EvC Forum: COVID vaccine works

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Topic: COVID vaccine works - we're saved!

Percy

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Message 893 of 1110 (910215)
04-19-2023 1:08 PM

Reply to: Message 891 by Kleinman
04-19-2023 11:17 AM

Re: The Right to Spread Disease

Kleinman writes:

Based on that understanding, why can't you show the data that mask mandates work for reducing the spread of Covid?
...
Do you have any data that these general mask mandate work?

See Message 890.

On what do you base that expectation that the general public would wear masks properly and the masks be effective?

That wasn't the expectation I expressed. I said that the expectation would be that properly worn high-quality masks should reduce spread in public spaces.

Where have I advocated for a mask mandate?

I didn't say that you were. I said you were the one who keeps mentioning it.

Do you understand the difference between the spread of Covid and the decline in hospitalization from Covid?

Not sure what you're saying here. If you're just asking if I know the difference, then yes I do. If you're implying a correlation between covid spread and declining covid hospitalization, then that seems unlikely to me.

Do you understand the difference between the instructions in how to use antibiotics and the instructions that would guide a patient in reducing the spread of their infection, respiratory or otherwise?

You're asking if I know the difference between instructions for taking medication and the instructions for reducing contagion? If so then yes.

Percy:
You asked about "the four classic signs of infection" but instead gave those for inflammation.

Aren't you aware that infections cause inflammation?

Yes. Are you saying that the answer to your question about the four classic signs of infection is identical to the answer to the same question for inflammation? Because they're not. It isn't even an appropriate question for infection because the symptoms for infection can be incredibly varied due to the wide variety of diseases. It might be best to just stay focused on covid in this thread.

Addressing this generally to the thread, I don't know if anyone has already posted this, but I found this message at Panda's Thumb: Evaluating Alan Kleinman's arguments

--Percy

This message is a reply to:
	Message 891 by Kleinman, posted 04-19-2023 11:17 AM		Kleinman has replied

Replies to this message:
	Message 895 by Tangle, posted 04-19-2023 1:30 PM	Percy has seen this message but not replied
	Message 898 by Kleinman, posted 04-19-2023 1:42 PM	Percy has replied

Percy

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From: New Hampshire

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Message 894 of 1110 (910216)
04-19-2023 1:09 PM

Reply to: Message 892 by Kleinman
04-19-2023 11:27 AM

Re: The Right to Spread Disease

Kleinman writes:

Why didn't you post this from your link:

Thank you for posting more content from the link.

--Percy

This message is a reply to:
	Message 892 by Kleinman, posted 04-19-2023 11:27 AM		Kleinman has not replied

Percy

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Message 905 of 1110 (910227)
04-19-2023 2:25 PM

Reply to: Message 898 by Kleinman
04-19-2023 1:42 PM

Re: The Right to Spread Disease

Kleinman writes:

I see your Message 890 and raise it to Message 892

Yes, I saw that and thanked you for supplying the additional information.

Percy writes:

I said that the expectation would be that properly worn high-quality masks should reduce spread in public spaces.

Why would you expect that?

Because for those infected it greatly reduces the number of infected droplets reaching the air, while for those uninfected it greatly reduces the number of infected droplets in the air being inhaled. The greater the concentration of people the more protection masks provide.

Percy writes:

I didn't say that you were. I said you were the one who keeps mentioning it.

That's because you have false expectations about what the public would do.

I haven't expressed any expectations about what the public would do. I said that it seems very hard to predict but that it does seem reasonable to expect that the greater and more obvious the threat the more likely the public would be to follow health advice.

Who is more likely to be hospitalized for Covid, a child or an elderly person?

An elderly person.

Do you think the general public understands that distinction? And if so, do they understand those instructions without the physician having to explain those instructions?

I think that as a group the public is not very discerning. I imagine physicians find it frustrating that their instructions and advice are so often misunderstood or ignored.

The Covid infection triggers inflammation, as do many other causes of injury to the tissues.

The signs of covid infection are by no means identical to the signs of inflammation.

Don't you want to know what the patient should understand when they are treated for an infection with antibiotics?

It might be better to keep the focus on covid in this thread.

Theodoric won't tell what his wife tells her patients, and Google doesn't tell you what the expert advice is.

Google finds a great deal of expert advice online.

Don't you want me to tell you so that you can say, "That's obvious", except you won't tell us now?

If you have useful information you'd like to present then please proceed.

And Tangle has already pointed out my discussion with Felsenstein on Panda's Thumb. Do you know that Felsenstein refuses to do the mathematics for the Lenski experiment?

You don't say!

