Category Archives: Communication

The Next Pandemic

In yesterday’s post, I outlined some of the factors that resulted in the very high COVID case rate in the US. Today I will discuss how we can prepare for the next pandemic.

I have a PhD in molecular biology, and I specialize in infectious disease testing. I am not a physician or epidemiologist. I have an informed but not expert opinion.

Identifying the threat:

First, most new infectious diseases do not pose a global threat.  SARS-2 was so dangerous because of its high infectivity, long incubation time, and asymptomatic spread. Most diseases do not have these parameters.  Whenever a new disease comes around, and they will, we should soberly and cautiously assess the real threat.  Coming to the wrong conclusions about the threat will lead to the wrong conclusions about combating it.

There have been several important new infectious disease outbreaks in the last few years, including Hantavirus (1993), SARS (2003), Avian Influenza (2004), H1N1 Swine Flu (2009), Ebola (2013), Zika (2015), and of course HIV in the 80s.  They all have different disease parameters which make them behave very differently.  Most of these diseases did not have global impact.  The first SARS for example was much less infectious than SARS-2, but much deadlier, so it was contained quickly and didn’t spread much beyond Asia.  HIV can be spread by asymptomatic victims for a full 8-10 years, avoids the immune system, and evades vaccination efforts, so it has become endemic in much of the world.

The following parameters determine how a new disease will behave:

  • Mechanism of spread
  • Infectivity
  • Asymptomatic/ambulatory spread – can the victim walk around and spread disease?
  • Incubation period
  • Fatality rate
  • Vector – what carries the virus to a new host
  • Non-human reservoir – diseases that come from non-humans are harder to control and cannot be eradicated.

Obviously, we cannot respond to different diseases in the same way. Part of the reason we failed to contain the virus was that we used measures that were designed for viruses that spread by droplet transmission against a virus that spreads through aerosol transmission.  Using the wrong measures was less effective.

Much of my concern with the SARS-2 virus was the Antibody Dependent Enhancement issue, which is very uncommon among viruses, so is not usually a concern.

Be cautious.
Whenever a new threat arises, it is wise to be extra cautious until information can be gathered.  Although many of our precautions turned out to be unnecessary, I still support taking extra precautions early on.  Remember that early estimates were that the fatality rate for COVID was 3.68%.  With the 82 million confirmed cases in the US, this would have been over 3 million deaths if the fatality rate had really been this high.  As it stands, we have had almost 1 million COVID related deaths, a death rate of approximately 1.2%.  Yes, I know we can debate how many of these are deaths really resulted from COVID and how many infections there really were.  But we cannot discount that COVID had an enormous impact.

What if COVID were deadlier? Or what if it had selectively killed children, or caused more long-term symptoms like polio did? Things would have been much different.

All this to say, I think caution was warranted in the beginning of COVID, and we should continue to be cautious in future pandemics. On the other hand, we should also learn to abandon precautions that are not effective.  Maintaining ineffective precautions wastes resources, causes extra economic and social suffering, and causes people to lose confidence in government agencies.  It started to become clear to me by May of 2020 that lockdowns were ineffective, and that transmission was happening mostly indoors, but I still see people wearing masks outside to this very day.

Persuasion, not coercion:
From the beginning of the pandemic, public communication was terrible.  Official guidelines were confusing and often contradictory.  Far worse, explanation or evidence was rarely given for policies.  Instead, disagreement was met with accusations of being anti-science, rather than persuasion.  This approach contributed to the loss in confidence in official channels. 

Going forward, officials need far better communication skills when dealing with emergencies.  Give evidence rather name-calling, and respect the population enough to tell the whole truth.

Then came the vaccine mandates.  Many people I know were coerced into getting vaccinated against their will, and many others were fired.  All at a time when information about the vaccines was being hidden from the public.  This is unacceptable, and no way to run an emergency.

Here is a link to my post on science communication:

Restoring Trust:
Both the CDC and FDA hid information from the public.  In order to restore confidence, senior leadership needs to be replaced and new leadership should explain how things will be better in the future.  Is likely to happen?  No, it is not.

Government agencies need to be far more transparent.  Lack of transparency forces people to wonder what is going on, and create their own theories.  Government agencies often decry conspiracy theories, but they had a big role in creating them.

Misinformation:
Freedom of speech, censorship, and misinformation had a major role in the public discussion over the pandemic.  Doctors and scientists were frequently censored, shunned, or fired for sharing ideas that went against WHO or CDC guidelines. This includes ideas like the lab leak hypothesis that later turned out to be likely.

Freedom of speech is a foundational principle of American life.  It’s in our DNA, as some would say.  We are not America without it.  Some will say that too much freedom of speech leads to misinformation and conspiracy theories.  While it’s true that this freedom allows the spread of falsehoods, it also allows all ideas to be debated, true ideas to be raised up, and false ideas to be discredited. Freedom of speech is the solution to misinformation, not the cause.  Most of the leaders in world history that wanted to control freedom of speech had something to hide. It is essential that we maintain this basic right.

State emergency powers:
As discussed in yesterday’s post, the US federal government has surprisingly little power to deal with a public health crisis.  The CDC can develop guidelines, but most of the real work is done at the state and local level.  State officials need to step up and realize it’s their responsibility to respond well.  Citizens need to hold state and local officials accountable.

Manufacturing:
The US needs to maintain manufacturing capacity for certain essential items like personal protective equipment, testing kits and equipment, and medications.  Tax incentives need to exist to encourage companies not to send these functions overseas.

In addition, we should have national and state stockpiles of certain equipment.  I know many hospitals and labs are now creating stockpiles of their own.

Testing:
Most countries that did well produced lots of COVID testing early.  In the US, the CDC tried to manage all the testing themselves, and quickly became overwhelmed.  By the time private labs were allowed to develop their own tests, it was way too late.  Testing capacity didn’t become nearly adequate until at least July of 2020. Next time, the CDC needs to allow testing by private labs right away.  Ideally, anyone who wants a test and anyone potentially exposed to an agent should be tested.

Quarantine, not Lockdown:
Countries that did well did not quarantine healthy individuals, although some of these countries had more restrictions during the big Winter waves.  Instead, only COVID positive people should be quarantined.  This is only effective when tests are readily available.

