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Ebola Is Now Curable

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Re: Ebola Is Now Curable

#141

Post by Dylan16807 »

Medicalidiot wrote: post #118
Dylan16807 wrote: post #83

Earlier quoted context omitted.

For a resistance to develop, ebola that has been exposed to the treatment inside a hospital has to escape back into the wild. There are significant barriers in the way of that. If everyone on penicillin was kept in an isolation chamber, the effectiveness over time would be different.

As someone who works in a hospital, we can bleach every single patient room, wear all the PPE we want, but pathogens will always spread; the only question is when, not if. Even in an isolation chamber a resistance to penicillin would develop independently of each other as penicillin resistance is usually predicated on a mutation in the penicillin binding protein.

Nothing's perfect, but ebola levels of paranoia drastically slow down any chance of spread.

While partial resistance can be encouraged in a single person, that doesn't matter if it dies inside them. And if a resistance mutation happens in the wild, away from drugs, there's no reason to expect it to spread at all.

Re: Ebola Is Now Curable

#142

Post by firethief »

billpg wrote: post #92
ladon86 wrote: post #67

I really have to apologize if this is not a HN-quality comment, but I initially read this as a startup rebrand announcement. Ebola is now Curable (YC 17)

I did that too. "Who the f... calls their business Ebola?".

Actually, the electronic bola industry has prospective revenues coming out the wazoo

Re: Ebola Is Now Curable

#143

Post by parasubvert »

hanniabu wrote: post #115
IfOnlyYouKnew wrote: post #53

Earlier quoted context omitted.

It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. And contrary to popular belief, they tend to be competent enough to at least cope with the sort of hair-brained schemes HN believes would fool them.[0] Stopping a trial early and it's statistical implications should, by the way, be somewhat familiar with web developers: it's commonly do…

> It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. Considering how much money is in pharmaceuticals, I'd definitely go with corrupt, especially considering this explains how a majority of the world works now and also since there's currently an outbreak and likely want to capitalize on it. I'm not at all saying this is the case, but th…

The issue with cynicism and corruption conspiracy theories is that they become a self-fulfilling prophecy.

If everyone is corrupt, then it’s OK if you are, etc.

There is no fair application of the rule of law, there’s no reason for rule of law, only the rule of men. Better hope they’re on your side!

My point is that clear corruption as we think of it (fraud, bibery, self dealing) in most Western countries is NOT considered normal. Ie. It happens but we’ve built institutions to counteract it. The FDA is notoriously bureaucratic in order to detect and prevent corruption, and for the few cases to slip through, to correct it.

When you hear about corruption stories, that’s about the system WORKING against those cynics that are testing it for their own benefit.

Cynicism is self destructive. If our institutions are broken, we must work to repair them.

Re: Ebola Is Now Curable

#144

Post by freewilly1040 »

Retric wrote: post #19
bifrost wrote: post #2

This is awesome that we've seen another horrendous disease go from incurable to curable in my lifetime. While ebola hasn't touched my community like AIDS/HIV has, reading this cracked my RBF and I smiled.

A 6% to 30% fatality rate depending on how early the treatment is not what I would call a cure. However, at best 6% fatality rate is still huge progress.

30% is still huge progress!

Re: Ebola Is Now Curable

#146

Post by gus_massa »

pvaldes wrote: post #95
gus_massa wrote: post #59

Earlier quoted context omitted.

> Ebola is a plant's virus adapted to trees. I never heard that and I can't find that in Wikipedia. Do you have a link with more information about that?

Is a plausible hypothesis. As we all know viruses do not fosilize easily, the origin of the virus is unknown (apart that is linked with tropical forest canopies in Africa). But there are several traits that would suggest a plant patogen that jump later to animals, maybe via plant sucking arthropods, and stablish later in bigger animals eating this arthropods. I could be wrong, I don't remember when I read it, but I r…

If you ever find a source for the virus for plant origin, I'd like to read it. (I'm not a biologist, but I'm curious. For example, I know about the relation with the Marburg disease.)

Re: Ebola Is Now Curable

#147

Post by laughinghan »

TeMPOraL wrote: post #120
IfOnlyYouKnew wrote: post #53

Earlier quoted context omitted.

