That's why frightening people with news stories is so harmful.

I can't say "no it is definitely wrong".

But only in the same way as I can't say "there is no Loch Thames monster".
Just because something is strictly speaking unknown and indeed *unknowable*, does not mean that it should be treated as having a 50 50 probability.

That is a recipe for going back to the dark ages.

"She could be a witch!”
"Or she may not be"
"Well let's just be safe..."
Sophisticated point here.
However, the danger is that while @MichaelPaulEdw1 might be clear on how to interpret the "don't know", a great many other people clearly have zero idea on what "don't know" means.

My evidence is that they write detailed articles about the "don't know".
The articles treat the "don't know" items as worthy of general attention and public concern, when in fact they are not.

No more worthwhile than writing that the Loch Thames monster might get bored of its fishy diet and climb out one night and eat me in my bed.
Strictly speaking, I don't know whether that may happen.

But science gives us a framework to decide which things we should ALL worry about, and that helps us not be like medieval villagers terrified of every unknown thing.
Of course individual scientists will worry about individual things, and conduct experiments to see how important they may be.

Each scientist picks a thing that they INDIVIDUALLY suspect may be important.
Across the millions of scientists the world possesses, most things will be looked into, by quite a few people.

They will communicate their findings once they have some. Importantly, they will communicate their REASONS for studying their topics.
There are uneducated observers who mistakenly believe that scientific knowledge comes from the speculation of scientists. They believe that enunciation of a REASON to study a topic, is identical to a promise of doom.
So when Eike Nagel says he "believes that many people may develop heart failure from Covid", I know what he means, because I have had the good fortune of a scientific education.

He means that this is the hypothesis he is testing.
Nothing wrong with testing the hypothesis.

Just like 1000 other scientists are testing other hypotheses about other actions of Covid.

Almost all will turn out in the end with the answer "no".

That doesn't make it a mistake to test them.
The mistake is for people who cannot distinguish between a scientific hypothesis and a scientific conclusion, to write - in magazines or on Twitter - that people's hearts are dissolving into mush.

It's frankly embarrassing for a species that has sent people to the moon.
Good points here.
I am not ready to say that we have over-reacted. At the time the decisions had to be made, we knew that the virus was VERY highly infectious, with R0 around 3.8.
Italy had hospitals so overflowing that, as one of my Italian colleagues reported during the crisis, "People are having a cardiac arrest and the anaesthetist doesn't even come. I don't mean they don't come to assess for ITU. I mean they don't routinely come to the arrest."
My colleagues and I were terrified that the same would happen in London.

I was VERY happy when the government ordered the lockdown (and long before, I had put my elderly family into personal lockdown, as I don't want them arresting in hospital with no anesthetist attending).
From the looks of it, New York had a major battering, but didn't overflow like Italy.

I am absolutely delighted that most of our governments locked down, rather than having overflowing hospitals and people left to die without normal medical care.
Maybe in the fullness of time we will find out that a much more limited lockdown, or no lockdown, would have still kept us out of the overflowing state.

People mention Sweden getting away with it. I haven't looked into the details, but clearly Italy did not get away with it!
Even if in years to come our mathematical models show that perhaps we could have had less, or no, lockdown, and somehow gotten away with it, I am still glad that the government ordered the lockdown, because they had to make a decision in a time of uncertainty.
We must judge their decisions like we want our own medical decisions judged, in light of the information available *at the time*, and the time available to process, sift and decide on the priority of the various pieces of information which likely point in all different directions
Social media helps in one way. It helps get the message out to do the social distancing / masks etc.

If complete social distancing had been possible, the virus would be gone within a couple of weeks. However it is not possible.
So now that we have gone past the need for consciousness-raising, you're quite right that much of what is spread on social media is unhelpful.

(a) The continuous leapfrog of panic-beyond-panic

or

(b) Covid denial. "I had Covid and it was mild. This fear is all a big hoax."
I blame the engineers and the entrepreneurs.

It is they who have saved the most lives over the last few hundred years.

By building better housing, water supply, sewage, electricity etc.

And organising us to be more efficient and therefore have a better quality of life.
We doctors have played a small part, through vaccinating away measles, mumps, rubella, diphtheria, polio and pertussis.

The population has FORGOTTEN what it is like to have epidemics and pandemics.

Since there hasn't been one in living memory.
As a globe, we know how to deal with a train crash, a suicide bombing or an earthquake.

We know what to do, and we have an idea of what it means for precautions for us as distant observers.
We are experienced, and accede to preventative actions:

- being interested in reports of near-misses on railway tracks, and willing to pay for safety

- grudgingly accepting being frisked or xrayed- at airports

- putting up with restrictive fire/safety regulations in buildings
But we have no experience of living through a global pandemic.

In reality pandemics have raged through human-kind hundreds of times, albeit only now at this breakneck pace.

We just haven't seen live TV news about them.
The only contagious viruses we have seen on the goggle-box have been make-believe ones in which the virus

- is caught only by being bitten
- changes you within seconds or minutes
- affects everyone equally
- so much so that you stop being human and need to be killed
I don't blame people for not realising that for Covid:

(a) we don't know EXACTLY how it is caught. (Think about it - how would we find out for sure?)
(b) takes days to show signs
(c) shows no signs in some people
(d) has no more reason to be 'permanent' than the common cold.

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More from @ProfDFrancis

Jun 9, 2022
How exciting !
I might have an Omicron !
Hmmmm...

Now this sounds a bit unlikely.

Boris johnson gonna come to my office and sit on me, will he?
Read 11 tweets
Mar 28, 2022
The pandemic has made it really clear to me that trend to have patients make their own health care decisions with advice from us, is well intentioned but harmful.

A great many people *don't realise* they have no idea how to decide wisely.
This unfortunate citizen thinks that this graph is what they should use to decide whether to have a vaccine.

the doctor has a choice of explaining about RCTs versus irrelevant 3d colour graphs, telescoping into a few minutes what it took years to grasp, or just sigh and move on.
When I get on a plane, I have paid for a pilot to have spent a very long time studying how best to fly a plane.

Even if I prefer him to fly lower so I "get less x-rays", or over the land "so I don't have a risk of drowning", I don't barge in and tweak the steering wheel myself.
Read 8 tweets
Mar 16, 2022
Which is more?
Which is a bigger discount?
Why are both of those questions obviously stupid and pointless?
Read 10 tweets
Jan 11, 2022
Businesses are financially incentivising vaccination by reducing sick pay for people insisting on not participating in community vaccination.
Some people advocate personal freedom with no responsibility to the community which makes it possible to live our lives so freely.

I personally think I drive best when drunk as a skunk.

Why should anyone tell me what I do with my body?
Ah wait. Obviously if I am legally proven to run over that kid with a pint of vodka in my blood, I should perhaps get a slap on the wrist.

But what if I have not collided with anyone?

Is that OK?
Read 24 tweets
Jan 9, 2022
Lots of people seem to be tweeting at me super-confidently that "Vaccines don't work".

Funnily enough, none of the people who go through any of my courses in clinical research stats are so overconfident in their interpretation. Image
Mop up any seminars on probability and risk that you haven't already done,

and if you've done them all, repeat the low-scoring ones aiming for the "gold" 100% status!

8-)

tweetorials.inspirion.org/h2/c48ed511bc7…
Absolutely brilliant example! Image
Read 54 tweets

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