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
But it's basically impossible to have a reasonable discussion about the pros and cons of various interventions against COVID-19, because on one side you've got the people who supported them and on the other the people who said they were always a waste of time
The most likely outcome is that some interventions worked very well, others not so much, and the best policy mix is probably very variable from location to location
There are probably places that should have implemented fewer NPIs. There are probably places that should've had far more. Most places probably should've taken more care about which ones they implemented, especially in 2021
(Of course, hindsight is 20/20, and saying this NOW, after those decisions were made, is quite easy)
But suggest this as a possibility, and you'll usually be accused of some kind of evil love of lockdowns, like a cartoon character plotting the world's demise inside a glowing tower
Equally, people rarely accept that the interventions some places implemented might not end up having a positive cost/benefit. I doubt that's true for everywhere, but it's certainly possible for some locations
(In particular, I suspect large countries where federal govts were lacking and province/state responses were very divergent will end up seeing that a piecemeal response may not have a great deal of overall benefit)
Anyway, the idea of "pro" or "anti" NPIs is ridiculous. Public health is fundamentally about choosing the most effective option, regardless of how that might interface with your own personal beliefs

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More from @GidMK

29 Dec 21
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
16 Dec 21
I think the tales of hydroxychloroquine, ivermectin, and fluvoxamine are such fascinating examples of the problem with accepting low-quality evidence for drugs
The argument for use of HCQ and IVM has always been that they are reasonably safe (true) and so the plausible benefit outweighs any harms. Conversely, until the positive RCTs of fluvox came in, it was FAR less popular because it does have quite a few side-effects
But it appears, at least in the case of HCQ, that there is definitely no benefit and there is a reasonable chance of modest harm. In this case, using the drug has almost certainly caused unnecessary deaths
Read 8 tweets
16 Dec 21
Another new ivermectin study out recently. Apparently it is quasi-randomized and proof that suppressing ivermectin is a "crime against humanity"

Let's do some twitter peer-review 1/n
2/n The preprint is here, and it's a retrospective analysis of routinely collected clinical registry data from the city of Itajai in Brazil…
3/n The design was very simple - take routine data on people who either had or had not elected to be part of an ivermectin distribution program, and controlled for a small number of confounding variables using either a propensity-score or regression model
Read 21 tweets
15 Dec 21
I do find the impact of ivermectin on people's basic critical thinking quite fascinating. This article is filled with obvious, easily checkable lies, but just look at the popularity
The primary claim is that an ivermectin researcher, Andrew Hill, received a grant for $40mil in exchange for lying about ivermectin
This claim centers around a grant awarded by UNITAID to the University of Liverpool for $32mil (the article incorrectly states $40mil) - UNITAID released a press release on the 12th of Jan, the preprint was published on the 8th. Dodgy, right?
Read 9 tweets
14 Dec 21

The paper has been retracted. Retraction notice not yet online… Image
Also, worth noting that in this whole process the editors of Scientific Reports have been really good. The faults lie with the system, not individuals, who mostly appear to genuinely care about science and evidence
Read 4 tweets
13 Dec 21
One of the more hilarious things that the ivermectin crowd is currently doing is equating any funding ever received by the Gates Foundation as being purchased personally by Bill Gates
For example, @UNITAID. Various bizarre claims have been made that any funding from Unitaid is equivalent to receiving a personal bequest from Bill Gates
However, even a very cursory examination shows that the Gates Foundation contributes only a tiny fraction of the Unitaid budget. The main funder is France, followed by the UK
Read 8 tweets

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