Everything you need to know about COVID-19, but you'll ignore because you'd rather believe some nutcase conspiracy theory

Before reading further you need to ask yourself two questions:

1) Do I accept the scientific method?
2) Do I accept the Germ Theory of Disease?

If the answer to any of the above two questions is no, then you may as well stop reading now. There is simply nothing I can do for you if you are wilfully illiterate when it comes to science. I'm sorry, but ignorance of science is not an argument against it. Before having an opinion about science, you need to go back and  revisit primary school science. Not high school - primary school.

If the answer is yes to both, then you will probably find the following to be quite obvious, so why am I writing all this down?

Good question.

The answer is that an argument unanswered continues to be argued. Even stupid, idiotic, completely brain dead arguments that anyone with a primary school understanding of science should be able to answer. So, here and now, all the asinine Coronavirus-denialist arguments I've come across will be thoroughly and completely debunked.

In short, if you accept the scientific method and the germ theory of disease, there is not a single scrap of evidence to support the politically motivated denialism that abounds.

So let's start with some background information before we take the deep dive into tinfoil hat hell.

Transmissibility and Exponential growth

Most people are pretty bad at understanding exponential growth. There's an old Chinese proverb about an Emperor asking his servant what he would like his reward to be. The servant replied "Just place one grain of rice on a chess square and double that for each squar on the board." The emperor agreed because he thought this was very cheap, however he found out that this would be more rice than all of China had, so instead he executed the servant.

Disease spreads according to the mathematical rules of exponential growth and decay. The speed of this growth or decay is called the exponent - or the 'R' factor. For steady state growth, R=1. For exponential growth, R>1 and for exponential decay R<1.

The base rate for a virus is known as the R0. This can and is modified by external factors. Some of these factors are common to most viruses, others are peculiar to a few.

Any virus with a R<1 will not propagate. It will simply die out of its own accord.

Virus with a very high value of R will propagate extremely quickly. Measles, for example, has an R0=16.

The following video is an excellent explanation of how exponential growth occurs:

Rather than explain further, I'm going to assume that you've either watched the video, or you have a grasp of exponential growth and decay.

Mortality Rate

For just about any disease, the mortality rate is highly variable. When a rate is presented, this is the overall mortality rate. In other words, how many people die as opposed to those who recover as a percentage. However for individual cases, this is affected by a huge number of factors:

 - the age and overall health of the patient
 - access to health care and ICU
 - comorbid conditions
 - weather
 - treatments

Sometimes these can be counter-intuitive, for example, the H1N1 Spanish Influenza had a higher mortality rate with young, fit people.

Incubation Period

This is how long from the time you are infected with a virus before you begin to show symptoms. For many diseases, you can be infectious to others during this period of time. 

Debilitating Conditions

Sometimes, not dying of a disease is not a completely successful outcome. A person may have permanent disability as a result of the disease or their life expectancy may be reduced. A text book example of this is polio which, although it didn't have a high mortality rate, it left numberless people crippled for life, some surviving only via living in an iron lung.

Putting it Together

The graph below plots mortality against transmissibility (R0) for various diseases compared to COVID-19.

Since this graph was made, COVID-19 has been established to have an R0=2.4.

What is COVID-19

COVID-19 or SARS-COV-2 is a novel (meaning new to our immune systems) RNA virus from the coronavirus family. They are named simply because of their shape, not all coronaviruses are related.

Three types of coronavirus are associated with what we refer to as the "common cold". They are usually mild and almost never fatal. They tend not to mutate very much, in fact mutations tend to die out very quickly.

Two types of coronavirus are extremely deadly. These are known as SARS and MERS. Fortunately, both of these viruses have a relatively low R0 and were contained locally.

So enough background material, now to the pseudoscientific claims...

"It's just a flu"

Influenza is a family of viruses that are closely related. They are two major divisions: Influenza 'A' and Influenza 'B'. The B types are usually mild flus by can also be the dreaded '24 hour' flu. The A types are more common and are in turn classified by HnNk classification system. These are the bad seasonal flus that usually have a low but significant mortality rate in the order of 0.1%.

The flu is considered seasonal because of its low R0 of 1.4. Warm weather, reduced physical content and improved immune systems in summer reduce the R0 to below 1.

Influenza 'A' is an amazingly adaptable virus. It exists in birds, pigs and humans and jumps back and forwards between species. This is why flu types are also named by the species they originate from.

Our bodies know the flu pretty well. Even with changes to its genome, we're pretty good at creating antibodies for it within a short period of time. When we catch the flu, we often get over it in a week or two.