--Percy

This message is a reply to:
	Message 898 by Kleinman, posted 04-19-2023 1:42 PM		Kleinman has replied

Replies to this message:
	Message 907 by Kleinman, posted 04-19-2023 3:32 PM		Percy has replied

Percy

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Message 908 of 1110 (910230)
04-19-2023 5:03 PM

Reply to: Message 907 by Kleinman
04-19-2023 3:32 PM

Re: The Right to Spread Disease

Kleinman writes:

Any time. You need additional information.

As do we all.

Do you think that children wear appropriate masks effectively?

About appropriate masks, I think children most likely wear the masks provided to them by adults.

As to how effectively children wear masks, I expect that how well any group wears masks is dependent upon their average competency, and the greater the competency of a group the more likely its members are to wear masks effectively. I'd guess that the very young and the very old are least likely to wear masks properly.

Some general mask mandates have an exception for masks for children. How does that affect the spread of Covid.

I don't have an answer for you.

Who explained the health advice to the public?

Public health officials at all levels of government and medical professionals.

Kleinman:
Who is more likely to be hospitalized for Covid, a child or an elderly person?
Percy:
An elderly person.

Why do you think that happens?

You're asking the wrong person, but one possibility might be that the immune system of children is more robust than in the elderly.

Does your understanding come from your imagination?

No.

What makes you think that as a group the public is not very discerning.

General observations over time.

Most of my adult patients understand my instructions. Pediatric patients will have trouble understanding some of these instructions, but parents generally do understand medical instructions including those I give on how to use antibiotics and what to expect from treatment.

That's wonderful.

Do you know what those instructions are?

Unless you tell me then no, I don't know what instructions you give your patients.

Kleinman:
The Covid infection triggers inflammation, as do many other causes of injury to the tissues.
Percy:
The signs of covid infection are by no means identical to the signs of inflammation.

And you say this from personal experience?

No. Does this mean you're going to continue to claim that the signs of covid infection are identical to the signs of inflammation?

Are you aware that one of the most common and most difficult diagnostic problems that pulmonologists face is the diagnosis of an inflammatory process in the lungs?

If you say so, but how is that relevant to your erroneously equating signs of inflammation to those of covid infection?

What should the patient be advised that has Covid but is not ill enough to be hospitalised and is put on an anti-covid medication as an out-patient?

I don't know. What?

What does Google tell you that the patient be advised that has Covid but is not ill enough to be hospitalised and is put on anti-covid medication as an out-patient?

This particular link (among many returned by a Google search) is about how to treat covid patients with Paxlovid: Fact Sheet for Healthcare Providers: Emergency Use Authorization for Paxlovid™

Kleinman:
Don't you want me to tell you so that you can say, "That's obvious", except you won't tell us now?
Percy:
If you have useful information you'd like to present then please proceed.

Don't you know the obvious?

Apparently not. Please tell us your useful information.

Felsenstein makes a blunder here. He assumes natural selection only depends on the relative fitness of different variants as seen with biological competition. Natural selection in descent with modification and adaptation depends on the absolute fitness of a variant, that is the number of replications that variant is able to do.

Felsenstein used the term generations, and I'll just assume that your "replications" and his "generations" mean the same thing. Anyway, Felsenstein doesn't address fitness at all in what you quoted, so I don't really know what his position on it is. You do quote him saying that you erroneously keep the succeeding subpopulations the same at nA, and you don't address that. I'm not myself qualified to discuss this, and it's not relevant to covid anyway.

--Percy

This message is a reply to:
	Message 907 by Kleinman, posted 04-19-2023 3:32 PM		Kleinman has replied

Replies to this message:
	Message 909 by Kleinman, posted 04-19-2023 7:00 PM		Percy has replied

Percy

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Message 910 of 1110 (910260)
04-20-2023 8:31 AM

Reply to: Message 909 by Kleinman
04-19-2023 7:00 PM

Re: The Right to Spread Disease

Kleinman writes:

Do you think that if someone wears a mask improperly or wears an ineffective mask that it will increase the spread of Covid?

Every little bit hurts.

Do you think if a child has Covid but is asymptomatic and the child is out in public that the child is more likely to spread the infection?

Current understanding is that covid infected children as a group tend to be much less contagious than adults, but an infected child in public is more likely to spread infection than one at home.

Did someone explain to you what mask was appropriate and what was the effective way of using the mask?

Most of my understanding was gained from written material.

That is partially correct. Very young children and infants don't have a fully developed immune system and as we get older, our immune system tends to become less effective in later years as do our other organ systems. There are other factors that affect our immune system such as our state of nutrition and comorbid conditions. Someone with cancer, heart disease, or diabetes,... tend to be more vulnerable to Covid, Influenza, and other infections because of their weakened state from other diseases. The extra stress that Covid puts on a person can push them over the edge.

Thank you for this useful information.

Where does your understanding come from of how physicians feel when communicating with their patients?

