4 ms·

How can the Lancet publish a letter with a) such basic statistical omissions and b) no editing whatsoever Like everyone operating in bad faith, they compare %

by xxpor 5y ago

How can the Lancet publish a letter with a) such basic statistical omissions and b) no editing whatsoever Like everyone operating in bad faith, they compare % of cases in fully vaccinated people to unvaxinated people, without talking about relative vaxination rates. Of course you're going to get more raw numbers infections of people who have been vaccinated (especially with waining immune effects as time passes) if you vaccination rate is 90%+. Here's the IMO right way to look at it: https://kingcounty.gov/depts/health/covid-19/data/vaccination-outcomes.aspx https://kingcounty.gov/depts/health/covid-19/data/vaccinatio... Unvaccinated people in King County are 7x more likely to catch covid, 38x more likely to end up in the hospital, and 24x more likely to die. The raw numbers don't matter in the context of arguing about effectiveness except to ensure you have a large enough sample to make statistical inferences with.

MandieD 5y ago
And it’s particularly irresponsible at the moment, because our hospitals in Germany are so clogged with mostly unvaccinated Covid patients that my father-in-law is having to just suffer with a hernia because that repair surgery is “elective”. It’s been rescheduled twice, and they’ve not bothered to give him a new date after the last cancellation.
- sharken 5y ago
  Things are somewhat better in Denmark, but hospitals and their staffing have been neglected for many, many years. And it seems that no political party wants to remedy the situation, it's more about image and public profile nowadays.
coffeepants2 5y ago
Additionally, there is no mention of the waning efficacy of the vaccine. The efficacy rate drops from ~94% to ~45% after 6 months w/ Pfizer & Moderna). The assertion: "It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission..." completely ignored the very obvious fact that a large percentage of the vaccinated population is entering a low efficacy phase leading up the booster (which actually surpasses the efficacy of the initial 2-dose regimen https://twitter.com/ryanlcooper/status/1461889784369008641 https://twitter.com/ryanlcooper/status/1461889784369008641). The number of breakthrough cases is on the rise as a result of the vaccine's decreased efficacy (https://ehrn.org/articles/breakthrough-covid-19-cases-on-the-rise-still-rare-for-vaccinated-people https://ehrn.org/articles/breakthrough-covid-19-cases-on-the...). It seems intentional, or grossly negligent to use their words, to omit this information.
- BlueTie 5y ago
  Still, it would seem negligent to bifurcate the population into (vaccinated = low transmission; unvaccinated = high transmission) when the reality is exactly as you describe - a forever variable efficacy rate across the board (transmission, infection, hospitalization, death) thanks to the waning effects of the vaccine + new variants. Having 30,000 vaccinated people pack into a basketball game can't be accepted in good faith when countries are trying to ban unvaccinated people from air travel, working in offices, working in healthcare settings with proper precautions, etc. when vaccination isn't a switch for forever lasting 95% immunity. Hopefully we can get to a point where a vaccine or something else can put an end to this, but until then telling a large group with variable levels of protection that are they safe is enabling the spread of the virus.
  - nradov 5y ago
    There is no prospect of stopping the spread. Almost everyone will be exposed eventually and no infection control measures can prevent that. Fortunately the vaccines are pretty effective at preventing deaths, and there are other good treatments as well. https://www.medpagetoday.com/opinion/vinay-prasad/94646 https://www.medpagetoday.com/opinion/vinay-prasad/94646
- blub 5y ago
  I really do not understand how any of that is relevant, it seems both you and OP are grasping at straws. The article’s conclusion was “It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission when deciding about public health control measures.”. If anything, waning vaccine protection is an argument for that conclusion.
quantumwannabe 5y ago
King County's data is misleading. They admit that there are practically zero unvaccinated people in the county in the age groups at highest risk of death, and they artificially inflate their numbers. The red box on your link links to a document that describes them claiming that at least 5+% of these age groups are unvaccinated, even when they are not. Relevant quote: "To resolve these issues, we have added a "continuity correction" to our estimates of the size of the unvaccinated population, to ensure that it would not become unrealistically small. To do this, we assume that we will not reach 100% vaccination and that at least 5% of each age group, race/ethnicity group, and zip code will always be unvaccinated." In the last 30 days (chosen because the only other stat includes time before vaccines were available), 80% of deaths (50/62) in King County were in people over the age of 60 [1]. The dashboard in your link states that "Over the past 30 days, people who are not fully vaccinated are 24.3 times more likely to die due to COVID-19 related illness than people who are fully vaccinated" [2]. These are the number of people who have been vaccinated compared to the total population of the age group, as well as how many died in each group in the last 30 days [3]: 60-69 y/o: 218.4k residents, 218.8k vaccinated partially, 207.6k vaccinated fully, 13 deaths. 70-79 y/o: 124.2k residents, 136.5k vaccinated partially, 129.0k vaccinated fully, 17 deaths. 80+ y/o: 59.9k residents, 70.3k vaccinated partially, 65.0k vaccinated fully, 20 deaths. Using the 24.3 times more likely to die ratio mentioned above, this means that, assuming the relative risk is constant across age groups, 2 people over 60 who died were vaccinated, and the other 48 were unvaccinated. Considering the ridiculously small population of unvaccinated people in this age group, the deaths per unvaccinated population rate (unadjusted) is insanely high, far higher than the pre-vaccine availability death rate. This does not smell right. Also, the graphs on that dashboard (by default) aren't raw deaths divided by population; they are adjusted by age because, in their words, "when considering rates, it’s important to standardize, or control, for age. For example, older adults are both more like to be vaccinated than younger people and more likely to have underlying health conditions that may decrease the protection they get from vaccination and increase their risk for being hospitalized or dying if they get COVID". I think this is a fair adjustment to make, but King County did not do age standardization in the past, and the only dashboard that does it today is the vaccination status one. Since the number of unvaccinated people in the age groups with the vast majority of deaths is "adjusted" from the real counts, which show that there are more people vaccinated than the most recent census, it is impossible to accurately perform age standardization. There is no raw data on the site with vaccination status attached, so it is impossible to see what effects their adjustments have had. [1] https://kingcounty.gov/depts/health/covid-19/data/daily-summary.aspx https://kingcounty.gov/depts/health/covid-19/data/daily-summ... Go to the "Demographics" tab, select "Deaths" from the drop down, and select the "Last 30 Days" radio button. [2] Exact quote comes from clicking the "Relative Risk trend" box below the "death" ratio on your dashboard. [3] https://kingcounty.gov/depts/health/covid-19/data/vaccination.aspx https://kingcounty.gov/depts/health/covid-19/data/vaccinatio... Select "Demographics", and "10 year age groups" from the dropdown.
blub 5y ago
That’s irrelevant in regard to the conclusion: the vaccinated still get sick and spread it, so they should wear masks and get tested. At least the latter is illogically the opposite of what’s happening in e.g. Germany.

