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21 Feb, 5 tweets, 2 min read
It's not like the CDC has detailed information easily available online about how influenza disease burden is calculated and obtained

Oh wait

cdc.gov/flu/weekly/ove…
The basic issue with influenza surveillance is that, JUST LIKE COVID-19, influenza can cause mild illness similar to a cold

Most people who have an infection don't get tested!
This raises a conundrum. We want to know how much influenza is around, but (based on research) only about 10-20% of people with infections get a test to see if it's influenza or something else
Thus, we build complex surveillance systems that look at how many influenza cases are REPORTED (based on testing) and infer back to a reasonable estimate of how many actually occurred
Of course, none of this is perfect, because it's tricky stuff, but if you actually read beyond the headlines all of that is explained in minute detail

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More from @GidMK

Health Nerd Profile picture
23 Feb
The United States recently reached 500,000 COVID-19 deaths

That means the POPULATION fatality rate (i.e. deaths/population) for the US is 0.15%

With an estimated ~25% infection rate, the INFECTION fatality rate is ~.6%
Really puts into perspective how wildly off the earlier estimates of very low IFRs in the US were. An IFR of 0.1% is numerically impossible at this point
Another important piece of perspective is that, in the 12 months from March 2020-March 2021, COVID-19 will likely be the leading cause of death in the US
Read 4 tweets
Health Nerd Profile picture
22 Feb
A new study has hit the headlines claiming that eyeglasses can reduce your risk of catching COVID-19 by "2-3 times:

Unfortunately the science is...not good

Some peer-review on twitter 1/n ImageImageImage
2/n The study is preprinted on medrxiv here. It is a single-author study on a survey done in India during COVID-19 medrxiv.org/content/10.110…

This will be a short thread, because...wow. Issues
3/n Some background here - traditionally, in epidemiology, to work out whether something is protective against disease, you need to know two basic things:

1. Likelihood of disease if exposed
2. Likelihood of disease if not exposed
Read 14 tweets
Health Nerd Profile picture
21 Feb
Headline: "COVID-19 pandemic impacts rich people less"

Epidemiologists everywhere: yes, this is true of ALL HUMAN DISEASE. WE'VE BEEN TRYING TO TELL YOU FOR YEARS
It'd be nice if from this global tragedy came a better understanding of the nightmarish social aspects of disease, but my guess is as soon as COVID-19 is gone most people will go back to not caring very much about it
If you want a quick introduction to the topic at a global scale, the @WHO produced this report in 2008 that is still very applicable today

who.int/publications/i…
Read 4 tweets
Health Nerd Profile picture
19 Feb
A very interesting paper on global excess mortality during COVID-19 from @hippopedoid

"...suggests that the world’s COVID-19 death toll may be at least 1.6 times higher than the reported number of confirmed deaths"
medrxiv.org/content/10.110…
Basically, they predicted excess mortality based on previous years using a linear forecast, and capturing seasonal and other variation in mortality
This came up with some very interesting results. For example, here are the excess mortality curves for Australia/New Zealand with #ZeroCovid
Read 5 tweets
Health Nerd Profile picture
19 Feb
The key issue with the Great Barrington Declaration and similar efforts was never about the policy per se, it was the absurd pretence that we could have enormous COVID-19 outbreaks without cost

This was clearly never true
We had more than sufficient evidence by mid-2020 (and earlier) that large COVID-19 outbreaks come with an associated cost. People desperately wanted this to be untrue, despite the very clear reality
And so we got all this obvious misinformation, like the idea that the whole pandemic was just down to false positive results, or that we were all already immune to COVID-19 anyway
Read 6 tweets
Health Nerd Profile picture
14 Feb
This vitamin D/COVID-19 study has gone viral, because the results appear to be impressive and people love promoting vitamin D

Unfortunately, the study itself is...problematic

Some peer-review on twitter 1/n
2/n The study itself is here papers.ssrn.com/sol3/papers.cf…

At first glance, it appears to be a randomized controlled trial comparing calcifediol (vitamin D metabolite) to a control for severe COVID-19 with amazing outcomes (60% mortality reduction 👀)
3/n So, if you only glance at the abstract, you get the picture of an amazing positive result for vitamin D

But reading further, the problems start almost immediately
Read 28 tweets

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