Later in the pandemic, some outlets acknowledged that most infections were happening in private settings.  Basically, people would get infected outside, then bring COVID home to infect everyone in the household.

Here is a very interesting video using computer models to show why our model of lockdown was not effective.  Computer models are only as good as they are programmed to be, so this is only for demonstration purposes, and is not data.

Contact tracing:
Contact tracing was very successful in some countries, but the long incubation time of COVID made this difficult.  Successful programs involved tracking of individuals by cell phone and credit card data, practices that would probably not be tolerated in the US. Such programs would need to be voluntary to not trigger the creepiness factor and violate constitutional rights.

Masking:
I was a big proponent of wearing a medical grade respirator (N95, KN95, or KN94) indoors during the pandemic.  Because COVID spread as an aerosol as well as droplet form, cloth and blue surgical masks were ineffective.  Simpler masks can be effective against colds and flu, however.  So the choice of mask depends on the agent in question.  CDC guidelines need to reflect the method of spread of the agent in question. 

So what should Dr. Fauci have said early on?  Something like this:

N95 masks offer the best protection against infection by the SARS-2 virus. However, our current supply is very low, and we desperately need to save these masks for our medical professionals.  Please do not purchase N95 masks at this time.  In the mean time, there are some options that will help reduce the risk…

In actuality, of course, I didn’t see an N95 in a store from March 2020 until at least February of 2021, so I couldn’t have bought one if I’d wanted to!

Treatment:
Most medical facilities in the US didn’t treat COVID until a patient was experiencing respiratory distress.  By then, treatment options were limited.  To their credit, intubation was largely abandoned by the medical community when it was learned that this treatment was largely ineffective.

However, controversy swirled over potential treatments that became disfavored by the medical community.  Doctors are usually granted the right to prescribe “off label” medications, meaning they can use medications for treatments outside the guidelines of the manufacturer.  But drugs like Hydroxychloroquine, Ivermectin, and others quickly become forbidden, and some doctors even got fired for prescribing them.  Research on these drugs were minimal.

I am not arguing here that these drugs are effective against COVID.  I’m simply saying that forbidding doctors from working with or publishing papers about these drugs was a big mistake.  While it is of course wise for a doctor to consider guidelines, treating a novel virus may require some “outside the box” thinking.

Let me know in the comments if I missed something important!

Don’t fear, but be smart!
Erik

Misinformation and Censorship

Originally part of a post on August 26, 2021, Video: “Top 3 vaccine Myths” and Tech Censorship.

A word on tech censorship: The WHO said 2 false things early on:

SARS-2 is not human to human transmissible
SARS-2 is not transmissible as an aerosol.

Both of these things were demonstrably false, and perhaps politically motivated, even at time the WHO stated them. In in spite of this, the social media platforms came to hold the WHO as the gold standard for the truth on COVID matters. To this day, F@¢3b00k may place a tag on the end of this post claiming the WHO as the authority on COVID matters. Most platforms would delete or restrict anything that ran against the WHO. Yes, computer programmers in Silicon Valley are still pulling down information posted by medical doctors and scientists. Even Dr. Damania has had videos censored!

One of the worst results of the pandemic in the US is censorship of divergent opinions. Freedom of speech allows 3 things:

All opinions to be held up to public scrutiny.
True things to rise to the surface.
False things to be discredited.

When freedom of speech is restricted, none of these can happen. If a wrong thing becomes the “orthodox” view, and no other views are permitted, then the orthodox view will always be wrong, and we will end up solving all of the wrong problems. If there is a hole in your gas tank, it doesn’t matter how many times you put gas in it. It will always be empty. Fix the real problem first.

This is why all the claims of misinformation, from all sides, are so insidious. When you claim misinformation, you are claiming to have the whole truth on an issue. Sure, we can and should argue against views we think are false. But we must also protect the right to air all views! Or we are doomed only to have the first view that becomes dominant, and we are less likely to find the truth!

I also found an article on why some are still vaccine hesitant. For those of you who are wondering, you should read it.
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Originally part of a post on August 30, 2021, Possible low efficacy of current vaccines against Delta, possible Delta enhancement in the future.

Another note on misinformation: My post from last Thursday generated a lot of discussion regarding censorship and misinformation. I argued strongly that the dangers of misinformation do not outweigh the benefits of free speech. Many of you are pro-vaccine and others are suspicious of the vaccine. I would simply urge this:

1) If you use the words “misinformation” and “disinformation” in a post or in a discussion, please come ready with evidence to support whatever claim your making! Don’t just throw out this word, support it!

I recently saw a video with a pro-vaccine medical person saying “we just need to keep pounding this information into people”. That is the wrong approach. With someone who is not yet convinced to get a vaccine, “pounding” away on them is just going to raise their defenses and exasperate you. Instead, gently show them your reasons for believing what you do! Explain to them what the data means. You may not convince them, but you may move them toward being more open to your view.

2) If someone makes a claim that sounds unfounded or that you don’t trust, don’t just tell them they’re wrong or make a counter claim, ask them to provide evidence, or where they got their information. You don’t have to do their homework for them! If they can’t produce any evidence, you are under no obligation to counter it. I’ve saved myself A LOT of work with this approach. It’s OK that they just heard it somewhere IF their source is reliable and has evidence themselves. You can still ask them to provide you with a link or something to that person’s statement. However, “I just heard it somewhere” is not evidence.

Part of the reason I’m not so worried about “misinformation” for myself is because of my regular use of suggestion #2.

Don’t fear, but be smart!
Erik

Case Update: November 23rd, 2021; Is Vaccine Effectiveness Going Down?

This is a case update.  I’ll also discuss data suggesting that the v@¢¢¡nes are having a mixed effect.

For the US, new case numbers have begun to creep back up.  Several states like Vermont, Minnesota, Colorado, and West Virginia are experiencing increased cases right now.  This is likely at least partly because colder weather is forcing more people inside. Several states are still enjoying decreasing case numbers after the Summer Delta wave, like Oregon, Washington, Alaska, and the Southern states.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Endcoronavirus County Level Map, November 21st, 2021
Endcoronavirus State Level Map, November 22nd, 2021

Last year’s Fall wave started in October, so it’s good news that a new wave may just be starting now, but keep in mind that new case numbers are just as high now as they were at the peak of last Summer’s wave.

