> Advances in medicine made iron lungs obsolete by the 1960s, replaced by ventilators. But Alexander kept living in the cylinder because, he said, he was used to it.
As somebody with a medical condition since birth, this line really hit home. I'm not speaking for Mr. Alexander, but for myself "used to it" is such a great way of putting the odd experience of living with frequent and cumbersome medical intervention.
On the one hand you have no choice so it is quite easy. You just do it. On the other hand there are often periods here and there through your life where you wrestle with the treatment, complain about it, explore other options, etc. But then a new option does come around every so often and, well, some times you stick with what you know even though there are "better" options.
"used to it" is such a disarmingly accurate way of putting it. It is simultaneously the most difficult and easy thing to do.
That line also jumped out at me. My understanding is iron lungs were only declared "obsolete" due to cost and mobility reasons, but the actual experience of an iron lung is better because it is less invasive and spreads the pressure more evenly over ones whole torso rather than forcing air into the lungs from the inside. In other words, an iron lung is more like actually breathing (and maybe that's how Mr Alexander was able to learn to breathe despite the prognosis).
yes I believe one of the videos of him expresses the better comfort the negative pressure has on his body somehow over the positive pressure contraptions he's used.
I remember a conversation in the 90’s about lung damage from over-inflation by dialing the volume incorrectly. They were talking about tech that was better at avoiding it, and thus the lung damaged caused by it.
That conversation stuck with me because I found it horrifying.
The field uses the term "barotrauma" for this. Ventilators use high pressure alarm limit among other things to limit the potential for barotrauma in volume-controlled modes. There's also flow-terminated modes which try to deliver a fixed volume but will terminate the breath if a flow criteria is met. The high pressure alarm limit can also terminate a breath early to try to prevent barotrauma.
Mechanical ventilation is very complex and has come a long way since the 1990's. The lung is an exceedingly complex organ, and breathing itself is an exceedingly complex bodily function that we largely take for granted until something goes wrong.
Suction devices also have their own horrifying outcomes. Someone told me a story once in the context of maximum vacuum limits of an EMT that was suctioning debris and fluid from an open brain injury and had the vacuum up so high they were vacuuming a person's brain tissue.
College roommate told of a history prof who worked for free. Plastic surgeon botched a lipo and caused muscle damage. Malpractice paid him enough to retire his board-flat ass.
He worked for free, or next to nothing, taught the curriculum he wanted to (can’t afford to fire him!). Apparently he brought high end audiophile speakers to school and played classical music on them when not lecturing. The kind that cost half a year’s salary for a teacher.
Many professors work for free… it’s called an unpaid adjunct position. You’d be surprised how extremely common it is- students paying a ton and the professors unpaid. Often they are doing it for experience hoping to move into a paid position someday, which are in short supply… or they have multiple jobs and the other one is related in some way and pays, but being a professor has advantages such as students that will work for you for free, and the ability to use the university’s name when writing grants and papers.
I knew a humanities professor that taught a heavy course load for years, and he and his wife lived off her paycheck serving food in the university cafeteria.
Sometimes getting an unpaid adjunct position can still be extremely competitive and hard to get. Academia is pretty weird.
This is something people don't seem to realize. Often you hear people talk about how difficult it is to be born blind.
Yet everyone I've ever spoken to that happened to has a simple answer: "not difficult at all. It isn't there". One put it like "I'm also not a tiger and can't jump 8 meters high. It's similar".
My best friend as a kid was blind and being a kid his acceptance of this used to bug the hell out of me. I often found myself in conversations trying to convince him he doesn't want to be blind.
But I remember asking him when we were teens and he me gave a really good answer about how he's learnt to interact with the world as a blind person so for him to be able to see it would a huge hinderance to him at this point – perhaps as much as me being blind.
He'd would need to read and write again. He would need to learn how to use a computer again. He might not like how his girlfriend looks. He would need reorganise his life and activities around the fact he can now see. Would he still be interested in doing the same things if he could see? Might he want to play video games instead of piano in his spare time if he could?
I think in a lot of cases it's not even just not knowing what you're missing, but it's also not worth hassle. If you're content as is then why change things?
I do wonder how much of that "not difficult at all" is just not knowing the difference. It would be interesting to see the difference in attitude between people born blind, and those who lost their sight later in life (old enough to have some solid sighted experiences and memories).
Just as sighted people take for granted a lot of things about their sight, I'm not surprised some blind people take many things for granted about their lack of sight -- even when they are negative, frustrating things.
While accessibility has come a long way, it still seems like it would be objectively more difficult to navigate the world blind than sighted.
> One put it like "I'm also not a tiger and can't jump 8 meters high. It's similar".
This makes a lot of sense, even if it's an imperfect analogy. Sometimes, if you have no experience with something, you won't mind not being able to do it, even if you know that a lot of other people can.
But if you look at it the other way: imagine a tiger with mobility issues that can't jump at all. Likely their life will be pretty limited, compared to most tigers.
I'm glad it seems there are (at least in your experience) a lot of people who are blind but don't consider it that big a hindrance. Ultimately what matters in life is that people are happy, and I imagine feeling like your life is constantly difficult due to something like blindness would reduce your happiness.
As a schizophrenia sufferer I discovered a curious statistic about the illness, there are no patients with schizophrenia who have been blind since birth. That fact is mind blowing to me, it seems to imply that blindness from birth creates a sort of immunity to mental illness.
> "used to it" is such a disarmingly accurate way of putting it.
This happens for medication too. If you're on a specific drug for your whole life, it may be disruptive to switch to a different medication even if it's notionally better. I take a pill every morning, and will for the rest of my life, would I prefer one I took every other day? Not really, it sounds like I'd just miss days sometimes. If it had fewer side effects? I haven't noticed any effects now, despite the list in the leaflet so "fewer" doesn't sound like a meaningful improvement.
In the first few days maybe even weeks of taking it I'd have been open to any improvements, but now I've settled into a habit, so any change needs a serious justification.
You've inadvertently described why most people hate software updates.
No, it's nothing as serious as chronic medical conditions and I certainly do not intend to make light of them, but the underlying motives are the same.
And the brain might be very sensitive (emotionally and to an extent physiologically) to stay in known condition when you're always walking a thin line.
I would say (from my own experience) it is a factor, but not the only one.
There are also enormous social pressures to stay in abusive relationships: people feel free to tell you you should stay in a relationship, that it can be fixed, etc. Very few people are willing to tell someone they should leave a relationship. So, what you hear is everyone thinks it should be fixed rather than ended.
There are many practical difficulties in ending a relationship too: financial, legal.
There are also many things in pop culture and media that can encourage it: normalisation of what are actually controlling behaviours, for example. The even "when you are right you are wrong" trope is just one common version of this.
Maybe because I was married? Maybe individuals you knew? Cultural differences?
Your profile says "chick" so most likely because people say different things to men and women. In general abusive behaviour by women is not taken seriously - in the UK handbook for the prosecution service it is even classified as "violence against women and girls" (although the text says men can also be victims) . Non violent abusive is not taken seriously even though "coercive control" is technically now a crime.
To piggy back on the same quote, I wonder if iron lungs should really be considered obsolete.
I used cpap for a while and fitting a mask to your face is just a total pain. The default ones would scab my nose, even with foam ones I had to strap is so hard to avoid leaks that it left red marks on my neck for hours after I woke up. You have the change/clean the masks. You risk problems like the recent Phillips one where a component was disintegrating, going into people's lungs and giving them cancer.
The iron lung not having to go over your face would avoid all of those problems so I'm surprised it completely disappeared.
Curious that the story doesn't mention he died of Covid – an infection that, you'd expect someone with his condition to be extremely keen to avoid, and who should have been able to, given reasonable precautions from his visitors.
Many people are asymptomatic, and not only that, are exposed by others who are asymptomatic. Short of every single human interaction being preceded by a PCR test, the odds are that he eventually would have been exposed.
It is easy to do an at-home nasal swab test when you are infected but before the viral load has gotten to the point of being highly contagious, at which point you think you are negative but really will soon become contagious.
"Reasonable precautions" would have to be very rigorous, and I have to imagine it would be easy to cave and relax precautions as loneliness sets in.
Reasonable precautions here were likely to be proper masking from visitors and adequate air filtering in the room. Not something too hard to expect from people visiting a sick person.
It's not like those "reasonable precautions" are guaranteed. I know a couple people who were absolutely terrified of getting Covid, such that they always masked with N95s and literally only would meet with people outside, 6 feet apart (probably the only time they were inside was with others at the grocery store, and when stores were enforcing masking) and they still got it.
I see this as an example of confusion between population-level and individual protection. Widespread use of N95s is great at keeping the hospitals from overcrowding, but if somebody is serious about personally avoiding COVID, 95% percent filtration seems rather low (and there's leakage around the sides too.) If they were truly serious about avoiding COVID, they'd use an elastomeric half-face respirator at the minimum (which has the bonus feature of being more comfortable to wear).
The N95 guarantees a minimum of 95% filtration at the worst possible particle size, which airborne virus particles are not.
The 3M 9210s I’ve been wearing since 2021 have been independelty tested as having >99.5% filtration efficiency at the relevant particle size, and that’s with physical testing so stuff like ability of the make to seal is also being tested.
They would never list healthcare on the general purpose version anyway, since there is a separate specific certification for that. The only difference is better fluid protection, which is irrelevant to the given threat model. They do indeed sell that.
"This healthcare N95 particulate respirator and surgical mask has comfortable inner materials and helps provide respiratory protection against certain airborne biological particles. The individually packaged, flat-fold design allows for convenient storage prior to use.
Fluid-resistant surgical masks help reduce your exposure to blood and body fluids. Cleared for sale by the Food and Drug Administration (FDA)."
