[HN Gopher] Paul Alexander, 'the man in the iron lung', has died
       ___________________________________________________________________
        
       Paul Alexander, 'the man in the iron lung', has died
        
       Author : palijer
       Score  : 253 points
       Date   : 2024-03-13 14:38 UTC (8 hours ago)
        
 (HTM) web link (www.bbc.com)
 (TXT) w3m dump (www.bbc.com)
        
       | whythre wrote:
       | Remarkable man! Good on him for achieving all that. The part
       | where he was able to learn how to breathe and leave the iron lung
       | for short periods of time is particularly interesting. I wonder
       | what he did on those outings...
        
         | drewzero1 wrote:
         | I've just been reading this longer article from 2020 which has
         | a lot more about his life:
         | https://www.theguardian.com/society/2020/may/26/last-iron-lu...
         | 
         | It says he went out with friends, saw movies, and even flew on
         | planes while "frog-breathing", as he called it. He couldn't do
         | it while unconscious so he still had to sleep in the lung.
        
           | rob74 wrote:
           | > _The technique had a technical name, "glossopharyngeal
           | breathing". You trap air in your mouth and throat cavity by
           | flattening the tongue and opening the throat, as if you're
           | saying "ahh" for the doctor. With your mouth closed, the
           | throat muscle pushes the air down past the vocal cords and
           | into the lungs. Paul called it "frog-breathing"._
           | 
           | So, to state it in computing terms, this wasn't a fix for not
           | being able to breathe, it was a workaround. But it seems to
           | have worked really well: at 40, he was "able to spend most of
           | his day outside the machine that still kept him alive".
        
             | zingababba wrote:
             | That's incredibly interesting. I'm attempting what I
             | believe to be the technique described at the moment. If I'm
             | doing it correctly I can see why he nicknamed it 'frog-
             | breathing.'
        
           | redkoala wrote:
           | It sounds like scuba diving, having enough in the tank to go
           | for dives in the outside world at a time before returning to
           | sleep in the lung.
        
         | danbruc wrote:
         | _Advances in medicine made iron lungs obsolete by the 1960s,
         | replaced by ventilators. But Alexander kept living in the
         | cylinder because, he said, he was used to it._
         | 
         | If this is reported correctly, it would even have been an
         | deliberate choice to not leave more often or entirely.
         | 
         | EDIT: This was seemingly not reported correctly, it seems he
         | only depended on the iron lung while sleeping but could
         | otherwise live without it.
        
           | throwitaway222 wrote:
           | Maybe his decision to keep using the lung was a smart one.
           | After all 2020 + ventilators...
        
         | thatwasunusual wrote:
         | > I wonder what he did on those outings...
         | 
         | Contracting Covid, unfortunately. :(
        
           | axelfontaine wrote:
           | No. Hadn't left the iron lung in 5 years.
           | 
           | Source: https://www.sueddeutsche.de/projekte/artikel/magazin/
           | eiserne...
        
       | scop wrote:
       | > Advances in medicine made iron lungs obsolete by the 1960s,
       | replaced by ventilators. But Alexander kept living in the
       | cylinder because, he said, he was used to it.
       | 
       | As somebody with a medical condition since birth, this line
       | really hit home. I'm not speaking for Mr. Alexander, but for
       | myself "used to it" is such a great way of putting the odd
       | experience of living with frequent and cumbersome medical
       | intervention.
       | 
       | On the one hand you have no choice so it is quite easy. You just
       | _do_ it. On the other hand there are often periods here and there
       | through your life where you wrestle with the treatment, complain
       | about it, explore other options, etc. But then a new option does
       | come around every so often and, well, some times you stick with
       | what you know even though there are  "better" options.
       | 
       | "used to it" is such a disarmingly accurate way of putting it. It
       | is simultaneously the most difficult and easy thing to do.
       | 
       | Requiem aeternum Paul Alexander.
        
         | dasil003 wrote:
         | That line also jumped out at me. My understanding is iron lungs
         | were only declared "obsolete" due to cost and mobility reasons,
         | but the actual experience of an iron lung is better because it
         | is less invasive and spreads the pressure more evenly over ones
         | whole torso rather than forcing air into the lungs from the
         | inside. In other words, an iron lung is more like actually
         | breathing (and maybe that's how Mr Alexander was able to learn
         | to breathe despite the prognosis).
        
           | jxramos wrote:
           | yes I believe one of the videos of him expresses the better
           | comfort the negative pressure has on his body somehow over
           | the positive pressure contraptions he's used.
        
             | hinkley wrote:
             | I remember a conversation in the 90's about lung damage
             | from over-inflation by dialing the volume incorrectly. They
             | were talking about tech that was better at avoiding it, and
             | thus the lung damaged caused by it.
             | 
             | That conversation stuck with me because I found it
             | horrifying.
        
               | throwway120385 wrote:
               | The field uses the term "barotrauma" for this.
               | Ventilators use high pressure alarm limit among other
               | things to limit the potential for barotrauma in volume-
               | controlled modes. There's also flow-terminated modes
               | which try to deliver a fixed volume but will terminate
               | the breath if a flow criteria is met. The high pressure
               | alarm limit can also terminate a breath early to try to
               | prevent barotrauma.
               | 
               | Mechanical ventilation is very complex and has come a
               | long way since the 1990's. The lung is an exceedingly
               | complex organ, and breathing itself is an exceedingly
               | complex bodily function that we largely take for granted
               | until something goes wrong.
               | 
               | Suction devices also have their own horrifying outcomes.
               | Someone told me a story once in the context of maximum
               | vacuum limits of an EMT that was suctioning debris and
               | fluid from an open brain injury and had the vacuum up so
               | high they were vacuuming a person's brain tissue.
        
               | hinkley wrote:
               | College roommate told of a history prof who worked for
               | free. Plastic surgeon botched a lipo and caused muscle
               | damage. Malpractice paid him enough to retire his board-
               | flat ass.
               | 
               | He worked for free, or next to nothing, taught the
               | curriculum he wanted to (can't afford to fire him!).
               | Apparently he brought high end audiophile speakers to
               | school and played classical music on them when not
               | lecturing. The kind that cost half a year's salary for a
               | teacher.
        
         | candiodari wrote:
         | This is something people don't seem to realize. Often you hear
         | people talk about how difficult it is to be born blind.
         | 
         | Yet everyone I've ever spoken to that happened to has a simple
         | answer: "not difficult at all. It isn't there". One put it like
         | "I'm also not a tiger and can't jump 8 meters high. It's
         | similar".
         | 
         | Very strange how adaptable humans are sometimes.
        
           | ska wrote:
           | I think born with a condition such as that is always
           | (mentally) easier than losing some capability, especially if
           | you are grown.
           | 
           | If you are born without sight, it only exists as an abstract
           | concept for you.
        
           | kypro wrote:
           | My best friend as a kid was blind and being a kid his
           | acceptance of this used to bug the hell out of me. I often
           | found myself in conversations trying to convince him he
           | doesn't want to be blind.
           | 
           | But I remember asking him when we were teens and he me gave a
           | really good answer about how he's learnt to interact with the
           | world as a blind person so for him to be able to see it would
           | a huge hinderance to him at this point - perhaps as much as
           | me being blind.
           | 
           | He'd would need to read and write again. He would need to
           | learn how to use a computer again. He might not like how his
           | girlfriend looks. He would need reorganise his life and
           | activities around the fact he can now see. Would he still be
           | interested in doing the same things if he could see? Might he
           | want to play video games instead of piano in his spare time
           | if he could?
           | 
           | I think in a lot of cases it's not even just not knowing what
           | you're missing, but it's also not worth hassle. If you're
           | content as is then why change things?
        
           | ekaryotic wrote:
           | As a schizophrenia sufferer I discovered a curious statistic
           | about the illness, there are no patients with schizophrenia
           | who have been blind since birth. That fact is mind blowing to
           | me, it seems to imply that blindness from birth creates a
           | sort of immunity to mental illness.
        
             | whelp_24 wrote:
             | I think it implies that schizophrenia has something to with
             | the visual system or something correlated to it.
        