I wouldn't call it an understanding. But my sense in talking to physicians (both friends and ones I see professionally) and reading articles by them is that treating patients can be like pushing on a string.

Kleinman:
What makes you think that as a group the public is not very discerning.
Percy:
General observations over time.

Give us an example of your observations that make you draw this conclusion.

The way that many responded to the pandemic is a good example. Many fit in the same category as two tennis buddies of mine, so I'll briefly describe their situations since they serve as good examples.

One caught covid back in 2020 which turned into long covid. Within about a year he had begun to improve but refused to be vaccinated, caught covid again which worsened his long covid, and now he can't stay on a tennis court for more than about 5 minutes at a time. He's had to give up the game.

Another tennis buddy declared that his immune system was so robust that he didn't need vaccination. He caught covid several months ago from which he still hasn't fully recovered, and he, too, cannot stay on a tennis court for more than 5 minutes at a time. Hopefully he'll continue to improve and it won't turn into long covid, but we'll see.

Had either friend been more discerning about the hail of conflicting covid information and gotten the vaccine and worn masks they could have reduced the likelihood of catching covid and of being hospitalized (both were).

I come to a very different conclusion than you. Perhaps it is because I live in a community where many people make their living by agriculture. I think these people are very smart and would never be so disrespectful as you are and say they are not very discerning.

My mother's side has been farmers and ranchers for generations. Good people, smart about livestock and agriculture and other areas where they have familiarity, but not so smart in other areas with which they're unfamiliar, which is true in a general sense of all of us.

The best thing one can know about oneself is awareness of those areas where one's knowledge is lacking. There are many people who have ready answers for things where their answers should be, "I don't now." That's what I mean by not very discerning.

What kind of community do you live in where the people cannot understand reasonable and logical instruction when given to them in a coherent manner?

I think people on average are about the same in terms of comprehension ability all over the country.

It's not that complicated. The history and physical exam give clues to what the infection most likely is. I have a reasonable idea what are the possible causes of infection but still will do bacterial culture and drug sensitivity testing but that will take several days to get the results. For most infections, antibiotics work quickly. I tell the patient that if he/she doesn't feel at least some improvement in the first 24 hours, to contact me. By about the 3rd day, I'll get the results of the lab tests. If they don't agree with what I have prescribed and the patient hasn't called me, I'll call the patient and find out how he/she is doing. It is not that uncommon for lab results to show that an antibiotic won't work but they do anyway. Do you know why? If necessary, I'll change antibiotics at that time. I also tell the patient to take the drugs for 3 days after their symptoms have resolved in case there is any residual occult infection. If symptoms return, restart the antibiotics and call me. It is just a matter of maintaining open lines of communication. The vast majority of my patients get it.

Thank you for this information.

The difference in the inflammatory response caused by Covid is often very similar to the inflammatory response caused by other diseases.

Your evolving answers are getting better.

I don't know, it might be the last 15 years of continuing medical education in pulmonary and intensive care medicine. It's only an hour per week but I do it for about 40 weeks per year. They have presented quite a few Covid cases. I realize your experience as a website administrator makes you much more knowledgeable in this topic.

Aw, shucks, you're embarrassing me.

Kleinman:
What should the patient be advised that has Covid but is not ill enough to be hospitalised and is put on an anti-covid medication as an out-patient?
Percy:
I don't know. What?

The same kind of advice as given above except viruses such as Covid and influenza are associated with bacterial superinfection. These people should be watched for superimposed bacterial pneumonia and treated appropriately and rapidly.

Good to know.

So, you think that pushing a pill is all you have to do to treat an infection?

What I think is that I provided what you requested, expert advice found with a Google search on how to treat covid with medication. That material covers dosage and administration, contraindications, warnings, adverse reactions, drug interactions, population specific concerns, overdosage, clinical pharmacology, nonclinical toxicology and references to clinical studies.

I have, and you don't know the obvious.

Alas.

Replications do not equal generations.

If you're going to comment in terms of "replications" while Felsenstein comments in terms of "generations", then I can't tell how your comments relate to his.

That math works.

How nice.

--Percy

This message is a reply to:
	Message 909 by Kleinman, posted 04-19-2023 7:00 PM		Kleinman has replied

Replies to this message:
	Message 911 by Kleinman, posted 04-20-2023 9:45 AM		Percy has replied

Percy

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Message 912 of 1110 (910265)
04-20-2023 10:44 AM

Reply to: Message 911 by Kleinman
04-20-2023 9:45 AM

Re: The Right to Spread Disease

Kleinman writes:

Do you think that a single infected person wearing a mask improperly or wearing an ineffective mask that they can spread infectious disease to more than one other person?

Yes.