> I recommend you to make IgG test for covid antibodies. Most likely you already have some
I've had Covid at least twice since this nightmare started, most recently in November 2023.
After both a chest x-ray and a CT scan in hospital eventually a Covid PCR test[0] came back positive and at that point the mood lightened and the doctors told me that a positive Covid test was "the good news" and to go home and rest.
I appreciate Covid is still a threat to some elderly and/or sick people. To the majority of us, it isn't ... and wasn't ... ever [1][2]
[0] Unwitting comedy moment from the (otherwise friendly and apparently competent) student doctor. Took my history very thoroughly, felt my glands, examined ears and looked down throat. All without her wearing any kind of mask. Then late on she decided to take a Covid swab, so left the small room that we'd been in together for 10+ minutes to retrieve swab and FFP mask, which she donned to swab my nostrils. Am afraid I giggled when I saw her go get the mask, had to tell a lie to avoid exposing the utter nonsense of fetching one at that stage :)
[1] https://twitter.com/d_spiegel/status/1241297511287046144?lan...
[2] https://twitter.com/d_spiegel/status/1271696043739172864
"Sir David John Spiegelhalter OBE FRS [..] is a British statistician and a Fellow of Churchill College, Cambridge. From 2007 to 2018 he was Winton Professor of the Public Understanding of Risk in the Statistical Laboratory at the University of Cambridge [..] He is currently Chair of the Winton Centre for Risk and Evidence Communication in the Centre for Mathematical Sciences at Cambridge"[0] He was invited to join SAGE[1] in April 2020 as a "scientific expert"[2]
I'm afraid at this point I'm obliged to quote Keynes: "When the facts change, I change my mind - what do you do, sir?"
Even if we assume that this paid blog is a legitimate alternative to peer reviewed research (it is not), the first article you cite starts with the below disclaimer, which seems to refute your claim.
> Note added 2nd May 2020. Some people seem to be interpreting this article as suggesting that COVID does not add to one’s normal risk. I should make it clear that I am suggesting that it roughly doubles your risk of dying this year.
The author, who you seem to consider an authority, has also written an entire book on COVID statistics. It's central theme seems to be contrary to your point.
The book is titled "Covid by Numbers: Making Sense of the Pandemic with Data". I've only skimmed it, but it seems to be well regarded.
> a legitimate alternative to peer reviewed research
I'm not sure that peer-reviewed research deserves to be put on a pedestal. I've worked in a research lab, I have a couple of [tedious and uninteresting] published papers. It's not a holy grail. We still employ humans to do this stuff, and they come with flaws. We also need funding for this stuff, and with it comes with warped incentives.
> the first article you cite starts with the below disclaimer, which seems to refute your claim
Why would it refute the claim?
If you double a very tiny risk, to all intents and purposes it may still be "very tiny", and irrelevant compared to other more significant risks (such as the increased risk of dying due to not having been able to attend your screening appointment because all non-critical healthcare in your area has been cancelled to "save lives", while achieving the opposite).
We can and should trust doctors at an individual level, but at planet scale we need to listen to statisticians too. That didn't happen during the pandemic.
It's pretty unfortunate if a "cure" ends up killing more people than the disease... and yes, there were people mentioning this concern already in early 2020, but apparently no-one was listening:
"A fierce debate is under way between those who believe that the current lockdowns in place across much of the world are an overreaction, and those who believe it would be barbaric to do anything other than try to avoid as many coronavirus deaths as possible. Those in the first camp [..] point out things like [..] the collateral damage from the lockdowns will end up causing more harm than coronavirus itself; and that the amount of money we are effectively spending on saving each life is completely out of whack with what we would normally consider reasonable."
> "I appreciate Covid is still a threat to some elderly and/or sick people. To the majority of us, it isn't ... and wasn't ... ever "
The fact that it doubled everyone's risk of dying disproves that.
I understand that it's unlikely for a young, healthy person to die in any given year but they should still wear seatbelts, or stop smoking if doing those things doubles their likelihood of death.
>I'm not sure that peer-reviewed research deserves to be put on a pedestal.
I'm unaware of any better alternative. Twitter and blog posts certainly aren't it.
>It's pretty unfortunate if a "cure" ends up killing more people than the disease
It would be pretty bold to make that claim. Do you have any reliable source to indicate that it was? I'm aware that many people speculated to that effect, often loudly. I've never seen any evidence though.
That said, the fact that this is Financial Times article kind of gives it away. It's reasonable (if a bit monstrous) to say that you think your income is more important than other peoples lives, but if that's what you mean you should state it plainly.
> We can and should trust doctors at an individual level, but at planet scale we need to listen to statisticians too.
I'm not sure I would agree with that statement. Statistics are like bikinis. What they display is important, but what they conceal is vital. To me, statements like this feel like another way of saying "There are things more important than human life."
> The fact that it doubled everyone's risk of dying disproves that.
It really doesn't.
> It would be pretty bold to make that claim. Do you have any reliable source to indicate that it was?
"Pandemics kill people in two ways, said Chris Whitty at the start of the Covid outbreak: directly and indirectly, via disruption.
He was making the case for caution amidst strong public demand for lockdown, stressing the tradeoffs.
While Covid deaths were counted daily, the longer-term effects would take years to come through. The only real way of counting this would be to look at ‘excess deaths’, i.e. how many more people die every month (or year) compared to normal.
That data is now coming through."[0]
EDIT - adding:
"COVID-19 lockdowns were “a global policy failure of gigantic proportions,” according to this peer-reviewed new academic study. The draconian policy failed to significantly reduce deaths while imposing substantial social, cultural, and economic costs.
“This study is the first all-encompassing evaluation of the research on the effectiveness of mandatory restrictions on mortality,” according to one of the study’s co-authors, Dr. Lars Jonung, professor emeritus at the Knut Wicksell Centre for Financial Studies at Sweden’s Lund University, “It demonstrates that lockdowns were a failed promise. They had negligible health effects but disastrous economic, social and political costs to society. Most likely lockdowns represent the biggest policy mistake in modern times.” "
and
"The Herby-Jonung-Hanke meta-analysis found that lockdowns, as reported in studies based on stringency indices in the spring of 2020, reduced mortality by 3.2 per cent when compared to less strict lockdown policies adopted by the likes of Sweden
This means lockdowns prevented 1,700 deaths in England and Wales, 6,000 deaths across Europe, and 4,000 deaths in the United States."
and
"The research concludes that, unless substantial alternative evidence emerges, lockdowns should be ‘rejected out of hand’ to control future pandemics."
I think we may just have different assumptions buried in the heart of our respective worldviews.
To me it is axiomatic that the value of a human life is not something that can be measured in dollars. All lives that can be saved, should be saved unless doing so would cost more lives.
To the "Institute of Economic Affairs" it's probably axiomatic that a humans only value is in their economic worth. The elderly that died therefore had little value in the first place. Their loss would mean little to that worldview.
When I see statements from the article like the ones below I see it as absolute proof that we made the right decisions, or at least something close to the right decisions. When the authors saw it they concluded that these lives were too expensive. A concept I find completely alien.
>Shelter-in-place (stay at home) orders in Europe and the United States reduced COVID mortality by between 1.4 and 4.1 per cent;
>Business closures reduced mortality by 7.5 per cent;
>Gathering limits likely increased COVID mortality by almost six per cent;
>Mask mandates, which most countries avoided in Spring 2020, reduced mortality by 18.7 per cent, particularly mandates in workplaces; and
>School closures resulted in a between 2.5 per cent and 6.2 per cent mortality reduction.
> If you were put in charge, how would you formulate policy for managing a resource-constrained health system?
I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own.
It is a big, complicated subject and just being generally clever isn't enough to qualify someone for that type of thing.
> Have you seen the excess deaths data for Europe 2020-2022?
I had not, and it's concerning.
I don't think it automatically counts as proof that covid interventions did more harm than the disease though. For example, I've seen other papers that suggest excess deaths are actually proof that covid deaths were wildly underreported, especially early on.
That and the paper you linked earlier are certainly enough to suggest we need more research to determine which interventions worked, and which didn't, with greater certainty. This won't be the last pandemic.
I may fully read the book by the statistician you cited earlier. I think he touches on the subject of those excess deaths a bit.
> I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own.
Like the UK NHS's NICE?
"The UK’s National Institute for Health and Care Excellence (NICE) is responsible for conducting health technology assessment (HTA) on behalf of the National Health Service (NHS). In seeking to justify its recommendations to the NHS about which technologies to fund, NICE claims to adopt two complementary ethical frameworks, one procedural—accountability for reasonableness (AfR)—and one substantive—an ‘ethics of opportunity costs’ (EOC) that rests primarily on the notion of allocative efficiency."[0]
"NICE’s use of ICERs, quality-adjusted life-years (QALYs) and the cost-effectiveness threshold as its preferred tools for decision-making, with some allowance for relevant social and ethical values, has been consistent since the institute’s inception"[0]
and as Karol Sikora said: "QALY [is] not a perfect metric, but it’s the best we’ve got"
"[NICE] guidelines are based on the best available evidence. Our recommendations are put together by experts, people using services, carers and the public"[1][2]
Sounds not unlike what you suggested ... and yet they've consistently used 'value for money' measures such as QALY.
Systems like this are necessary primarily because these programs are given lower priority than other government spending. If I were in charge the queen would've been buried in a pine box, and the money wasted on her funeral would've gone towards life saving medical treatments.
Any system that prioritizes anything above human health is fundamentally broken, and that's not the SME's fault.
That said, the world is finite and tough decisions do still need to be made. In those cases I would defer to the SME's. If they still thought a system like the above was necessary after being fully funded I would accept that, despite it being distasteful to me.
