High sensitivity low specificity would be nearly useless. “Yup, it’s always positive. We don’t know what that means, but it is definitely positive.” This is actually a strategy we use in some 2-stage screening tests. A highly sensitive first stage, so you don’t miss any real positives, then a very specific second stage to eliminate the false positives. The trick is always to make it so the first test is not soooo sensitive that you don’t eliminate enough true negatives. So that your highly specific second test isn’t “confirming” things in error. It’s a tough dance, and constantly evolving and being reevaluated. This is the root of a lot of the stories you read about such-and-such screening test is no longer recommended.
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In that case I find thinking about the normal meanings does help. Or at least, calling something sensitive means it is not going to miss much, though it might be too easy to set off – maybe false positives but not false negatives. Specific has to be the other way then.
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Yeah. An ideal screening test has 100% sensitivity (never misses - zero false negatives) with as high of a specificity as possible (willing to accept a few false positives that can be corrected with a follow-up test).
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Ontario 
Provincial numbers have us at about 2/3 of the hospital bed occupancy of the peak around this time last year, trending upwards. Jessica Wildfire of the OKDoomer site does a bit of familial epidemiology to trace how her family all came down with COVID lately.
Dr. Tara Moriarty of U of Toronto reports “Severe” levels of infection in all provinces. The wastewater signal confirms that and is high enough that the press is noticing.
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Went to an outdoor family gathering.
How long are you going to live in fear? How does me living in what you believe to be fear affect you?
By the way, where is cousin so and so, her spouse, and kids? Home with covid? That’s odd.
My wife went to pick up some prescriptions and asked how my RSV approval was going, a different pharmacist checked and said it was still pending but it should have been approved. She made four phone calls, my vaccine is approved with zero cost and waiting for me.
As soon as my wife gets home I’m going to go get poked.
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I wonder how this helps the people that elected them.
Three guesses who one of them is.
Three right-wing House members petitioned the Supreme Court on Tuesday to hear their lawsuit over penalties they incurred for flouting a pandemic-era mask requirement in Congress.
https://www.axios.com/2023/11/28/gop-mask-lawsuit-supreme-court
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Oh look, Paxton is suing Pfizer.
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Except for the sparsely inhabited North East and, by a small margin the Greater Toronto Area, the COVID-19 Wastewater signal in Ontario is higher than it has been for the past 12 rolling months. Hospital bed occupancy is also at a rolling 12-month high.
Edit: The Canadian COVID-19 Resouce Site by Moriarty Labs and U of Toronto has a brutal plot of reported excess mortality, here from the provinces with a rapid reporting rate, and how well it matches the waste water signal over the past while. Actual COVID deaths are severely under-reported (30% to 50%) and it’s hard to escape the conclusion that the excess death rate is well explained by the prevalence of COVID in the population.
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Christ, what a destructive asshole.
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Meanwhile, in TX:
In all, Paxton’s 54-page complaint acts as a compendium of pandemic-era anti-vaccine misinformation and tropes while making a slew of unsupported claims. But, central to the Lone Star State’s shaky legal argument is one that centers on the standard math Pfizer used to assess the effectiveness of its vaccine: a calculation of relative risk reduction.
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Fully open to comments from our resident experts, of course, but I have the impression that the article is somewhat understating the immunodeficiency problems with COVID and potential impact of walking pneumonia with everything else going around.
I base my impression partly on a new article by Jessica Wildfire (who is smart, does her work, but isn’t a specialist and, although I can’t fault her for this, is a pessimist). She is concerned in particular about the ≥90% resistance rate to first-line macrolide antibiotics observed in current Chinese walking pneumonia cases, quoting Foreign Policy: “This means there is no treatment for MPP in children under age eight.” She notes earlier research indicating walking pneumonia co-infections with COVID-19 have higher mortality and are more severe. She extrapolates this to a concern about the effects on children, particularly with the risks of Long COVID.
The other part of my impression is seeing people around me get sick. I don’t feel like I’m out and about much more than I have been the past couple of years, but even my anti-social self knows people (N=3) who, in the past couple of months, have been knocked out for weeks with odd combinations of hard-to-pin-down diseases.
Sidebar: The latest high profile Long COVID case here is CBC Radio host Gill Deacon, whose voice soothed my savage evening commute for years. She got knocked out of work by Long COVID after an asymptomatic case. Estimates are that 1 in 100 's are suffering life limiting symptoms from COVID right now.
Anyhow… this morning’s breakfast table discussion was “contingency plans to the fambly gathering plans for 
”. 
Hospital bed occupancy due to COVID, in Ontario , is rising, and below only 3 other peaks seen since the start of the pandemic.
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Yeah, this is starting t surface in the literature.
One of the most concerning long-term effects of COVID-19 is immune dysfunction or hypofunction. Confirmatory research by Fei Gao, PhD, et al was reported this week and summarized in a National Institute of Health news release, which stated:
“… findings suggest that SARS-CoV-2 infection damages the CD8+ T cell response, an effect akin to that observed in earlier studies showing long-term damage to the immune system after infection with viruses such as hepatitis C or HIV.” The authors conclude that this dysfunction causes lasting damage and may “contribute to long COVID, perhaps rendering patients unable to respond robustly to subsequent infections by SARS-CoV-2 variants or other pathogens.”
Not definitive just yet, and there are other papers suggesting it’s not that bad, but we are just getting hammered with RSV, flu, covid and “generic crud.”
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Oh, and bonus! Pull up Infection Control Today and test your skills with their “Bug of the Month” challenge… 
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Infection control people have the grossest job. They are constantly thinking about piss, shit, blood and snot. And handwashing, which is related to these things in a big way. Though, of course, if more of us did the handwashing, they would not have to do nearly so much thinking on it!
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22 posts were split to a new topic: Their secret weakness is…copper?
I’ve had no luck getting the Statistic report that prompted this tweet. Via Jessica Wildfire. The report says that at 3 or more infections, the rate of Long COVID rises to 38%. 
Dr. Lisa Iannattone
@lisa_iannattone
Bill Comeau noted this page of the report. Almost half of sufferers aren’t getting better.
These aspects of the report were not been reported in today’s Toronto Star article about the study.
Global News piece on the report.
Edit: Link is working now
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