by xxpor 5y ago

MandieD 5y ago

And it’s particularly irresponsible at the moment, because our hospitals in Germany are so clogged with mostly unvaccinated Covid patients that my father-in-law is having to just suffer with a hernia because that repair surgery is “elective”. It’s been rescheduled twice, and they’ve not bothered to give him a new date after the last cancellation.

sharken 5y ago
Things are somewhat better in Denmark, but hospitals and their staffing have been neglected for many, many years. And it seems that no political party wants to remedy the situation, it's more about image and public profile nowadays.

coffeepants2 5y ago

Additionally, there is no mention of the waning efficacy of the vaccine. The efficacy rate drops from ~94% to ~45% after 6 months w/ Pfizer & Moderna). The assertion: "It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission..." completely ignored the very obvious fact that a large percentage of the vaccinated population is entering a low efficacy phase leading up the booster (which actually surpasses the efficacy of the initial 2-dose regimen https://twitter.com/ryanlcooper/status/1461889784369008641 https://twitter.com/ryanlcooper/status/1461889784369008641). The number of breakthrough cases is on the rise as a result of the vaccine's decreased efficacy (https://ehrn.org/articles/breakthrough-covid-19-cases-on-the-rise-still-rare-for-vaccinated-people https://ehrn.org/articles/breakthrough-covid-19-cases-on-the...). It seems intentional, or grossly negligent to use their words, to omit this information.