Cause of deaths is not described. If vaccines works, why productive population still dies in high numbers during winters? Why elders are dying in same numbers?
No, I am, first, being supportive of your repeated edits to uncover important details. No trolling -- thank you to dig into those references. Second, I was offering a sarcastic remark about other pseudo-medical topics that are frequently debated on this board. All kinds of Internet randos come out from the woodwork when "inflamation" or "natural foods" are discussed here. This place is great to discuss tech, but the discussions around legal, medicine, and economics are pathetic. All kinds of people trying to apply their nerd programmer knowledge to fields about which they know little.
A properly fitted mask shouldn't leak around the sides. The PFF2 (my country's equivalent of N95) mask I use doesn't leak anywhere when properly adjusted. (Like the sibling comment, it's a 3M, either the 9320+BR or the 9360H; see https://www.3m.com.br/3M/pt_BR/p/d/v000465595/ for its page complete with usage instructions.)
This is exactly why masking isn't as effective as it should be _in aggregate_. N95s aren't foolproof to use even for people who are trying to use them properly, then you have to add in the folks who pull their mask down to cough or to talk.
My favorite was the chin diaper. Particularly because the state I live in (idaho) never really had strict masking requirements so it really never made any sense.
I still occasionally see adults out in public wearing the chin diaper, or with the mask partially or mostly covering the mouth but not the nose at all.
I just don't get it. Why bother? Public outdoor masking rates even here (San Francisco) are anecdotally well under 10%. Why waste the time and effort (and in some places, social consequences) to do something like that completely ineffectively, when nearly no one else is bothering at all?
The "mask on the chin" allows one to quickly pull up the mask to cover the face, at the cost of potentially contaminating the inside of the mask (which then touches the face). The "mask not covering the nose" might be a badly fitted mask slipping down, or it might be the same case as the "mask on the chin" (allowing one to quickly pull up the mask to also cover the nose).
I know this is well known but still worth mentioning again I think. That the "regular" facemasks were primarily so asymptomatic people with covid would spread it less. 100% protection was never possible but anything to delay to spread so that not everybody was sick at the same time was necessary.
I think the global "everyone put on a mask" moment highlighted some large cultural differences.
My Asian friends understood that "not sharing germs" was as important as "not getting sick" mask compliance as much about being kind to others as to yourself. It also helps that lots of them were already socially accepting of masks due to climate, pollution and weather (or what ever you want to call dust out of Mongolia every year).
I think that there is an interesting corollary with PPE culture in general, one that has changed in my life time (safety glasses and seat belts). I think we saw a lot of that same behavior bleed out to normal people (who don't wear PPE at a day job) in action.
All in all there is a cultural aspects at play that are worth looking at.
Against COVID, you would probably get more bang for your buck by protecting the eyes with goggles or by choosing an elastomeric full-face respirator. Anything that lands in the eye ends up in a lacrimal duct, and then in a nasal passage.
If you stick a mask on a dummy in a lab and fire COVID at it, it might show pretty good protection. However, at the population level there is no evidence that masking confers any benefit in preventing the spread of COVID.
People wear N95s to protect against COVID transmission because they work. Yet every time the topic comes up online, someone is always quick to reach for the flawed Cochrane review.
> However, at the population level there is no evidence that masking confers any benefit in preventing the spread of COVID.
1) Several studies from India seem to contradict this and barely had enough statistical power to be useful.
2) The fact that we can't generate a masking study with sufficient statistical power does NOT disprove the hypothesis--either direction.
Citing your source:
"The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions."
This one REALLY grinds my gears. "Well the study said that masks don't work". No, it fucking didn't. It said they couldn't prove they worked given the data and quality of data they had. And the data was lousy as adherence by the general population was terrible.
Things can work and still not be provable--especially when the experiment involves human beings since morally we can't just create two groups and infect one.
Here's your counterexample: take a look at what hospitals are still doing when handling Covid patients. Hospitals get to collect data and enforce adherence. They absolutely do not want to transfer Covid between patients. And they do not want to transfer Covid to their staff as that throws things into disarray. Whatever they're doing seems to be working. I had a stint in the hospital recently, and they had several Covid patients on my floor--they weren't isolated to a specific wing or anything anymore. The hospital managed to not give Covid to me, so something they are doing is working.
So, what that suggests is that procedures and masks work just fine. What seems to be problematic is lack of adherence to said procedures and masks.
Basically, what all of these studies manage to prove is that the general population has enough non-compliant dipshits that active interventions don't work at the population level. Consequenctly, vaccines and other passive interventions that take into account the stupidity of the general population are required.
>>This one REALLY grinds my gears. "Well the study said that masks don't work". No, it fucking didn't. It said they couldn't prove they worked given the data and quality of data they had.
So you admit people were calling for mask-wearing with no evidence. Sounds like we agree.
>>Things can work and still not be provable--especially when the experiment involves human beings since morally we can't just create two groups and infect one.
You don't have to infect one. Just see which one gets infected. This happens all the time with vaccine etc testing of have thought.
>>Basically, what all of these studies manage to prove is that
the general population has enough non-compliant dipshits that active interventions don't work at the population level
It sounds like we're pretty much in agreement here as well. Unless you have some magical solution to ensure perfect adherence.
Of course, you may be super-diligent as an n=1 and nobody ever sneezes on you without warning or anything and you stay free of a disease the CDC says should be treated like the flu.
And the other name for "non-compliant dipshits" is "children".
>>Also doesn't claim what people like you says it claims.
By people like me, you mean people who believe in science? This is what it claims:
"Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness (ILI)/COVID‐19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants; moderate‐certainty evidence. Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza/SARS‐CoV‐2 compared to not wearing masks (RR 1.01, 95% CI 0.72 to 1.42; 6 trials, 13,919 participants; moderate‐certainty evidence)."
>>Also, look at the history. Date of the original review is 2007. You know what didn't exist in 2007?
I don't see the point of your comment. You're presenting an anecdotal case where someone who took some precautions which are known for not being 100% effective against airborne diseases ended up contracting an airborne disease.
It makes as much sense as ranting about wearing seatbelts because you can put together an anecdotal case of someone who got hurt in a car accident in spite of wearing one.
What's the point of that sort of argument, really?
The point is that even with reasonable precautions, it is (and was) possible for the man in the iron lung to be exposed to COVID.
The actual precautions necessary to protect him from any exposure at all would have been significantly more stringent than what people tend to believe are reasonable, as GPs anecdote demonstrates.
The problem here is what people believe are reasonable and what is actually reasonable are pretty far apart. COVID will cripple you for the rest of your life if you're unlucky. Chance of that happening increases greatly with each infection. It is not the flu! It's not a cold!
Certainly in any medical context, *everyone* should be wearing N95s (at minimum). This should in particular not be optional for anyone calling themselves a medical professional or working in a medical office. This should not be controversial; it's basic preventative care.
For particularly sensitive people like this gentleman was, more substantial protection should be employed. Facemasks. Superior air recirculation.
The science on this is not controversial. Masks work. Denying that only shows you have fallen for the soundbites and not read the actual studies. For one thing, most of the ones usually cited are testing, with loose controls, surgical style masks for the flu, which has both a different particle size and far lower infectivity than Covid.
You can get home tests that are similar to PCR. They are more expensive but the performance of the antigen tests since about 2022 is so bad that they’re almost useless.
There is no "since 2022"--they have performed at relatively the same level to date. They just are not perfect and are unlikely to prevent the kind of non-symptomatic exposures people have, but in most cases, they are good to quickly differentiate a random sore throat from a COVID-related one.
No the performance is worse with newer variants. One factor seems to be that newer variants tend to replicate a lot in the throat at first and only later move to the nose, but there is probably more than one reason for the change. In 2021, the antigen tests were pretty sensitive if you were symptomatic, but now the false negative rate is 50% or greater if you're on your first day or two of symptoms. They perform better a few days later.
The problem is that people will have symptoms consistent with covid and they're going to visit grandma or whatever, so rather than just cancel, they take a test, the test is negative, and they go do their thing. IMO going just based on symptoms is more reliable at this point unless you're using a molecular test.
When you say, "so bad", you mean in terms of sensitivity? They seem to be sufficiently selective, but under-sensitive. So, not great for risk aversion.
So the tests are good as confirmatory devices. But yeah, it was extremely unserious when they were used to gatekeep public events, etc. The reasonable presumption has always been that transmission of respiratory pathogens will occur at public events (which is a strength: humans are quite good at quickly acquiring community immunity - it's one of the reasons our species is so incredibly robust against respiratory pathogens).
That is a point of view. In terms of gatekeeping public events, requiring a negative test certainly is going to reduce the number of people who show up with covid, but with only antigen tests, you're reducing the risk maybe 50-60% or so. If you're going to require people to do something annoying, it would be a lot better if the risk reduction were more than that.
When you say "humans are good at quickly acquiring community immunity", I don't really think we've done that with Covid. Covid is still over 2% of all deaths in the U.S., and it's causing way more disability and injury. We won't truly know what it's done to us for years.
> Covid is still over 2% of all deaths in the U.S.
The presence of a particular pathogen (or for that matter, any phenomena) coincident with death is not a meaningful metric.
Nearly 100% of human deaths involve a person with a belly button.
> and it's causing way more disability and injury
While it's important and long past-due that post-infection syndromes are finally getting the attention they deserve, there is no evidence that this particular coronavirus is different from other four endemic coronaviruses (and several other pathogens) in this regard.
> The presence of a particular pathogen (or for that matter, any phenomena) coincident with death is not a meaningful metric.
