This paper is from Marianne J Middelveen, who is well known for embracing quackery and producing questionable papers.
Her earlier claims that Lyme is a sexually transmitted disease were quickly dismissed, though not before generating a lot of noise in the media: https://www.aldf.com/wp-content/uploads/2016/12/Lyme-Borreli...
She also writes papers about "Morgellons Disease", a delusional disorder in which patients believe threads and fibers from their clothing and other fabric are actually sprouting from within their skin. The condition is universally acknowledged as a delusional disorder, but MJ Middelveen treats it as a real disease with no real evidence.
> I'm not gonna bother digging up the others, honestly not worth my time to try and convince one random person.
This is my least favorite part of discussing Lyme online. So many people are deeply convinced of their chosen narrative that they unquestioningly accept any papers that support their claims, while refusing to acknowledge any evidence to the contrary. This has created quite the market for pseudoscientific researchers to peddle narratives and pseudo-research that meets the demand for what people want to hear.
In the end, it only sets the field back. I would love to see a magic combination of antibiotics that reverse PTLDS symptoms, but decades of high-dose, extended duration antibiotic trials have provided zero benefit to patients, despite the demand.
SCAM SOP. Because it’s all about Them. Peddlers reap wealth and adulation; victims are miserable AF but “vindicated”. Talk about mutual parasitosis.
Let's ignore the research because we don't like the researcher. That's how science works.
The gold standard in microbiology for diagnosing an infectious disease has always been to culture the organism alive. Despite notorious difficulties in culturing Borrelia burgdorferi, in about 30 studies this organism has been cultured alive from patients despite at least standard antibiotic therapy, and in many cases after antibiotics far in excess of what is deemed curative by IDSA and CDC. If the pathogen that causes a disease is still present in conjunction with symptoms compatible with that infection, it would appear to me that the fundamental questions about the cause of long term symptoms should have been answered a very long time ago. To add insult to injury, recent studies from Tulane, Johns Hopkins, and Northeastern University all demonstrate that we can’t even kill Borrelia in the test tube with the currently recommended antibiotics. What are the chances that a second disease of mysterious etiology but with the same symptoms as the first disease, would come and replace the first disease when there is published evidence that the pathogen which causes the first disease persists despite both short and long-term antibiotics? There are numerous chronic bacterial infections which require long-term combination antibiotic therapies: Tuberculosis, leprosy, coxiella endcocarditis, brucellosis, Whipple’s. Why should Lyme be different?
>I would love to see a magic combination of antibiotics that reverse PTLDS symptoms, but decades of high-dose, extended duration antibiotic trials have provided zero benefit to patients, despite the demand.
Let's take the PLEASE[0] study for example. Although significant improvement in health was measured (on average 4.6 points on the SF-36 scale; 3 points is considered significant progress) the results were presented with the headline: 'Long-term use of antibiotics does not benefit long-term complaints of Lyme'.
While tens of thousands of patients have been cured by a cocktail of antibiotics taken for several months or sometimes years. This is also what the current in vitro research is showing. Lyme persisters can only be killed by a combination of antibiotics.[1] Like tuberculosis. And it's also what this data analysis of 200 patients shows.[2]
>We collected data from an online survey of 200 of our patients, which evaluated the efficacy of dapsone (diaminodiphenyl sulfone, ie, DDS) combined with other antibiotics and agents that disrupt biofilms for the treatment of chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS). ... Conclusion DDS CT decreased eight major Lyme symptoms severity and improved treatment outcomes among patients with chronic Lyme disease/PTLDS and associated coinfections.
And recently we have the spectacular results of Disulfiram.[3][4] A clinical trial is underway at Colombia University so we won't have official results until 2021 but all signs point to it being a game-changer. Lyme communities are full of people with miracle stories after taking Disulfiram. Why would Disulfiram work if the persistent Lyme hypothesis is wrong?
[0]https://www.nejm.org/doi/full/10.1056/NEJMoa1505425
[1]https://www.jhsph.edu/news/news-releases/2019/three-antibiot...
[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388746/
What is the CDC saying about masks for covid-19? Are you saying they're not effective or the CDC is downplaying their effectiveness?
Surgical masks are not effective at preventing infection. They are effective at spreading infection.
New data on asymptomatic spreaders means than public health authorities are considering changing their advice. The default assumption would then be that everyone has it, and should therefore wear a mask to prevent spreading it.
