Nick Mark MD Profile picture
Jun 5 11 tweets 7 min read
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 🧵.
1/ ImageImageImageImage
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…
4/ Image
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

Jun 2
Once again EFD is fear-mongering without actually reading the paper.

In this study they placed anesthetized macaques in a plexiglass box & continuously inhale virus that was aerosolized by nebulizer.

This does not mean that #monkeypox is transmitted by aerosol!
1/ ImageImage
There is a huge difference between showing that a virus *CAN* be aerosolized in a controlled laboratory setting and saying it actually *DOES* spread as an aerosol.

There is no evidence that airborne transmission actually occurred in this (or any prior) monkeypox outbreak.
2/ ImageImage
Key points:
- read the whole paper including the methods
- try not to fall asleep with your head in a plexiglass box filled with nebulized monkeypox
- get medical advice about Monkeypox from actual experts in infectious disease (see my list below)
3/
twitter.com/i/lists/152708…
Read 4 tweets
Jun 1
FLCCC has gone from anti-vax dog whistles to full blown anti-vax yells.

Their new “protocol” (based on zero studies) treats “vaccine injuries” with their usual snake oil: vitC, IVM, HCQ, + hyperbaric O2 & more.

A🧵debunking this nonsense & a call for medical boards to act.
1/
First, this organization & its fringe doc members have moved from anti-vax adjacent IVM pushers to outright anti-vaxxers.

The official FLCCC position is “there is no medical justification to recommend vaccination.”flccc.substack.com/p/how-our-thin…

About as clearly anti-vax as it gets.
2/
They’ve also developed a new protocol to treat what they call “vaccine injury”?

What is “vaccine injury” you ask? Well they say it isn’t defined.

Basically anything bad that happens to a vaccinated person (snake bite, car crash, stroke, etc) could be “post-vaccine syndrome”
3/
Read 18 tweets
May 21
Observational study from 🇭🇰 demonstrates the real-world efficacy of oral COVID treatments: paxlovid, molnuparivir.

Both meds appear to prevent mortality, & reduce mechanical ventilation & ICU admission. Suggests that PAX may be superior to MOLN.

A🧵
medrxiv.org/content/10.110…
1/
This was a case control study of ~40k hospitalized people with COVID19, comparing people who received oral therapies (🟩MOLN, 🟦PAX) to those who didn't.

It was propensity matched 4:1. After matching there were n=2,116 MOLN, n=991 PAX, & n=12,348 matched controls.
2/
They examined hospitalizations from 26 February to 26 April 2022, which corresponded to the Omicron surge in Hong Kong.

During this period about 80-90% of people in Hong Kong had received ≥ 1 vaccine dose, and 70-80% were fully vaccinated.
3/
Read 5 tweets
May 15
A historical note about rounds.

A century ago, residents had to go all over the hospital to collect the data: medical records for the PMHx, lab for lab results, radiology to review scans, the bedside for vitals.

Presenting the data was important because only they had it all.
1/
That obviously isn’t true anymore. You can get all that data (& more) from the EHR. I can chart round on my phone at home. I don’t need data read to me.

But like many traditions in medicine, the practice of reading the data aloud continued long after the raison d'etre passed.
2/
For other examples of weird historical things we continue to do for no reason, you can read about the myth of OR shoe covers & or the most-translation of having a person say “ninety nine” to assess for fremitus.

onepagericu.com/blog/cx1l66qxj…

onepagericu.com/blog/tactile-f…
3/3
Read 5 tweets
Apr 23
Part 6️⃣ in my extremes of animal physiology #tweetorial series:

Case 1: How low can PaO2 go?

You are called by the lab about an abnormal ABG result.
pH 7.5 / PaCO2 20 / PaO2 22 / HCO3 15

“That’s gotta be venous” they say.
“No” you reply, “Its from a ___"
1/
Answer: bar-headed goose!

The Himalayan summits are almost lifeless.

In the midst of this barren landscape, breathless climbers have heard the thrum of wings & the honking of geese above their heads.

How can these geese breathe so easily while flying at over 8000m?
2/
Bar headed geese have many amazing adaptions to altitude: large hearts, specialized hemoglobins, highly capillarized muscles with dense mitochondria, and cerebral insensitivity to hypocapnia.

But most of all they have amazing lung physiology!

ncbi.nlm.nih.gov/pmc/articles/P…
3/
Read 30 tweets
Apr 23
Fun fact: in sauropod dinosaurs the recurrent laryngeal nerve (RLN) may have been up to 28 meters long!

For context:
in humans the RLN is ~10 cm long
in giraffes the RLN is ~5 meters long
in sauropods the RLN was ~28 meters!

1/ Image
This makes the sauropods RLN one of the longest cells ever!

How did neurotransmitters get to the end of this 28m nerve?

Recall that fast axonal transport moves cargo at 200-400 mm/day & slow axonal transport is more like 1 mm/day (this is why nerve healing is so slow btw!)
3/
Read 7 tweets

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