606 Matching Annotations
  1. Sep 2020
    1. Take away: The claim here is ultimately a value judgement, but the data used to support the claim is subject to examination. Overall the source for the presented data was not identifiable and the overall argument requires greater context to evaluate.

      The claim: Students are harmed more by not being in school/sports than by COVID-19.

      The evidence: The claim is supported by a single data table. Unfortunately, the source for the table presented was not found. It is well documented that the infection fatality rate in age groups 15-24 is lower than for older age groups, however the actual infection fatality rate for this age group is still not entirely clear. As one example, the CDC website has two data sets to estimate COVID-19 deaths. One is provisional COVID-19 deaths with 242 deaths reported in the age group 15-24 in the entire United States. The second dataset estimates COVID-19 deaths based on the increase over the number of expected deaths based on historical data. The second dataset does not present data for 15-24 age group, only "under 25 years." The lower range of the second dataset is ~10,000 deaths in people under 25 years in Florida above the expected deaths for the year. These deaths may be attributed to COVID-19.

      Regardless, no data is presented which measures how students are harmed by not being in school. Additional data needs to be presented for the claim to be validated including measurable metrics by which students are harmed. These are not presented in the Twitter post.

      Sources: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm#dashboard https://data.cdc.gov/NCHS/Provisional-COVID-19-Death-Counts-by-Sex-Age-and-S/9bhg-hcku/data https://experience.arcgis.com/experience/96dd742462124fa0b38ddedb9b25e429 https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html#:~:text=As%20you%20get%20older%2C%20your,than%20people%20in%20their%2050s.

    1. It is so mild that half of infected people are asymptomatic, shown in early data from the Diamond Princess ship, and then in Iceland and Italy.

      The takeaway: Reported numbers of asymptomatic individuals are discordant but generally are less than 20% of reported cases.

      The claim: Half of people infected with COVID-19 are asymptomatic.

      The evidence: 17.9% of the Diamond Princess ship were asymptomatic (1). Only 48 out of 473 total cases were from asymptomatic individuals in Iceland (2). The initial analysis of China's asymptomatic cases was 1% (3). A research article summarizing data from China and Italy lists China's asymptomatic cases as 80.9% and Italy's asymptomatic cases as 8.5% (4). It appears that mild symptoms and asymptomatic cases were combined in reference 4 for China's data as mild symptom numbers were N/A.

      Therefore, there is no consensus on the number of asymptomatic individuals. Additional clarity is needed in the data before conclusions can be made based on the number of asymptomatic individuals.

      Sources:

      1 https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.10.2000180

      2 https://www.government.is/news/article/2020/03/15/Large-scale-testing-of-general-population-in-Iceland-underway/

      3 https://jamanetwork.com/journals/jama/fullarticle/2762130

      4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278221/

    1. Blokland, I. V. van, Lanting, P., Ori, A. P., Vonk, J. M., Warmerdam, R. C., Herkert, J. C., Boulogne, F., Claringbould, A., Lopera-Maya, E. A., Bartels, M., Hottenga, J.-J., Ganna, A., Karjalainen, J., Study, L. C.-19 cohort, Initiative, T. C.-19 H. G., Hayward, C., Fawns-Ritchie, C., Campbell, A., Porteous, D., … Franke, L. H. (2020). Using symptom-based case predictions to identify host genetic factors that contribute to COVID-19 susceptibility. MedRxiv, 2020.08.21.20177246. https://doi.org/10.1101/2020.08.21.20177246

  2. Aug 2020
    1. Candido, D. S., Claro, I. M., Jesus, J. G. de, Souza, W. M., Moreira, F. R. R., Dellicour, S., Mellan, T. A., Plessis, L. du, Pereira, R. H. M., Sales, F. C. S., Manuli, E. R., Thézé, J., Almeida, L., Menezes, M. T., Voloch, C. M., Fumagalli, M. J., Coletti, T. M., Silva, C. A. M. da, Ramundo, M. S., … Faria, N. R. (2020). Evolution and epidemic spread of SARS-CoV-2 in Brazil. Science. https://doi.org/10.1126/science.abd2161