Kleinman:
Do you think if a child has Covid but is asymptomatic and the child is out in public that the child is more likely to spread the infection?
Percy:
Current understanding is that covid infected children as a group tend to be much less contagious than adults, but an infected child in public is more likely to spread infection than one at home.

Where did you get that idea? This is anecdotal, but I have treated a large number of elementary school teachers for respriratory infections. Can you imagine where these teachers contracted their infections?

Covid infections are most commonly contracted by inhaling covid-laden droplets in the air from the exhalations of nearby infected persons.

Kleinman:
Did someone explain to you what mask was appropriate and what was the effective way of using the mask?
Percy:
Most of my understanding was gained from written material.

Can we assume that you have some interest in the subject?

Sure.

Do you think that the general public has the same interest?

No.

It is particularly difficult to tell if a new born is sick.

Good to know.

Kleinman:
Where does your understanding come from of how physicians feel when communicating with their patients?
Percy:
I wouldn't call it an understanding. But my sense in talking to physicians (both friends and ones I see professionally) and reading articles by them is that treating patients can be like pushing on a string.

That's interesting because that's not how I feel and I don't know any physicians that feel like that.

Even greater frustration comes from the requirements and constraints imposed upon them by insurance companies.

Perhaps it is due to the physicians that you listen to are trying to force their patients to do what they say and the patients are not compliant.

I think it is more the lack of control. It is frustrating when people become sick or more sick due to ignoring or in some way failing to follow sound medical advice.

So, if someone doesn't believe as you do they are not discerning?

No, I wouldn't say that. Discernment is usually associated with the ability to assess evidence according to its relevance and reliability.

Do you know that in the CME course that I attend, they have presented quite a few cases of patients that were vaccinated for Covid but still ended up in the ICU with Covid?

Statistics show that vaccination reduces the odds of visiting an ICU.

That is reasonable.

Nice of you to say.

Do you think you can identify what caused an inflammatory response just by looking at it?

No.

You are mistaken, I'm showing you that you are not discerning.

You mean I missed the sarcasm? Darn!

You think you understand inflammation,...

I never made any claims regarding my understanding of inflammation.

What I did was notice when you asked about the four signs of infection, then answered your own question by telling us about the four signs of not infection but inflammation.

What do you think of the advice, "You can't treat a viral infection with antibacterial medication".

It's good advice.

Kleinman:
So, you think that pushing a pill is all you have to do to treat an infection?
Percy:
What I think is that I provided what you requested, expert advice found with a Google search on how to treat covid with medication. That material covers dosage and administration, contraindications, warnings, adverse reactions, drug interactions, population specific concerns, overdosage, clinical pharmacology, nonclinical toxicology and references to clinical studies.

Do you think that is all that is required to treat Covid or any other infection?

No.

Kleinman:
Replications do not equal generations.
Percy:
If you're going to comment in terms of "replications" while Felsenstein's comments in terms of "generations", then I can't tell how your comments relate to his.

Is the meaning of "replications" and "generations" that complicated?

I only noted that the different terminology means it isn't possible to know how your comments relate to Felsenstein's.

--Percy

This message is a reply to:
	Message 911 by Kleinman, posted 04-20-2023 9:45 AM		Kleinman has replied

Replies to this message:
	Message 913 by Kleinman, posted 04-20-2023 12:10 PM		Percy has replied

Percy

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Message 914 of 1110 (910270)
04-20-2023 12:35 PM

Reply to: Message 913 by Kleinman
04-20-2023 12:10 PM

Re: The Right to Spread Disease

How many people could a single infected person transmit that infection?

Potentially many.

Can Covid be transmitted by any other means other than inhaling covid-laden droplets?

Yes.

And

And what?

Does that make the general public nondiscerning?

No.

Are you aware that there is a very high probability that you harbor infectious agents that under the right conditions can cause you serious and even life-threatening diseases?

Yes.

This should be obvious to you.

Sorry.

Do you think that the cost of medical care is of no consequence?

No.

Do you understand the difference between a medical opinion and sound medical advice?

The difference is context dependent.

How do you determine that evidence is relevant and reliable?

Good question. I expect that one becomes better at it through validating one's reasoning from evidence with feedback from the real world.

Do you think that someone that refuses to get vaccination should be punished?

If by punishment you mean isolation to prevent the risk of infecting others with a dangerous contagion because they're unwilling to self-isolate, then sure. If by punishment you mean incarceration, then that would depend upon other factors such as intentionality.

There can be a pattern of inflammation that can be attributed to certain diseases but it is not absolute.

Interesting.

What makes you think I'm being sarcastic?

Because "I realize your experience as a website administrator makes you much more knowledgeable in this topic" is sarcastic.

Do you think that someone with Covid that gets a secondary bacterial pneumonia should not be treated with antibiotics?

Yes.

What do you think of the advice, "Take all your antibiotics until they are finished"?

