Health Nerd Profile picture
9 Nov, 7 tweets, 2 min read
Sigh. An interesting study, but such a ridiculous prediction. The authors estimated the relative risk of wearing a mask to not based on studies mostly conducted in healthcare workers during SARS/MERS, and then extrapolated this directly to the US
In fact, the reduction in deaths that's cited here as the main outcome is a direct result of the relative risk (0.65) that the authors found for mask-use compared to no mask-use when aggregating together studies on masks
So, they predict 500k deaths in the US by Feb 2021, but if 95% of people wear masks in public, this goes down by just under 35%
But is this reasonable? The study uses the results from two previous systematic reviews that almost exclusively looked at data from SARS and MERS for mask-wearing. Are studies like the below ones reflective of the risk of transmission for people in public for COVID-19?
Even if we accept that, on average, face masks will prevent 35% of infections in healthcare professionals from MERS/SARS and influenza, what in the world does that mean for COVID-19?
Given that the main result is a direct consequence of this assumption for mask-wearing, I think it's worth noting how flimsy the evidence is!
Anyway, I suspect that 95% mask-wearing in public would have a relatively small impact on the eventual death toll from COVID-19 given that most transmission happens in non-public places such as workplaces, schools, universities, and at home

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More from @GidMK

9 Nov
A lot of people are asking the question, so I think it's useful to point out that a vaccine that prevents 90% of infections would be sufficient for herd immunity in most cases
There are, of course, HUGE caveats here:

- protection must be long-lasting
- must protect against infection, not just symptoms
- vaccination rate has to be quite high
Nevertheless, if a vaccine does stop 90% of infections, and we can vaccinate 90%+ of the population, then you'd have about 80% of people immune to the disease which is well above any herd immunity threshold for COVID-19
Read 4 tweets
8 Nov
For all the absurd noise about "academic silencing" throughout the year, it's interesting to note that it hasn't appeared to have stopped anyone getting papers accepted, published, and cited hundreds of times
The Santa Clara serology study, whose authors claim at length and publicly that they have been silenced horribly, has been cited nearly 300 times!

If they're being silenced, it's not evident in the citation count. That's >1 citation a day
I mean, most of the academics who talk about silencing have done so on massive media platforms and have carried that through to enormous academic acclaim

We're all scientists here. By what possible metrics have they been silenced?
Read 4 tweets
7 Nov
Ah yes, the strong Confucian ethic of Australia, Uruguay, New Zealand, and Uganda 🙄

This is just ridiculous - many countries with many cultures have done well, by:

a) sticking to the science
b) acting early and often
Honestly, it feels quite patronising for someone who is not from one of the Asian countries to say it was their culture, rather than the enormous effort and clear govt action, that saved the day
It's also ridiculously fatalistic for people to say that if their culture isn't like that of South Korea there's no way this could've been avoided. I promise you, Sydney is not much like Seoul, but we're both doing well
Read 4 tweets
4 Nov
Thoughts on the American election:

- it is a shame the meteor didn't run again
- too many states start with M, not enough with E or Y, this strikes me as unfair
- red and blue remain boring colours, why not try a nice fuschia?
- if you were to combine the Midwest into one state you could call it Megahio. This is very ridiculous, but quite a good name
- New York is similarly a silly name. Presumably it came into being at roughly the same time as Old York when the Earth's crust was formed, and so it should be renamed Also York

- counting votes is meant to take time, unless we reimagine time as non-linear
Read 12 tweets
3 Nov
There is, I think, an ongoing and pervasive misunderstanding about hospital 'capacity' during COVID-19

Capacity is NOT the TOTAL NUMBER of beds

It is the number of FREE beds

This is a very important point
So, for example, England had around 4,000 ICU beds at the start of the year

But they were operating at 85% capacity! So in fact they had more like 600 FREE ICU beds to treat COVID-19
What I mean by this is that, on any given day, 85% of the critical care beds were occupied by people - heart attacks, car crashes, urgent surgeries and the like
Read 8 tweets
3 Nov
At least once a month in 2020:

"CASES ARE RISING BUT DEATHS AREN'T. PANDEMIC OVER"

"But there's a death lag - often of 6-8 weeks! It'll happen soon"

"NAH BUDDY PANDEMIC OVER"

*6-8 weeks later*

"FUCK"
Partly, this is because cases don't have a big reporting lag but deaths do - because certifying an infection takes very little effort but certifying a death takes quite a lot more
Add to this the fact that the MEDIAN time from infection to death for COVID-19 is 3 weeks, and you get a 5+ week lag from when cases first start to rise to when deaths do (in many cases, not all)
Read 4 tweets

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