Perhaps Dr Lyons-Weller would respond to:

https://urldefense.proofpoint.com/v2/url?u=https-3A__www.ncbi.nlm.nih.gov_pmc_articles_PMC7144200_&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=LXRs4yqzzu7UNpsoi4dxktRCNm-Eg8YB58QSPK88ff8&s=9N4rqoeLCuVdoIeSsm7jNA121vNLktgKHlpac0QBlqM&e=  <https://urldefense.proofpoint.com/v2/url?u=https-3A__www.ncbi.nlm.nih.gov_pmc_articles_PMC7144200_&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=LXRs4yqzzu7UNpsoi4dxktRCNm-Eg8YB58QSPK88ff8&s=9N4rqoeLCuVdoIeSsm7jNA121vNLktgKHlpac0QBlqM&e= > 

At the same time, would you clarify for those of us who are aged, the significance of the data you present?

Respectfully,

Waldemar

Waldemar A Schmidt, PhD, MD
(Perseveret et Percipiunt)
503.631.8044

Strive not to be a success, but rather to be of value. (A Einstein)

> On Sep 25, 2020, at 10:46 AM, Joseph Michalski <[log in to unmask]> wrote:
> 
> Hi folks. Gregg provided some info on COVID-19 shared through JMU, while James has offered a variety of different reasons to suggest that "the data are off by quite a bit." From what I can infer, James mainly seems to be arguing that there are medical dimensions that are certainly more nuanced and complicated, such that there may be reasons to consider the pandemic somewhat less serious and more manageable through various treatments and different approaches. That seems like a reasonable assertion, or at least one that can be debated credibly amongst those who have greater scientific expertise in those fields. Alas, I do not have adequate knowledge or expertise - and thus have to rely upon others & weigh their competing arguments & evidence. If we are quite honest, then many of us - myself included - will have to conclude that for the most part "I don't know." Here, I'm channeling Daniel Schmactenberger here with the statement "I don't know." Not because I don't care, but because I genuinely don't have the expertise and the science remains hotly contested in some realms. What's salient here is the Daniel's argument from a recent podcast that:
> 
> "I actually care so much that I’m not willing to have false confidence that biases me, because once I start to believe ‘I think I know’, now I just have confirmation bias where I look for things that confirm that and throw out the other things and surround myself with people that agree with me. And if I really care, that’s the worst thing I can do. I ruin my ability to be connected to reality at that point, instead just wanting to get confirmation of a particular type of social signal from a particular audience that will confirm that for me. And so I’d much rather be able to say ‘I really care and I really don’t know and that’s uncomfortable.”
> 
> So, on the scientific matters that pertain to the behavior of pathogens, their mutation, and the human-immuno responses to such pathogens, I would certainly like clearer evidence & explanations for public consumption - but I do have to trust the scientists in these areas and their expertise since I do not have the same knowledge base obviously. It would certainly seem plausible based on the broader epidemiological & publish health frameworks - where I have much more knowledge - that we would expect highly variable risks across the population associated with: a) contracting COVID-19; and b) the more adverse effects. What would be most helpful, then, for public consumption would be a greater consensus on the importance of different risk factors in these regards. That still doesn't tell people how they "should" behave or what government policies "should" be, but it would certainly help place the discussion of firmer footing and more common ground. For example, if the elderly are at significantly greater risk, then one can debate the degree to which they should be more "quarantined" and "protected" - and what measures that might involve - as compared with, say, elementary school children. One then has to factor into the models what kinds of contact can occur and how that might be restricted. Speaking from a practical, policy standpoint, then that may lead to what has happened, for example, to my 91-year-old mother in her assisted-living facility in Virginia (I'm from the U.S. originally), where they've implemented strict rules for contact & visitation, etc. But that's a vastly different envt than your average Wal-Mart store. Our schools are open here in Canada, but there are some mixed results and some concerns (which I won't get into here) - and thus we are constantly updating our policies and responses. The generally accepted wisdom has been social distancing, masks for entering stores/fitness facilities/etc. (but not for outdoor meals at restaurants), and other simple measures that are widely accepted by the vast majority of the population - and more targeted testing, among other strategies. Then, when a nursing friend of ours contracted COVID-19 - along with her two 20-something daughters - they all quarantined & we delivered food & other essentials by dropping them off on the doorstep for a couple of weeks. They recovered without having to be hospitalized - again perhaps reflecting different "risks" and yet at the same time behaving in an obviously socially responsible way by not putting anyone else at risk.
