interview, Jay Bhattacharya summarizes my views on SARS-Cov-2 very concisely.Here are my notes:
- Vaccination is not "sterilizing" but rather "protective". After vaccination you can get infected and spread the virus, but you will probably be completely asymptomatic. Illness post vaccination is usually in people with immune system problems. (12:00)
- Given that, and the many animal hosts for coronavirus, we will never "eliminate" Covid-19. It is now endemic. But it's not to be feared: the vaccine has "defanged" the disease. Nevertheless, public health officials continue to act as if the disease will be eliminated (15:00, 34:00ff)
- Delta is probably more infectious than the wild Wuhan but no more deadly than other variants. (UK data) (6:30) Vaccination "breakthrough" is common but only very rarely consequential. (11:00)
- There is currently no data suggesting a need for a booster (14:30) Protection from vaccines and infection/recovery is almost certainly for your lifetime.
- Natural immunity is 6.7X more effective than vaccination (Israeli study.
- No randomized trial shows that masks actually stop the disease from spreading at all. No RCT shows any efficacy from masks. No RCT shows that N95 masks in hospitals stop 'flu. We had near 90% compliance with masks last winter with no measurable effect. The one study suggested that relative risk reduction with careful use of N95 masks is 14%, 95% CI 0-20%, but that wasn't statistically significant. Public health officials probably mandate masks because they think there is no cost, but that's not true. The biggest cost is the division between the virtuous and the enemy - the opposite of what public health officials should do. (18:00)
- Ventilation is the only effective preventive measure.
- Worldwide IFR is 0.2%. IFR at age 60 is 0.4%, and that halves or doubles with each 7 years younger or older (9:45) Vaccination reduces IFR for a factor of 50-100 - so for age 67, IFR is 0.004% to 0.008%. (47:10)
- Public authorities have done everything possible to generate fear - to treat other people as vectors of infection, bags of germs, rather than fellow human beings. It's not right epidemiologically. Stigmatizing disease is pernicious, a violation of the norms of medicine which is treating and providing comfort to people. (25:00)
- Proof of vaccination is deeply unethical (27:00). It's discriminatory - food workers and delivery people (many poor and minorities) who got sick and are now immune might reasonably decline vaccination.
- Covid-19 vaccination does not generate a positive externality - that is, vaccinated or not you can spread the disease. What public health purpose is served by vaccination? It just divides society into clean/unclean rich/poor. (29:30)
- Florida has done better than California. Evidence doesn't support government interventions. (41:00ff)
- Ivermectin and other cheap drugs might help but there's no large definitive trial - which is a scandal, since NAIAD should be running multiple trials on cheap and potentially useful drugs (50:00)
The news on vaccines is nothing short of miraculous. Note that only
seven new vaccines have been developed in the last 25 years (four by Merck!). The fastest a new
vaccine has ever been brought to market is 4 years; the average time is 10 to 15 years.
Vaccines intended for mass use by the general population have always required years of testing
with very large test groups, because the side effect rate must be minuscule. Indeed, no Phase 3
clinical trials of a Covid-19 vaccine is due to end before October 2022 (see "Vaccines" below
for links). Nevertheless, several effective and safe Covid-19 vaccines has been rolled out
with minimal adverse events. This is an incredible achievement.
Mitigation measures like "social distancing" and mask-wearing have no effect on the virus's
progress. See Non-Pharmaceutical Interventions
Masks don't work.
"Virus gonna virus." In no case has a Covide-19 outbreak been "controlled." It burns its way
through the population until it runs out of susceptible hosts.
The current best estimate rule of thumb for the Infection Fatality Rate - the percentage of
people who die from Covid-19 as a result of infection by Covid-19 - is 0.40% for people age 60.
It halves or doubles for each 7 years younger or older than 60. A 32-year-old's risk of dying
from Covid-19 following infection is therefore roughly 0.0025% - less than 3 in 10,000. A
74-year-old faces a risk of 1.6%. (The IFR for influenza is roughly 0.10%.)
Covid-19 is much less dangerous than
influenza for people under age 50, and more dangerous than influenza only for those over 65.
The overwhelming majority of people who die from Covid-19 have a serious
comorbidity, most often Alzheimer's or obesity. A large proportion of Covid-19 deaths take
place in long term care facilities, where annual mortality before Covid-19 was 32%.
Children overwhelmingly have asymptomatic or mild cases, and only rarely pass the disease to
adults. The cumulative numbers from the CDC (August 18, 2021) show 614,531 deaths involving
Covid-19. 361 of those were in people under 18. (There were 53,193 deaths for that age group
from all causes - including accidents, cancer, drowning, homicide, etc.)
Testing is a total fiasco. Even the NY
Times reported that as many as 90% of positive results are false. Most infections are
asymptomatic. People who get tested do it because they're required to (hospital admissions,
employees who face mandatory testing) or because they're stupid. The test has no clinical value
outside a hospital: if you're sick, stay home until you're better and do your very best to stay
away from elderly and infirm people. If you have trouble breathing call your doctor. You don't
need a Covid-19 test to figure that out. But if you have the test and get a positive result,
you're in the system, with attention from officialdom, mandatory quarantine, possible fines, and
intrusive contact tracing.
