Finally, the debate New Zealand should have had in March 2020. Simon Thornley and Michael Baker discuss using elimination and lockdowns against Covid19.
Covid Plan B was ‘fact checked’ as ‘misleading’ for publishing on Facebook our article which used the existing conventional standard of statistical interpretation to find that a Danish study on mask wearing meant there was no significant benefit to wearing a mask against Covid19.
This so-called ‘fact check’ used a non-conventional approach which would mean that any study showing no significant effect of the studied intervention would mean the intervention does work.
This is clearly astounding. It reverses decades of scientific interpretation. It defies common-sense. But that is what ‘fact checking’ has become in the Covid19 era: a means of upholding the establishment policy position (using non-scientist media staffers).
It is not a means of checking facts. It is a means of denying them.
We outlined this deeply worrying development in an article in the British Medical Journal. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence | The BMJ
Should we abandon convention altogether? If we did, we may eventually promote ineffective treatments. As an example, electrostimulation, laser therapy, and acupuncture are not generally thought to improve smoking cessation success, yet several promising pooled effects were calculated in a meta-analysis, although the majority were not“statistically significant.”
The tone of the“fact checking”piece that apparently supports mass masking as having a“small protective effect”over a conventional interpretation as“misleading”turns usual scientific practice on its head. Pointingto observational evidence to contradict trial results is another subversion of usual epidemiological practice. While this may seem trivial, it is a subtle distortion of results and the politicisation of evidence in the covid-19 era.
Full PDF here: bmj.m4919.full
A short piece from us published in NZ Journal of Primary Health Care.
How many more lockdowns, billions of dollars and social and health harm is an acceptable price to pay before this misguided and expensive strategy is abandoned? We implore Prime Minister Jacinda Ardern, Director-General of Health Dr Ashley Bloomfield, and fellow health advisors to reflect on the points raised in this paper and to abandon elimination as a strategy and the use of lockdowns. We believe that future policy should return to the initial approach that was taken. That is to reduce transmission of COVID-19 through reasonable use of infection control, to maintain capacity in our hospitals and intensive care, while focusing public health and infection control efforts to protect the frail and elderly of our community.
As lead vaccines announce good results and intentions to register for fast-tracked safety authorisation in EU and the US, immunologist Byram Bridle, reminds us of questions that they will need to answer:
Dr. Byram Bridle, PhD, Associate Professor of Viral Immunology, University of Guelph, Ontario, Canada
- How many of the total study subjects are being reported on? Partial results can range from being representative of the entire data set to being biased.
- How many study subjects had detectable immune responses and what was the magnitude?
- Were there antibody responses in the respiratory tract, which is where SARS-CoV-2 infects, and did these antibodies efficiently neutralize the virus?
- Were SARS-CoV-2-specific T cells induced? A balanced anti-viral response should include antibodies to prevent infection and T cells to kill viruses that get past the antibody barrier.
- Did the immune responses have a ‘Th1’ or ‘Th2’ bias? The former type of immune response is optimal against viruses, the latter is usually sub-optimal and sometimes even dangerous in the context of respiratory viral infections.
- Did the vaccine confer long-term immunological memory? A prophylactic vaccine may be useless without this. If immunological memory is short-lived, vaccinated individuals could become susceptible to infection before enough people are immunized to achieve ‘herd immunity’. Another term for this is ‘duration of immunity’ (i.e. how long does immunological protection last?)
- How did the vaccine perform in senescent animals and/or elderly humans? Those most in need of protection against COVID-19 are the elderly and immunocompromised.
- How was safety assessed and what were the results?
- Have the results been published for review by other scientists? If not, when? It is recommended to publish in open-access journals, which are available to the public. Comments merely reflect opinions unless there are validated data to back them up.
- Related to #6 above, what is the plan to manufacture and roll-out enough vaccine doses to achieve herd immunity in any given country? What is the realistic timeline for this? If >1 year, there is no way to know if COVID-19 vaccines will confer protection for this long because they didn’t exist one year ago. The development of every historical vaccine took >4 years, so there were years-worth of ‘duration of immunity’ data. For example, optimistic projections suggest ~1 billion doses might be possible by the end of 2021, but for two-dose regimens, that means only 500 million people could potentially be vaccinated in just over one year. With the global population at 7.8 billion people, that represents only 6% of the world’s population. The lowest estimate to achieve herd immunity is 60%.
- How will equitable distribution of vaccines be accomplished? For example, pre-order waiting lists seem to be dominated by developed countries; are any developing countries on these waiting lists?
- What is the cost of a full vaccine regimen going to be? Is it affordable for developing countries? Some epidemiologists have predicted that efficient roll-out of vaccines to developing countries will require the price to be <$6 US.
- Storage conditions for vaccines could impact distribution and market competitiveness. What data are available to support the claimed storage conditions? For example, the default storage temperature for RNA in research laboratories is -80o This is based on a plethora of scientific evidence that RNA is more stable at this temperature compared to -20oC.
Only two days after the NZ government announced mandatory mask wearing rules the much awaited Danish mask study was published, and it is conclusive; masks give no statistically significant protection from Covid19.
Here’s the study: https://www.acpjournals.org/doi/10.7326/M20-6817
A total of 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%). The between-group difference was −0.3 percentage point (95% CI, −1.2 to 0.4 percentage point; P = 0.38) (odds ratio, 0.82 [CI, 0.54 to 1.23]; P = 0.33). Multiple imputation accounting for loss to follow-up yielded similar results. Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.
The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.
Below is our Euler diagram summarising the findings of the Danish mask trial.
The small difference in event proportions, with a slightly higher proportion in the control group, was not distinguishable from a chance finding (“not statistically significant” is the boffin term).
This is probably the best evidence we have up to now, which is disappointing for advocates of mask use to prevent covid-19 infection. This evidence is consistent with previous trials which found no effect in trials designed to assess the effect of masks to prevent the community transmission of influenza.
A study shows a ‘peak’ of Covid19 cases in Italy in September 2019, and no one had noticed.
This hints that Covid19 was circulating even earlier, as the study used blood samples from a lung cancer patient screening trial that had begun in September 2019.
This study shows an unexpected very early circulation of SARS-CoV-2 among asymptomatic individuals in Italy several months before the first patient was identified, and clarifies the onset and spread of the coronavirus disease 2019 (COVID-19) pandemic. Finding SARS-CoV-2 antibodies in asymptomatic people before the COVID-19 outbreak in Italy may reshape the history of pandemic.
A banal report from the Children’s Commissioner about life in lockdown for NZ kids has a few interesting findings when you dig into it.
By and large, it appears that our kids dealt reasonably resiliently with what the report stupidly claims to be “unprecedented times”
From their survey, half of kids’ parents worked at home and half went out to work – that’s a lot different from the “work from home” message that dominated the perspective of the Government.
Only 8% of kids list the public health messages as a memorable feature of the period.
The absolutely dominant feature and commonality among all kids is that they really missed and disliked the physical separation from their friends, particularly via school. That speaks to a reality of the lives of almost all of us – and something denied by lockdown and social distancing: we simply cannot live for very long separated from each other.