    1. Felipe, L. S., Vercruysse, T., Sharma, S., Ma, J., Lemmens, V., Looveren, D. van, Javarappa, M. P. A., Boudewijns, R., Malengier-Devlies, B., Kaptein, S. F., Liesenborghs, L., Keyzer, C. D., Bervoets, L., Rasulova, M., Seldeslachts, L., Jansen, S., Yakass, M. B., Quaye, O., Li, L.-H., … Dallmeier, K. (2020). A single-dose live-attenuated YF17D-vectored SARS-CoV2 vaccine candidate. BioRxiv, 2020.07.08.193045. https://doi.org/10.1101/2020.07.08.193045

    1. Yonker, L. M., Neilan, A. M., Bartsch, Y., Patel, A. B., Regan, J., Arya, P., Gootkind, E., Park, G., Hardcastle, M., John, A. S., Appleman, L., Chiu, M. L., Fialkowski, A., Flor, D. D. la, Lima, R., Bordt, E. A., Yockey, L. J., D’Avino, P., Fischinger, S., … Fasano, A. (2020). Pediatric SARS-CoV-2: Clinical Presentation, Infectivity, and Immune Responses. The Journal of Pediatrics, 0(0). https://doi.org/10.1016/j.jpeds.2020.08.037

    1. Qu, J., Cai, Z., Liu, Y., Duan, X., Han, S., Zhu, Y., Jiang, Z., Zhang, Y., Zhuo, C., Liu, Y., Liu, Y., Liu, L., & Yang, L. (2020). Persistent bacterial coinfection of a COVID-19 patient caused by a genetically adapted Pseudomonas aeruginosa chronic colonizer. BioRxiv, 2020.08.05.238998. https://doi.org/10.1101/2020.08.05.238998

    1. Lednicky, J. A., Lauzardo, M., Fan, Z. H., Jutla, A. S., Tilly, T. B., Gangwar, M., Usmani, M., Shankar, S. N., Mohamed, K., Eiguren-Fernandez, A., Stephenson, C. J., Alam, M. M., Elbadry, M. A., Loeb, J. C., Subramaniam, K., Waltzek, T. B., Cherabuddi, K., Morris, J. G., & Wu, C.-Y. (2020). Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients. MedRxiv, 2020.08.03.20167395. https://doi.org/10.1101/2020.08.03.20167395

    1. Asymptomatic spread of coronavirus is ‘very rare,’ WHO says

      Take away: Dr. Van Kerkhove appeared to refer to only “asymptomatic” individuals and not “presymptomatic” individuals in her statement. Clarification from the WHO, and public availability of the data leading to the claim, is needed for proper interpretation. At the current time, existing published data indicates that a significant amount of SARS-CoV-2 infections are due to individuals who did not have symptoms when they spread the virus.

      The claim: According to the WHO, asymptomatic spread of coronavirus is ‘very rare’.

      The evidence: This statement is attributed to WHO official Dr. Maria Van Kerkhove during a recent news conference. It deserves greater clarification from the WHO, but Dr. Van Kerkhove appears to make the distinction between “asymptomatic” and “pre-symptomatic” individuals during her comments. This distinction is essential for proper interpretation of her statement. “Asymptomatic” refers to persons who test positive, but who never display symptoms throughout the course of their SARS-CoV-2 infection. In contrast, “presymptomatic” individuals are those with confirmed infection, who do not currently display symptoms, but later go on to develop COVID-19 related symptoms (fever, cough, loss of taste/smell, etc).

      Importantly, the distinction between asymptomatic and presymptomatic can only be made retrospectively. From a clinical standpoint, if someone currently has no symptoms, but tests positive, there is no way of knowing at that time if they are “asymptomatic” or “presymptomatic”. Preliminary data estimates that around 20% of SARS-CoV-2 infections are truly “asymptomatic”.

