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20 Jul, 15 tweets, 4 min read

New paper out in BMJ Global Health with a brilliant team of researchers on the health impacts of lockdowns

Long story short - lockdowns aren't ideal, but COVID-19 outbreaks are probably much worse 1/n…
2/n What did we do in this paper?

It's a narrative review, so basically represents our knowledge and opinions about the topic, using all of the data that we could find ourselves
3/n That means that this isn't the definitive word on lockdowns, or interventions like them

Having said that, we do think that there are a few points that are extremely clear from the evidence to date
4/n Firstly - lockdowns cannot possibly cause massive increases to short-term deaths. We used the World Mortality Dataset to look at this, thanks again @ArielKarlinsky and @hippopedoid
5/n Places WITH lockdowns but WITHOUT COVID-19 epidemics did not see excess deaths. There are numerous examples of this, and it largely invalidates the idea that lockdowns in and of themselves cause fatalities
6/n Importantly, this DOES NOT MEAN that lockdowns necessarily prevented deaths, as comparisons such as the UK vs Sweden show, but that it is not consistent with the evidence to claim that lockdowns have large impacts on short-term mortality
7/n After that, we get into the REALLY complex stuff. We looked at:

1. Disruptions to health services
2. Mental health/suicide
3. Global health programmes
8/n To cut a long story short, the evidence for all of these is mixed. There's some data showing impact of government interventions. There's also data showing that large numbers of COVID-19 cases are bad as well
9/n Mental health in particular is a tricky subject. Lockdowns certainly have not been associated with increases in suicide, but there have been consistent worries about mental health
10/n That being said, there's also evidence that people dying from COVID-19 in large numbers is not, uh, ideal for mental health, and disentangling those two impacts is extraordinarily hard
11/n What does this all mean?

Well, it takes us back to the start of the thread

Lockdowns = bad
COVID-19 = probably worse
12/n If government interventions against COVID-19 work, then it's likely that they are beneficial on the whole. There may be lockdowns that have been both good and bad, and it will take us a long time to solve that riddle
13/n The bottom line is pretty simple really - all of this is far more complex than a simple yes/no. Rather than the tedious rhetoric of "lockdowns bad", we should be asking WHICH lockdowns were good/bad, and WHY
14/n All that being said, based on current best evidence we do not think it is possible to say definitively what harms lockdowns do have to health, but we can say that it is likely that these harms are not worse than the disease itself
15/n Thanks to the amazing team who've worked on this @DrSamirBhatt @LeaMerone @GYamey @flaxter and all the rest of the authors!

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More from @GidMK

17 Jul
So, @Covid19Critical does not agree with me, and says that the conclusions of meta-analyses do not change at all once excluding the retracted ivermectin study

Let's go over exactly why I said that removing the study makes a huge difference 1/n
2/n I went over this in my article, which you can find here, but I'll repeat the precise analysis I've done on twitter, because I think it's a fair question

To be clear - I'm not perfect, and not everything I say is right!
3/n Judge for yourself whether it is fair to argue that removing Elgazzar largely eliminates the benefit for mortality here, the headline finding and the primary analysis of the paper
Read 22 tweets
16 Jul
This is not unexpected. If the authors of the retracted ivermectin study claim that the data was not really the data for their paper, they now need to explain:

1. Why did they upload fake data that quite clearly matched their results?
2. The plagiarism. Lengthy, extensive plagiarism

3. The implausible/impossible values remaining in the text

4. The incorrect and bizarre statistical tests

5. Why it is only NOW that we're told the data us fake. Was it a joke? A prank???
5. (cont.) Seriously, how do the authors explain the fact that they uploaded a dataset, said it was the data of their study, and now claim it wasn't? How do we reconcile that with what they claim now?
Read 4 tweets
16 Jul
So, one of the biggest studies to date on ivermectin for COVID-19 has issues significant enough that, if not fraud, are so serious that it invalidates the study without further explanation

I promised a thread

Here we go 1/n
2/n Firstly, none of this would've been possible without @JackMLawrence, who uncovered this in the first place and investigated it himself well before any of us gronks got on board

Read his piece here:…
3/n The basic story is pretty astonishing. I've previously written about this study, Elgazzar et al, and why there are some indications that it's low-quality and potentially very unreliable
Read 27 tweets
10 Jul
Real-life scientist: hugely specialised, often to the point where even side-fields of the same broad discipline can't parse each other's data

TV scientist: "You need someone to analyse DNA? Good that I'm an astrophysicist, just give me a moment to finish hacking into the CIA"
Real-life scientist: "Dammit, I spilled coffee on my keyboard, my work is ruined!"

TV scientist: "Amazing, I spilled coffee on my keyboard and DISCOVERED A NEW ELEMENT (Caffenium)!
Real-life scientist: "I spent a whole day pipetting 🙁"

TV scientist: "I have never seen a pipette, here are endless perfect samples. SCIENCE"
Read 4 tweets
7 Jul
Another day, another systematic review and meta-analysis of the same ivermectin research published

This one is positive. I don't think it should be 1/n
2/n Study is here, and generally it looks fine - search strategy was decent, they followed most guidelines (I.e. PRISMA), and overall the methodology was pretty reasonable for the stated purpose…
3/n In fact, it is amazingly similar to the other systematic review that I looked at recently, down to THE SAME DETAILS THAT ARE WEIRD

This whole thing feels like some bizarre deja-vu
Read 18 tweets
27 Jun
This paper was recently published, arguing that vaccines cause as much death as they prevent and so we should stop vaccinating people

I rarely say this, but it is truly awful and should be retracted as soon as possible 1/n
2/n The paper is here. It is truly woeful, but worth reading just to see how easy it can be to make a plausible-sounding argument if you are very free with your methodology…
3/n The authors did two things - they calculated a Number Needed To Vaccinate (NNTV) from a propensity-matched cohort study done in Israel. They also calculated the number of deaths reported through the Dutch vaccine reporting system
Read 27 tweets

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