COVID-19 is a novel virus. Our bodies haven't seen it before and it takes time to adapt. Most people take a minimum of 3 - 4 weeks to recover from it. Also, the mortality rate is much, much higher than the seasonal flu.

The second factor is that for some reason we don't understand yet, nearly 80% of people are asymptomatic carriers. The majority of these are those younger than 50. The mortality rate for those over 70 is over 20%. This means people can be carrying and spreading the disease without knowing it.

"The death rate isn't that high"

To calculate the death rate, you look at the number of people that have died against those who have recovered, not the number of people that still have the disease. When you do that, you get a figure between 1% and 10%.

Part of that reason is the amount of testing that is done. Some areas don't test asymptomatic people, so that will tend to inflate the death rate. Other areas test everybody, which tends to lower the apparent death rate, so you need to look at the positive rate for comparison. Some locations - like Italy - have aging populations which bump up their rate a little.

All testing methodologies have both a small false positive and false negative rate. When the case load is high, this false positives and negatives become statistically negligible. However when there are very few instances of the disease, they can max out the statistics. There is a statistical method called Bayes' Theorem that is used to account for and correct these anomalies. As an aside note, I have used Bayes' Theorem in my work in developing ways of identifying spam emails. It's an extremely useful and highly accurate statistical tool.

First world health care is also very good at reducing mortality - as long as the system is not overloaded. The European (and potentially the American) experience has shown that when the health system is overloaded and ICU beds are not available, the mortality rate rises dramatically. But this is not all, if the health system is overloaded and you have a life threatening medical emergency such as a heart attack or car accident, an ambulance may not be available, or there may be no ICU beds or surgeons to treat you and you may die as result. Your death won't be recorded as a COVID-19 death, but you'll die nonetheless. 

UPDATE: 26 Aug 2021

I was recently challenged on the death rate with the claim that the mortality had dropped to less than 0.1%. So I crunched the numbers again, this time differentiating between the Infection Fatality Rate (IFR) and the Case Fatality Rate (CFR). I've pasted a screenshot of the spreadsheet here.

Consistently, the fatality rate is between 1% and 9%, with the majority between 1 and 3%. The list of reasons for variation between countries is too long to go into in this snippet, but there are a few standouts. When a country's health system is overwhelmed, that's when the death rate tends to shoot up - when no ICU beds are available. Countries with Universal Health Care tend to do better than countries that don't. Third-world countries tend to do worse. 

Israel's figures also show an interesting trend. One of the few countries that is mostly vaccinated, the majority of cases are amongst the vaccinate, but nearly all the sever cases are amongst the unvaccinated. So while vaccination may not prevent you from getting COVID, it will prevent you from having a serious case.

The data on Israel is very early, however, and it does seem to indicate that protection falls off quicker than expected. Those vaccinated in January are over represented in the number of cases, so a booster shot at six months might be required rather than waiting twelve months as is typical.

"It's not that bad"

For nearly 80% of people, it's not bad at all - in fact, most don't even know they have it. This is called "survivor bias". A moderate number have mild symptoms, but a significant number have severe symptoms. Now "severe' means hospitalisation. When was the last time you were hospitalised for the flu? Never?

If you are hospitalised for coronavirus, you are very sick. You may need intubation - something very unpleasant. You will most likely carry some form of permanent impairment - reduced lung capacity, heart or liver damage. You may never be able to physically exert yourself ever again. You may have your life expectancy reduced by ten years. You may live the rest of your life in chronic pain.

But then again, you may be one of the 80%. Do you want to take that gamble?

"Masks don't work"

There are three types of masks to consider:
 - surgical masks
 - N95 & KN95 masks
 - cloth masks

Surgical masks are designed to protect the 'other person' and not yourself. If you have coronavirus, wearing a surgical mask reduces transmissibility by 75%. So, its a bit like having third party insurance. If everybody has it, everybody is protected. However testing has shown surgical masks do offer some level of protection to you in the order of 5% - so they aren't ineffective.

N95/KN95 masks are designed to protect you. They are more expensive and must be fitted with a tight seal to be fully effective. The '95' means that 95% of particles of 3 microns or larger are filtered out. COVID-19 is between 2 & 3 microns in size. This doesn't mean the masks don't work, just that they don't filter out 95%. Testing has shown the mask filters approximately 60% of COVID-19 viruses.

Cloth masks are less effective than either surgical or N95 masks. Properly made, they will filter up to 50% of COVID-19 viruses. To be properly made, they must have three layers, with the innermost layer made of cotton, and the inner layer made of polypropylene. They should be washed regularly.