- The mere notion of contact tracing for this disease is moronic. The virus has been endemic
for almost a year. Most infected people are asymptomatic. By the time a contact tracer gets
your data, you've shed virus for days and have recovered. And why cooperate with a contact
tracer? Just give them the names of your worst enemies.
There's no end of panic porn about Covid-19, and "Team Apocalpyse"
(The Atlantic, CNN, New York Times, etc.) eagerly promotes every possible scary
trope. For all the following actual observations, those outlets publish hysterical (and
sometimes false) reports of the extremely rare counterexamples:
Covid-19 is not a leading factor in overall morbidity and mortality. For one example, in the
past eight months in Santa Clara County, there have been 1901 Covid-19 deaths out of roughly
21,000 total deaths from all causes. More than half of those fatalities were in people 80 years
of age or older. Nearly three-quarters of deaths were in people 70 and over. Just 5% were in
people under 50. There have been 4 deaths in people under 30 in Santa Clara County out of more
than 113,000 proven cases.
The disease is less dangerous than influenza for non-obese people under 75.
Infection/recovery confers lasting immunity.
Sequelae like viral myocarditis are extremely rare, and no more common in Covid-19 than in
Kawasaki disease in young children is no more common now than in past years, and no connection
with Covid-19 has been shown.
Lockdowns and social distancing and economic disruption have huge negative effects which will be
with us for decades. University Ave in Palo Alto has one empty storefront after another. More
disturbing, see e.g. Famines related to
the Covid-19 pandemic - "12,000 people per day could die from COVID-19 linked hunger"... It
is "projected to be among the worst famines in human history." And then there are suicides, and
abuse, and morbidity and mortality because people avoid the healthcare system.
Further readings on Covid-19:
Santa Clara County Dashboard
San Mateo County Dashboard
ACIP, August 30, 2021
San Mateo County reports on just 390 beds, but the county has seven hospitals:
|Kaiser Redwood City ||149
|Kaiser South SF ||120
|Mills Peninsula ||301
|Sequoia Hospital ||208
|Seton Medical Center ||434
|Seton Coastside ||121
|San Mateo Medical Center ||448
Daily Update of COVID-19 Costs
One America News Network
The Silence of Economists
Jay Bhattacharya on Covid-19 and delta, and everything else
The Rise of the Erudite Technocrats
City Journal: Panic Pandemic
Bleached New World
Sweden was right.
HART: Lockdowns Serve No Purpose
Lockdown Casualty: Science
Michael Senger on harms of lockdown, "the greatest crime of the 21st century."
The Long-Term Impact of the Covid-19 Unemployment Shock on Life Expectancy and Mortality Rates
Why the hysteria?
500,000 fewer U.S. births?
Nature: No asymptomatic transmission!
@BallouxFrancois: Covid-19 response is a policy question, not science
Delaying herd immunity is costing lives - spiked
National coronavirus response: A road map to reopening | American Enterprise Institute - AEI
COVID-19 and the Path to Immunity | JAMA
Anders Tegnell and the Swedish Covid experiment
Covid-19 T Cell (ELISPOT) test kits
Commercially Available Covid-19 test kids
EUAs for serology tests | FDA
At-home test for novel coronavirus (SARS-CoV-2)
Coronavirus Test Tracker: Commercially Available COVID-19 Diagnostic Tests | 360Dx
COVID-19 T cell assay kits
EUA Authorized Serology Test Performance | FDA
RP5800950 Premier Biotech INGM-MC42S
Balloux: Covid-19 Response is Policy, not Science
Aaron Ginn: Evidence Over Hysteria
Why Conservatives and Liberals Are Not Experiencing the Same Pandemic
They Blinded Us from Science
AEI: Roadmap to Reopening
Jay Bhattacharya - Questioning Conventional Wisdom
Swiss Propaganda Research
Matt Ridley: Virulent does not mean infectious
Jonathan Sumption skewers the "Precautionary Principle"
Brookings: How misinformation is distorting Covid policies and behaviors
The Atlantic: The Liberals Who Can’t Quit Lockdown
Asymmetric Risk and Coercion
Severe Covid-19 in Scotland
Indoor risk calculator
Expert says coronavirus 'as dangerous as having a bath' after calculating risk of dying - Mirror Online
Z-Scores Are Misleading & Create Panic: Or, How Not To Compare Pandemics - William M. Briggs
Our Dangerous Illusions About Risk
Life Has Become the Avoidance of Death
Fear Is a Viral Monster
Covid-19 Mortality, Factor Analysis
Covid-19 circulating prior to January 2020 Oxford Clinical Infectious Diseases
Substantial underestimation of SARS-CoV-2 infection in the United States, Nature, Sept 9, 2020
Estimated incidence of COVID-19 illness and hospitalization — USA, Feb–Sept 2020 Clinical Infectious Diseases, IDSA
COVID-19 was circulating in the US in December 2019 Clinical Infectious Diseases, IDSA
IFR Random-Sample Prevalence Annals of Internal Medicine, superior, peer-reviewed journal
Iceland: Large-scale testing
High prevalence of Covid-19 among pregnant women in NYC
Holman Jenkins: Should You Get Covid-19?
