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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
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@GidMK

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Health NerdVerified account

@GidMK

Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him

Sydney, New South Wales
theguardian.com/profile/gideon…
Joined November 2015

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    1. Health Nerd‏Verified account @GidMK 14 Jul 2020

      12/n If nothing else, the numbers here imply that 99.9996% of all infections in Chongqing were asymptomatic (500 official cases, widespread testing, but seropositivity of 3.8% in the study implying 12 million 'true' cases) Is this plausible???pic.twitter.com/qSm99jQ0Kw

      4 replies 1 retweet 26 likes
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    2. Health Nerd‏Verified account @GidMK 14 Jul 2020

      13/n There are also some numbers in this revised paper that are wrong This figure should read 44%, not 47%pic.twitter.com/xccqCxh6Om

      1 reply 1 retweet 18 likes
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    3. Health Nerd‏Verified account @GidMK 14 Jul 2020

      14/n Moreover, in the example highlighted above, the IFR calculated is for Brooklyn, but this was only true for a tiny subset of 240 patients in this 28,523 patient study. The IFR calculation should've been for the whole of NYC, not just Brooklyn!pic.twitter.com/178IRcCQ3x

      1 reply 1 retweet 18 likes
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    4. Health Nerd‏Verified account @GidMK 14 Jul 2020

      15/n There are also some worrying inconsistencies in how Ioannidis has split up studies that sampled multiple places within countries

      1 reply 2 retweets 19 likes
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    5. Health Nerd‏Verified account @GidMK 14 Jul 2020

      16/n For example, the ENE-COVID and Brazilian studies, which sampled entire countries by region, are only summed up as a single valuepic.twitter.com/6295tiG91O

      1 reply 1 retweet 18 likes
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    6. Health Nerd‏Verified account @GidMK 14 Jul 2020

      17/n On the other hand, several studies that sampled multiple regions (but found MUCH lower IFRs) in other places are split up by area I cannot see any explanation for this in the paperpic.twitter.com/sdMyr7qGCo

      1 reply 2 retweets 20 likes
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    7. Health Nerd‏Verified account @GidMK 14 Jul 2020

      18/n On top of this, we've got another problem - collinearity The basic issue is that you shouldn't lump multiple samples of the same group of people together into one study

      2 replies 2 retweets 26 likes
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    8. Health Nerd‏Verified account @GidMK 14 Jul 2020

      19/n But now, in the study we have Wuhan (A), Wuhan (B), and Hubei (not Wuhan) It's very poor statistical practice to lump all these estimates together like this

      1 reply 1 retweet 17 likes
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    9. Health Nerd‏Verified account @GidMK 14 Jul 2020

      20/n Similarly, we have two estimates from Spain. One is the ENE-COVID study, a rigorous randomized seroprevalence study that is the envy of the world The other is a non-random sample of pregnant women at one place in Barcelona These are given EQUAL WEIGHTS in the analysispic.twitter.com/j2r5CLKGlj

      1 reply 4 retweets 35 likes
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    10. Health Nerd‏Verified account @GidMK 14 Jul 2020

      21/n The Spain example is even more of a problem because the ENE-COVID (the rigorous study) implies an IFR in Barcelona of ~1% The survey of pregnant women implies ~.5% Guess which one is used?pic.twitter.com/1JO5aNfrbV

      1 reply 3 retweets 31 likes
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      Health Nerd‏Verified account @GidMK 14 Jul 2020

      22/n Now, all of this collinearity is particularly troubling for that 0.27% estimate that I mentioned way back at the start of the thread

      7:48 PM - 14 Jul 2020
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      1 reply 1 retweet 17 likes
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        2. Health Nerd‏Verified account @GidMK 14 Jul 2020

          23/n If we get average the collinear results - where we've included the same study or the same sample multiple times - the median jumps immediately to 0.35% That's quite a bit higher!

