10/n Conversely, there is fairly good evidence that in the majority of cases COVID-19 was indeed the primary cause of death, despite comorbidities, and that the biggest issue in many places may be UNDERCOUNTING of deathshttps://www.bmj.com/content/370/bmj.m2859 …
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21/n Of note, however, the author makes a classic statistical error in dichotomizing age into two buckets We now know that the risk from age is CONTINUOUS, and so looking at the arbitrary cutoff of 70 years will lead to an erroneous resultpic.twitter.com/EBQ3MVCLXT
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22/n The author also makes the interesting claim that the WHO has estimated an infection rate of 10% of the world, referencing a recent news reportpic.twitter.com/yup98Ftm2Q
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23/n However, as
@zorinaq has pointed out, this is simply bad reporting, with the WHO arguing that LESS THAN 10% of the world is likely infected This is, perhaps, an issue with relying on headlines in a scientific paperhttps://twitter.com/zorinaq/status/1314160523613593600?s=20 …Show this thread -
24/n There are, sadly, further errors in the paper. The author repeats a common myth, that t-cells mean that the threshold for herd immunity is much lower than usually estimatedpic.twitter.com/q1sPO5voVd
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25/n Interestingly, Ioannidis here cites
@profshanecrotty, who has a great thread on why this interpretation is incorrecthttps://twitter.com/profshanecrotty/status/1313580981341712386?s=20 …
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26/n Now, I actually think that all of these errors are a real shame, because the final parts of the commentary are both interesting and worth considering
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27/n The basic idea is that, rather than thinking about the next few months, we should be designing policies based on what will likely happen over the next 5-10 YEARS This is a good point, and not made often enough!
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28/n Short-term lockdowns made sense in the early days of the pandemic, but given the months since it is perfectly reasonable to suggest that there may be better ways to manage the disease moving forward
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29/n For example, from a GLOBAL perspective, I think that there may certainly be places in which heavy long-term restrictions do not make that much sense
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30/n Nigeria, for example, has a median age of 18 years. Less than 10% of the population is over 55. Given how much lower the risk is for younger people, harsher restrictions may not make as much sensehttps://www.medrxiv.org/content/10.1101/2020.07.23.20160895v6 …
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31/n Conversely, the U.S. has a much older population, on average, and thus is at far greater risk from COVID-19 generally
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32/n That being said, this piece appears to use inappropriate evidence, misleading comparisons, and generally underestimate the risk/impact of COVID-19, which makes it problematic as a resource
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33/n As one final example, the author makes this statement in the conclusion, that measures taken to halt the pandemic are essentially destroying the world The reference? His own opinion piece in the Boston Readerpic.twitter.com/yUsFmyAWEO
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34/n I just checked, and Ioannidis cites himself 8 times in this paper, with 4 of those references being media or commentary articles
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35/n Oh also, on another note, given the relatively few meta-studies on COVID-19 IFR, it appears that the authors that Ioannidis here describes as "inexperienced" and "overtly wrong" are me and
@LeaMerone Academic civility!pic.twitter.com/CRV0VElQfh
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36/n I should also note - some people have pointed out that the actual numbers in this review are almost certainly inaccurate (e.g. 1.5 mil COVID-19 deaths over 5 years is probably impossible) but I have not focused on the numbers themselves...
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37/n ...thing is, the numbers are largely a result of the assumptions. If you extrapolate out an assumed incorrectly low death rate then you'll find the numbers are low Therefore, I focused on the assumptions, because the numbers themselves are just a consequence of these
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38/n That being said, it is absolutely worth pointing out that some of these figures that the paper has postulated as reasonable are extraordinarily unlikely and show how the errors have caused a misleading result (remember, this is globally over 5 years!)pic.twitter.com/GoFDd6x2Rn
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39/n Also, because a lot of people seem confused about this point - here is why it is nonsense to suggest that because people may have had a comorbidity that COVID-19 didn't kill themhttps://medium.com/@gidmk/covid-19-deaths-are-mostly-caused-by-coronavirus-2a6d2d43bd09 …
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