This very slick website presents what appears to be a research report using the language of randomly controlled trials, even talking about "assigning" countries to the control group or the treatment group.
We don't say randomized controlled trial, defenders of the website protest. We say country-randomized controlled trial, and that's a different thing.
How many members of the public will know the difference? This is designed to confuse.
The report itself is a case study in Humpty-Dumpty's "When I use a word, it means just what I choose it to mean—neither more nor less."
The fact that different countries used different treatment approaches is referred to as a randomized controlled trial.
I try hard to follow the advice we give in Calling Bullshit of not ascribing to malice what can be explained incompetence, but when the authors co-opt the language of randomized controlled trials and pretend countries were assigned different treatments, my self-control shatters.
1. As you may know, I'm a strong advocate of COVID testing. For the past few months, I've been collaborating with the people at @Color Genomics to understand how workplace testing could reduce outbreak sizes.
I've commented elsewhere on how epidemiology is the truly dismal science. Whenever you discover something new that would be good news all else equal, it's not as good of news as you think because now not all else is equal.
For example, if you discover that the infectious period is shorter than you thought, that might sound like good news. It would be, ex ante. But ex post, holding the epidemic trajectory constant, it means that the disease is more transmissible per contact event than you expected.
One of the impediments to frequent COVID testing is the discomfort associated with the NP swabs that go deep into the nasal passages. Some find it mildly uncomfortable, others dislike it more strongly.
It doesn't have to be that way. This isn't necessary for diagnosing COVID.
A new study in the NEJM demonstrates this. Self-collected swabs (tongue, nasal, and mid-turbinate) perform very nearly as well as professionally administered NP swabs and may actually have even higher viral titres.
Today has seen a remarkable push of pro-hydroxychloroquine propaganda. The America's Frontline Doctors video on Breitbart. Trump retweeting a claim that it works, now removed by Twitter. Massive social media action. Rudy (below).
I don't understand it, but it feels coordinated.
Every single issue around COVID has become politicized.
Fascinating how arbitrary the political alignment is in some cases.
Back in 2019 you might have been able to predict some things: GOP wouldn't want to limit church services and Democrats would want free health care....
But I think you'd have been very hard pressed to predict which side would be pro-hydrochloroquine or even pro-mask.
For me this severe politicization of the entirely arbitrary highlights the ingroup-outgroup dynamics of the entire epidemic.
It's late July. SARS-CoV-2 has been in the USA for over six months. In the past week, the FDA issued the first two emergency use authorizations for pooled testing: for pools of four w/ symptoms, and pools of five without.
Given the logistical overhead associated with pooling, this is next to useless.
The Quest EUA is only for suspected cases. At least the LabCorp is for proactive testing of asymptomatics.
But what are we doing? Screening can be low-sensitivity as long as it's high throughput.
As I've written elsewhere, test results are taking 5-10 days nationwide. Companies that want to enter with new testing technology get hung up for months in the FDA approval process—and this is just the rapid emergency use process!
But whether you are testing for individual health, surveillance, or mitigation, speed is of the essence.
2. When testing for individual health, every person with symptoms deserves to be able to be tested in a timely fashion, and to receive results promptly. Any functioning health care system would offer its members as much.
3. When testing for surveillance, we want to know what is happening now, not what was happening last week or the week before. Every day's delay in returning results is a day that we lose in being able to respond to changing prevalences of disease.
This is not wholly unexpected—I was never persuaded by the small studies suggesting reduced transmission in this age group–but it's not going to help one bit as we try to keep the pandemic under control while returning to some sense of normalcy.
Imagine having such a severe case of Dunning-Kruger that you write something like this in @USAToday and attempt back it up with a mere 269 words that would constitute a low-quality effort even for your average Covid-denialist twitter troll.
I get it that the White House would like to discredit Tony Fauci.
But my goodness they're really not sending their best people. Or if they are....yikes.
There's also a question of journalistic ethics.
I understand that the OpEd page follows different rules, but when should a newspaper allow a government figure to publish blatant misinformation around a national crisis?
1. This thread about an important paper from @jonassjuul, K. Græsbøll, L. Christiansen, and @suneman will be more technical than usual.
The paper addresses how to depict ranges of outcomes in simulations of COVID outbreaks (or other stochastic processes). arxiv.org/abs/2007.05035
2. As such it is of critical importance to people modeling the pandemic. But it's also important for anyone who wants to read and interpret models that others have created, because it warns against a trap that would be easy to fall into.
3. Disease outbreaks are fundamentally stochastic processes. The same disease, introduced into the same population, might infect a large number of people one time, and disappear quickly another time, based on the luck of the draw.
I don't want to succumb to the temptation of hyperbole, but watching the Trump administration's response to the COVID pandemic I can't help but think about the Three Years of Famine in China from 1959-1961. I'm far from expert. My understand is based largely on one college class.
That said, my sense of what happened is that Chairman Mao became enamored of some crackpot agricultural ideas from Trofim Lysenko (yes, that Lysenko) and Terentiy Maltsev.
These involved high-density planting and deep ploughing, both of which led to crop failures.
At the same time, the central government mounted an aggressive Smash Sparrows Campaign. Millions of birds were killed as supposed agricultural pests, leading to an explosion of the far more harmful insect pests that they would have fed upon.
Sixteen hours ago the South China Morning Post published a story about what is purported to be a new, deadlier-than-COVID pneumonia in Kazakhstan. The source seems to be a statement from the Chinese embassy there. Details are sparse and skepticism merited. scmp.com/news/china/dip…
CNN has now picked up the story is essentially repeating it without any further information. There is nothing about how COVID has been ruled out, nor much by way of epidemiological detail. Until we know a lot more, COVID seems the most likely explanation.
Last night I dreamed I was trying to steal a pizza from a sleeping grizzly bear. The bear woke, and very kindly asked for the pizza back. (It talked.) I should have just returned the pizza but instead I cursed the bear out and insulted its mother.
The bear started moving toward me, and I should have run. But instead I thought maybe I could still steal the pizza if I played my cards right. To make a distraction, I started smashing all the furniture in its bear house. The bear was pissed and started to growl as it advanced.
At this point I was in big trouble. I should have set down the pizza and begged for my life. But no. The magical thinking kicked in and I decided to up the ante. I opened the box and threw the hot pizza right in the bear's face. The bear swatted the pizza away with a huge paw.
It is heartbreaking to watch @CDCDirector Robert Redfield turn a great public health institution @CDCgov into a political propaganda tool. I feel dreadful for the thousands of talented, devoted professionals under his direction.
Today President Trump tweeted this:
In response, @CDCDirector Redfield undermined his own agency's position, promising to go back and issue new, politically expedient recommendations.
This is the exact opposite of public health leadership.
I don't want this pandemic to be a disaster. I don't want to see hundreds of thousands lives lost in the USA. I don't want to see hospitals overrun in a second wave. I don't want to see businesses closed, livelihoods lost. I don't want any of this. I'm not rooting for the virus.
This is not a career opportunity for me. In my line of work, no one cares how many twitter followers I have. I haven't submitted a single paper (the currency of our realm) in 2020—I've been too busy doing public communication and response planning around COVID.
@CDCDirector@cdc 2) Your agency provided COVID modeling parameters to federal agencies and scientific researchers. You set the IFR at less than half consensus estimates, and as of yesterday refused to explain why while stonewalling FOIA requests.