This apparently ‘unknown’ and ‘uncertified’ source of the Elgazzar data was…. a link provided in the 3rd preprint of Elgazzar’s paper!
Once in your live you could provide us some facts! So where is the link?
No preprint contains a link to data. Usually you have to ask the author. We make the test. You provide the data and I ask the author (not a fake agent) for his data....
An other nice report about vaccine side effects:
https://scivisionpub.com/pdfs/…e-event-database-1746.pdf
So may be banning Oxford crap is more urgent...
Oh dear… Are you resorting to trawling unindexed (ISI, GIS, clarivate) journals whose sole criteria for publishing a paper is that the author coughs up $1200, and that boasts an impact factor of 0.34…
Perhaps you were trying to find an outlet for your SO(4) paper? One that won’t ask to many difficult questions about the apparently nonsensical and unreferenced diagrams maybe?
We do not know this. This is not even slightly true. The vaccine greatly lowers your chance of catching and spreading the virus.
Do not make up imaginary statements and post them as facts. That's W's role here. One W is enough.
It is unofficially known that all 85 infected people (age 20…35) at a so called 2G party with 380 participants in Münster in Germany a few weeks ago were double vaccinated, none from the other G (Genesen = recovered from Cov-19) group. Access to party had only double vaccinated and people recovered from the disease. This shows 4 interesting things: you can catch the virus despite being vaccinated with a quite high probability, the natural immunity of non-vaccinated who ran through a Covid infection seems to be more robust, 3rd the vaccination is effective in preventing serious illness, and 4th for some reasons there seemed to be no public interest to clarify and publish the findings of this event 
…
All infected did show at max mild symptoms only.
(Wyttenbach was right in this case, but that doesn’t change my mind on him at all)
No preprint contains a link to data.
No preprint contains a link to data? …LOL. Is it possible for you to make a post without trying to sneak in another Wyttenfact?
Once in your live you could provide us some facts! So where is the link?
Ignoring the apparent anosognosia in the above statement: https://assets.researchsquare.…e5ededf0.pdf?c=1631869233
Ignoring the apparent anosognosia in the above statement: https://assets.researchsquare.…e5ededf0.pdf?c=1631869233
I asked for the data not for a broken link!
Here a more perfect analysis of Pfizer:: Moderna protection:
As already said its about 6:1 for death protection in favor of Moderna.
2/3 of the Swiss "vaccinated" got Moderna (world record for a cancer therapy...)
This also explains why we have a somewhat higher protection rate as e.g. UK where the age group 80+ now more or less is unprotected. But as said this group in Switzerland got more Pifzer than the younger ones!
LongA Letter to the BBC
A Letter to the BBC
Note that views expressed in this opinion article are the writer’s personal views and not necessarily those of TrialSite.
The BBC recently did a complete hit job on ivermectin—not surprising given the money circulating to ensure such events occur as planned. Among the many inaccuracies the BBC proclaims up to a third of the ivermectin studies as probable frauds, yet they have no basis to make such a claim. In fact, the BBC’s critique in part rests on the work of a questionable group. One that while seemingly innocently muckraking, execute an agenda.
The center of the BBC critique used to bash dozens of studies including a study favoring ivermectin in Egypt led by Elgazzar et al. Yes, the public British broadcaster’s thrust against the drug is based on a questionable investigation into this study. One that led to the pulling of the preprint write-up and 24 hours with no consultation to the author—by no means a reasonable amount of time—then a bashing by a major newspaper. Smells like a setup.
What follows is a letter from Dr. Tess Lawrie, Ph.D. director of the British Ivermectin Recommendation Development Group (BIRD) to Jack Goodman, a journalist from the BBC.
Dear Jack
Thank you for taking an interest in early treatment for Covid-19. Remarkably, you are the first BBC journalist to contact us in almost 20 months. In those 20 months, doctors around the world have been treating patients successfully with multi-drug protocols (of which ivermectin is one medicine used) – while the NHS guidance to the public has been to drink water, stay home and wait until their oxygen levels go below 92% or a number of other serious signs and symptoms develop.
