AwareofAware

AWARE II is not powered to validate an OBE

I am currently revising a chapter in my book on NDEs, and having reviewed some of the videos of Sam Parnia and the various presentations he has given, and the posters from AHA, I have come to conclusion that the AWARE II study is not powered to validate a visual OBE. Moreover, despite some enthusiasm over the patients in the AHA poster, I am not convinced that they are validated auditory OBEs. However, I am of the view that something has either already occurred or will occur, from this study, or another study, that will provide new evidence.

To my first point, and the title of this post. In autumn 2017 Dr. Parnia presented a slide showing current status of the study. In it he said that 300 patients had been included. This caused us considerable excitement as it suggested that he would have had a few hits if he had only included subjects in the way that I suggested on here after AWARE I. I realize now that this is not the case. This is the update from may 2019:

In the year since his March 2018 update there had been just under another 100 patients recruited. The target number  is 1500. They have increased the number of sites over 2019 and were aiming to complete recruitment by the end of this year, but with COVID, their attention for the next few months will be rightly on other things. These guys will be at the frontline, putting themselves at risk every day, and will have other things on their mind than AWARE II. However, it really doesn’t matter whether the results come this year, or five years from now, as I think it is quite unlikely now that we will see a validated visual OBE. Auditory OBEs I am not sure of, and will get onto in a moment.

So if you look at the flow chart you can see why I might be concerned that this study is not sufficiently powered to generate scientifically confirmed visual OBEs. Patients are included in the study if they have a CA and the crash cart with the kit arrives before resuscitation occurs. As Parnia has said, this in itself has proved a rate limiting step for the AWARE team due to lack of research staff, and the fact that many of the patients come round before the special cart arrives. However, and this was my aha moment as i was reviewing all the bits and pieces related to this, this is still the main inclusion criteria. Patients are still included in the study if they die before being interviewed, which was the reason why AWARE I did not produce any hits (as well as the targets being in a few specific locations).

In the AHA analysis presented in November 2019, the dataset used in the slide above was the one used as it had all the same numbers, with the exception of the number of patients interviewed, which was 22, although only 19 were counted for the data analysis. Going back to NDE stats, only 10% of CA survivors have NDEs, of these 25% have visual OBEs. If everyone who had an OBE saw the image on the ipad, then the chances of a visual OBE hit would be roughly 50% – 19X2.5%. Of course, we have often said that the chances of someone actually observing the image would be quite low, despite the position of the ipad, probably less than 50%. Therefore if you had 100 interviews from CA survivors you might get 1 or 2 visual OBEs (2.5/2).

Since Dr Parnia said they were intending to recruit 1500 patients, and in the May 2019 data they were a third of the way there, then going by their current rate, they will have about 150 survivors, and 60 interviews. In my view you would be very fortunate to get even one visual OBE from 60 interviews considering only 6 of those would have had NDEs, maybe 2 OBEs if you are lucky, and if you were super lucky one who saw the image. This of course would not be enough to convince even the most moderate skeptic.

When the number 1500 was originally announced, I assumed this would be 1500 who survived to be interviewed, other wise what is the point of including them in the study? With 1500 you could expect 150 NDEs and possibly upwards of 5-10 validated visual OBEs. Now I am seeing that actually the true objective of the study is possibly to look at EEG and oxymetry and determine what effects CPR have on this and the potential for Awareness. I wish I had a laptop made out of chocolate…I said I would eat my laptop if AWARE II didn’t get a hit based on the understanding that only patients who had been interviewed would be included.

To my second point, the auditory OBEs. Looking at the presentation in 2017, and picking up on other things that have been said, we only know that sounds were “timed”. Also, we don’t know if headphones were put in both ears. My feeling is that timed means they may have been playing intermittent sounds, and if that is the case, then they would have been able to hear the conversations in the room if they had sufficient oxygen to produce some consciousness. This last point relates to the second AHA poster in which it was postulated that in some patients CPR produced enough circulating oxygenated blood to produce EEG activity that might support consciousness. What has never been discussed by Dr Parnia, despite repeated requests for clarification, is exactly what is going with the sounds (i.e. would it have been possible for the patients to hear conversations or not) and whether there was any overlap between the 2 sets of subjects in the two AHA posters, and therefore the ability to correlate, or not, the ability to make auditory observations and the potential for consciousness.

