Dazzling, daring, stunning piece by JH Russell and @DmpPatterson in @tabletmag tellin the true story of masking during COVID 👇
"The overselling of policies began in the early days of the pandemic with the problematic #masks4all movement...."
must read
🧵 tabletmag.com/sections/scien…
First, they are spot on. Many don't see it, but Trump is so influential, He sets the sides!
When he was for schools, Liberals lost their mind and worked to keep them closed; AAP did a bizarre flip flop & sided with unions to keep them closed.
And the same for masks 👇
Absolutely right again 👇
Inexperienced & naive twitter pundits kept saying the pandemic would vanish if we all worse a mask or n95 for 14, 21 days, a claim....
"neither true nor possible"
Yes! The CDC & FDA have made so, so, so many blunders, and most during 2021
Political appointees have cut the legs out from under the agency; In the next ten years, it may topple entirely
"The arbitrariness of the resulting policy recommendations and mandates is etched into the many photographs of masked kids, sometimes posed with unmasked politicians, that will likely come to represent much of our badly flawed pandemic response."
I tried to warn that going beyond WHO and UNICEF to mask 2 year olds-- against global guidance was absolute madness. It was too young; too scant data.
CDC & AAP further cut their own legs
Authors, are spot on👇👇
Since the summer it was clear that vaccination with mRNA products in young men required nuance & Paul Offit advised his son not to be boosted
But White House pushed so hard FDA vax directors quit!
The authors are right that the reason Fauci went on 60 mins and said community masking doesn't work is that was the best consensus of the totality of data pre-pandemic, including multiple RCTs from influenza
"While studies of aerosols on masked mannequins may tell us something about fabric quality, they do not tell us much about the effect of a mask mandate—the actual policy—in reality."
Absolutely right; This group & twitter activists effectively poisoned efforts to run RCTs, polluting equipoise
Misdirected activism is harmful
Activism without evidence generation is catastrophic
A scientific q needed an RCT; now it is political
YES! people say with straight face that there are ZERO downsides; if that was true you should have been wearing it for years, and never take it off
"...little was known about the effects of masking on childhood development, which is part of the reason why the WHO and most European countries recommended against masking 2-year-olds."
"Some say it is unfair to criticize PH for... flip-flops—whether about cloth masks, herd immunity, natural immunity, or the vaccines’ effects on transmissibility—because they were just “following the science”.... But in many cases, what evolved was politics, not science"
Everything we feared has come true
Totally, "the rules seemed not to apply to them"
True for all these hypocrite politicians who mask 6 year olds while they party with celebrities at football games
A beautiful ending
Pls, pls, pls read their full essay here
Its a work of genius
Historians should frame it
It is what really happened @ID_ethics
Wow! 👇
secondary endpoint
potential for infinite looks at data
yet still, scant events (50?) of dubious clinical value (some asx?)
Plus other issues, including durability discussed in video
But postponing/ flip flopping is going to poison vax confidence
White house should not have pressured FDA on boosters
Gruber and Kraus should still be there
Politics cannot dictate vaccine approval
This is a total fiasco
This administration is doing serious, serious damage to vaccine confidence
The backlash will hurt a lot of people
States will get rid of good programs to encourage routine childhood immunization
Vaccines become even more political
This administration does not have a plan here
They should have awknowledged natural immunity
and tried for just 1 dose in people with no prior NI
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
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
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
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.