In California and San Diego County, new case numbers are persistent, at around 5000 and 500 new daily cases respectively.  The higher persistent number likely reflects the higher infectiousness of the Delta variant.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.

Internationally, several European countries like Germany, the Netherlands, Hungary, and Czechia are experiencing increasing numbers of cases right now.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Daily new cases from Germany, November 23rd, 2021.
Daily new cases from the Netherlands, November 23rd, 2021.
Daily new cases from Czechia, November 23rd, 2021.

V@¢¢¡ne effectiveness:  A pile of new papers have come out regarding v@¢¢¡ne effectiveness.  A few weeks ago, I discussed Subramanian et al which claimed that v@¢¢¡nation rates are not correlated to case numbers internationally.  New papers from Britain, Germany, and even a story on msn.com are claiming that v@¢¢¡ne effectiveness is becoming reduced. 

The British paper states something I’ve suspected for a long time, that most SARS-2 transmission takes place in households, explaining why lockdowns are not an effective means of controlling COVID. They also claim that v@¢¢¡nation status is nearly irrelevant in a household setting, because of long term exposure to family members.

A Swedish paper (Nordström et al) suggested that v@¢¢¡ne effectiveness is reduced over time, especially for elderly men and those with co-morbidities. Effectiveness against severe symptoms begin to be reduced after about 9 months.

From Chris Martenson, using data from Nordström et al.

Disturbingly, some have suggested that v@¢¢¡nation is doing more harm than good.  A set of British data claims that v@¢¢¡nated individuals are dying at twice the rate of the unv@¢¢¡nated.

A German analysis of national data comparing German states is claiming similarly that excess mortality is actually due to v@¢¢¡nation.

Meanwhile, in the US, the CDC is claiming that v@¢¢¡nation greatly reduces the chances of hospitalization and death, although not to zero.  The agency currently claims that the unv@¢¢¡nated are 5.8 times more likely to become infected and 14 times more likely to die than v@¢¢¡nated individuals.

What are we to make of all this?  Is the v@¢¢¡ne really making people sicker?  Are things different in the US and Europe?  It’s hard to know right now.  We are in a period when v@¢¢¡ne effectiveness may be going down right now, so we may be getting mixed signals because we’re seeing this in real time.  The Delta variant is certainly exacerbating the issue, eluding antibodies developed against the Wuhan strain. We also have to consider that we may be seeing the effect of Antibody Dependent Enhancement (ADE), which may cause greater symptoms in those already infected with a related strain.

The present confusing situation is a great example of why it’s so crucial to accumulate as much data as we can, and to be as objective as possible about the results.  US agencies are still openly admitting that they have as a goal to promote vaccination (see slide 2),

From CDC powerpoint, July 29, 2021, slide 2. Red oval is mine.

and even to suppress information that works against this goal (see “Are adverse reactions …”). 

Screenshot from OSHA FAQ on vaccines. Accessed November 23rd, 2021

I cannot stress strenuously enough that if we work from incomplete or faulty data, we have no hope but to come to faulty conclusions and bad solutions.  If you have a hole in your gas tank, it doesn’t matter how much gas you put in it.  You will still have no gas.  You have to deal with the real problem first. 

The CDC has one and only one job.  To produce data and guidance on how to fight disease. But the very sad fact is that I don’t trust the CDC to produce truthful and/or complete data.  This is why we are relying on papers from foreign sources like Britain, Israel, and Japan to inform us on how to approach COVID.  With all the cases here, and 53 different approaches to the virus, we should have the best and most complete data set for figuring out what to do.  But politics continues to make this impossible. I hope this will change.

As discussed in the paper by Liu et al, boosters against the Wuhan strain will likely not offer long term protection against the Delta strain.  Instead, those who have been v@¢¢¡nated should get a v@¢¢¡ne against the Delta strain as soon as it is available.

Most people with severe symptoms are Vitamin D deficient. If you aren’t already, remember to be supplementing with Vitamin D, Vitamin C, and Zinc in order to reduce symptoms and viral load if you should be infected. Most Americans, especially those with darker skin, are Vitamin D deficient, since we spend so much time in doors. Alternatively, make your own by spending 30 minutes outside per day in shorts and a T-shirt!

Don’t fear, but be smart,
Erik

Case Update, November 5, 2021; Vaccine mandate details released, Should you get a booster, do vaccines cause new variants?

This is a case update. I’ll also talk about the newly release v@¢¢¡ne mandate from OSHA, whether you should get a booster, and the question of whether v@¢¢¡nes lead to new SARS variants.

New cases in the US, California, and San Diego County are all fluctuating right now.  It’s hard to say if this represents the beginning of a new wave.  Most of us are feeling like the pandemic is basically over, but I will point out that in the post-Delta trough, we still have as many new cases per day as we did at the peak of last Summer’s wave.  Minnesota, Colorado, New Mexico, and Arizona are all experiencing increases in cases right now.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Endcoronavirus County Level Map, November 3rd, 2021
Endcoronavirus State Level Map, November 5th, 2021
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

V@¢¢!ne mandate finally drops: In September, the President said he wanted government agencies to produce a mandate for v@¢¢¡nation.  Just this week, OSHA issued an Emergency Temporary Standard. This is official form of the v@¢¢¡ne mandate we’ve been waiting for.  The mandate conforms to the news you’ve heard, all employers with more than 100 employees must get v@¢¢¡nation status from all employees, and those who are not v@¢¢¡nated must be tested weekly.  The testing option means that the standard does NOT require that everyone be v@¢¢¡nated. Enforcement will begin January 4th, 2022.

Full length OSHA Emergency Temporary Standard.