I think the same thing as last time you asked.

Do you think that Felsenstein uses a different definition for replication and generations than others?

I think only you know what you mean.

--Percy

This message is a reply to:
	Message 913 by Kleinman, posted 04-20-2023 12:10 PM		Kleinman has replied

Replies to this message:
	Message 916 by Kleinman, posted 04-20-2023 1:12 PM		Percy has replied

Percy

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From: New Hampshire

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Message 917 of 1110 (910277)
04-20-2023 2:34 PM

Reply to: Message 916 by Kleinman
04-20-2023 1:12 PM

Re: The Right to Spread Disease

Kleinman writes:

Should you be required to get medical care?

Depends.

Why should doctors be frustrated that insurance companies be involved in medical decisions?

It's obvious why.

What is that context for Covid?

Depends.

Is that the same real world that doesn't discern your view?

You have already admitted that you may be harboring microbes that can cause serious or fatal diseases. Should you be self-isolating? If not, why not?

Contagiousness.

Did I say I was experienced as a website administrator?

No.

When should that treatment start?

Medical decision.

Do you think that a patient should take their antibiotics even if they are not showing any clinical benefit?

I don't know.

What do you mean by "replication" and "generation"?

I'm not the one who used those terms, you were, in your Felsenstein quote and your response to it. I only asked if by "replications" you meant the same thing as Felsenstein did by "generations", because if you didn't then you didn't actually respond to what he said.

--Percy

This message is a reply to:
	Message 916 by Kleinman, posted 04-20-2023 1:12 PM		Kleinman has replied

Replies to this message:
	Message 918 by Kleinman, posted 04-20-2023 3:25 PM		Percy has replied

Percy

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From: New Hampshire

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Message 919 of 1110 (910281)
04-20-2023 5:05 PM

Reply to: Message 918 by Kleinman
04-20-2023 3:25 PM

Re: The Right to Spread Disease

Kleinman writes:

Kleinman:
Should you be required to get medical care?
Percy:
Depends.

Depends on what?

On the same things I said last time you asked this question.

Do you think that others should pay for your medical care? If you think others should pay for your care, explain why?

I think societies should share in the expense of maintaining the health of their citizens.

Kleinman:
What is that context for Covid?
Percy:
Depends.

Depends on what?

On the context of any discussion about covid.

Kleinman:
Is that the same real world that doesn't discern your view?
Percy:
?

Do you think that everyone in the real world agrees with your view. If not, why?

I don't think there's any view that everyone in the real world agrees with. But the real world is the ultimate arbiter of what is true.

Kleinman:
You have already admitted that you may be harboring microbes that can cause serious or fatal diseases. Should you be self-isolating? If not, why not?
Percy:
Contagiousness.

How do you determine that?

Research studies.

Kleinman:
Did I say I was experienced as a website administrator?
Percy:
No.

How did my telling you that I do CME in pulmonary and intensive care cause you to bring up website administrators?

The first to mention website administrators was you in Message 909.

Kleinman:
When should that treatment start?
Percy:
Medical decision.

How should that medical decision be made?

By medical professionals.

Would you want to take a medicine that shows no clinical change in your condition?

I would listen to my doctors' reasons for continuing the regimen and make a decision based on that. And then there are those diseases where maintaining the status quo is a good thing, such as Parkinson's or muscular dystrophy.

Felsenstein refuses to do the mathematics of the Lenski experiment because it would take too long?

He seemed to be implying that the effort would exceed the benefit.

Among other things, the Lenski experiment demonstrates phylogenetics. Why wouldn't Felsenstein want to demonstrate his mathematics of phylogenetics on a repeatable experimental example?

You're asking the wrong person. I only noted that your response to Felsenstein used different terminology, making it appear that your response didn't actually address his concerns.

--Percy

This message is a reply to:
	Message 918 by Kleinman, posted 04-20-2023 3:25 PM		Kleinman has replied

Replies to this message:
	Message 920 by Kleinman, posted 04-20-2023 6:10 PM		Percy has replied

Percy

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From: New Hampshire

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Message 922 of 1110 (910287)
04-20-2023 6:56 PM

Reply to: Message 920 by Kleinman
04-20-2023 6:10 PM

Re: The Right to Spread Disease

Why shouldn't you be confined?

This is just a reformulation of a question you've already asked. The answer hasn't changed.

Do you think that society should pay for STDs? And if so, why.

A healthy society benefits all.

You are still not clear. In what context should people be compelled to get medical care for Covid. Should people be compelled to get medical care for influenza or STDs or any infectious medical condition?

You keep asking the same questions in different ways. If it's because you disagree perhaps you should describe your own position.

Does the real world ever come to a consensus that is wrong? If so, why are they found to be wrong?

