Continuation The One Covid-19 Science and Medicine Thread Part 4

[Bubba]

Dear Leader Biden will sign it, and you will pay SEVEN HUNDRED THOUSAND DOLLARS per each non-vaccinated employee in the bill decribed below....


https://www.youtube.com/watch?v=mhNaELdPH4s

[Planigale]

Originally Posted by The Great Zaganza

Would do, but it's not on offer.
It's a "use up what the anti-vaxxers refused before it expires" situation where I am.

It may offer some re-assurance but most studies I have seen suggest the boosting effect is greater if a different vaccine is used for boosting. This is routine in hepatitis immunisation. My guess the best option would be a mRNA based vaccine to boost following J&J.

[Planigale]

Originally Posted by Aridas

Since you were the first to poke at this drug...

I think that I'll advise caution for the moment, as a matter of course. There's good reason for hope, but, as far as I understand it, Merck hasn't yet released much in the way of the raw data and nor has the wider medical or scientific community had a chance to review the experiment or findings. How much more important those things are than hype is hard to overstate.

One problem is that you can get false positive results in a clinical trial. The more times you repeat a trial, the more likely you are to get a false positive result. Conventional reporting does not consider this effect, each trial is reported as an individual event*. But it is one to consider when you have an initially negative trial, that when repeated becomes positive, which is the false result.

*Meta-analysis can actually increases the risks of a false positive result as compared with a single trial of comparable size.

[Planigale]

Originally Posted by angrysoba

I’be been put off by ivermectin backers given their use of terrible data that has in many cases been shown to be outright fraud and the association with many of its proponents with outright anti-vax cranks. That said, I’ll be interested in the findings of the Oxford study.

The preliminary results from the TOGETHER trial run out of McMaster show no effect. This has not been published but have been presented asa presentation.

https://rethinkingclinicaltrials.org...ills-phd-frcp/

High quality RCT seem to show little benefit. If you weight towards the quality of the trial (and professionalism of those running the trial), ivermectin is likely of no benefit. As you say the published results of TOGETHER and PRINCIPLE (Oxford), will be critical, large well run RCTs.

[angrysoba]

Originally Posted by Planigale

The preliminary results from the TOGETHER trial run out of McMaster show no effect. This has not been published but have been presented asa presentation.

https://rethinkingclinicaltrials.org...ills-phd-frcp/

High quality RCT seem to show little benefit. If you weight towards the quality of the trial (and professionalism of those running the trial), ivermectin is likely of no benefit. As you say the published results of TOGETHER and PRINCIPLE (Oxford), will be critical, large well run RCTs.

Oh wow! Thanks for the heads up on this!

It's pretty much what I expected (although, to be fair, I thought it possible that there would be a small effect, possibly caused by ivermectin fighting secondary infections).

[Aridas]

Originally Posted by Bubba

Dear Leader Biden will sign it, and you will pay SEVEN HUNDRED THOUSAND DOLLARS per each non-vaccinated employee in the bill decribed below....


https://www.youtube.com/watch?v=mhNaELdPH4s

1) That topic would be for the US politics covid thread.

2) Why would you trust a guy who, by his own company's account, no reasonable or informed person should trust to be telling the truth?

[marting]

Originally Posted by angrysoba

Oh wow! Thanks for the heads up on this!

It's pretty much what I expected (although, to be fair, I thought it possible that there would be a small effect, possibly caused by ivermectin fighting secondary infections).

Actually the Together trial did show point numbers consistent with a small effect. It was widely reported as showing no benefit at all but the correct description is that it didn't show a statistically significant benefit with fairly large CIs when they terminated it because it wasn't potentially good enough to continue at the expense of testing other candidates. Most likely what it shows is that any benefit for IVM is small. The Together trial is an ongoing adaptive trial where they add on new candidates and drop those not considered good enough. Fluvoxamine looks reasonably good. At least as of the date of the slides.

