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I'm out. I'm moving on to a new career. My wife just told me I MAY have the largest penis she has ever seen so I am going to become a mobile billboard for cialis. Lets face it. I have a better chance at succeeding at that than convincing DRB that he's buying into a fake lying media that has the same goal as BLM and that is to remove Trump from office. It has nothing to do with telling the truth or making a better world for all people only certain people.
Swamp
Apparently this is a thing...

...or not...



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I'm out. I'm moving on to a new career. My wife just told me I MAY have the largest penis she has ever seen so I am going to become a mobile billboard for cialis. Lets face it. I have a better chance at succeeding at that than convincing DRB that he's buying into a fake lying media that has the same goal as BLM and that is to remove Trump from office. It has nothing to do with telling the truth or making a better world for all people only certain people.
Swamp
Yes, you do have a better chance, and for the same reason. Facts are provable, simply measure. Oh, by the way, the word "may" means that the user, DRB, is not buying the story as a fact. Think about it, I used may, which you think, correctly by the way, indicates that I don't know positively, so you have proven, again, that DRB is not buying into the media. How ever, the fiction repeated about the BLM is so completely wrong that there is evidence that someone is buying into a lying media.

And I don't lie. I do make mistakes(well, some have claimed so), but have never intentionally posted anything that I did not believe was true.

I do believe that the best way to remove Trump and his gang from office is to tell the truth to anyone who will listen. I think the truth is sufficient, so there is no need for lying. Much easier to tell the truth since since the proof is so available.
 

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Well drb, I didn't say anyone was lying first off. I did say that since the statement contained the word may it was an irrelevant or meaningless statement. Only the radicals like blm, antifa, socialists,marxist and communists believe Trump needs to be removed from office. The rest of the country believes blm, antifa, socialists, marxist and communists need to be removed from the country because we believe in equal rights not special rights. The FACTS about blm are just that.
Patrisse Cullors the co founder of blm stated on air that their(blm) goal was to get Trump removed from office or at the minimum keep him from being reelected. The reason being is that blm is a Marxist group. Cullors makes that statement hundreds and hundreds of times that they(blm) are trained Marxists. Get your $h!t together drb and get some facts! It isn't about Blacks it's about who controls the country. Once again Blacks are being used as pawns by radicals.
By the way, you are getting way to contradictory. You posted something, then say you used "may" so that everyone believed that you didn't buy into it and then you say you never post something that you don't believe is true. Come on boy you're making me dizzy.
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Medscape:
Doctors Wonder What to Do When Recovered COVID-19 Patients Still Test Positive
Donavyn Coffey
June 09, 2020
  • 15Read Comments
Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.
More than 1 month after she was diagnosed with COVID-19, a 44-year-old patient phoned Ana Amorim, MD, PhD, with an unexpected question: When would it be safe for her to kiss her husband and children?
This patient, diagnosed on March 11, was one of several physician colleagues of Amorim, an ear, nose, and throat specialist in Coimbra, Portugal, to contract COVID-19. She had a myriad of symptoms — cough, dyspnea, asthenia, anorexia, diarrhea, fever, anosmia — but overall, the case was mild. For 15 days she remained in quarantine in her bedroom. Then she started to move about her home, doing housework and recuperating. By the end of April, the patient was feeling normal, only slightly fatigued. She started preparing to return to work, but week after week, repeated tests came back positive for SARS-CoV-2 RNA.
As Amorim's hospital moved past the viral peak and testing became more available, recovered patients such as the physician who felt well but still tested positive became a regular problem. Seeking to help her patient and colleague get back to normal, Amorim posted to Medscape Consult, a social media platform where doctors can share cases and offer advice. "Is the test revealing dead virus or infection? Is she still contagious?"
Amorim's was one of more than a dozen recent Consult posts asking these questions. The medical director of a correctional facility wrote about keeping five persistently positive patients isolated from the other inmates. Several other doctors posted to Consult about their own positive results, asking when it was safe for them to work. CDC guidance currently requires two consecutive negative PCR tests before a patient is moved out of isolation, because false negatives are not uncommon. But clinician experience and new data show that patients can continue to test positive for months after they recover.
"We are seeing [positive PCR results] 6 and 8 weeks after first presentation," Susan Bleasdale, MD, the medical director of infection control at University of Illinois, told Medscape Medical News. "It's hard to say. Is it still transmittable? There's been some concern that if you can still find RNA, there's some virus present. But there is some argument that the amount of virus is negligible."