The real world is never wrong.

What research study shows that you will never transmit an infectious disease?

None.

You are angry because I have spent decades studying and treating people with infectious diseases and you haven't and I called you out on this.

Oh. Interesting.

Why would people use the cliche "You can't treat viral diseases with antibiotics"?

Antibiotics have no effect on viruses.

What is the incidence of people with Covid that died from bacterial pneumonia?

Pretty high.

Even the rhinovirus which is implicated in the common cold can cause serious disease.

E. coli, too.

Should you be confined if you have a cold?

You keep asking the same questions in different ways. The answer hasn't changed.

Is Covid anything like Parkinson's or muscular dystrophy?

No.

That might seem to be what Felsenstein is implying but wouldn't he want to test his model of phylogenetics against a real, measurable, and repeatable example?

Sounded like he'd like to but that the felt the benefit wasn't worth the effort.

I use the same terminology that Darwin uses and clearly define any terms I use.

The word "replication" never appears in Origin of Species.

--Percy

This message is a reply to:
	Message 920 by Kleinman, posted 04-20-2023 6:10 PM		Kleinman has replied

Replies to this message:
	Message 925 by Kleinman, posted 04-20-2023 8:04 PM	Percy has replied
	Message 931 by xongsmith, posted 04-21-2023 3:32 AM	Percy has replied

Percy

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Posts: 22504

From: New Hampshire

Joined: 12-23-2000

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Message 939 of 1110 (910331)
04-21-2023 10:09 AM

Reply to: Message 925 by Kleinman
04-20-2023 8:04 PM

Re: The Right to Spread Disease

Kleinman writes:

So you think that people should be confined if they have infectious diseases? Is Covid the only disease for which they should be confined or should they be confined for other infectious diseases?

You're still asking the same basic question, and the answer hasn't changed. How to balance personal freedom, individual safety and the risks to the overall population is a tough question. I don't have a ready "one size fits all" answer for you.

20% of Americans have an STD, is that a healthy society?

You can continue asking the same question in different ways, but my answer is the same. Societies should share the cost of health because a healthy society benefits all.

Many of these diseases are life-threatening and drug resistance is appearing in many others.

Sounds like a large and difficult problem that only society as a whole could tackle.

I've already given you my position on this subject, don't you remember?

Of course, but the nature of your continued questions strongly hints that you have more to say.

Kleinman:
Does the real world ever come to a consensus that is wrong? If so, why are they found to be wrong?
Percy:
The real world is never wrong.

What, no smilie?

No, no smilie, I was serious. You may have misinterpreted what I meant by real world. I was using it as a synonym for laws of the universe or natural physical laws, not the planet's population.

Kleinman:
What research study shows that you will never transmit an infectious disease?
Percy:
None.

Somebody confine Percy, there is no research that shows that he won't transmit an infectious disease.

No such research exists for any of us, including you. And as I said previously, isolation must take into account both degree of contagiousness and the severity of the disease. A highly contagious disease that for most individuals presents with very mild symptoms, such as a cold, requires no isolation. But isolation might be considered for highly contagious diseases that can cause severe illness or death.

Kleinman:
Why would people use the cliche "You can't treat viral diseases with antibiotics"?
Percy:
Antibiotics have no effect on viruses.

That is not necessarily correct.
https://www.sciencedirect.com/...ticle/pii/S0014299921003447

Highlights
• Azithromycin...

Studies have found that azithromycin is not an effective treatment for covid, including when combined with hydroxychloroquine. For example, this is from the Interpretation section of Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform tria:

quote:
Our findings do not justify the routine use of azithromycin for reducing time to recovery or risk of hospitalisation for people with suspected COVID-19 in the community. These findings have important antibiotic stewardship implications during this pandemic, as inappropriate use of antibiotics leads to increased antimicrobial resistance, and there is evidence that azithromycin use increased during the pandemic in the UK.

And this is from the Discussion section of Azithromycin versus standard care in patients with mild-to-moderate COVID-19 (ATOMIC2): an open-label, randomised trial:

quote:
In conclusion, our findings in mild-to-moderate COVID-19 managed in ambulatory care, taken together with trials in early disease in primary care and from trials in patients admitted to hospital with severe disease, suggest that azithromycin does not reduce hospital admissions, respiratory failure, or death compared with standard care, and should not be used in the treatment of COVID-19.

Do you think the incidence of bacterial pneumonia could have been reduced if they had been given antibiotics (such as Azithromycin) early in the episode?

It would make sense that anticipating opportunistic bacterial infections like pheumonia through early regimens of antibiotics like azithromycin on covid patients who have not yet contracted pneumonia would have a beneficial impact, but studies did not find one.

