Nick Mark MD Profile picture
Jun 5, 2022 11 tweets 7 min read Read on X
Once again there is a wave of #misinformation about #ExcessMortality & #vaccines in the US.

A mysterious insurance report says “excess mortality is rising” could it be the vaccines?
No. Virtually all the excess mortality is associated with COVID infections!

A debunking 🧵.
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Every few months, a myth of “unexplained deaths not from COVID” resurfaces.
Last time they claimed “young people” were inexplicably dying. Looking at the actual data it was pretty clear that virtually all the excess deaths under 45 were due to COVID.

2/
In a later incarnation, this conspiracy theory revolved around a mysterious (and nameless) "insurance industry expert” & "former Wall Street analyst” who did his own analysis and “found an 84% increase in excess mortality."

This too has been debunked.
reuters.com/article/factch…
3/
Let’s look at the actual data:
If we look at weekly deaths of all cause, we can see five spikes above baseline in weekly deaths, each corresponding to a wave of the pandemic.
Source: CDC
cdc.gov/nchs/nvss/vsrr…
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How much of the increase in mortality is due to COVID?
If we look at # of deaths/week, comparing weekly COVID deaths to total deaths. we can see the answer is almost all of it!
Example: Of the ~27k excess deaths in early 2021, ~26k were due to COVID!
cdc.gov/nchs/nvss/vsrr…
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But we don’t have to look just at correlations, because Doctors put the cause of death on death certificates.

Looking at COVID associated deaths🟦vs non COVID deaths 🟩, we can see that virtually all of the excess mortality can been attributed to COVID infection!
Source: CDC
6/ Image
This isn’t really surprising since COVID was the THIRD leading cause of death in the US in 2021.
cdc.gov/mmwr/volumes/7…
7/
Not only do mortality spikes correlate with surges in COVID infections, they do NOT correlate with vaccinations.
Compare 3 lines: weekly excess Mortality ⬛, COVID cases 🟥, & vaccinations🟦
The correlation (R²) is higher for mortality⬛ & cases🟥.
github.com/hmatejx/COVID_…
8/ ImageImage
If we look at that insurance report that Kory shared (and clearly didn’t read), we can see more evidence that vaccination *reduces* excess mortality.
Specifically excess mortality is HIGHEST in the places with the LOWEST vaccinations!
Source: soa.org/48ff80/globala…
9/ Image
This too isn't surprising, we know that at this point in the pandemic the vast majority of COVID mortality occurs among unvaccinated people.
Source: Our World in Data
ourworldindata.org/grapher/united…
10/ Image
Summary:
-there IS a significant increase in excess mortality...due to COVID infection
-there IS NOT a temporal association between vaccines & excess mortality. In fact, quite the opposite: states with the highest vaccination rates had the lowest mortality #VaccinesWork
11/

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More from @nickmmark

Mar 9
Every year, there is a predictable spike in fatal car accidents, medical errors, & heart attacks.

It’s estimated that there are thousands of excess deaths, a 1% increase in energy consumption, & billions of dollars in lost GDP.

The cause? Daylight savings transitions.

🧵

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Earth's axis of rotation and orbital axis are not precisely aligned. The 23.5 degree difference - 'axis tilt' - gives us our seasons and a noticeable difference in day length over the course of the year.

2/
For millennia this seasonal variation was an accepted fact of life.

In 1895, George Hudson, a New Zealand entomologist, was annoyed that less afternoon light meant less time for bug collecting.

He realized that clocks could be adjusted seasonally to align with daylight.

3/ Image
Read 27 tweets
Feb 14
Musk is so stupid. Exhibit #10544

There aren’t thousands of 150 year olds getting paid social security. There are null values in a database he doesn’t understand how to read… Image
When unidentified people get admitted to the hospital the default DOB is 1/1/1900. The EHR shows their age as 125 yo.

But *almost* everyone is smart enough to understand this is just a result of missing data… Image
Nice summary here debunking Elon’s “duplicate SSNs” claim.

thedatageneralist.com/elon-musk-does…
Read 4 tweets
Feb 8
Important point re indirects:

Unlike other Trump moves, this is arguably GOOD news for researchers!

If the NIH budget is unchanged (a big if), this allocates more money to researchers; if you go from an indirect of 75% to 15% it means you can fund 3 grants instead of 2.
Some context:

Between 1947 and 1965, indirect rates ranged from 8% to 25% of total direct costs. In 1965, Congress removed most caps. Since then indirects have steadily risen.

2/
A lot of indirects go to thing like depreciation of facilities not paying salaries of support staff.

This accounting can be a little misleading.

If donors build a new $400m building, the institution can depreciate it & “lose” $20m/year over 20 years. Indirects pay this.

3/
Read 4 tweets
Jan 22
🚨Apparently all NIH Study Sections have been suspended indefinitely.

For those who don’t know, this means there won’t be any review of grants submitted to NIH

Depending on how long this goes on for, this could lead to an interruption in billions in research funding.
With a budget of ~$47.4B, the NIH is by far the biggest supporter of biomedical research worldwide.

Grants are reviewed periodically by committees of experts outside of the NIH.

When these study sections are cancelled, it prevents grants from being reviewed & funded.
Hopefully this interruption will be brief (days)

A longer interruption in study sections (months) will inevitably cause an interruption in grant funding. This means labs shutdown, researchers furloughed/fired, & clinical trials suspended. This will harm progress & patients!
Read 8 tweets
Oct 13, 2024
#HurricaneHelene damaged the factory responsible for manufacturing over 60% of all IV fluids used in the US, leading to a major national shortage.

As clinicians what can we do to about the #IVFluidShortage and how can we prevent this crisis from happening again?

A thread 🧵
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There are many things we can do as clinicians to improve ICU care & reduce IVF use.

1️⃣Don't order Maintenance IV Fluid!
Almost no patient actually needs continuous IV fluids.
Most either need resuscitation (e.g. boluses) or can take fluid other ways (PO, feeding tube, TPN).
2/
Frequently if someone is NPO overnight for a procedure, MIVF are ordered.
This is wrong for two reasons.
We are all NPO while asleep & don't need salt water infusions!
We should be letting people drink clears up to TWO HOURS before surgery, per ASA.

3/ pubs.asahq.org/anesthesiology…Image
Read 16 tweets
Oct 1, 2024
New favorite physiology paper: Central Venous Pressure in Space.

So much space & cardio physiology to unpack here including:
- effects of posture, 3g shuttle launch, & microgravity on CVP
- change in the relationship between filling pressure (CVP) & LV size
- Guyton curves!
1/

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To measure CVP in space they needed two things:
📼 an instrument/recorder that could accurately measure pressure despite g-force, vibration, & changes in pressure. They built & tested one!
🧑‍🚀👩‍🚀👨‍🚀 an astronaut willing to fly into space with a central line! 3 volunteered!
2/
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The night before launch they placed a 4Fr central line in the median cubital vein & advanced under fluoro.

🚀The astronauts wore the data recorder under their flight suit during launch.

🌍The collected data from launch up to 48 hrs in orbit.
3/
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Read 16 tweets

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