It is very frustrating that these questions have never been cleared up. I have approached all the names on the posters, and I know that a couple sniffed around my LinkedIn profile, but no one has ever responded. I posed these questions at the November meeting, and they were ignored. As I have said, it is one thing being patient about the progress of the study given the restraints they operate under, but another to know that a burning question could be answered with currently available data. It begs the question why not? I have some thoughts on this, but won’t go into them here.

At the end of the day it may all be irrelevant though. As we have said countless times, Dr Parnia has stated unequivocally on numerous TV shows in recent years that the consciousness persists beyond death for at least a short while. He doesn’t say that we have evidence that it does, he just states it as fact, which makes me think he does have some evidence in his pocket. Also, I think that AWARE II may become irrelevant. The DHCA study, which is under controlled conditions, and possibly with prior consent from the patients, may be the one to watch, and may yield results much more efficiently, and therefore quickly than the AWARE II study…depending on how many of these procedures occur a week, and how many of the patients consent. They may even be told to look at the ipad! So if you had 3 of these procedures a week, and 60% consented to be involved, you would have 100 subjects in a year, which should yield 2-3 visual OBE hits.

Anyway, this may not be news to some here, and maybe I am a bit slow, but the penny only really dropped recently about the powering. Lastly , please be civil in the discussions…

Life has a case fatality rate of 100%

I received an email from Eduardo last week in which he echoed something that I had been thinking during this coronavirus nightmare which everyone has suddenly been engulfed by. He said that if Sam Parnia has any “informative” data beyond what he presented at AHA last fall, then now would be the morally right time to share it. The rationale for this is that many people are scared to death of this virus, and in fear of their, or their loved ones, lives, and that having more evidence that our souls, or consciousness, survive death would provide enormous comfort for millions.

I completely agree. My own personal faith, which arises from a number of things including a certainty that life was not due to a spontaneous natural process (as discussed in my book, DNA: The Elephant In The Lab), and my knowledge of NDEs, helps me put the 0.5-4% risk of dying from this bug in perspective. So too does the simple fact stated in the title of this topic. Whether you die a lonely “premature” death gasping for breath in a crowded field hospital in the next 2 months, or whether it is in your 90s gently slipping away surrounded by your children and grandchildren…you will die…and if there’s something “eternal” beyond, then that puts death at any time in its place.

In my book, Aware of Aware which I self-published in 2013, and which this blog is named after, I discuss this in detail and how knowledge of NDEs can help us in many ways in this life. (By the way, don’t buy the book, it is terrible, I am in the process of writing a new one). Here is an excerpt from very near the end:

“I know other scary things much closer to home. I work on treatments for HIV. I know that there is the potential for a virus to appear that could eliminate mankind. I haven’t even mentioned nuclear weapons or asteroids. Anyway, you see where I’m going. The human race could end tomorrow. For many people, and it could be you, life will end tomorrow anyway. Maybe the Being Of Light wants to give those of us left, a last ditch chance to get our spiritual house in order.”

I was going to delay the publication of my revised and hopefully much improved book on the evidence around NDEs until the AWARE study had indisputable proof of verified OBEs, but I have decided to go full steam ahead now. My reasoning for this change of plan is partly due to what I just said, namely that I believe it is important that people should be thinking about these things today. I hope that the perspective I have gained from following this subject for years provides insights that may benefit the lives of others now…and for some that may be important. The other reason is related to the whole chloroquine issue.

Now, I am not going to get into too much detail here, and definitely don’t want to enter a debate or discussion about it. The reason I bring it up is due to the reasoning process which is related to the NDE subject, as you will see.