As far as the antiviral effects of antibiotics, it's a large and complicated world out there. While antibiotics do not as a rule have any impact on viral infections, it is not inconceivable that there are cases where an antibiotic through some indirect channels has a measurable positive effect. Despite the findings of some researchers azithromycin didn't pan out, either to prevent pneumonia or to improve covid outcomes, and a casual Google search didn't turn up any antibiotics suggested for use with viral infections. But that doesn't mean none exist.

Kleinman:
Even the rhinovirus which is implicated in the common cold can cause serious disease.
Percy:
E. coli, too.

You might be surprised at the number of lethal pathogens that you are exposed to every day.

But we don't worry about them because they are so rarely lethal, and usually only for people with comorbidities such as cancer or advanced age.

What are the conditions that someone should be confined or lose their job due to any infectious disease?

You keep asking the same question in different ways. The answer hasn't changed. If there's a point you're trying to make beyond what you've already said then it would probably work better if you just stated it.

Kleinman:
Is Covid anything like Parkinson's or muscular dystrophy?
Percy:
No.

Parkinson's is a consequence of the destruction of the substantia nigra, muscular dystrophy is a genetic disease. Covid is a viral disease. Influenza has been implicated as a causative factor for Parkinson's. Should influenza patients be confined?

How high are the risk factors?

It certainly won't benefit his work on phylogenetics. It would reveal he is doing his mathematics incorrectly.

I think Felsenstein's actual point was that your math was already wrong at a basic level, and so there was no need to demonstrate that again in a more complex context.

Kleinman:
I use the same terminology that Darwin uses and clearly define any terms I use.
Percy:
The word "replication" never appears in Origin of Species.

Do you think that Darwin understood DNA? He did understand the concept of "reproduction",...etc...

I only pointed out that Felsenstein used the term "generations" while you used the term "replications", and since you claim they're not synonymous that means you didn't actually address what Felsenstein said. You attempted to rebut this by claiming you used the same terminology as Darwin, but Darwin never used the term "replication." You then attempted a further defense by irrelevantly changing the subject to DNA and reproduction.

The original question concerned your response to Felsenstein's comments. He employed the term "generations", but your response used the term "replications", and you said they do not mean the same thing. This makes it appear that you did not actually address what Felsenstein said. You need to respond to Felsenstein's comments in a way that actually addresses his concerns.

--Percy

This message is a reply to:
	Message 925 by Kleinman, posted 04-20-2023 8:04 PM		Kleinman has replied

Replies to this message:
	Message 950 by Kleinman, posted 04-21-2023 12:06 PM		Percy has replied

Percy

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Posts: 22504

From: New Hampshire

Joined: 12-23-2000

Member Rating: 4.9

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Message 941 of 1110 (910333)
04-21-2023 10:17 AM

Reply to: Message 931 by xongsmith
04-21-2023 3:32 AM

Re: The Right to Spread Disease

This was the original exchange:

Percy in Message 914 writes:

Kleinman in Message 913 writes:

How do you determine that evidence is relevant and reliable?

I expect that one becomes better at it through validating one's reasoning from evidence with feedback from the real world.

In this context "real world" just means laws of the universe or natural physical laws. I'm referring to validating hypotheses through experiments. It has nothing to do with polling the world's opinion.

--Percy

This message is a reply to:
	Message 931 by xongsmith, posted 04-21-2023 3:32 AM		xongsmith has replied

Replies to this message:
	Message 945 by xongsmith, posted 04-21-2023 10:54 AM		Percy has seen this message but not replied

Percy

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Posts: 22504

From: New Hampshire

Joined: 12-23-2000

Member Rating: 4.9

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Message 960 of 1110 (910354)
04-21-2023 1:21 PM

Reply to: Message 950 by Kleinman
04-21-2023 12:06 PM

Re: The Right to Spread Disease

Kleinman writes:

If some stranger moves into your home, you can't tell him to leave because he has a right to housing.

What makes you think there's a right to housing?

Why don't you list for us the major factors that help prevent the spread of these diseases?

If you think it's germane to discussion, please list them for us.

The nature of my questions should give you a hint that you aren't stating your position.

Your questions mostly imply I have opinions that I've never stated and that I do not hold. Your questions are of the "Are you still beating your wife" variety.

Who should be locked up for engaging in activity that increases the risk of spreading a contagious disease?

And this question is a good example. I never advocated locking anyone up, so why are you asking me this? I said that balancing personal freedoms against public safety is a tough problem, that I have no answers for you, and I've said it several times now.

...it shows that you don't know under which conditions what some consider a mild disease that is highly contagious can be serious to some people.

If you think those conditions would contribute to the discussion, go ahead and describe them for us.

I keep asking this because your answer is so vague. Where do you draw the line where you should confine someone?

I keep saying I have no answers for you. If you have answers please tell us.

