Thinking Citizen Blog — Covid Data: US, Israel, the Orion Challenge

Thinking Citizen Blog — Thursday is Health, Health Care, Health Insurance and Global Health Policy Day

Today’s Topic: Covid Data: US, Israel, the Orion Challenge

So much data related to Covid, so little data on what matters most. What is a non-expert to do? “Decisions on boosters relied on data from Israel. Why isn’t the US producing this research?” asked Marty Makary, professor, Johns Hopkins Medical School (first link). So many opinions, so many axes to grind. How do you sort the important from the unimportant and arrange the important stuff into a coherent story that makes sense? What should an eighth grader know about Covid data? A 12th grader? A Harvard graduate? What teachers at medical schools, public health schools, or public policy institutions have come up with compelling graphics to help citizens see the big data picture? What is the best reasonably simple but reasonably complete graphic on this topic you have ever seen?

Could Orion help? Perhaps someone very brave out there will give it a shot. Remember the Orion Challenge? The most important fact or question about anything is Alnilam — the central and brightest star of the belt. The next two most important facts or questions are the other two stars of the belt. The next are the two stars above the belt (think of them as either shoulders or upraised hands of a dancer). The final two are the two stars below the belt (think of them as the dancer’s feet). So what are the seven more important questions related to Covid in order of importance? What are the seven most important facts? Personally, I’m too confused to make either Orion at this point — even though I’ve constructed many on other topics. Today, some excerpts from two recent articles on Covid-related topics. Experts — please chime in. Correct, elaborate, elucidate.

THE CDC FAILURE TO REPORT MEANINGFUL DATA

1. “The CDC’s failure to report meaningful data has left policy makers flying blind. In the absence of good data to answer the basic questions Americans have been asking, political opinions have filled the vacuum. Strong data might have prevented much of the polarization over Covid.” (Makary)

2. “Sound data from the CDC has been especially lacking on natural immunity from prior Covid infection. On Aug. 25, Israel published the most powerful and scientifically rigorous study on the subject to date. In a sample of more than 700,000 people, natural immunity was 27 times more effective than vaccinated immunity in preventing symptomatic infections.”

3. “Despite this evidence, U.S. public health officials continue to dismiss natural immunity, insisting that those who have recovered from Covid must still get the vaccine. Policy makers and public health leaders, and the media voices that parrot them, are inexplicably sticking to their original hypothesis that natural immunity is fleeting, even as at least 15 studies show it lasts.”

NB: “Meanwhile, employers fire workers with natural immunity who won’t get vaccinated. Schools disenroll students who won’t comply.”

THE CDC REPORT ON NATURAL IMMUNITY PUBLISHED IN AUGUST

1. “The CDC did put out a study of natural immunity last month, forcefully concluding that vaccinated immunity was 2.3 times better than natural immunity. The CDC used these results to justify telling those with natural immunity to get vaccinated.”

2. “But the rate of infection in each group was less than 0.01%, meaning infections were exceedingly rare in the short two-month time period the agency chose to study. This is odd, given there are more than a year of data available.”

3. “Moreover, despite having data on all 50 states, the CDC only reported data from Kentucky. Was Kentucky the only state that produced the desired result? Why else exclude the same data from the other 49 states?”

NB: “Some public health officials are afraid to acknowledge natural immunity because they fear some will choose infection over vaccination. But leaders can encourage all Americans who aren’t immune to get vaccinated and be transparent with the data at the same time.The CDC shouldn’t fish for data to support outdated hypotheses. Heeding the robust Israeli data on natural immunity could help restore the agency’s credibility and even help vaccination efforts. Israel also contributed a brilliant study on vaccinating children. Researchers found that one dose of the Pfizer vaccine, instead of the normal two, was 100% effective in children ages 12 to 15. Such a finding could have significant implications for achieving broad immunity in adolescents while reducing the risk of heart complications, which have been clustered around the second dose. These are the studies U.S. public health agencies should be doing but aren’t. By any metric, the CDC has failed in its primary task of preparing the country for a pandemic and telling us how to reduce harm from the novel Covid pathogen.”

A CASE STUDY OF WHY GOOD DATA MATTERS: dexamethadose (see second link)

1. “To see the dangers of insufficient data and the powers of appropriate data, consider the case of dexamethasone, an inexpensive generic corticosteroid drug.”

2. “In the early days of the pandemic, doctors were warned against using it to treat Covid patients. The limited literature from SARS and MERS — illnesses related to Covid — suggested that steroids, which suppress the immune system would harm rather than help Covid patients.”

3. “The assessment changed on June 16, 2020, when the results of a large-scale randomized clinical trial from Britain, one of all too few such efforts during the pandemic, demonstrated that dexamethasone was able to reduce deaths by one-fifth among patients needing supplemental oxygen and an astonishing one-third among those on ventilators.”

NB: “The study also explained the earlier findings: Given too early, before patients needed supplemental oxygen, steroids could harm patients. But comprehensive data from the randomized trial showed that when given later, as the disease progressed in severity, dexamethasone was immensely helpful. Dexamethasone has since become a workhorse of Covid treatment saving perhaps millions of lives at little cost or fanfare.”

Opinion | Covid Confusion at the CDC

Opinion | Show Me the Data!

For the last three years of posts organized by theme:

PDF with headlines — Google Drive

YOUR TURN

Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history…. Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed. Or just some random health-related fact that blew you away.

This is your chance to make some one’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.

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