IVM
Hospitalization RR .91, CI (.69 1.19) 85 v 95
Deaths RR .82, CI (.44 1.52) 9 v 11*

*The 9(IVM) v 11(Placebo) deaths wasn't published but easily determined from the RR

[rjh01]

The ACT in Australia has a table giving where the hotspots are including the times. I put that table into an Excel spreadsheet. Then I gave it the third degree. It told me that the most dangerous times to be out shopping are between 11 am and 4 pm.

[The Great Zaganza]

Originally Posted by Planigale

It may offer some re-assurance but most studies I have seen suggest the boosting effect is greater if a different vaccine is used for boosting. This is routine in hepatitis immunisation. My guess the best option would be a mRNA based vaccine to boost following J&J.

Thanks!

[Planigale]

Originally Posted by marting

Actually the Together trial did show point numbers consistent with a small effect. It was widely reported as showing no benefit at all but the correct description is that it didn't show a statistically significant benefit with fairly large CIs when they terminated it because it wasn't potentially good enough to continue at the expense of testing other candidates. Most likely what it shows is that any benefit for IVM is small. The Together trial is an ongoing adaptive trial where they add on new candidates and drop those not considered good enough. Fluvoxamine looks reasonably good. At least as of the date of the slides.

IVM
Hospitalization RR .91, CI (.69 1.19) 85 v 95
Deaths RR .82, CI (.44 1.52) 9 v 11*

*The 9(IVM) v 11(Placebo) deaths wasn't published but easily determined from the RR

A better description even is that the results may be consistent with a small benefit, but would also be consistent with a small harm, though this would be less likely than a small benefit. One could not conclude from this study alone that Ivermectin was harmless if given to people with Covid-19, nor could one exclude a small benefit, but certainly there is no evidence of a benefit comparable with that from vaccination.

[marting]

Originally Posted by Planigale

A better description even is that the results may be consistent with a small benefit, but would also be consistent with a small harm, though this would be less likely than a small benefit. One could not conclude from this study alone that Ivermectin was harmless if given to people with Covid-19, nor could one exclude a small benefit, but certainly there is no evidence of a benefit comparable with that from vaccination.

Right. Too small an N to determine much of anything. Tends to a small benefit but nothing close to vaccination. Study powered for a larger benefit which just isn't there. It is, however, an error, to state that the study showed no benefit whatsoever as has been widely reported. I suspect much of this is pushback against the true believer claims that IVM was a 'miracle drug." It clearly is not. There is a small possibility it will show better results when given within a day or so of first symptoms but trials for this aren't due for some months. Even if somewhat more effective early, my guess is the Merck drug will prove more effective under the same conditions.

[The Atheist]

I'll just drop this in here - Aussie's current outbreak is showing that kids are still rarely impacted and don't spread the delta variant a lot, just as with previous strains: https://www.stuff.co.nz/national/hea...s-and-children

[dann]

Originally Posted by The Atheist

I'll just drop this in here - Aussie's current outbreak is showing that kids are still rarely impacted and don't spread the delta variant a lot, just as with previous strains: https://www.stuff.co.nz/national/hea...s-and-children

Where do you see that?! If by "rarely impacted", you mean that most cases are mild or even asymptomatic, then yes. But the spreading?!

Quote:

Between 16 June 2021 and 19 August 2021, there were 10,782 COVID-19 notifications in NSW (population 8.1 million). Of these, 2,864 (27%) were among those aged 0 to ≤18 years. The majority of children (98%) had asymptomatic or mild infection.
(...)
Transmission rates in schools, ECEC services and households seen during the current SARS-CoV-2 Delta variant outbreak in NSW are 5.2 times higher than those seen throughout 2020.

[The Atheist]

Originally Posted by dann

Where do you see that?! If by "rarely impacted", you mean that most cases are mild or even asymptomatic, then yes. But the spreading?!

