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COVID Stupid

No, just didn't get around to it last night.



I guess the question then should be why it is made freely available? I'm not saying it should be hidden, but perhaps only provided to those doing real research.
Maybe they should block access. But then the anti-vaccine people don’t say the government is hiding data. I would imagine the open access is about providing transparency. And if you’re going to pick and choose who gets the data, then you need to employ some sort of system to approve/deny it which I assume no one wants to deal with on either side. If anybody can request the data, than what’s the point other than making things more complicated, again requiring some sort of system to handle request. And presumably the information could just be republished elsewhere and given VAERS is being continuously updated, now you potentially have outdated information being passed around.

For most people it’s been historically been a very niche database a normal person would never pay attention to.

Like any clinical information, be it a database of raw data or clinical trials or studies, the information is only as good as it’s context. There’s plenty of peer reviewed, double blinded placebo controlled clinical trials freely available that are absolute garbage because of how the studies are designed. But that doesn’t mean they should be censored. To a large extent way our scientific system works is that the reader must be the judge of quality (though where studies are published are usually one way to help with that). Otherwise we get into arbiters of truth and things of that nature.
 
I guess the question then should be why it is made freely available? I'm not saying it should be hidden, but perhaps only provided to those doing real research.

Give to anyone who requests it, just don't make it freely available on a website.
You know the basic idea was that it is reasonable to expect people to respect publicly valuable resources just like it's reasonable to expect people not to dump trash in water reservoirs or prank call 911.
 
You know the basic idea was that it is reasonable to expect people to respect publicly valuable resources just like it's reasonable to expect people not to dump trash in water reservoirs or prank call 911.
There will always be people who spit gum on the sidewalk. That’s no reason to get rid of sidewalks. If you start down that path, everybody loses.

For example, Lakewood, New Jersey had a homeless problem. Instead of finding them accommodations, they chopped down all the trees in the public park that some were using for shade. Now nobody gets shade on a hot day.

 
There’s an endless amount of stupidity coming from the conspiracy minded Anti-vaxxers of the world. For example, evidently, there is a belief the government “engineered” the hurricane to hit Florida and devastate the population, a population largely comprised of those who opposed mandates including the many people who were somehow manipulated into moving there because of their anti-mandate beliefs. So basically the hurricane intentionally created to target those who oppose mandates. The fact this is fact checked is mind blowing on multiple levels.

On the other hand, there is insanity on the pro-vaccination side where at this point they’re practically bordering on mild mental illness. There are obviously some people with conditions that may put them at increased risk and limited environments where such people are in abnormally high numbers where masking is reasonable. But I’m not talking about those situations.

Then we have situations like this that I’m not entirely sure what to make of. Apparently California is banning doctors from spreading COVID “misinformation” to patients in an attempt the reinforcement of BS ideas and potentially inappropriate practice/malpractice. The law however only applies to discussions with patients directly, not blog posts or social media. If you’re trying to stop BS from spreading, it seems stopping the widespread dissemination of that information on the internet would be a good starting place.

I don’t know where begin to talk about the problems of such a law. On the one hand I find the use of hydroxychloroquine and ivermectin and other stupid, wasteful, and unscientific beliefs. On the other hand, it wasn’t long ago if you said the vaccines didn’t prevent you from getting ill or spreading the virus you would have been censored and exiled from the professional community.

This very much seems like a slippery slope that could find its way into other areas of medicine. To some extent so such policies already have.

There’s plenty of quack doctors out there that give bad advice. There’s plenty of doctors who in nonsensical treatments for everything under the sun. Like all that crap Dr. Oz was marketing. Hell, my sisters has a dentist that refers to her for implants who believes titanium implants pickup radio signals and cause disturbances to the patient. There’s plenty of anti-pharma, anti-scientific doctors out there- many of them believe what they’re selling, perhaps many more know it’s snake oil but see it as a lucrative market.
 
Then we have situations like this that I’m not entirely sure what to make of. Apparently California is banning doctors from spreading COVID “misinformation” to patients in an attempt the reinforcement of BS ideas and potentially inappropriate practice/malpractice. The law however only applies to discussions with patients directly, not blog posts or social media. If you’re trying to stop BS from spreading, it seems stopping the widespread dissemination of that information on the internet would be a good starting place.