      If “asymptomatic” individuals were rarely involved in transmission of the virus, this would be an important finding, but from a practical standpoint if “presymptomatic” individuals still spread the virus (as the data indicates), then the rationale for preventative measures still stands. Early studies [1] [2] have estimated that up to 40-60% of virus spread occurs when people don’t have symptoms. Preventative measures such as social distancing and universal mask wearing have been implemented to prevent the spread of virus from individuals not currently demonstrating symptoms.

  3. Jul 2020
    1. Seow, J., Graham, C., Merrick, B., Acors, S., Steel, K. J. A., Hemmings, O., O’Bryne, A., Kouphou, N., Pickering, S., Galao, R., Betancor, G., Wilson, H. D., Signell, A. W., Winstone, H., Kerridge, C., Temperton, N., Snell, L., Bisnauthsing, K., Moore, A., … Doores, K. (2020). Longitudinal evaluation and decline of antibody responses in SARS-CoV-2 infection. MedRxiv, 2020.07.09.20148429. https://doi.org/10.1101/2020.07.09.20148429

    1. When virus levels in the population are very low, the chances of a test accurately detecting Covid-19 could be even less than 50 per cent

      Take away: Real-world evidence from countries like New Zealand, that already have very low disease incidence, suggests that the concerns for false positives raised in this article are overhyped.

      The claim: "When virus levels in the population are very low, the chances of a test accurately detecting Covid-19 could be even less than 50 per cent..."

      The evidence: The author explains theoretical scenarios where, when rates of true COVID infections are low, the rate of true positives (test positive and have COVID) may be equal to or less than false positives (test positive but do not have COVID). The background here is that no test is perfect and every screening test used in medicine has some percentage of false negatives and false positives. Several anecdotes are cited in support, however real world data from countries that already have very low disease incidence, suggests that the concerns or false positives raised in this article are unfounded. New Zealand, for example, has tested an average of 2127 people per day from July 1-22, with an average of 1.2 positive cases identified per day—an average % positive of only 0.07%. In order for the authors assumptions to hold, all of the positive tests reported there would have to be false positives—highly unlikely as New Zealand still has symptomatic patients. Therefore, real-world evidence from standard PCR based COVID testing in low incidence populations suggests that the concern for high rates of false positives raised in this article is overhyped.

      Source: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-current-situation/covid-19-current-cases

    1. Zhong, H., Wang, Y., Shi, Z., Zhang, L., Ren, H., He, W., Zhang, Z., Zhu, A., Zhao, J., Xiao, F., Yang, F., Liang, T., Ye, F., Zhong, B., Ruan, S., Gan, M., Zhu, J., Li, F., Li, F., … Zhao, J. (2020). Characterization of Microbial Co-infections in the Respiratory Tract of hospitalized COVID-19 patients. MedRxiv, 2020.07.02.20143032. https://doi.org/10.1101/2020.07.02.20143032

    1. Yurkovetskiy, L., Wang, X., Pascal, K. E., Tomkins-Tinch, C., Nyalile, T., Wang, Y., Baum, A., Diehl, W. E., Dauphin, A., Carbone, C., Veinotte, K., Egri, S. B., Schaffner, S. F., Lemieux, J. E., Munro, J., Rafique, A., Barve, A., Sabeti, P. C., Kyratsous, C. A., … Luban, J. (2020). Structural and Functional Analysis of the D614G SARS-CoV-2 Spike Protein Variant. BioRxiv, 2020.07.04.187757. https://doi.org/10.1101/2020.07.04.187757

    1. Mulligan, M. J., Lyke, K. E., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S. P., Neuzil, K., Raabe, V., Bailey, R., Swanson, K. A., Li, P., Koury, K., Kalina, W., Cooper, D., Fonter-Garfias, C., Shi, P.-Y., Tuereci, O., Tompkins, K. R., Walsh, E. E., … Jansen, K. U. (2020). Phase 1/2 Study to Describe the Safety and Immunogenicity of a COVID-19 RNA Vaccine Candidate (BNT162b1) in Adults 18 to 55 Years of Age: Interim Report. MedRxiv, 2020.06.30.20142570. https://doi.org/10.1101/2020.06.30.20142570