Federal spending spree

In 2008 Rahm Emanuel, former Chief of Staff to President Barack Obama and mayor of Chicago, said: "You never want a serious crisis to go to waste. And what I mean by that [is] it's an opportunity to do things that you think you could not before."

It has become a common catchphrase. Emanuel repeated it last year amid the coronavirus pandemic (link). Spendthrifts Joe Biden and the "progressives" and leftist radicals of the Democratic party have strongly embraced it 

FEE: Federal ‘COVID’ Spending Just Hit $41,870 Per Taxpayer Signed by Biden last month, the 
American Rescue Plan Act of 2021 called for spending $1.9 trillion on the Covid19 crisis, with a large part of the $1.9 trillion not directly related to Covid19. It includes, among other things, spending on

• agriculture and nutrition programs;
• schools and institutions of higher education;
• child care and programs for older Americans and their families;
• mental health and substance-use disorder services;
• emergency rental assistance, homeowner assistance, and other housing programs;
• payments to state, local, tribal, and territorial governments for economic relief. (Link)

The $6 trillion stated in the FEE article includes the $4.1 in relief measures passed while Donald Trump was President (link).

Still far from satisfied, Biden and his cronies propose another spending spree called the American Jobs Plan. It proposes spending another $2 trillion on infrastructure and jobs (link). Of course, it includes lots of "pork", such as subsidies for buying all-electric vehicles and charging stations for them. In other words, it is a down-payment -- merely a down-payment -- on the so-called Green New Deal.

The $2 trillion would increase total spending to about 8/6*$41,780 = $55,707 per taxpayer.

As usual, the the promoters of such legislation hype how many jobs it will create while ignoring how many jobs it will destroy.

This proposed legislation also includes tax increases to pay for some of it. The corporate tax rate would rise from 21% to 28%, half way toward the 35% pre-2018 tax rate. It would mostly raise personal income tax rates for people with incomes exceeding $200,000 for single filers and $400,000 for married filing jointly. However, it will very likely hit a lot of people with incomes lower than those.

Of course, all this spending (over 10 years) will increase the federal debt and sow seeds of inflation. Much of the debt will likely be funded by the accommodating Federal Reserve.

Bad news bias

 Bad News Bias by David Leonhardt of The New York Times  

Bruce Sacerdote, an economics professor at Dartmouth College, and two other researchers built a database of Covid coverage from every major network, CNN, Fox News, Politico, The New York Times and hundreds of other sources, in the U.S. and overseas. The researchers then analyzed it, classifying the coverage as positive, neutral or negative. 

"The coverage by U.S. publications with a national audience has been much more negative than coverage by any other source that the researchers analyzed, including scientific journals, major international publications and regional U.S. media."

"When Covid cases were rising in the U.S., the news coverage emphasized the increase. When cases were falling, the coverage instead focused on those places where cases were rising. And when vaccine research began showing positive results, the coverage downplayed it."

"About 87 percent of Covid coverage in national U.S. media last year was negative. The share was 51 percent in international media, 53 percent in U.S. regional media and 64 percent in scientific journals."

"Sacerdote is careful to emphasize that he does not think journalists usually report falsehoods. The issue is which facts they emphasize."

I credit Leonhardt for reporting on the study. It's still a case of the pot calling the kettle black. Leonhardt himself did some very negative reporting about Covid, President Trump, and the U.S.A. compared to other countries. I wrote about some of his reporting on this blog. 

Coronavirus - sloppy, biased NY Times

Coronavirus -- NY Times biased statistic

Coronavirus -- NY Times biased statistic #2

Coronavirus - Andrew Cuomo and nursing homes deaths

Last year tyrannical Dem. New York Gov. Andrew Cuomo issued as executive order forcing nursing homes to admit people known to have been infected by the coronavirus. The following stories show the consequences. His action caused far more people to become infected and die as a result.

