Thursday, 22 April 2021

The confusing politics behind John Stossel asking Are We Doomed?

As member of Climate Feedback I just reviewed a YouTube video by John Stossel. In that review I could only respond to factual claims, which were the boring age-old denier evergreens. Thus not surprisingly the video got a solid "very low" scientific credibility. But it got over 25 million views, so I guess responding was worth it.

The politics of the video were much more "interesting". As in: "May you live in interesting times". Other options would have been: crazy, confusing, weird.

That starts with the title of the video: "Are We Doomed?". Is John Stossel suggesting that damages are irrelevant if they are not world ending? I would be surprised if that were his general threshold for action. "Shall we build a road?". Well, "Are We Doomed?" "Should we fund the police? Well, "Are We Doomed?" "Shall I eat an American taco?" Well, "Are We Doomed?"

Are we not to invest in a more prosperous future unless we are otherwise doomed? That does not seem to be the normal criterion for rational investments any sane person or corporation would use.

Then there is his stuff about sea level rise:

"Are you telling me that people in Miami are so dumb that they are just going to sit there and drown?”

That remind me of a similar dumb statement by public intellectual Ben Shapiro (I hope people hear the sarcasm, in the US you can never be sure) and the wonderful response to it by H Bomber Guy:

Bomber also concludes that this, this, ... whatever it is, has nothing to do with science:

"How have things reached a point, where someone thinks they can get away with saying something this ridiculous in front of an audience of people? And how have things reached the point where some people in that audience won't recognize it for the obvious ignorant bullshit that it is?
This led me down a particular hole of discovery. I realized that climate deniers aren't just wrong, they're obviously wrong. In very clear ways, and that makes the whole thing so much more interesting. How does this work if it's so paper thin?"

Politically interesting is that Stossel wants Floridians to get lost and Dutch people to pay an enormous price, in this video, while the next Stossel video Facebook suggests has the tagline: "Get off my property". And Wikipedia claims that Stossel is a "Libertarian pundit".

So do we have to accept any damages Stossel wants to us to suffer under? Do we have to leave our house behind? Does Stossel get to destroy our community and our family networks? Is Stossel selling authoritarianism where he gets to decide who suffers? Or is Stossel selling markets with free voluntary transaction and property rights?

In America, lacking a diversity of parties, both ideologies are within the same party, but these are two fundamentally different ideas. But either you are a Conservative and believe in property rights or you are an Authoritarian and think you can destroy other people's property when you have the power. 

You can reconcile these two ideas with the third ideological current in the Republican party: childish Libertarianism, where you get to pretend that the actions of person X never affect person Y. An ideology for teenagers and a lived reality for the donor class that funds US politics and media.

But in this video Stossel rejects this childish idea and accepts that Florida suffers damages:

"Are you telling me that people in Miami are so dumb that they are just going to sit there and drown?”

So, John Stossel, do you believe in property rights or don't you?

Friday, 16 April 2021

Antigen rapid tests much less effective for screening than previously thought according to top German virologist Drosten

Hidden in a long German language podcast on the pandemic Prof. Dr. Christian Drosten talked about an observation that has serious policy implications.

At the moment this is not yet based on any peer reviewed studies, but mostly on his observations and those of his colleagues running large diagnosis labs. So it is important to note that he is a top diagnostic virologist from German who specialized on emerging and Corona viruses and made the first SARS-CoV-2 PRC test.

In the Anglo-American news Drosten is often introduced as the German Fauci. This fits as being one of the most trusted national sources of information. But Drosten has much more expertise, both Corona virusses and diagnostic testing are his beat.

Tim Lohn wrote an article about this in Bloomberg: "Rapid Covid Tests Are Missing Early Infections, Virologist Says." And found two experts making similar claims.

Let me give a longer and more technical explanation than Tim Lohn of what Prof. Dr. Christian Drosten claims. Especially because there is no peer reviewed study yet, I feel the explanation is important.

If you have COVID symptoms (day 0), sleep on it and test the next day the antigen tests are very reliable. But on day zero itself and especially on the one or two days before where you were already infectious they are not as reliable. So they are good for (self-)diagnosis, but less good for screening, for catching those first days of infectiousness. The PCR tests are sensitive enough for those pre-symptomatic cases, if only people would test with PCR that early and would immediately get the result.

Figure from Jitka Polechová et al.

In those pre-symptomatic days there is already a high viral load, but this is mostly active virus. The antigen test detects the presence of the capsid of the virus, the protective shell of the virus. The PCR test detects virus RNA. When infecting a cell, the capsid proteines are produced first, before the RNA is produced. So in that respect one might expect the rapid tests to be able to find virus a few hours earlier.

But here we are talking about a few days. The antigen test can best detected capsids in a probe sample when epithelial cells die and mix with the mucus, which takes a few days. So the difference between the days before and after symptoms is the amount of dead virus material, which the rapid tests can detect to get reliable results. That is the reason why in the time after symptom onset the antigen tests predict infectiousness well. But in those early days possibly not.

This was not detected before because the probes used to study how well the tests work were mostly from symptomatic people; it is hard to get get positive probes from people who are infectious before they are symptomatic. Because you do not often have pre-symptomatic cases with both a PCR and an anti-gen tests, also the observations of Drosten are based on just a few cases. He strongly encouraged systematic studies to be made and published, but this will take a few months.

In the Bloomberg article Tim Lohn quotes Rebecca Smith who found something similar:

In a paper published in March -- not yet peer reviewed -- researchers led by Rebecca L. Smith at the University of Illinois at Urbana-Champaign found that, among other things, PCR tests were indeed better at detecting infections early on than a Quidel rapid antigen test. But the difference narrowed after a few days, along with when the different tests were repeatedly used on people.

The article also quotes Jitka Polechová of the University of Vienna, who wrote a review comparing PCR tests to antigen tests:

“Given that PCR tests results are usually not returned within a day, both testing methods are similarly effective in preventing spread if used correctly and frequently.”

This is a valid argument for comparing the tests when are used for diagnostics or as additional precautions for dangerous activities that have to take place.

However, at least in Germany, rapid tests are also used as part of opening up the economy. Here people can, for example, go into the theatre or a restaurant after having been tested. This is something one would not use a PCR for, because it would not be fast enough. These people at theatres and restaurants may think they are nearly 100% safe, but actually 3 of the on average 8 infectious days would not be detected. If, in addition, people behave more dangerously, thinking they are safe, opening a restaurant this way may not be much less dangerous than opening a restaurant without any testing.

So we have to rethink this way of opening up activities inside and rather try to meet people outside.

Related reading

Original source: Das Coronavirus-Update von NDR Info, edition 84: "(84) Nicht auf Tests und Impfungen verlassen". Time stamp: "00:48:09 Diagnostik-Lücke bei Schnelltests"

Northern German public media (NDR) article: 'Drosten: "Schnelltests sind wohl weniger zuverlässig als gedacht."' Translated: Drosten: "Rapid tests are probably less reliable than expected"

Tim Lohn in Bloomberg: "Rapid Covid Tests Are Missing Early Infections, Virologist Says."

Jitka Polechová, Kory D. Johnson, Pavel Payne,Alex Crozier, Mathias Beiglböck, Pavel Plevka, Eva Schernhammer. Rapid antigen tests: their sensitivity, benefits forepidemic control,and use in Austrian schools. Not reviewed preprint.