As we saw last week, the CDC has known since July that a significant number of hospitalizations and deaths have occurred in fully v@¢¢¡nated individuals.  In addition to this, a recent Lancet paper from Singanayagam et al suggests that the transmission of Delta is less from v@¢¢inated individuals, but is still very significant. In light of this, I think all employees, regardless of v@¢¢¡nation status, should be tested regularly, although it would be impossible to test everyone every week. Ignoring the transmission threat from v@¢¢inated individuals is likely to lead to trouble. Everyone exposed to someone who tested positive for COVID should also be tested.

I saw a truly amazing thing on an OSHA FAQ page regarding v@¢¢ination. I checked it again just now to make sure it was still there.  Under the item “Are adverse reactions to the COVID-19 v@¢¢¡ne recordable on the OSHA recordkeeping log?” The answer reads:

DOL and OSHA, as well as other federal agencies, are working diligently to encourage COVID-19 vaccinations. OSHA does not wish to have any appearance of discouraging workers from receiving COVID-19 vaccination, and also does not wish to disincentivize employers’ vaccination efforts. As a result, OSHA will not enforce 29 CFR 1904’s recording requirements to require any employers to record worker side effects from COVID-19 vaccination at least through May 2022. We will reevaluate the agency’s position at that time to determine the best course of action moving forward.

In effect, an official government page is saying, we are asking you to ignore health information in order to get people to do what we want.  Some of you may be wondering why so many people are willing to ignore official calls to get v@¢¢¡nated, or are suspicious of government in general.  This is why. This also answers the question as to why it is so difficult to get clear information on adverse events. The government appears to have an official policy of ignoring these events.

Screenshot from OSHA FAQ on vaccines. November 5th, 2021

I’ll say again what I’ve said many times, I am not anti-v@¢¢¡ne.  I think many people with risk factors including age, obesity, respiratory or cardiac issues, those who work closely with the public, etc. should get v@¢¢¡nated. However, I am against a v@¢¢¡ne mandate.  I am not v@¢¢¡nated, mostly because of the ADE issue, and because I think I can avoid being infected.

I will also state what is obvious to many, but not to some that are making policy.  Lying or hiding information from the public will make people mistrust you.  You can sometimes force people to comply, but you cannot, even in principle, force people to trust you.  Trust must be earned. Once you lose it, it is very difficult to get back. 

This rule can be applied to any area of life.  Remember this if you’re a husband, wife, parent, child, pastor, politician, consultant, leader of a company, employee, or anything else where trust is required.  Trust is earned, and once broken, is very hard to get back. 

Should you get a booster?: Several people in the past few weeks have asked me if they should get a booster.  Right now, unfortunately, my best answer is “I don’t know”.  A booster may improve your immune response to the originally Wuhan strain of the SARS-2 virus, but the Spike protein from the v@¢¢¡ne is likely toxic on it’s own. In addition, the paper from Japan I wrote about some time ago suggests that another booster of the current variety is unlikely to provide complete protection against Delta.  Instead they recommend a Delta derived booster. 

Anyone who has had COVID or has been v@¢¢¡nated should get a Delta v@¢¢¡ne as soon as it is available to protect from any ADE related effects. Several companies are currently working on v@¢¢¡nes against Delta.

Does the v@¢¢¡ne create variants?: A nobel prize winning scientist is claiming that v@¢¢¡nation creates SARS variants.  I absolutely agree that v@¢¢¡nation creates selection pressures that can force viruses to gain new forms to avoid neutralization.  However, the very same can be said for natural immunity.  Both natural immunity and v@¢¢¡nation create selection pressures that can lead to new viral variants.  This is true of all viruses and other invading agents. In spite of this, our bodies are designed to use the immune system to fight off infection, and immunity has had a tremendous benefit, despite the selection pressure it poses. ADE is a rare exception to this rule. Our immune systems work much more quickly than viruses can adapt to them, which is why they are so effective at preventing infectious disease.

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Updated November 23rd, 2021:

No COVID case update this week. Like last week, new cases are persistent in the US, California, and San Diego County. 

However, just wanted to note that the 5th circuit has placed a second stay on the OSHA vaccine mandate until further notice.  OSHA has suspended efforts to enforce the mandate. Text on the OSHA website reads:

“On November 12, 2021, the U.S. Court of Appeals for the Fifth Circuit granted a motion to stay OSHA’s COVID-19 Vaccination and Testing Emergency Temporary Standard, published on November 5, 2021 (86 Fed. Reg. 61402) (“ETS”). The court ordered that OSHA “take no steps to implement or enforce” the ETS “until further court order.” While OSHA remains confident in its authority to protect workers in emergencies, OSHA has suspended activities related to the implementation and enforcement of the ETS pending future developments in the litigation.”
_______________________________________

Don’t fear, but be smart!
Erik

Case Update, October 5th, 2021; Project Veritas video regarding Pfizer

This is a case update. I’ll also discuss a new video from Project Veritas featuring interviews from employees of Pfizer.

The Delta wave continues to wane in the US, with cases overall continuing to go down sharply.  This is great news, but I have to caution that last year’s Fall/Winter wave started in October, so there is a chance we will see a new wave starting in the Northern states.  In fact, cases are starting to increase right now in Minnesota, Wisconsin, Michigan, and Maine, while they are going down in the Southern states.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Endcoronavirus County Level Map, October 3rd, 2021
Endcoronavirus State Level Map, October 5th, 2021

Cases are also going down in California and San Diego, although there was a spike in cases last week.  Since both regions saw the same spike, it suggests that the event causing the spike may have taken place in Southern California, but this is only speculation.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

Pfizer employees discuss immunity:  I always hate making politically charged posts, but this is another occasion when I must.  Project Veritas posted another video just yesterday.  In it, 3 scientists at Pfizer discuss the v@¢¢!nes, saying among other things that natural immunity is actually better protection against the virus than v@¢¢!ne mediated immunity. This is in agreement with the data from Israel published as a pre-print a few weeks ago.

As I’ve stated many times, for at risk people, a v@¢¢!ne is very likely to be of benefit. I have recommended that at risk people get v@¢¢!nated. If you’ve already had COVID, 1 dose of v@¢¢!ne is likely to provide extra benefit.  However, if you’ve had COVID, your natural immunity is likely to provide better protection than “full v@¢¢ination”.