           | kelnos wrote:
           | I do wonder how much of that "not difficult at all" is just
           | not knowing the difference. It would be interesting to see
           | the difference in attitude between people born blind, and
           | those who lost their sight later in life (old enough to have
           | some solid sighted experiences and memories).
           | 
           | Just as sighted people take for granted a lot of things about
           | their sight, I'm not surprised some blind people take many
           | things for granted about their lack of sight -- even when
           | they are negative, frustrating things.
           | 
           | While accessibility has come a long way, it still seems like
           | it would be objectively more difficult to navigate the world
           | blind than sighted.
           | 
           | > _One put it like "I'm also not a tiger and can't jump 8
           | meters high. It's similar"._
           | 
           | This makes a lot of sense, even if it's an imperfect analogy.
           | Sometimes, if you have no experience with something, you
           | won't mind not being able to do it, even if you know that a
           | lot of other people can.
           | 
           | But if you look at it the other way: imagine a tiger with
           | mobility issues that can't jump at all. Likely their life
           | will be pretty limited, compared to most tigers.
           | 
           | I'm glad it seems there are (at least in your experience) a
           | lot of people who are blind but don't consider it that big a
           | hindrance. Ultimately what matters in life is that people are
           | happy, and I imagine feeling like your life is constantly
           | difficult due to something like blindness would reduce your
           | happiness.
        
         | tialaramex wrote:
         | > "used to it" is such a disarmingly accurate way of putting
         | it.
         | 
         | This happens for medication too. If you're on a specific drug
         | for your whole life, it may be disruptive to switch to a
         | different medication even if it's notionally better. I take a
         | pill every morning, and will for the rest of my life, would I
         | prefer one I took every other day? Not really, it sounds like
         | I'd just miss days sometimes. If it had fewer side effects? I
         | haven't noticed any effects now, despite the list in the
         | leaflet so "fewer" doesn't sound like a meaningful improvement.
         | 
         | In the first few days maybe even weeks of taking it I'd have
         | been open to any improvements, but now I've settled into a
         | habit, so any change needs a serious justification.
        
         | deadbabe wrote:
         | It's also why people stay in toxic, abusive, exploitative
         | relationships. They just get used to it.
        
           | jamiek88 wrote:
           | Yeah the dark side of human adaptability, we can get used to
           | pretty much anything.
        
           | graemep wrote:
           | I would say (from my own experience) it is a factor, but not
           | the only one.
           | 
           | There are also enormous social pressures to stay in abusive
           | relationships: people feel free to tell you you should stay
           | in a relationship, that it can be fixed, etc. Very few people
           | are willing to tell someone they should leave a relationship.
           | So, what you hear is everyone thinks it should be fixed
           | rather than ended.
           | 
           | There are many practical difficulties in ending a
           | relationship too: financial, legal.
           | 
           | There are also many things in pop culture and media that can
           | encourage it: normalisation of what are actually controlling
           | behaviours, for example. The even "when you are right you are
           | wrong" trope is just one common version of this.
        
         | agumonkey wrote:
         | And the brain might be very sensitive (emotionally and to an
         | extent physiologically) to stay in known condition when you're
         | always walking a thin line.
        
       | bonaldi wrote:
       | Curious that the story doesn't mention he died of Covid - an
       | infection that, you'd expect someone with his condition to be
       | extremely keen to avoid, and who should have been able to, given
       | reasonable precautions from his visitors.
        
         | zdragnar wrote:
         | Many people are asymptomatic, and not only that, are exposed by
         | others who are asymptomatic. Short of every single human
         | interaction being preceded by a PCR test, the odds are that he
         | eventually would have been exposed.
         | 
         | It is easy to do an at-home nasal swab test when you are
         | infected but before the viral load has gotten to the point of
         | being highly contagious, at which point you think you are
         | negative but really will soon become contagious.
         | 
         | "Reasonable precautions" would have to be very rigorous, and I
         | have to imagine it would be easy to cave and relax precautions
         | as loneliness sets in.
        
           | 0xAFFFF wrote:
           | Reasonable precautions here were likely to be proper masking
           | from visitors and adequate air filtering in the room. Not
           | something too hard to expect from people visiting a sick
           | person.
        
             | hn_throwaway_99 wrote:
             | It's not like those "reasonable precautions" are
             | guaranteed. I know a couple people who were absolutely
             | terrified of getting Covid, such that they always masked
             | with N95s and literally only would meet with people
             | outside, 6 feet apart (probably the only time they were
             | inside was with others at the grocery store, and when
             | stores were enforcing masking) and they still got it.
        
               | foofie wrote:
               | > (...) and they still got it.
               | 
               | I don't see the point of your comment. You're presenting
               | an anecdotal case where someone who took some precautions
               | which are known for not being 100% effective against
               | airborne diseases ended up contracting an airborne
               | disease.
               | 
               | It makes as much sense as ranting about wearing seatbelts
               | because you can put together an anecdotal case of someone
               | who got hurt in a car accident in spite of wearing one.
               | 
               | What's the point of that sort of argument, really?
        
               | zdragnar wrote:
               | The point is that even with reasonable precautions, it is
               | (and was) possible for the man in the iron lung to be
               | exposed to COVID.
               | 
               | The actual precautions necessary to protect him from any
               | exposure at all would have been significantly more
               | stringent than what people tend to believe are
               | reasonable, as GPs anecdote demonstrates.
        
               | mrob wrote:
               | >masked with N95s
               | 
               | I see this as an example of confusion between population-
               | level and individual protection. Widespread use of N95s
               | is great at keeping the hospitals from overcrowding, but
               | if somebody is serious about personally avoiding COVID,
               | 95% percent filtration seems rather low (and there's
               | leakage around the sides too.) If they were truly serious
               | about avoiding COVID, they'd use an elastomeric half-face
               | respirator at the minimum (which has the bonus feature of
               | being more comfortable to wear).
        
               | TylerE wrote:
               | The N95 guarantees a _minimum_ of 95% filtration at the
               | _worst possible_ particle size, which airborne virus
               | particles are not.
               | 
               | The 3M 9210s I've been wearing since 2021 have been
               | independelty tested as having >99.5% filtration
               | efficiency at the relevant particle size, and that's with
               | physical testing so stuff like ability of the make to
               | seal is also being tested.
               | 
               | Zero COVID infections here.
        
               | t0bia_s wrote:
               | _Potential Applications Include: Bagging, grinding,
               | sanding, sawing, sweeping, woodworking and other dusty
               | applications._ source:
               | https://multimedia.3m.com/mws/media/813534O/3m-aura-
               | particul...
               | 
               | No words about viruses. Also, I recommend you to make IgG
               | test for covid antibodies. Most likely you already have
               | some.
        
               | ceejayoz wrote:
               | How are you managing to read "Potential Applications
               | Include" as "The following is an exhaustive list of all
               | possible applications"?
        
               | TylerE wrote:
               | They would never list healthcare on the general purpose
               | version anyway, since there is a separate specific
               | certification for that. The only difference is better
               | fluid protection, which is irrelevant to the given threat
               | model. They do indeed sell that.
               | 
               | https://www.3m.com/3M/en_US/p/d/v101143973/
               | 
               | And whatta ya know...
               | 
               | "This healthcare N95 particulate respirator and surgical
               | mask has comfortable inner materials and helps provide
               | respiratory protection against certain airborne
               | biological particles. The individually packaged, flat-
               | fold design allows for convenient storage prior to use.
               | 
               | Fluid-resistant surgical masks help reduce your exposure
               | to blood and body fluids. Cleared for sale by the Food
               | and Drug Administration (FDA)."
               | 
               | Notice it's still "just" an N95.
        
               | logifail wrote:
               | > I recommend you to make IgG test for covid antibodies.
               | Most likely you already have some
               | 
               | I've had Covid at least twice since this nightmare
               | started, most recently in November 2023.
               | 
               | After both a chest x-ray and a CT scan in hospital
               | eventually a Covid PCR test[0] came back positive and at
               | that point the mood lightened and the doctors told me
               | that a positive Covid test was "the good news" and to go
               | home and rest.
               | 
               | I appreciate Covid is still a threat to some elderly
               | and/or sick people. To the majority of us, it isn't ...
               | and wasn't ... ever [1][2]
               | 
               | [0] Unwitting comedy moment from the (otherwise friendly
               | and apparently competent) student doctor. Took my history
               | very thoroughly, felt my glands, examined ears and looked
               | down throat. All without her wearing any kind of mask.
               | Then late on she decided to take a Covid swab, so left
               | the small room that we'd been in together for 10+ minutes
               | to retrieve swab and FFP mask, which she donned to swab
               | my nostrils. Am afraid I giggled when I saw her go get
               | the mask, had to tell a lie to avoid exposing the utter
               | nonsense of fetching one at that stage :) [1] https://twi
               | tter.com/d_spiegel/status/1241297511287046144?lan... [2]
               | https://twitter.com/d_spiegel/status/1271696043739172864
        
               | ParetoOptimal wrote:
               | I prefer elastomeric n99s.
        