Given there a number of different studies, albeit small non-randomized single cohort studies, combined with very positive in vitro data, and an announcement that the Chinese found Chloroquine to be significantly better in reducing symptoms and presence of virus than standard of care in 100 patients vs controls, and that as a result they would include it in their COVID-19 treatment guidelines, I am inclined to be more optimistic than pessimistic about the prospects that this drug holds. For those who don’t know, I have a Ph.D. in medicinal chemistry from the 1990s in which I designed anti-viral drugs. I also spent a significant chunk of my career in virology and anti-infectives, so I have seen new treatments emerge over the years for various conditions, and sometimes the early signals showing promise for new indications of existing medications take a similar path to the one we are witnessing with chloroquine. Also, in such circumstances, as you do now, you see the research and medical community divided equally.

Some are early adopters and see the potential and run with it, especially when there are no other options. They would even feel that they would be negligent if they didn’t. Others need data from large randomized double blinded multi-center studies before they will risk a new treatment on their patients. There is no absolute right or wrong in this until we know for sure. It may well be that chloroquine doesn’t work, but if I was a doctor, I would be prescribing this for my patients given what data we have, the lack of alternatives, and the good understanding we have of its safety profile. What is there to lose by doing it, provided the side effects are understood? (I strongly advise against self-medicating chloroquine for treatment of COVID-19 – used at the wrong dose can result in serious, and even fatal side effects. All use should be under the guidance of a qualified health care professional)

With NDEs we are now in a similar situation I believe. We have thousands of accounts of NDEs and OBEs from credible people, many of which have been verified by equally credible health care professionals. We also have a number of peer reviewed studies looking at retrospective accounts. We also have a small number of prospective studies (3 now I believe) in which OBEs were verified by health care professionals in the study. For the “early adopters”, like myself, this is enough. What have you got to lose by believing this stuff? You will live life without fear etc and actually be excited at the prospect of what lies ahead. Refusal to believe may have negative impacts on your spirituality though.

AWARE II has always promised to be the study that tips the balance of evidence. If it had any scientifically verified OBEs, either auditory or visual, then it really becomes irrational to remain skeptical when combined with all the other evidence, just like if another respected doctor comes forward with even better cohort data in the next week or two about chloroquine. This would be important for many people.

I believe that the AHA data does contain scientifically verified auditory OBEs in which patients who couldn’t possibly have heard what was going on in the room because they had headphones playing music AND had no EEG/oximetry data to support the presence of consciousness, did hear documented discussions. However, despite multiple requests from myself and others for clarification on this issue, Dr Parnia had not responded with answers that he surely must have.

I have enormous respect for Dr Parnia…huge huge respect. I have sent him yet another message, via the research portal this time, asking for some clarification on this, and whether there are any other cases of interest. I know that at this time he will be overwhelmed with work in New York City, very very important work, but I believe that it is actually more important for humanity that if he is sitting on any significant data that he shares it sooner rather than later. I know he asked us to be patient, but there are limits.

Anyway, whether or not he responds to my plea for clarification on the AHA data, I will be pushing ahead with my book, and my next post will contain a link to a chapter that I would love people here to read and help me refine. Probably late April or early May

Avoiding an Actual Death Experience

I know this is outside the normal scope of my blog, but given that thousands of people visit this site each month, and that I wish the best for everyone, I want to share my thoughts on what I believe is the truth about the Covid-19 virus, and what should be done by you to protect yourself. It may be that one person reading this doesn’t get infected because they did, and so it will be worthwhile.

I believe that unless radical action is taken, or we get lucky, we all currently have a probability of between 0.1 and 2% of dying in the coming months. Even 0.1% is much higher than it would have been but for the emergence of Covid-19. This statement is based on what we know from China and how national governments are failing to learn from the mistakes of the Chinese Communist Party.