From the link:

Quote:

The study found the primary spread of Covid-19 was within households, was primarily driven by unvaccinated adults, and that the actual transmission between children in education settings was very low.

Kids are catching off their adult family members, not each other.

The rate of infection being 5 times higher is actually a guide as to how ineffective it is at spreading between kids, despite their much closer contact than adults. The overall infection rate for NSW is more than 20 times the 2020 rate, so only increasing by five times is a good thing.

[The Atheist]

Now, this is interesting - the idea that the waves of Covid are due to some unknown factor rather than public health measures, etc: https://news.yahoo.com/trying-sense-...121821028.html

No idea advanced as to what that might be, but I think the answer is touched on in this bit:

Quote:

The most-plausible explanations involve some combination of virus biology and social networks.

[dann]

Originally Posted by The Atheist

Kids are catching off their adult family members, not each other.

I doubt it:

Quote:

While children are less susceptible to illness with the new coronavirus, they are nearly 60% more likely than adults over 60 to infect other family members when they are sick, a new study shows.
Kids Highly Likely to Transmit COVID to Others (WebMD, Jan 21, 2021)

Quote:

The rate of infection being 5 times higher is actually a guide as to how ineffective it is at spreading between kids, despite their much closer contact than adults. The overall infection rate for NSW is more than 20 times the 2020 rate, so only increasing by five times is a good thing.

Five times higher is obviously preferable to 20 times higher, but it doesn't say much about "how ineffective it is at spreading between kids," unless you can compare precautions taken in schools against the spread as compared to the rest of the population.
One thing that seriously impacted earlier studies was that children were much less likely to get tested than adults.

[rdwight]

Originally Posted by dann

Five times higher is obviously preferable to 20 times higher, but it doesn't say much about "how ineffective it is at spreading between kids," unless you can compare precautions taken in schools against the spread as compared to the rest of the population.
One thing that seriously impacted earlier studies was that children were much less likely to get tested than adults.

I view that differently. If they are less likely to be tested, then there are more positive cases in schools at any given time. Wouldn't we see large clusters happening faster if spread was efficient in kids?

There are more than a few parents that are just terrible people, and will send their kid to school sick, covid or not. They will avoid getting their kids tested just to save an hour of their time from dealing with an urgent care. So far things haven't gotten out of control but it's still early so we will see.

[Puppycow]

In podcast I listened to today, the idea of using dogs to test for Covid was brought up.

("The Dog Will See You Now" - Malcolm Gladwell)

If you think this sounds like a kooky idea, it really isn't. Dogs have incredibly sensitive noses, and they are able to sniff out diseases with as much or even higher accuracy than most scientific methods.

Imagine if every school or large-scale event or gathering had a Covid dog, which could identify anyone who might be infected. We all know that dogs are used to sniff out explosives or drugs. The dogs aren't perfect, but they do seem to be as good or better than any kind of test we can devise.

The only issue is getting it up to scale, but it could be done if enough resources are invested.

Have you ever had a colonoscopy (for cancer screening)? If both methods were equally accurate, wouldn't you rather forgo having an instrument inserted into your nether regions? Dogs can accurately sniff out early stage bowel cancer

[Puppycow]

Originally Posted by The Atheist

Now, this is interesting - the idea that the waves of Covid are due to some unknown factor rather than public health measures, etc: https://news.yahoo.com/trying-sense-...121821028.html

No idea advanced as to what that might be, but I think the answer is touched on in this bit:

Not sure I'm convinced by that, but the surge-and-decline cycle seems to be evident in Japan. We've had 5 distinct waves here. The most recent wave had more positive tests than in previous waves, but not more deaths. From the graphs, the 4th wave appears to have resulted in more deaths than the 5th wave. Even the 3rd wave was more deadly. Anyway, since the beginning of September, positive tests are down by an order of magnitude, from over 20,000/day to less than 2,000/day.

I credit vaccines.