Morning Dispatch: Cuomo Under Fire for Undercounting Nursing Home Deaths

New York Post: COVID-19 deaths in NY nursing homes were 50 percent higher than claimed

Update Jan. 30: Cuomo won't apologize (link).

"Attorney General Letitia James found that [Cuomo's] administration had drastically undercounted nursing-home deaths."

"Residents who died of COVID-19 in the facilities themselves were listed as nursing home deaths, while residents who died after being transported to a hospital were not included in that tally."

Cuomo added, “If you look at New York State, we have a lower percentage of deaths in nursing homes than other states. A third of all deaths in this nation are from nursing homes. New York State, we’re…about 28 percent, but we’re below the national average in number of deaths in nursing homes. But who cares — 33, 28, died in a hospital, died in a nursing home — they died.”

If 28%*1.5 = 42%, which is higher than other, maybe all, states.

Coronavirus - new drug

New, more effective drug to treat COVID-19

Aplidin, also known as Plitidepsin, has gone through a Phase II clinical trial against COVID-19 and is now awaiting the start of Phase III testing. It comes from sea squirts, marine creatures that look like plants and have tubular openings allowing them to draw in and expel water. Their only known habitat is around the Spanish island of Ibaza east of Spain in the Mediterranean Sea.  

Coronavirus -- symptoms of Covid

Sure Signs You've Already Had COVID, According to New Study

1. Amnosia - loss of smell
2. Ageusia - loss of taste
3. Difficulty concentrating
4. Dyspnea - shortness of breath
5. Memory loss
6. Confusion
7. Headache
8. Heart palpitations
9. Chest pain
10. Pain with deep breaths
11. Dizziness
12. Tachycardia fast heart rate
13. Fatigue

I assume the more symptoms you have, the stronger the sign. Some singly, e.g. headache, chest pain, dizziness, fatigue seems more likely a sign of something else.

Happy New Year and take care.

Coronavirus - vaccine development

The Vaccine Story’s Heroes Do Not Fit the Liberal Narrative

Excerpts:

"Moderna had hundreds of vials of its vaccine shipped to the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland by February 24. Everything that has happened since — 1.4 million deaths worldwide, crippling lockdowns — has gone on while we were waiting for that vaccine to be tested, approved, and distributed."

"Moderna’s testing was slowed for a critical juncture by demands to include more racial minorities in the trials."  

I guess the demands came from the FDA. Regardless, clinical trials were yet to be done, and they take a long time. Reference: Coronavirus – clinical trials #2

Update Dec 7: We Had the Vaccine the Whole Time

Coronavirus -vaccine approval

The U.S. FDA drags its feet and the UK acts quickly to grant emergency use authorization to the Pfizer and BioNTech Covid-19 vaccine. 

Dr. Marty Makary [Johns Hopkins University] blasts FDA timetable to approve coronavirus vaccine: 'Why are they waiting three weeks?'

https://www.foxnews.com/health/dr-marty-makary-coronavirus-vaccine-fda-approval-timetable

TheHill Nov. 28: UK to approve Pfizer and BioNTech COVID-19 vaccine next week 

https://thehill.com/policy/international/527822-uk-to-approve-pfizer-and-biontech-covid-19-vaccine-next-week-report

Update Dec. 2, 2020. https://www.nytimes.com/2020/12/02/world/europe/pfizer-coronavirus-vaccine-approved-uk.html

"LONDON — Britain gave emergency authorization on Wednesday to Pfizer’s coronavirus vaccine"

The European Union authorities say they will decide by December 29.

Update Dec. 3, 2020. https://morning.thedispatch.com/p/the-morning-dispatch-uk-green-lights?

"White House officials reportedly summoned FDA Commissioner Stephen Hahn [nominated by Trump Nov. 2019] to the West Wing earlier this week for an explanation as to why the U.S. still has not granted emergency use authorization to Pfizer, which applied for FDA approval late last month."

“We are one of the few regulatory agencies in the world, if not the only one, that actually looks at the raw data from clinical trials,” Hahn told CBS News on Wednesday. “So we’re not going to take a summary from a company and take their conclusions and base our decision on that.”