               | throwway120385 wrote:
               | P100 cartridges are also great and as an added bonus you
               | never have to smell perfume, farts, body odor, or Axe
               | ever again if you don't want to.
        
               | cesarb wrote:
               | > (and there's leakage around the sides too.)
               | 
               | A properly fitted mask shouldn't leak around the sides.
               | The PFF2 (my country's equivalent of N95) mask I use
               | doesn't leak anywhere when properly adjusted. (Like the
               | sibling comment, it's a 3M, either the 9320+BR or the
               | 9360H; see https://www.3m.com.br/3M/pt_BR/p/d/v000465595/
               | for its page complete with usage instructions.)
        
               | jkubicek wrote:
               | > A properly fitted mask
               | 
               | This is exactly why masking isn't as effective as it
               | should be _in aggregate_. N95s aren't foolproof to use
               | even for people who are trying to use them properly, then
               | you have to add in the folks who pull their mask down to
               | cough or to talk.
        
               | cogman10 wrote:
               | My favorite was the chin diaper. Particularly because the
               | state I live in (idaho) never really had strict masking
               | requirements so it really never made any sense.
        
               | kelnos wrote:
               | I _still_ occasionally see adults out in public wearing
               | the chin diaper, or with the mask partially or mostly
               | covering the mouth but not the nose at all.
               | 
               | I just don't get it. Why bother? Public outdoor masking
               | rates even here (San Francisco) are anecdotally well
               | under 10%. Why waste the time and effort (and in some
               | places, social consequences) to do something like that
               | completely ineffectively, when nearly no one else is
               | bothering at all?
        
               | hollerith wrote:
               | Against COVID, you would probably get more bang for your
               | buck by protecting the eyes with goggles or by choosing
               | an elastomeric _full_ -face respirator. Anything that
               | lands in the eye ends up in a lacrimal duct, and then in
               | a nasal passage.
        
               | gadders wrote:
               | Agreed.
               | 
               | If you stick a mask on a dummy in a lab and fire COVID at
               | it, it might show pretty good protection. However, at the
               | population level there is no evidence that masking
               | confers any benefit in preventing the spread of COVID.
               | 
               | The Cochrane Review demonstrated this: https://www.cochra
               | nelibrary.com/cdsr/doi/10.1002/14651858.CD...
               | 
               | There are also numerous dis-benefits of masking,
               | especially among young children.
        
               | TylerE wrote:
               | Not a study, a review.
               | 
               | Also doesn't claim what people like you says it claims.
               | 
               | Also, look at the history. Date of the original review is
               | 2007. You know what didn't exist in 2007?
        
               | zdragnar wrote:
               | > You know what didn't exist in 2007?
               | 
               | Airborne viruses?
        
               | gadders wrote:
               | >>Not a study, a review.
               | 
               | It's a meta-analysis of other trials.
               | 
               | >>Also doesn't claim what people like you says it claims.
               | 
               | By people like me, you mean people who believe in
               | science? This is what it claims:
               | 
               | "Wearing masks in the community probably makes little or
               | no difference to the outcome of influenza-like illness
               | (ILI)/COVID-19 like illness compared to not wearing masks
               | (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84
               | to 1.09; 9 trials, 276,917 participants; moderate-
               | certainty evidence. Wearing masks in the community
               | probably makes little or no difference to the outcome of
               | laboratory-confirmed influenza/SARS-CoV-2 compared to not
               | wearing masks (RR 1.01, 95% CI 0.72 to 1.42; 6 trials,
               | 13,919 participants; moderate-certainty evidence)."
               | 
               | >>Also, look at the history. Date of the original review
               | is 2007. You know what didn't exist in 2007?
               | 
               | It has been updated several times. The latest edition was
               | published in January 2023. https://www.cochranelibrary.co
               | m/cdsr/doi/10.1002/14651858.CD...
        
               | bsder wrote:
               | > However, at the population level there is no evidence
               | that masking confers any benefit in preventing the spread
               | of COVID.
               | 
               | 1) Several studies from India seem to contradict this and
               | barely had enough statistical power to be useful.
               | 
               | 2) The fact that we can't generate a masking study with
               | sufficient statistical power does _NOT_ disprove the
               | hypothesis-- _either_ direction.
               | 
               | Citing your source: "The high risk of bias in the trials,
               | variation in outcome measurement, and relatively low
               | adherence with the interventions during the studies
               | hampers drawing firm conclusions."
               | 
               | This one _REALLY_ grinds my gears.  "Well the study said
               | that masks don't work". No, it fucking didn't. It said
               | they couldn't _prove_ they worked given the data and
               | quality of data they had. And the data was lousy as
               | adherence by the general population was terrible.
               | 
               | Things can work and _still not be provable_ --especially
               | when the experiment involves human beings since morally
               | we can't just create two groups and infect one.
               | 
               | Here's your counterexample: take a look at what hospitals
               | are still doing when handling Covid patients. Hospitals
               | get to collect data and enforce adherence. They
               | _absolutely_ do not want to transfer Covid between
               | patients. And they do not want to transfer Covid to their
               | staff as that throws things into disarray. Whatever they
               | 're doing seems to be working. I had a stint in the
               | hospital recently, and they had several Covid patients on
               | my floor--they weren't isolated to a specific wing or
               | anything anymore. The hospital managed to not give Covid
               | to me, so _something_ they are doing is working.
               | 
               | So, what _that_ suggests is that procedures and masks
               | work just fine. What seems to be problematic is _lack of
               | adherence_ to said procedures and masks.
               | 
               | Basically, what all of these studies manage to prove is
               | that the general population has enough non-compliant
               | dipshits that active interventions don't work at the
               | population level. Consequenctly, vaccines and other
               | passive interventions that take into account the
               | stupidity of the general population are required.
        
               | gadders wrote:
               | >>This one REALLY grinds my gears. "Well the study said
               | that masks don't work". No, it fucking didn't. It said
               | they couldn't prove they worked given the data and
               | quality of data they had.
               | 
               | So you admit people were calling for mask-wearing with no
               | evidence. Sounds like we agree.
               | 
               | >>Things can work and still not be provable--especially
               | when the experiment involves human beings since morally
               | we can't just create two groups and infect one.
               | 
               | You don't have to infect one. Just see which one gets
               | infected. This happens all the time with vaccine etc
               | testing of have thought.
               | 
               | >>Basically, what all of these studies manage to prove is
               | that the general population has enough non-compliant
               | dipshits that active interventions don't work at the
               | population level
               | 
               | It sounds like we're pretty much in agreement here as
               | well. Unless you have some magical solution to ensure
               | perfect adherence.
               | 
               | Of course, you may be super-diligent as an n=1 and nobody
               | ever sneezes on you without warning or anything and you
               | stay free of a disease the CDC says should be treated
               | like the flu.
               | 
               | And the other name for "non-compliant dipshits" is
               | "children".
        
               | theshackleford wrote:
               | > And the other name for "non-compliant dipshits" is
               | "children".
               | 
               | That's certainly what I called them only they didn't seem
               | to like it.
        
               | swed420 wrote:
               | Cochrane review has many flaws
               | 
               | https://www.cidrap.umn.edu/covid-19/commentary-wear-
               | respirat...
               | 
               | People wear N95s to protect against COVID transmission
               | because they work. Yet every time the topic comes up
               | online, someone is always quick to reach for the flawed
               | Cochrane review.
        
               | gadders wrote:
               | Again, for an n=1 case of a medical professional doing it
               | in a diligent fashion they probably do work.
               | 
               | In gen pop with patchy adherence to usage not so much.
        
               | lawlessone wrote:
               | I know this is well known but still worth mentioning
               | again I think. That the "regular" facemasks were
               | primarily so asymptomatic people with covid would spread
               | it less. 100% protection was never possible but anything
               | to delay to spread so that not everybody was sick at the
               | same time was necessary.
        