In such a health emergency, particularly one which has clear age stratification and obesity indicators, one might consider preventative and outpatient advice of paramount importance (perhaps recommended changes to diet or increased exercise or safe medicines with anti-viral properties) in order to take the number of hospitalisations downward and remove the pressure from the NHS. But no such advice has been given. In respect of this vacuum, many doctors have sought answers on how to prevent and treat covid-19 and found them. There are real people all over the world who have been well served by their guidance and continue to be so – you should talk to some of them.
If you sense some cynicism in this reply, you would be correct. I have never experienced a situation where censorship has been applied to medical discussion and guidance. The government and media disdain for the mountain of evidence supporting early covid-19 treatment seems to be restricted to anything that is not a novel therapy.
How did remdesivir at around $3000 a treatment get to be approved by the FDA, MHRA, etc on the back of one trial that had a marginally positive effect? It has since been shown to be ineffective and is not recommended by the WHO, yet it is in our British National Formulary for use in covid-19 and appears to be widely used in our hospital ITU’s despite growing concerns over its safety.
Ivermectin, at 50 pence a tablet, now has 63 controlled studies, 45 of them peer-reviewed, 31 RCTs, 7 meta-analyses, and several published country case studies that overall, clearly support its use and show no evidence of harm, as well as many expert opinions and testimonials. Why is it not approved in this country, but it is in others?
You may be surprised to hear that, in the UK, ivermectin is indicated to treat the most vulnerable people with covid-19 – those who are immunocompromised; this is not recommended for covid per se, but to prevent worms. Surely the question to ask then is if ivermectin can be used among the most vulnerable, why do the authorities insist that it is a horse medicine and/or that it is dangerous for use in humans?
Diagram, map Description automatically generated
Why does the UK have among the highest Covid-19 death rates in the world? At some point, the BBC should look at how Indian states (for example, Uttar Pradesh) managed to suppress Delta with 15% vax levels while UK cases remain stubbornly high, with 80+% vaxxed. Despite NICE stating that they would look at real world data for Covid-19, they have failed to do so.
We welcome open scientific discussion and trust that you intend to facilitate this as time is running out, particularly for the many in ITU’s around the country today without effective treatment. I hope the following answers will help to inform the BBC’s position and that you are able to give a more balanced view to this really important issue of early covid-19 treatment.
Best wishes,
Tess
On 14/09/2021 16:47, Jack Goodman wrote:
>
> Dear Dr Lawrie,
>
> I’m working on a story for the BBC News website looking into the clinical studies supporting ivermectin as a Covid treatment. Independent scientists that have looked into the evidence say some of these studies are highly flawed or contain fabricated data.
I am aware of a journalist and an epidemiologist in Australia who hold a very vocal position against ivermectin; however, most independent scientists who have looked at the evidence on ivermectin agree that the big picture supports its use for covid-19.
Whether or not the Elgazzar study is discredited remains to be determined but it may well be. We have rerun removing the disputed trial from the relevant analysis and have reported the findings here.
Whilst the quantitative result inevitably changes with the removal of the Elgazzar study, the mortality outcome remains clear, demonstrating an average reduction in deaths of 49% in favour of ivermectin. The effect on reducing covid-19 infections when used for covid prevention remains virtually unchanged.
It is important to remember that systematic reviews are just one type of evidence on ivermectin, which restricts studies to randomised control trials only. There is also a vast amount of real-world evidence from patient, doctors, and countries that are successfully using ivermectin. Please visit the http://www.worldivermectinday.org and also see the proceedings of the International Ivermectin for Covid Conference held in April for more information.
> In addition, the Together trial found no benefit from the drug and the Cochrane review said there was no evidence of benefit.
The Together trial is one of many and will be added to our meta-analysis in due course. Trials are often flawed, and single trials are not as robust as systematic reviews, which are the best way to understand the effects of treatments because they consider all the relevant trials. In addition, particularly during a health emergency, it is important to consider all data, including observational and real-world data, which is what the British Ivermectin Recommendation Development meeting on 20th February 2021 was about. This meeting was conducted in accordance with the WHO Handbook for Guideline Development. As required, the evidence-to-decision document considered people’s preferences, acceptability, feasibility, equity, and cost of ivermectin used in the context of covid-19.
The Together trial is a medium size, non-peer-reviewed study and adds to the bank of knowledge that suggests that given late and for only 3 days, ivermectin may have little effect on covid-19 hospitalisation rates. This is not too surprising, as this would be the case for most medicines.