What the Data Say

The PCR test does what it is designed to do: detect pieces of viral RNA. That's critical information for diagnostics and preventive care. But it's a poor test of cure, emerging data suggest, and it can't tell whether someone is infectious, says John Mills, MD, an infectious disease specialist and hospital epidemiologist at the University of Michigan.
In South Korea, researchers from the country's Centers for Disease Control and Prevention traced the contacts of 285 COVID-19 patients who tested negative and were removed from isolation but who then tested positive again. The investigators concluded that none of these patients transmitted the infection after reverting to positive.
A small German study of nine COVID-19 patients that was published in Nature found that the virus collected from patients after 8 days of illness didn't grow in culture or yield subgenomic mRNA — which is only present when a virus is replicating. So, even though viral RNA was detectable, there was no evidence that it was active or infectious after the eighth day. On the basis of their cell culture results, the authors posit that for patients who are found to have fewer than 100,000 viral RNA copies/mL of sputum 10 days post symptom onset, there is "little residual risk of infectivity."
"Just because you can't grow it doesn't mean it's not there," Mills said. But the small study is an initial proof of concept, he said, and it suggests that requiring two negative PCR results is "way overkill" in many of the milder COVID-19 cases.
It's possible that for patients who feel well but test positive, the PCR test may be picking up "pieces of genetic material that are still being sloughed off by cells," said Gigi Gronvall, PhD, an immunologist at Johns Hopkins University. In other viral respiratory diseases, such as SARS, MERS, and influenza, viral RNA is detectable long after the virus is noninfectious.

There are not yet enough data on the infectiousness of SARS-CoV-2 to be sure it follows this pattern, and there's not a test that can detect only intact, infective virus, according to Gronvall. Viral cultures — such as those in the German study — can be used to tell whether the RNA is from a replicating virus, but Gronvall says culturing virus is extremely difficult and is not feasible for most hospitals.

Antibody testing can offer more context with respect to disease progression, Gronvall said. For Amorim's patient, "serology showed a good progression of IgM going down and IgG going up — last titers 16 of IgG (reactive) and 0.9 IgM (non-reactive)," she wrote in her Consult post. The progression of IgM to IgG could suggest the patient is further from the onset of infection. It is believed that viral shedding peaks early in the course of disease; if so, a patient such as Amorim's would be less infectious.

However, Jeff Martin, MD, an epidemiologist at the University of California, San Francisco, cautions against weighing serology results too heavily. He said that "for a given person we don't know how to interpret [SARS-CoV-2 antibody results], we don't know what it means." And although studying immune response is critical, at this point, "you can't at all say it has a role in clinical management."

Cycle threshold — the number of times genetic material must be replicated in the PCR test to become detectable — may also offer context on positive PCR results. A higher cycle threshold means there is less virus present in the sample, so the infection may be waning. The CDC, however, doesn't recommend using cycle threshold alone to determine infectiousness.

The Waiting Game
CDC guidance offers an alternative to testing: the symptom-based strategy, according to which a person remains in isolation for at least 10 days after symptoms start and for at least 3 days after fever subsides.

For patients who aren't hospitalized and are recovering at home, the symptom-based strategy is likely best, according to Bleasdale. It may also be a good choice for discharging hospitalized patients who don't share a home with anyone who is at high risk. But for patients returning to a congregate living situation — such as an assisted living facility, campus housing, or prison — some variation of the test-based approach is probably preferable, Bleasdale said.

Likewise, individual risk assessments are necessary to help patients get back to work, she said. "If social distance and safety measures are possible, a symptom-based [strategy] is probably okay. But if they can't maintain distance at all times, wear a mask, and disinfect surfaces — a test-based return [policy] might be a better idea." When a patient is persistently positive, antibody results, symptoms, time, and cycle threshold should be considered together on a case-by-case basis, Bleasdale said.