               | zer00eyz wrote:
               | Yes,
               | 
               | I think the global "everyone put on a mask" moment
               | highlighted some large cultural differences.
               | 
               | My Asian friends understood that "not sharing germs" was
               | as important as "not getting sick" mask compliance as
               | much about being kind to others as to yourself. It also
               | helps that lots of them were already socially accepting
               | of masks due to climate, pollution and weather (or what
               | ever you want to call dust out of Mongolia every year).
               | 
               | I think that there is an interesting corollary with PPE
               | culture in general, one that has changed in my life time
               | (safety glasses and seat belts). I think we saw a lot of
               | that same behavior bleed out to normal people (who don't
               | wear PPE at a day job) in action.
               | 
               | All in all there is a cultural aspects at play that are
               | worth looking at.
        
           | cameldrv wrote:
           | You can get home tests that are similar to PCR. They are more
           | expensive but the performance of the antigen tests since
           | about 2022 is so bad that they're almost useless.
        
             | jMyles wrote:
             | When you say, "so bad", you mean in terms of sensitivity?
             | They seem to be sufficiently selective, but under-
             | sensitive. So, not great for risk aversion.
        
               | cameldrv wrote:
               | Yes sensitivity. False positives are fairly rare.
        
               | jMyles wrote:
               | Yeah, seems so.
               | 
               | So the tests are good as confirmatory devices. But yeah,
               | it was extremely unserious when they were used to
               | gatekeep public events, etc. The reasonable presumption
               | has always been that transmission of respiratory
               | pathogens will occur at public events (which is a
               | strength: humans are quite good at quickly acquiring
               | community immunity - it's one of the reasons our species
               | is so incredibly robust against respiratory pathogens).
        
             | virusduck wrote:
             | There is no "since 2022"--they have performed at relatively
             | the same level to date. They just are not perfect and are
             | unlikely to prevent the kind of non-symptomatic exposures
             | people have, but in most cases, they are good to quickly
             | differentiate a random sore throat from a COVID-related
             | one.
        
               | cameldrv wrote:
               | No the performance is worse with newer variants. One
               | factor seems to be that newer variants tend to replicate
               | a lot in the throat at first and only later move to the
               | nose, but there is probably more than one reason for the
               | change. In 2021, the antigen tests were pretty sensitive
               | if you were symptomatic, but now the false negative rate
               | is 50% or greater if you're on your first day or two of
               | symptoms. They perform better a few days later.
               | 
               | The problem is that people will have symptoms consistent
               | with covid and they're going to visit grandma or
               | whatever, so rather than just cancel, they take a test,
               | the test is negative, and they go do their thing. IMO
               | going just based on symptoms is more reliable at this
               | point unless you're using a molecular test.
        
         | Teever wrote:
         | It sounds like you learned nothing from the pandemic.
         | 
         | It is practically impossible to avoid catching covid in modern
         | society.
         | 
         | 'On a long enough timeline everyone's chance of survival drops
         | to zero.'
        
           | BjoernKW wrote:
           | > It is practically impossible to avoid catching covid in
           | modern society.
           | 
           | For the average human going about an ordinary and active life
           | that statement is quite true.
           | 
           | However, the person in question didn't lead an ordinary life.
           | He was confined to a medical device and probably very rarely
           | had in-person contact with random people. Besides, the people
           | who met him personally all must have known about his
           | condition.
           | 
           | Under such circumstances avoiding COVID-19 is actually pretty
           | easy: Have everyone in the room wear high-quality face masks.
           | 
           | Even for the average person during the height of the
           | pandemic, avoiding COVID-19 was still possible, but required
           | significant effort (no lockdowns though, mind you):
           | Basically, it meant wearing such a mask properly in public
           | settings (and changing it at appropriate intervals) as well
           | as frequent testing of everyone you were in touch with
           | regularly.
        
             | whelp_24 wrote:
             | Masks are not 100% effective. Indeed, at it's height the
             | hope was only to slow the spread to manageable levels, the
             | spread was inevitable.
        
           | asveikau wrote:
           | I think for certain people with an extreme illness or
           | vulnerability like this, it's reasonable to still be very
           | cautious in 2024. You'd probably also be very cautious about
           | cold and flu.
        
           | _silicon wrote:
           | Avoided it until Feb of this year. Frequent antibody and
           | antigen testing. If you're stationary and isolated like this
           | someone around you failed you.
        
             | Teever wrote:
             | It is possible for the support staff to follow all the
             | rules that they were given and yet still unknowingly
             | transmit COVID-19 to their vulnerable patient
        
           | blueflow wrote:
           | I know someone who is medically confirmed to never had covid:
           | https://www.thelancet.com/journals/laninf/article/PIIS1473-3.
           | ..                 Here, we report on a 62-year-old male
           | hypervaccinated individual from Magdeburg, Germany (HIM), who
           | deliberately and for private reasons received 217
           | vaccinations against SARS-CoV-2 within a period of 29 months
           | (figure A; appendix 1 tab 1).
           | 
           | [snip]                 Furthermore, HIM had no signs of a
           | past SARS-CoV-2 infection, as indicated by repeatedly
           | negative SARS-CoV-2 antigen tests, PCRs and nucleocapsid
           | serology (figure A; appendix 1 tab 1).
        
             | riffic wrote:
             | > 217 vaccinations
             | 
             | that's wild.
        
             | t0bia_s wrote:
             | This is anecdotal evidence on one individual. Data from
             | 99,068,901 vaccinated individuals shows many adverse
             | events.
             | 
             | https://www.sciencedirect.com/science/article/pii/S0264410X
             | 2...
        
           | foofie wrote:
           | I think your comment reflects that you learned nothing from
           | the pandemic. Lockdowns were proven to reduce the spread, as
           | was practicing basic personal higiene measures such as
           | washing hands, wear a mask, and respect social distancing.
           | They are 100% full proof specially if you are forced to share
           | public and private spaces with irresponsible people who don't
           | even practice basic higiene, but that does not mean that you
           | do not improve your odds of contracting and spreading the
           | disease if you take responsible measures.
           | 
           | We're in the 21st century and we are still trying to deny the
           | point that Ignaz Semmelweis made two centuries ago.
           | 
           | https://en.wikipedia.org/wiki/Ignaz_Semmelweis
        
             | Teever wrote:
             | > Lockdowns were proven to reduce the spread,
             | 
             | I agree 100% that lockdowns reduced the spread of covid-19
             | significantly and that they did not eliminate it.
             | 
             | > They are 100% full proof specially
             | 
             | I disagree strongly with this statement.
        
           | ParetoOptimal wrote:
           | I have purposely avoided getting covid by being covid
           | conscious in modern society despite having been exposed by
           | using n99 masks, HEPA filters that circulate air 4x per hour,
           | and only eating at resturaunt patios when they aren't busy.
        
         | PaulKeeble wrote:
         | All his visitors or carers needed to do was wear an N95 or
         | better respirator and he would still be alive. But people have
         | weird aversions to them to such an extent they are willing to
         | kill vulnerable people rather than wear one to save others
         | lives.
        
           | busterarm wrote:
           | Scabies spreads the most in retirement homes and hospitals
           | too.
           | 
           | Maybe our medical professionals should be wearing PPPS[1] at
           | all times, hmm?
           | 
           | [1]:Positive Pressure Personal Suit. Aka "moon suits".
        
             | zer00eyz wrote:
             | Ummm...
             | 
             | The positive pressure keeps airborne contaminants away from
             | the wearer. The germs off of the researcher in the lab as
             | it were. I'm not sure how it would prevent contamination
             | from getting on people outside the suit?
        
               | busterarm wrote:
               | I was offering a farcical suggestion to a farcical
               | problem.
        
               | nerevarthelame wrote:
               | Seems like a real problem to me. On average around 1,200
               | people die from COVID in the US every week, including the
               | guy in the article that started this conversation.
        
               | kelnos wrote:
               | It wasn't funny, then. At least make a farcical
               | suggestion that would actually help, not make the problem
               | (farcical or otherwise) worse.
               | 
               | I do agree with the overall point that it's likely not
               | really anyone's fault that Alexander eventually got
               | COVID. Being perfect 100% of the time isn't feasible for
               | anyone, even people in health-compromised situations.
        
             | foofie wrote:
             | > Maybe our medical professionals should be wearing PPPS[1]
             | at all times, hmm?
             | 
             | I'll bite your fallacy.
             | 
             | Scabies are prevented by avoiding direct skin-on-skin
             | contact. Wearing latex gloves is already effective, as is
             | routinely changing clothing and bedding.
             | 
             | Is any of this something you feel is outlandish for a
             | health professional working on hospitals and retirement
             | homes?
        