--Percy

This message is a reply to:
	Message 950 by Kleinman, posted 04-21-2023 12:06 PM		Kleinman has replied

Replies to this message:
	Message 961 by Kleinman, posted 04-21-2023 2:06 PM		Percy has replied

Percy

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Posts: 22504

From: New Hampshire

Joined: 12-23-2000

Member Rating: 4.9

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Message 962 of 1110 (910356)
04-21-2023 3:47 PM

Reply to: Message 961 by Kleinman
04-21-2023 2:06 PM

Re: The Right to Spread Disease

Do you think society should be required to pay for someone elses healthcare but not their housing? You like to be generous, with other people's money.

What do you think society's goal should be?

I'll list them for you if you can explain whether or not they need to be taken into account in any statistical analysis.

Why do you need me to explain anything before you list them?

I'm not asking you if you are still beating your wife, I'm asking you under what conditions someone should be confined if they have a contagious disease.

Are you telling us you don't understand how your questions are "Are you still beating your wife" style questions?

I've given you my opinion on the specific conditions, but you haven't given those conditions.

If you already know the specific conditions, why do you need me to give them to you?

Even here in California, they will lock up people with HIV if they have sex with their partner without informing them that they have HIV. So, what are your conditions?

Wasn't that the law that was changed a couple years ago?

I've already given you those conditions and they were also given in the references I gave.

If you've already told us those conditions, why do you keep asking me what they are?

Since you don't seem to get the point, I'll repeat them again for you. People with weakened immune systems and comorbidities (heart disease, cancer, diabetes, asthma,...) are at much greater risk from diseases that might be considered mild. This should be obvious to you.

Of course it's obvious to me. I just said the same thing a few messages ago. It's probably obvious to everyone here because it's just common sense.

That's why Governor Cuomo from New York made a major blunder when he confined elderly people in rest homes and caused a large number of deaths from Covid.

Why do you think it was Cuomo who confined them? Weren't they already there when covid started? What should have been done instead?

I've already given you many answers based on by experience.

Great. I guess that just about wraps it up, then.

--Percy

This message is a reply to:
	Message 961 by Kleinman, posted 04-21-2023 2:06 PM		Kleinman has replied

Replies to this message:
	Message 965 by Kleinman, posted 04-21-2023 4:52 PM		Percy has replied

Percy

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Posts: 22504

From: New Hampshire

Joined: 12-23-2000

Member Rating: 4.9

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Message 979 of 1110 (910384)
04-21-2023 8:20 PM

Reply to: Message 965 by Kleinman
04-21-2023 4:52 PM

Re: The Right to Spread Disease

Kleinman writes:

Percy:
What do you think society's goal should be?

Read the Bible and you can find out.

Why do you think society should include goals like not suffering witches to live or stoning adulterers?

It is called preparation.

So you're not yet prepared for this discussion.

If you can't tell us what you think the conditions are that someone should be confined for spreading an infectious disease, say so.

Why are you having so much trouble comprehending that no one here is arguing for this?

Instead, you find a line in a paper that you think supports your viewpoint about masks when the same paper has paragraphs saying that there are confounding factors in the analysis.

Why do you think papers invalidate their conclusions by enumerating potential problems and issues that they were already aware of when they drew their conclusions?

I'm trying to get you to think about what you propose.

Why do you keep thinking people have proposed things that they haven't?

Kleinman:
Even here in California, they will lock up people with HIV if they have sex with their partner without informing them that they have HIV. So, what are your conditions?
Percy:
Wasn't that the law that was changed a couple years ago?

Yes,...

Then why are you asking about arrests being made under a law that is no longer in effect?

I don't think you fully appreciate how complex the treatment and prevention of infectious diseases are. It is not always as simple as wearing a mask and getting a vaccination.

Why do you think masks and vaccinations do not reduce the spread and severity of respiratory pandemics?

Kleinman:
Since you don't seem to get the point, I'll repeat them again for you. People with weakened immune systems and comorbidities (heart disease, cancer, diabetes, asthma,...) are at much greater risk from diseases that might be considered mild. This should be obvious to you.
Percy:
Of course it's obvious to me. I just said the same thing a few messages ago. It's probably obvious to everyone here because it's just common sense.

It is obvious to you now.

You're obviously having difficulty following the discussion.

I don't think you fully understand what Cuomo did.
Andrew Cuomo’s Report on Controversial Nursing Home Policy for COVID Patients Prompts More Controversy — ProPublica

I recognize what you're referring to now. I didn't find the policy made under difficult circumstances while New York hospitals were overwhelmed of prohibiting nursing homes from discriminating on the basis of covid status anywhere near as egregious as then hiding the data.

I noticed you had a thread and are a strong advocate for gun control.

Thanks for the warning that you'll be soiling another thread soon.

--Percy