> 
> This leads me to a couple of James' latter points (#9 & #11), where I can offer some sociological insights, since that's my actual area of expertise (although I confess that I often don't feel like an expert there either, despite 35 years of training in that field, which is more of a mess than psychology, IMHO). RE: Sweden. Even there, the discussions are complicated & there's not yet really a consensus, even though there are clearly some positive results that are worth noting. So why not simply "emulate Sweden"? Because neither the U.S. nor Canada are anywhere close to Sweden in terms of the ecological environments and, more important, in terms of population diversity - and trust in government. Thus we have far more diverse populations with which to contend - meaning there will be different distributions of relative risk factors, as well as cultural diversity that involves different sequalae & behavioral responses, not to mention different risks of things like obesity, etc. Additionally, Swedes arguably have far more trust in their government & experts - based on public opinion polling and attitudinal research - than in Canada and definitely as compared w/ the U.S. In turn, that trust tends to be reciprocated and the Swedish govt does not have to be as heavy-handed w/ their enforcement, trusting the good will and intelligence of a better educated, more homogeneous, and more trusting population to "do the right thing." That's much harder to accomplish, especially in the U.S. where many of risk factors are exacerbated with huge discrepancies in education, wealth, languages/cultures, access to affordable healthcare, etc. The general point is that where you have less diversity & less extremes on a number of key measures, it's much easier to get people to go along w/ the program - and to look after each other in more meaningful ways.
> 
> Finally, in regard to James' last point that "The politicization of COVID19 and early mistakes in policy (IMHO) have had immeasurable costs to society including deaths of despair," I would tend to agree. But then look at who has been mainly responsible - try to be as objective & apolitical in your assessment - and how the U.S. system lacked a meaningful, coordinated response - and you have to admit a highly dysfunctional system & far more that I could comment on than anyone would be willing to listen to from just another "outsider." But I can objectively compare policies and practices in Canada and the U.S. - and draw some reasonable conclusions. Yes, we wanted businesses to re-open here & have no interest in destroying the economy any more than anyone else would wish that for the U.S. or for other countries. But we responded differently. For example, we invested heavily in our EI supports (employment benefits) and extended these in far more generous ways, made sure no one fell through the cracks in terms of our collective responses to health, housing, and econ marginalization, and have invested further in mental health supports, as well as other preventive responses. And that includes in jurisdictions, like Ontario, headed by quite conservative political leadership. Have we handled things perfectly? Of course not. Yet our re-opening in phases strategu seems to be working reasonably well, the key behavioral changes like wearing masks in indoor spaces w/ the general public remain intact, and we are not pointing the fingers at one another or at our politicians or public health experts for the most part (but we certainly have our extremists here too, both on the left and on the right). 
> 
> In closing, I think it's still reasonable to argue that the pandemic remains a serious public health issue on a global scale - and much of the science remains to be decided. I'd rather trust the experts in immunology and people like James to work on these issues, and not rush to judgments or to vaccines. But I still have faith in the many scientists & experts to figure out the biomedical & immunological issues, if we can slow down and let them do their jobs - including the critical feedback and skepticism from the broader community that science requires. On the social/cultural/political side, however, I'd argue the issues are even more complex and the dynamics in the U.S. especially have created something of a "perfect storm". One doesn't have to be a Trump hater to recognize that he's probably not the person you'd want in charge during a pandemic. But, to be fair, I don't know that anyone could have led the U.S. effectively on this one, given the deeper social, cultural, political, and ecological problems currently facing the nation. I mean, it boggles the mind that you'd still not be able to get safe, clean water to the residents of Flint, Michigan. Compare that to our response to Walkerton here in Ontario some years ago. More specifically, if you're going to engage in a largescale econ shutdown, then you'd need to invest far more resources to deal w/ the fallout (such as mental health issues, suicidal ideation, etc.) rather than just let everyone cope of their own. Apart from the divisive rhetoric associated w/ an econ shutdown, the last thing you would want to do from a public health perspective would be to guarantee widespread unemployment and combine that with a lack of policies to ensure healthy access to basic resources, healthcare, and income security. Naturally, if you're not willing to provide these sorts of things for the economically at-risk, the small business owners, etc. - than you better NOT shut down the economy. You see the dilemma? Simply put, you need to have some degree of trust and "depoliticization" to coordinate integrated, constructive responses to public health crises, pandemics, and even natural disasters. That's a tall order when you have so much division, diversity and inequality in the U.S., as I can explain further based on my work and my field. 
