Now I’m Committed

I’m at City of Hope, and I’ve just received my big dose of chemo to kill off my bone marrow. Tomorrow, I get the stem cells that were harvested from me put back in.

The idea here is to kill off the cancer in my bone marrow without killing me off, and then grow a new set of bone marrow from the stem cells.

My doctor thinks he’s actually cured a couple of patients, rather than merely extending the time until they relapse.

I won’t mind if it turns out I’m number three. Or even four.

Ronald Bailey: The World Is Getting Cleaner, Richer, and Safer

In the time of a global pandemic, soaring unemployment, massive wildfires, and racial strife, it feels like the world is going to hell. It’s not, says Reason Science Correspondent Ronald Bailey, the coauthor (with HumanProgress.org’s Marian Tupy) of Ten Global Trends Every Smart Person Should Know: And Many Others You Will Find Interesting .

Source: Ronald Bailey: The World Is Getting Cleaner, Richer, and Safer

Why is the COVID death rate so low in Africa?

Well, it could just be poor statistics-taking and reporting. But apparently the death rate has not gone up, either, and a rise in that would be more noticeable. So it seems the low rate of (and/or better prognosis from) COVID in much of Africa is real.

….

Could it be, could it possibly be – the widespread use of hydroxychloroquine?

You’d never know from this article that such a thing is even a possibility. The Science article discusses the data from Africa – it’s even titled “The pandemic appears to have spared Africa so far. Scientists are struggling to explain why” – but nary a whisper about the drug.

Is the drug already widely taken in African countries where malaria is endemic? I’ve been trying to discover whether that is the case, and I’m hesitant to say it is because I read somewhere, months ago, that malaria in Africa became resistant to the drug some years ago and so it’s no longer all that widely used there. I can’t seem to find that information at the moment.

Source: Why is the COVID death rate so low in Africa?

Medical Research’s Cross of ‘Gold’ Imperils Covid Treatments

Randomized controlled studies have advantages, but there are other valuable sources of data.

….

As Thomas Frieden, who directed the Centers for Disease Control and Prevention under Mr. Obama, wrote in a 2017 New England Journal of Medicine article: “Elevating RCTs at the expense of other potentially highly valuable sources of data is counterproductive.” Such limitations affect their use for “urgent health issues, such as infectious disease outbreaks.” He added: “No study design is flawless, and conflicting findings can emerge from all types of studies.”

Two randomized trials of Gilead’s antiviral drug remdesivir show how such studies can produce inconclusive results. A randomized trial in China, published in the Lancet in May, enrolled 237 patients. The study found no significant clinical benefit over a placebo, but most of the patients were severely ill when treated. Patients who had symptoms for 10 or fewer days, however, were 25% less likely to die. Similarly, a randomized National Institutes of Health trial with 1,063 patients found the drug reduced average recovery time by four days and the risk of death by 30%, but the survival benefit was statistically insignificant.

Some experts have dismissed the antimalarial hydroxychloroquine, or HCQ, even though more than a dozen observational studies have found it beneficial. A retrospective observational study of Covid-infected nursing-home residents in France, for instance, found those treated with HCQ and azithromycin were 40% less likely to die.

But a few randomized controlled trials found no benefit. A Spanish randomized trial of HCQ for prophylaxis found it didn’t reduce risk of illness among a large group of people exposed in nursing homes, households and health-care settings. Yet two-thirds of the subjects “reported routine use of masks at the time of exposure,” so they were probably less likely to be infected. Nursing-home residents, who may be less likely to wear masks, were 50% less likely to become sick if they took HCQ. But this finding was statistically insignificant, because the trial included only 293 residents.

Source: Medical Research’s Cross of ‘Gold’ Imperils Covid Treatments

Natural Gas & Coal Prevent L.A. Blackouts (75 percent market share)

“Southern California has been able to withstand the heat wave mainly due to municipal power contracts for imported coal and nuclear power, as well as generation from its local gas-fired power plants. Northern California, meanwhile, suffered the brunt of the blackouts due to green power mandates.” “Soon, many Californians may have to install stationary gas or propane electrical generators or portable gasoline generators to withstand regular outages, but the poor will not be able to afford them.” About 75 percent of Los Angeles electricity demand is being met by imported coal power and local gas-fired power plants during peak hours of the August triple-digit heat wave.

….

Los Angeles, not part of the state energy grid, operates its own power plants, transmission lines, and distribution grid. The municipality Los Angeles Department of Water & Power (LADWP) reports its reliance on:

  • Natural gas – 34% (three gas power plants in Los Angeles)
  • Green power – 33% (wind-Tehachapi, CA; solar, Kern County)
  • Coal power – 19% (from Utah and Arizona)
  • Nuclear power – 9% (from Arizona)
  • Hydropower – 5% (Hoover Dam, Castaic Lake)

Pollution from coal power plant emissions in Utah and Arizona do not create smog in Los Angeles, which is important because the LA Basin traps air emissions from an inversion layer. Conversely, Arizona and Utah do not have basin topographies but are plains states where natural winds dilute air pollution instead of trapping it (“the solution to pollution is dilution”).

So, despite Los Angeles’s quixotic goal to shift to 100 percent green power by 2045, the City has imported coal power and exported any air pollution to areas where it is dissipated instead of trapped.

Source: Natural Gas & Coal Prevent L.A. Blackouts (75 percent market share)

Early treatment with hydroxychloroquine: a country-based analysis

Source

From the FAQ:

Why should we trust @CovidAnalysis? There is no need to. We provide organization and analysis, but all sources are public and you can easily verify everything. For the country-based analysis, all data is public and the analysis is simple to replicate. We also note that many equally qualified experts report contradictory conclusions. If you don’t like our analysis, you can use our database to locate information you may have missed for your own research.

FAQ

It’s also available as a 65-page PDF file.

Testing Targets and Intensifies Social Distancing on the Infectious

I’ve been pounding on the need for fast, frequent testing but it’s clear from some of the comments to The Beginning of the End that I have failed to convey some fundamental points. A seemingly sophisticated objection is to note that given background prevalence rates even a fairly specific test will result in a high fraction of false positives among those who test positive. (This is the standard Bayesian doctor puzzle .) It’s nice to see people doing the Bayes calculation but some of them are then drawing the wrong conclusion.

Source: Testing Targets and Intensifies Social Distancing on the Infectious