COVID19 update, June 7, 2020: Do-it-yourself COVID-19 tests found to be more accurate as well as comfortable; Israeli study confirms protective effect of smoking?!; “half of colleges may close in the next 5-10 years”

(1) Via Instapundit, a popular writeup of a study that found samples acquired by the patients themselves were more accurate than the usual deep nasal and pharyngeal swabs, and not just more comfortable. Besides, they are less likely to expose healthcare personnel, as deep sampling often causes sneezing, coughing, and gagging.

I should perhaps clarify here that the accuracy-limiting factor of RT-PCR testing, at this point, is not the testing apparatus at all (with lab-prepared samples, accuracy approaches 100%) but the sampling technique.

 

The original scientific article about the study was published in the New England Journal of Medicine: http://doi.org/10.1056/NEJMc2016321

Here is an animation of how, once the sample has been acquired, RT-PCR testing works in the lab.

 

(2) There were several reports that, counterintuitively, smokers were underrepresented among COVID19 positive cases. Now in https://www.medrxiv.org/content/10.1101/2020.06.01.20118877v2.full.pdf is an intriguing large-sample study from doctors associated with Clalit Health Services, the largest HMO in Israel which has about 3 million patients in its central database. [Full disclosure: we are insured through a competitor. All four authorized HMOs operate such databases—unlike with Surgiscape, I have every reason to believe these data are kosher.]

As of the cutoff date (May 16), over 145,000 adults insured with Clalit underwent RT-PCR testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2),  3.3% of which tested positive. After discarding cases aged under 18 and over 95, as well as those where it was unknown whether they smoked or not, the authors were left with 4,235 positive tests and 124,192 negative. Out of the latter, they randomly selected a control sample of 20,755 patients (5x as many) that matched statistical make-up of the positive sample in terms of gender, age distribution, and ethnosocial group — Jewish Orthodox, Arab, General(mostly Jewish non-Orthodox).

Guess what: Statistically, 9.8% of the  COVID19 positive cases smoke currently, one-half the percentage in the control group 18.2%. Because of the large sample size, p<0.001, i.e., the probability that this result could have arisen from “the luck of the draw” is less than 0.1%. There was no significant difference for past smokers (11.6 vs. 12.9%) — it’s definitely got something to do with current smokers (nicotine or some other component of tobacco smoke).

Of the COVID19-positive tests, 1.8% deceased, 2.0% hospitalized in severe condition, 4.0% in moderate condition, 15.0% in mild condition, the remaining 77.2% did not require hospitalization. There was no significant correlation between the degree of severity and the patient’s smoking status.

Changeux et al11, relying on similar observations, propose a crucial role for the nicotinic acetylcholine receptor (nAChR) in COVID-19 pathology. According to their neurotropic hypothesis, SARS-CoV-2 invades the central nervous system through the nAChR receptor, present in neurons of the olfactory system, as reflected by the frequent occurrence of neurologic symptoms, such as loss of smell or taste, or intense fatigue in patients affected by COVID-19. Other mechanisms may also affect SARS-CoV-2 infection potential in smokers. It is widely accepted that the angiotensin converting enzyme 2 (ACE2) represents the main receptor molecule for SARS-CoV-2, and smoking has been shown to differentially affect ACE2 expression in tissues12–14. Other putative explanations could involve altered cytokine expression such as IL-6, for which increased levels are associated with unfavorable disease outcome14,15.

 

 

(3) Business school professor admits that as many as half of tier-2 colleges will be gone in the next 5-10 years. This was a bubble waiting to burst anyway: the COVID-19 crisis and the attendant shift to online learning is just precipitating the burst, the way Amazon and online shopping more generally were the downfall of many a brick-and-mortar store.

(4) This is the sort of behavior that makes me cringe in embarrassment for my profession. True scientists follow the facts wherever they lead, and seek the truth wherever it may be found. Political hacks exist in every profession — but they are especially grating in ours. And when the public loses all faith in us because of such politicized hacks, it will be blamed on “anti-science” and anti-intellectualism.

 

Why you don’t want professors ruling you

The late lamented William F. Buckley famously quipped that he would rather be governed by the first 500 people in the Cambridge, MA phone directory (i.e., a random sample) than 500 Harvard professors. Stuart Schwartz, himself a professor, explains at some length why. Welcome to the club of “traitors to the New Class”, Stu.

This is an administration stuffed with academics. And not just any academic: These are educators from elite universities, the kind of experts prized by a political and media elite seeking confirmation of a worldview that expects, notes the Washington Examiner, “the rest of us … to shut up and do as we are told.”