As many on here will know, I have a Ph.D. in medicinal chemistry and I have spent years interpreting clinical data on infectious diseases. My early research focused on developing anti-virals for HIV and Hepatitis, and I have spent much of my subsequent career working in virology or anti-biotics. I also live near the UK’s ground zero for Covid-19…Brighton. My wife works in a busy clinic less than half a mile from where the Brighton super spreader lives. One of my closest friends was on the same flight as the Brighton super spreader from Geneva, so thoughts about this virus have been urgent for me, and these are the conclusions I have drawn, and the actions I believe you…whoever, and wherever you are in the world, need to take to reduce your risk of actual death.

Firstly what we know…the facts:

1. Covid-19 is highly infectious. It’s R0, the number of people an infected person infects is at least 2, but maybe as high as 3 or 4. This is more infectious than seasonal flu and without controls will result in the majority of the planet being exposed within a year. On Thursday 13^th February a special adviser to the WHO said that 60% of the global population may become infected.
2. Covid-19 has a high complication rate, between 10 and 20%. these complications are mostly severe respiratory in nature. With proper healthcare, the majority of cases resolve, but in those that don’t, the patient will die. The current case fatality rates, according to research from Imperial College in London, is between 0.5 and 4%. Seasonal flu is about 0.02-0.05%% by comparison. The time to death from first symptoms can be up to a month, as was the case for Dr Li, a healthy 30 year old, whose warnings could have spared the world from this looming catastrophe if they had been heeded.
3. Most importantly is that Covid-19 has an asymptomatic infectious phase of anything from 1 to 14 days, or possibly in rare cases, longer. This means that infecters are completely indistinguishable from non-infecters, and could, theoretically, be anyone you are in contact with.
4. China has risked a financial, political and social crisis by locking down many of its major cities in response to what they know about this virus.
5. The Chinese data is not reliable.

Crucial things we don’t know:

1. The mode of transmission. Droplets definitely, but what about aerosol? We don’t know for sure at this stage. Knowing this will determine exactly how we protect ourselves from this virus…the measures we need to take.
2. The actual case fatality rate (CFR). Is it <0.5% or is it 4% or more? Knowing this will determine to what extent we need to act…individually and corporately as a global society.

Until these final two factors are fully characterized, which will take a few more weeks, given what we have observed in China, and what we know, we should act as though it is on the worse end of the spectrum now. Government bodies, like Public Health England (PHE) and CDC, are not doing this at the moment, but you can do things yourself at low personal cost to minimize your own risk.

So back to the data and observations. This is my take on what has happened in China.

They are in shock. The whole society has been completely caught out. While they are being less than honest, the data they have been producing is not technically a lie, but I (and some at the WHO) believe from what we are seeing, that it is just the tip of the iceberg. This is what I believe has happened:

The response to Dr Li’s warnings is the root to all of China’s current problems, and before long, the rest of the world. However, looking at the way that PHE are acting for example, and they know more than the Chinese authorities (CCP) did 2 months ago, our own authorities are no better. While the Wuhan authorities had the opportunity to kill the virus shortly after birth, and didn’t, so our own health authorities and governments, through radical action, could severely reduce the rate of spread, buying us more time, and potentially saving many lives. But like in Wuhan 2 months ago, they aren’t.

Up until about 3 weeks ago the Chinese authorities were able to produce what they thought was reasonably accurate data, but due to one factor, they were caught out – the long asymptomatic infectious phase and the large number of non-serious but infectious cases, and I believe it is fooling our own health authorities today.

Three weeks ago the Chinese thought they were dealing with a virus on the scale of thousands, but due to the silent carriers it was in fact tens of thousands. Then about 2 weeks ago the whole thing exploded in their faces. Suddenly they reached the limit of their PCR (genetic) testing capability. They were seeing thousands of people getting sick, possibly tens of thousands, and maybe thousands dying. I believe they suddenly realized that their testing data was possibly out by a factor of 10 as they had only been capturing symptomatic patients. Looking around, and with no actual idea of numbers, but a realization they were huge, they hit the panic button. They shut down Wuhan first, then the rest of the province and now these lock-downs are extending into places like Shanghai and Beijing.