Had the investigators followed a dosing regimen from well-documented expert protocols on early treatment, this study could have shown better results. A late-stage intervention will have less positive outcomes. Ivermectin is widely available in Brazil, but the researchers did not check to see if participants in the placebo group had access to it or were using it. This could have skewed the results against ivermectin. In addition, the authors state that their study was under-powered to detect a difference between the two groups. These potential flaws were pointed out to them in the early stage by experts in the field. There are therefore many doctors who feel this study was designed to fail.
The Cochrane study has some concerning problems and I invite you to take this opportunity to investigate them. Out of 24 available RCT’s the authors chose only 4 to include in their mortality analysis, a small subset of those available. The Cochrane authors split these up further into two separate analyses. This dilutes their findings to the extent that meta-analysis was not possible in most instances, as there were no trials to pool. Instead of utilising all available evidence and presenting appropriate caveats around such wider evidence, they present an empty review with bulk but little analysis. We have written a letter to the BMJ regarding the limitations of their approach. You can find the preprint here.
>
>
> As someone who has remained a promoter of ivermectin, have such issues with the evidence base weakened your belief in ivermectin?
I am not a promoter of ivermectin – I am a mother, medical doctor, and scientist trying to help families survive covid-19. The only issues with the evidence base are the relentless efforts to undermine it. There are over 100 scientific papers on the use of human ivermectin that are relevant to covid-19. The majority suggest benefit, none show harm. I do not have a belief; I have knowledge that I would like to share.
>
>
> You said on a panel that: “Ivermectin works. There’s nothing that will persuade me.” Do you stand by that statement?
Yes. We are beyond the point of whether ivermectin works, with ivermectin now being used widely by doctors around the world to treat covid-19 in combination with other effective medicines and supplements. Ivermectin is included in covid treatment protocols as evidenced at the recent International Covid Summit in Rome. Please refer your readers to http://www.earlycovidcare.org for expert guidance on how to treat covid.
>
> In a Talk Radio interview, you implied that the Covid vaccine has led to many deaths.
>
> “If you take a vaccine, like the tetanus vaccine, which has been around since 1968, there’s only, you know, 36 deaths reported again, you know, attributed it on the World Health Organization’s database, whereas there’s 67,000 deaths reported against the COVID vaccines in just a few months on the World Health Organization database, and on the UK database there are 1440. So, this is unprecedented, I would say in the history of any medicine, to have so many deaths reported in such a short time, and indeed, so many reports in such a short time against a medicine.”
>
> Figures from vaccine monitoring sites refer to any deaths reported in people after they have been vaccinated, whether it had anything to do with the vaccine. It’s unsurprising that several vaccinated people died in the days and weeks after their jab from unrelated causes.
> Given this, do you stand by your statement, and do you believe the vaccine rollout should be paused?
I have been following pharmacovigilance data on the World Health Organisation’s Vigiaccess.org since the beginning of the year for both ivermectin, remdesivir (which is used in the UK despite there being little evidence that it works or is safe), and the covid-19 vaccines. Whilst very few reports of adverse drug reactions have been posted for ivermectin, a considerable number (2 million) have been posted for the covid-19 vaccines, including more than 10,000 deaths. This led me to look at the data reported to our UK Yellow Card system. The Yellow Card system is our early warning system for possible safety issues; clinical trials are not powered to do this.
Of the Yellow Card system, Dr June Raine (CEO of the MHRA) has said previously in a Guardian article: “There is no need to prove that the medicine caused the adverse reaction, just the suspicion is good enough.” As of today, on the Yellow Card system, there are 357,956 reports of adverse reactions to the vaccines and 1,625 reported deaths in the UK. This is much higher than the number of reports that led to the cessation of the Swine Flu vaccine and needs to be urgently looked into by the MHRA. Why have a system designed to sound an alarm and then ignore it? Perhaps you should look into that.”
>
> We’ve spoken to an expert who has been critical of the quality of the meta-analysis you co-authored and the claims it followed the Cochrane method. They said you and the group have muddled up advocacy and the scientific process and didn’t examine your own conflicting interests. How do you respond?
The authors of Bryant et al have over 120 Cochrane systematic reviews under our belt. I think you can safely say that we know what we are doing. The review team included three highly experienced systematic reviewers; two of them are guideline methodologists. The meta-analysis was peer-reviewed and conducted according to PRISMA methods (the base of Cochrane reviews), using GRADE and WHO guidance.