This is where things get hard for patients such as Amorim's — the healthcare workers. It would likely be okay for Amorim's patient to go back to work if she were in another profession, but many medical facilities have very conservative return-to-work policies. The University of Illinois, where Bleasdale works, requires two consecutive negative PCR test results to return to work. The University of Michigan, where Mills is affiliated, allows workers to return 10 days after symptom onset if the fever and respiratory symptoms markedly improve, but personnel must wear a mask and cannot care for severely immunocompromised patients. Other healthcare facilities that are facing workforce shortages during the pandemic have less conservative policies.

The CDC offers two other strategies for healthcare workers. A symptom-based approach allows healthcare workers to return to work 3 days after fever subsides and respiratory symptoms improve (at least 10 days after symptom onset). As for asymptomatic medical personnel who test positive, the time-based strategy allows them to return to work after "10 days have passed since the date of their first positive COVID-19 diagnostic test assuming they have not subsequently developed symptoms."

The reality is that we don't really have the test we want — the test of cure, Mills said. Although the data are limited and there's still a lot that is unknown about COVID-19's course, he says it is becoming clear that PCR tests are "a very poor surrogate for infectivity." He thinks time and symptom-based strategies are likely better alternatives. Epidemiologist Martin concurs: "PCR test at 14 days, I don't see the value in it."

After more than 8 weeks, Amorim's patient tested negative, and she went back to work. Amorim thinks her patient probably wasn't infectious for most of the 8-week isolation period. But without more data and a better protocol, she was not willing to send a PCR-positive doctor back into a hospital.

Donavyn Coffey is a Manhattan-based health and science journalist.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube. Here's how to send Medscape a story tip.


  • 15 Read Comments

COMMENTS

Patty Buzzelli| Registered Nurse (RN)8 days ago


There is not one company making covid testing that does not have FALSE +’s
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Dr. Nicholas Bachynsky| Internal Medicine13 days ago



Leave them alone. They may now be permanent carriers of the virus but not infectious. Don't be surpirsed how many other viruses humans also carry in our upper respiratory tracts. Humans are not "sterile" beings and never will be.How about get ridding Staph on the skin, E.coli in the stool and various fungi on our feet?
I have heard horses consider us to be infectious pests on their backs.

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Dr. Maarten Vasbinder| Family Medicine13 days ago


A neutralization assay will show, if there is a "living" vrius
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Dr. Kurt Kirkpatrick| Ob/Gyn & Women's HealthJun 10, 2020


Regarding the debate over asymptomatic spread risks, I have a question. If, as the CDC reports, that up to 40% of cases were the result of asymptomatic spread, then how does the virus get passed on if there is no coughing, sneezing, singing or yelling? We have been told that contact with infected surfaces is not much of a factor any more. The data for this 40% estimate is based on modeling, not on actual science, correct?
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Dr. kazzim mawji| Family Medicine12 days ago


I gather that they can spread the virus by just having a conversation with nearby you. Hence the face mask and distance. I remain corrected.
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Dr. Timothy C Hlavinka MD| UrologyJun 10, 2020


This only way this is resolved is accurate, and widely available ANTIGEN testing. That way active viral counts can be monitored and the decline to baseline witnessed. If still high enough to theoretically transmit infection to another, strict isolation must be maintained. A local urgent care center with multiple locations converted to this method of testing and it has made management of these questions much easier.
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stephanie bazel| Physician AssistantJun 10, 2020


This isn't new or surprising. We have bee using PCR testing to diagnose STD's for years and the CDC guidelines state not to retest patients for at least 3 weeks after treatment has been completed.
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debra mccorkindale| Registered Nurse (RN)Jun 10, 2020


can I ask, do we know, are these repeated tests being reported as "new cases" when we look at test/case numbers per state/country? just trying to figure the numbers out.
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Mary Lee| Registered Nurse (RN)Jun 10, 2020


@debra mccorkindale It's easy to see how these tests could be reported as new cases which increases the counts as well as the fear factor. Patients and healthcare workers are being required to have 2 negative test before being allowed to returned to work. Do the math 2x2x2x2 if they are still positive.
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Dr. JayRobert Seebacher| Orthopaedic SurgeryJun 9, 2020



