Coronavirus Sars-CoV-2/Covid-19 Megathread

[The Brain]

In 1720, ...

Powerful city merchants wanted the silk and cotton cargo of the ship for the great medieval fair at Beaucaire and pressured authorities to lift the quarantine.

I know you should always be an optimist, but I have to question their judgment here. Or did they also suffer a plague of re-enactors?

[Threviel]

In 1720... for the great medieval fair at Beaucaire and ...

[The Brain]

Yeay verily, thou snoozest thou losest.

[Sheilbh]

Someone posted a link to the city chronicle of Stettin of the 1830s from a Cholera outbreak. People were told to stay home etc. Lots of people lost their livelihood, people bought into rumors that the whole thing was a plan to eradicate the lower classes, and there were protests to reopen everything.

Plus ça change and all that.

I recommended it before, but this podcast with Richard Evans on the Hamburg cholera outbreak is really, really interesting:
https://www.talkingpoliticspodcast.com/blog/2020/231-from-cholera-to-coronavirus

[Eddie Teach]

I suspect they just mean it was a long-standing institution and not that it had an anachronistic theme. But still a curious turn of phrase...

[viper37]

The snob french are hating on Ikea. Such a cliché.

I've never even set foot in an Ikea.   

[viper37]

Pandemic science out of control

A toxic legacy of poor-quality research, media hype, lax regulatory oversight, and vicious partisanship has come home to roost in the search for effective treatments for COVID-19.

On September 14, 1918, in the midst of the worst pandemic in modern history, an article in the New York Times quoted Dr. Rupert Blue, then surgeon general of the US Public Health Service. Blue reported that doctors in many countries were treating their influenza patients with digitalis and the antimalaria drug quinine. There was no evidence that the two drugs were any more effective than folk remedies being used by patients, including cinnamon, goose grease poultices, and salt stuffed up the nose, but doctors were desperate and willing to try just about anything. They would eventually abandon quinine and digitalis as treatments for flu when studies showed they were not only ineffective but caused serious and sometimes deadly side effects.

Today, just shy of two months since the World Health Organization declared COVID-19 a pandemic, the media are once again flooded with cures, patients such as Michigan State Representative Karen Whitsett are being quoted with claims that hydroxychloroquine "saved my life," and doctors are prescribing drugs that have not been shown to be effective. Only this time, it's the twenty-first century, the age of "evidence-based medicine." Or so it might seem. But instead of no science to back up treatments, we now have bad studies being reported uncritically in the press, and Twitter storms of doctors, journalists, and researchers arguing about the ethics of withholding drugs from dying patients, even though we have no idea if those drugs do more harm than good.

If there is a silver lining to all the confusion, it is that this pandemic is exposing three persistent fault lines in medicine. First is the willingness on the part of clinicians to abandon the prime dictum of medicine, to do no harm, and rush into treatments that not only may not work but may well cause serious harm. The fact is, most physicians are not trained to recognize good science from bad. Nor do they have the time to analyze every study, and too many are willing to ignore the need for reliable evidence when fear sets in. Even in non-pandemic times, doctors often favor treatments that have long been in use, seem biologically plausible, are highly remunerative, or have been heavily marketed by manufacturers. In the case of two drugs now being used against COVID-19, hydroxychloroquine and remdesivir, there is a very real possibility that patients who might have recovered from the virus without them will be harmed or even killed by the treatment.

The second issue exposed by the pandemic is the role the media invariably play in hyping science and the physicians who purvey it without regard to the quality of the underlying studies. Some reporters are acting out of ignorance. They know less about good study design than the doctors they quote. Others report on faulty research because it is their business to hype the stock of drug and biotech manufacturers, which have been known to release spurious results of studies when those results favor their products. Whatever the reason, stories in the media help shore up claims of miracle cures made on the basis of poor-quality research.

Third, as has been disturbingly revealed over and over in the past decade or more, too much biomedical research simply isn't very good. Especially in times of crisis, statistically meaningless, methodologically shoddy, and even fraudulent research can find a receptive audience in desperate patients, credulous doctors, and uninformed journalists.

[...]

[The Brain]

Don't doctors operate under some kind of regulation? Seems weird that individual doctors should try to decide what works.

[grumbler]

I suspect they just mean it was a long-standing institution and not that it had an anachronistic theme. But still a curious turn of phrase...

Actually, that's what the fair is called, by some traditions.  I doubt the name goes back as far as 1720, though.  Still when one uses Wikipedia as though it were an authoritative source, this kind of anachronism is inevitable.