This is a common misconception, for which CDC is also partially the one to be blamed.
Laboratory tests find that improvised cloth masks block 60 – 80% of virus particles
Most experts in the early 2000s agreed that these masks were probably better than nothing.
https://bmjopen.bmj.com/content/bmjopen/5/4/e006577.full.pdf
https://www.cambridge.org/core/services/aop-cambridge-core/c...
http://akkie.mods.jp/2019-nCoV/images/c/c0/%E3%82%B5%E3%83%B...
How many virus particles do you need to become infected? Is 20% of the load in a typical aerosol droplet from an asymptomatic infected person above or below that critical number?
>higher viral loads associated with severe clinical outcomes
Actually, they very much are.
1. Regular old surgical masks (not N95 respirators), when worn by the public without training, had a strong protective effect for the people wearing them during the SARS-CoV-1 outbreak. They reduced the risk of infection by ~70%. (Source: https://wwwnc.cdc.gov/eid/article/10/2/03-0730_article) The CDC even coauthored this one.
2. Despite being very different in their ability to actually filter out fine particles, N95 respirators and surgical masks actually show no significant difference in their ability to prevent diagnosed respiratory infections including influenza, when worn by healthcare workers according to two large meta-studies. Though both had a protective effect over no mask. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868605/) (2nd source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779801/)
3. When infected people wear a mask, it does help reduce the amount of viral shedding which occurs, presumably making them less likely to infect others. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591312/)
In fact, if you dig into the research evaluating different mask types including homemade masks, one of them suggests that the masks are actually MORE protective on the way in than they are in preventing shedding of aerosols: (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/) (2nd source: https://www.researchgate.net/publication/258525804_Testing_t...)
Surgical masks are particularly helpful in stopping _infected_ people from spreading the disease.
New information and data on asymptomatic spreaders means that the CDC (and many other Western health authorities) are considering changing their advice. The idea is that everyone must assume they are an asymptomatic spreader.
Additionally, surgical masks aren't the only PPE that medical workers use to protect themselves. Furthermore, hospitals and medical workers need surgical masks for many different non-coronavirus activities.
See here for more info:https://www.npr.org/sections/health-shots/2020/03/31/8245604...
First, you're implying that the data is new, but it's been around for a long time:
https://docs.google.com/document/d/1HLrm0pqBN_5bdyysOeoOBX4p...
> Surgical masks are particularly helpful in stopping _infected_ people from spreading the disease.
One of the ways the CDC twisted the information was to pretend this is only about surgical masks. There are also N95 masks, but the advice from the CDC and Surgeon General was generalized to all masks, not just surgical masks. Like this tweet:
Seriously people- STOP BUYING MASKS!
They are NOT effective in preventing
general public from catching #Coronavirus,
but if healthcare providers can’t get
them to care for sick patients, it puts
them and our communities at risk!
Furthermore, even surgical masks block 60-80% of pathogens. And if you seal the sides with tape, they block as much as other respirators.
And for the public, 60-80% is wayyyyy better than nothing!
So although it's true that there is a shortage of medical-grade masks for healthcare workers, and it's true that we should give them priority for any masks we have, it's absolutely a lie to say that "masks" in general are not effective at stopping the virus for the public.
Note the following points, with sources (The context is a bit off because I did this research in response to another question, but the points are still pretty much relevant here):
1. Regular old surgical masks (not N95 respirators), when worn by the public without training, had a strong protective effect for the people wearing them during the SARS-CoV-1 outbreak. They reduced the risk of infection by ~70%. (Source: https://wwwnc.cdc.gov/eid/article/10/2/03-0730_article)
2. Despite being very different in their ability to actually filter out fine particles, N95 respirators and surgical masks actually show no significant difference in their ability to prevent diagnosed respiratory infections including influenza, when worn by healthcare workers according to two large meta-studies. Though both had a protective effect over no mask. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868605/) (2nd source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779801/)
3. Improvised, homemade masks have only a marginally lower filtration efficiency than surgical masks (which we established are about as effective as an N95 respirator anyway). (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/) (2nd source: https://www.researchgate.net/publication/258525804_Testing_t...)
4. There is evidence in the studies linked in item 2 that hand hygiene alone did not demonstrate much of a protective effect (for civilians caring for a sick family member) against transmission of influenza compared to use of any type of mask.