Up until Thursday morning they were still pumping out the PCR numbers, but while these weren’t lies, I believe they are only a sample of the true picture due to limitations in the amount of tests. Then we had the spike yesterday. They added a few days’ worth of clinically diagnosed cases through CT scan and chest X-ray. This has thrown everything out of kilter. Organizations like PHE and the WHO had been blindly trusting the PCR data, but now suddenly they were told the infection rates were higher by a factor of at least 50%. They are still blindly taking this new data at face value, but it is again not accurate. Just like PCR testing has a limited bandwidth, so too does clinical confirmation by CT scan. In the west, your local primary care clinic does not have a CT scan. In most countries it doesn’t even have enough doctors to treat seasonal flu effectively. To perform and interpret one test requires time and the work of highly trained professionals. Moreover, those getting a scan are probably very ill, and only a small sample of those infected have had these scans.

The official numbers, even now, I believe are hopelessly wrong. The Chinese authorities know this but for a number of reasons are not speaking about it. The first reasons are cultural. The Chinese are very proud, and they are desperate to hide the implications of this whole episode – the combination of incompetence and ineffectiveness that lies at the heart of the communist government system (currently being replicated by our own governments).

The second is political. The communist party must been seen as being in control, and it clearly is not. Once the façade of control slips, the belief in the all-powerful nature of the CCP will fade and become challenged, this is what they are most scared of…more than a financial crash.

Thirdly, they are not technically lying. They genuinely don’t know the true extent of the numbers of infections, or the number of deaths, so they are choosing to only report to the rest of the world their official statistics. They aren’t lying, but they are not being completely honest. But their actions, and the reports from citizen reporters do point to the full story.

YOU DO NOT PUT 400 MILLION PEOPLE IN LOCK-DOWN UNLESS YOU HAVE SEEN SOMETHING TERRIFYING.

They may not be able to precisely quantify the nature of TERRIFYING, but they would not take such extreme measures unless they had a very real sense that it was massive and deadly.

In the absence of official information on this, we are left to rely on the YouTube videos that the likes of bureaucrats at PHE etc dismiss as conspiracy theory nonsense as they continue to follow the data produced by the CCP. In these videos you see people saying that crematoria have been working 24/7 burning tens of thousands of bodies. People are going into giant government hospitals, and not receiving any care…they are effectively death camps. Hundreds of millions of people are still forcibly locked inside.

From these observations, I believe it is sensible to conclude that the answers to the key unanswered questions…the way this disease is spread – droplet vs aerosol, and the mortality rates – low vs high, are not particularly reassuring. As a result, until we know these answers for sure, or we get lucky and the spring kills it off, or find effective licensed anti-virals etc, we should do the following.

Corporately:

1. Countries should in effect go into external lock-down. This may be too late for some countries as the disease has established a beachhead (in the UK quite literally on a town with a famous beach), but not too late for others. By stopping all but essential international travel, you will massively reduce the rate of spread. I personally have skin in the game. I am due to go to New Zealand later this year, and will go, with a mask, if I am allowed, but I think we shouldn’t be allowed.
2. Public Health bodies should be much more urgent in their warnings. The idiot mayor of London Sadiq Khan was reassuring people that it was safe to travel on the tube yesterday. He said he was basing that advice on PHE guidance. That is wrong. At the moment, it may be relatively safe to travel on the tube due to the low incidence of Covid-19 infection in the UK, but because we don’t know how many have it, how easily it is spread and the death rate, and because of the asymptomatic infectious phase, we are unable to quantify just how safe it is to travel on the tube.
3. Areas with known cases should go into some kind of proportionate lock down. Pubs and restaurants closed. Shopping times allocated etc. Public transport limited to all but health care and other essential workers.

The advice from authorities should be honest. We don’t know exactly how bad this could be, and until we do, depending on your appetite for risk, you may want to consider severely reducing your person to person interactions, whether it be social, work or on transport. In addition you should be applying rigorous measures to avoid transmission when in public…hand washing, avoid touching others, and surfaces which others may have touched. Schools should be closed very soon, and in places like Brighton…now! Work meetings should be held remotely. Etc etc.

That should be the advice governments are giving until we know things aren’t really that bad.