> 
> Respectfully yours, -Joe
> 
> Dr. Joseph H. Michalski
> Professor
> King’s University College at Western University
> 266 Epworth Avenue, DL-201
> London, Ontario, Canada  N6A 2M3
> Tel: (519) 433-3491
> Email: [log in to unmask] <mailto:[log in to unmask]>
> ______________________
> eiπ + 1 = 0
> 
> From: tree of knowledge system discussion <[log in to unmask] <mailto:[log in to unmask]>> on behalf of James Lyons-Weiler <[log in to unmask] <mailto:[log in to unmask]>>
> Sent: Friday, September 25, 2020 11:47 AM
> To: [log in to unmask] <mailto:[log in to unmask]> <[log in to unmask] <mailto:[log in to unmask]>>
> Subject: Re: FW: UHC COVID 19 update
>  
> 
> Thanks, Gregg. I'm going to upload for you all 11 points on COVID that will certainly be food for thought.
> 
> As far as I can tell, the data are off quite a bit.  As we are, I believe, a collection of realists. I should point out that
> 
> (1) CDC decided to count all who die with PCR positive COVID tests as "died from", failing to distinguish "died from" from "died with".  They have
> in the past convolved "influenza" deaths with deaths from other respiratory viruses (RSV, SV and, ironically, coronavirus). Only about 9% of 
> "flu deaths" from 2014-2019 were confirmed to involve influenza virus. Dr. Biix announced this in March.
> (2) FDA did not require empirical estimates of false positives in PCR tests for Emergency Use Authorization.  Even more recently, they had all test
> makers characterizing sensitivity, but not specificity.  I have written to FDA wondering why.
> (3) Independent studies are finding high false positive rates of PCR tests (e.g., Dr. Sin Hang Lee, Millford, CT).
> (4) Coupled (1) with the reality that the PCR tests have false positives in the field use, mass testing (screening) will find more false positives
> in raw numbers than true positives.  This is true for cases and deaths.  It's the reason we do not all get CT scans for cancer every year - 
> too many infections due to biopsies of FPs. There is no rule (that exists or that is in use) telling us when, as pandemic progresses, it is ethical to switch from symptom-based testing to mass testing (I've worked that out mathematically and am trying to publish it).
> (5) The safety of COVID19 medical care has increased dramatically; high death rates due to the use of ventilators are being replaced with low pressure high 02 protocols.
> (6) Many deaths have involved a strange coagulopathy.  This condition is very simple to prevent with proper medicine.
> (7) Only certain types of people (with pro-inflammatory, autoimmune-prone Th2 skewed immune systems) appear to be at risk.   Some think this may be genetic (lack of a particular initial "innate" immunity (mediated by interleukin-1):
> https://urldefense.proofpoint.com/v2/url?u=https-3A__www.nih.gov_news-2Devents_news-2Dreleases_scientists-2Ddiscover-2Dgenetic-2Dimmunologic-2Dunderpinnings-2Dsome-2Dcases-2Dsevere-2Dcovid-2D19&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=LXRs4yqzzu7UNpsoi4dxktRCNm-Eg8YB58QSPK88ff8&s=aX46KUfu6090zHg89m7T-mz6Efn-dSXHehU3nmLDudc&e= 
>  <https://urldefense.proofpoint.com/v2/url?u=https-3A__www.nih.gov_news-2Devents_news-2Dreleases_scientists-2Ddiscover-2Dgenetic-2Dimmunologic-2Dunderpinnings-2Dsome-2Dcases-2Dsevere-2Dcovid-2D19&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=rp42bcAc7ghxhiY3EZqDjJXHt9X3Sf3SFD6kThve7Ys&e=>
> (8) Combine (1) with (7) and the fact that in 2019 people >70 have the same probability of dying in one year as the Infection Case Fatality Rate 
> in COVID19, a large portion of deaths were likely due to "COVID19 exacerbating pre-existing conditions" (get and stay healthy, my friends!)