This is where Covid is listed on the death certificate as the primary cause of death. Everyone that dies of cardiac arrest or cancer also has a belly button.
> While it's important and long past-due that post-infection syndromes are finally getting the attention they deserve, there is no evidence that this particular coronavirus is different from other four endemic coronaviruses (and several other pathogens) in this regard.
Generally there hasn't been all that much research on post-viral syndromes. To some degree that's because they don't obviously affect so many people. It could very well be that other viruses are the cause of more conditions than is currently appreciated though. Certainly the Epstein-Barr/MS results could be the tip of the iceberg. Regardless of what other viruses do, it's looking to me like Covid is likely to be pretty bad long-term, but we won't know for sure for 30+ years I suppose.
> This is where Covid is listed on the death certificate as the primary cause of death. Everyone that dies of cardiac arrest or cancer also has a belly button.
Where are you getting death certificate data for 2023? I can't seem to find it yet.
If you are looking at WISQARS coded deaths, then I imagine you are already familiar with this critique:
If SARS-CoV-2 disappeared magically tomorrow, do we expect overall mortality to suddenly decrease by 2%? Of course not. The deaths will just go back to being coded with their prior ICD-10 code. For example, multiple myeloma deaths caused by respiratory distress will go back to the C00 series.
But getting back to the broader point: even in the worst reading, even falling to 2% of all deaths for a deadly respiratory pathogen shows pretty good immune robustness. Some influenza is so lethal to some birds that it becomes the only cause of death for an entire flock, causing a 90% mortality rate. No other species communicates immunity across subpopulations as fast as humans.
As far as the mortality data: the change in practice to code deaths as resulting from a particular coronavirus seems like a good evolution in terms of data richness. But to clarify what it means for population mortality, we'd need to do it for other infectious pathogens, not just SARS-CoV-2. To continue the example, if HCoV-HKU1 is the pathogen resulting in lethal respiratory distress for a multiple myeloma patient, than it makes just as much sense to code that death HKU1 as it does for a patient who does from respiratory distress from COVID-19 as COVID-19.
> Everyone that dies of cardiac arrest or cancer also has a belly button.
Many of those also have COVID-19. And of those, some are coded as COVID-19 and some are not. If a person is infected with a coronavirus and dies from cardiac arrest, is it properly understood as a coronavirus death? Prior to 2020, the answer was always "no" (in fact, there was no ICD-10 code available for this (and to my knowledge, there won't be any deaths coded for coronaviruses other than COVID-19 in this year's dataset either)). But now, the answer is "yes" for only one of the five endemic coronaviruses. The data needs to catch up to the reality in order to have an actionable picture of population mortality.
> Generally there hasn't been all that much research on post-viral syndromes. To some degree that's because they don't obviously affect so many people. It could very well be that other viruses are the cause of more conditions than is currently appreciated though. Certainly the Epstein-Barr/MS results could be the tip of the iceberg. Regardless of what other viruses do, it's looking to me like Covid is likely to be pretty bad long-term, but we won't know for sure for 30+ years I suppose.
Hopefully the crazy dearth of research on this topic is something that the COVID-19 pandemic will have changed for the better. It's about time.
> it's looking to me like Covid is likely to be pretty bad long-term, but we won't know for sure for 30+ years I suppose.
Given the unavailability of data on the matter, I'm not sure how you can draw that conclusion. Are people reporting post-viral syndromes following COVID-19? Yes. Are they more frequent than with the other four endemic coronaviruses? We can't know, because we've never tracked this before. But we do know that what we have suddenly started calling "long covid" has been known to science for decades (and can be evinced by searching, for example, "{hku1|oc43|nl61} cardiovascular" on Google Scholar).
And sadly, I don't know that we'll really know much better in 30 years. Hopefully we'll understand more about the prognosis, and have some treatments. But distinguishing between the post-infection syndromes of the five endemic coronaviruses might be impossible.
Your lack of COVID is certainly largely due to being purposeful and careful, but there's still a component of luck. The only sure-fire way to avoid it is to stay locked up and away from all other humans and things other humans have potentially breathed on. Anything less and there's always a decent chance you'll get it despite your precautions.
Also, you may have gotten it, were asymptomatic, and didn't notice. COVID is fun like that.
You can. But that still doesn't tell you if you've had COVID. Antibodies wane overtime and you can also test positive for antibodies after having had a vaccine. So even if you have been taking antibody tests every couple of weeks year now, you could have contracted it before the tests were available (it was about a year before they were publicly available in much of the US), or after a vaccination.
Depends on the test. The right test can tell the difference between the set of vaccine antibodies and the set from an actual infection. Vaccine only creates antibodies that target the spike protein structure. I participated in a study and got updates every six months.
Just because they can't be certain that they'll never get it in the future doesn't mean that all attempts to minimize cumulative infections are pointless.
Masks and procedures are effective but not 100%. I was religious about masking and distancing and hand washing and still got Covid Original Flavour(tm). Fortunately, I did quarantine after getting back from my travel (required: had to shut a house down) before even knowing I had Covid so my elderly relatives didn't get it from me.
Quarantining is very effective but is really inconvenient. You can't get every single person who wants to interact with you to quarantine for 14 days prior unless you are super important.
The reason might be simply that the cause of death isn’t widely confirmed yet, and BBC News (more so than most other news organisations) likes to err on the side of caution.
The Guardian article from May 2020 which others have linked (https://www.theguardian.com/society/2020/may/26/last-iron-lu...) has more information on his life than this BBC one and his thoughts on the present pandemic. Given that his death was recent, I too am curious as to whether there are any further details on his acquiring the illness but suspect there may be little to report on. If you read the Guardian article he is not apathetic at all but expresses a sense that it will likely be what finally gets him.
I think for certain people with an extreme illness or vulnerability like this, it's reasonable to still be very cautious in 2024. You'd probably also be very cautious about cold and flu.
I have purposely avoided getting covid by being covid conscious in modern society despite having been exposed by using n99 masks, HEPA filters that circulate air 4x per hour, and only eating at resturaunt patios when they aren't busy.
It is possible for the support staff to follow all the rules that they were given and yet still unknowingly transmit COVID-19 to their vulnerable patient
> It is practically impossible to avoid catching covid in modern society.
For the average human going about an ordinary and active life that statement is quite true.
However, the person in question didn't lead an ordinary life. He was confined to a medical device and probably very rarely had in-person contact with random people. Besides, the people who met him personally all must have known about his condition.
Under such circumstances avoiding COVID-19 is actually pretty easy: Have everyone in the room wear high-quality face masks.
Even for the average person during the height of the pandemic, avoiding COVID-19 was still possible, but required significant effort (no lockdowns though, mind you): Basically, it meant wearing such a mask properly in public settings (and changing it at appropriate intervals) as well as frequent testing of everyone you were in touch with regularly.
N95 / FFP2 masks are sufficiently effective (if worn correctly) to reduce the likelihood of getting infected to the extent they effectively prevent infection on a personal level.
There's of course still a small chance of contracting COVID-19 in spite of wearing a mask, which is why for society at large masks only slowed down the spread at best. For the individual person by and large the probability for getting infected is negligible, though.
This precisely what those - quite heated - arguments (and pertinent studies) regarding masks being not effective at all were about: Masks are highly effective on a personal level; for preventing community spread their usefulness is limited.
Here, we report on a 62-year-old male hypervaccinated individual from Magdeburg, Germany (HIM), who deliberately and for private reasons received 217 vaccinations against SARS-CoV-2 within a period of 29 months (figure A; appendix 1 tab 1).
[snip]
Furthermore, HIM had no signs of a past SARS-CoV-2 infection, as indicated by repeatedly negative SARS-CoV-2 antigen tests, PCRs and nucleocapsid serology (figure A; appendix 1 tab 1).
You can't make a half-counterfactual comparison like that because the COVID rate may have been impacted by the lockdown.
Assume, for the sake of argument, that lockdowns worked smashingly well. Then, you'd see a) very few COVID deaths and b) relatively more "side effects". That is exactly what you're using to argue that they didn't work.
Any minor sniffles could have brought down a 78 yo with major comorbidities and who’s been immobile for a significant portion of his life. Heck any case of the sniffles can bring down many healthier 78 year olds.
I’d suggest instead focusing on that this man managed to live a fulfilling and accomplished life in what I would be terrified of being in for even one day.
Rest in peace sir. You are not a cultural war bargaining chip.
False. Every step you take is a risk reduction, there's no magical solution that completely removes risk unless you want to live in a completely sealed environment, and even then you need to exchange with the outside world. A 78 year old man with a serious health condition died of a common infection, this is normal and nothing to moralize about or throw around blame and shame.
The positive pressure keeps airborne contaminants away from the wearer. The germs off of the researcher in the lab as it were. I'm not sure how it would prevent contamination from getting on people outside the suit?
Seems like a real problem to me. On average around 1,200 people die from COVID in the US every week, including the guy in the article that started this conversation.
It wasn't funny, then. At least make a farcical suggestion that would actually help, not make the problem (farcical or otherwise) worse.
I do agree with the overall point that it's likely not really anyone's fault that Alexander eventually got COVID. Being perfect 100% of the time isn't feasible for anyone, even people in health-compromised situations.
> Maybe our medical professionals should be wearing PPPS[1] at all times, hmm?
I'll bite your fallacy.
Scabies are prevented by avoiding direct skin-on-skin contact. Wearing latex gloves is already effective, as is routinely changing clothing and bedding.
Is any of this something you feel is outlandish for a health professional working on hospitals and retirement homes?
> Wearing latex gloves is already effective, as is routinely changing clothing and bedding.