How Not to Compare Pandemics
Are we underestimating seroprevalence of SARS-CoV-2? British Medical Journal
Immunity and Communicability:
The Strange Neglect of Natural Immunity
SARS-CoV-2 T-cell epitopes define heterologous and COVID-19-induced T-cell recognition
SARS-CoV-2 infection induces long-lived bone marrow plasma cells in humans (Nature)
Probable Lifetime Immunity (Nature)
Herd Immunity Threadhold 10-20%
Indoor Transmission of Covid-19
Pre-Existing Covid-19 immunity
NBER: Lockdowns net negative for public health
Youyang Gu: Lockdowns correlate with unemployment, not mortality
Thirty-one studies show no lockdown benefit
Stay-at-home policy is a case of exception fallacy (Nature)
Assessing mandatory stay-at-home and business closure effects
NBER: Four Stylized Facts about COVID-19
WHO on NPIs
A Country Level Analysis… EClinicalMedical/The Lancet
The Failed Experiment of Covid Lockdowns Wall Street Journal
Shutdown Began as a High School Science Project
Airline Passenger Risk
California Summer Lockdowns Have Been Ineffective
Bangladesh study, updated, removes claim that masks reduce infections perhaps following this
Do Masks Work? (City Journal)
Masks work, but mandates have no effect
An evidence review of face masks against COVID-19 (they work?)
Mask mandate and use efficacy in state-level COVID-19 containment (2021-05-25)
JAMA Pediatrics: Unsafe CO2 levels in masked children
Danmask-19: Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers
Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings
CDC Scientific Brief
NEJM: We know that wearing a mask outside health care facilities offers little, if any, protection from infection.
Rapid systematic review: efficacy of face masks and respirators
Twitter thread on DANMASK-19 status
Justin Hart's master thread on masks
A few charts
Masking Lack of Evidence with Politics | Centre for Evidence-Based Medicine, Oxford
Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings | CDC: Emerging Infectious Diseases
Masks for All Not Based on Sound Data | University of Minnesota
Randomised Trial of Cloth Masks | BMJ
Denmark Mask Trial
WHO face mask recommendations
Systematic Review of Face Masks | NIH
Uncompromised Science on Masks
Timing of Masks and Outbreaks, by Country
"We're in a race between bureaucracy and exponential growth and evolution, and those two are winning fast over bureaucracy." - economist John Cochrane
Flu vaccines don't reduce hospitalization or mortality
AstraZeneca Phase 3 trial due to end October 5, 2022
Moderna Phase 3 trial due to end October 27, 2022
Virus Gonna Virus:
Common Cold at Antarctic Base | NIH
Ushuaia fishing boat infections
Reconciling estimates of global spread and infection fatality rates of COVID-19: an overview of systematic evaluations
COVID-19 Epidemiology: Evidence, Risks and Misunderstandings 2021-02-20
Lockdown effects on Covid-19 spread
Effects of non-pharmaceutical interventions on COVID-19: A Tale of Three Models
Inferred IFR, October 2020
The infection fatality rate of COVID-19 inferred from seroprevalence data | medRxiv
Population-level COVID-19 mortality risk 2020-05-05
Perspectives on the Pandemic | Dr John Ioannidis of Stanford University | Interview - YouTube
Perspectives on the Pandemic | Dr. John Ioannidis Update: 4.17.20 | Episode 4 - YouTube
Global perspective of COVID-19 epidemiology for a full-cycle pandemic (October 2020)
A Fiasco in the Making - March 17, 2020
John Ioannidis - Perspectives - 2020-04-17
Perspectives - 2020-03-26
Covid-19 Seroprevalence in Santa Clara County, California
Wall St Journal profile
The Harms of Exaggerated Information and Non-Evidence-Based Measures
Ioannidis Explains His Views
Ioannidis Debates Taleb
And a few from Aaron Ginn and Alex Berenson:
Michael Levitt: Excess Deaths
Lungs damaged by coronavirus can repair in three months
Has the post-covid future already been decided?
Has Switzerland handled the crisis better than almost anyone else in Europe?
Going to school does not increase risk of young children catching coronavirus
The smear campaign against the Great Barrington Declaration
Bruce Fenton's Personal Transformation
Man Shot by Police Dies of Coronavirus
Why Is All Covid-19 News Bad News? NBER
California keeps key virus data out of public sight
Kansas mask charts
He died in a motorcycle accident.
Joe Biden's bubble
Vladimir Putin's bubble
Misguided Shutdown Policy Began as High School Science Project
On My Mind: They Blinded Us From Science
The origin story of COVID-19 lockdowns - The Mass Illusion
Sources of data in the early days of Covid-19