          1 reply 1 retweet 21 likes
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        3. Health Nerd‏Verified account @GidMK 14 Jul 2020

          24/n But there are more corrections to be made. In several places, the IFR that is in this paper does not match the IFR calculated by the study authors

          1 reply 1 retweet 19 likes
          Show this thread
        4. Health Nerd‏Verified account @GidMK 14 Jul 2020

          25/n For example, Geneva. The original authors calculated an IFR of 0.64%, but this is downgraded to 0.45% in the paperpic.twitter.com/lEEG7LPjez

          1 reply 2 retweets 26 likes
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        5. Health Nerd‏Verified account @GidMK 14 Jul 2020

          26/n And this is not the only example. Another study tested over three weeks and found seroprevalence of 3.85%, then 8.36%, then 1.46%. Overall 3.53% The 8.36% figure is used, giving 5x more infections than the study itself found, and the lowest IFR possiblepic.twitter.com/ZeC8arsL7P

          3 replies 4 retweets 31 likes
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        6. Health Nerd‏Verified account @GidMK 14 Jul 2020

          27/n Taking all this into account, let's look at the IFRs for only those studies using representative population samples that were correctly calculated

          1 reply 1 retweet 15 likes
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        7. Health Nerd‏Verified account @GidMK 14 Jul 2020

          28/n Here's the revised table. The lowest IFR is, again, Ioannidis' own study, at 0.18%. Nearly half of the estimates are above 1%, and they range all the way up to 1.63% (!)pic.twitter.com/7xU7DGrq2Q

          2 replies 2 retweets 23 likes
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        8. Health Nerd‏Verified account @GidMK 14 Jul 2020

          29/n Somehow, for the third time running, there are innumerable decisions made in the paper that seem to only ever push down the IFR, rather than produce the best estimate

          1 reply 8 retweets 35 likes
          Show this thread
        9. Health Nerd‏Verified account @GidMK 14 Jul 2020

          30/n As I've outlined, there are also a number of simple errors that make this very problematic as an estimate of the IFR (or the IFR range) for COVID-19

          1 reply 2 retweets 23 likes
          Show this thread
        10. Health Nerd‏Verified account @GidMK 14 Jul 2020

          31/n All that being said, the discussion is now MUCH better, and really engages with some of the things I (and others) discussed in previous threads. Too much to go over here, but well worth a read

          1 reply 2 retweets 24 likes
          Show this thread
        11. Health Nerd‏Verified account @GidMK 14 Jul 2020

          32/n Ioannidis has also now included some of the government-conducted studies in the paper, which is good to seepic.twitter.com/VRLXEr8geQ

          3 replies 2 retweets 17 likes
          Show this thread
        12. Health Nerd‏Verified account @GidMK 14 Jul 2020

          33/n All in all, some definite improvements, but a lot of things still in the paper that are really hard to reconcile with best practice

          1 reply 1 retweet 18 likes
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        13. Health Nerd‏Verified account @GidMK 14 Jul 2020

          Health Nerd Retweeted Health Nerd

          34/n The one thing I would point out - this from earlier in the thread is a classic example of moving the goalposts. The influenza comparison was clearly wrong, so now we have another comparison which is bad but slightly less wronghttps://twitter.com/GidMK/status/1283232032085032961?s=20 …

          Health Nerd added,

          Health NerdVerified account @GidMK
          6/n On the downside, we now have this comparison with the death rates from flu, which is also just...weird If nothing else, the COVID-19 pandemic is STILL GROWING and has ALREADY killed as many people as a 'bad' influenza season pic.twitter.com/Et7Ofqt8LI
          Show this thread
          2 replies 2 retweets 20 likes
          Show this thread
        14. Health Nerd‏Verified account @GidMK 14 Jul 2020

          35/n imo much better practice would be to acknowledge that COVID-19 is probably substantially more lethal than influenza, but that quantifying this difference is somewhat challenging

          5 replies 5 retweets 26 likes
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        15. Health Nerd‏Verified account @GidMK 15 Jul 2020

          36/n Also, another statement that is incorrect and has remained in each version - that disadvantaged populations/settings are uncommon exceptions in the global landscape This remains simply untruepic.twitter.com/8M8QjQ6ZWv

          1 reply 0 retweets 8 likes
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        16. Health Nerd‏Verified account @GidMK 15 Jul 2020

          37/n Also, you can find my personal best estimate in the paper that @LeaMerone and I authored on IFR here. A reasonable guess for most areas seems to be 0.5-0.8%https://www.medrxiv.org/content/10.1101/2020.05.03.20089854v4 …

          4 replies 7 retweets 24 likes
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        17. Health Nerd‏Verified account @GidMK 15 Jul 2020

          Health Nerd Retweeted

          38/n Another addition, this thread goes through some of the headaches with the paper that have remained through every version TL:DR - it's not systematic! https://twitter.com/AVG_Joseph96/status/1283236273558294528?s=20 …

          Health Nerd added,

          This Tweet is unavailable.
          2 replies 2 retweets 10 likes
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        18. End of conversation

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