"Masks build up CO2"

No, they don't. This argument is absurd and extremely easy to test.

Put on a mask and put your finger in an O2 optical measurement device. Several doctors have demonstrated that even wearing multiple masks does not reduce Oxygen saturation. If this was a problem, surgeons would have been dropping dead like flies for years now.

"America's Frontline Doctors" (added 30  July)

Where to to start with this one? The TLDR is this video is one of the biggest deliberate frauds/hoaxes I've ever seen.

In this viral video, you see a doctor standing in front of the US Supreme Court steps claiming that “you don’t need masks” because “there is a cure” for the coronavirus.

The speaker, Stella Immanuel, says that she is a doctor and that she practiced in Nigeria. That much checks out: a person of that name does have a medical licence on file with the state of Texas, and the licence states that she got her medical degree from a university in Nigeria.

She says that she has treated 350 patients with COVID-19, given them all a regimen of hydroxychloroquine, zinc, and the antibiotic Zithromax, and that none have died. We don’t have any way of judging whether this is true; she hasn’t released any data that lifehacker has been abled to find.

“You don’t need masks,” she says. This is wrong; masks are imperfect but extremely helpful in protecting us from giving the coronavirus to each other.

Immanuel claims that a paper about hiccups “proves” that the NIH knows hydroxychloroquine “cures” COVID-19. But the paper is no proof of a cure. It states that a patient had hiccups and was positive for COVID-19, and that the patient felt well enough to be released from the hospital a few days later. The authors’ conclusion is that doctors should consider COVID-19 as a possible diagnosis for patients with hiccups or with other unusual symptoms. Yes, the patient was treated with hydroxychloroquine while in the hospital, but from this paper we can’t say if that actually helped or if he would have done just as well without it.

The truth is that hydroxychloroquine has been used a lot in the last few months. The first trials that put it in the news had serious flaws, but doctors around the world often chose to give it a try. It’s (normally) an easily available drug, with known side effects that are often mild to manageable. Immanuel says she used it to treat malaria in Nigeria, and it’s true that the drug is commonly used for this. Its use for malaria and for other conditions like lupus is why the drug is so widely available and its side effects well known.

But in all these studies, hydroxychloroquine — with or without zinc and azithromycin — has not shown itself to be a “cure,” nor even a promising treatment. You can read here about which experimental treatments are showing promise and which are not. Hydroxychloroquine lands squarely in the “not promising” category.

On her social media profiles, Stella Immanuel has shared other misinformation, including a claim that the coronavirus vaccine “will fuse with your own genes and modify your genetic makeup,” which is not a thing any of the vaccines in development are designed nor, as far as anyone knows, remotely able to do. The Daily Beast has more on her past statements about health, including the idea that gynecological problems are caused by having sex in one’s dreams with demons. She also claims that scientists are developing a vaccine to make you an atheist and modern medical treatments contain alien DNA. And if you look at her twitter feed, you can see she isn't exactly playing with a full deck.

There's something to be said for taking a job lot. If someone's obviously crazy with some things, that tends to dilute what they have to say about others - no matter what their level of conviction. In fact, ESPECIALLY if they are heavily convicted. At the very least, skepticism of what they say should be very high.

She claims masks are unnecessary and she and all her medical staff take Hydroxychloroquine to prevent COVID-19, but she wears a mask in her videos promoting her Fire Power Ministry -- just not when she's trying to influence public health policy. Among her Fire Power Ministry services are conversion therapy and removing generational curses from your placenta.

When you search for her clinic, it shows her religious gift shop in a strip mall. In her posts and videos, she Photoshops her clinic sign over the actual sign next door. She "runs" another clinic in Katy, TX out of an aged care home but again the sign says it's her ministry.

Each doctor in the video is wearing a white coat with an "America's Frontline Doctors" logo. They are organized by the "Tea Party Patriots". AFD's site was created right before the video, on July 16, less than two weeks ago, so Breitbart could say, "We're here with America's frontline doctors." Not exactly an established group. The AFD site runs out of that strip mall. The listed phone number leads to a website called "Southern Flare [sic] Urgent Care" with another photoshopped clinic encouraging anyone with COVID to pay for virtual treatment.

Incidentally, their website (hosted at squarespace) has already expired.
In the video, she says she's saving the lives of patients who are about to die from COVID-19. On her page, she says she accepts patients with mild cases.
She set up a GoFundMe for any future legal issues she may have.
Dr. Simone Gold, with America's Frontline Doctors, claimed to be affiliated with Centinela Hospital (they have confirmed she is not a current staff member), and inferred she was affiliated with Cedars-Sinai ER -- who has clarified that she is not.