A virologist at Columbia University: Dr Vincent Rascinello recently used the term ”amplisome”
in describing the detectable RNA fragments specific to SARS CoV-2, that are shed generously and persistently by convalescing patients and are easily detectable In their throats, deep sputum and feces, which do not indicate whether or not such patients are still infectious to others. Detected when amplified and sequenced through Homeology techniques, PCA is highly sensitive and specific, but those precisely identified RNA fragments themselves, would not be capable of inducing viral mediated cellular death, if distributed in an aerosol over a human branchial cell mono-layer: a so called plaque assay test.
In theory a single functioning viral particle Should be able to infect one cell and replicate and spread to a florid consuming infection and on to a plague. The likelihood of its success or failure statistically, depends on many other familiar variables individual to each virus, as well as the size of the inoculum, the defenses of the host etc.
As Dr. Racinello stressed, the shedding of viral RNA detritus, is a far cry from shedding of competent infectious viral particles.

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Dr. Rosemaria Alappat| Endocrinology, MetabolismJun 9, 2020


I have read that the respiratory competent virus at 10 days is at low levels, so using that mark I advise pts according to symptoms..if improvement from symptom onset is at least 10 days as stated in article and no fever without antipyetics for at least 3 days then they can discontinue quarantine. In regards to antibody tests I am not sure how reliable they are....I certainly haven't seen an IgM test, only IgG so the trend or ratio idea cannot be done at least where I work.
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Dr. Stephen Merola| Surgery, GeneralJun 9, 2020



I have had 2 cases of patients with very symptomatic gallbladder disease still positive. Both had surgery postponed after coming to the ED in the height of the pandemic (in Queens NY). They now wanted their gallbladders out due to symptoms (pain) 2-3 times a week. One bad enough I said come to the ED but she refused weekly. So I got them both on the schedule and per our hospital policy they had PCR tests the day prior. I got called both times because the test was posittive.

I then called the patient to tell them the bad news--- but both were like I had symptoms 2 months ago and an antibody test > 1 month ago that is igG positive (they both provided me copies of their reports). They were both also obviously symptoms free.

So I made some phone calls to people who would know more about this than me (I'm a general surgeon)- and they immediately came back to tell me that patients are shedding viral particles for weeks and that the PCR is very sensitive. Given symptoms were > 2 months ago, they were both IgG positive and symptoms free I proceeded with the laparoscopic cholecystectomies given there symptoms and the liklihood they are not shedding transmissible virus (I know at this point this has not been proven). So I removed the first patients gallbladder 2 weeks and the other yesterday and both did fine.

They have asked me should they test until negative-- but the funny thing is they both had the disease 2 months ago and are antibody positive and would NEVER had had another PCR and no one would have been any wiser --- they only now have a positive test because it was pre-procedure. More clear guidance from the CDC would be wonderful for the surgical community because I have 2 cases in 2+ weeks this is going to continue to happen throughout the country and may even lead to surgical cancellations and delays which I would say are unnecessary (but again no one knows for sure since there is not enough science yet to confirm this).

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Dr. Howard Grossman| Internal MedicineJun 9, 2020


I have seen multiple cases like this. CDC does not recommend the PCR cycle threshold number because it has not been validated in the case of Covid 19 but in other viral illnesses a cycle threshold of over 35 is often associated with not being infectious. (Full disclosure--I was able to obtain that number on my own samples when I had a basically asymptomatic case. After my cycle threshold number went above 35 I developed antibodies and my PCR test became negative). This needs to be validated as it could be a useful tool. I think the 2 negative PCRs is overkill. Seems to me if antibodies develop that would be a good sign for return to work in addition to the symptom strategy. And I have heard reports that there are several unpublished studies in addition to the German study showing infectious virus cannot be found after day 9 of symptoms. Cannot track them down yet.
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Justin VandenBosch| Nurse Practitioner (NP)Jun 9, 2020


This definitely happens, and I think it's best to follow either symptom based strategy or a combination of the two. I've had patients repeatedly test positive up to 6 -8 weeks later, but it doesn't mean they are infectious. A nurse in one of our clinics has been tested 9 times with varying results positive/negative.
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Dr. Sandra Gompf| Infectious DiseasesJun 9, 2020