Inside the Beltway, “Harvard know-it-allness” is a prized commodity; outside, its practitioners are largely regarded as “obnoxious and arrogant” in the classroom and “jaw-droppingly incompetent” out of it. Small wonder trust in government has hit a fifty-year low.
Welcome to government by professor. Assorted faculty of Ivy League schools have come together to form an administration with the least real-world and most academic experience of any in modern times, the American Enterprise Institute notes. And so we have a government of scolds, lecturers, and bullies, arrogant academics cheered on by mainstream media when they take a “paddle” to average citizens and taxpayers.
Main Street, say hello to Harvard Drive, Chicago Place, and Berkeley Boulevard. The latter are roads that begin in the elite universities and bring “someone better than you” to power in Washington, D.C. Or so says the dean of the School of Law at the University of California at Berkeley, a card-carrying member of what David Brooks of the New York Times fawningly calls “the educated class.”
It’s okay to be ordinary, a “swiller of beer,” Berkeley Dean Christopher Edley, Jr. says, but it takes a “superior intellect” like that of Barack Obama and his taxpayer-paid faculty, Ivy Leaguers most, to understand the needs of Main Street.
The dean well represents the arrogance of an educated class who sees the ordinary taxpayer as raw material to be shaped by regulations wielded by their intellectual superiors, as one of those superiors — Obama regulatory czar Cass Sunstein — has written.
Smart people lead and ordinary people follow, Dr. Sunstein maintains, showing the common touch developed during a lifetime on the law faculties of the University of Chicago and Harvard. He is part of a new breed of executive gathered by the [wannabe-]Professor-in-Chief, all of whom share the view that Joe the Plumber and Millie the Hairstylist are too simple to understand their real needs…and require a federal government led by an educated elite to regulate them into appropriate behavior and values.
Ordinary taxpayers, those who simply live life and take up space in the world outside of the faculty lounge…well, it’s about time they recognized that, as the Berkeley dean noted, “what’s good for Harvard and Yale [is] good for America.” […] It may take a village to raise a child, but it takes a Harvard Ph.D. to raise the consciousness of a nation of village idiots.
And so they gather in Washington to “reengineer” your life according to the “abstract theories” they have taught for so many years, as political observer Michael Barone put it. Witness the latest addition to the administration’s professorial ranks: Dr. Donald Berwick, the Harvard Medical School professor picked to head the Medicare program. Of course, his knowledge of senior health care is academic, having never actually treated seniors.
But he has consulted for National Institute for Health and Clinical Excellence (NICE), the infamous British rationing board that is responsible for killing more ailing seniors through long waits and treatment denials than any single disease in the United Kingdom. […] With classic understatement, Thomas Lifson noted that the “skill set of the faculty lounge rarely translates into great leadership.” He points to the nation’s last professor-president, Woodrow Wilson, who “paved the way for the emergence of fascism” at the beginning of the last century.
Where professors rule, life is cruel. Elite professors have routinely championed thugs and butchers. Ivy League campuses and at least three of Obama’s czars continue to extol the virtues of communism, “a totalitarian and bloodthirsty theory that killed one hundred million people in the 20th century.”
And Nazis and Nazi sympathizers have always found a home among our nation’s educated elite. Just this past month, Dr. Stephen H. Norwood of the University of Oklahoma published what critics are calling the definitive study of the relationship of America’s elite universities with the Nazi. In The Third Reich in the Ivory Tower: Complicity and Conflict on American Campuses, Norwood is blunt: Our top universities, led by Harvard and Columbia, openly supported Nazi Europe and gave faculty jobs to Nazis who were no longer welcome in Europe after the Second World War.
[…]”Hail the Conquering Professor,” the New York Times proclaimed after passage of health care legislation that takes life and death decisions away from Main Street and empowers the White House faculty lounge. This is the elite group that has given the nation its highest unemployment in three decades, an “ever-expanding government” with exploding payrolls, and who has created a “debt time bomb” threatening the prosperity and freedoms built by generations of “beer swillers” over more than two hundred years.

Read the whole thing. A summary of the Stephen H. Norwood book (published by an obscure bloghost called Cambridge University Press ;-)) can be found here. I ordered the book itself and (G-d willing) will find time to review it upon reading. What I managed to skim via “look inside” looks pretty revealing — and damning, even for somebody broadly familiar with US academia in the 1930s.

Some readers may wonder why humanities academics, of all people, would succumb to flirtations with antidemocratic or post-democratic ideas, be they authoritarianism, its softened guise of paternalism, or its hardened expression as totalitarianism. I do not share this surprise. Humanities academics deal in ideas, and becoming intoxicated by ideas is a professional hazard for them. (Those of us in sciences and engineering may be equally open to intellectual delusions of grandeur, but at least get reminded periodically that “Nature cannot be fooled”, as the great Richard Feynman put it.) The tragicomic history of academics being outright apologists, or mere “useful idiots”, for Communism, Nazism, and now islamofascism should be a cautionary tale for all of us, including about the much broader phenomenon of academics feeling affinity with the “kid-glove tyranny” of transnational oligarchic collectivism.

ADDENDUM: On a related matter, Isi Leibler explains how, sadly, even Israeli universities are not immune to antisemitic academentia (or should this be properly considered an “autoimmune disease” in that specific case?)