               | busterarm wrote:
               | > Wearing latex gloves is already effective, as is
               | routinely changing clothing and bedding.
               | 
               | Both of those things are done already and yet scabies
               | still spreads in these environments like wild. You say
               | that it's effective, but in actuality it isn't -- you can
               | be so careful but all of the small mistakes add up.
               | 
               | That's the point. I'm suggesting a farcical solution to a
               | farcical problem...that we need to go so far above and
               | beyond from what's already being done in these
               | environments.
               | 
               | The whole point is that it's useless and acting like this
               | man's caregivers killed him like my comment-parent did is
               | wildly misplaced blame.
        
             | ParetoOptimal wrote:
             | covid is like bumping your head: Either a minor bump or
             | brain bleeding that can occur after 3 - 5 days of a lucid
             | period.
             | 
             | If long COVID didnt make getting COVID like Russian
             | roulette for long term disability it would be "like the
             | flu".
        
           | jMyles wrote:
           | You say this as if it is established fact, but there has been
           | no RCT convincingly showing the effect you are describing -
           | typically called "source control" - can be achieved from the
           | use of a respirator to interdict individual transmission. In
           | fact, no RCT powered for such a finding has even been
           | attempted to my knowledge (though I haven't combed through
           | the research in the past couple months or so - link me if I'm
           | out of date!).
           | 
           | It has also not been demonstrated that source control can be
           | used to reduce community transmission (though I realize that
           | your point is not about community transmission).
           | 
           | The reasons for not funding / performing such a RCT continue
           | to astound - the demagoguery of comparing masks to parachutes
           | notwithstanding.
        
             | autoexec wrote:
             | You should probably read this:
             | https://www.scientificamerican.com/article/masks-work-
             | distor...
             | 
             | More if you're interested:
             | https://www.statnews.com/2023/05/02/do-masks-work-rcts-
             | rando...
             | 
             | https://www.acsh.org/news/2023/03/14/do-masks-prevent-
             | covid-...
             | 
             | The tl;dr is this: Randomized controlled trials are simply
             | not the appropriate tool for the job and we've got a
             | mountain of other evidence already.
        
               | jMyles wrote:
               | ...this link is not a new RCT. It is an article about the
               | Cochrane review which we all read a long time ago.
               | 
               | And, despite the (somewhat reasonable) chagrin expressed
               | by the authors, the Cochrane review did indeed show that
               | masks are largely ineffective (and cloth masks,
               | completely so) at stopping viral transmission - the link
               | is right there in the article to which you've linked.
               | 
               | What we need are sober, old-school RCTs powered to assess
               | both filtration and source control across individuals
               | (and sure, some for community transmission as well). And
               | then we need them replicated. And then we can finally
               | stop this ridiculous 'debate'. Today's humans are the
               | most scientifically literate society in history; there's
               | no reason we need to make important social and political
               | decisions with such shitty data.
        
               | autoexec wrote:
               | > the Cochrane review did indeed show that masks are
               | largely ineffective (and cloth masks, completely so) at
               | stopping viral transmission - the link is right there in
               | the article to which you've linked.
               | 
               | That's actually not what it showed. That bit of
               | misinformation is probably best addressed in another
               | article (https://www.acsh.org/news/2023/03/14/do-masks-
               | prevent-covid-...)
               | 
               | Here's the most important part:
               | 
               | Many commentators have claimed that a recently updated
               | Cochrane review shows that 'masks don't work,' which is
               | an inaccurate and misleading interpretation," Karla
               | Soares-Weiser, the editor in chief of the Cochrane
               | Library, said in a statement.
               | 
               | "The review examined whether interventions to promote
               | mask wearing help to slow the spread of respiratory
               | viruses," Soares-Weiser said, adding, "Given the
               | limitations in the primary evidence, the review is not
               | able to address the question of whether mask wearing
               | itself reduces people's risk of contracting or spreading
               | respiratory viruses."
               | 
               | She said that "this wording was open to
               | misinterpretation, for which we apologize," and that
               | Cochrane would revise the summary.
               | 
               | Soares-Weiser also said, though, that one of the lead
               | authors of the review even more seriously misinterpreted
               | its finding on masks by saying in an interview that it
               | proved "there is just no evidence that they make any
               | difference." In fact, Soares-Weiser said, "that statement
               | is not an accurate representation of what the review
               | found."
        
               | gadders wrote:
               | You are guilty of pushing the very misinformation that
               | you claim to be against.
               | 
               | The review itself said:
               | 
               | 'Wearing masks in the community probably makes little or
               | no difference to the outcome of influenza-like illness /
               | Covid-19-like illness compared with not wearing masks...
               | Wearing masks in the community probably makes little or
               | no difference to the outcome of laboratory-confirmed
               | influenza / SARS-CoV-2 compared with not wearing masks.'
               | 
               | The fact that the editor-in-chief of Cochrane embarrassed
               | herself due to the pressure of an opinion-piece by a non-
               | expert in the NYT is irrelevant.
               | 
               | You can read the views of one of the reports actual
               | authors here: https://www.spiked-
               | online.com/2023/07/19/the-junk-science-be...
        
               | autoexec wrote:
               | If you think that Cochrane revises their reviews based on
               | "pressure of an opinion-piece by a non-expert in the NYT"
               | I doubt any amount of research will change your mind from
               | what you've decided to believe. I think it's clear that
               | Tom Jefferson was embarrassed at being called out for
               | misinterpreting the evidence, but he's plainly wrong that
               | she never provided a reason. She was clear that it was
               | due to the "limitations in the primary evidence",
               | something many others pointed out as well.
        
               | jMyles wrote:
               | Please, I beg for your sensibility and brief attention
               | here. This issue continues to tear fissures in what seem
               | like otherwise reasonable and literate communities.
               | 
               | The sentence in question is:
               | 
               | "Wearing masks in the community probably makes little or
               | no difference to the outcome of influenza-like illness
               | (ILI)/COVID-19 like illness compared to not wearing masks
               | (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84
               | to 1.09; 9 trials, 276,917 participants;"
               | 
               | This is very typical wording, and a very typical
               | application of limited data, for a Cochrane review.
               | There's nothing here that jumps out, on first read or
               | after ingestion of all of the primaries, which I'm
               | guessing we've all done multiple times.
               | 
               | I think we all agree with you (and thus, with Soares-
               | Weiser) about the frustration (heck, downright
               | confounding) resulting from the lack of evidence. Top
               | experts from every one of the big 5 have repeatedly
               | called for and proposed RCTs to solve this problem.
               | 
               | ...but there is absolutely nothing wrong with looking at
               | these data and concluding that, in each statistically-
               | significant case, masking "probably makes little or no
               | difference to the outcome of" ILI.
               | 
               | Is it possible that a larger, properly-powered RCT will
               | find that some form of N95 application will have some
               | effect on community transmission? Sure. We'd all love to
               | know about that.
               | 
               | It it possible that a larger, properly-powered RCT will
               | find a similar outcome from cloth masks? No. Not unless
               | all of the current data on the matter is completely
               | flawed.
               | 
               | Is it possible that even a small, properly-powered RCT
               | will find statistically significant reductions in
               | individual transmission from source control measures?
               | Yes! That's possible! And that's the topic of this entire
               | thread - we're talking about an individual patient
               | largely confined to an iron lung.
               | 
               | Has that RCT been performed? No.
               | 
               | Can we all agree on at least these limited, well-defined
               | assessments of the available data?
        
               | gadders wrote:
               | And to be fair to Jefferson and Heneghan they have
               | repeatedly called for proper RCTs to be run.
        
               | gadders wrote:
               | Cochrane didn't revise their review, neither did the
               | author so I'm not sure where you imagined that. What
               | happened was the the managing editor issued a statement
               | in response to an NYT op-ed that criticised the review.
               | 
               | And there was no misinterpreting the evidence. He said
               | that there is no evidence that masks work. You can't then
               | say "yeah but there's only no evidence because all the
               | evidence is low quality" because then you are effectively
               | agreeing that there is no evidence.
               | 
               | If people are so confident masks work, do an RCT. That is
               | how science is supposed to work, right? Not guessing
               | something might work and doing it anyway.
        