[Oexmelin]

https://twitter.com/thebushcenter/status/1256607729151619073?s=12

Dubya.

And, in an utterly predictable move,

Trump rips George W. Bush after he calls for unity amid coronavirus outbreak:
n an early morning tweet on Sunday, Trump called out Bush for his failure to support him as he faced an impeachment trial earlier this year over his alleged dealings with Ukraine. He cited apparent comments from Fox News anchor Pete Hegseth, who asked why Bush didn't push for "putting partisanship aside" amid the trial.

"He was nowhere to be found in speaking up against the greatest Hoax in American history," Trump said.

https://thehill.com/homenews/administration/495843-trump-rips-george-w-bush-after-he-issues-call-to-unite-amid?fbclid=IwAR0hNzGU3dHJtxylKBuJOZu2MzpwASeTjX2bzJp7UQT50DDsBHnfoCLA1cE

[Oexmelin]

Actually, that's what the fair is called, by some traditions.  I doubt the name goes back as far as 1720, though.  Still when one uses Wikipedia as though it were an authoritative source, this kind of anachronism is inevitable.

I have never seen it referred as that at all. I suspect this wording we see on the internet nowadays all stem from a single (English) source (whether Wikipedia itself, or amplified by Wikipedia). It was always called "the fair at Beaucaire" (la foire de Beaucaire, or by the name of its patron saint, "The Madeleine fair of Beaucaire". The current "medieval fairs of Beaucaire" is a yearly reenactment if the fair in costume (it's quite fun, and the town is lovely).

[Sheilbh]

I mean it's time you admit: the average opinion is right, the government did mess up the early phase.

And, some countries might be lifting the lockdown but they also started the lockdown 1-2-3 weeks ahead of us. Makes sense if we are in late. At least we can see how it works out for them.

I agree there could be some plans published but maybe people will start going out immediately once they know a timeline.

I think it's too soon to tell. The figure that matters is all cause excess mortality over the duration of this pandemic.  I don't think we'll know who has done "well" or "badly" for a year or two. At the minute we've clearly got probably the worst outbreak in Europe - but I think it'll be a while before we really know how bad it is here or elsewhere.

I don't think lockdown's a solution it's a policy failure because your initial plan failed. We seem to be going down the testing plus contact tracing route, which may be right - but it could be Sweden's right (hospital rates are now decreasing in Sweden, they seem to have peaked as well), if you have enough capacity - we didn't. So the real issue, I think is why the initial plan failed - which also depended on testing. The biggest issue to me seems to have been the failure to take advantage of an early lead on testing (which we had with Germany) and the reason for that from what I can tell is we centralised all testing until this month into a few hospitals and Public Health England, while Germany involved the private sector, universities, hospitals and are federal. That might have been a political decision, but over-centralisation strikes as too much the default position of the British state to rule out it just being an administrative decision taken by Public Health England or civil servants.

PPE I blame squarely on a decade of Tory policies - I also blame that (and their reorganisation of the NHS under Lansley) for the initial lack of capacity and fragmentation in the NHS. I suspect the decision to increase capacity by moving people to care homes (which is generally done but was sped up) when testing wasn't in place I feel was probably a political decision (it seems like they would have had to get sign off from the Health Secretary at least) and is probably the biggest failing. Aside from those I don't know what's the scale of mistake or where responsibility lies, with the politicians or the state/establishment - as I say I've not seen anything suggesting ministers were going against the advice they received and so many of the things I think went wrong were centralised and secretive and non-transparent, which is basically a description of the British state in general for the last 100+ years.

[PDH]

All I know is that if the rest of the country is reacting like California on the first two days of May then the next bloom is about...2 weeks away.

It is as if everyone thinks it is suddenly over.

[HisMajestyBOB]

https://www.youtube.com/watch?v=krW7CiVv3uw

[grumbler]

I have never seen it referred as that at all. I suspect this wording we see on the internet nowadays all stem from a single (English) source (whether Wikipedia itself, or amplified by Wikipedia). It was always called "the fair at Beaucaire" (la foire de Beaucaire, or by the name of its patron saint, "The Madeleine fair of Beaucaire". The current "medieval fairs of Beaucaire" is a yearly reenactment if the fair in costume (it's quite fun, and the town is lovely).

I didn't understand from what i read that there were, in fact, two fair (the actual one and the re-enactment).  My understanding was that it was all one big fair, referred to by the reenactment types differently.  It makes sense, I suppose, to keep them separate.