We are seeing this not infrequently, including one case of (preprocedure) + RT-PCR over 10 weeks following mild disease that did not require hospitalization and had a quick and complete recovery. Vexing.
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Our Little Tyrant governor DeWine continues to fear-monger by presenting the data in such a way to keep people scared so he can control them and the most of the media complies by reporting it as such. An investigative journalist, Jack Windsor, has been digging into the issue and has been attending the pressers and asking questions that DeWine cannot/will not answer. He did a live video 2 nights ago with 2 men who've been following the data. One is a teacher who choses a project for his students every year. This year he chose the virus because one of his students is from Wuhan, China. He has been researching and following the data since December and does not watch the media so as not to be tainted by it. The other man is a data annalist for the Mayo Clinic and other medical facilities. He also studies the way information is presented, so he has been watching the governors and the media. I found it very interesting and thought some of you would also. It's kinda long, but here's the first part.

 

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See how safe these guys are being? The guy on top even keeps his covid mask on till he gets down.
 

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Well drb, I didn't say anyone was lying first off. I did say that since the statement contained the word may it was an irrelevant or meaningless statement. Only the radicals like blm, antifa, socialists,marxist and communists believe Trump needs to be removed from office. The rest of the country believes blm, antifa, socialists, marxist and communists need to be removed from the country because we believe in equal rights not special rights. The FACTS about blm are just that.
Patrisse Cullors the co founder of blm stated on air that their(blm) goal was to get Trump removed from office or at the minimum keep him from being reelected. The reason being is that blm is a Marxist group. Cullors makes that statement hundreds and hundreds of times that they(blm) are trained Marxists. Get your $h!t together drb and get some facts! It isn't about Blacks it's about who controls the country. Once again Blacks are being used as pawns by radicals.
By the way, you are getting way to contradictory. You posted something, then say you used "may" so that everyone believed that you didn't buy into it and then you say you never post something that you don't believe is true. Come on boy you're making me dizzy.
Swamp
Of course my statement contained the word may. Unlike your statement here, which does not contain the word may, but is totally incorrect and therefor meaningless. Opinions which do not contain some form of may are of zero value since they are trying to hide as facts, not opinion. While I may have slipped a time or two, I try and form all opinions as such, and facts as facts.

I again apologize for not being as articulate as I would like.
Let me try and clear it up for you.
I posted something, a study by a very reputable research organization. That post stated the finding of the organization as results they had found. There was no ambiguity, no obfuscation, simply a statement of what they found. Clear, concise statements.

I posted my interpretation of those facts, and used the word may, because as unlikely as it is, it is possible that my interpretation might, or "May" be wrong.

I posted facts, which you have never disagreed with in any way, so lets except them as facts.
I posted an opinion, clearly marked as an opinion by the use of the word "May".
I then posted the facts again.
I then posted my opinion again.

Fact: CT scans were foggy.
Opinion: Foggy CT scans may indicate that the supposed very high recovery rate may be incorrect.
If there is any ambiguity here, I have found several more studies that indicate that the supposed very high recovery rate of the virus is incorrect. This virus MAY be very much worse for patients then we thought. Permanent long term damage MAY be the result. Recovery MAY be equivalent to recovery from an accident missing a leg.

Do not see where BLM might be germane to the discussion.

Hope this clears up your dizzy condition.
 

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Of course my statement contained the word may. Unlike your statement here, which does not contain the word may, but is totally incorrect and therefor meaningless. Opinions which do not contain some form of may are of zero value since they are trying to hide as facts, not opinion. While I may have slipped a time or two, I try and form all opinions as such, and facts as facts.

I again apologize for not being as articulate as I would like.
Let me try and clear it up for you.
I posted something, a study by a very reputable research organization. That post stated the finding of the organization as results they had found. There was no ambiguity, no obfuscation, simply a statement of what they found. Clear, concise statements.

I posted my interpretation of those facts, and used the word may, because as unlikely as it is, it is possible that my interpretation might, or "May" be wrong.

I posted facts, which you have never disagreed with in any way, so lets except them as facts.
I posted an opinion, clearly marked as an opinion by the use of the word "May".
I then posted the facts again.
I then posted my opinion again.