Update Dec. 4, 2020. FDA Career Staff Are Delaying the Vaccine As Thousands of Americans Die by Marty Makary.

Coronavirus - spread

Social Distancing Isn’t Enough to Prevent Infection – How to Detect COVID-19 Super-Spreaders

This is an interesting article about the physics of transmission of the coronavirus. Detecting super-spreaders requires a sophisticated device now being used in hospitals.

Coronavirus -- vaccine effectiveness

"Hopes are soaring that a Covid vaccine is within reach, following news that an interim analysis has shown Pfizer/BioNTech’s candidate to have 90% efficacy in protecting people from transmission of the virus in global trials.

This article was amended on 18 November 2020 to clarify that results of vaccine trials at this stage refer to “efficacy” – the performance of an intervention under ideal and controlled circumstances – not “effectiveness”, which describes performance under real-world conditions" (The Guardian).

"In Moderna's trial, 15,000 study participants were given a placebo, which is a shot of saline that has no effect. Over several months, 90 of those people developed Covid-19. Another 15,000 participants were given the vaccine, and five of them developed Covid-19" (CNN). 

News reports from other sources are very similar. 

Okay, so 90% or 95% effectiveness or “efficacy” means that of the people who got the vaccine, 90% or 95% of them did not get Covid-19. This doesn’t answer the question of how many of them were enough exposed to the coronavirus to get Covid-19. If the people in the clinical trials wore masks, washed hands often, and minimized social contact, then it should not be surprising if effectiveness falls when people who get vaccinated during the big roll-out are not so precautious. Of course, effective rates depend on the degree of presence of the virus, and herd immunity will be reached eventually.

I heard a doctor say on television that he expects effective rates will fall as the vaccine is more widely distributed. He wasn’t clear about why.

Both vaccines are type mRNA. There are many articles on the Internet about this, such as this one.

Coronavirus – clinical trials #5 (& statistics)

The New York Post reports that a clinical trial has shown another repurposed drug, baricitinib (brand name Olumiant) is effective in reducing mortality rates of Covid patients.  Other sources, such as news-medical.net report the same. 

The articles say baricitinib reduces mortality by two-thirds or 71%. I don't understand how, because 1 - 17/35 = 0.514 is significantly less. Moreover, I have seen other cases where I didn't understand how the number was calculated. 

I have heard of other metrics used for clinical trials, such as odds-ratio and Cox Proportional Hazards-model but have been unable to replicate numbers the story claimed. I couldn't calculate an odds ratio for baricitinib because the news stories do not give all the numbers needed. Anyway, the alleged number in the news story has every time been higher than the number I got using the simple method shown above.

Coronavirus - how much infected? #2

Since about early April I have wondered: Doesn't it matter to what extent a person is infected by the coronavirus? I posted about it on August 11. 

Recently I read this article which is relevant to my question. 

Coronavirus - remdesivir #2

 A Wall Street Journal article says that nearly three dozen attorneys general are attempting a legal act of theft of Gilead's patent on remdesivir. Since the article is behind a paywall, the following are some excerpts.

The attorneys general effectively assert that remdesivir belongs to the government because taxpayers helped fund its development. 

First, Gilead’s scientists are entirely responsible for the invention of remdesivir.

The government didn’t get involved until later, when it teamed up with Gilead to test whether the drug was effective against Ebola. 

Later, Gilead collaborated with academic and government institutions to test remdesivir against coronaviruses like SARS and MERS. But the total government expense for research adjacent to remdesivir, about $70 million, is a fraction of the more than $1 billion Gilead has committed to the drug. 

Coronavirus -- HCQ, RCT, politics

This article, title Hydoxychloroquine: A Morality Tale, is sort of long (> 15,000 words), but well worth reading. It is about the drug (HCQ), randomized control trials (RCT), facing a pandemic due to a novel virus, and how they have been so politicized.