Our findings are robust to the exclusion of the questionable study by Elgazzar and others and are supported by an independent team from Queen Mary’s University in London .
Please explain what my conflicts of interest are? Does my Hippocratic Oath constitute a conflict of interest? Personally, I have more to lose than to gain. As a doctor, advocating for a safe and effective medicine in a pandemic is not a conflict of interest, it is being a good doctor. That I champion a medicine known to work in an environment hostile to its existence is my duty. I am the Director of an independent not for profit company with no paymasters to please. I have absolutely no commercial interest in any medicine nor pharmaceutical company. My aim is to save lives and alleviate suffering.
In a pandemic context, the benefits of Ivermectin almost certainly outweigh any risks, given its outstanding safety profile, negligible base cost, and the existing large body of evidence showing that ivermectin provides benefit in a variety of important clinical outcomes.
> In order for us to reflect your position in our story, we would need to have received your response by no later than 12pm on Thursday 16 September.
>
> Best,
> Jack
Vaccine protection against infection:: This is physiologically impossible with all current vaccines.
93% protection from death. This is currently the actual Big pharma commercial 100% FUD. In all these figures the > 80% deaths from prevaxx age are included
Wyttenfact. maybe not a lie since the second sentence indicates terminal confusion or weirdness (not sure which). Perhaps W has been playing too much Myst. (OK, some of you too young to get the reference!).
absolute best figure for vaccine protection from deaths is 3x overall
Lie (sorry - I meant, not to offend others by speaking truth, Wyttenfact)
0..20% for 80+.
WyttenSubgroupitis. When proven wrong, subgroup data to some very small subset of population. It does not then matter whether wrong or right because those like me who prove wrong by looking up all the numbers needed, and because we do not ignore base rate fallacy that is twice the number W bothers with, cannot find all those numbers with the correct subgrouping.
personally I think subgroup when challenged is the cleverest Wyttenism used on these pages.
If we account for natural protection group size 75% and add partial protection 95% then only 5 % are vulnerable at most 1..2% of PCR+ end up in hospitals this is 0,25.. 0.5 of all infection. So the real vaccine protection for the average is far below 10%.
Natural protection can be measured through N IgG antibodies (not made from vaccine, part of virus immune response) which are at 18% in UK. You can for a second order correction add 50% due to decay of infection-based immunity.
So 75% is wrong. You can similarly count cases and multiply by the infection / case ratio (1.6 in the UK, which measures infections reliably via random sampling). You get about the same number 25%. We are a long way from infection-based natural immunity in developed countries. (India however, with its ivermectin*-induced ultra high second wave of COVID, has > 70% natural immunity)
* (this is actually wrong. Correlation does not imply causation. There are many other factors that could account for India's super-high COVID wave and no reason to think this was ivermectin)
But even if 75% were right that extra protection affects both vaccinated and unvaccinated. And it affects vaccinated more. Just as WyttenBaseRateFallacy, so we have WyttenCountOnlyOneSideOfConfounder fallacy.
CoV-19 is a disease of the old age > 65 and very severe for age >75. So any general statistics anyway is FUD.
WyttenExcuse. If you reckon > 65s don't count (old, soon to die or at least be a burden on society) the stats look much better!
Once in your live you could provide us some facts! So where is the link?
No preprint contains a link to data. Usually you have to ask the author. We make the test. You provide the data and I ask the author (not a fake agent) for his data....
the authors have, well, "sort of" made their data available. To quote from the preprint (p. 6): "The study data master sheet are [sic] available on reasonable request from the corresponding auther [sic] from the following link. https://filetransfer.io/data-package/qGiU0mw6#link". It is tempting to imagine that one might be able to download the data file directly from that link; however, when you attempt to do that, the site says that you have to create a premium account ($9 per month), and after you have done that and downloaded the file, it turns out to be password-protected. This suggests that the authors did not want anyone to be able to read it without their approval, which is not quite in the spirit of open science.
Somone else can check whether the author has taken it down yet - my AV did not like that link! It is one of those grey file sharing sites you tread on at your peril.
The BBC recently did a complete hit job on ivermectin—not surprising given the money circulating to ensure such events occur as planned.
