Thread by @MatanHolzer

Vaccine efficacy in preventing covid hospitalizations and deaths coming from Israel:
Is it reliable?

The answer is NO.

Why?

No differentiation between hosp./death *due to* covid vs. *with* covid.
"with" numbers are affected by testing policy, which differ in vax vs. unax⬇️

First, we must understand the difference between hospitalization / death *due to* covid vs. *with* covid.

By "*due to* covid" we mean that covid19 illness was the cause of hosp. and death. The patient developed respiratory syndrome, that's why he/she hospitalized, and died.

There is a very different scenario, in which somebody is hospitalized due to some other reason, but upon admission he/she was tested for the virus SARS-CoV-2, and found positive. Then he/she is assigned to covid department (to prevent infecting other patients).

But since he/she in covid department, so he/she is considered a covid patient, right?
Then, if he/she is severely ill, he /she is reported to the public as severely ill covid patient.
if ventilated, as covid ventilated.
if died, as covid death.

Here is a recent example of this cascade.
A 8 year old kid was injured by fireworks. sedated and ventilated, treated for his severe injury.
But he was tested for SARS-CoV-2 and found positive.
So he is hospitalized in Covid department.

https://twitter.com/yair_kraus/status/1418133652119162883

The authorities explained why is he considered a covid critical patient:

https://twitter.com/yair_kraus/status/1418322175656878082?s=20

It's an anecdote, and one may argue it's not representative.
But there are many sources confirming that it happens in many cases. Even majority, for age groups who do not get severe covid.
Obviously, it won't be in peer-reviewed paper, or article in English... I'll do my best:

In Feb. 2021, media and @IsraelMOH reported tens of children hospitalized for covid.
Health journalist @hillaalroy of @newsisrael13 (MSM) checked in hospitals, and concluded: none of them is hospitalized *due to* covid; they're hospitalized for other reasons and found positive

Dr. Galia Barka, children-infectiologist from @SHEBA_ hospital (largest in Israel) confirmed in @kann_news:
"the children hospitalized in our covid departments are hospitalized not due to covid, but due to other reasons, while positive to virus... it has logistic consideration"

Well, children, everybody knows children are not at risk of covid, right?

But it happens in adults, and old people, too.

Obviously, adults and old people are hospitalized generally more than children, so it will be enormous amount of that.

Prof. Jonathan Halevy, president and former CEO of @ShaareZedekMed, in August 2020:

"unlike before... now the patients who dies "with" covid, and not due to covid, are very many... people come with heart attack, and positive for the virus... they are counted as covid deaths..."

I see you there, "this guy with youtube clips"....

What is the authorities' response to those claims?

In September 2020, just before Israel 2nd lockdown, Dr. Sharon Alroy-Preis, head of public health in @IsraelMOH, were invited to a parliamentary committee in Israeli parliament, headed by MK @sbyifat.

She (Preis) were asked exactly those question:
"What is the definition of covid death? Is it true that anybody with positive test is considered a covid death?"
she replied: "I think yes, but I'm not sure, need to check"

and the Dr. Amir Shahar (the one who asked) went far in asking: "even if the patient come with car accident?"
- "I think yes, but need to check".

Needless to say, a formal answer was never given.

you can find a record of this meeting here:
facebook.com/wallanews/vide…

and clips:

https://twitter.com/Eitan_Marchand/status/1307461592116793344

And one has many circumstantial evidence for that.

e.g., only 40% of covid deaths were ventilated before their death, as expected from respiratory illness (as Halevy noted)
data.gov.il/dataset/covid-…
(filter for "ventilated")

and excess death is about 40% of covid death (see? 40% ventilated)

and *overall* hospital occupancy was never too high, only in covid departments, which are nothing but some beds with a sign above. it's the same amount of patients, only assignments to departments...

