14/n But if we look at the other included studies, this problem is repeated. The French and Japanese studies both used highly-selected patient populations, both of which likely would lead to a biased (low) estimate of IFRpic.twitter.com/imYkR1aEyN
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25/n In particular, Ioannidis argues that places with lots of elderly and disadvantaged individuals are "very uncommon in the global landscape" This is trivially incorrect. Most of the world is far worse off than people in NEW YORK CITYpic.twitter.com/HzmUcBdq0V
26/n There's also some discussion of the obviously underestimated studies, which begs the question why they were included in the first place? They are clearly not realistic numberspic.twitter.com/PFpfWbNTZk
27/n ...and then a paragraph about Iran that contradicts the earlier points raised about why NYC has seen so many deathspic.twitter.com/u70mD8SEWH
28/n Some discussion about press release science (we are agreed that it isn't good) but no mention of government reports This is a HUGE gap to the study
29/n For example, why wasn't this Spanish seroprevalence study included? It is the biggest in the world, and estimates IFR to be ~1-1.3% - triple the highest estimate in this review!pic.twitter.com/VUxKFVNO2O
30/n On the other hand, why were clearly biased estimates included? Why was 500 arbitrarily the minimum size considered for included research (if you choose 1,000, the IFRs are suddenly much higher)
31/n Which brings us to this conclusion, which is, frankly, a bit astonishing Is it a fact? That's certainly not shown in this review, and most evidence seems to contradict this statementpic.twitter.com/V9LKRjHKHv
32/n The final thoughts here may make this a bit more understandable It seems the author is not a fan of lockdowns. Perhaps this has driven his decisions for his review?pic.twitter.com/BcvRv1XooZ
33/n Ultimately, it's hard to know the why, but what we can say is that this review appears to have very significantly underestimated the infection-fatality rate of COVID-19
34/n Moreover, the methodology is quite clearly inadequate to estimate the IFR of COVID-19, and thus the study fails to achieve its own primary objective
35/n Something that people are pointing out - another weakness of this study is that the author appears to have taken the LOWEST POSSIBLE IFR estimate from each study For example, the Gangelt authors posited an IFR of 0.37-.46%, this paper cites 0.28% https://twitter.com/FreisinnigeZtg/status/1262983934549397511?s=20 …
36/n I should note - this paper is currently a PREPRINT This gives us a great opportunity. We can correct the record in real time, and put up a study that actually achieves its aims Let's hope it happens
37/n I think it's also worth pointing out that I personally WISH that the IFR of COVID-19 was 0.02%. It would solve so many of our problems - unfortunately, it seems extremely unlikely
38/n Another good critique of the study is here: https://quomodocumque.wordpress.com/2020/05/19/pandemic-blog-23-why-one-published-research-finding-is-misleading/ … It appears that for the Netherlands study, the number provided in this review is roughly 6x lower than the true IFR
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