Patient: So Doc, what can you tell me about ??? treatment for COVID.

Doc: I have plenty of information on my blog.

Patient: Thanks Doc. I will check it out when I get home.
 
Then we have situations like this that I’m not entirely sure what to make of. Apparently California is banning doctors from spreading COVID “misinformation” to patients in an attempt the reinforcement of BS ideas and potentially inappropriate practice/malpractice. The law however only applies to discussions with patients directly, not blog posts or social media. If you’re trying to stop BS from spreading, it seems stopping the widespread dissemination of that information on the internet would be a good starting place.
This restriction is allowed because of rules regarding “unprofessional conduct” for doctors. The government cannot censor social media or blogs.
 
More COVID stupidity from Florida’s surgeon general…


For those who don’t mind scrolling through a Twitter thread, here’s a detailed takedown of the idiocy:

 
We saw it happening in real time, but this report gives further confirmation and more details from behind the scenes.

Trump and his cabinet didn’t care about the health of Americans at all. There‘s absolutely no doubt that their constant working against the CDC instead of with it led to hundreds of thousands of unnecessary deaths. And not just from bad policies, but by openly undermining the agency, destroying people’s faith in it, especially people who supported Trump.

Trump appointees oversaw a concerted effort to restrict immigration at the U.S.-Mexico border during the pandemic, change scientific reports and muzzle top officials at the Centers for Disease Control and Prevention, according to emails, text messages and interviews gathered by a congressional panel probing the pandemic response.

Former CDC director Robert Redfield, former top deputy Anne Schuchat and others described how the Trump White House and its allies repeatedly “bullied” staff, tried to rewrite their publications and threatened their jobs in an attempt to align the CDC with the more optimistic view of the pandemic espoused by Donald Trump, the House select subcommittee on the coronavirus crisis concluded in a reportreleased Monday.

Several public health officials detailed a months-long campaign against Schuchat sparked by Trump appointees’ belief that her grimassessments of the pandemic reflected poorly on the president, leading Schuchat, a 32-year CDC veteran, to openly wonder if she would be fired in the summer of 2020, her colleagues told the panel.

Title 42 was not effective in stopping the virus, and was created by racist ghoul Stephen Miller, not the CDC.

“If we constantly are finger-pointing and blaming somebody else for things, we lose the fact that the real enemy here was the virus,” Cetron said in a May 2022 interview included in the report, adding that political infighting contributed to a subpar pandemic response. Cetron also criticized a federal order, Title 42, which used the pandemic as a public health reason to bar people from entering the United States at its borders with Canada and Mexico, as an example of a poorly constructed policy on which CDC experts were overruled.


The order was “handed to us,” Cetron told the panel, saying that then-White House adviser Stephen Miller was among the officials who discussed the immigration restrictions. Other emails and media reportshave linked Miller to the order’s creation.

While Cetron said he and his team opposed the order, arguing that it lacked a scientific basis because the coronavirus was already widely spreading in the United States and could lead to harm for asylum seekers, Redfield signed Title 42 in March 2020. The Trump administration characterized the measure, which allows the government to immediately send asylum seekers back to their home countries, as a way to prevent the spread of infection inside detention cells, border stations and other crowded settings. Hundreds of thousands of migrants have since been turned away at the U.S.-Mexico border. The measure remains in place under the Biden administration, after a district court judge in May blocked the administration’s plan to lift the order.

The report also details how Trump appointees at the Department of Health and Human Services worked to wrest control of the agency’s Morbidity and Mortality Weekly Reports (MMWRs), which offer public updates on scientists’ findings and had been considered off-limits to political appointees for decades.

McGowan and Campbell told the panel that fellow Trump appointees were angry about a May 2020 MMWR written by Schuchat that they believed did not give them sufficient credit for their efforts to contain the pandemic.