Japan is now more vaccinated than the USA, and similar to the EU average, plus they're still doing over a million/day, so it looks like maybe we will end up even higher than Europe. So much for the stereotype that the Japanese are vaccine-hesitant. I thought the government was overly cautious at first in rolling out the vaccines, but once they finally did ramp up their program around May, it has been averaging over a million shots per day for several months now.

[angrysoba]

Originally Posted by Puppycow

Not sure I'm convinced by that, but the surge-and-decline cycle seems to be evident in Japan. We've had 5 distinct waves here. The most recent wave had more positive tests than in previous waves, but not more deaths. From the graphs, the 4th wave appears to have resulted in more deaths than the 5th wave. Even the 3rd wave was more deadly. Anyway, since the beginning of September, positive tests are down by an order of magnitude, from over 20,000/day to less than 2,000/day.

I credit vaccines.

Japan is now more vaccinated than the USA, and similar to the EU average, plus they're still doing over a million/day, so it looks like maybe we will end up even higher than Europe. So much for the stereotype that the Japanese are vaccine-hesitant. I thought the government was overly cautious at first in rolling out the vaccines, but once they finally did ramp up their program around May, it has been averaging over a million shots per day for several months now.

Yes. This is absolutely true. I have actually been amazed and very pleasantly surprised by how many people are getting vaccinated. The numbers of vaccinations are really soaring and there doesn’t seem to be much slowdown. The Covid cases are plummeting. Really impressive! Japan finally got its act together with the vaccines and it really does look like slow and steady wins the race. It probably helps that in Japan you don’t have the kind of idiot political tribes that propogandize for douchebaggery as a display of freedom unlike in the US and the UK.

[Puppycow]

More on the situation in Japan:

Japan’s dip in COVID-19 cases baffles experts; winter ‘nightmare’ still a risk

Well, the experts may be "baffled" but I think it's the vaccines.

[marting]

Plant-based and/or fish diets may help lessen severity of COVID-19 infection
https://www.bmj.com/company/newsroom...-19-infection/

Associated with 73% and 59% lower odds, respectively, of moderate to severe disease

and, on the other side.

And compared with those who said they ate a plant-based diet, those who said they ate a low carb-high protein diet had nearly 4 times the odds of moderate to severe COVID-19 infection.



Interesting. Might explain some of the differences between countries along with general demographics.

[The Atheist]

Originally Posted by Puppycow

Not sure I'm convinced by that, but the surge-and-decline cycle seems to be evident in Japan.

Yeah, I think it's food for thought only. The pandemic still has a fair way to go.

If we take the 10x position, about 1/3 of the world's population has been infected so far. Hopefully, the rate of vaccination will keep future surges in check.

Originally Posted by marting

Plant-based and/or fish diets may help lessen severity of COVID-19 infection
https://www.bmj.com/company/newsroom...-19-infection/

Associated with 73% and 59% lower odds, respectively, of moderate to severe disease

and, on the other side.

And compared with those who said they ate a plant-based diet, those who said they ate a low carb-high protein diet had nearly 4 times the odds of moderate to severe COVID-19 infection.

Interesting. Might explain some of the differences between countries along with general demographics.

My initial vitamin D suggestion was partly based on high levels among fish eaters, so that part is interesting.

Is the low-carb diet a simple artifact of those people not being obese, which is a known issue?

[marting]

Originally Posted by The Atheist

My initial vitamin D suggestion was partly based on high levels among fish eaters, so that part is interesting.

You've been a long Vit. D advocate. Here's a recent study in Nature.

Confirms a previous study of minimal association with measured blood levels. The one problem is those measurements were a decade earlier than Covid-19.

However, shows a strong inverse association between Covid-19 hospitalization and recent uVB levels which produces D. From a couple weeks ago.