It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. And contrary to popular belief, they tend to be competent enough to at least cope with the sort of hair-brained schemes HN believes would fool them.[0] Stopping a trial early and it's statistical implications should, by the way, be somewhat familiar with web developers: it's commonly do…

> Stopping a trial early and it's statistical implications should, by the way, be somewhat familiar with web developers: it's commonly done with A/B tests AFAIK stopping an A/B test early is the way to go if you want to convince yourself (or your customer) that something has an effect, even though it hasn't.

Yes, if you "peek" at the results of an A/B test before it's done in order to decide whether to stop early, the numbers you "peeked" at have much lower statistical power than if you foreswore stopping early. Obviously, failing to take that into account when drawing conclusions about the effectiveness of the treatment is a colossal mistake.

However, the decrease in statistical power is still quantifiable, and with the right math you can still calculate an accurate 95% confidence interval on the effect size (which will be much wider than the wrong math where you naively don't account for the "peeking"). And of course, it's totally possible that the treatment is so effective that even the accurate calculation shows that the lower bound on the effect size is so much higher than the control group that the responsible thing to do is to stop the trial early.

Here's some the math on how much lower the statistical power is if you "peek": https://www.evanmiller.org/bayesian-ab-testing.html

Re: Ebola Is Now Curable

#148

Post by aflag »

jraph wrote: post #104
bigend wrote: post #68

So how many people ebola ever killed? Compared to, for instance, cancer or traffic accidents?

If you are making the point that we'd better address cancer or traffic accidents, then your argument falls under the false dichotomy fallacy. This is probably why you've been downvoted. If your were not making this point, then I don't have the answer. :-)

Besides cancer numbers are a bit inflated because people are living more now. If you live long enough the odds of getting cancer is quite high. Whilst it's always good to extend life even more, even if it was a dichotomy, that seems less pressing than a diseases that are killing in their prime or even before they had a chance of having a good go.

Re: Ebola Is Now Curable

#149

Post by panopticon »

IfOnlyYouKnew wrote: post #53
jcranmer wrote: post #43

Earlier quoted context omitted.

Actually, it's quite terrifying when you remember that stopping a clinical trial early is a great way to create statistical fraud. https://blogs.sciencemag.org/pipeline/archives/2019/08/08/st... cites an example of a drug whose clinical trial was stopped early due to obviously effective success... only to discover later on that the "obviously effective" was a statistically spurious event, and the drug did not confer…

It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt. And contrary to popular belief, they tend to be competent enough to at least cope with the sort of hair-brained schemes HN believes would fool them.[0] Stopping a trial early and it's statistical implications should, by the way, be somewhat familiar with web developers: it's commonly do…

> It's only a "great way to create statistical fraud" if you assume that the statisticians, and the FDA, are either stupid or corrupt.

This is a legitimate issue in the scientific community. The FDA made it a requirement to publish drug trial criteria beforehand to prevent trials from stopping prematurely or adding more participants. This resulted in a massive drop in drugs with positive results: "...before the registry was created, more than half of the published studies of heart disease showed positive results. After the registry was created, only 8 percent had positive results". [0]

The FDA and scientific community isn't as "pure" as your flippant dismissal would suggest. The FDA can only do so much, and trial runners have misaligned incentives.

[0] https://www.npr.org/templates/transcript/transcript.php?stor...

Re: Ebola Is Now Curable

#150

Post by Medicalidiot »

Dylan16807 wrote: post #141
Medicalidiot wrote: post #118

Earlier quoted context omitted.

As someone who works in a hospital, we can bleach every single patient room, wear all the PPE we want, but pathogens will always spread; the only question is when, not if. Even in an isolation chamber a resistance to penicillin would develop independently of each other as penicillin resistance is usually predicated on a mutation in the penicillin binding protein.

Nothing's perfect, but ebola levels of paranoia drastically slow down any chance of spread. While partial resistance can be encouraged in a single person, that doesn't matter if it dies inside them. And if a resistance mutation happens in the wild, away from drugs, there's no reason to expect it to spread at all.

There's a significant amount of fake news around the Ebola outbreak epicenters, such as aid workers trying to take people's blood and other conspiracy theories. We have to keep in mind some of these places recently had a genocide and/or are generally unstable.
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