Remdesivir has been politicized, too, but not as much. Many people on the political left favor it. Its success in treating Covid is modest. Some had a change of heart when they assumed the FDA was unduly influenced by the Trump administration when the emergency use authorization was broadened for remdesivir. See my September 1 post.  

The article gets philosophical: "We live in a culture that has uncritically accepted that every domain of life is political, and that even things we think are not political are so, that all human enterprises are merely power struggles, that even the idea of “truth” is a fantasy, and really a matter of imposing one’s view on others. For a while, some held out hope that science remained an exception to this. That scientists would not bring their personal political biases into their science, and they would not be mobbed if what they said was unwelcome to one faction or another. But the sordid 2020 drama of hydroxychloroquine—which saw scientists routinely attacked for critically evaluating evidence and coming to politically inconvenient conclusions—has, for many, killed those hopes." 

Coronavirus - remdesivir

'Without evidence': Once again, FDA expands use of COVID-19 treatment without research to back it up is the title of a USA Today article about remdesivir, a drug being repurposed to treat Covid-19.

Without evidence?? The NIH said otherwise four months ago! The author Karen Weintraub even named two recent journal article that gave some evidence in favor of remdesivir. "Without research to back it up" sounds like a mantra alluding to randomized controlled trials (the "gold standard") and used as a "weapon."

Weintraub much disapproved the FDA decision. She found an ally in Dr. Topol. Dr. Marty mildly approved the FDA's decision. Dr. Meyer mildly disapproved.

There are at least three things the article says nothing about.

1. Weintraub did not name any alternative drugs. Is there an allegedly better one than remdesivir or is remdesivir as good as or better than any alternatives at this time? Context matters. Is it reasonable to denounce what is one of the best or better than others by a good margin because it isn't perfect?

2. At clinicaltrials.gov one can search with keywords Covid19 and remdesivir and find 48 studies underway or completed. Only two are completed, but maybe they gave some evidence favoring remdesivir.

3. Have practicing doctors encouraged the FDA to extend emergency authorization use (EAU) like the FDA did for only medical reasons? 

So what is Weintraub's motivation for saying "without evidence" and "without research to back it up"? My guess is that she wanted to smear the Trump administration. Weintraub writes, "[T]hose who follow the [FDA] said they have never seen such consistent politicization." What about her, USA Today's, and other main stream media's politicization?

Coronavirus - Sweden

Sweden Has Developed Herd Immunity After Refusing to Lock Down, Experts Claim. Others Point to its High Fatality Rate is an article in Barron's. 

Sweden's powers that be have been amply criticized for not imposing a severe lock-down by those who want severe lock-downs. The critics projected doom for Sweden. That has not been the case.

Of course, there is some evidence for either side. Sweden's experience is worse than its closest neighbors Norway, Finland, and Denmark, which had lock-downs. On the other hand, Sweden's experience is better than its European neighbors Belgium, Spain, Italy, United Kingdom, and France. Where Sweden's experience stands versus all of them or all countries is hard to say because there are so many relevant variables and differences -- time, ages in population, population density, extent of international travel, extent of testing, personal behavior, quality of health care, etc.

The article claims that Sweden's fatality rate is lower than four countries, France not one of them. It then claims Sweden's fatality rate is higher than France's. This is incorrect if fatality rate means deaths/cases. The following are the numbers from here thru 8/29/2020.

                     cases       deaths        pop.(mil.)     deaths/cases    deaths/pop.  tests/pop.

Sweden:       83,958       5,821         10.1                 6.9%                576          108,299

France:       272,530     30,602         65.4               11.2%                468            94,571

France's death/cases is about 1.63 times Sweden's. France's death/population (millions) is somewhat lower. However,  the article says Sweden's fatality rate is 6.8%, so it must be referring to deaths/cases.

A Market Watch article disagrees with Barron's and is critical of Sweden and its no lock-down approach. It says, "Sweden has an overall COVID-related death rate of 57.12 per 100,000 [571 per million], which is the ninth highest in the world, according to Johns Hopkins University." That's accurate. However, Belgium, Spain, UK, and Italy, all with severe lock-downs, had higher deaths/pop than Sweden.