Both of those things are done already and yet scabies still spreads in these environments like wild. You say that it's effective, but in actuality it isn't -- you can be so careful but all of the small mistakes add up.
That's the point. I'm suggesting a farcical solution to a farcical problem...that we need to go so far above and beyond from what's already being done in these environments.
The whole point is that it's useless and acting like this man's caregivers killed him like my comment-parent did is wildly misplaced blame.
You say this as if it is established fact, but there has been no RCT convincingly showing the effect you are describing - typically called "source control" - can be achieved from the use of a respirator to interdict individual transmission. In fact, no RCT powered for such a finding has even been attempted to my knowledge (though I haven't combed through the research in the past couple months or so - link me if I'm out of date!).
It has also not been demonstrated that source control can be used to reduce community transmission (though I realize that your point is not about community transmission).
The reasons for not funding / performing such a RCT continue to astound - the demagoguery of comparing masks to parachutes notwithstanding.
RCT is unlikely to be a good tool to determine the effectiveness of masks, if for no other reason, compliance is marginal at best (how do you recognize &record every instance when someone pulls it down for a short time exposing their nose or both airways?).
Perhaps the best evidence that even badly used masks are effective is that measures such a using masks for a year killed every instance of a strain of flu - deas, gone, extinct.
Just by reducing the R0 value to the point where there were no survivors. (but not enough that more virulent COVID-19 strains couldn't survive).
Masks, particularly N95-level, work. Period. Not perfectly, nothing does. But they work. Regardless of any FUD you may want to spread.
>> RCT is unlikely to be a good tool to determine the effectiveness of masks, if for no other reason, compliance is marginal at best (how do you recognize &record every instance when someone pulls it down for a short time exposing their nose or both airways?).
But this is exactly the point, surely? If people won't comply in an RCT, they won't comply in real life either and so mask wearing will have no benefit.
It just tells us that people probably need to comply more, not that we shouldn't bother with certain interventions. Suggesting we shouldn't try mask mandates because not everyone complies is like suggesting you shouldn't have laws about piling bags of trash on your lawn because some people still pile trash on their lawn. The real problem is the people who feel that "take your trash to the dump" is an imposition and resent having to do something to help the community around them.
Yes, perhaps someone could develop a new kind of glue that will enable them to be stuck to children's faces so they can't be removed.
I don't think that getting the levels of compliance required is possible, absent civil liberty abuses which are worse than the disease we are trying to cure.
Yes, it should be strongly encouraged in crowded places, not discouraged.
As to "You First", I still do avoid random crowds and I wear an N95 when I do go out in random crowds, including the last time I went to the grocery store. I'm not the only one I see doing that ('tho it is far less common than a year ago).
But sure, you do you, because evidently your approach to life prioritizes your immediate gratification, and doing nothing that might help the general welfare, or help everyone (even you) in the longer term.
I am disgusted by the totalitarian urge which has been normalized by the pandemic. Your trauma is not my problem, and I will not permanently alter my behavior to satisfy your ever-escalating urge to dominate me.
You think that having no public health measures is data driven? Go read some data. Seriously. Or, just go to pre-1950s graveyards and gather data on how many dead children there were before public health measures. Or look at the data on how the public health measures ran extinct a strain of flu so it is no longer being included in the vaccine formula.
I don't see anybody advocating for no public health measures - perhaps you might consider that the views of others are as nuanced as yours.
> Or, just go to pre-1950s graveyards and gather data on how many dead children there were before public health measures.
Indeed! But this doesn't mean that every measure undertaken was reasonable or evidence-based. Germane to the thread at hand: at the height of the polio epidemic, some states sprayed DDT in a bizarre and mistaken belief that it was likely to reduce transmission of the virus. As with lockdowns and masks and surface 'disinfectants' and other unproven measures today, this happened over the objection of a chorus of experts who had already begun to unearth the fecal-oral route of transmission of polio.
Yes, in retrospect, this seems silly and trivial. But at the time, it must have been very frustrating to spend your life (or even your hobby time, as I do) studying public health only to have a hairbrained idea with no empirical basis become the framework on which policy was decided.
> Or look at the data on how the public health measures ran extinct a strain of flu so it is no longer being included in the vaccine formula.
I... presume you are talking about the B/Yamagata lineage of Influenza B?
Nobody knows why this lineage disappeared, and anybody who claims to is trying to sell you something or influence you.
One exciting prospect is that it is the result of viral interference, a phenomenon frequently observed but not yet understood, and potentially the basis of future immune therapy.
In any case, the disappearance of a particular lineage of Influenza B or of H3N2 (which of course is the current endemic influenza, but began as an epidemic subtype in the 1960s) is not an overall public health win or loss; it just means that other lineages (in this case, B/Victoria) will present the endemic strains in future years unless B/Yamagata re-emerges.
EXACTLY, the Flu strain had a lower R value than COVID-19. So, the experiment has been done, proving that masks work as expected, even badly implemented.
Two different airborne diseases, F and C, with R0 values under unprotected conditions of something like F=3 and C=9, and masking very badly implemented [0,1,2,3,4]. The results are that disease F went completely extinct, but disease C was slowed in areas with better compliance, but still persevered, and mutated in favor of better-spreading strains such that the unprotected R0 of current strains is ~15.
This unequivocally shows that there is a real public health benefit to simple measures of using N95 masks, and strongly suggests that better implementation (e.g., full supply and broader use) would improve containment, reducing cases, and reducing the rate of cases, allowing for better treatment.
There is no requirement that the measures be perfect, indeed it is a multi-layered approach that works for public health, due to the dynamics of disease.
>>Again, listen to me. I'm not telling you merely that I disagree with you. I'm telling you that you have no power over me, and you never will.
Yes, that was evident from the beginning, and you've confirmed it.
Your attitude has nothing to do with actual science, and everything to do with serious ignorance about how public health works, a hard unwillingness to help your fellow citizens, hostility to anyone who might slightly inconvenience you, and a misguided idea of "muh fredumbs' mixed with entitlement.
The fact is no one GAF about controlling you; you are just not that important to anyone but you (I'm not either, and contrary to your assertion, IDGAF abt "controlling" you either).
Wearing N95s is no different a safety measure than hard hats or steel-toed shoes on a worksite, or seat belts in a car or airplane. If you think that is somehow an affront to your manhood or whatever, shows you have real issues. Seriously. Perhaps you will learn to join society as a contributing member and stop acting like a spoiled petulant child. We can all hope so.
[0] WHO and CDC failed to emphasize the importance of N95-quality masks, likely in an effort to preserve limited stocks for the healthcare workers (they knew N95s work)
[1] the supply of N95-level masks was constrained so many people used only makeshift or lower-quality masks.
[2] many people were very lax about using masks, consistently failing to cover their nose, or just wearing them as a 'chin-diaper' to comply but not really.
[3] a significant part of the population turned it into a misguided political event, adamantly refusing to wear masks and belligerently intimidation others and businesses to not wear them and not require them.
[4] inconsistent measures implemented in different countries, some much stronger and some much weaker.
Yikes, Pandemic public health measures are NOT totalitarian in any way, shape or form.
Totalitarian measures are "TOTAL"; i.e., they encompass all aspects of govt and society.
Public health measures are LIMITED to the scope of the public health threat.
Being unwilling to take even small measures that not only help you but also help your fellow citizens does not make you some kind of 'free-thinking libertarian'.
It simply shows you like to behave like a sociopath, and your statement that a policy idea is a result of "trauma" is an uncalled-for insult, as you intended it (which again shows your drive to prioritize feelings over facts). Seriously, no one is trying to "dominate" you. As if you were that important. Sheesh.
It's not totalitarian. How do you feel about having a sewer hookup or a septic system in your house? Because those things were largely mandated and not by grassroots. With that kind of attitude we'd all be crapping in outhouses and standing in our own poop within a decade.
I agree with reasonable limits to public power, but I think data driven public health approaches are an area where the public should have a lot of power. We've eradicated things like hookworm in part because we have asked people to put shoes on their children and stop pooping in holes in the ground.
In an unlikely turn of events, you appear to be an actual human and not a bot (from a cursory look at your comment history). So I say, gently:
> because evidently your approach to life prioritizes your immediate gratification
Do you genuinely believe that this is a fair characterization of the sentiment of the person (or position) to which you are responding, giving the benefit of the doubt?
> Yes, it should be strongly encouraged in crowded places, not discouraged.
It boils down to this: encouraging an intervention in public places needs to be based on unambiguous evidence, supported by genuine, authentic science and presented in a way that is convincing to a scientifically-literate society such as ours.
Consider, for example, the evidence in favor of the use of seatbelts, condoms, traffic-calming infrastructure, or hard hats (the latter of which I acknowledge don't require RCTs to be validated).
These products have produced a reliable, measurable, significant change in outcomes to the extent that no reasonable person questions their efficacy impact (though even with these, there is some reasonable dispute regarding trade-offs in each case).
The intervention in question has fallen way, way short of this standard - so much so that it's difficult to make a viable comparison. Despite mandates across a literal majority of geographic landmass of the country, there is still no evidence of any benefit with regard to community transmission rates. And on the research side, only nine RCTs - and none at all regarding source control - have been conducted.
We've watched as a huge chorus of the world's experts have called for RCTs, and have been told by charlatan bureaucrats and profiteers that such a venture is comparable to a parachute RCT. Do you think that's likely to be convincing?
Meanwhile, the (typical, expected, obvious) extrapolation in the Cochrane review has been singled-out, and the waters muddied, for pointing out in sober terms what the RCTs actually said.
It has been reduced to "well, absence of evidence isn't evidence of absence", creating an obvious catch-22 as the same data is puzzlingly used as an excuse not to perform further science on the matter.