               | 1224530282 wrote:
               | First, as the sibling comment pointed out, the Cochrane
               | review article didn't show that masks were ineffective.
               | "Relatively low numbers of people followed the guidance
               | about wearing masks or about hand hygiene, which may have
               | affected the results of the studies" [1]. Their results
               | were inconclusive since the people the asks to wear
               | masks, didn't.
               | 
               | But there's still evidence that masks are effective. The
               | question of whether N95 filter media can block virus-
               | carrying droplets is a _physics_ question-- which has
               | been replicated in experiment after experiment since the
               | 90s ([2] is a recent study).
               | 
               | I've done a lot of looking, but I've yet to find any
               | explanation as to why if someone is wearing a (properly
               | fitted) N95, so their air goes through a filter media,
               | which has been repeatedly shown to block droplets, they
               | could still inhale disease-carrying droplets.
               | 
               | [1]: https://www.cochrane.org/news/featured-review-
               | physical-inter... [2]:
               | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9947910/
        
               | autoexec wrote:
               | > I've yet to find any explanation as to why if someone
               | is wearing a (properly fitted) N95, so their air goes
               | through a filter media, which has been repeatedly shown
               | to block droplets, they could still inhale disease-
               | carrying droplets.
               | 
               | It's worth keeping in mind that even if someone wearing
               | an N95 mask does manage to inhale some percentage of the
               | airborne disease-carrying droplets around them, viral
               | load matters a lot. A tiny amount of virus could be
               | fought off by the immune system before it has a chance to
               | take hold in the body, and even if that fails and the
               | virus does infect the body, larger exposures tend to
               | result in worse outcomes. Even an imperfect protection
               | can have a beneficial effect.
               | 
               | It's the same for people spreading the virus. Even if a
               | mask isn't perfect, that doesn't make it useless. Putting
               | just about anything in front of someone's virus spewing
               | face holes is going to reduce the amount of virus that
               | gets into the air and limit how far it spreads. This is
               | why we teach small children to "vampire cough". Not
               | because the inside of our elbows provide N95 levels of
               | protection, but because doing so still helps to prevent
               | the spread of disease.
        
               | gadders wrote:
               | >>Their results were inconclusive since the people the
               | asks to wear masks, didn't.
               | 
               | Their review was at the macro, population level. If
               | people aren't wearing masks properly through carelessness
               | or ignorance, this proves their point.
               | 
               | Shooting a virus at a masked mannequin in a lab might
               | show some prevention, but in the real world people forget
               | and scratch their nose, rub their eyes, get sneezed on by
               | a stranger etc.
        
               | 1224530282 wrote:
               | I agree that the Cochrane review is better evidence of
               | "if you don't wear/use a mask properly, it won't work,"
               | rather than "masks don't work." (This is one of the
               | reasons I'm against mask mandates, btw.)
               | 
               | I'm invested in this only because, due to my health
               | condition, I don't want to get covid. As far as I'm
               | aware, the evidence says that so long as I properly wear
               | an N95 (so I'm not taking my mask off to scratch my nose,
               | have passed a fit test, etc.), I will significantly
               | reduce my risk of getting covid.
        
               | gadders wrote:
               | But rather than "if you don't wear/use a mask properly,
               | it won't work", I'd more restate it as "for a given
               | population size, enough people would mess up that making
               | everyone wear one would not slow the spread of the
               | disease".
               | 
               | I also think that if you, as an individual, are
               | especially diligent it may well lower your personal
               | chances of catching COVID. And given your health
               | conditions, I really hope that is the case for you.
               | 
               | But I think we are broadly in agreement.
        
               | jMyles wrote:
               | > I'd more restate it as "for a given population size,
               | enough people would mess up that making everyone wear one
               | would not slow the spread of the disease".
               | 
               | ...but this is even less conservative than the review
               | summary, which was inexplicably panned.
               | 
               | The clause "enough people would mess up that making
               | everyone wear one would not slow the spread of the
               | disease" is part of the consideration that goes into
               | "community transmission" (or the phrase "in the
               | community", which is sometimes used in formal
               | publications as an abstraction for real-world compliance
               | levels) and is distinct from "individual transmission".
               | 
               | The sentence in question is:
               | 
               | "Wearing masks in the community probably makes little or
               | no difference to the outcome of influenza-like illness
               | (ILI)/COVID-19 like illness compared to not wearing masks
               | (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.84
               | to 1.09; 9 trials, 276,917 participants;" [0]
               | 
               | ...it's hard to imagine how this extremely sober (and
               | factually proper) extrapolation of the data has caused
               | such a kerfuffle.
               | 
               | Is it any wonder that the people who have been studying
               | this topic since before it was cool are puzzled?
               | 
               | 0: https://pubmed.ncbi.nlm.nih.gov/36715243/
               | 
               | edit: my apologies - I just read that you addressed this
               | elsewhere in the thread. It seems that we are in
               | agreement (and I just don't think there is a reasonable
               | alternative assessment for any numerate / literate
               | reading of the data.)
        
             | toss1 wrote:
             | RCT is unlikely to be a good tool to determine the
             | effectiveness of masks, if for no other reason, compliance
             | is marginal at best (how do you recognize &record every
             | instance when someone pulls it down for a short time
             | exposing their nose or both airways?).
             | 
             | Perhaps the best evidence that even badly used masks are
             | effective is that measures such a using masks for a year
             | killed every instance of a strain of flu - deas, gone,
             | extinct.
             | 
             | Just by reducing the R0 value to the point where there were
             | no survivors. (but not enough that more virulent COVID-19
             | strains couldn't survive).
             | 
             | Masks, particularly N95-level, work. Period. Not perfectly,
             | nothing does. But they work. Regardless of any FUD you may
             | want to spread.
        
               | s1gnp0st wrote:
               | Let's wear them forever then. You first.
        
               | toss1 wrote:
               | Yes, it should be strongly encouraged in crowded places,
               | not discouraged.
               | 
               | As to "You First", I still do avoid random crowds and I
               | wear an N95 when I do go out in random crowds, including
               | the last time I went to the grocery store. I'm not the
               | only one I see doing that ('tho it is far less common
               | than a year ago).
               | 
               | But sure, you do you, because evidently your approach to
               | life prioritizes your immediate gratification, and doing
               | nothing that might help the general welfare, or help
               | everyone (even you) in the longer term.
        
               | s1gnp0st wrote:
               | I am disgusted by the totalitarian urge which has been
               | normalized by the pandemic. Your trauma is not my
               | problem, and I will not permanently alter my behavior to
               | satisfy your ever-escalating urge to dominate me.
        
               | jMyles wrote:
               | Well put. Though I suspect that the overwhelming majority
               | of the sentiment to which you are referring is being
               | carried by bots and not real humans.
               | 
               | It's a difficult time to be empirically-driven, though
               | hopefully we will come out better for it.
        
               | toss1 wrote:
               | You think that having no public health measures is data
               | driven? Go read some data. Seriously. Or, just go to
               | pre-1950s graveyards and gather data on how many dead
               | children there were before public health measures. Or
               | look at the data on how the public health measures ran
               | _extinct_ a strain of flu so it is no longer being
               | included in the vaccine formula.
        
               | s1gnp0st wrote:
               | That strain of flu had a lower R value than COVID-19.
               | 
               | Again, listen to me. I'm not telling you merely that I
               | disagree with you. I'm telling you that you have no power
               | over me, and you never will.
        
               | throwway120385 wrote:
               | It's not totalitarian. How do you feel about having a
               | sewer hookup or a septic system in your house? Because
               | those things were largely mandated and not by grassroots.
               | With that kind of attitude we'd all be crapping in
               | outhouses and standing in our own poop within a decade.
               | 
               | I agree with reasonable limits to public power, but I
               | think data driven public health approaches are an area
               | where the public should have a lot of power. We've
               | eradicated things like hookworm in part because we have
               | asked people to put shoes on their children and stop
               | pooping in holes in the ground.
        
               | toss1 wrote:
               | Yikes, Pandemic public health measures are _NOT_
               | totalitarian in any way, shape or form.
               | 
               | Totalitarian measures are "TOTAL"; i.e., they encompass
               | all aspects of govt and society.
               | 
               | Public health measures are LIMITED to the scope of the
               | public health threat.
               | 
               | Being unwilling to take even small measures that not only
               | help you but also help your fellow citizens does not make
               | you some kind of 'free-thinking libertarian'.
               | 
               | It simply shows you like to behave like a sociopath, and
               | your statement that a policy idea is a result of "trauma"
               | is an uncalled-for insult, as you intended it (which
               | again shows your drive to prioritize feelings over
               | facts). Seriously, no one is trying to "dominate" you. As
               | if you were that important. Sheesh.
        