France's daily new cases is surging again. Sweden's is not. The virus might be less virulent in this new surge. Time will time if France's deaths/pop surpasses Sweden's.

Update 9/1/2020: This article was first published by The Washington [Com]Post. It is highly critical of  Trump-appointed Dr. Scott Atlas, 'herd immunity' and mentions Sweden. "Sweden’s handling of the pandemic has been heavily criticized by public health officials and infectious-disease experts as reckless — the country has among the highest infection and death rates in the world."

Ignored are countries who had severe lock-downs, yet had infection and mortality rates higher than Sweden's. 

The article includes this quote: "The administration faces some pretty serious hurdles in making this argument. One is a lot of people will die, even if you can protect people in nursing homes.” The person quoted is an economist! Yet the next paragraph says, "Atlas, who does not have a background in infectious diseases or epidemiology[.]" How ironic! The Post authors regard an economist with no medical expertise as credible, but a medical doctor as not credible!

Coronavirus - convalescent plasma

The FDA has granted emergency use authorization (EUA) to convalescent plasma to treat hospitalized patients with Covid-19 (link). This is plasma containing antibodies drawn from persons who had Covid-19 and have fully recovered.

A Wall Street Journal op-ed calls the FDA's decision good. The op-ed being behind a paywall, some reading this may only be able to see the start of it. Hence, the following in italics are some excerpts. 

This is what occurred with the anti-malaria drug hydroxychloroquine and now is happening with convalescent plasma, which the FDA on Sunday granted “emergency use authorization” (EUA). Mr. Trump was wrong to tweet over the weekend that “the deep state” at the FDA was thwarting development of therapies and vaccines to sabotage his re-election.

There’s no evidence for his claim or that the FDA is making decisions based on anything but the science. There is, however, ample evidence that convalescent plasma may be effective and that the potential benefits outweigh the risks. This is the FDA standard for EUAs, and the agency was right to increase patient access to the potentially life-saving therapy.

But individuals produce varying levels and types of antibodies in response to viruses, so convalescent plasma from some recovered patients will be more effective. This makes it especially hard to do randomized trials with control groups. The two randomized placebo trials on convalescent plasma were inconclusive.

The evidence for convalescent plasma relies on more than a dozen observational studies and clinical trials that don’t meet the randomized placebo standard. 

Current evidence suggests that benefit is most likely in patients treated early in the course of the disease (e.g., prior to intubation). This make sense. Hospitalized patients in the early stages of the disease tend to have low levels of lymphocytes that produce antibodies. Infusing them with more antibodies probably helps. But patients who must be intubated may be suffering from a cytokine inflammatory storm, which mere antibodies won’t calm.

They [others, e.g. The New York Times] want evidence from gold-standard clinical trials, but these are hard to pull off in a pandemic and often yield conflicting results.

Thousands typically need to be enrolled to prove statistically significant benefits, and trial designs obscure benefits among patient subsets. It’s unlikely that any treatment will show an aggregate benefit among all sick patients because people suffer different symptoms at different stages of the disease.

*****

Of course, and like the op-ed says, others have lambasted the decision, such as The New York Times. What else should one expect from that source? Again, the following in italics are excerpts.

F.D.A. ‘Grossly Misrepresented’ Blood Plasma Data, Scientists Say

But scientists were taken aback by the way the administration [President Trump, Azar of HHS, Hahn of FDA] framed this data, which appeared to have been calculated based on a small subgroup of hospitalized Covid-19 patients in a Mayo Clinic study: those who were under 80 years old, not on ventilators and received plasma known to contain high levels of virus-fighting antibodies within three days of diagnosis. 

The WSJ op-ed compared the plasma treatment to the treatments dexamethasone and  remdesivir. The two drugs are for more serious cases, but they haven't clearly passed a gold standard either. The New York Times article said nothing about those drugs and them versus the gold standard. It seems the gold standard is for things the NYT doesn't like, but not for things the NYT does like.

