Covid-19 Related Investigations

I have attempted to apply the empirical method to several of the contentious issues that have been raised by Covid-19 and the Government's response to it. I have learnt that this approach tends to please few on either side of the increasing divide. My objective has been, and remains, to attempt honestly to locate where the truth lies. It is a lonely endeavour which will lose you all your friends. Hey ho. Note the stated dates. There will be further studies and data since those dates but I have not updated the analyses since those dates.

1) Literature review of the evidence for Ivermectin efficacy as a prophylactic or treatment (August'21) here. Outcome: Ivermectin has a very good level of efficacy as a prophylactic or in early treatment (63%-85% effective) and some, but poorer, efficacy in late treatment (23%-47%)

2) Literature review of the efficacy of cloth or medical/surgical masks when used by the general public (September'21) here. Of the 17 studies I found, 10 indicated no benefit against viruses whilst only 4 indicated a statistically significant benefit.

3) Literature review of the efficacy of lockdowns in preventing the spread of Covid-19 (September'21) here. I read 52 papers then ran out of enthusiasm (there are many more). Based on those 52 there were 18 which indicated lockdowns had been of some efficacy and 26 that indicated lockdowns were not efficacious (8 inconclusive). Not exactly an overwhelmingly vote of confidence in lockdowns when set aside their enormous financial cost and impact on peoples' wellbeing.

4) Review of the safety and efficacy of the Pfizer and AstraZeneca Covid-19 vaccines (November'21) here. Can't summarise, you'll have to read the Conclusions. It includes a Risk-Benefit analysis.

5) There have been many claims on sceptic sites that national death statistics show indications of enhanced deaths which can be related to vaccination. In the above review on vaccines, item 4, I refute two such claims. Here I refute another. The latter appeared alarming at first, as the death rate for single vaccinated people is indeed higher than for the unvaccinated. But it is not what it seems at first sight and is an object lesson in how careful one needs to be in analysing such data. Sample bias is an ever-present trap to fall into.

6) A paper in Nature Medicine in December 2021 reports an association between Covid-19 vaccines and Myocarditis, albeit very small effect size. Here I critique the paper and conclude there is an association and, if anything, it is rather larger than the paper claims, though still small.

7) A paper in JAMA Network in January 2022 reports an association between mRNA Covid-19 vaccines and Myocarditis, based on the US VAERS (Vaccine Adverse Event Reporting System), here. The rates of Myocarditis are elevated by about x85 and 82% of those effected are male. The effect is confined to the under-40s and mostly the under 30s, the median affected age is 21. The criteria applied to meet a positive diagnosis was quite restrictive so the effect may be even larger. Moreover, VAERS reports are only a fraction of the underlying cases, so the true effect may be massively greater.

8) A paper in Studies in Applied Economics in January 2022 reported a meta-analysis of the efficacy of various non-pharmaceutical interventions, particularly lockdowns, in reducing mortality from Covid-19. "Shelter in Place Orders" were found on average to reduce morality by only 2.9% and the 95%CL bound was consistent with zero effect. Paper is here.

9) Three more very large studies have been published in the first three months of 2022. Two show excellent efficacy of Ivermectin against Covid, one based on prophylaxis and the other on mortality, respectively here and here. The third paper is of a large, ostensibly blinded RCT which shows no statistically significant efficacy against hospitalisation for early treatment, you can find it here. This muddies the waters of what was beginning to look like a clarifying picture. Howver this latter "negative" study has come in for severe criticism (49 queries or criticisms are listed here). Moreover, one of the study's senior authors (Ed Mills) is on record as stating, "There is a clear signal that Ivermectin works in COVID patients...I think if we had continued randomizing a few hundred more patients, it would have likely been significant... you will hear me retract previous statements where I had been previously negative", source here. The best overall picture of Ivermectin efficacy continues to be that presented excellently by this compilation site. I carried out a reliability assessment of this site as part of my review linked in item 1, above. It's sound. It continues to include all studies, not just those that are supportive of Ivermectin, which is crucial of course.

10) An Israeli study published February 2022 identifies that vitamin D has a strong protective effect against acquiring severe Covid-19. Patients with vitamin D deficiency (<20 ng/mL) were 14 times more likely to have severe or critical disease than patients with good levels of vitamin D (≥40 ng/mL). Importantly, the serum vitamin D levels were obtained at least two weeks prior to the patient's first positive Covid test (thus avoiding the criticism that the disease had caused a lowering of vitamin D levels). The study is here.

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