> (9) Sweden did not lock down, and their # new cases has been near zero; thus, the elderly etc are now protected in Sweden.  While they have been criticized for higher number of deaths in the elderly, this was temporary because they appear to have achieved herd immunity; we have not; flattening the curve obviously extends the duration of the outbreak, and there are now many, many scholars, including MDs and public health scientists who say Sweden "got it right".
> (10) I am editor-in-chief of a journal "Science, Public Health Policy & the Law" and I suggest a read of the case series by Dr. Brownstein and team, which I have attached.  Many studies are now showing protective value of Vitamin D (specifically D3).   I think it helps us fold our proteins properly, reducing endoplasmic reticulum stress (1/3 of our proteins require help folding in the lumen of the ER, and environmental toxins impair that process are increasingly abundant).
> (11) The politicization of COVID19 and early mistakes in policy (IMHO) have had immeasurable costs to society including deaths of despair.
> 
> If you're into immunology, attached is a compressed file with some slides for a lecture I gave with .pdfs of publications relevant to most of the points of the talk.
> 
> Cheers,
> JLW
> 
>  Immunology of COVID19.rar <https://urldefense.proofpoint.com/v2/url?u=https-3A__drive.google.com_file_d_10lXizA7n6nuiyV-5FaB99KkNYiCcGgLNIh_view-3Fusp-3Ddrive-5Fweb&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=O0smwdV2Fdlhve0s1cfBFstDpqb9khTMjI9hrZXTSUc&e=>
> 
> 
> 
> 
> On Fri, Sep 25, 2020 at 9:56 AM Henriques, Gregg - henriqgx <[log in to unmask] <mailto:[log in to unmask]>> wrote:
> Hi Folks,
>   I thought this was a useful summary of COVID that JMU University Health Center provided, so I am sharing it.
> G
> >>> 
> Global cases now exceed 32 million. New global daily cases now average about 285,000. India continues to have the most new daily cases, averaging about 87,000.
> The US and Brazil continue in 2nd and 3rd place. Other South American countries (Argentina, Columbia) and some European countries are also seeing significant numbers. France and Spain are seeing a greater surge now than they did in the spring. On the positive side, the death rate has been significantly lower in these countries. The US 7-day moving average for test positivity rate has decreased to 4.9%, but daily testing still remains only around 800,000. Testing volume in the US continues to lag. However, these data reflect PCR testing. Antigen testing is becoming more available and being used more. States are just now adding these tests to their data.
> <Outlook-o04hdpqa.png><Outlook-tunqnyoi.png>
> Nationally, total cases have now exceeded 7 million and are currently reported at 7,139,553. New daily cases continue to hover around 40,000. The average daily death rate is around 800. This is significantly lower than in April. Texas, California, and Florida remain as the top 3 states for new cases.
> <Outlook-3oeb0tqv.png><Outlook-afhtij3h.png>
> The Commonwealth reports a total of 143,492 cases and 3,113 deaths. The testing % positivity is currently at 5.3% which is a significant downward trend over the past 2 weeks. 
> <Outlook-lxlk1n5n.png>
> The Central Shenandoah Health District has also seen a significant decline in the 7-day moving average for test positivity, dropping from 18.3% on 9/6 to 7.9%.
> <Outlook-nk0mz1ny.png>
>  
> Locality
> Current total cases
> New cases over the past 9 days
> Prior 5 day data on new cases
> Harrisonburg
> 2564
> 518
> 233
> Rockingham County
> 1403
> 199
> 90
> Augusta County
> 472
> 38
> 28
> Staunton
> 250
> 31
> 30
> Waynesboro
> 257
> 9
> 14
> Shenandoah County
> 804
> 13
> 9
> Page County
> 389
> 13
> 10
> At JMU we are seeing fewer positive test and fewer people reporting a positive test performed elsewhere. However, we are also seeing fewer people get tested and therefore our 7-day average test positivity remains around 17%. All cases occurring in employees have been a result of either non-JMU related exposure or employee to employee (rather than student to employee) exposure. The reports are that face mask use in the academic settings has been very good. This significantly accounts for a lack of transmission between student and faculty.