An observational and Mendelian randomisation study on vitamin D and COVID-19 risk in UK Biobank
https://www.nature.com/articles/s41598-021-97679-5


Here's a pre-print meta-study that attempts to separate causation from correlation

https://www.medrxiv.org/content/10.1...1263977v1.full

COVID-19 mortality risk correlates inversely with vitamin D3 status, and a mortality rate close to zero could theoretically be achieved at 50 ng/ml 25(OH)D3: Results of a systematic review and meta-analysis]

Quote:

Background Much research shows that blood calcidiol (25(OH)D3) levels correlate strongly with SARS-CoV-2 infection severity. There is open discussion regarding whether low D3 is caused by the infection or if deficiency negatively affects immune defense. The aim of this study was to collect further evidence on this topic.

[The Atheist]

Excellent stuff! Thanks.

Why the hell isn't that headline news?

[Bubba]

Originally Posted by The Atheist

Excellent stuff! Thanks.

Why the hell isn't that headline news?

Steady now....they are listening

[angrysoba]

Originally Posted by The Atheist

Excellent stuff! Thanks.

Why the hell isn't that headline news?

Good question. But one simple answer could be that many scientists and medical authorities are not persuaded of either the link between Vitamin D and Covid-19 or the idea that supplementing with Vitamin D will simply lead to a reduction of mortality/ hospitalization.

In addition, comparing countries and demographics is fraught with difficulty given that there are often multiple factors involved and given that many countries have different ways of counting (as well as different levels of testing) and often have unreliable figures.

[angrysoba]

Okay, so that Vit D study….I am not qualified to make many judgments about it but if I understand it correctly (someone with better statistical knowledge than me may have to chime in here) the Pearson R numbers and p numbers look pretty “meh!” to me. Unless I am missing something fundamental….

In addition, aren’t we likely to find people with co-morbidities to be deficient in vitamin D anyway? This is apparently a well recognized feature of all kinds of illnesses. For example someone dies of cancer and we notice they had low vitamin d, does it mean that if only we had dosed them with vitamin D they would have been fine? Or could it just be that vitamin d is the symptom of other problems?

Anyway, like I said, I am not qualified to make any judgments on this, but usually when you have a single study that turns everything on its head despite this having been investigated for some time, it seems odd that this would either not have received more attention unless it was simply not persuasive in some way. The conclusion in the title itself seems like a huge stretch and does not match the conclusion in the main paper….

Quote:

and a mortality rate close to zero could theoretically be achieved at 50 ng/ml 25(OH)D3: Results of a systematic review and meta-analysis

[The Atheist]

Originally Posted by angrysoba

Good question. But one simple answer could be that many scientists and medical authorities are not persuaded of either the link between Vitamin D and Covid-19 or the idea that supplementing with Vitamin D will simply lead to a reduction of mortality/ hospitalization.

I did a serious search for research on it just before Covid hit NZ, and there were still no definitive studies. I don't think it's ever been taken seriously, and I don't believe there's a good research piece on it to date.

I do note one of the researchers involved seems to be fairly heavyweight - Julian von Mendel has a substantial number of papers to his name and has been referenced thousands of times.

Originally Posted by angrysoba

In addition, comparing countries and demographics is fraught with difficulty given that there are often multiple factors involved and given that many countries have different ways of counting (as well as different levels of testing) and often have unreliable figures.

That's true, and the worst example is the study most others refer to, which is the one we discussed a year back. The one where vitamin D levels from 12 months earlier were used, and therefore actually worthless.

Originally Posted by angrysoba

In addition, aren’t we likely to find people with co-morbidities to be deficient in vitamin D anyway?

Yes, particularly obesity.

Originally Posted by angrysoba

This is apparently a well recognized feature of all kinds of illnesses. For example someone dies of cancer and we notice they had low vitamin d, does it mean that if only we had dosed them with vitamin D they would have been fine? Or could it just be that vitamin d is the symptom of other problems?

Could be, but I'm very interested in this one, because I've only seen two meta-analyses, and they both reach the same conclusion. I'll try to drag the old one up - completely different people involved.

