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14 Jan, 7 tweets, 4 min read
This is the myocarditis study that was brought up by journalist @joshzepps who 'debunked' @joerogan
tinyurl.com/2httdr9n
Only problem: paper made the diagnosis based on certain diagnostic codes that were charted. ICD10 codes listed include R01.1 (cardiac murmur unspecified)
Studies that are more rigorous about how myocarditis was defined (requiring lab abnormalities + imaging abnormalities + clinical symptoms) show vaxx myocarditis rates >> COVID myocarditis rates
There is a CDC report floating around that claims a 16x higher rate of myocarditis (this was mentioned by @drsanjaygupta on @joerogan ) . There are some basic major issues with this as well that I go into on this thread
Contrary to what some seem to think, it is not only far from settled that covid myocarditis in young men occurrs more often than vax myocarditis... there are multiple concerning signals that suggest rates of vaxx myocarditis r actually higher in this demographic.
The prolific @VPrasadMDMPH has a nice summary of a recent nature article
vinayprasadmdmph.substack.com/p/uk-now-repor…
Again this pic from a JAMA study which shows NO myocarditis spike in all of 2020 (Lots of COVID, no vaccine available)
Major issue with C19&myocarditis appears to be overdiagnosis by academic imaging centers that rely on screening healthy people to diagnose them with things they don't have. I go through the flawed study that almost cancelled college football here:

medscape.com/viewarticle/93…

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More from @anish_koka

Anish Koka Profile picture
18 Dec 21
A quick word about Antibody Dependent Enhancement (ADE). Must say, there is nothing to suggest this is operative at present with Sars-COV2 or the vaccines for it, but the historical context is very interesting!
ADE occurs when the antibodies generated during an immune response recognize and bind to a pathogen, but instead of preventing infection, the complex allows easier access of the pathogen into the cell.

When vaccinated individuals fall ill this is but one possibility..
The other possibilities are :
1. A mild illness (evidence the vaccine worked to prevent more severe disease
2. A breakthrough (a term normally used to describe severe illness that results even after a vaccine, which cld mean the vaxx didnt work, didnt generate enough antibodies)
Read 9 tweets
Anish Koka Profile picture
18 Dec 21
Its possible for the following 2 things to be true :

1. Vaccines appear to be safe for most people, and appear to be effective in reducing the burden of severe disease

2. mRNA vaccines are associated with myocarditis (the CDC agrees : tinyurl.com/kfj9kc9y)
Much of the debate from mostly non-cardiologists focuses on "mildness" of vaxx-myocarditis, and risk of myocarditis from Sars-COV2 (COVID).
Some thoughts :
1st - multiple datasets beyond the much maligned VAERS report links vaccines with
myocarditis
Israeli Study: Notice uptick after 2nd shot.
"Most cases were mild or moderate in severity, but one patient had cardiogenic shock, and one patient with preexisting cardiac disease died of an unknown cause soon after hospital discharge."
tinyurl.com/hd3nrbun
Read 14 tweets
Anish Koka Profile picture
4 Dec 21
Appreciate the conversation with @Jabaluck

The TL/DR version

RCTs are attractive for divining cause and effect because randomization is supposed to deal with confounders
@Jabaluck acknowledges the concern about effective randomization because the survey teams that enrolled participants were more motivated to enroll patients in villages randomized to masks. [~14,000 more Pts were in the mask intervention than control.]
This imbalance creates a potential fundamental problem because the 1º endpoint (symptomatic sero positive patients) only differed by a total of 20 cases in the 10,000 out of 300,000 patients that were convinced to give blood samples.
Read 16 tweets
Anish Koka Profile picture
25 Nov 21
Again kudos to @beenwrekt for taking the trouble to find out what the raw numbers actually were in the Bangladesh mask RCT that’s been used in court to support school mask mandates.

The difference between the raw data and what was presented in the Preprint is striking 1/
Here is the verbiage from the study —> an 11% relative risk reduction in symptomatic seroprevalence with the treatment group that was given surgical masks,
The tables to support these words are here ..

The authors could have chosen to give us the actual raw numbers of symptomatic sero positives in treatment vs control, but instead we get interventional prevalence ratios and interventional coefficients ..

But they don’t.
Read 7 tweets
Anish Koka Profile picture
24 Nov 21
Appreciate authors of the 🇧🇩 RCT finally releasing raw data.

Dismayed at their topline conclusion on mask effectiveness that generated so much buzz

Out of ~340,000 ppl in mask and control arm.. the difference in symptomatic cases was 20 over 8 weeks.

benjamin-recht.github.io/2021/11/23/mas…
Brief summary for those interested. Bangladesh mask was a cluster RCT, (cluster because unit of randomization was a village) Treatment group had public policy intervention to increase use of masks, Control group was basically a poorly enforced govt. mask mandate)
Per pre-print 342,126 individuals in study. Endpoint was COVID 19 +ve symptoms AND positive antibodies.
Key Table shows of ~150k pts in each arm, blood samples could only be collect from ~5k patients in each arm.

poverty-action.org/sites/default/…
Read 14 tweets
Anish Koka Profile picture
23 Nov 21
Trying to make sense of all things COVID with @VPrasadMDMPH

What does Foucault have to do with COVID epistemology, you ask?

Listen to find out :)
The strongest case I’ve heard for vaccinating kids against COVID : @DrPaulOffit (Part 1)
accadandkoka.com/episodes/episo…
Important considerations for parents choosing to vaccinate their kids. Cody Meissner : Chief of peds ID, VRBPAC member.

Not as easy a decision as some would suggest..

accadandkoka.com/episodes/episo…
Read 7 tweets

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