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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 20 Oct 2020

      Now, I think it's reasonable to assume that the proportion of people who die after being infected by COVID-19 will fall over time. It's probably true that being infected today is less deadly than earlier this year

      1 reply 6 retweets 47 likes
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    2. Health Nerd‏Verified account @GidMK 20 Oct 2020

      That being said, I'm quite skeptical of the evidence presented. This story seems to claim that death rates have dropped ENORMOUSLY, while I would expect something more in the range of a relative 10-20% drop (say from 25% to 20%)pic.twitter.com/ursEABLS8V

      2 replies 4 retweets 45 likes
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    3. Health Nerd‏Verified account @GidMK 20 Oct 2020

      The study that's linked to to verify the statement above is this one, and it's an interesting piece of research looking at some hospitals in NYC and the people they admitted for COVID-19 over time https://www.medrxiv.org/content/10.1101/2020.08.11.20172775v1.full.pdf …

      1 reply 1 retweet 31 likes
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    4. Health Nerd‏Verified account @GidMK 20 Oct 2020

      Looking at the results table, something immediately springs out. The denominator here - the number of patients being admitted by week - has changed DRAMATICALLY over timepic.twitter.com/5yPTtA3VeV

      2 replies 4 retweets 48 likes
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    5. Health Nerd‏Verified account @GidMK 20 Oct 2020

      Perhaps more worryingly, that precipitous drop from 25% death rate to 7.6% cited in the news article appears to be based on...a single week of data. If you move back two weeks, there's no drop in death rates at all!pic.twitter.com/2JFezlEklb

      2 replies 14 retweets 97 likes
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    6. Health Nerd‏Verified account @GidMK 20 Oct 2020

      There also isn't really any trend here - a nonsignificant drop from 23% to 21% over two months, and then a sudden halving of the death rate in just one week, which corresponds to a sudden decrease in the average age

      4 replies 2 retweets 52 likes
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    7. Health Nerd‏Verified account @GidMK 20 Oct 2020

      Moving on, we have the second paper cited in the NPR article, which looks at a very large sample of people who were admitted to ICU in English hospitals for COVID-19https://www.medrxiv.org/content/10.1101/2020.07.30.20165134v2 …

      1 reply 2 retweets 27 likes
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    8. Health Nerd‏Verified account @GidMK 20 Oct 2020

      This study found that if you take the average death rate of these patients from the 'peak', it decreased in a linear fashion each week, and thus COVID-19 is getting less lethalpic.twitter.com/tkUdISvTfr

      1 reply 1 retweet 25 likes
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    9. Health Nerd‏Verified account @GidMK 20 Oct 2020

      But why did they choose the 'peak' week? It wasn't the first week of data collection, and it's a bit arbitrary to only start counting from the worst week in the whole dataset

      1 reply 1 retweet 36 likes
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    10. Health Nerd‏Verified account @GidMK 20 Oct 2020

      Indeed, if we extend the analysis back even just 3 weeks, the relationship disappears almost entirely and suddenly there's been very little difference since March!pic.twitter.com/8tGKmYXi7g

      2 replies 5 retweets 66 likes
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      Health Nerd‏Verified account @GidMK 20 Oct 2020

      I would go so far as to say that this study implies that any differences in ICU mortality in England due to COVID-19 are ~almost certainly~ down to admission criteria (which were strained during the peak in early April)

      9:48 PM - 20 Oct 2020
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      6 replies 7 retweets 74 likes
        1. Health Nerd‏Verified account @GidMK 20 Oct 2020

          So, back to the question at the beginning of the thread: are your chances of dying from COVID-19 lower today than they were in March? Honestly, while we'd hope so, I'm not sure we can conclude much either way

          12 replies 11 retweets 103 likes
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        1. Carmel Apicella‏ @ApicellaCarmel 20 Oct 2020
          Replying to @GidMK

          Yes! If the large change in mortality reported by the media was due to changes in treatment, then there would be RCTs showing these changes in mortality. But there aint. Dexamethasone / anticoagulants possibly some effect. So the rest is an issue of sampling!

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        1. Joseph‏ @JosephOnions 21 Oct 2020
          Replying to @GidMK

          Fascinating. But isn’t ICU death rate itself a bad stat to consider for how deadly the disease is? In other words, if treatments are much improved, wouldn’t we expect both the death rate and the % of cases that end up in ICU to decrease?

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        2. Jacob Gudiol‏Verified account @JacobGudiol 21 Oct 2020
          Replying to @GidMK

          The same effect in Sweden. This is 30 day mortality per month There was a decline in the average age of people admitted from March to April. Since then the average age has stayed about the same. And mortality toopic.twitter.com/XNGn3d1uz7

          1 reply 0 retweets 1 like
        3. Jacob Gudiol‏Verified account @JacobGudiol 21 Oct 2020
          Replying to @JacobGudiol @GidMK

          I should ad that the mortality around 15-25% is the "normal" mortality for influenca in Swedish ICU. Here are the previous 2 seasons So the doctors seem to do about the same "estimation on survival triage" today with covid-19 patientspic.twitter.com/9KODU1on49

          0 replies 0 retweets 1 like
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        1. New conversation
        2.  🌱 Jens-Petter Salvesen  🌍‏ @jpsalvesen 21 Oct 2020
          Replying to @GidMK

          So the mortality at peak to some degree reflects the damage of overloaded health care systems being unable to provide care for all who needs it? And therefore this informs us about what would happen if the health care systems once again became overwhelmed?

          1 reply 0 retweets 0 likes
        3.  🌱 Jens-Petter Salvesen  🌍‏ @jpsalvesen 21 Oct 2020
          Replying to @jpsalvesen @GidMK

          https://www.cebm.net/covid-19/declining-covid-19-case-fatality-rates-across-all-ages-analysis-of-german-data/ … Maybe Germany is a better candidate for estimating the effects of treatments? Their health care system wasn't overwhelmed.

          0 replies 0 retweets 1 like
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        2. Ben Millette‏ @ben_millette 21 Oct 2020
          Replying to @GidMK

          Begging your pardon but there is evidence to contradict your supposition from the ICNARC dataset. No changes in demographics over time that would imply change in admission criteria. Markers of how sick patients are (APACHE score, PF ratio) not greatly different

          1 reply 0 retweets 0 likes
        3. Health Nerd‏Verified account @GidMK 21 Oct 2020
          Replying to @ben_millette

          I published these tweets before the ICNARC data came out 😉 I do think that analysis suffers from similar weaknesses tho, it's really hard to disentangle the differences in the patient population from the death rate

          0 replies 0 retweets 0 likes
        4. End of conversation

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