events that play a major role in driving the pandemic occur overwhelmingly, if not exclusively, indoors...

If the aerosols had been considered a major form of transmission, in addition to distancing and masks, advice would have centered on ventilation and airflow, as well as time spent indoors. Small particles can accumulate in enclosed spaces, since they can remain suspended in the air and travel along air currents...

In India, where hospitals have run out of supplemental oxygen and people are dying in the streets, money is being spent on fleets of drones to spray anti-coronavirus disinfectant in outdoor spaces. Parks, beaches and outdoor areas keep getting closed around the world. This year and last, organizers canceled outdoor events for the National Cherry Blossom Festival in Washington, D.C. Cambodian customs officials advised spraying disinfectant outside vehicles imported from India...

Meanwhile, many countries allowed their indoor workplaces to open but with inadequate aerosol protections. There was no attention to ventilation, installing air filters as necessary or even opening windows when possible, more to having people just distancing three or six feet, sometimes not requiring masks beyond that distance, or spending money on hard plastic barriers, which may be useless at best...

The United States has been a bit better, but the C.D.C. did not really accept aerosol transmission until October, though still relegating it to a secondary role until its change on Friday, which put the risk infection from inhaling these tiny particles first on its list of means of transmission...

In February 2020, after an infected person was found to have boarded the cruise ship Diamond Princess, hundreds of people trapped on board for weeks were infected, including 567 of the 2,666 passengers, who were largely confined to their rooms and delivered food by masked personnel — hard to explain solely with droplet-driven transmission. (Hitoshi Oshitani, a Japanese virologist who played an important role in his country’s response to the epidemic, said it was this ship outbreak that helped convince him this was airborne — and it’s why Japan planned around airborne transmission assumptions from as early as February 2020.)

Then there were the many superspreader events around the world that defied droplet explanations. In March 2020 in Mount Vernon, Wash., 61 pandemic-aware people showed up to a choir practice and sang with some distance between them in a large space, were provided hand sanitizer and left the doors open, reducing the need for people to touch the handles. But 53 of them were confirmed or strongly suspected to have contracted Covid-19 anyway, and two died. Long-distance transmission was being documented as well: One study from China in April 2020, clearly documenting transmission from beyond one meter, had video evidence showing the initially infected person had not come very close to those he infected, and there were no common surfaces touched...

Large-scale studies showed that more than 70 percent of infected people did not transmit to any other person, while as few as 5 percent may be responsible for 80 percent of transmissions through superspreading events...

None of this could be explained easily if the disease were “primarily transmitted between people through respiratory droplets and contact routes,” as the W.H.O. had said, since those larger, heavier particles would behave the same indoors as outdoors, would be largely indifferent to ventilation and would not be conducive to so much superspreading...

In July, hundreds of scientists signed an open letter urging the public health agencies, especially the W.H.O., to address airborne transmission of the coronavirus...

That month, after the open letter, the W.H.O. updated its guidance to say that “short-range aerosol transmission” from infected people in poorly ventilated spaces over time “cannot be ruled out” but went on to say that “the detailed investigations of these clusters suggest that droplet and fomite transmission could also explain human-to-human transmission within these clusters” and that close contact could still be the reason, “especially if hand hygiene was not performed and masks were not used when physical distancing was not maintained.”..

When reviewing airborne transmission, the group focused mostly on studies of air samples, especially if live virus was captured from the air, which, as mentioned above, is extremely hard. By that criterion, airborne transmission of the measles virus, which is undisputed, would not be accepted because no one has cultivated that pathogen from room air. That’s also true of tuberculosis. And while scientists, despite the difficulties, had managed to capture viable SARS-CoV-2 in three studies that I’m aware of, the review noted that the virus was detected only intermittently in general, disputed whether the captured live virus was infective enough and ultimately said it could not reach “firm conclusions over airborne transmission.”..

the initial public health report on the Mount Vernon choir case said that it may have been caused by people “sitting close to one another, sharing snacks and stacking chairs at the end of the practice,” even though almost 90 percent of the people there developed symptoms of Covid-19. Shelly Miller, an aerosol expert at the University of Colorado Boulder, was so struck by the incident that she initiated a study with a team of scientists, documenting that the space was less full than usual, allowing for increased distance, that nobody reported touching anyone else, that hand sanitizer was used and that only three people who had arrived early arranged the chairs. There was no spatial pattern to the transmission, implicating airflows, and there was nobody within nine feet in front of the first known case, who had mild symptoms.

• Dr. Eric Ding on Twitter, May 16, 2021, says:

"KEEP WEARING THE MASK—We card-carrying epidemiologists (with formal doctorate in epidemiology) know what we are talking about. Vast majority of 700+ epidemiologists surveyed says we would keep wearing masks for 1 year or longer. "

• 

"With Hugs and Haircuts, U.S. Epidemiologists Start Returning (Carefully!) to Everyday Life," NYTimes, May 12, 2021:

In a new informal survey this month by The New York Times, 723 epidemiologists in the United States responded to questions about their life...

The Centers for Disease Control and Prevention said that fully vaccinated people could gather indoors with other vaccinated people without precautions, but it did not specify how many households could do so at once. In the survey, a plurality of epidemiologists said they would recommend limiting such gatherings to two households at a time. But a sizable number said larger gatherings among vaccinated people were OK.

The C.D.C. has also said that people no longer need masks when they are outdoors and can maintain physical distance from others, like on a walk, regardless of whether they’re vaccinated. Most epidemiologists agreed.

“This policy was always idiotic,” said Joe Lewnard, an epidemiologist at the University of California, Berkeley, who supported maskless exercise.

• Ben Kaufman letter of May 12:

This article is illustrative of the fundamental mistake that has characterized all popular coverage of this pandemic. It needs to be clarified on what subject matter epidemiologists are more qualified to speak than the average lay person. Epidemiologists ARE more qualified to QUANTIFY risks of certain behaviors. Epidemiologists are NOT more qualified to prescribe what all of us should do with those risks. When it comes to assessing what is the appropriate amount of risk that we as a society should accept in exchange for certain elements of normal life, a medical expert's opinion is precisely as valid as that of literally any other person.

When news outlets publish headlines or write stories reporting that medical experts are "against" certain rollbacks of restrictions, these reports aren't necessarily "false" but they are absolutely misleading. Putting the risk tolerance opinions of medical experts on a pedestal conflates in what realms medical experts are in fact experts. Medical experts are really good at CALCULATING risk: (i.e., if X number of people do this, Y number of people are likely to get sick). But arriving at a consensus acceptable level of risk is a society-wide job, and unfortunately not one where an M.D. is a significant qualification. Accordingly, the fact that medical experts are more cautious as a group in their personal decision making, is no more relevant than if pipe-fitters happened to be more cautious in their personal risk tolerances.

Articles

• "The Failure of Academic Epidemiology: Witness for the Prosecution

Carl M. Shy American Journal of Epidemiology, Volume 145, Issue 6, 15 March 1997, Pages 479–484, https://doi.org/10.1093/oxfordjournals.aje.a009133