               | jMyles wrote:
               | In an unlikely turn of events, you appear to be an actual
               | human and not a bot (from a cursory look at your comment
               | history). So I say, gently:
               | 
               | > because evidently your approach to life prioritizes
               | your immediate gratification
               | 
               | Do you genuinely believe that this is a fair
               | characterization of the sentiment of the person (or
               | position) to which you are responding, giving the benefit
               | of the doubt?
               | 
               | > Yes, it should be strongly encouraged in crowded
               | places, not discouraged.
               | 
               | It boils down to this: encouraging an intervention in
               | public places needs to be based on unambiguous evidence,
               | supported by genuine, authentic science and presented in
               | a way that is convincing to a scientifically-literate
               | society such as ours.
               | 
               | Consider, for example, the evidence in favor of the use
               | of seatbelts, condoms, traffic-calming infrastructure, or
               | hard hats (the latter of which I acknowledge don't
               | require RCTs to be validated).
               | 
               | These products have produced a reliable, measurable,
               | significant change in outcomes to the extent that no
               | reasonable person questions their efficacy impact (though
               | even with these, there is some reasonable dispute
               | regarding trade-offs in each case).
               | 
               | The intervention in question has fallen way, way short of
               | this standard - so much so that it's difficult to make a
               | viable comparison. Despite mandates across a literal
               | majority of geographic landmass of the country, there is
               | still no evidence of any benefit with regard to community
               | transmission rates. And on the research side, only nine
               | RCTs - and none at all regarding source control - have
               | been conducted.
               | 
               | We've watched as a huge chorus of the world's experts
               | have called for RCTs, and have been told by charlatan
               | bureaucrats and profiteers that such a venture is
               | comparable to a parachute RCT. Do you think that's likely
               | to be convincing?
               | 
               | Meanwhile, the (typical, expected, obvious) extrapolation
               | in the Cochrane review has been singled-out, and the
               | waters muddied, for pointing out in sober terms what the
               | RCTs actually said.
               | 
               | It has been reduced to "well, absence of evidence isn't
               | evidence of absence", creating an obvious catch-22 as the
               | same data is puzzlingly used as an excuse not to perform
               | further science on the matter.
               | 
               | Believe me when I say: we care about you. I wish you good
               | health and am happy to take evidence-based steps to
               | ensuring that the world is a healthy, vibrant place for
               | you and people like you. But you go too far when you ask
               | that others to ignore their own good-faith assessment of
               | the facts at hand. And the facts are unambiguous:
               | respiratory pathogens emerge every so often and infect
               | nearly all members of many animal species. There does not
               | appear to be a viable intervention to stop this, and it's
               | not even obvious is stopping it is desirable, as these
               | pathogens confer immunity to those infected. It's an
               | equilibrium and part of a broader ecology in which we
               | live.
               | 
               | You are loved, even by this stranger. Please don't see
               | commitment to data-driven approaches to public health
               | interventions as a hunger for immediate gratification;
               | this is nearly the opposite of the reality of the
               | situation.
        
               | gadders wrote:
               | >> RCT is unlikely to be a good tool to determine the
               | effectiveness of masks, if for no other reason,
               | compliance is marginal at best (how do you recognize
               | &record every instance when someone pulls it down for a
               | short time exposing their nose or both airways?).
               | 
               | But this is exactly the point, surely? If people won't
               | comply in an RCT, they won't comply in real life either
               | and so mask wearing will have no benefit.
        
               | throwway120385 wrote:
               | It just tells us that people probably need to comply
               | more, not that we shouldn't bother with certain
               | interventions. Suggesting we shouldn't try mask mandates
               | because not everyone complies is like suggesting you
               | shouldn't have laws about piling bags of trash on your
               | lawn because some people still pile trash on their lawn.
               | The real problem is the people who feel that "take your
               | trash to the dump" is an imposition and resent having to
               | do something to help the community around them.
        
               | gadders wrote:
               | Yes, perhaps someone could develop a new kind of glue
               | that will enable them to be stuck to children's faces so
               | they can't be removed.
               | 
               | I don't think that getting the levels of compliance
               | required is possible, absent civil liberty abuses which
               | are worse than the disease we are trying to cure.
        
           | colechristensen wrote:
           | False. Every step you take is a risk reduction, there's no
           | magical solution that completely removes risk unless you want
           | to live in a completely sealed environment, and even then you
           | need to exchange with the outside world. A 78 year old man
           | with a serious health condition died of a common infection,
           | this is normal and nothing to moralize about or throw around
           | blame and shame.
        
         | ics wrote:
         | The Guardian article from May 2020 which others have linked
         | (https://www.theguardian.com/society/2020/may/26/last-iron-
         | lu...) has more information on his life than this BBC one and
         | his thoughts on the present pandemic. Given that his death was
         | recent, I too am curious as to whether there are any further
         | details on his acquiring the illness but suspect there may be
         | little to report on. If you read the Guardian article he is not
         | apathetic at all but expresses a sense that it will likely be
         | what finally gets him.
        
         | riffic wrote:
         | he was also 78 and mostly immobile so that may have also played
         | a role.
         | 
         | Edit: the quote below (Palahniuk, fight club I believe,) is an
         | actuarial reality.
        
         | lr4444lr wrote:
         | COVID made its way to Antarctica. I have no doubt 4 years later
         | that it would find its way to Paul Alexander's home.
        
           | ParetoOptimal wrote:
           | Your implication that covid is unavoidable is false. I've
           | avoided getting it by being purposefully covid conscious.
        
             | unclad5968 wrote:
             | You have no way of knowing that. Some people are
             | asymptomatic.
        
               | CrazyStat wrote:
               | > You have no way of knowing that.
               | 
               | You can get a antibody (blood) test that will test
               | positive for COVID antibodies even if you were
               | asymptomatic.
        
               | kube-system wrote:
               | You can. But that still doesn't tell you if you've had
               | COVID. Antibodies wane overtime and you can also test
               | positive for antibodies after having had a vaccine. So
               | even if you have been taking antibody tests every couple
               | of weeks year now, you could have contracted it before
               | the tests were available (it was about a year before they
               | were publicly available in much of the US), or after a
               | vaccination.
        
               | whelp_24 wrote:
               | Some variants didn't show up in tests well. And being
               | asymptomatic was/is really common. Why would you check if
               | you don't have symptoms?
        
             | jjulius wrote:
             | >I've avoided getting it...
             | 
             |  _So far_ , is the missing clarifier.
        
               | nerevarthelame wrote:
               | Just because they can't be certain that they'll never get
               | it in the future doesn't mean that all attempts to
               | minimize cumulative infections are pointless.
        
               | jjulius wrote:
               | You're arguing a point that I never made. By all means,
               | OP should keep it up!
        
             | bsder wrote:
             | Or perhaps you have some immunity to it, for some reason
             | ...
             | 
             | Humans have high variation. It's what keeps the species
             | alive when things like pandemics come rolling in.
             | 
             | Your personal situation doesn't automatically apply to
             | anybody else.
        
               | ParetoOptimal wrote:
               | Or quaranting and masking despite being inconvenient is
               | very effective.
               | 
               | That would be an inconvenient truth though.
        
             | kelnos wrote:
             | Your lack of COVID is certainly largely due to being
             | purposeful and careful, but there's still a component of
             | luck. The only sure-fire way to avoid it is to stay locked
             | up and away from all other humans and things other humans
             | have potentially breathed on. Anything less and there's
             | always a decent chance you'll get it despite your
             | precautions.
             | 
             | Also, you may have gotten it, were asymptomatic, and didn't
             | notice. COVID is fun like that.
        
         | xanderlewis wrote:
         | The reason might be simply that the cause of death isn't widely
         | confirmed yet, and BBC News (more so than most other news
         | organisations) likes to err on the side of caution.
         | 
         | They're often late with details for this reason.
        
         | StarterPro wrote:
         | That's the irony, survived from Polio for decades only to be
         | brought down by Covid, which by all points was and is being
         | handled poorly.
        
           | spacebuffer wrote:
           | it is indeed iron-y...
        
       | freitzkriesler2 wrote:
       | Very sad. I hope him and his family will find peace. His story
       | was interesting and the team that helped him refurbish his iron
       | lung were angels in disguise.
        