Believe me when I say: we care about you. I wish you good health and am happy to take evidence-based steps to ensuring that the world is a healthy, vibrant place for you and people like you. But you go too far when you ask that others to ignore their own good-faith assessment of the facts at hand. And the facts are unambiguous: respiratory pathogens emerge every so often and infect nearly all members of many animal species. There does not appear to be a viable intervention to stop this, and it's not even obvious is stopping it is desirable, as these pathogens confer immunity to those infected. It's an equilibrium and part of a broader ecology in which we live.
You are loved, even by this stranger. Please don't see commitment to data-driven approaches to public health interventions as a hunger for immediate gratification; this is nearly the opposite of the reality of the situation.
What data do you have that say that my comment is likely to be a bot? (genuinely curious)
As I first mentioned, Random Controlled Trials are unlikely to be the best measure for this.
>>encouraging an intervention in public places needs to be based on unambiguous evidence, supported by genuine, authentic science and presented in a way that is convincing to a scientifically-literate society such as ours.
>>These products have produced a reliable, measurable, significant change in outcomes
Yes, true for those products and also for the intervention of wearing N95 masks (I fully agree that other masks are basically placebos).
Again, the most convincing evidence of the effectiveness of mask intervention is that despite crazy levels of anti- and poor-compliance, and limited availability of N95 masks, we drove extinct an entire lineage of another airborne disease, simply by taking small measures that reduce R0 of airborne pathogens. It was not even the target, just collateral damage.
>>to the extent that no reasonable person questions their efficacy impact
This is a nice to have but definitely not necessary qualifying criteria. And, with every one of the measures you mentioned, there were and still are people who claim to be unconvinced. It is kind of what leadership is about - moving the comfort zone to a better place.
>>hunger for immediate gratification
Watching the anti-mask / anti-vax attitudes, especially when they are expressed as some kind of fear of state power over the individual, I'm sorry to say that the most fundamental basis I've seen for that is freeloading and entitled hostility to inconvenience or needing to care about others in society.
They refuse to undertake a minor inconvenience to what will help them and everyone else in society, and in doing so, freeload on the herd immunity or reduction in R0 maintained by their smarter peers. Valuing your own convenience over everyone else's health maybe isn't best called "instant gratification", but it isn't far off. If you have a better suggestion, let me know.
Thx for the love; same to you. I'm all for data-driven approaches to public health interventions; sadly many of those who oppose them are not data driven, but have other motivations, and disguising those as "data driven" does not make it so.
...this link is not a new RCT. It is an article about the Cochrane review which we all read a long time ago.
And, despite the (somewhat reasonable) chagrin expressed by the authors, the Cochrane review did indeed show that masks are largely ineffective (and cloth masks, completely so) at stopping viral transmission - the link is right there in the article to which you've linked.
What we need are sober, old-school RCTs powered to assess both filtration and source control across individuals (and sure, some for community transmission as well). And then we need them replicated. And then we can finally stop this ridiculous 'debate'. Today's humans are the most scientifically literate society in history; there's no reason we need to make important social and political decisions with such shitty data.
First, as the sibling comment pointed out, the Cochrane review article didn't show that masks were ineffective. "Relatively low numbers of people followed the guidance about wearing masks or about hand hygiene, which may have affected the results of the studies" [1]. Their results were inconclusive since the people the asks to wear masks, didn't.
But there's still evidence that masks are effective. The question of whether N95 filter media can block virus-carrying droplets is a _physics_ question-- which has been replicated in experiment after experiment since the 90s ([2] is a recent study).
I've done a lot of looking, but I've yet to find any explanation as to why if someone is wearing a (properly fitted) N95, so their air goes through a filter media, which has been repeatedly shown to block droplets, they could still inhale disease-carrying droplets.
> I've yet to find any explanation as to why if someone is wearing a (properly fitted) N95, so their air goes through a filter media, which has been repeatedly shown to block droplets, they could still inhale disease-carrying droplets.
It's worth keeping in mind that even if someone wearing an N95 mask does manage to inhale some percentage of the airborne disease-carrying droplets around them, viral load matters a lot. A tiny amount of virus could be fought off by the immune system before it has a chance to take hold in the body, and even if that fails and the virus does infect the body, larger exposures tend to result in worse outcomes. Even an imperfect protection can have a beneficial effect.
It's the same for people spreading the virus. Even if a mask isn't perfect, that doesn't make it useless. Putting just about anything in front of someone's virus spewing face holes is going to reduce the amount of virus that gets into the air and limit how far it spreads. This is why we teach small children to "vampire cough". Not because the inside of our elbows provide N95 levels of protection, but because doing so still helps to prevent the spread of disease.
>>Their results were inconclusive since the people the asks to wear masks, didn't.
Their review was at the macro, population level. If people aren't wearing masks properly through carelessness or ignorance, this proves their point.
Shooting a virus at a masked mannequin in a lab might show some prevention, but in the real world people forget and scratch their nose, rub their eyes, get sneezed on by a stranger etc.
I agree that the Cochrane review is better evidence of "if you don't wear/use a mask properly, it won't work," rather than "masks don't work." (This is one of the reasons I'm against mask mandates, btw.)
I'm invested in this only because, due to my health condition, I don't want to get covid. As far as I'm aware, the evidence says that so long as I properly wear an N95 (so I'm not taking my mask off to scratch my nose, have passed a fit test, etc.), I will significantly reduce my risk of getting covid.
But rather than "if you don't wear/use a mask properly, it won't work", I'd more restate it as "for a given population size, enough people would mess up that making everyone wear one would not slow the spread of the disease".
I also think that if you, as an individual, are especially diligent it may well lower your personal chances of catching COVID. And given your health conditions, I really hope that is the case for you.
> I'd more restate it as "for a given population size, enough people would mess up that making everyone wear one would not slow the spread of the disease".
...but this is even less conservative than the review summary, which was inexplicably panned.
The clause "enough people would mess up that making everyone wear one would not slow the spread of the disease" is part of the consideration that goes into "community transmission" (or the phrase "in the community", which is sometimes used in formal publications as an abstraction for real-world compliance levels) and is distinct from "individual transmission".
The sentence in question is:
"Wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness (ILI)/COVID-19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants;" [0]
...it's hard to imagine how this extremely sober (and factually proper) extrapolation of the data has caused such a kerfuffle.
Is it any wonder that the people who have been studying this topic since before it was cool are puzzled?
edit: my apologies - I just read that you addressed this elsewhere in the thread. It seems that we are in agreement (and I just don't think there is a reasonable alternative assessment for any numerate / literate reading of the data.)
Your point is even stronger than you make it sound.
Nobody shot a virus at anything. They shot beads of polystyrene latex.
If you woke up from a dream where such a study occurred, you'd laugh/sigh at your own outlandish imagination.
I admit - I actually took this seriously for a brief while and believed that masks were a plausible intervention. But how people can still hold that assessment years on is baffling. I have to believe it's mostly just bots at this point; no humans in my actual life have had their mind unchanged by the intervening data.
> the Cochrane review did indeed show that masks are largely ineffective (and cloth masks, completely so) at stopping viral transmission - the link is right there in the article to which you've linked.
Many commentators have claimed that a recently updated Cochrane review shows that ‘masks don’t work,’ which is an inaccurate and misleading interpretation,” Karla Soares-Weiser, the editor in chief of the Cochrane Library, said in a statement.
“The review examined whether interventions to promote mask wearing help to slow the spread of respiratory viruses,” Soares-Weiser said, adding, “Given the limitations in the primary evidence, the review is not able to address the question of whether mask wearing itself reduces people’s risk of contracting or spreading respiratory viruses.”
She said that “this wording was open to misinterpretation, for which we apologize,” and that Cochrane would revise the summary.
Soares-Weiser also said, though, that one of the lead authors of the review even more seriously misinterpreted its finding on masks by saying in an interview that it proved “there is just no evidence that they make any difference.” In fact, Soares-Weiser said, “that statement is not an accurate representation of what the review found.”
You are guilty of pushing the very misinformation that you claim to be against.
The review itself said:
‘Wearing masks in the community probably makes little or no difference to the outcome of influenza‐like illness / Covid‐19-like illness compared with not wearing masks… Wearing masks in the community probably makes little or no difference to the outcome of laboratory‐confirmed influenza / SARS‐CoV‐2 compared with not wearing masks.’
The fact that the editor-in-chief of Cochrane embarrassed herself due to the pressure of an opinion-piece by a non-expert in the NYT is irrelevant.
If you think that Cochrane revises their reviews based on "pressure of an opinion-piece by a non-expert in the NYT" I doubt any amount of research will change your mind from what you've decided to believe. I think it's clear that Tom Jefferson was embarrassed at being called out for misinterpreting the evidence, but he's plainly wrong that she never provided a reason. She was clear that it was due to the "limitations in the primary evidence", something many others pointed out as well.
Cochrane didn't revise their review, neither did the author so I'm not sure where you imagined that. What happened was the the managing editor issued a statement in response to an NYT op-ed that criticised the review.
And there was no misinterpreting the evidence. He said that there is no evidence that masks work. You can't then say "yeah but there's only no evidence because all the evidence is low quality" because then you are effectively agreeing that there is no evidence.
If people are so confident masks work, do an RCT. That is how science is supposed to work, right? Not guessing something might work and doing it anyway.
> Cochrane didn't revise their review, neither did the author so I'm not sure where you imagined that.
That would have been the part where the editor in chief of the Cochrane Library said that they would, and then did. To quote (again):
She said that “this wording was open to misinterpretation, for which we apologize,” and that Cochrane would revise the summary.
> If people are so confident masks work, do an RCT. That is how science is supposed to work, right?