Logically, it must be true: even if a completely harmless pathogen is spreading, many already-sick people will be positive for it, if isolated in a dedicated department and counted as <this virus>'s patients/deaths, there will be enormous of them...

https://twitter.com/BonehElad/status/1284039982957637632

This is not a discovery. Neither Israeli-specific phenomenon.
For example, UK reduced the number of covid deaths retrospectively by 10%, realizing that the definition of covid death was way too broad (everybody within 30 days of PCR+):
bbc.com/news/health-53…

Of course, it's always a mixture of commodities and virus, and it's a very hard to point out what's the main cause of death.
CDC estimates 92% of covid death had this mixture. now it's definitions.
Look for WHO definitions, are flu death defined the same?
cdc.gov/nchs/nvss/vsrr…

Alright.
We've established that a large portion of covid patients and deaths is other cause deaths, counted as covid because they carry the virus (w/ mild symptoms / asymptomatically).

Now, how can it effect calculation of vaccine efficacy (VE) in preventing hosp. and death?

We're usually given data like this
(assume for similar demographic characters, and very at-risk people. only didactic)

so we conclude that VE in preventing a severe illness is 75% (5% compared to 20%, i.e. 15%/20% were spared, 75% efficiency)

but that assumes they are ill *due to* covid.
the true data may look like that:

we don't care about "with" covid shares, as it's merely preventing infection, not severe illness.
In severe illness due to covid, it's 3% compared to 5%, so 2%/5% is spared - 40% efficiency.

The diagrams are didactic examples.
In general, we might assume that the distribution of "with" and "due to" within each group is similar, so "with" part is proportional to the reported numbers, so we can calculate VE from overall number as well.

Risky, but that's all we got..

the problem is that the testing policy may be different for vax and unvax.
If unvax people are tested before admission and vax people are not (binary for simplicity), then there is no "with" in vax numbers, only in unvax numbers.

that's the true data - same 40% efficiency:

but it presented to you as:

which look like 85% efficiency (17%/20% are spared)

well, it remains to show that testing policy is different.

Here is a formal file from July 5.

gov.il/BlobFolder/pol…

so, only in July 5 they gave the instruction to test vax people upon asmission to hospital, implying that until then there were not tested.

The direct way to manipulate data: test people from specific areas, inflating the number of covid patients from there.
that's a direct way to make a town "red" with covid hospitalizations" and "covid deaths" only because they test every hosp from there, but not from other towns.

here is a testimony how it's managed in hospitals:
they sign vax and unvax with different color bracelets, and test only the unvax.

https://twitter.com/ghffhhjjjfdd/status/1416860224812630024?s=20

So, any data coming from Israel regarding prevention of severe illness and death, is, to large extent, nothing but positive PCR, and, as such, confounded by testing policy, exactly as the data for "preventing infection" measured by number of confirmed cases.

P. S.
BTW you can see how to increase number of "covid hospitalized" and "covid deaths" upon demand -
just change the testing policy, and find much more severe patients "with" covid...
if they change the testing policy gradually, there will be gradual increase........

Dr. Dror Dicker, Hasharon hospital (a small one):

"we see hospitalized patients, reason of hospitalization is not covid, but other diseases...
In fact, 2 of 3 ventilated people in our dept. are ill unrelated to covid... found positive... covid isn't the reason for ventilation"

this guy (Dr. Dror Dicker) is also a member of Israeli government Covid Cabinet, was chosen to lit up a torch in Israeli Independence day torch-lighting ceremony...
But only he now got "an insight" that many people in the covid dept. are not *due to* covid...

Update 7.1.2022
State of New York's official breakdown of patients who are hospitalized FOR Covid versus just hospitalized WITH Covid.
in 43% of the hospitalizations, covid is not one of the reason for hospitalization

Source:
governor.ny.gov/news/governor-…

More from Fauci:

https://twitter.com/Breaking911/status/1476988310845329412?t=CEucIGR3ExACnQa5LtHGfQ&s=19

More from Israel:

first, they say that:

https://twitter.com/GLZRadio/status/1480572762464862208?s=20

then, they comment in retweet:

so basically they just put some signs on sickbeds of children with burns, and then fear mongering "increase in children covid hospitalizations"

https://twitter.com/GLZRadio/status/1480849993556758531?s=20