5. When infected people wear a mask, it helps reduce the amount of viral shedding which occurs, presumably making them less likely to infect others. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591312/)
What the study says is that we don't have enough information. As an example, one of the studies referenced in that study gives odds of 0.58 for getting infected with surgical and 0.42 with N95.
Bonus quote: "Furthermore, we do not have an adequate understanding of the number, size and dispersion of the droplets that contain live, infectious particles produced by infected patients.56 A laboratory-based study reported data that humans infected with influenza rarely produce aerosols that contain infectious viral particles.57 In 2 other laboratory studies, participants infected with influenza produced droplets containing viral RNA, but viral RNA could not be detected on manikin headforms or on filters of breathing manikins at distances as close as 0.1 m following participants breathing, counting, coughing or laughing.7"
The quote you're referring to, regarding 95% CIs, in context specifically applies to comparing surgical masks vs. N95 respirators, not mask vs. no-mask. In other words, surgical masks are not shown to be worse than N95 respirators.
That's in complete agreement with the point 2 that you're apparently trying to refute.
Their Jan 8 publication says:
> CDC currently recommends a cautious approach to symptomatic patients with a history of travel to Wuhan City. Such patients should be asked to wear a surgical mask as soon as they are identified and be evaluated in a private room with the door closed. Personnel entering the room to evaluate the patient should use contact precautions and wear an N95 disposable facepiece respirator
- https://emergency.cdc.gov/han/HAN00424.asp
And on Feb 21 their FAQ said:
> Q: Does CDC recommend the use of facemask in the community to prevent COVID-19?
> A: CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a mask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected. The use of facemasks also is crucial for health workers and other people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility).
- https://wayback.archive-it.org/13529/20200221195555/https://...
So I'm not seeing where they ever said they were not effective. It says that if you are sick or showing symptoms you should wear a mask, but that they don't advise the general public to wear a mask because they are crucial to health care workers. To me this sounds like very good advice.
To be clear, I'm just saying the CDC never lied. You can disagree with its recommendation to try and save the masks supplies for Health Workers and people showing symptoms, but it never said that masks are ineffective. If anything, it might have said that it's still unclear how effective they are, but even then, it clearly took the cautionary approach.
If you read to the contrary, that was probably just a poor news source spewing misinformation. Or at least, I cannot find where on the official CDC channels they would have lied.
This isn't necessarily true. Doctors and nurses could have training on how to use masks, whereas most people will touch their faces more with them on.
1) spirochete reproductive form and susceptible to a number of antibiotics (vitro/vivo) 2) round body "starvation forms" which are resistant to most antibiotics (vitro/vivo) 3) biofilm colonies which harbor many pathogens, metals and mycotoxins are resistant to antibiotics (think immunosuppression here)
I've gone through a shit ton of tests in the last few years going over much of this. I have relatives that experienced it as well. There is growing scientific evidence a ton of clinical improvement, yet "anecdotal" patient evidence that many of these pathogens can persist beyond initial treatment. Buhner does an excellent job of explaining some of this in "Healing Lyme" and backs it up with studies from around the world. His protocols certainly help people (myself included).
Immune expression and context is a tough nut to crack and we need billions of more data points capturing cytokine signaling in conjunction with T-cell, Nk cells, mast cells, antibodies, etc to get a better understanding of HOW UNIQUE EACH IMMUNE RESPONSE IS TO A PATHOGEN. Life on our planet is biological and tightly coupled with bacterial/parasitic/viral pathogens and would not exist without them. Things quickly change through reproduction or in the case of Borellia by shifting its outer protein to better evade compromised immune systems. Or has there just been one flu/corona/etc viral strain in the last hundred years? (<- No). These things have remained in existence for a long time, it is foolish to think they cannot adapt.
Mind the 'gap' with disulfiram. It seems side effects vary, but also the quick elimination of Lyme, Babesia (not sure about Bartonella, which is mainly endothelial), and the cytokines cascades they trigger, but removing them all it once vs reducing them from severe to immune manageable levels might cause its own set of issues.
I won't bring up the CDC as they've failed millions of Lymies at this point with poor test protocols and failure to push for more research data. Test skipping 31, 34 antibody proteins when they are primary Borellia proteins (if the body is able to produce them, immunocomprimised or the load from multiple infections). The single dose doxy is absolute bullshit (1 data point from me). The denial that ticks can transmit Borellia (Lyme) and Bartonella in the same bite (bullshit, many tick samples on both costs show something like 2.6 pathogen average). In my personal experience, Bartonella is an absolute bitch to get rid of.
