Study their behaviors. Observe their territorial boundaries. Leave their habitat as you found it. Report any signs of intelligence.

Loading Table of Contents...
 
 
 
 
 
 

Thursday, June 17, 2021

Why Did We Fumble COVID-19 Therapeutics?

A variety of reasons, in roughly descending order of guestimated importance:

  • The early focus was on "flattening the curve" to preserve hospital and ventilator capacity, and so insufficient attention was paid to early-stage therapeutics.
  • Hydroxychloroquine was unsuccessfully tried as a late-stage therapeutic, and this politicized episode made the healthcare establishment afraid of an embarrassing replay.
  • Therapeutics don't appreciably reduce R0 compared to a vaccine. Treatment is super important, but curtailing exponential spread is super-duper-important.
  • Risk-averse government bureaucrats didn't think to waive the rule that Emergency Use Authorization for vaccines is only allowed if no therapeutics are available.
  • Risk-averse medical bureaucrats are indoctrinated to oppose any therapy that hasn't been proven effective, particularly in randomized control trials.
  • The pharmaceutical industry has no profit incentive to re-purpose off-patent drugs for new indications.
  • The Orange Man was promoting therapeutics, and we can't give him a win.
  • It was harder to recruit early-stage trial subjects because 1) they're not in hospital beds and 2) the pandemic ebbed in summer.

Tuesday, June 15, 2021

COVID-19 Heterogeneity

A list of possible factors for why COVID-19 has affected different regions differently, in decreasing order of my guestimated importance. 

Beware the political agenda of anybody selling a monocausal theory.

  • geographic/travel connectivity, incl. travel bans
  • vaccination curve
  • efficacy of vaccine(s) used
  • population age structure
  • lockdown policies
  • population density
  • hemisphere (summer vs. winter)
  • co-morbidities: obesity, heart disease, hypertension, smoking, asthma, diabetes/kidney, sickle cell, cancer
  • mask polices
  • vaccine demographic targeting
  • elderly clustering e.g. nursing homes vs. multi-generational domiciles
  • super-spreader opportunities
  • under-/over-reporting of COVID-19 deaths
  • domicile ventilation
  • air conditioning
  • temperature
  • humidity
  • ultraviolet incidence
  • prior culture of mask use
  • advanced contact tracing
  • cultural acceptance of lockdowns
  • compliance culture (e.g. Italians racing to trains against lockdown deadlines)
  • vitamin D use
  • anti-parasite Ivermectin use
  • anti-malaria hydroxychloroquine use
  • use of mass transit
  • blood type
  • prior experience with SARS/MERS
  • greeting culture: kiss, handshake, bow
  • nursing home return policy
  • South Asian Neanderthal haplotype (Zeberg, Paabo 2020) makes hospitalization 2X likely
  • chromosome 12 Neanderthal haplotype (vs RNA viruses, 2021) makes hospitalization 22% less likely