They also make the claim that v@¢¢!nation benefit drops over time because the antibodies gained from v@¢¢!nation drop off over time.  I would also point out that another cause may be that new variants may diverge from the original Wuhan strain enough to makes v@¢¢!nes less effective, but this point is not addressed in this video.

One person even states “I mean, I still feel like I work for an evil corporation.” I want to make a comment about this.  It’s easy for us to blame big corporations for some of the decisions they make, since most of us aren’t in that position. I worked for Quest Diagnostics, a large medical testing company.  The vast majority of the people who worked there believed in the mission of providing high quality information to our client doctors and patients.  However, as with any large organization, there were those who were focused on profit, at times over the interests of the clients.  Most often this came in the form of passing over projects that would help patients, but would not bring in a lot of income. They would argue something like “We aren’t a charity.  We need to bring in money to survive as a business.”  This is of course partially true.  Director Spike Lee once commented in an interview that the most interesting conflicts are those in which both sides are correct.

Of course, a company or an individual can cross a line after which their actions become unambiguously wrong.  This often happens because they’ve made well intentioned compromises until they have lost their moral sensitivity. But I want you to remember something important.  The Presidents and CEO of companies work most directly for the board of directors. The board of directors works most directly for the shareholders. In our modern investment environment, which includes mutual funds, many of the shareholders don’t even know they are part owners of a company!  As far as they know, they just own a mutual fund.  As far as their mutual fund goes, they only care if it’s making them money, since they don’t know what companies they hold, or what their business practices are!  So the CEOs are ultimately working for people for whom profit is the only concern.  Folks, those people are you and me!

Yes, companies that behave unethically should be held accountable.  If Pfizer has misled the public, then they should be held accountable.  But we can’t forget that anyone who holds a mutual fund that includes Pfizer has a voice in this as well.  I will tell you that I am talking to myself as well.  I currently have no idea what companies are in the mutual funds that I own. We should all take the time an find out what companies we hold the most stock in, and consider finding out what they are doing.  You can then contact your mutual fund company and make suggestions about what they can communicate to these companies, or consider selling funds with stocks you don’t like. The small choices we make every day do have an impact.

V@¢¢!ne mandates:  V@¢¢!nes will certainly benefit at-risk individuals.  In addition, it is clear that countries with large v@¢¢!nation programs have had lower fatality rates during the Delta wave than other countries.  However, I am not v@¢¢inated, and am firmly against v@¢¢!ne mandates.  It is especially counter productive for hospitals and other organizations to be letting go of highly trained people who have chosen not to be v@¢¢!nated. I hope this new information will bring some balance to the current discussion.

Don’t fear, but be smart,
Erik

Case Update, September 23rd, 2021; Project Veritas Video on Vaccines

This is a case update. With some trepidation, I’ll also discuss the new video by Project Veritas concerning vaccines.

It appears that the US has reached the peak of the Delta Variant, with cases clearly starting to come down.  On the other hand, as numbers start to come down in the South, we may already be starting to see increasing cases in the North, as Wisconsin, Pennsylvania, Ohio, and Iowa are experiencing increased cases right now.  If last year was any pattern, we may see large case numbers in the North as people start to spend more time indoors.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.
Endcoronavirus County Level Map, September 13th, 2021
Endcoronavirus State Level Map, September 23th, 2021
Endcoronavirus County Level Map, September 13th, 2021

California and San Diego County are continuing to improve. LA County has “achieved” something in the last week, improving enough to give up the spot as the county with the most cases since last Winter.  2 counties in Texas, Harris (Houston) and Tarrant (Fort Worth), have had more cases in the last 2 weeks than LA County.

Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a logarithmic format to emphasize small numbers. Note that each number on the left is 10x higher than the one below it.
Graph is by me, from data collected from San Diego County Public Health. See also regularly updated slides from SD County. Graph is presented in a linear format.
Graph is by me, from data collected from Johns Hopkins University COVID site. Graph is presented in a linear format.

Project Veritas released a video of a taped conversation between medical workers at a medical center in Phoenix. In it, the workers use, shall we say, colorful and scientifically imprecise language to suggest that the COVID vaccines are not performing as expected. 

There is a lot to say about this! First, let me say that available data is still insufficient to say with any certainty how many adverse effects there are, and of what kind.  I will speculate here, so keep in mind that I am mostly guessing, since I don’t have sufficient information to know exactly what’s going on.

Anecdotal evidence is based on the experiences of a few people, often relayed as a story or rumor.  This kind of evidence is an important pointer that something may be going on, but very often, it is insufficient to understand the situation with any clarity or as a foundation for policy.  At best, anecdotal evidence gives researchers the motivation to conduct a careful study of a situation so there can be more understanding.  At worst, they can cause rumors to overwhelm careful thinking, and lead to wrong conclusions in the minds of many.  This kind of evidence must be taken with a grain of salt, with final judgement reserved until more information is available.

My own thinking on adverse events has evolved a lot since the vaccines came out.  All vaccines carry risks, with a few adverse events happening with even routine vaccines like the flu.  On balance, vaccines have been extremely beneficial to individuals and society as a whole, effectively ending diseases like smallpox and polio. So when rumors of adverse reactions to the COVID vaccines first started coming out, I initially dismissed them as the standard rare event.

But then came the suggestion that the Spike protein itself was responsible for the vaccine’s toxicity.  While still not proven, this idea makes sense to me because it could explain the wide variety of reported adverse events. Increased inflammation aggravates the part of your body that is already under stress.  The Spike protein causes inflammation, so it’s no wonder that the vaccine causes strange and varying symptoms in some individuals. As someone with an auto immune disease, inflammation is a big deal for me.

Unfortunately, the vaccines cannot work without producing the Spike protein, because the protein is needed to produce a working immune response. The Spike protein is an unavoidable risk.

The recent Project Veritas video is a remarkable piece of anecdotal evidence.  It does not provide scientific or statistical evidence, but it does demonstrate that more information on adverse events is desperately needed. 

