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


(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

18 Sep
Anything I say to give hard-pressed doctors a well-deserved laugh, has a risk of making some of them angry.

But this will amuse not only to every doctor, but everyone who has a science degree, and indeed a many other people who have merely been to school…
At first I thought Twitter was being a wet blanket and opposing fun and frolics.

But then I noticed the yellow text, and Twitter is right - there are some people uneducated enough to fall for this nonsense.
So here is a short thread to rescue people who have been misled by the Koch Postulators.

#MedEd #FOAMed

In your opinion, infections are caused by what?
Read 32 tweets
12 Sep
We are all doomed by this virus.

My last tweet on this earth perhaps? (hat tip to @BogdanEnache)

During viral infection, in ATHLETES, CMR shows:

Myocardial EDEMA in 19% acutely, 24% at followup.
Myocardial INFLAMMATION in 38% acutely, 48% at followup.

Winter is coming.
What proportion of athletes will get this virus?
Read 8 tweets
6 Sep
My advice for the general public?


"If you as a member of the public are searching the internet for scientific data on heart damage, you are doing it wrong."

Uncle Darrel
J Condescending but True Facts
The reason why I recommend the general public not to worry about such things is that there is nothing useful you can do about the worry, other than just worry.

The whole point of having scientists to do science and doctors to explain it to you, is so that it is done well.
Scientists spend a lifetime learning how to examine experimental designs, results, and claims from the results; how to check track records of researchers; and how to integrate this into a useful view of the universe.

It is not easy and it is not quick.
Read 63 tweets
3 Sep
Somehow I find myself cornered into being a world expert on everything.

(My daughter used to believe that. But that was when she was three after a remorseless campaign of me emphasising that point.)
In my simplistic view, Myocarditis is like a bruise.

If someone punches you in the arm, you will get a bruise, and it will eventually get better (unless you die from complications of a broken bone).
During the immediate few days after the punch-ment, there will be:

Raised CRP
Raised CK from the traumatised muscle
It will probably hurt a lot.

Then it will get better and go away.
Read 17 tweets
3 Sep
This story is interesting:
Now that you are all scientific thinkers, I am sure you are all wondering:
Read 17 tweets
3 Sep
Innocent looking chap, eh? Trustworthy?
Wouldn't con his poor doddery old boss?

"You know you said you would give me anything, if I could teach you Machine Learning?"

"Yes, and you did. What is your 1 wish?"

"22% pay increase."


--- and I certainly have been!

He didn't fully emphasise that this was 22%, per year, FOREVER.

If his salary is $1000 a year at present, what will it be in 1 year's time?
And after the 20th increment, what will his salary be?
Read 47 tweets

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