Originally Posted by angrysoba

Anyway, like I said, I am not qualified to make any judgments on this, but usually when you have a single study that turns everything on its head despite this having been investigated for some time, it seems odd that this would either not have received more attention unless it was simply not persuasive in some way.

I don't believe it has been investigated properly, and if you can find proper clinical studies suggesting otherwise, show me where they are - my Nobel Prize is at stake here!

The authors finish the study with this:

Quote:

...we strongly recommend initiating well-designed observational studies as mentioned and/or double-blind randomized controlled trials (RCTs) to convince the medical community and the health authorities that vitamin D testing and supplementation are needed to avoid fatal breakthrough infections and to be prepared for new dangerous mutations.

You can't ask fairer than that - they're not saying it's a done deal, they're saying "Why the hell isn't this being studied and it bloody well ought to be, right now". Scientific studies were done on HCQ, Ivermectin, and even nicotine, I believe, plus a huge number of other drugs - when we have a substance known as beneficial in the body's response to respiratory infections, when you have a new respiratory disease creating a pandemic, it should probably have been the first substance studied properly.

[marting]

Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar
https://www.nejm.org/doi/full/10.1056/NEJMoa2114114

The preprint from Qatar data I linked to back on #2872 has been published by the NEJM. By far the most detailed analysis of Pfizer efficacy against infection, symptomatic disease, hospitalization, and death for upwards of 6+ months. The CIs that I noted had been clamped to 0 when negative on the preprint have been corrected and the paper is better organized and explained.

Quote:

CONCLUSIONS
BNT162b2-induced protection against SARS-COV-2 infection appeared to wane rapidly following its peak after the second dose, but protection against hospitalization and death persisted at a robust level for 6 months after the second dose.

[Puppycow]

Originally Posted by marting

Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar
https://www.nejm.org/doi/full/10.1056/NEJMoa2114114

The preprint from Qatar data I linked to back on #2872 has been published by the NEJM. By far the most detailed analysis of Pfizer efficacy against infection, symptomatic disease, hospitalization, and death for upwards of 6+ months. The CIs that I noted had been clamped to 0 when negative on the preprint have been corrected and the paper is better organized and explained.

The most important part to me is the following:

Quote:

Effectiveness against any severe, critical, or fatal case of Covid-19 increased rapidly to 66.1% (95% CI, 56.8 to 73.5) by the third week after the first dose and reached 96% or higher in the first 2 months after the second dose; effectiveness persisted at approximately this level for 6 months.

So while it may not prevent you from testing positive, it remains quite effective at keeping people out of the hospitals and the cemeteries.

Nobody should be discouraged from getting vaccinated by the results of this study. It shows that the vaccine is very effective at preventing severe disease and death from Covid-19.

[angrysoba]

Originally Posted by Puppycow

The most important part to me is the following:



So while it may not prevent you from testing positive, it remains quite effective at keeping people out of the hospitals and the cemeteries.

Nobody should be discouraged from getting vaccinated by the results of this study. It shows that the vaccine is very effective at preventing severe disease and death from Covid-19.

Exactly. Waning is really to be expected. But it beats the alternative.

[The Atheist]

I think that study should ensure vulnerable people at the very least, receive a booster after six months.

[Puppycow]

I don't know if it really shows that.

Where it says that "effectiveness [against any severe, critical, or fatal case of Covid-19] persisted at approximately this level for 6 months", I don't think it means that it then begins to wane after 6 months. I think it means that 6 months is as far as their study covered and didn't go beyond that. Also, it wasn't a study of booster shots.

I agree that booster shots may be advisable, but I hope that people who are still waiting for their first round of shots have their opportunity first. I suppose that most middle-aged or older people in first-world countries have already at least had the opportunity to get vaccinated.

[zooterkin]

Originally Posted by The Atheist

I think that study should ensure vulnerable people at the very least, receive a booster after six months.