The most disturbing part of the video to me is the claim that adverse events are not being reported to the CDC VAERS system simply because the forms take too much time to fill out!  If true, this is frankly typical of a program from the CDC.  Since long before the pandemic started, the CDC has sought to keep tight control of information and guidance regarding the spread of infectious disease and related matters.  Legitimately, they try very hard to be accurate.  During a pandemic, however, information changes too quickly for this approach to be effective.  They are so careful to publish only accurate information, that information is often hopelessly out of date.  Ironically, in an effort to always be right, the CDC has usually been wrong. Nothing illustrates this better than the mixed messaging on masks.  Now almost everyone is hopelessly confused on this issue.

When there is a large vacuum of information, people will attempt to fill it with speculation. People from the federal government often complain about misinformation, but the CDC has contributed to it by leaving a huge hole for people to fill with guesses.

A form that takes 30 minutes to fill out is useless if no-one has the time to fill it out.  In response to the video, the CDC should immediately re-make the form, making it take only 5 minutes or even 30 seconds to fill out. Yes, they will be missing some information from each patient, but they’re getting nothing on them right now, so it will still be an improvement. Instead of making the necessary changes, the CDC will probably just call the video misinformation, and try to send it behind the Digital Curtain.

A note on the VAERS system: the system is meant to capture all data that may point to a vaccine producing a pattern of adverse reactions.  Any negative medical event that happens within a few days after a vaccination is recorded.  This even includes events that are unlikely to be attached to the vaccination. The hope is that patterns may be recognized by immunologists that will point to a problem with a vaccine.  For example, if you notice that a lot of people report hitting their head after a vaccination, this may suggest dizziness or disorientation.

Because of this practice not all adverse reactions are vaccine related.  Careful study of cases by a scientist may be required to notice patterns.  The data is not presented in a user friendly fashion!

Of course, the usefulness of this system is limited if a systematic problem, like a long form, is preventing events from being reported!

Vaccine rumors:  I still get questions about vaccine rumors like the following:

The vaccines will re-write your DNA
The vaccines will keep women from getting pregnant.
The vaccines will make you shed Spike protein into the environment

When addressing questions like this, I always ask “What evidence do you have that this is happening.”  Almost always, it’s just something they heard.  I can’t disprove that any of these things are happening.  Trying would take an enormous amount of time.  I can say, however, that I haven’t seen any evidence that they are. This doesn’t mean they aren’t happening! But if there isn’t any evidence for them, we don’t have to spend time and emotional energy worrying about them.

If you have any evidence, aside from persistent rumors, that any of above things or things like them are happening, please let me know.  If you see an article or blog post that argues for any of the above, they should contain actual data that supports these ideas, not just speculation.

Don’t fear, but be smart,
Erik

Possible low efficacy of current vaccines against Delta, possible Delta enhancement in the future.

This post is detailed, but adds an important new set of facts regarding the Delta Variant, the current vaccines, and prospects for a new booster shot.

You may have heard commentators in the last few days talking about the reduced efficacy of the current set of vaccines. There has also been a lot of discussion about a study from Israel about relatively high numbers of Delta COVID cases among vaccinated individuals.

First a little background on antibodies. Your immune system is making a random set of new antibodies all the time. In an ingenious mechanism, your immune cells “mix and match” pieces of a gene in your immune cells, producing the ability to make a zillion (scientific language for a whole lot) of different antibodies. Your body is basically making different “keys” that can fit into the “lock” of some new protein.

When you get an infection, several different antibodies may bind to the invading agent, on different regions, so you may be protected by several different “keys”. When this happens, a bunch of different things happen, including the manufacture of Memory B cells which makes just the antibody that binds to a particular protein. These cells get activated if you get re-invaded by something with that protein. All this to say, if you’ve had COVID, or been vaccinated, your body will have B cells with antibodies on them that bind to different parts of the Spike protein.

Before I say anything else, I want to repeat that I have not been vaccinated, but have recommended that high risk individuals get vaccinated! I’ve also pointed out many times in the past few weeks that countries with large vaccination programs have lower death rates due to Delta than other countries!

Literally 30 minutes after Thursday’s post on vaccine myths, a doctor friend of mine sent me a pre-print paper from a lab in Japan. Please note, this is a pre-print paper and has not yet finished peer review! The paper describes experiments using antibodies derived from patients infected with the Wuhan strain, as well as with the Delta Variant. They then studied binding of these antibodies to artificial viruses. The paper argues that Delta variant viruses are less neutralized by vaccines against “wild-type” or Wuhan strain vaccines. While the “wild-type” antibodies against Wuhan can neutralize a region of the Delta Spike protein called the Receptor Binding Domain (RBD) (Figure 1C), other antibodies binding to another region of Delta Spike protein actually enhance infectivity. Figure 1D from the paper shows negative levels of “neutralization” for antibodies that bind the N-terminal domain of the Spike protein. The paper calls this “enhanced”. Yes, this is the ADE I’ve been talking about.

Figure 1 from Liu et al 2021.

They suggest that with rapid changes in COVID variants, a new version of Delta is going to be able to use the ADE pathway in the near future, when Wuhan era antibodies will no longer be able to neutralize a mutated Delta strain.

To sum that all up in simpler language, it basically says that Delta is more infectious because it is partially using the ADE method of infection. Future versions may be less prone to be neutralized by Wuhan antibodies, making them fully enhanced. If this happens, we may have more severe disease in those who get infected with this new enhanced Delta.

They conclude by saying a booster against the Wuhan strain will not be effective in improving protection from Delta, and that a new vaccine against Delta will be required.

The material in the paper may help to explain why we have been seeing lowering levels of vaccine effectiveness in some countries.

Just to be very clear, they are not saying that this new enhanced Delta exists now, just that it may exist in the future.

I will pay close attention to this issue. If you have already been vaccinated or had COVID, a new Delta vaccine will be your best defense against possible ADE arising from a possible enhanced Delta.

If an enhanced Delta arises, and you have had Wuhan COVID or a Wuhan vaccine, and you haven’t had Delta, then you may be at greater risk for severe disease.

If you have had COVID since July 2021, you are likely already immune to the Delta variant, and this will not be an issue for you.

I am fully aware this complicated. Also, the CDC has rarely if ever discussed this possibility, so unfortunately, most of the people you talk to about this will not believe it. I am sharing this with you so you can make wise decisions for you and your family.