Update 8/26: FDA Commissioner Stephen Hahn issues mea culpa for his plasma treatment claims, saying he had overstated the benefits of convalescent plasma as a treatment of coronavirus at a news conference last weekend with President Trump (link).

Update 8/29: A key person behind Stephen Hahn's apology was removed (reassigned, not fired) from her public relations position (link).

Coronavirus - how much infected?

Since maybe early April when the number of new cases in the U.S. began rapidly rising, I have wondered: Doesn't it matter to what extent a person is infected by the coronavirus? Mildly infected likely means no or mild symptoms. Severely infected likely means severe symptoms, maybe hospitalization or worse. Of course, the strength of the person's immune system can constrain the severity of symptoms.

I finally saw an article that has some answers to my question.

40% of people with coronavirus have no symptoms. Might they be the key to ending the pandemic?

The article taught me another word, inoculum, the amount of virus someone is exposed to. It also says that wearing a mask might constrain the degree of infection.

A different article includes the following.

“When we looked in the setting of Covid disease, we found that people who had prior vaccinations with a variety of vaccines — for pneumococcus, influenza, hepatitis and others — appeared to have a lower risk of getting Covid disease,” Dr. Andrew Badley, an infectious disease specialist at Mayo Clinic told CNN’s Anderson Cooper on Monday night.

It’s what immunologists call immune training: how your immune system creates an effective response to fight off infections, Badley says.

This article has more about the immune response.

This article has more about potential immunity to the coronavirus.

Coronavirus – clinical trials #3

Yesterday’s post was about a clinical trial for a coronavirus vaccine and Mill’s Method of Difference. In this post I consider a clinical trial for a Covid-19 cure and Mill’s Method of Difference.

A clinical trial for a cure for Covid-19 would enroll patients who already have Covid-19. There is no contingency analogous to becoming infected like there is for a coronavirus vaccine clinical trial. On the other hand, there are a lot more variables – a variety of patients’ ages, each patient’s health status, degree of infection, and so forth. Dosage amounts may also differ, for which the logic is also Mill’s Method of Concomitant Variation.

Dr. Anthony Fauci often invokes the “gold standard” for clinical trials (randomized double blind placebo control studies) when he comments on any drug doctors might prescribe to treat patients. This standard is mainly for new drugs, but may also be used for already FDA approved medications for treating medical conditions outside the scope of prior approval, e.g. remdesivir for Covid-19. These are often called “off label” uses. It is also called repurposing. The FDA has relaxed its standards for drugs to treat Covid-19 patients. The FDA has made emergency use authorizations (EUA). The FDA may grant Investigational New Drug (IND) permission to test a drug. To my knowledge no drugs – even Remdesivir, which Fauci personally approves -- have passed the “gold standard” for treating Covid-19.

The following are the NIH guidelines for the treatment of Covid-19 with four different drug therapies.  Remdesivir.  Chloroquine and Hydroxychloroquine.  Hydroxychloroquine Plus Azithromycin.  Dexamethasone.

Conspicuously non-existent are web-pages for (1) Hydroxychloroquine (HCQ) Plus Zinc and (2) HCQ Plus Zinc Plus Azithromycin, especially with outpatients. Several doctors who recommend using HCQ for Covid-19, mainly with outpatients, have said zinc is a necessary enabler and without zinc the HCQ is minimally effective. Note that the NIH's web-page for HCQ + Azithromycin page concerns only trials with inpatients (hospitalized).

Dr. Anthony Fauci still approves using remdesivir. Regardless, it falls far short of a cure for Covid-19. Like the above web-page shows, some clinical trials have shown at best that remdesivir reduced  recovery time compared to a placebo. Other trials have shown no observed improvement or the data is insufficient. I would not call that passing the “gold standard.”

