This administration's COVID-19 policy is best summarized by n95 for kids, while nursing home patients are unboosted

We do controversial things on the lowest risk that will make no difference, but poison public sentiment

And we don't do simple things that would save lives

🧵
Here are some controversies:
White House pushes boosters so FDA officials resign
We push boosters down to 12 years old without all appropriate advisory committees
We use Pfizer data so Moderna can be given booster at 5 months
We mandate millions of 20-year-olds get boosted in college or for certain employers even though they are at negligible risk after vaccine, and there is no evidence, booster will further lower their risk of severe outcomes
We literally change the rules at the FDA to try to bring a failed vaccine product to 6-month-old to 4-year-olds

The administration has aggressively pursued masking children despite weak evidence
The administration is obsessed with pushing interventions on the low risk population

Meanwhile
Nurses were actively sick with COVID-19. Can work in nursing homes

The US lags European nations in vaccination of the elderly
The US is a total failure in boosting the elderly

US has no mechanism to exert pressure on the elderly, and settles for exerting pressure on children
The unique aspect of the administration is that they are willing to use the brute force power of government to try to stop the pandemic, yet they routinely use that force in the wrong direction
They were quickly burn through all their political capital. They will create a deep resentment from most people, and they will still witness staggering death tolls when the virus eventually sweeps back through the older community
The administration has never articulated what its strategy is. The left hand is not talking to the right hand. Messages are confused and muddled
One week fauci says we'll all get the virus and the next week they mail you an n95 but not enough to last
There testing is a fiasco
The FDA has such low rules for vaccinating children, but such high rules for selling tests. It's crazy
And at no point has anyone actually said who is in charge of these decisions. Who is actually making these decisions. It's not even known.
Any historian of public Health will view 2021 as a total failure of government to tackle a pandemic

Focusing on the wrong population, and using force in a way that will create an inevitable backlash
I truly worry that in the next 20 years many states will pass laws that actually make it harder to do the routine vaccination that we know works. They will be a huge backlash to all these efforts.
They will be a huge backlash to all these efforts.I truly worry that in the next 20 years many states will pass laws that actually make it harder to do the routine vaccination that we know works.
There were two kinds of people in the world. People who understand the risk of gradient by age and people who want to push restrictions on kids
As a lifelong progressive, Bernie Sanders supporter, it's been sad for me to watch the follow. The science administration basically follow the Twitter. At times actually seed stories on Twitter with their agents
It will be a toss up. But I think some historians of science will recognize that greater errors were made in 2021 than 2020. When it comes to US pandemic policy.
Each day those people who resign from FDA, Gruber and Krause are probably more and more happy that they are not going to be responsible for this fiasco

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More from @VPrasadMDMPH

Feb 3
Lots of talk of wearing masks.
The policy question is: what happens when you advise people to:
Wear cloth masks
Wear surgical
Wear n95s

You have to combine mask properties with real world compliance

Ans:
No benefit
11% benefit in setting w no immunity & high bias rct
No trial
The 11% benefit should have an* because there is a serious risk of concealment being revealed in the study due to imbalance and study population by arm
If you pair this imbalance with the idea that people will be slightly less likely to report symptoms if they were enrolled on the margin. You have a big problem
Read 6 tweets
Feb 2
Some people are reporting that the failed Pfizer trial kids 6mo -4yo will show a reduction in symptomatic infections even though the antibody titers failed

Here is why even that data will be problematic 🧵
The first question will be how many of these infections occurred when Omicron was the dominant strain.

Any infection from the prior strain will not be that interesting or pertinent.
The next question will be: how symptomatic were the kids.

The second dose of their vaccine was perfectly timed so that the transient immunity would occur during the Omicron Wave. This also coincided with widespread asymptomatic testing for the holidays
Read 10 tweets
Feb 1
Last I saw the RCTs in kids at this age failed to meet the modest benchmark of non-inferior antibody titers from 2 doses of 3 micrograms of vax. Pfizer had extended the trial to add a 3rd dose, but the trial is ongoing. What changed? Do we realize how low a bar this is? 🧵
We are going to approve mass vaccination in the USA based on antibody levels-- not fewer severe cases of COVID19. The trial has absolutely no power to ascertain this rare outcome in kids.

But, even that low bar was not met. the trial added a 3rd dose as Ab levels low
So has the trial met the endpoint?
Is this really the evidence we want? Or should we demand more

Our failure was not demanding kids RCT powered for clinical endpoints.
Read 4 tweets
Feb 1
Few thoughts on Rogan/ Spotify 👇👇

1. If Rogan is pushed off Spotify, his influence will actually rapidly grow

Spotify makes it slightly harder to listen to the show. Being independent means he will reach more peopel Clever analysis of this

🧵
theverge.com/22632213/joe-r…
2. The "bad"/ "deadly" claims made on the show are actually far more complex.

I listened to both episodes twice and dissect what was right and wrong for Unherd Magazine 👇👇

It cannot be reduced to simple soundbites
unherd.com/2022/01/we-nee…
3. Many passionate commenters have not listened to the episodes/ have not explained what they view as correct or incorrect.

We increasingly enter a culture where it is acceptable to criticize something without providing examples or reasoning. Not good.
Read 12 tweets
Jan 31
Not only am I a progressive, Bernie Sanders fan, but I wrote 2 books about how to reform drug regulation & medicine to improve health & save society $$

So it has been heartbreaking to watch the left on the wrong side of many COVID19 issues: masking, kids, school, mandates, etc
Everything done to keep kids "safe" has been delusional, unproven, harmful mitigation that is not proportionate to the risks they face, harmful to their language and development, and has hurt a generation more than any other insult this century.

The left failed kids
End of story
Here are some links:
I can't believe they never ran a single, cluster RCT in kids
tabletmag.com/sections/scien…
Read 5 tweets
Jan 30
Wes' argument is that misinformation thrives in a vacuum where experts/ institutions have lost trust through repeatedly lying or pushing flawed or distorted science...
Is True!

A few e.g.
The Nobel Lies: slate.com/technology/202…
🧵
That was just the start on many issues...
city-journal.org/public-healths…
It even applies to people outside of anointed circles.

What am I to think when someone offers this paper as evidence that masks keep daycares open?

Just read the issues with it. It is astonishing.

vinayprasadmdmph.substack.com/p/a-new-paper-…
Read 7 tweets

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