We need to better educate ourselves by owning all of our data in a way that enables us to submit it to research projects that are publically funded and not driven by patent revenue which pushes economies of scale. (off soapbox now :-)
You probably should though: this is HN, there are typcially quite some people with a background in academics here. Or just criticially thinking people in general who understand how science works on this planet. tldr; one single paper on a controversial subject isn't going to cut it as proof I'm afraid.
Even more concerning are the number of doctors I've seen blatantly lying about the effectiveness of masks. Most people aren't idiots - if the masks help protect medical professionals from Covid-19, they can also help non-medical professionals.
The proper message would have been: masks can be effective, even a bandana can likely help prevent disease transmission. But it's important for Americans to save N95 masks for medical professionals until they're widely available. Given that it's highly likely that wearing any mask helps prevent the spread of the virus by keeping the mask wearer from transmitting it to others, this is what they should have done.
Why not? This is a classic trolley problem and throwing the switch is absolutely the correct answer.
... probably.
Going forward, misinformation gives every anti-vaxxer, skeptic, conspiracy theorist, and snake oil peddling bullshitter more ammunition with which to displace effective medical treatment going forward. Even the well meaning general populace becomes skeptical. You know what this results in?
Dead kids. Covid parties.
Trust in government is already so fucking slow people are throwing covid parties. And now you're suggesting that undermining that trust even more is the obvious answer?
For members of the public walking around a mask provides at best marginal benefit, and that's only if the wearer complies with a strict regime of donning and doffing protocols, and if it's combined with a full set of other PPE (disposable gowns, gloves, eye shields) and frequent handwashing.
As soon as you drop any of those you're not just making the mask a bit less effective, you're probably increasing the risk over not wearing a mask at all.
There are a few routes of transmission -
fecal oral; fomites to hand and then to eyes, nose, or mouth; and droplets landing on your eyes or being breathed in.
It's likely that in members of the public the main route is touching an infected surface and then touching your eyes, nose or mouth. Masks only help with breathing in droplets, and they only help if they're worn correctly. Incorrect mask wearing increases risk because masks feel weird and cause people to touch their face more often, and because masks give permission to people to go outside and mingle in crowds.
There's not much research around whether members of the public can wear PPE correctly, but there's plenty of research around PPE and healthcare professionals. We know that qualified registered healthcare professionals who know the consequences of not wearing PPE correctly still struggle to do it all correctly.
> Most people aren't idiots - if the masks help protect medical professionals from Covid-19, they can also help non-medical professionals.
The difference is that healthcare professionals spend all day in close contact with symptomatic people and are more likely to come into contact with blood or fecal matter or sputum, and are more likely to be doing aerosol-generating procedures, so the baseline risk is much higher, so that marginal benefit turns into an actual benefit. But importantly they're not just wearing masks. They're wearing gowns and gloves and eye protection and they have access to water and soap and alcohol hand gels and infection control teams to train them on how to wear it correctly.
Here's what HCPs are wearing. Are you honestly suggesting this for members of the public? https://twitter.com/QEGateshead/status/1244208756600307712
Here's a simple graphic for donning: https://twitter.com/agtruesdell/status/1245470479059767297?s...
Here's a thread talking about donning, wearing, and doffing PPE. https://twitter.com/halletjulie/status/1245409318775767042?s...
This is not the CDC / WHO / etc lying, this is them talking about the science as they understand it. https://twitter.com/shinybluedress/status/124277978004452147...
> even a bandana can likely help prevent disease transmission
You're basing this on a small study carried out in a lab using research bacteria (not viruses) carried in a calibrated spray, that didn't include "people breathing through the mask". You've massively overstated those results.
It's pretty fucking obvious that if you have Covid-19, and are expelling infected droplets into the air, almost any kind of mask will help reduce those droplets. I mean, wait for the double-blinded mask study (n=200) if you want. You may end up waiting for quite a while. Meanwhile, overall transmission rates in Asian mask-wearing countries are lower than Western transmission rates, despite taking many of the same precautions other than masks.
The point with masks, even rudimentary ones, is that they help prevent the wearer from transmitting respiratory disease.
And there's a point during a pandemic when you drop the Nature/Science level of evidence when you're talking about a relatively low-risk intervention like wearing a bandana.