There is money circulating to fund anti-vaxx propaganda. A lot of it. For example, the TrialSiteNews funding.
Since a lot of scientists would like ivermectin to work, and therefore test it in big trials, and the BBC may be captured by scientists/experts but NOT in any way by industry, it is really difficult to see where this anti-ivermectin money would come from.
there is zero - zilch - evidence for industry-funded anti-ivermectin campaign
Look for example at Chaccour. Independent scientist who pioneered use of ivermectin. Who strong hoped it would work against COVID, did his own trial. Who now says that the large trials will not be able to report soon because if there is an effect it is a small one needs larger numbers to show it.
You have to assume the whole scientific community is corrupt.
You may be surprised to hear that, in the UK, ivermectin is indicated to treat the most vulnerable people with covid-19 – those who are immunocompromised;
News to me! And I regularly look at the UK guidelines
Recommendations | COVID-19 rapid guideline: managing COVID-19 | Guidance | NICE
also this (updates)
Update information | COVID-19 rapid guideline: managing COVID-19 | Guidance | NICE
No ivermectin???
I can find this:
The therapy will be added to the PRINCIPAL Trial, a large clinical trial designed to assess potential COVID-19 therapies for non-hospitalized patients, including at-home recovery, who are at higher risk of progressing to serious illness.
So this is the PRINCIPAL trial - which will test whether ivermectin works - along with several otehrs worldwide. Because no-one is suppressing ivermectin. (immunocompromised => higher risk).
More antivax pro-ivermectin truthy-twisties!
Israel still sees 5-6 double/triple vaxx deaths a day among age group 60+. But the backlog of booster victims is decreasing to about 300. So this will improve soon (3 weeks) .
This double/triple vaxx death rate is in sync with the CH death rate that overall is 5x lower thanks to moderna.
Our childish FUD'er THHuxleynew still does not understand that for preventing a CoV-19 infection you need mucosal IG-A. These are not produced by the cancer gene therapy called CoV-19 vaccines.
But as a mafia member he operates as all soldiers do. Execute the order and as such daily prove your mediocre understanding and lack of free will.
We have to accept that this forum tolerates children & professional liars. No problem for me its not LENR...
I asked for the data not for a broken link!
I've given you Elgazzar's link from which the data analysis was done. The guys who did that uploaded the data to a safe non-password-protected place (read their account). - in case the author took it down (not sure).
But if looking for it from any publishing organisation - the paper was retracted. They would therefore also remove the data. LOL.
Our childish FUD'er THHuxleynew still does not understand that for preventing a CoV-19 infection you need mucosal IG-A. These are not produced by the cancer gene therapy called CoV-19 vaccines.
Not sure whether this is a Wyttenfact (because its false) or a WyttenLie - because I recently pointed out that a TSN op-ed idiot surprised at high nasal viral loads for delta, with good protection against serious illness, just was totally out of touch. The commonly accepted reason (sort of expected) is that indeed the mRNA vaccines do not produce mucosal IgA and therefore are less effective at suppressing nasal viral replication than they are at stopping it in the lungs or other parts of the body, where it would need to go to make infection serious.
Maybe it is just WyttenNormal - spread dangerous antivax memes because you have never, ever, actually opened your mind to any of the contrary arguments and have some grudge involving Israel, the Mafia, and weird letters.
Our childish FUD'er THHuxleynew
Well, you must laugh, or cry, or indulge occasionally in childish humour.
New York Times issues massive correction after overstating COVID hospitalizations among children
Paper added over 800,000 to total of kids hospitalized with coronavirus
The New York Times issued a massive correction Thursday after the liberal newspaper severely misreported the number of COVID hospitalities among children in the United States by more than 800,000.
A report headlined "A New Vaccine Strategy for Children: Just One Dose, for Now," by science and health reporter Apoorva Mandavilli, was peppered with errors before major changes were made to the story. The Times initially reported "nearly 900,000 children have been hospitalized" with COVID since the pandemic began, when the factual data in the now-corrected version is that "more than 63,000 children were hospitalized with Covid-19 from August 2020 to October 2021."