No it isn't. There are zero RCTs done for all kinds of things that we're confident work. There are many reason RTCs aren't always done. Reasons like "well understood physics" and "ethics" and "unfavorable signal to noise ratios" that would make doing them pointless at best, and harmful in the worst cases. RCTs are only a tool, and like all tools, they aren't appropriate or necessary in all circumstances.
Please, I beg for your sensibility and brief attention here. This issue continues to tear fissures in what seem like otherwise reasonable and literate communities.
The sentence in question is:
"Wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness (ILI)/COVID-19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants;"
This is very typical wording, and a very typical application of limited data, for a Cochrane review. There's nothing here that jumps out, on first read or after ingestion of all of the primaries, which I'm guessing we've all done multiple times.
I think we all agree with you (and thus, with Soares-Weiser) about the frustration (heck, downright confounding) resulting from the lack of evidence. Top experts from every one of the big 5 have repeatedly called for and proposed RCTs to solve this problem.
...but there is absolutely nothing wrong with looking at these data and concluding that, in each statistically-significant case, masking "probably makes little or no difference to the outcome of" ILI.
Is it possible that a larger, properly-powered RCT will find that some form of N95 application will have some effect on community transmission? Sure. We'd all love to know about that.
It it possible that a larger, properly-powered RCT will find a similar outcome from cloth masks? No. Not unless all of the current data on the matter is completely flawed.
Is it possible that even a small, properly-powered RCT will find statistically significant reductions in individual transmission from source control measures? Yes! That's possible! And that's the topic of this entire thread - we're talking about an individual patient largely confined to an iron lung.
Has that RCT been performed? No.
Can we all agree on at least these limited, well-defined assessments of the available data?
Of course. And John Ioannidis. And Jay Bhattacharya. And Martin Kulldorf. And Stefan Baral. And Sunetra Gupta. And Vinay Prasad. And dozens of other acclaimed researchers who represent the core of the incredible, laudable, essential, dear sciences of epidemiology and evidence-based medicine.
An entire generation of the top experts in these fields were sidelined, and the spotlight suddenly shifted to nervous second-stringers in order to present the appearance of a vibrant debate in front of profiteering media, piped into television screens in the waiting rooms of daycare centers where under-privileged two-year-olds were forced to put cloth across their face for no reason.
It's obvious to everyone, and yet the apperance of debate is still kept up through not only through dishonest pundits, but botnets on reddit and, I fear, even here on HN.
It's wild.
But we'll overcome it. Don't let it get you down. The scientific method endures and it will eventually win out. People are getting more and more literate and younger ages. The facade is nearly finished.
> The sentence in question is:
"Wearing masks in the community probably makes little or no difference to the outcome of influenza-like illness (ILI)/COVID-19 like illness compared to not wearing masks (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84 to 1.09; 9 trials, 276,917 participants;"
In a statement about the review, Lisa Bero (the Cochrane Public Health and Health Systems Senior Editor) says explicitly:
“The results of this review should be interpreted cautiously, and the uncertain findings should not be taken as evidence that these measures are not effective."
> I think we all agree with you (and thus, with Soares-Weiser) about the frustration (heck, downright confounding) resulting from the lack of evidence.
There is not lack of evidence on the effectiveness of masks to prevent/spread illness. There is a lack of evidence on the effectiveness of policy. This is not evidence that those polices are themselves ineffective. Quoting again:
"An updated review of physical interventions by Jefferson and colleagues assesses three commonly recommended interventions: masks, hand hygiene, and physical distancing.[2] They found evidence that masks had limited or no benefit in terms of preventing influenza‐like illnesses or laboratory‐confirmed influenza. However, except for a handful of studies, most of the evidence is from studies examining effects in wearers. An important effect may still lie in how masks reduce transmission of virus to others, which is more difficult to ascertain.[3] Resulting uncertainty in the evidence for public health measures has fed controversies regarding the legitimacy of public health policies involving these measures, with face masks being a special target for criticism.[4, 5]"
"For each measure, though, lack of evidence of effectiveness is not evidence that the interventions are ineffective. Rather, the details of these reviews show why there may never be strong evidence regarding the effectiveness of individual behavioural measures when deployed, often in combination, in a general population living in the complex, diverse circumstances of individuals' everyday lives. Waiting for strong evidence is a recipe for paralysis." (source: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED...)
> Is it possible that a larger, properly-powered RCT will find that some form of N95 application will have some effect on community transmission?
Anything is possible, but it appears that any attempt at such a study would likely result in a failure to uncover actionable data. Reasons for that are explicitly listed in the source above which goes on to state the following: "However, while there is reason to believe in the combined effects of multiple behavioural measures, there is not, and may never be, high‐quality evidence from randomized trials on those effects."
RCTs are a very useful tool, but they aren't the right tool for every circumstance. This appears to be one of those cases. It's fortunate then that we don't need to depend on them in every circumstance. We can have an extensive pool of other types of high quality evidence to draw conclusions from. We have lab tests where we have no issues testing the physics involved in different kind of masks blocking virus-sized particles on simulated inhales and exhales. There have been RCTs involving health care personnel which show that worn correctly and consistently masks work. The effectiveness of masks to help keep people from getting and spreading disease is not really in question. The questions we do have, aren't ones RCTs are likely to help us answer.
If someone comes up with some way to perfectly control, and fully and accurately observe and record the behavior of large populations 100% of the time for the entire duration of the trial, and can do all of that ethically, then you might get the perfect research you'd love to see. Until then, we should focus on what we do know with confidence and what we've learned through other forms of high quality research.
I think any reasonable observer can conclude that we have reached a point in the discussion in which it is evident that you are not participating in good faith.
> That sentence is not in question. It doesn't exist anywhere in the review. Please read the review yourself.
Please don't implicitly accuse me of not having read the material. I read it the day it was published, with the counsel of friends who are experts in the field, who, along with most of their colleagues, have objected to this entire charade all along.
It's hard to imagine that you actually believe that this sentence is not the controversial one; it has been the topic of discussion in circles of epidemiology and evidence-based medicine around the world and is the focus of the clarification you've linked. A simple web search will confirm this.
Moreover - and I presume this was a mistake on your part - the PDF you've linked actually still contains the sentence in question (I assume you meant to sneakily link the revised summary and pasted the wrong URL). I hope this reveals the tactics at work here to any discerning reader. (As I write this, the PDF linked in your comment is: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD...)
> RCTs are a very useful tool, but they aren't the right tool for every circumstance. This appears to be one of those cases.
Yes of course those cases exist, and no this isn't one of them. And essentially all of the world's top researchers in evidence-based medicine agree on this point (despite having a wide array of opinions on the underlying question).
We're talking about asking one group of people to put something on their face for a while, and another not to, in a variety of circumstances. Nearly all of the world's top experts have asked for this (including the authors of the review and primaries in question, which together represent tenure at all five of the world's top institutions of medicine) and been silenced, while a group of second-stringers willing to toe the line have been propped up to create the appearance of significant debate. I have no doubt based on your knowledge and articulation that you are well aware of this, and I hope that now anyone reading this far is as well.
Given the decreasing apparent veracity of your statements, I'm choosing as my last message in this thread.
I don't want to be adversarial, but it feels impossible and invalidating to engage in discussion when we can't agree that the sky is blue.
All I can ask is that you contemplate whether what you are doing is in the best interests of science.
If anyone in interested in reading further rebuttal, I suggest this piece by Tom Jefferson (author of the review in question) joined by Carl Heneghan (whom you probably already know, but if not, was the editor-in-chief of the BMJ of evidence-based medicine at the time of the publication in question). [0]
edit: I had originally written a response that dissected the dishonest characterization of the text of the review, but replaced it with the Jefferson / Heneghan piece, which goes directly into the substance, which seems more appropriate.
> Please don't implicitly accuse me of not having read the material.
I didn't intend for my invitation to be an accusation. I'm sorry that I wasn't clearer. I'd publish my own revision if I could. I just wanted to give you the opportunity to see for yourself that the text isn't there. I'd hoped to even make it easy for you, but also for anyone else reading who might be working from outdated information on this topic.
> It's hard to imagine that you actually believe that this sentence is not the controversial one; i
It was a controversial sentence, but mostly because it was poorly/incorrectly worded which is what necessitated it being removed from the text and replaced with something more appropriate. It was exactly because it was misleading so many people that Cochrane has worked so hard to clarify the situation. From revisions, to statements made to the press, to editorials published on their own site, I think they've done everything they reasonably could do to let the public know that the review does not support what was initially said as it was initially phrased. It'd be hard to get more explicit than they have been. "the uncertain findings should not be taken as evidence that these measures are not effective." I don't know what more people want from them. It must be maddening for them to know that for all their efforts what was initially published is still giving people the wrong idea.
> Moreover - and I presume this was a mistake on your part - the PDF you've linked actually still contains the sentence in question (I assume you meant to sneakily link the revised summary and pasted the wrong URL).
Yes, I did link to an outdated version in error. I apologize for that too. I had (and have) enough tabs and browser windows open that it was all too easy to just grab the wrong one by mistake (it's a wonder firefox hasn't crashed on me yet). I corrected it as soon as I noticed but you were too quick for me. This wasn't "sneaky" or some trick. My intent was very much to post the most current and corrected version. What good is it to argue over something that was later corrected? The most recent version is always best to work from, and that's especially true in cases where you know revisions had to be made and the problems with older versions are leading to misunderstandings and confusion.
> Yes of course those cases exist, and no this isn't one of them.
