I support dramatic public health interventions in hard hit areas to slow Covid (and buy time to vaccinate everyone possible) but I strongly dislike this irresponsible mode of reporting which will scare the shit out of every parent with a kid with a cold. nytimes.com/2021/08/08/hea…
The hypothesis that a mild upper respiratory tract infection - even if caused by a new virus - causes a chronic dementing illness in children is a sweeping, massive, frightening claim. It is unlikely to my mind, given what we know about mild upper respiratory tract infections …
… but like all things, it is possible. Yet it is an extraordinary claim, and requires robust evidence which is thus far lacking. Our mantra that correlation does not equal causation goes out the window on this particular topic.
Understandably, this discussion invariably returns to “should we do more or less to mitigate spread”? I say much more. But that’s a separate question from boldly asserting that the 1/3 of Americans (including kids) with past SARS-Cov-2 infections (per CDC) are brain damaged.
What we know about COVID is bad enough — it is killing millions of people. We don't need to exaggerate the risk of an upper respiratory tract infection from a virus that can cause pneumonia and death.
Here’s a now somewhat dated article of mine exploring some of my concerns around the Long Covid narrative.

statnews.com/2021/03/22/we-…

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More from @awgaffney

25 Jul
Anti-vaccination crew blather endlessly about how breakthrough infections prove uselessness of vaccines — neglecting the fact that they basically eliminate severe disease.

Compare surges last winter vs. this summer in the UK, with cases on top and hospitalizations on bottom.
Yes, severe COVID (pneumonia / acute respiratory distress syndrome) is what really matters. From a syndromic perspective, mild COVID-19 is typically a cold, or a flu-like illness, which of course can be miserable but is not what makes this a once-in-a-century pandemic.
Truth is that breakthrough *mild* infections are far more common than we realize, as many people are not getting a COVID test if they develop a cold (although doing so can help protect others). Otoh, we're not undercounting breakthrough severe infections - mostly can't be missed.
Read 4 tweets
16 Jul
We simply don’t have enough of the population vaccinated. Waves of hospitalizations and deaths, even if smaller than before, are inevitable until we do.
It’s only one small part of this, but the active role some prominent, noxious media figures with big right-wing platforms have played in gleefully disseminating delusional anti-vaccination passion will kill so many people.
Tucker Carlson was already a vicious, pathetic, sniveling little bigot before all this, and now he’s somehow made himself into something worse.

google.com/amp/s/www.wash…
Read 5 tweets
9 Jul
The important COVID-19 vaccine effectiveness metric is: how well does it prevent *severe disease*?

With a respiratory virus, severe disease is what matters.

Severe disease = pneumonia & acute respiratory distress syndrome (ARDS), which is why and how COVID-19 kills.
Vaccine effectiveness in preventing mild disease matters *mostly* insofar as it prevents us from spreading the virus & thereby causing severe disease in others.

Because, mild respiratory tract infections themselves = colds & flu-like syndromes. Misery for a bit, but we survive.
So fact that we're talking about 3rd booster shots, when so far Pfizer vaccine w/ 2 shots has retained same effectiveness against severe disease from delta as in the original trials, doesn't make sense, particularly when 1% in low-income nations haven't been vaccinated at all.
Read 10 tweets
22 Jun
Notable that one of the leading physician advocates for using ivermectin for COVID-19, Paul Marik, was once also convinced that he had cured sepsis with a combination of vitamins and steroids — a finding not replicated once a randomized trial was actually performed.

/Thread
His words: "We haven't seen a patient die of sepsis since we began using the combination therapy a year ago. We have completely changed the natural history of sepsis."

nbc12.com/story/34986689…
He's a member of the FLCCC Alliance, along with Pierre Kory, who testified in the Senate for Ron Johnson that Ivermectin is "effectively a 'miracle drug' against COVID-19."

Ivermectin is not the only FLCCC Alliance's recommendation that is not evidenced-based.
Read 16 tweets
11 Jun
This article argues that the FDA's approval of Biogen's new expensive Alzheimer's drug could "mark a seismic change in how Medicare thinks about covering new drugs of marginal effectiveness."

But that's not what I want to see come out of this.

Thread.

theatlantic.com/ideas/archive/…
If the FDA approves a drug, and insurers (like Medicare) deny it for whatever reason, the public will feel that a useful therapeutic is being denied to them. Rich people, of course, will still be able to purchase the drug.
Now you may say: OK, but you said this new Alzheimer's drug may be useless, so what's the problem? Well, there are many.

First, desperate families/patients who do whatever they can to purchase it out-of-pocket may be harmed by the ineffective drug.

washingtonpost.com/outlook/2021/0…
Read 10 tweets
4 Apr
One of the most under-emphasized findings of the Oregon Medicaid Experiment was that it found a causal link between lack of health insurance and depression that cannot be explained by lack of access to mental healthcare alone ...

ncbi.nlm.nih.gov/pmc/articles/P…
... Gaining health insurance reduced the rate of depression by about 30% (or 9 percentage points).

The increase in mental health treatment experienced by those newly covered can't fully explain this increase. So what can?
...Well, it should be unsurprising that the uncertainty and profound strain produced by precarity & deprivation would worsen mental health! Alleviating some of that uncertainty might, conversely, help improve mental health.
Read 7 tweets

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