So, I have had a proper read of this document, and I thought it might be worthwhile to actually go through and carefully analyze the document Let's do some peer-review on twitter 1/nhttps://twitter.com/MartinKulldorff/status/1337379606739841036 …
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10/n Moving on, the authors establish that the harms of lockdown are "manifold and devastating" Except, well, none of these references really support that statementpic.twitter.com/nwQDBGrI8k
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11/n For example, reference 11, for "worse cardiovascular disease outcomes" shows a decline in ED presentations and admissions, but not only was this sustained after lockdown the authors found nothing about worse outcomes
pic.twitter.com/Fk4xFbd750
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12/n The statement that social isolation has led to a greater number of drug-related deaths is referenced to this brief, which actually shows that the drug epidemic in the US has been increasing since January and talks about remedies to that during COVID-19pic.twitter.com/VuxmueVZUk
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13/n The statement "Social isolation of the elderly has contributed to a sharp rise in dementia-related deaths around the country" is referenced to this document, which disagrees with that assertionpic.twitter.com/aiPPY8I3yc
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14/n The authors then reference the problematic JAMA Open paper that we have critiqued here to show that school closures have killed more people than COVID-19 https://osf.io/9yqxw/ pic.twitter.com/Z46hrAHmDJ
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15/n And we finish this paragraph with the suggestion that, since suicidal ideation is high in a survey by the CDC, the excess deaths attributable to young people are probably due to suicide (even though this is not supported by the references cited)
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16/n Next, we have this paragraph, which basically says that lockdowns cause older adults to be in constant contact with younger people who are out of work, and therefore die morepic.twitter.com/FLmlpUOklw
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17/n This is supported largely by this study. While the work is interesting, the basic methodology - correlating residence statistics from 2018 with some ecological measures of COVID-19 deaths - don't really give us much informationpic.twitter.com/URGFPUSNuE
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18/n The other statements - that economic harms are inequitable - are both true and a bit pointless COVID-19 harms are also inequitable In a system of inequity, EVERYTHING IS INEQUITABLE
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19/n Finally, we get to some actual policy proposals for this idea of "focused protection" I, for one, am unimpressed by thesepic.twitter.com/IIDKQVWD97
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20/n They range from obvious things that every aged care home in the world is already doing (i.e. staff rotations) to obvious nonsense (i.e. temporary accommodations for older people - this is just creating aged care homes of a different sort)
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21/n Scientifically, what we have in this document is a mixture of facts and fiction, with some very misleading language thrown in
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22/n Logically, the document is fairly incoherent, and ignores some basic realities of the COVID-19 situation
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23/n For example, we've shown that at at age 60 the death rate from COVID-19 is 1 in 130. Does "focused protection" extend to this age group? If so, that's >25% of the entire United States
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24/n And, not to belabor the point, but the GBD authors have explicitly called for a herd immunity approach constantly for the last few months. They may not like the moniker, but it is transparently their aim
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25/n Moreover, the authors go on about the secondary harms of lockdown, but completely ignore the secondary harms of large COVID-19 epidemics, which have been estimated to be just as bad if not worse
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26/n Because some people will inevitably say that I'm calling for lockdowns here, I should point out that I'm not, but that any scientific evaluation of good public health policy requires us to be transparent about the facts
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27/n This document instead obfuscates and misleads, in a very deceptive way. We should discuss the pros and cons of govt action, but as a starting point that requires us to, for example, acknowledge that COVID-19 is pretty dangerous even for relatively young people
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28/n Worth noting that this thread is *not* a review of the GBD itself. The GBD does not cite evidence and is clearly not intended as a scientific document, and as such is impossible to really review except from a political perspective
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End of conversation
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