That’s certainly the plan in the UK.
https://www.nhs.uk/conditions/corona...oster-vaccine/

[The Atheist]

Originally Posted by Puppycow

I don't know if it really shows that.

Not yet, but waning protection is likely to lead to lower success in severe disease, and is it something we should wait for until people are keeling over?

Originally Posted by Puppycow

I agree that booster shots may be advisable, but I hope that people who are still waiting for their first round of shots have their opportunity first. I suppose that most middle-aged or older people in first-world countries have already at least had the opportunity to get vaccinated.

I don't believe there's a shortage of vaccines anywhere now, but clearly you'd make sure that was the case before going ahead.

Originally Posted by zooterkin

That’s certainly the plan in the UK.
https://www.nhs.uk/conditions/corona...oster-vaccine/

Yeah, I saw that. We're in the process of moving to that over here as well, which is handy, since we vaccinated all the oldies first, so if their protection has declined we'll know about it pretty quickly.

[angrysoba]

Originally Posted by The Atheist

I do note one of the researchers involved seems to be fairly heavyweight - Julian von Mendel has a substantial number of papers to his name and has been referenced thousands of times.

He does? He is listed as being affiliated with "IU International University of Applied Sciences" but I cannot find anything about him online. The link to his Google Scholar page shows not much...

There seems to be another Julian Mendel at Florida International Univeristy. Different person, I think.

The other two are listed as "independent researchers". Hmmm....

[marting]

Pandemic enters transition phase—but to what?
https://www.science.org/doi/10.1126/science.acx9290

Good piece on possible futures as Covid-19 transitions.

Quote:

Denmark is a pioneer. As the second coronavirus winter approaches in the Northern Hemisphere, Denmark and a few other countries where vaccines now protect a large percentage of the population from severe disease are entering a momentous transition: from pandemic to endemic COVID-19, when the virus is still present but now faces a population that is mostly immune to it. Researchers are closely watching what happens next, because it could yield valuable information about what lies ahead for the rest of the world.

[Puppycow]

Originally Posted by marting

Pandemic enters transition phase—but to what?
https://www.science.org/doi/10.1126/science.acx9290

Good piece on possible futures as Covid-19 transitions.

From the article:

Quote:

Life in Denmark now feels so much like it did before the pandemic that it can put visitors on edge, says Lone Simonsen, an epidemiologist at Roskilde University. The country lifted all of its remaining coronavirus restrictions on 10 September. Copenhagen clubs are buzzing, music lovers flock to festivals, and buses are packed with unmasked commuters. The government has given up its power to close schools and shut down the country. “When we have guests now, they feel uncomfortable about how normal everything is,” Simonsen says.

If this is true, that seems to be different from how things are here in Japan. Emergency measures were allowed to expire at the end of September, but people still wear masks on public transportation like busses and trains. Also in supermarkets and the like, and even outdoors. If you aren't wearing one, you'll feel like you are the only one, so I think there is a social pressure element to it that isn't present in countries where mask-wearing is not part of the culture.

I don't know that mask-wearing is a panacea. I think it needs to be almost universal to really make a significant difference. But when it is almost universal as it is here, I think it really does make enough of a difference to be quite significant. Remember that only a small difference in the effective reproduction number of a virus can make a huge difference over time. And I do suppose that universal masking only makes a small difference in the effective reproduction number, but that small difference really multiplies up to a large difference over time, just as earning a small percentage gain on an investment every year can multiply up to a large gain if the gains are reinvested each time.

[The Atheist]

Originally Posted by marting

[b]Good piece on possible futures as Covid-19 transitions.

I note that while numbers are still low, Denmark's case numbers are up 50% in the past fortnight. Watching with interest.

Originally Posted by Puppycow

I don't know that mask-wearing is a panacea.

They sure make a hell of a difference in casual contact situations. We've had hundreds of thousands of casual contacts in the current outbreak due to infected cases going to the supermarket while infectious, but not a single case has arisen from them.