“Secretary [Alex] Azar, in particular, was upset and said that if the CDC would not get in line, then HHS would take control of approving the publication,” McGowan and Campbell’s lawyer wrote to the panel. As a result, Trump appointees increasingly received access to the CDC’s draft summaries and sought to edit or block the reports, including one on the rise in hydroxychloroquine prescriptions that was held up for more than two months amid concerns that it would call attention to an unproven treatment touted by Trump.

(paywall removed)
 
Master of the obvious:


I'll have to take a look (quite busy these days), but Dr Black's argument isn't really valid because if COVID drove those spikes you would see multiple peaks in the excess mortality data. That said, I believe none of the stuff posted there. Both he and Dr Hoeg are super junior researchers, so I don't get excited by their comments. And Dr Ladapo...well, is Dr Ladapo. Florida hasn't done so great in preventing deaths since the vaccine is out and it isn't driven by the old folks there.
 
Master of the obvious:


And looking at the data, Dr Black is correct, but used a really shitty diagram to demonstrate it. One can always dig deeper, but just looking at the excess mortality data, I just don't see an alarming signal beyond COVID killing a lot of people who weren't expected to die. So that sole excess mortality peak in the 25-44 age group followed excess mortality in 45-64... If vaccines were to blame we'd see a similar rise in the 0-24 age group. If we look at the trends for the whole US, those excess death peaks are time locked with COVID peaks and not the vaccination campaign. It's just weird.

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More COVID stupidity from Florida’s surgeon general…


For those who don’t mind scrolling through a Twitter thread, here’s a detailed takedown of the idiocy:



Thank you for posting this for everyone. It’s a very well done and concise explanation of the problems with FL’s “study”.

When this news broke a few of my colleagues and I looked into this and came to the exact same conclusions. This is a laughably poor analysis based on very, very vague, not to mention scarce data. Not to mention the fact it’s not peer reviewed and neglects to even mention authors names and loads of other expected info- total red flags. There’s so many cofounders here too that were not sorted. And there’s no statistical power analysis, another red flag, which is my quick math suggests is on the very, very borderline of showing statistical significance. But given so much uncertainty around the actual cause of death this could easy slip to insignificance.

The Dr. In the Twitter thread mentions that the cause of death were drawn from death certificates as being problematic. to expand a little more, studies show only 50-60% of the time when cardiac arrest is listed as the COD is the death actually found to be caused by sudden arrhythmic arrest when an autopsy is actually preformed. Up to 20% of the time the actual COD is drug overdose- a remarkably common form of death in people under 40, particularly in FL these days. Not to mention many other possible misconstrued of causes.

This definitely looks like a study done on a zero dollar budget and zero resources and in like a 3 day period… by a bunch of undergrads. FL should be embarrassed to put something out like this, let alone base policy on it.

This really is not all that an uncommon phenomenon that garbage studies get published. It seems increasingly common flawed science is used in policy these days. It’s also nothing new large swaths of medical providers have little-to-no ability to assess the quality of medical literature. It’s a learned skill that requires practice and upkeep, sadly many don’t bother.

To be clear, it’s extremely important to closely monitor potential adverse effects of marketed pharmaceuticals and is required by law. There have been numerous high profile examples of such issues going unnoticed in initial trials due to study limitations, only to be discovered many years and deaths later. That said, the COVID-19 vaccines are probably the most intensely studied pharma product in history. If a problem exists I would think it would have been discovered at this point.

There have been numerous studies on COVID vaccines causing blood clots (which could lead to cardiac arrest). Pfizer and Moderna have not been found to have an increased risk. J&J and AstraZeneca however do carry a risk- at the rate of like single digits in a million. AZ (not sold in the US) age restricted their vaccine to those above 40 and that essentially solved the problem. AZ and J&J are barely used in the developed world at this point in favor of Moderna and Pfizer which are perceived as superior products.

If there’s one thing that pisses me off it’s garbage studies.
 