Some companies are already working on Delta versions of the vaccine. If you have had the current vaccines, or had COVID, you should get the Delta vaccines as soon as they are available.

Of course, discuss your medical history with your doctor before making medical decisions.

Another note on misinformation: My post from last Thursday generated a lot of discussion regarding censorship and misinformation. I argued strongly that the dangers of misinformation do not outweigh the benefits of free speech. Many of you are pro-vaccine and others are suspicious of the vaccine. I would simply urge this:

1) If you use the words “misinformation” and “disinformation” in a post or in a discussion, please come ready with evidence to support whatever claim your making! Don’t just throw out this word, support it!

I recently saw a video with a pro-vaccine medical person saying “we just need to keep pounding this information into people”. That is the wrong approach. With someone who is not yet convinced to get a vaccine, “pounding” away on them is just going to raise their defenses and exasperate you. Instead, gently show them your reasons for believing what you do! Explain to them what the data means. You may not convince them, but you may move them toward being more open to your view.

2) If someone makes a claim that sounds unfounded or that you don’t trust, don’t just tell them they’re wrong or make a counter claim, ask them to provide evidence, or where they got their information. You don’t have to do their homework for them! If they can’t produce any evidence, you are under no obligation to counter it. I’ve saved myself A LOT of work with this approach. It’s OK that they just heard it somewhere IF their source is reliable and has evidence themselves. You can still ask them to provide you with a link or something to that person’s statement. However, “I just heard it somewhere” is not evidence.

Part of the reason I’m not so worried about “misinformation” for myself is because of my regular use of suggestion #2.

Don’t fear, but be smart!
Erik

Video: “Top 3 vaccine Myths” and Tech Censorship

In the interest of openness and full disclosure, I need to share a video with you that I just watched. Dr. Zubin Damania is a Youtube commentator that I actually listen to a lot, and I find him more reliable than many. He just posted a video “Top 3 COVID Vaccine Myths“. Two of his myths are:

2) The Spike protein is toxic.
3) Antibody Dependent Enhancement may cause vaccinated individuals to experience more severe disease if infected with SARS-2.

If you have been reading my posts, then you know I have been concerned about both these issues. So am I spreading myths?

2). My concerns about Spike protein toxicity are based on persistent rumors of people having moderate severe reactions to the vaccines. For awhile, I dismissed these as just the standard reaction that some have had to any vaccine, including those for flu. But more and more rumors piled up and made me wonder if something else was going on. Then I saw the video by Bret Weinstein and Robert Malone. Dr. Malone is the inventor of the mRNA vaccine technology. The video argues that the Spike protein itself is toxic. Dr. Malone’s credentials are at least as good as Dr. Damania’s on this matter, likely better, so I can’t dismiss his view.

Unfortunately, I haven’t yet been able to find enough reliable information on adverse events to form my own opinions based on the data, so I’ve been relying on others to inform me. Frankly, because of the politicized nature of the vaccine issue, I don’t feel at all confident that I can get reliable information. So I may never be able to develop an informed opinion on this matter.

Dr. Damamia claims that convincing evidence exists that demonstrates that Spike protein is not toxic, but he doesn’t give it in this video. This of course is very common.

3) I’ve talked a lot about the ADE issue. In this video, Dr. Damania claims that ADE has not been an issue in the vaccine roll out, and the new variants have not caused more severe symptoms. I agree with both of these points. I point these out in my November 2020, December 2020, and April 2021 updates to my ADE post. I am still concerned about that new variants may someday arise that can use the ADE pathway, or that a new SARS strain, a hypothetical “SARS-3” will arise that will be different enough to trigger ADE. So while I agree with Dr. Damania’s point on ADE, it’s not quite the point that I’m still concerned with.

As I’ve stated many times, the vaccines are likely to help you if you have a risk factor and I have several friends and family members that I have recommended get the vaccine. So I am not anti-vax per se. But I don’t think it’s the obvious choice for everyone, and I’m staunchly for personal medical freedom in regards to COVID vaccines.

So what do I do now? What should a thinking person do when confronted with new information from a trusted source that you’re not sure about? These things are all true when dealing with complicated issues:

People you generally agree with may say something you don’t agree with.
People you generally disagree with may say something you agree with or makes you think about an issue in a new way.

Both of these are normal. When dealing with a complicated issue like COVID, race relations, worldview, politics in general, it is critical to keep an open but critical mind. You have to read widely from both your side and others to hope to get a clear view of the issues involved.

I respect Dr. Damamia. He might be right! I’ll have to think about his points, do some more homework, and reassess my opinion. There are 3 possibilities.

I will abandon my position and accept his.
I will learn new things that will reinforce my position.
I will do a bunch of research, but will not find conclusive information that will allow me to form a new opinion either way.

If I can arrive at a place closer to the truth, then the exercise will be a good one. If I decide I think Dr. Damania is wrong on these points I’ll likely still watch his videos, since I think he is right more often than he is wrong, and he’s more open minded than most, so I think he is at least being honest about what he believes, which is a very valuable trait! Dr. Damania is both for COVID vaccination and against vaccine mandates.

I started out posting on COVID because as a scientist I felt a responsibility to help my non-scientific friends and family members make some sense of the pandemic, especially when scientific communication is so often poor. I hope I have done that. I can’t claim to always be right, and have changed by view several times. But I have given you the truth as best as I can find it, and supported it with evidence.

A word on tech censorship: The WHO said 2 false things early on:

SARS-2 is not human to human transmissible
SARS-2 is not transmissible as an aerosol.

Both of these things were demonstrably false, and perhaps politically motivated, even at time the WHO stated them. In in spite of this, the social media platforms came to hold the WHO as the gold standard for the truth on COVID matters. To this day, F@¢3b00k may place a tag on the end of this post claiming the WHO as the authority on COVID matters. Most platforms would delete or restrict anything that ran against the WHO. Yes, computer programmers in Silicon Valley are still pulling down information posted by medical doctors and scientists. Even Dr. Damania has had videos censored!