> Vaccine development continues with new vaccines being developed and entering clinical trials. Two of the vaccines that are furthest along in development are m-RNA vaccines (Moderna and Pfizer). However, there is a very interesting and concerning logistic related to these vaccines-the cold chain storage required. These vaccines require storage at -94 degrees Fahrenheit (yes, minus 94). Transport would require storage in dry ice. These vaccines last 24 hours at refrigerated temperatures between 36.6-46.4 Fahrenheit. In contrast, vaccines under development by Sanofi and Novavax are stable for months at typical refrigerated temperatures.
> Johnson & Johnson has a single dose vaccine entering phase 3 trials while Merck and Sanofi (both well-known and well-respected in vaccine development) have vaccines in development and entering clinical trials. An important factor is the corporate knowledge, infrastructure, and ability of these two companies to both vaccine development and large-scale production. They may be late in the game but they should not be counted out. This article <https://urldefense.proofpoint.com/v2/url?u=https-3A__www.statnews.com_2020_09_24_here-2Dcome-2Dthe-2Dtortoises-2Din-2Dthe-2Drace-2Dfor-2Da-2Dcovid-2D19-2Dvaccine-2Dslow-2Dstarters-2Dcould-2Dstill-2Dwin-2Dout_&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=-LgSClvKm4eb9XM_TzRo26jPfnNUT2LnjptOkglHrec&e=> covers some information about vaccines in trials and development.
> It seems very unlikely there will be a single winning vaccine-at least in the beginning. Time will tell which vaccine approach seems to work best with the optimal immune response and duration.
> As an aside, recently the head of the CDC (Robert Redfield) commented that mask wearing was likely to be more effective than any vaccine.  “I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine,” Redfield said while testifying before the Senate Subcommittee on Labor, Health and Human Services on expectations around the release of COVID-19 vaccines.  He was not indicating that vaccine are not likely to be effective but instead on the value of masks as a preventative measure. He may also have been forecasting the need for mask use even when vaccines are available.
> Enjoy the beautiful weekend!
> Andy Guertler
> Andrew T. Guertler, MD
> Medical Director
> University Health Center
> James Madison University
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> -- 
> ---
> james lyons-weiler, phd
> Author, CEO, President, Scientist
> Editor-in-Chief, Science, Public Health Policy, and the Law <https://urldefense.proofpoint.com/v2/url?u=https-3A__www.publichealthpolicyjournal.com_&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=dhpM-2NwuVQgxfv80ICU1sbvDCcDxi5zIrit1prhQpw&e=>
> Guest Contributor, Children's Health Defense  <https://urldefense.proofpoint.com/v2/url?u=https-3A__childrenshealthdefense.org&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=7y9dnEYZpEhi2udVzxmo1pecGTdLkM8thq3ZUXvM6GA&e=>
> 
> The Environmental and Genetic Causes of Autism <https://urldefense.proofpoint.com/v2/url?u=http-3A__amzn.to_1KNSxPp&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=W7Vlz4XUatxADYJ__2KMlv5muqEQNa4ct6tQ0K6aviY&e=> (Skyhorse Publishing)
> Cures vs. Profits: Successes in Translational Research <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.amazon.com_gp_product_9814730149_ref-3Das-5Fli-5Fqf-5Fsp-5Fasin-5Fil-5Ftl-3Fie-3DUTF8-26camp-3D1789-26creative-3D9325-26creativeASIN-3D9814730149-26linkCode-3Das2-26tag-3Dlivgrelivwel-2D20&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=YTC6wjKLl_sF5Ob6ak0Z6zZj8Dqdebjwy7e0JjMj3MA&e=> (World Scientific, 2016)
> Ebola: An Evolving Story <https://urldefense.proofpoint.com/v2/url?u=http-3A__amzn.to_1TGYY9r&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=vCxqv7KrcvNrv2RSxUNtwDOOAoIOSEteZy_ixuypMUs&s=mq4pNrrrMHd1SZBfgv9aLvYn2Vy7JU3ULWzo1C_cL2I&e=> (World Scientific, 2015)
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