The paper also botched actions taken by regulators in Sweden and Denmark and even bungled the timing of a critical FDA meeting
An earlier version of this article incorrectly described actions taken by regulators in Sweden and Denmark. They have halted use of the Moderna vaccine in children; they have not begun offering single doses. The article also misstated the number of Covid hospitalizations in U.S. children. It is more than 63,000 from August 2020 to October 2021, not 900,000 since the beginning of the pandemic. In addition, the article misstated the timing of an F.D.A. meeting on authorization of the Pfizer-BioNTech vaccine for children. It is later this month, not next week," the lengthy correction stated in full.
Intentional? You better believe it!!!
It is unofficially known that all 85 infected people
Interesting if true, but is this a polite way of saying ‘a wyttenfact’?! 
I read a couple of German news articles on this party, none seem to mention whether the infected were vaxxed or recovered. Do you have a link that suggests otherwise, please?
Reuters Fact Checkers Perpetuate Misinformation on COVID-19 mRNA Vaccines
Dr. Ron Brown – Opinion Editorial
October 8, 2021
Reuters published a “fact check” article several months ago: Why Relative Risk Reduction, not Absolute Risk Reduction, is most often used in calculating vaccine efficacy. In presenting their arguments, the authors of this article minimized the importance of reporting the absolute risk reduction (ARR) and defended the use of the relative risk reduction (RRR) to represent vaccine efficacy. Yet, the article also mentioned that the ARR is more dependent on group infection rates in a clinical trial, implying that the ARR is a more sensitive and relevant measure for vaccine efficacy than the RRR. For example, the larger the groups in a clinical trial, and the smaller the rate of infected people in the groups, the smaller the absolute risk reduction (ARR), even if the relative risk reduction (RRR) remains the same. This is why both the ARR and RRR of a clinical trial must be reported. The following examples illustrate this effect based on formulas for calculating the ARR, RRR, and the relative risk (RR)—a method that an epidemiologist might use to calculate these measures.
First, we have to define three terms.
ARR = Placebo infection rate – (minus) Vaccine infection rate.
This is the absolute risk reduction, or the simple mathematical difference in the infection rates between the Placebo and Vaccine groups, assuming a higher rate in the Placebo group.
RR = Vaccine infection rate / (divided by) Placebo infection rate.
This is the relative risk, or the proportion of the Vaccine infection rate (the numerator) relative to the Placebo group (the denominator).
RRR = 1 – RR.
This measures the relative risk reduction assuming that the relative risk is less than 1. In other words, the RRR assumes that the Vaccine infection rate (the RR numerator) is lower than the Placebo infection rate (the RR denominator).
Let’s say we have three infected people out of four people in our mini trial. That is, we have one infected person out of two people in the Vaccine group, and two infected people in the Placebo group.
Vaccine infection rate = 1 infected person out of 2 people = 50%
Placebo infection rate = 2 infected people out of 2 people = 100%
ARR = 100% – 50% = 50%
RR = 50% / 100% (same as .5 / 1) = 50%
RRR = 1 – 50% = 50%
The ARR and RRR both start off evenly with each other at 50%. But our sample is too small to give us accurate estimates, so, let’s see what happens if we place the three infected people in larger groups of 100 people. Notice that the RRR stays the same, but the absolute risk reduction drops by 49 percentage points to 1%.
Vaccine infection rate = 1 infected person out of 100 people = 1%
Placebo infection rate = 2 infected people out of 100 people = 2%
ARR = 2% – 1%= 1%
RR = 1% / 2% = 50%
RRR = 1 – 50% = 50%
The examples show that the absolute risk reduction is dependent on the increasing number of people in the groups and the dropping group infection rate, while the relative risk reduction is not. In the RRR, as long as the proportion of the group rates don’t change, the RRR doesn’t change regardless how many people are in the groups.
This explains why the ARR can be used to determine the number of people needed to be vaccinated to prevent one infection. The Number Needed to Vaccinate (NNV) is the reciprocal of the ARR (1/ARR). In other words, one reduced infection (the numerator) relative to the difference in the group infection rates (the ARR in the denominator).
Let’s put our three infected people into even larger groups of 1000 people.
Vaccine infection rate = 1 infected person out of 1000 people = 0.1%
Placebo infection rate = 2 infected people out of 1000 people = 0.2%
ARR = 0.2% – 0.1%= 0.1%
RR = 0.1% / 0.2% = 50%
RRR = 1 – 50% = 50%
The absolute risk reduction further drops by 10-fold to one tenth of one percent, while the RRR continues to remain the same. This proves that the absolute risk reduction is the more sensitive and relevant measure for vaccine efficacy depending on the group size and infection rate.