       | schiffern wrote:
       | The fact is _conspicuously omitted_ from the article, but
       | Alexander died after contracting COVID-19.[0] Some sources
       | indicate he contracted it from a home healthcare worker, which _a
       | priori_ is likely.
       | 
       | As we know, COVID infections are almost unknown when infected
       | individuals consistently wear a high-quality fitted mask. Of all
       | people, I would think healthcare workers would make sure to
       | properly mask around _the guy in an iron lung_. :-\
       | 
       | We know they'd never come clean (and I'll probably be downvoted
       | for even raising the possibility (and for saying that too :D)),
       | but the reality of the situation is that it's quite probable some
       | foolish "muh freedumbs" healthcare worker has killed the last
       | iron lung guy, and they'll never be meaningfully held accountable
       | for it...
       | 
       | [0] https://www.dailymail.co.uk/news/article-13192005/Iron-
       | lung-...
        
         | blueflow wrote:
         | Also i'd like to know why you are getting downvotes. Is this
         | factually wrong conspiracy garbage or something? I don't know
         | but i would like to.
         | 
         | Edit: valid reasons presented.
        
           | jMyles wrote:
           | My presumption is that the downvotes are related to this
           | unsourced and incorrect assertion:
           | 
           | > As we know, COVID infections are almost unknown when
           | infected individuals consistently wear a high-quality fitted
           | mask.
        
           | gambiting wrote:
           | I downvoted because of a completely unfounded and frankly
           | offensive assumption that the worker "who killed him" must
           | have been one of those "muh freedumbs" types - if you read
           | about Paul's life and the people who were next to his side,
           | they were most kind and most caring people you could ever
           | wish for, he was so lucky to have them. To say to the people
           | who literally spent decades with him and looked after him,
           | frequently without any compensation, that they must be the
           | "muh freedumbs" types will all related connotations - to me,
           | that feels like spitting directly into their faces, like the
           | armchair judgement of an internet expert to the highest
           | degree. We don't know anything about the circumstances here,
           | but we are so quick to pass judgement - that's why I
           | downvoted OP.
        
         | ParetoOptimal wrote:
         | They were likely misinformed a surgical mask was enough or
         | thought "taking my mask off for just a second wont hurt".
        
         | anon291 wrote:
         | > As we know, COVID infections are almost unknown when infected
         | individuals consistently wear a high-quality fitted mask.
         | 
         | Suppose you're visited by a home health aid everyday and in
         | every instance of mask application the protective rate is
         | 99.999%. That means at each instance (each day), you have a
         | 0.001 risk of contracting COVID. If we extrapolate out, after
         | four years, the risk of contracting COVID is 1.5%. Now suppose
         | you have two or three visitors each day. Your risk is now 4.3%.
         | 
         | Even 'unheard' of risks become quite common as you tempt fate.
        
       | nadermx wrote:
       | "That year, he published a memoir which reportedly took him eight
       | years to write using a plastic stick to type on a keyboard and
       | dictating to a friend."
       | 
       | Talk about determination
        
       | UniverseHacker wrote:
       | I've read his autobiography... I highly recommend it, it is a
       | mind blowing story. Amazing that someone with such a severe
       | disability was able to live such a full life with romance and
       | adventure that most able bodied people would be jealous of.
       | 
       | His story and positive attitude has had a lasting impact on me in
       | making me appreciate and enjoy life more- and to really work to
       | make the best out of whatever is thrown at me.
        
         | samstave wrote:
         | TLDR?
         | 
         | WOW -- I just read this:
         | 
         | https://www.theguardian.com/society/2020/may/26/last-iron-lu...
        
           | rootusrootus wrote:
           | That picture of all the children in a room full of iron lungs
           | is what we should be showing every time someone tells us
           | about the evil vaccines.
        
             | johndevor wrote:
             | The vaccine was introduced after polio prevalence was
             | already plummeting.
        
               | autoexec wrote:
               | I would hardly call that "plummeting" considering the
               | baseline
               | 
               | https://www.eisenhowerlibrary.gov/sites/default/files/res
               | ear...
        
               | anon291 wrote:
               | I'm sorry... this is ridiculous. I'm not vaccine-heavy
               | (like I don't really think you _need_ a chickenpox
               | vaccine or a rotavirus vaccine if you 're healthy or a
               | Hep B vaccine at birth if you're low risk), but the idea
               | of forgoing vaccines for illnesses like polio is just
               | stupid. Too many kids died or were disabled for this.
               | It's just stupid.
               | 
               | The injectable vaccine is safe and has been used for
               | decades. There should really be no objection to it. The
               | oral ones are a different story and I wouldn't let my kid
               | anywhere near those (too high a risk of polio)
        
               | t0bia_s wrote:
               | _Cutter incident - The mistake produced 120,000 doses of
               | polio vaccine that contained live polio virus. Of
               | children who received the vaccine, 40,000 developed
               | abortive poliomyelitis (a form of the disease that does
               | not involve the central nervous system), 56 developed
               | paralytic poliomyelitis--and of these, five children died
               | from polio.[2] The exposures led to an epidemic of polio
               | in the families and communities of the affected children,
               | resulting in a further 113 people paralyzed and 5
               | deaths._
               | 
               | source: https://en.wikipedia.org/wiki/Cutter_Laboratories
        
               | anon291 wrote:
               | I already addressed this concern. I am categorically
               | against live polio vaccines. Thankfully, today, only the
               | oral one is live. There is no longer live injectible
               | vaccine.
               | 
               | The inactivated injectible vaccine is very safe.
               | 
               | You reference an incident from 1955 when injectible
               | vaccines were similar to oral ones today. Don't take
               | these. Luckily, in 2024, you don't have to.
               | 
               | It is irresponsible TODAY to not get vaccinated. None of
               | what I wrote above applies to 1955.
               | 
               | You're smarter than this.
        
               | t0bia_s wrote:
               | - It is irresponsible TODAY to not get vaccinated.
               | 
               | It is irresponsible to give/take medical statements on
               | internet without consulting it with your doctor that
               | knows your medical records. Are you're smarter than this?
               | 
               | Also: _In 2023, there were a total of 14 polio cases
               | reported globally, with six cases in 2022._ source:
               | https://polioeradication.org/this-week/
        
               | BitwiseFool wrote:
               | >"You're smarter than this."
               | 
               | Regardless of how correct you are, or how persuasive you
               | might have been up to this point, uttering this
               | accomplishes nothing and is entirely counterproductive.
        
               | samstave wrote:
               | I'm not anti-vax, though but my daughter actually got
               | chicken pox from the vaccine. It sucked - we had to get
               | her vaccined to fly back east, so we did... flew and it
               | was supposed to be a trip to chicago zoo but she got CP
               | then night we got there and spent a couple days in the
               | hotel bath with calamine.
               | 
               | I got the chicken pox twice. Once at 6 months. and at
               | 14y.
        
             | moralestapia wrote:
             | Some vaccines can be good, some vaccines can be bad; why is
             | that so hard to understand?
        
       | keepamovin wrote:
       | What a legend. You poor man. Thank you for showing us what's
       | possible. Thank you for never giving up on life. He always had a
       | smile.
        
       | speedylight wrote:
       | This man demonstrated such an outstanding will to live and over
       | come his disability. A part of me hopes he has moved on to a
       | better life. Rest in peace, Paul.
        
       | reddickulous wrote:
       | I didn't even know he was sick.
        
       | runjake wrote:
       | Paul regularly livestreamed on TikTok -- almost daily.
       | 
       | When I first saw him, I was rather horrified by his predicament.
       | But then I saw that Paul was always upbeat and positive and
       | accomplished. He seemed to live his life to his maximum. And he
       | accomplished more than the average abled person.
       | 
       | I hadn't seen him the past couple weeks (though my TikTok usage
       | is more cautious morbid curiosity and at an arm's length). I
       | guess this explains it.
        
       | begueradj wrote:
       | He was too brave.
        
       | daft_pink wrote:
       | They should post a link to the book. I want to read it now.
        
       | yiiyiyiyi wrote:
       | I remember reading this story a few years ago and realizing that
       | the engineer who maintained it, a guy named Brady, was the same
       | guy who ran my school FIRST robotics team back in 1998-2000. What
       | a guy.
        
       | anon115 wrote:
       | <333333333333333333333333333333 you can rest now my sweet prince
        
       | Uptrenda wrote:
       | He managed to become a lawyer and live a productive life in that
       | thing. Crazy inspiring story.
        
       | Strom wrote:
       | Paul was an inspiration for having amazing perseverance and
       | determination. I especially enjoyed a 30min interview he did in
       | 2022. https://www.youtube.com/watch?v=O5DOre3MFlw
        
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