BlueTie 5y ago
Still, it would seem negligent to bifurcate the population into (vaccinated = low transmission; unvaccinated = high transmission) when the reality is exactly as you describe - a forever variable efficacy rate across the board (transmission, infection, hospitalization, death) thanks to the waning effects of the vaccine + new variants. Having 30,000 vaccinated people pack into a basketball game can't be accepted in good faith when countries are trying to ban unvaccinated people from air travel, working in offices, working in healthcare settings with proper precautions, etc. when vaccination isn't a switch for forever lasting 95% immunity. Hopefully we can get to a point where a vaccine or something else can put an end to this, but until then telling a large group with variable levels of protection that are they safe is enabling the spread of the virus.
- nradov 5y ago
  There is no prospect of stopping the spread. Almost everyone will be exposed eventually and no infection control measures can prevent that. Fortunately the vaccines are pretty effective at preventing deaths, and there are other good treatments as well. https://www.medpagetoday.com/opinion/vinay-prasad/94646 https://www.medpagetoday.com/opinion/vinay-prasad/94646
blub 5y ago
I really do not understand how any of that is relevant, it seems both you and OP are grasping at straws. The article’s conclusion was “It appears to be grossly negligent to ignore the vaccinated population as a possible and relevant source of transmission when deciding about public health control measures.”. If anything, waning vaccine protection is an argument for that conclusion.

quantumwannabe 5y ago

King County's data is misleading. They admit that there are practically zero unvaccinated people in the county in the age groups at highest risk of death, and they artificially inflate their numbers. The red box on your link links to a document that describes them claiming that at least 5+% of these age groups are unvaccinated, even when they are not. Relevant quote: "To resolve these issues, we have added a "continuity correction" to our estimates of the size of the unvaccinated population, to ensure that it would not become unrealistically small. To do this, we assume that we will not reach 100% vaccination and that at least 5% of each age group, race/ethnicity group, and zip code will always be unvaccinated." In the last 30 days (chosen because the only other stat includes time before vaccines were available), 80% of deaths (50/62) in King County were in people over the age of 60 [1]. The dashboard in your link states that "Over the past 30 days, people who are not fully vaccinated are 24.3 times more likely to die due to COVID-19 related illness than people who are fully vaccinated" [2]. These are the number of people who have been vaccinated compared to the total population of the age group, as well as how many died in each group in the last 30 days [3]: 60-69 y/o: 218.4k residents, 218.8k vaccinated partially, 207.6k vaccinated fully, 13 deaths. 70-79 y/o: 124.2k residents, 136.5k vaccinated partially, 129.0k vaccinated fully, 17 deaths. 80+ y/o: 59.9k residents, 70.3k vaccinated partially, 65.0k vaccinated fully, 20 deaths. Using the 24.3 times more likely to die ratio mentioned above, this means that, assuming the relative risk is constant across age groups, 2 people over 60 who died were vaccinated, and the other 48 were unvaccinated. Considering the ridiculously small population of unvaccinated people in this age group, the deaths per unvaccinated population rate (unadjusted) is insanely high, far higher than the pre-vaccine availability death rate. This does not smell right. Also, the graphs on that dashboard (by default) aren't raw deaths divided by population; they are adjusted by age because, in their words, "when considering rates, it’s important to standardize, or control, for age. For example, older adults are both more like to be vaccinated than younger people and more likely to have underlying health conditions that may decrease the protection they get from vaccination and increase their risk for being hospitalized or dying if they get COVID". I think this is a fair adjustment to make, but King County did not do age standardization in the past, and the only dashboard that does it today is the vaccination status one. Since the number of unvaccinated people in the age groups with the vast majority of deaths is "adjusted" from the real counts, which show that there are more people vaccinated than the most recent census, it is impossible to accurately perform age standardization. There is no raw data on the site with vaccination status attached, so it is impossible to see what effects their adjustments have had. [1] https://kingcounty.gov/depts/health/covid-19/data/daily-summary.aspx https://kingcounty.gov/depts/health/covid-19/data/daily-summ... Go to the "Demographics" tab, select "Deaths" from the drop down, and select the "Last 30 Days" radio button. [2] Exact quote comes from clicking the "Relative Risk trend" box below the "death" ratio on your dashboard. [3] https://kingcounty.gov/depts/health/covid-19/data/vaccination.aspx https://kingcounty.gov/depts/health/covid-19/data/vaccinatio... Select "Demographics", and "10 year age groups" from the dropdown.

blub 5y ago

That’s irrelevant in regard to the conclusion: the vaccinated still get sick and spread it, so they should wear masks and get tested. At least the latter is illogically the opposite of what’s happening in e.g. Germany.