Given the unknowns, this all makes complete sense. Now if the CFR is nailed down, and it is below 0.5%, we may decide that is a risk that we can live with to avoid economic collapse, because make no mistake, that is why governments are behaving like the mayor of Amity did in Jaws. He kept those beaches open so the tourists would keep coming, and bring their dollars, and get eaten by the monster. Our governments led by Trump, by Boris, by Xi are all precisely the same…as are we to an extent…I would be prepared to take on a small defined increased risk of death to avoid becoming impoverished, however at the moment that risk is not clearly defined, and could be much higher than we are prepared to tolerate. Our governments are taking an undefined risk with our lives to preserve the illusion of economic well-being.

You however, can choose to take you own measures:

Reduce person to person interactions

Take sanitation measures to avoid exposure to infection

Keep healthy to boost your immune system – sleep and eat well.

Or you could do nothing, hope we get lucky and avoid the bullet that has hit China between the eyes.

Please share this post if you feel this is fair analysis of the situation and sensible advise. Thank you for allowing me to side track our great discussions here. Also, if you want to read a great thriller about deadly viruses with asymptomatic infectious phases, then buy the book Deadly Medicine by Orson Wedgwood:

Deadly Medicine US Amazon link

Happy New Year! Will it be more of the same, or will this be the year the scales tip.

I hope you all had a nice Christmas, and I wish you a Happy New Year.

Last year finished with the tantalising presentation of data by Dr Parnia at the American Heart Association. It was the ultimate tease in my view and gave food for believers and sceptics alike. I don’t wish to reopen the discussion again after over 200 comments in the previous post, but its fair to say that that Parnia Giveth and Parnia Taketh away. On the one hand we had 4 instances of patients hearing things while they were being resuscitated, offering the potential for scientifically verified NDEs (or TEDs…more on that in a minute), and on the other we had data showing that there may have been sufficient brain activity in an undisclosed number of patients that could support consciousness.

I have tried to contact Dr Parnia and other authors on the abstracts, but have not received any answers to my questions on how the auditory experiments were conducted or whether there is any correlation between the reports of subjects hearing real world events and these signs of brain activity. We are therefore none the wiser on the implications of the findings the Parnia team presented. They know, but are choosing to sit on this.

We can speculate, as we have done for many years. We can say that he must have hits because of the way that he commits to the position of the consciousness surviving physical death. However, this is just speculation, and while those who believe have nothing to undermine those beliefs, neither do we have anything new from a meaningful scientific standpoint with which to challenge materialistic orthodoxy. The one thing I hope from this year regarding this subject, is that this state of affairs will end. I hope that Dr Parnia either presents further analysis from the two abstracts shedding light on whether there is overlap between the two subsets of patients (or hopefully that there is no overlap), or that we finally have a verified visual iPad hit.

In the meantime we have a new piece of research presented by Dr Parnia that says more about how he may be trying to reframe the whole subject, than it does about anything else (thanks Eduardo).

Latest Parnia abstract

The findings are not in themselves earth shattering. They describe various NDE like experiences of patients who have been in the ICU, and the potential benefits on the mental well being of these patients. Like I said, nothing new there. What is of note though is the attempt by Parnia to once again change the core terminology of the field. Instead of NDE he uses the term Transformative Experience of Death (TED). As Eduardo asked me in his email…what is he playing at? Why is he doing this? My gut feeling is that he is trying to move the field out of the UFO/paranormal/kook category, which NDEs are unfairly lumped in with, into an area of genuine clinical research in which these experiences that people have at the time of death are examined from a medical perspective, rather than a philosophical one. This may or may not work in terms of allowing the subject matter to become more acceptable to mainstream clinical researchers. Time will tell.

Another shift in terminology is that rather than describing OBEs as OBEs, the language used is subtly different…although the same thing. The percentages in this sample of subjects experiencing an OBE were very high (83%). If only the AWARE study had similar results!

Let’s hope 2020 will be less frustrating than 2019, 2018, 2017, 20…