One of the worst results of the pandemic in the US is censorship of divergent opinions. Freedom of speech allows 3 things:

All opinions to be held up to public scrutiny.
True things to rise to the surface.
False things to be discredited.

When freedom of speech is restricted, none of these can happen. If a wrong thing becomes the “orthodox” view, and no other views are permitted, then the orthodox view will always be wrong, and we will end up solving all of the wrong problems. If there is a hole in your gas tank, it doesn’t matter how many times you put gas in it. It will always be empty. Fix the real problem first.

This is why all the claims of misinformation, from all sides, are so insidious. When you claim misinformation, you are claiming to have the whole truth on an issue. Sure, we can and should argue against views we think are false. But we must also protect the right to air all views! Or we are doomed only to have the first view that becomes dominant, and we are less likely to find the truth!

I also found an article on why some are still vaccine hesitant. For those of you who are wondering, you should read it.

As always, Don’t fear, but be smart!
Erik

PCR and the Ct Value

In the past few weeks in San Diego, I’ve heard several stories that discuss Ct values in regards to COVID testing. Since this is my field, I thought I’d talk about what a Ct value is and it’s relation to your results. This post is going to be pretty in the weeds, so if your not interested in the detail, you can skip this one.

PCR: The Polymerase Chain Reaction (PCR) was invented in 1983, and by the 90s, it has become a commonly used technique foundational to several molecular biology techniques, including DNA sequencing, DNA manipulation, sequence detection, and many more. Basically, the technique is used to make many many copies of a small amount a DNA. The DNA molecule is double stranded, the 2 strands are reverse copies of each other, binding to each other with weak interactions.

Heat is used to separate the 2 strands, and small pieces of DNA called “primers” bind to the DNA copies at a lower temperature.

The primers are designed to perfectly match sequences in the template strands. This is why PCR reactions can be very specific to a particular target, like SARS-2.

Next, the template strands are copied by a protein called “DNA Polymerase”.

After this, the reaction is heated up again, and the process is repeated. For a PCR reaction used for detection, this is repeated 40 – 45 times. With every repetition of this process, the numbers of molecules doubles, so from every 1 molecule of starting DNA, you could theoretically end up with almost a trillion copies!

Real-time PCR: Lots of copies of DNA aren’t enough to detect it. You also need something else. Medical detection uses a process called “real-time PCR”. In this process, a third piece of DNA called a “probe” is also added. The probe has a fluorescent molecule called a “reporter” on the front end, and a molecule called a “quencher” on the back. The reporter gives off light during the reaction. The quencher is a molecule that absorbs light and coverts it to heat, effectively dimming the light coming from the reporter.

As the real-time PCR reaction progresses, the DNA Polymerase chops up the probe as well. When this happens, the quencher is separated from the reporter, and the reporter appears to give off more light! The medical instrument detects this extra light which leads to the result.

Ct values: You may have heard the term “Ct value” thrown around. As I mentioned before, with every cycle of PCR, the number of DNA copies doubles. At the same time, the reporter molecules start to give off more light. Even with all the reporter molecules around, the instrument can’t detect it until at least cycle 15. When it does, a graph of fluorescence coming from the reaction will start to show an increase.

Real-time PCR Results. This is from an ABI 7500 running version 2.3 software. The results for 5 patient samples. 3 would be reported as being positive, 1 negative. The sample giving the green line is over 40 Ct and may be repeated, or a new sample may be collected from the patient.

The more starting DNA you have in the reaction, the sooner the instrument will detect a rise in light. Scientists designing the test set a Cycle Threshold (the yellow line in “Real-time PCR Results”). This line is somewhat arbitrary at first, but when the test is validated, it is “set in stone” before being submitted to the FDA for approval. After the threshold line is set, the cycle at which the line of fluorescence for sample crosses the threshold line is called the “Ct value”. As you can see in the graph, the more starting DNA you have, the lower the Ct value is. The lower the starting DNA you have, the later the line will cross the Threshold, and the higher the Ct value.

A patient with a lot of SARS-2 in their sample will give a very low Ct value, almost never lower than 15-19. In the example above, the orange line represents a patient with a lot of virus. The higher the Ct value, the less virus a patient has in their sample. A sample that gives Ct value in the high 30s has very little virus, and is most likely not symptomatic. In fact, some scientists have even said that a Ct value of higher than 35 means the test is really just detecting viral debris after the virus has been cleared and the infection is basically over. A good test can detect as few as 50 virus molecules in a sample.

Most labs don’t even bother to report any result with Ct over 40. I’ve never heard of a lab reporting a result with a Ct over 45. Results like this are generally considered un-reliable, since PCR can give false positive results at very high cycle numbers. Most labs eliminate this possibility by just not reporting Cts over 40. A few weeks ago, a person at a San Diego County meeting claimed that many labs are reporting Cts over 45, and thus giving false positive results. I happen to know this man personally. We disagree on the proper approach to COVID, but he’s a good guy, and I like him personally. He is not a scientist. Anyway, I contacted him to ask him for evidence that labs are reporting Cts over 45, and I have not heard back. As I said before, I’ve never heard of a lab reporting a positive result for a real-time PCR test with a Ct over 45. So I’d be surprised if this was happening. If you have evidence of this, please let me know!

A local radio commentator in San Diego suggested on air that labs should report the Ct number. I’m all for this, but I know first hand that labs usually do not report the Ct number. In fact, many patients, and yes, even many physicians, don’t know what this number means and don’t actually want to see it in a report! Yes, that’s right, on one complicated test I built in which I included the Ct value in the report, doctors called to ask us to remove it! They said it was confusing the issue for them. This may have been because it was confusing their patients, but suffice it to say, many downstream users don’t want the Ct value and that’s why it’s not included. Generally, labs just report “COVID Positive” or “COVID Negative”. In some cases, “Detected” or “Not Detected” are used instead, to avoid confusion.

This is to avoid the issue of a patient saying “My result is positive! That’s great!” No, sir, it’s not that kind of positive.

I actually think the Ct number is very useful, and would love to see it included, but it probably won’t be.

Anyway, hope that was helpful. Your questions below will help me make this all clearer.

Don’t fear, but be smart!
Erik