covid-19

Stephen Senn: Losing Control (guest post)

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Stephen Senn
Consultant Statistician
Edinburgh

Losing Control

Match points

The idea of local control is fundamental to the design and analysis of experiments and contributes greatly to a design’s efficiency. In clinical trials such control is often accompanied by randomisation and the way that the randomisation is carried out has a close relationship to how the analysis should proceed. For example, if a parallel group trial is carried out in different centres, but randomisation is ‘blocked’ by centre then, logically, centre should be in the model (Senn, S. J. & Lewis, R. J., 2019). On the other hand if all the patients in a given centre are allocated the same treatment at random, as in a so-called cluster randomised trial, then the fundamental unit of inference becomes the centre and patients are regarded as repeated measures on it. In other words, the way in which the allocation has been carried out effects the degree of matching that has been achieved and this, in turn, is related to the analysis that should be employed. A previous blog of mine, To Infinity and Beyond,  discusses the point. Continue reading

Categories: covid-19, randomization, RCTs, S. Senn | 14 Comments

Colleges & Covid-19: Time to Start Pool Testing

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I. “Colleges Face Rising Revolt by Professors,” proclaims an article in today’s New York Times, in relation to returning to in-person teaching:

Thousands of instructors at American colleges and universities have told administrators in recent days that they are unwilling to resume in-person classes because of the pandemic. More than three-quarters of colleges and universities have decided students can return to campus this fall. But they face a growing faculty revolt.
Continue reading

Categories: covid-19 | Tags: | 8 Comments

Paradigm Shift in Pandemic (Vent) Protocols?

Lung Scans[0]

As much as doctors and hospitals are raising alarms about a shortage of ventilators for Covid-19 patients, some doctors have begun to call for entirely reassessing the standard paradigm for their use–according to a cluster of articles to appear in the last week. “What’s driving this reassessment is a baffling observation about Covid-19: Many patients have blood oxygen levels so low they should be dead. But they’re not gasping for air, their hearts aren’t racing, and their brains show no signs of blinking off from lack of oxygen.”[1] Within that group of patients, some doctors wonder if the standard use of mechanical ventilators does more harm than good.[2] The issue is controversial; I’ll just report what I find in the articles over the past week. Please share ongoing updates in the comments. Continue reading

Categories: covid-19 | 61 Comments

The Corona Princess: Learning from a petri dish cruise (i)

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Q. Was it a mistake to quarantine the passengers aboard the Diamond Princess in Japan?

A. The original statement, which is not unreasonable, was that the best thing to do with these people was to keep them safely quarantined in an infection-control manner on the ship. As it turned out, that was very ineffective in preventing spread on the ship. So the quarantine process failed. I mean, I’d like to sugarcoat it and try to be diplomatic about it, but it failed. I mean, there were people getting infected on that ship. So something went awry in the process of quarantining on that ship. I don’t know what it was, but a lot of people got infected on that ship. (Dr. A Fauci, Feb 17, 2020)

This is part of an interview of Dr. Anthony Fauci, the coronavirus point person we’ve been seeing so much of lately. Fauci has been the director of the National Institute of Allergy and Infectious Diseases since all the way back to 1984! You might find his surprise surprising. Even before getting our recent cram course on coronavirus transmission, tales of cruises being hit with viral outbreaks are familiar enough. The horror stories from passengers on the floating petri dish were well known by this Feb 17 interview. Even if everything had gone as planned, the quarantine was really only for the (approximately 3700) passengers because the 1000 or so crew members still had to run the ship, as well as cook and deliver food to the passenger’s cabins. Moreover, the ventilation systems on cruise ships can’t filter out particles smaller than 5000 or 1000 nanometers.[1] Continue reading

Categories: covid-19 | 54 Comments

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