Population studies versus clinical studies
Still, noting that the RRR remains consistent regardless of the setting, the Reuters article quoted an assistant professor of biostatistics from the University of Florida, who said of the RRR, “It is more meaningful.”
Meaningful, perhaps, for epidemiological analysis of various sized populations, based on the RR or risk ratio used by epidemiologists. As long as the proportion of the populations exposed and unexposed to the risk remains the same, larger population sizes in different settings do not matter. But, as demonstrated in the examples above, the RRR is less meaningful for clinical research involving smaller groups of individuals where the size and infection rate of the group matters, even if the proportion of the group infections (the RRR) remain the same.
A similar distinction between population and clinical studies occurs in the Body Mass Index (BMI), used to categorize weight and height. Originally intended to measure entire populations, BMI is not sensitive to an individual’s body composition such as body fat and lean body mass levels, and BMI often miscategorises people by weight class.
Summing up, vaccine efficacy in clinical trials, based solely on RRR normally used by epidemiologists for larger population studies, ignores absolute risk differences in smaller group sizes and misrepresents vaccine efficacy in clinical trials. At the least, both ARR and RRR should be reported in clinical trials to prevent information bias.
Furthermore, I see no reason why clinicians shouldn’t drop the RRR altogether and leave its use exclusively for larger population studies. If clinicians want to compare treatment efficacies from different trials, the NNT or number needed to treat (or the NNV for vaccine trials) are more informative than the RRR.
Unfortunately, our current dysfunctional public health system continues to ignore this important issue, and with the assistance of media outlets like Reuters, the public remains largely unaware of the COVID-19 mRNA vaccines’ true efficacy.
Some Anchorage doctors dispute New York Times story on Alaska’s Covid crisis
The New York Times says doctors in Alaska are now having to make a choice about who lives and who dies.
In a front-page story, Providence Alaska Medical Center Dr. Steven Floerchinger is quoted saying he gathered with his crisis triage colleagues for an agonizing discussion: One patient in the emergency room had a better chance of making it than the other patient, so the other person would have to wait for a bed in the intensive care unit.
“That patient died,” the story says.
“This is gut-wrenching, and I never thought I’d see it,” the newspaper quoted Floerchinger, who lives in Oregon and travels to Alaska to work at Providence Alaska Medical Center. “We are taxed to a point of making decisions of who will and who will not live.”
“Since that night, more grim choices have had to be made as Alaska confronts what is currently the nation’s worst coronavirus outbreak. Nearly two years after the virus began circulating in the United States, some of the scenes here on the country’s northern frontier echo the darkest early days of the pandemic: testing supplies are depleted, patients are being treated in hallways and doctors are rationing oxygen. With emergency rooms overwhelmed, the governor has asked hundreds of medical workers to fly in from around the country to help,” the story says.
Medical workers across America are indeed suffering from burnout, and some are leaving the field. Others are being fired because they will not take the Covid-19 vaccine, but hospitals tell mainstream media reporters that the vaccine requirement is not the cause of the staffing shortages.
Must Read Alaska has reached out to doctors in Anchorage who are disputing that care is being rationed in Alaska.
“Neither I nor any of my close colleagues have seen or heard of a single example,” one doctor said. In fact, the shortage is still not beds, but nursing staff, and it’s not helping that people are being driven from the field by vaccine mandates.
Because of the heavy-handedness of the hospital administration and the intense politicization of care at Providence Alaska Medical Center, the doctors in this story cannot be identified. It’s where they work. It’s where they have to thread the needle with their criticism, trying to preserve their jobs, while advocating for better patient care.
“There is nothing magical about the ICU,” one doctor said. “It’s merely a lower patient-to-nursing ratio, and each room has all of the fixings pre-installed. But do you think we can’t provide ventilation, oxygen, IV drugs and monitoring in any bed? I would like to know why that patient died. My guess is they would have died anyway.”
Another doctor agreed. He, too, cannot be identified because of the risk of being ostracized.
“Medicine has always been triaged here in Alaska — it’s a matter of resources. Does an 80-year-old person need a double heart valve operation when it will only extend his life three years? Probably not, but if you delay that surgery because of Covid ICU bed status and they die in the meantime, it makes a good headline and has a patina of truth,” he said.