Dr. Fauci and the NIH recommend dexamethasone for some patients. The web-page above says clinical trials have shown significant mortality reduction in patients requiring supplemental oxygen, with or without a ventilator. On the other hand, no benefit of dexamethasone was observed in patients who did not require supplemental oxygen. Does this mean that dexamethasone passed the “gold standard”? Arguably 'yes' in some cases, but a cure? Many who got the drug still died during the trial.

Despite the many unknowns about the coronavirus and Covid-19 and the long time frame of clinical trials, Dr. Fauci often appeals to the “gold standard” as an argument against anything that doesn’t meet his or the FDA’s approval. In effect, he has little regard for individual judgments of practicing physicians to prescribe drugs absent his or the FDA’s approval, despite the lack of “gold standard” drugs for curing Covid-19 or halting its progress.

Dr. Fauci also consequently has shown little regard for giving placebos to patients who are seriously ill with Covid-19. Assume such patients participate in a clinical trial hoping to be cured and they later learn – if they survive – they were given a placebo and other patients in the trial who got the drug benefited. I suspect they would not be content.

Coronavirus – clinical trials #2

My previous post posited that the logical basis of clinical trials is Mill’s Method of Difference. The following is a simple example of a clinical trial based on Mill’s Method of Difference. Suppose there are N patients with disease D and the clinical trial is to treat some, e.g. two-thirds, of the N patients with medicine M and give the other one-third a placebo. Assume the later result is that the patients who are given M are cured of D, but the patients who are given the placebo are no better off than at the start. Then one could conclude that M is a cure for D. Call this the SDMT (for simple disease medicine trial).

A real world clinical trial is probably rarely as clear-cut as SDMT. It also seems to me that a clinical trial for a vaccine against the coronavirus would be far less clear-cut, for at least the following reasons.

1. The SDMT has a huge advantage over the coronavirus vaccine trial at the start. The participants at the start of the vaccine trial presumably have all tested negative for the coronavirus.* Some get the vaccine and the rest get a placebo. Then they wait to see if they do become infected by the virus to some degree. If they do become infected, and the vaccine protects against Covid-19, whereas those given the placebo get Covid-19, then the vaccine justifiably worked. However, many of the participants may not become infected any by the virus. They provide no basis for any conclusion about the efficacy of the vaccine. Presumably, such a vaccine trial must have many, many more participants than a SDMT kind of trial to make up for the probability of not becoming infected.

2. Those given the placebo might get infected, but their natural immune system might protect them from testing positive for the coronavirus or getting very ill from Covid-19 anyway.

3. Some participants may become only mildly infected and others far more so. This might come about due to the extent of precautions they take while in the trial, such as wearing a mask, keeping a safe distance from others, and washing hands. 

4. Some given the vaccine may be infected and the vaccine works. Others given the vaccine may be infected and the vaccine doesn't work or works poorly.

For all these reasons, and more not stated, a clinical trial for a coronavirus vaccine falls far short of all factors being the same except for one key difference for ideally applying Mill’s Method of Difference. It makes me quite skeptical about achieving a “gold standard” vaccine clinical trial per the wishful Dr. Anthony Fauci.

*The trial might also include groups of people who tested positive and are (a) asymptomatic or (b) have mild symptoms. They should be considered as separate trials.

Coronavirus – clinical trials #1

The coronavirus pandemic has pushed the concept and use of clinical trials into the mainstream media. Searching the Internet for {coronavirus clinical trials news} or {coronavirus clinical trials method} or {clinical trials logic} yields many results about clinical trials underway, but very little about the logic behind such trials. For example, this web-page is about clinical trials for a Covid-19 vaccine. The title says “here’s what you need to know”, but none of it is about the logic behind such trials.

When I became aware of clinical trials, I supposed that such trials are an application of John Stuart Mill’s Method of Difference. Researching it very recently, I found this web-page which supports the supposition. Despite that, it doesn’t link the logic of clinical trials directly to the influence of John Stuart Mill himself. Another web-page addresses the direct influence of Mill, but such influence is sketchy.