If there’s one thing that pisses me off it’s garbage studies.
Ladapo has a PhD in public health from Harvard and had been an clinician-scientist/epidemiologist until now. He also has all the resources Florida has to do an adequate analysis. The early data showed very high rate of myocarditis in COVID (double digit percentages). Per my vague recollection the risk increase with the mRNA vaccines was in the 1 in 10,000 range, and these weren't fatal. So the risk/benefit ratio is obvious, and when the COVID risk is so high, it just washes away the minute risks from COVID vaccination. Ladapo simply has an agenda. Florida didn't do well with COVID mortality, they are in the top 13 of the mortality list, and they are even worse in the postvaccine deaths, their vaccination rates might be decent for 63+ but quite low with younger and they are lagging with boosters. So when the Surgeon General goes now "incidentally" drawing false conclusions then it's no longer negligence, ignorance, or sloppiness, it's an agenda.
 
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Ladapo has a PhD in public health from Harvard and had been an clinician-scientist/epidemiologist until now. He also has all the resources Florida has to do an adequate analysis. The early data showed very high rate of myocarditis in COVID (double digit percentages). Per my vague recollection the risk increase was in the 1 in 10,000 range, and these weren't fatal. So the risk/benefit ratio is obvious, and when the COVID risk is so high, it just washes away the minute risks from COVID vaccination. Ladapo simply has an agenda. Florida didn't do well with COVID mortality, they are in the top 13 of the list, and they are even worse in the postvaccine deaths, their vaccination rates might be decent for 63+ but quite low with younger and they are lagging with boosters. So when the Surgeon General goes no "incidentally" drawing false conclusions then it's no longer negligence, ignorance, or sloppiness.

I’m sure the SG knows exactly what he’s doing, which makes this all the more troubling. I have no idea whether or not he is the one responsible for writing this study. It’s not terribly hard to yield the results you want if you set things up appropriately. But for those practitioners who think this is is sound, evidenced based advice… it’s just silly.

I believe the rate of myocarditis pre-COVID was 1:100,000 while during the pandemic numbers reached as high as 150:100,000. Yes the COVID vaccines carry a risk of myocarditis, but as you mentioned it’s rarely fatal (not to minimize the severity of the condition). The AHA has firmly said the benefits outweigh the risks related to myocarditis.

At the end of the day people are going to do what they’re going to do. The best we can do is provide education and positive encouragement.
 
I’m sure the SG knows exactly what he’s doing, which makes this all the more troubling. I have no idea whether or not he is the one responsible for writing this study. It’s not terribly hard to yield the results you want if you set things up appropriately. But for those practitioners who think this is is sound, evidenced based advice… it’s just silly.

I believe the rate of myocarditis pre-COVID was 1:100,000 while during the pandemic numbers reached as high as 150:100,000. Yes the COVID vaccines carry a risk of myocarditis, but as you mentioned it’s rarely fatal (not to minimize the severity of the condition). The AHA has firmly said the benefits outweigh the risks related to myocarditis.

At the end of the day people are going to do what they’re going to do. The best we can do is provide education and positive encouragement.
The issue is there tends to be peer discussion / expert discussion, panel review, etc when it comes to big items like vaccine recs. Something seems wrong with Florida, but TBH I don't have the stomach to really dig into how this all had been communicated, etc. I generally prefer to just ignore problematic sources.

Also, as a peer reviewer (I just rejected 2 papers today), I'm getting increasingly bitter about the peer review process. I see a lot of papers coming back to me for second round revisions that I really don't think deserve a second round and I don't even do reviews under like 5 impact factor journals (so I'm not doing reviews for low-impact journals, not out of snobbery but because I don't want to deal with this).
 
The issue is there tends to be peer discussion / expert discussion, panel review, etc when it comes to big items like vaccine recs. Something seems wrong with Florida, but TBH I don't have the stomach to really dig into how this all had been communicated, etc. I generally prefer to just ignore problematic sources.

Also, as a peer reviewer (I just rejected 2 papers today), I'm getting increasingly bitter about the peer review process. I see a lot of papers coming back to me for second round revisions that I really don't think deserve a second round and I don't even do reviews under like 5 impact factor journals (so I'm not doing reviews for low-impact journals, not out of snobbery but because I don't want to deal with this).