Dr. Gold has 4 reviews, at least one of which was made today and simply thanks her for being so "brave" in the video.

Dr. Jeff Barke is a QAnon conspiracy theorist who was busted in a drug sting. He is affiliated with an online school that was recently sued for fraud and was under investigation for preying on seniors. He's a member of a group that funds Republican candidates, and the Orange County Republican Central Committee. He said COVID-19 is no more dangerous than the flu, when US flu deaths are at 34,000/year and US COVID-19 deaths are at 150,000.

Dr. Barke founded a religious charter school using right-wing curriculum developed by Betsy DeVos-linked Hillsdale College. A charter school PAC gave his wife's campaign $245,000.

In short - can you possibly not consider this video as anything more than an elaborate fraud designed to push misinformation?

The fact that this "news conference" had more speakers than attendees was of little matter. Livestreamed by the far-right website Breitbart News, the video spread quickly, initially through conservative, anti-vaccination and government conspiracy groups. Within hours, it had reached over 20 million Facebook users.
As previously mentioned, the event was hosted and funded by the Tea Party Patriots, led by Jenny Beth Martin, the group's co-founder, who spoke at the news conference.

Tea Party Patriots have been critical of measures enacted to slow the spread of the coronavirus. Before America's Frontline Doctors, the group launched the Second Opinion Project, a website that hosted videos of doctors attacking state and local coronavirus efforts.

Videos from supposed experts bucking public health consensus have been a recurring brand of misinformation during the pandemic. In April, viral videos were eventually removed from Facebook and YouTube of two doctors in Bakersfield, California, downplaying the risk of the coronavirus and spreading a conspiracy theory about doctors purposefully misattributing unrelated deaths to the coronavirus. Dan Erickson, one of the two doctors in the clip, spoke at Monday's news conference.

In May, a "Plandemic" video from a discredited scientist promoting conspiracy theories about the coronavirus and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, drew 8 million views before it was removed.

Whatever happens to the video, the myths in it will continue to circulate because they are attractive. It tells us, falsely, that masks are unneeded, that lockdowns are unnecessary, and that there is a surefire cure for COVID-19 that the government is covering up. This is all clearly, obviously false, and these myths were circulating long before this specific video. They’re still as wrong as ever.

LifeHacker
Yahoo News

"It's a Hoax"

To believe this, you have to ignore all the evidence and believe in a global conspiracy involving all the doctors and nurses in the world conspiring to ... achieve what exactly?

If you accept this, then I'm afraid you are a candidate for mental health intervention.

Delta Update (17th/18th August 2021)

The new Delta strain, which originated in India has completely changed the game for coronavirus. At first, it was estimated that the delta strain had an R0=5. Now, the estimates are for an R0=9!!!

That is insanely high. The only other virus I'm aware of with that high an R0 is the measles. Assuming that vaccines confer 90% immunity, then in reality we need 98.7% of people vaccinated for herd immunity. That is never going to happen.

There are two possibilities: a third shot as a booster to increase immunity beyond 90%, or a mixture of vaccinated and naturally immune (through catching and recovering from COVID.

We also have some sobering data from Israel - which has a nearly fully vaccinated population. Because of their high vaccination rates, Israel has opened up pretty much completely. But now that the Delta strain has hit, cases are rising dramatically - even amongst the vaccinated. In fact, particularly amonsgt the vaccinated.

If the data from Israel is correct, those vaccinated in January have an immunity below 50%. Those since January have a much higher level of immunity.

Now, this could be a limitation of the Pfizer vaccine. There's no evidence the other vaccines have this level of reduced immunity to Delta, however, we don't know.

The other side is that although most of the infected have been vaccinated, most of the serious cases are amongst the unvaccinated and nearly all of the ICU cases are unvaccinated. So, the Israeli approach is "Meh. We'll stay open."

The rationale being that although the vaccine's effectiveness in preventing infections has dropped, it's effectiveness in reducing the symptoms and the severity of COVID-19 is still close to 100%. Some may argue this is a better outcome as the mild infection will now confer close to 100% of future infections, but this remains to be seen. We simply don't have enough data yet.
 

That's probably enough for now. I know this is a little snarky, but I'll only suffer fools for so long. I'll add more as I'm reminded of more 'objections' and source it up better. I still have to write up why social distancing and quarantining are important measures, but I'll finish up with an explanation of Aatish Bhatia's COVID-19 excellent data analysis.