In the words of the author of one the studies you disdain: "In normal times we'd say that if it wasn't shown statistically significant or the effective in real-world studies, we don't recommend it," he said. "But in the middle of a pandemic, we're desperate. The thinking is that even if it cuts down transmission a little bit, it's worth trying."
BTW, the author of the study I'm talking about here studied transmission of viral infections (influenza and coronaviruses) with an n of 111, not bacterial infections: https://www.nature.com/articles/s41591-020-0843-2 But there are multiple studies from the past decade that indicate that masks help prevent spread of respiratory viruses.
Finally, you harshly criticize my comment for lack of evidence, and yet you pull this one out: "It's likely that in members of the public the main route is touching an infected surface and then touching your eyes, nose or mouth." We have no idea if that's true or not at this point.
And here's another statement you pulled out of nowhere: "As soon as you drop any of those you're not just making the mask a bit less effective, you're probably increasing the risk over not wearing a mask at all."
You seem to have started from a position of defending the CDC, and then from there gone on cherry pick evidence or pull statements out of thin air.
There are people I know working at the CDC that I respect a great deal. But this PR campaign to lie to the American people to preserve mask stocks was a bad, bad idea.
> We know that qualified registered healthcare professionals who know the consequences of not wearing PPE correctly still struggle to do it all correctly.
No significant difference between fitted and non-fitted N-95 masks: https://www.ncbi.nlm.nih.gov/pubmed/21477136
And no, I wasn't even talking about wearing hospital-level PPE. I was talking about masks, and even mentioned bandanas, for crying out loud. But keep on spearing that red herring.
And here yet again, obviously N95 masks can help prevent transmission of respiratory viruses, including SARS-CoV-19. We know this to be true.
> This is not the CDC / WHO / etc lying, this is them talking about the science as they understand it.
You linked to some random ICU nurse, who makes some great points but has nothing to do with the CDC or WHO. But I agree that frontline health workers should absolutely have precedence to N-95 masks and other PPE.
> You're basing this on a small study carried out in a lab using research bacteria (not viruses) carried in a calibrated spray, that didn't include "people breathing through the mask".
Finally, you have no idea what I'm basing this on. Actually, it's common sense here that if you're infected, even as an asymptomatic carrier, wearing a bandana can reduce spread of droplets.
I would argue no, not a net positive at all. To start, nearly everyone now distrusts the CDC (and WHO) to deliver accurate information.
> CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.
> CDC increases the health security of our nation. As the nation’s health protection agency, CDC saves lives and protects people from health threats. To accomplish our mission, CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise.
I think the same people who were inclined to distrust health organizations probably continue to do so, and the folks who were inclined to trust health organizations probably continue to do so as well.
Lies undermine all of this. Lies undermine the means by which they accomplish their mission.
> the folks who were inclined to trust health organizations probably continue to do so as well
One point of ancedata: not all of us.
This implies that trusting public health organizations is some kind of personal preference? Or that health organizations are inherent liars? Not sure what you're getting at.
Let's adjust the statement a bit to parse out its meaning, and make it not about health organizations, but about lying organizations.
"I think the same people who were inclined to distrust [lying] organizations probably continue to do so, and the folks who were inclined to trust [lying] organizations probably continue to do so as well."
That's a true statement that I can get behind.
Think a moment. The sick people need the doctors and nurses alive. Stripping the supply of PPE for medical professionals is lose-lose for everyone. Even if only all of the high-risk non-medical-workers bought effective masks, it would obliterate the supply available to nurses and doctors.
Lie once, lie always. Honesty is imperative for a public trust.
Now, what do you think the crazy anti-vaxxers will say, next time they're told to trust the CDC, and other public bodies, and that vaccination is safe, and makes sense?
When a vaccine is created, perhaps, for this virus?
Now it is easier to convince others that the truth is concealed. That lies abound.
Any medical official should lose their license, for spreading quackery.
>RESULTS: Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borreliaburgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods https://www.ncbi.nlm.nih.gov/pubmed/29662016
The CDC is wrong and negligent about persistent Lyme. Just like they are about the masks for covid-19.
This is just one study demonstrating spirochetes surviving. I'm not gonna bother digging up the others, honestly not worth my time to try and convince one random person.
Look up disulfiram and it's effects on Lyme patients. It's another drug discovered in the same way as this one. Miraculous.