Fact: CT scans were foggy.
Opinion: Foggy CT scans may indicate that the supposed very high recovery rate may be incorrect.
If there is any ambiguity here, I have found several more studies that indicate that the supposed very high recovery rate of the virus is incorrect. This virus MAY be very much worse for patients then we thought. Permanent long term damage MAY be the result. Recovery MAY be equivalent to recovery from an accident missing a leg.

Do not see where BLM might be germane to the discussion.

Hope this clears up your dizzy condition.
I feel like something my Grandma taught me when I was young could apply here "Everything before but is bullshit, and everything after may is hot air"
 

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What happened to all the it's just the flu you have on a tin hat or put your underwear over your head responses go. Did they run out of blunt papers.
 

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Discussion Starter #695
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.
Ya' Pepe` It's the Human condition,
If you can't See it, Track it, or Kill it it must Not be a Threat.

Kinda like wayyyyy back in time,,,,,
Don't Partake in the animal with "Cloven Hoof"
(Wait,, Fire does Whaaaat?)


From todays article about FLA. (Partial Quote)

“I think we were careless and we went out into a public place when we should not have. And we were not wearing masks. I think we had a whole ‘Out of sight, out of mind’ mentality. The state opens back up and said everybody was fine, so we took advantage of that,” said Erika Crisp, who works in health care.

Here is the rest,
CDC maps show Florida's deepening coronavirus crisis, as state shatters daily case record


Anyway, I get the "Waning" of concerns.
We (as a Species) have been so Spoiled and focused on other things than basic Survival
It's has gotten really easy to "tune shit out".
(then add in the Political Drama,,,,,like in the Other Thread.)
 

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Did that blow that guy’s-on the ground-leg off? Holy Smokes!
I don't know. It could have if he was part of the circuit. It's so grainy & the angle is poor. I was focused on the guy who fell & was amazed that he was up & moving after landing across the curb. Now that you've pointed him out, I also don't see the left arm of the guy who threw the coil after the accident. But it seems like if he was hit with enough volts to blow off body parts he wouldn't likely still be conscious.
 

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Ahhh DRB you still don't get it. Printing the words and numbers and statements like "50-100% may" is simply a waste of everyone's time. If the study cannot provide a reasonable estimate then why bother except to stir up more crap. Using the statement like reputable with results that are between 50-100% is absolutely contradictory. 50-100% is NOT clear and concise.It is vague A reputable group wouldn't put out findings like that because that is not findings that is more like an estimate. That came from someone changing numbers to benefit the scare tactics. I am sorry that you cannot see that. I also am sorry hgow you can't see how blm fits into the whole equation. This isn't just about the Kung Flu. It's about the entire Republic being shredded from the inside out by removing rights of people in the name of safety and many people are buying into it.
Swamp
 

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This is from Dr. Frank that is in the video I posted above that probably no one watched:

In my interviews, I've been emphasizing:
a) The wild Covid epidemic is essentially over in the US. We are now cleaning up hot spots, which are predominantly in densely populated areas and congregate living;
b) Follow deaths, not cases, to track the progress of the epidemic, especially if you can track by county. Because describing a whole state by a hot spot in that state gives the wrong impression;
c) Ignore the media hype. Instead, investigate the numbers. Even hospitalization numbers often don't mean what they appear to. If a news item leads with cases, ignore it, because not only are cases numbers unreliable and convoluted, they are vulnerable to political manipulation;
d) The people at risk in the epidemic are primarily elderly people with co-morbidities. The best thing individuals can do is to use good hygiene, stay healthy, and protect our vulnerable populations;
e) There is a huge percentage of people in the US who are suffering real and serious consequences because of the shut-downs. Emotional, psychological, physical, medical, economic, etc. Since the main wave is over, we now need to address the economic, social, and health consequences of our reaction to the pandemic;
f) The Dr Frank Models page began as an experiment with scientific parameters and controls. The experiment is ongoing, but the page has rapidly grown into a place where people study the data, find out where they stand, and have polite "after dinner conversations" that bring them peace, hope, and understanding.
The Dr Frank Models Facebook page is public, and now has about 18,000 members and thousands of followers. About 50,000 people see content from the page every few days. In order to become a member, people have to agree to the rules and respect the experimental controls.
 
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