Unhappy with the CDC’s paltry number of myocarditis cases attributable to mRNA vaccines, @TracyBethHoeg et al set out on the vast sea of VAERS in hopes of catching more fish by using "broader search and inclusion criteria" aka a bigger, but definitely not better, net. 🧵
Admirable if only for the nakedness of its ambition, the authors don’t hide that their aim is to “update” the CDC’s estimate,
or that, by “update” they mean “inflate”.
So after vacuous statements about how the CDC's undue sensitivity “may have failed”, the authors search for reports, not just where myocarditis is diagnosed, but, more broadly, for reports of “chest pain” bc armchair cardiologists can do their own diagnostics thank you very much.
Though the authors claim to align themselves with the CDC’s case definition of “probable myocarditis”, where they part ways is telling.
Typically, the broader the search, the greater the need for careful exclusion criteria but, unsurprisingly, for a crew focused on addition and not subtraction, exclusion is a more limited enterprise. Where the CDC excludes cases where abnormal findings have ANY alternate cause,
the authors’ dedication to collection limits exclusion to just cases where viral myocarditis or pneumonia is an alternate explanation.
This is problematic because first, they don’t actually exclude viral myocarditis despite a positive rhinovirus test,
h/t @jhowardbrain
or viral myocarditis being mentioned as likely in clinical notes,
or where notes indicate results for viral myocarditis are pending,
or, though not mentioned, where viral myocarditis remains possible given the presence of other symptoms associated with viruses.
In other cases, Covid itself is present,
h/t @jhowardbrain
or had been which certainly may matter.
Second, since elevated troponin in the presence of chest pain is our armchair epidemiologists’ dream team of vaxx-induced myocarditis, the many other causes of elevated troponin are overlooked. Definitely read this whole excellent thread.
Third, elevated troponin together with chest pain allows the authors to diagnose vaxx-related myocarditis even when, as the CDC puts it, there is some “other identifiable cause of the symptoms and findings” as here where the clinician’s notes indicate possible pulmonary disease,
or here where both viral myocarditis and MIS-C are alternatives under consideration.
None of this is to say that the cases from this non-exhaustive list are definitely not vaccine related but, rather, that given the presence of a competing explanation, it is at best premature to add these to the tally of vaccine related cases as if we knew that they were.
Expand what you include, minimize what you exclude & your bigger net catches more. But don’t be surprised if your new additions turn out to be, not good epidemiological evidence but, instead, clutter & junk. Which, given the problematic VAERS, is just about what you’d expect.
Sincere apologies to @JHowardBrainMD who I incorrectly h/t'd as @JHowardBrain and whose screenshot of the PCR + case got mixed up with the rhinovirus case.

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More from @Loretta_Torrago

21 Aug
This study by @TracyBethHoeg, @KrugAlli et al. reinvents the need for the adage "absence of evidence isn't evidence of absence" as a response to the authors’ novel approach “If you don’t have symptoms, you don’t have cases."🧵
The study is allegedly about player-to-player transmission being contained by the protocols for youth ice hockey the authors develop. Alarm bells ring almost immediately when the authors introduce us to the study’s crew: a “volunteer epidemiologist”,
and other “neutral” parties.
Read 23 tweets
19 Aug
Judith Danovitch's researches how preschool & elementary school kids evaluate & think about information. In this article, she evaluates claims of "mask harms" and the impiactions, for cognitive development, of not seeing mouths, smiles & frowns.🧵
Daovitch admits that, though there is little data on masks per se, there is evidence from head coverings. “Children in cultures where caregivers & educators wear head coverings that obscure their mouths & noses develop skills just as children in other cultures do.”
What’s more, she adds, blind people still learn to speak, read and socialize.
Read 12 tweets
14 Aug
Covid minimizers, like @drlucymcbride, are like eclipses that cover astronomical objects. The disaster behind their obfuscations is still there despite the cover of misleading and often irrelevant “good cheer” they try to throw in front of it. 🧵
Implying the well-off and protected have nothing to fear because hospitals are only filling up “in states with where low vaccination rates” may reassure the privileged McBride seems most concerned with. Image
However, it belies the actual evidence. Image
Read 39 tweets
12 Aug
While @ProfEmilyOster denies consulting with @GovRonDesantis, she hasn’t yet repudiated her study. She should. The study claims to show mitigations don't work but has so many design flaws, even effective measures would fail her trials. Very long🧵.
Probably because they’re assumed to be the “gold standard”, Oster’s studies employ the all the signs of being Randomized Control Trials (RCTs) in which mitigations: mask mandates, in-person density and ventilation are compared with schools absent those same mitigations.
Oster’s conclusion is, more or less, that mitigations make no difference to Covid case counts in students, staff and teachers associated with schools.
Read 42 tweets
10 Aug
They won't stop will they? Despite the evidence that cases in kids rise even when adults are well vaccinated (see the UK), the fact is an adult vaccinated today is weeks away from providing indirect protection. They have no interim plan except widespread infection of kids.
Here is evidence from the more highly vaxxed UK, that cases in kids rise despite adult vaccination Image
Read 5 tweets
10 Aug
No, @TracyBethHoeg, the article you point to does not claim delta is not "resulting in increased rates of in-school transmission”. In fact, it says the opposite. 🧵 Image
Speaking of the 12 presumed cases of in-school transmission for the summer, the article offers this: "By way of comparison, the district reported 2 cases of apparant transmission during the regular school year."
In fact, the article very explicitly implicates Delta in the rise of infections. Image
Read 10 tweets

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