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Marc Lipsitch Profile picture
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21 Dec, 4 tweets, 2 min read
Hey #econtwitter is there a common explanation behind 1) the incomparability of medical data from different EMR instances; 2) the incomparability of mattresses made by different manufacturers and sold by different retailers 3) the incompatibility of different mfg camera lenses?
Feels like the common thread may be that the opportunity to prove oneself better/ better for the cost that would arise from comparability is less appealing than the risk of being proven worse; better to hold onto market share from loyalists than risk competition.
but having a hard time seeing the medical record analogy, perhaps because it's not there. If this is something Freakonomics covered in 2017 I'd be happy for a reference.
#datenight with @meiralevinson #jealous?

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More from @mlipsitch

Marc Lipsitch Profile picture
18 Dec
the following thread is purely my personal opinion as a @CCDD_HSPH @HarvardEpi epidemiologist. I would welcome feedback though I am trying to take some breaks so don't promise to reply. Thanks in advance to anyone who provides critique or further info
Impact of #Omicron obviously depends on severity. Number of cases is growing exceptionally fast and several countries have seen such growth continue for quite a while (weeks, which is a lot of time with doubling times of small number of days
AFAIK there are two publicly available assessments of severity. Kudos to @Imperial_IDE and Discovery Health for rapidly putting out reports imperial.ac.uk/mrc-global-inf… and discovery.co.za/corporate/news… (site down as I write, but previously had a link to a detailed webinar
Read 21 tweets
Marc Lipsitch Profile picture
6 Dec
Clear explainer of a very carefully nuanced report. While the main thing to say is "small numbers," it does seem that the average severity among those in the hospital is comparatively low. Two thoughts about interpretation:
1/ Omicron growing very fast. Patients hospitalized for COVID are typically (not always) well into their infection. In a fast-growing epidemic, the proportion infected 10d ago, say, is lower on any given day than in a slow-growing one. This alone could cause unusually lo ...
proportion of hospitalizations with primary diagnosis. Fast-growing epidemic = most infections are new is basic demographic theory (just like in a fast-growing population of people, most people are young). The unusually high growth rate can at least partly explain observation.
Read 7 tweets
Marc Lipsitch Profile picture
18 Aug
@CT_Bergstrom @jsm2334 Certainly this kind of bias merits consideration. I think the particular figure cited in that table is an example of Simpson's paradox, which is a special type of confounding.
@CT_Bergstrom @jsm2334 For those new to these terms, confounding is just the problem that (in this case) vaccine is not randomly distributed in the population, so the vaccinated have different risks from the unvaccinated for reasons other than their vaccine: in this case, age.
@CT_Bergstrom @jsm2334 Simpson's paradox is an extreme form of confounding in which a combined analysis for two groups of people gives an unusually misleading estimate, relative to the (more) accurate estimate for each group individually.
Read 17 tweets
Marc Lipsitch Profile picture
13 Aug
As often happens, the headline is too simple for the more subtle message of the article washingtonpost.com/outlook/corona…
The article's main point is unarguable: "we cannot control the delta variant by maximizing the immunity of only a segment of the population."
But some (incl me) have thought the main goal of vaccination all along should be to defang (make less harmful) not defeat (eliminate) the virus.
Read 7 tweets
Marc Lipsitch Profile picture
20 Jul
At the risk of boiling down too much and certainly losing some detail, one way to summarize this wonderful thread is that when we think about vaccine effectiveness, we should think of 4 key variables: 1 which vaccine, 2 age of the person, 3 how long after vax, 4 vs what outcome.
We've been using the simple view that the major vaccines in use in the US/Europe are possibly less effective against infection/symptoms when a variant is involved, but remain highly effective against severe outcomes. Published data so far support this view.
To be more precise, we would say "so far in the general population, up to about 6 months after vaccination, the vaccines have held up against severe outcomes even from Delta, though there is some evidence from Israel, UK, and Canada of declines in effectiveness vs infection."
Read 14 tweets
Marc Lipsitch Profile picture
7 Jul
Now published led by @G_RegevY and with @rebeccajk13 sciencedirect.com/science/articl… . .
Different approach from many other VE studies, following HCW vaccinated vs unvaccinated, tested when exposed to a case, to assess VE against infection given exposure, consistent with our recommendations in sciencedirect.com/science/articl…
Also looked at infectiousness (proxied by Ct). Take home messages: fully vaccinated 65% (45-79) protected against infection given exposure. This is lower than other estimates of symptomatic or arbitrary mix of symptomatic and other cases, as expected.
Read 8 tweets

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