Hold2 Profile picture
24 Apr, 8 tweets, 5 min read
Thread on "Consilience" (tm @EthicalSkeptic)

I hope Dr. Jacobs will engage and discuss with us in good faith.

My intent is to explain how we analyze patterns and look for consilience before predicting or calling peaks.

It's important to know what to expect, right?

This started with my tweet on 4/12 claiming MI/NY/NJ had peaked and that Hosps would peak next...likely the following week.

I didn't post that based on hopes and guesses. It was based on known data/patterns:
- Historical evidence
- Leading indicators


Historical Evidence:

- Hope-Simpson N. Temperate pattern
- April 2020 pattern

Instead of assuming US states dropped in unison at the same time last Spring due to NPIs, we consider natural forces to be predominant.

Leading Indicators:

1) CLI
2) Pos%
3) Illness Onset (Actual Date of Case)
4) Reported Cases

We learned long ago that CLI - COVID-Like Illness % of ER Visits - was the best leading indicator.

On 4/12, we saw peak signals on all 4.

If we did not look for Multi-Factor Consilience, we'd be much more susceptible to single-factor anomalies like the 220% Test dump on 4/14, which gave an artificial rise in Reported Cases trend.

This did not affect us, because we saw Pos% and CLI fall.


Just 2 days later on 4/16, everything began materializing.

The inevitable drop - despite MI choosing not to lock down again - began in earnest.

Now, here we are on 4/23/21 with huge drops in Hospitalizations in MI/NY/NJ just as we expected and stated.

Is this not how Dr. Jacobs (@TheAngryEpi) analyzes data and comes to conclusions on policy advice?

How does the rest of the PH/Epi world do it?

Disappointingly, we have our answer.

No response. No defense of her attacks on me nor her claims about the data.

We can only hope her followers see all of this and incorporate some critical thought into evaluating the rest of what she says.

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More from @Hold2LLC

12 Apr
Taking this one step further, you HAVE to watch this review of the JAMA study.

As a reminder, this is a CDC study claiming over 50% of transmission is caused by asymp (Fauci).

They use a model where they ASSUME asymp is 75% as infectious as symptomatic.
Lee paper (9):
- Viral load is similar between asymp and symp
- "Viral load is not the same thing as infectiousness or transmissability"

Johansson (JAMA author) used that to claim asymp infectious is 100% as much as symptomatic (fed into the 75% model assumption).

Chaw paper (#15):
- Symptomatic was 2.7X as presymp and asymp COMBINED
- Presymp more infectious than asymp

Johansson counts this as asymp being 40-140% as infectious but that does not match the paper.

Read 5 tweets
27 Mar
Thread: Masks and NPIs.

This thread reviews information published from Oct 2019 - Dec 2020.

The point is to see what was known/believed before & after discovery of COV2.

We'll start with research on epidemic/pandemic influenza (flu) from Oct of 2019.

Aerosols vs. droplets.
/1 ImageImageImage
Seasonality? This was actually a known phenomenon?

/2 ImageImageImage
Intended impact of NPIs.

Does this look familiar? This published in October of 2019 - that's very interesting to me.

Why does this "flatten the curve" image always go to 0 with no resurgence and not have values on either axis?

Let's look at NY and FL for fun.

/3 ImageImageImage
Read 22 tweets
3 Jan
AZ COVID Update: 1/3/21


Lots of data to look at for AZ. Holiday behavior patterns both for residents (when they get tested) and gov't (when they process the results) are difficult to predict, so it's important to look closely at the details.

First, Cases.

Today, 17k cases were reported, but it's important to know the difference between Report Date and Date of Specimen Collection. You see in my chart that there was a major dip in cases right when very few tests were performed on the 24th-26th despite 2 being weekdays.

Those who would have tested, but didn't, showed up to get tested on the 27-29th. Due to this, we see the 2 highest single case dates on 12/28-12/29, but the 7-day-avg is still lower than the 12/23 peak currently.

Just like CA with every restriction imaginable.

Read 7 tweets
3 Dec 20

COVID vs. Hope-Simpson Flu Patterns: 12/3/20

We're not through a whole year yet, but patterns are emerging, and I wanted to take a closer look.

We'll start with NY/IL who both are N. Temperate but not exactly the same climate pattern.

Now FL/TX.

FL is closest to true N. Tropical.

TX is very large with varying climates. Some are almost as far north as the southern tip of IL but most pop is further south.

Like IL vs. NY, we would not expect TX to mirror FL exactly but to be much closer to FL than IL/NY.

Now all 4 together. Notice the "W" shape mixing the N Temperate with N Tropical.

Also notice the obvious high winter peak for NY/IL that drops to near-zero in summer.

Notice the lower wave pattern for FL/TX that never gets to zero. Summer peak occurs; winter peak higher?

Read 4 tweets
19 Oct 20
US Update: 10/19/20

Graph 1: Daily Deaths + Current Hospitalizations

- Hospitalizations bottomed 4 weeks ago and then increased tangibly 2 weeks ago. That new increase trend already started abating the past 4 days
- Reported Deaths down 83 Week-over-Week (WoW)

/1 Image
Graph 2: COVID ICU Census vs. Deaths (7DayAvg) vs. Daily Detected Cases

***Case hunting now in mega-hyperdrive and some states now include antigen positives (not antibody)

- 7-Day-Avg Reported Deaths down 15 WoW
- ICUs sizable jump last 2 weeks but peaking again already

/2 Image
Graph 3: Daily Tests + Detected Cases + Case Positivity

***Last 10+ days have seen a real increase in Pos% that coincides with a bump in national CLI

- Test Positivity up 1.0 from trough
- Daily Test avg above 1M for 26 days
- Increase rate much lower than June surge

/3 Image
Read 6 tweets
4 Oct 20
US Update: 10/4/20

Graph 1: Daily Deaths + Current Hospitalizations

- Hospitalizations bottomed out and turned up a little
- Increases past week were mostly from WI (+118), NY (+120), MI (+120), PA (+129), TN (+134)

- Reported Deaths down 129 Week-over-Week (WoW)

Graph 2: COVID ICU Census vs. Deaths (7DayAvg) vs. Daily Detected Cases

***Case hunting still in hyperdrive

- 7-Day-Avg Reported Deaths down 68 WoW
- ICUs below 6k again
- Date of Death curve is below the June/July low point and dropping

Graph 3: Daily Tests + Detected Cases + Case Positivity

***Why are so many being tested daily, and who are they? CLI is at a national record low

- Test Positivity down 0.2 WoW
- 0.4 away from the low point in mid-June
- Tests up 43k WoW
- Detected Cases DOWN 3.4k WoW

Read 6 tweets

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