I would imagine peer reviewing minimal impact publications in many cases is hardly worth anyones time. And the lower the impact I would assume the more garbage comes in, at least on more mainstream topics. Unless you’re in some super niche field that’s not going to have a lot of impact due to its extremely niche topic and you have a passion for that. A friend of mine reviews for the Journal of Liposomal Research- impact factor of maybe 3. You can’t get much more niche than that. Liposomal drug delivery systems have a lot of importance and a growing one at that- we wouldn’t have mRNA vaccines without them, but obviously not a topic most people would have any interest in.

I imagine that is extremely frustrating dealing with multiple submissions of poor quality research. On the other hand it’s pretty troubling that even at the Lancet and NEJM they published those Surgisphere-sourced COVID treatment studies that appear to have just fabricated data from thin air. I believe in the HCQ study they reported more deaths from HCQ treatment than actual COVID deaths had occurred up until that point in Australia. No hospitals have ever been found that claim they provided data. The most cursory review of the data should have indicated a problem to the peer reviewers. And then such a study calls into question the use of HCQ for other conditions, not to mention shut down research entirely (granted the evidence for HCQ use IMO was never really existed and the French studies promoting it were basically garbage that suggested nothing). I suppose the question is we’re they trying to once and for all shut down the HCQ nonsense by any means necessary or was it just a grift?

AFAIK Dr. Mehra is still employed by BWH. Harvard Medical appears to have cut ties with him, or at least create that appearance. Surgisphere appears to no longer exist, at least to any meaningful extent. I know Mehra is otherwise an extremely well regarded physician and researcher which is quite sad considering how he conducted himself. These studies weren’t just a poorly designed or flawed, they appear to have been intentionally deceptive. I’m a bit troubled that the studies were retracted and essentially the issue was just swept under the rug. I would think an investigation as to how this happened and at a minimum some disciplinary sanctions if deemed appropriate.
 
I would imagine peer reviewing minimal impact publications in many cases is hardly worth anyones time. And the lower the impact I would assume the more garbage comes in, at least on more mainstream topics. Unless you’re in some super niche field that’s not going to have a lot of impact due to its extremely niche topic and you have a passion for that. A friend of mine reviews for the Journal of Liposomal Research- impact factor of maybe 3. You can’t get much more niche than that. Liposomal drug delivery systems have a lot of importance and a growing one at that- we wouldn’t have mRNA vaccines without them, but obviously not a topic most people would have any interest in.
That's pretty funny. I do some niche research on liposomal delivery systems.🙂 Though as a translational researcher my goal is always and consistently to take it all back to the clinic, so kinda un-niche things. Truth be told there are well-regarded low impact factor journals. A good editor has full control over keeping junk away from reviewers. But predatory publishing has different priorities and what I think is going on is lack of prescreening can serve as a kind of cost reduction. Though I don't know how much the wear down reviewers. I do know that I got 4 or 5 review requests just this week...
I imagine that is extremely frustrating dealing with multiple submissions of poor quality research. On the other hand it’s pretty troubling that even at the Lancet and NEJM they published those Surgisphere-sourced COVID treatment studies that appear to have just fabricated data from thin air. I believe in the HCQ study they reported more deaths from HCQ treatment than actual COVID deaths had occurred up until that point in Australia. No hospitals have ever been found that claim they provided data. The most cursory review of the data should have indicated a problem to the peer reviewers. And then such a study calls into question the use of HCQ for other conditions, not to mention shut down research entirely (granted the evidence for HCQ use IMO was never really existed and the French studies promoting it were basically garbage that suggested nothing). I suppose the question is we’re they trying to once and for all shut down the HCQ nonsense by any means necessary or was it just a grift?
The HCQ thing was a huge mess. Essentially, there's no incentive in double checking data source integrity. Surgisphere made up data, and the investigators wanted to be quick like most of us during COVID (hell, even I got a COVID kind of editorial in a very high impact journal). The original HCQ study on the other hand was more than just naïveté. There's a long article on that. I think that paper turned out to have not even been sent out to reviewers. And it only took a 5min read to see that they excluded all patients who went to the ICU on HCQ.


 
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