A fairly well-demonstrated fact about COVID-19 and lockdowns is that the more severe restrictions tend to have smaller marginal benefits once enacted
In practice, this means that the reduction in transmission for, say, limiting travel to 5km radius is probably quite small once you've already implemented other interventions such as stay-at-home orders
In other words, when we talk about 'hard' vs other lockdowns, the language often doesn't match the evidence. There's no strong reason to believe that adding small extra limits on behavior will have a large impact on the spread of COVID-19
This is not to say that further restrictions will not do anything, but it is worth remembering that adding more restrictions on top of stay-at-home orders and the like may not actually impact infection numbers all that much

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More from @GidMK

22 Jul
A large, well-done observational trial just found a big mortality benefit for ondansetron in the treatment of COVID-19

I think this is a fascinating case study in how we use observational research
academic.oup.com/ofid/article/8…
The authors used a huge database of people who'd been treated for COVID-19, and looked at the associations between mortality and 84 drugs or drug classes
They found that metformin, nicotine, fluticasone, SNRI, expectorants and ondasetron reduced the risk of death from COVID-19, but given the potential for residual confounding only focused on ondasetron
Read 10 tweets
22 Jul
This is a fascinating paper by @EpiEllie and team. The available high-quality evidence shows "no evidence to support the conclusion of the existence of a biological relationship" between blood type and COVID-19 risk medrxiv.org/content/10.110…
For those who remember, the headlines claiming that there was a relationship were numerous and, it appears, incredibly misleading
Just goes to show how easily bad science can cause serious, long-term beliefs and research investment, and it takes months of effort to even make a dent in terms of correction
Read 5 tweets
20 Jul
BIG NEWS

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

gh.bmj.com/content/6/8/e0…
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
Read 15 tweets
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: grftr.news/why-was-a-majo…
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

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