Many people, including experts, disagree with you. Experts can disagree, but if someone thinks they can design a RCT that doesn't suffer from the kinds of problems that others see as being highly likely then they are free to design one, make their case for funding, and run it. Evidence is king. We know this review was deeply flawed because of the lack of high quality evidence. If finding that high quality evidence is possible, then let someone do it already and prove everyone else wrong. That's how science works.
> All I can ask is that you contemplate whether what you are doing is in the best interests of science.
All I'm doing is telling you what Cochrane themselves says of the review they published, and in this case, I happen to agree with them. I'd be happy to change my mind, once someone delivers better evidence. Tom Jefferson and the rest of the review's authors weren't able to do that with this review due to the numerous problems with the evidence they had to work with and the lack of other evidence to draw from. Not a huge deal. Let's see the viable RCTs people come up with and the quality of the evidence they get from them, then we'll see what the review says.
Paul regularly livestreamed on TikTok -- almost daily.
When I first saw him, I was rather horrified by his predicament. But then I saw that Paul was always upbeat and positive and accomplished. He seemed to live his life to his maximum. And he accomplished more than the average abled person.
I hadn't seen him the past couple weeks (though my TikTok usage is more cautious morbid curiosity and at an arm's length). I guess this explains it.
that's how I heard of him too. at first the idea of his stationary life seemed terrifying, but he looked like he made the most of it. sad to hear his passing
I've read his autobiography... I highly recommend it, it is a mind blowing story. Amazing that someone with such a severe disability was able to live such a full life with romance and adventure that most able bodied people would be jealous of.
His story and positive attitude has had a lasting impact on me in making me appreciate and enjoy life more- and to really work to make the best out of whatever is thrown at me.
There aren't any vaccines I can think of that made it past clinical trials and were a net negative. There are possibly some cases where they were a net negative for a subgroup of the population or where a batch was contaminated, but I don't think that counts as overall "bad".
Either you're using a different definition of bad, or you've got some information I don't have, or you're wrong.
I don't understand your point. Vaccines that don't make it past clinical trails are not used. So there are no vaccines that were used that were net negative bad. Does it make it clear?
What I meant was that the general population can't use those vaccines anyway, unless they do the synthesis on their own or get into a clinical trial, so it's disingenuous to talk about them in the context of public safety.
Making a claim about the safety of pre-approval vaccines is misleading because it's claiming one uncontroversial true thing ("some vaccines in development are found to be net negative in trials and do not progress further") that sounds superficially similar to a scary untrue thing ("getting vaccinated by your doctor with an approved vaccine may be net negative across the population") and hoping everyone else will confuse the two.
In this case "some vaccines are bad" was clearly intended to be an ambiguous statement, otherwise it would have been more detailed about which exact vaccines were bad.
I'm sorry... this is ridiculous. I'm not vaccine-heavy (like I don't really think you need a chickenpox vaccine or a rotavirus vaccine if you're healthy or a Hep B vaccine at birth if you're low risk), but the idea of forgoing vaccines for illnesses like polio is just stupid. Too many kids died or were disabled for this. It's just stupid.
The injectable vaccine is safe and has been used for decades. There should really be no objection to it. The oral ones are a different story and I wouldn't let my kid anywhere near those (too high a risk of polio)
I'm not anti-vax, though but my daughter actually got chicken pox from the vaccine. It sucked - we had to get her vaccined to fly back east, so we did... flew and it was supposed to be a trip to chicago zoo but she got CP then night we got there and spent a couple days in the hotel bath with calamine.
I got the chicken pox twice. Once at 6 months. and at 14y.
Cutter incident - The mistake produced 120,000 doses of polio vaccine that contained live polio virus. Of children who received the vaccine, 40,000 developed abortive poliomyelitis (a form of the disease that does not involve the central nervous system), 56 developed paralytic poliomyelitis—and of these, five children died from polio.[2] The exposures led to an epidemic of polio in the families and communities of the affected children, resulting in a further 113 people paralyzed and 5 deaths.
I already addressed this concern. I am categorically against live polio vaccines. Thankfully, today, only the oral one is live. There is no longer live injectible vaccine.
The inactivated injectible vaccine is very safe.
You reference an incident from 1955 when injectible vaccines were similar to oral ones today. Don't take these. Luckily, in 2024, you don't have to.
It is irresponsible TODAY to not get vaccinated. None of what I wrote above applies to 1955.
so? if they stop vaccinating it WILL come back. FAST. also the ONLY way to eradicate an infectious disease is through vaccination. even then we only manage to do it once with smallpox
You ignore hygiene and wealth that rised up significantly over the world during last century. All polio cases today are in countries where it is not common or even possible to wash hands regularly.
It wonders me why we are able to give them milion doses of vaccines but there is not same attitude with drinking water?
It's not only way, sure. But have huge impact. As well as access to clean drinking water.
Polio occurs naturally only in humans. It is highly infectious, and is spread from person to person either through fecal–oral transmission[1][6] (e.g. poor hygiene, or by ingestion of food or water contaminated by human feces), or via the oral–oral route.
even in countries with good hygiene and clean water ~ 1st world countries ~ when vaccination rates dip because of anti science anti vaxx nonsense, you get outbreaks of measles, rsv, whooping cough you name it. i don't understand why anyone would prefer to let their childs body be ravaged by all kinds of exotic viruses rather than protect them with the generally gentle and safe vaccines
- why anyone would prefer to let their childs body be ravaged by all kinds of exotic viruses rather than protect them with the generally gentle and safe vaccines.
If there is no reasonable possibility to get in touch with that virus, why should you "put" it in body of your health child by medical intervention that is based on irrelevant fear? But it's choice that every parent can freely make.
Should we all be vaccinated against for example malaria?
Regardless of how correct you are, or how persuasive you might have been up to this point, uttering this accomplishes nothing and is entirely counterproductive.
Remarkable man! Good on him for achieving all that. The part where he was able to learn how to breathe and leave the iron lung for short periods of time is particularly interesting. I wonder what he did on those outings…
It says he went out with friends, saw movies, and even flew on planes while "frog-breathing", as he called it. He couldn't do it while unconscious so he still had to sleep in the lung.
> The technique had a technical name, “glossopharyngeal breathing”. You trap air in your mouth and throat cavity by flattening the tongue and opening the throat, as if you’re saying “ahh” for the doctor. With your mouth closed, the throat muscle pushes the air down past the vocal cords and into the lungs. Paul called it “frog-breathing”.
So, to state it in computing terms, this wasn't a fix for not being able to breathe, it was a workaround. But it seems to have worked really well: at 40, he was "able to spend most of his day outside the machine that still kept him alive".
That's incredibly interesting. I'm attempting what I believe to be the technique described at the moment. If I'm doing it correctly I can see why he nicknamed it 'frog-breathing.'
Advances in medicine made iron lungs obsolete by the 1960s, replaced by ventilators. But Alexander kept living in the cylinder because, he said, he was used to it.
If this is reported correctly, it would even have been an deliberate choice to not leave more often or entirely.
EDIT: This was seemingly not reported correctly, it seems he only depended on the iron lung while sleeping but could otherwise live without it.
"Alexander, who lived in Dallas, Texas, was rushed to the hospital in late February after testing positive for Covid, according to his social media manager. He was released from the hospital but was struggling to eat and drink."
"That year, he published a memoir which reportedly took him eight years to write using a plastic stick to type on a keyboard and dictating to a friend."
This man demonstrated such an outstanding will to live and over come his disability. A part of me hopes he has moved on to a better life. Rest in peace, Paul.
Very sad. I hope him and his family will find peace. His story was interesting and the team that helped him refurbish his iron lung were angels in disguise.
Paul was an inspiration for having amazing perseverance and determination. I especially enjoyed a 30min interview he did in 2022. https://www.youtube.com/watch?v=O5DOre3MFlw
I remember reading this story a few years ago and realizing that the engineer who maintained it, a guy named Brady, was the same guy who ran my school FIRST robotics team back in 1998-2000. What a guy.
The first time I've learned of an iron lung was from The Big Lebowski, "Is this your homework Larry" scene. Larry's father was in the iron lung, in the living room. I was very curious about the machine, so I've looked it up. Quite an incredible machine, and led me into a deep Wikipedia rabbit hole.
> As we know, COVID infections are almost unknown when infected individuals consistently wear a high-quality fitted mask.
Suppose you're visited by a home health aid everyday and in every instance of mask application the protective rate is 99.999%. That means at each instance (each day), you have a 0.001 risk of contracting COVID. If we extrapolate out, after four years, the risk of contracting COVID is 1.5%. Now suppose you have two or three visitors each day. Your risk is now 4.3%.
Even 'unheard' of risks become quite common as you tempt fate.
I downvoted because of a completely unfounded and frankly offensive assumption that the worker "who killed him" must have been one of those "muh freedumbs" types - if you read about Paul's life and the people who were next to his side, they were most kind and most caring people you could ever wish for, he was so lucky to have them. To say to the people who literally spent decades with him and looked after him, frequently without any compensation, that they must be the "muh freedumbs" types will all related connotations - to me, that feels like spitting directly into their faces, like the armchair judgement of an internet expert to the highest degree. We don't know anything about the circumstances here, but we are so quick to pass judgement - that's why I downvoted OP.
As somebody with a medical condition since birth, this line really hit home. I'm not speaking for Mr. Alexander, but for myself "used to it" is such a great way of putting the odd experience of living with frequent and cumbersome medical intervention.
On the one hand you have no choice so it is quite easy. You just do it. On the other hand there are often periods here and there through your life where you wrestle with the treatment, complain about it, explore other options, etc. But then a new option does come around every so often and, well, some times you stick with what you know even though there are "better" options.
"used to it" is such a disarmingly accurate way of putting it. It is simultaneously the most difficult and easy thing to do.
Requiem aeternum Paul Alexander.