Health Nerd Profile picture
Oct 15, 2021 25 tweets 7 min read
This paper came out recently, and it is HUGELY popular among anti-vaccine advocates who are using it to suggest that vaccines don't work

It's also very fundamentally flawed. I'm a bit surprised it was published. Some thoughts 1/n Image
2/n The paper is here, and it's basically a series of comparisons of publicly-available COVID case and vaccine data conducted by a Harvard professor and a high-school student (note-DO NOT BE MEAN TO THE STUDENT, NEVER BE MEAN TO STUDENTS)… Image
3/n The study is broken into 2 sections. In the first, the authors took @OurWorldInData info, comparing the previous 7 days of case data between countries by vaccine rates. They produced this graph, showing no relationship between vaccines and reported cases Image
4/n There are several fundamental mistakes with this analysis. The first one is a biggie - confirmed cases, as reported by countries, are a useless statistic by themselves
5/n This goes back to the very early days of the pandemic - cases are, by definition, a function of tests. Without tests, you don't confirm cases, and therefore this comparison makes no sense at all on its own
6/n Did this impact the author's graph?

Very clearly yes. For example, let's compare the country Georgia (5408 cases/mil) with some of the places with less than 50 cases/mil in the author's graph on case/testing numbers ImageImage
7/n So the y-axis of this figure is uninterpretable. Meaningless.

What about the x-axis? Image
8/n There are 2 ways you can become immune to COVID-19 - vaccines and PRIOR INFECTION

In some of these countries (India, Russia, USA etc) it's likely that upwards of 40% of the entire population is immune to COVID-19 because they've had the disease and recovered (or died)
9/n In other words, we might expect that in places like Brazil, where 1 in every ~350 people has died from COVID-19 since the pandemic began, there would be quite a bit of immunity even with relatively low vaccination rates
9.5/n So comparing places on case numbers without taking infection-induced immunity into account is nonsensical, unless for some reason you think that it does not prevent infections
10/n On top of this, we've got the issue of an arbitrary 7-day window. Angola looked really good if you downloaded the data on 3/09. It looks less good if you download the data today Image
11/n So the first graph is pretty much useless as evidence. What about the second bit of the analysis?

Well, the authors essentially did the same thing, but for US counties. They found no difference in cases in US counties by vaccination status ImageImage
12/n So vaccines didn't prevent cases in the US!

Except, well, there's issues here too. Let's look at the places that the authors explicitly mention in the text Image
13/n Going to the file that the authors used, from Healthdata dot gov, you can see some really weird things pop up. Chattahoochee, GA, has a population of 10,907, but has 30,233 people who are fully immunized Image
14/n Indeed, looking down the list, all three of the counties identified by name - Chatahoochee, Mckinley, and Arecibo - have vaccinated more people than live there by quite a wide margin Image
15/n Meanwhile, of the counties classified as "low" transmission have rates of vaccination not just below 20%, but close to 0%!

What's going on here? Image
16/n The answer appears, based on this excellent @jburnmurdoch thread, to be that in the US vaccine doses are recorded based on the county *where they are given* not where the person lives
17/n This actually explains those discrepancies very neatly. Arecibo Municipio, for example, contains a stadium listed as a mass vaccination site in Puerto Rico Image
18/n On top of this, we've got the same issue with picking an arbitrary 7-day window as before - the median population in a county from this spreadsheet is ~26k people, which means that small variations in case numbers make a big difference
19/n This is even more apparent when looking at those "low" transmission counties - the median population is ~1k people, with some counties having <100. Weekly variation makes a HUGE difference!
20/n For example, Mineral County, CO, pop 769 is a "low" transmission county on 9/2, but a week later on 9/9 it's a "high" transmission county because it reported...2 cases
21/n All in all, this analysis is a bit meaningless as well. Using a 7-day period is pointless, it again ignores infection-derived immunity, and the vaccine rates are clearly not correct by county
22/n Ultimately, I don't think this paper has much, if any, meaning, and it's kind of bizarre that it was published at all. It certainly proves nothing whatsoever about vaccines and their effectiveness
23/n Oh, also, these are the most basic issues in the paper. I didn't even get started on things like Non-Pharmaceutical Interventions, confounding, etc etc etc
24/n Worth noting that the authors' intentions were clearly not anti-vaccine per se, but I do think that the paper is nevertheless not sufficiently robust to actually conclude anything about vaccines Image

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More from @GidMK

Jan 19
I think the vaccine/COVID myocarditis issue in kids really shows the difference between those reasonably weighing up costs and benefits and those who are either dishonest or not very good at epidemiology 1/n
2/n We know two things with a great deal of certainty for younger people:

1. myocarditis following vaccination is rare
2. myocarditis following COVID-19 is rare
3/n This is probably not a surprise, because myocarditis is rare in younger people regardless of the situation. Here's a study that found an incidence of 2 cases per 100,000 kids each year…
Read 16 tweets
Jan 19
One thing I don't think people realize about 'endemic' COVID, where we have regular seasonal outbreaks that wax and wane, is how damaging THAT situation will probably be
It's hard to estimate the death/severe disease rate for COVID at this point, due to prior infection, vaccination, and better medication use (e.g. fluvoxamine), but we could say that for someone who's been vaccinated/infected, the risk is probably similar to seasonal influenza
But...influenza kills A LOT of people each year. We may not shut down society because of it, but one study found that eliminating seasonal influenza may reduce total mortality in a country by 3-6%…
Read 4 tweets
Jan 19
The new viral claim is that cannabis can help with COVID-19, due to a few lab-bench studies

I'm interested to know what people think the likelihood of this panning out is (poll in next tweet)
On average, what proportion of compounds that are found to do something in the lab end up having a benefit in actual clinical trials of human beings?
Now, this is a complex question, but it's also enlightening, because the real answer is that it kind of depends
Read 10 tweets
Jan 17
I don't think weird right-wing people from overseas who pretend to care about borders only when it's convenient to them realize how deeply unpopular Djokovic was here in Australia
This is polling by @theage, as mainstream as media gets here, showing that in a reasonably representative sample the anti-vaccine tennis twat had virtually no support at all. 6 out of 7 voters either didn't care or thought he should fuck off
Problem is, most Australians are very pro-vaccine, hate tall poppies, are a bit touchy about borders, have had a hard time of travelling during the pandemic, and feel very strongly about following rules (especially COVID rules)
Read 7 tweets
Jan 5
One of the more fascinating things when looking at the story of the pandemic is how tribal most arguments have become
Take lockdowns, for example. We have ample evidence that various non-pharmaceutical interventions were not as harmful as initial predictions suggested. It's just not correct at this point to argue that lockdowns have caused enormous death tolls…
We might expect that at some point in the future places that locked down will do worse on some metrics, but based on evidence we also might not. It's very uncertain, because large COVID-19 outbreaks also cause bad things to happen
Read 11 tweets
Dec 29, 2021
I thought I'd put together a short list of terms that, while they may have some formal definition, tell you more about the person using them than conveying any actual meaning in conversation

First up, "cancel culture". Means basically nothing
My perennial favourite, "nanny state". It's only used when people consider a govt intervention to be overreach, but what defines overreach is entirely subjective
Btw, feel free to add your own examples to this list, there are SO MANY
Read 8 tweets

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