“A community doctor trying to get an ICU transfer has to jump through a lot of hoops and that often involves a lot of factors like insurance, transport logistics, and current hospital resources. Sometimes patients that are pretty sick don’t make the cut and sometimes patients that probably shouldn’t do [make the cut] but that’s often ultimately decided by the ICU doc on call in conjunction with the administrator. A quasi elective heart surgery can be (and often was) delayed if it looks like there won’t be staff to cover what is likely to be a 2-3 day stint in the ICU recovering. Covid has complicated this because these patients, once intubated and vented, rarely get better and often take a month to die,” he said.
“The community docs, like they always have done, have to figure out who to triage. My nursing friends at Providence are doing 3:1 ICU management and that’s really hard and leads to burnout. Also leading to burnout is seeing the traveling nurses get signing bonuses, but full time staff not getting retention bonus. So a lot of people are leaving,” he said.
Most ICU nurses are vaccinated, but he believes up to 30 percent of floor nurses are not vaccinated and some of those “are getting out to fill positions at local facilities that have signaled they won’t have a mandate, which makes overall staffing harder because the hospital can’t staff the step-down units (which are for almost-sick-enough-to-be-in-ICU patients) and the ICU patients can’t be discharged to one of those beds,” the doctor said.
The Wall Street Journal also has a story on Sunday about the rationing of healthcare in Alaska. It carries the same message as the New York Times and reports no opposing views.
“In recent weeks, a triage team of doctors at Providence Alaska Medical Center in Anchorage have been using a formula to score patients on their potential for dying and consulting with an ethicist on the decisions they make. The patients include those sick with Covid-19 and with other ailments,” the Journal wrote.
“Recently, the team had to choose which of two patients critically ill with Covid-19 should use a single specialized dialysis machine. The team saw little hope for one patient and selected the other to start dialysis. The patient who had to wait died,” the newspaper wrote.
“’We have the most highly sophisticated medicine and advanced training in the world, and we’re having to ration care,” Dr. Javid Kamali, an intensive-care doctor at Providence, told the Wall Street Journal. “We didn’t sign up for this.”
But the five doctors Must Read Alaska spoke to said neither they nor their close colleagues have seen rationing. One doctor pointed out that Alaska Regional Hospital, which has not mandated a vaccine for its employees, is not using the media to tell the story of rationing care, like Providence is doing.
The New York Times went on to describe what happened to Providence medical staff when they waded into the political arena by asking the Anchorage Assembly last week to mandate masks for everyone in the city over the age of 2. They were met with open hostility.
Read: Medical theater as doctors and nurses come to Anchorage Assembly with mask plea
“When the Anchorage Assembly considered a mask mandate last week, some of the doctors who came to speak were jeered at. “Do you use ivermectin?” someone in the crowd shouted, referring to a deworming medicine that has been touted as a Covid-19 treatment on social media even as the Food and Drug Administration has warned people against taking it,” the Times wrote. Ivermectin has been used for decades to treat parasites and is now successfully used in other countries to help open up the airways of those who have become infected with Covid. But the American medical establishment appears to be firmly against the drug, which is relatively cheap and has had millions using it successfully in India.
“As a group of doctors left the meeting, one person followed them outside, heckling. “You guys have sold out and are liars,” he shouted. Others outside holding signs — “Liberty or Tyranny,” one of them said — also mocked the physicians,” the newspaper wrote, illustrating the very difficult position Providence has put itself in by stepping into what is a political battle at the Assembly.
That event was coordinated by one of the local unions in collaboration with Assemblyman Forrest Dunbar, who stepped down from the dais before the meeting to advise the group on testimony.
Read the New York Times story at this link.
Now, it appears the pro-mask advocates are taking their stories to the national media, which is only telling their views, at the exclusion of others.
The Anchorage hospital has had over a year and a half to prepare for a surge in the infectious disease and to develop treatment protocols, but instead, some residents claim, are sending people home with no treatment options until their lips turn blue from lack of oxygen, after which they can be admitted to the hospital to face a very uncertain outcome.
I asked for the data not for a broken link!
Works fine for me. But try this one.
The sky is falli
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ownership bread crumb trail.
