The art of statistics, the emperor’s new clothes!

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Source: trendy meditation (id:xinchaochensi)

Author: north wind

In 1854, a cholera epidemic occurred in London. During this cholera epidemic, Dr. johnsnow concluded through investigation and analysis that the spread of cholera was related to the water source. Based on this analysis, he gave a plan and successfully controlled the cholera epidemic, which is generally regarded as the landmark practice of the birth of modern epidemiology. This event is so famous that it has been written into some English textbooks in China.

However, there are some things that the textbook did not tell us, that is, the mainstream in the medical community at that time believed that cholera was spread through polluted air. Therefore, even though johnsnow’s proposal controlled the epidemic, the academic community did not recognize it. Instead, some people criticized his theory as heresy. This debate did not end until Vibrio cholerae was isolated, and lasted for decades.

This story illustrates an unpleasant but realistic problem. The consensus of the medical community is not consistent with the facts. Even with sufficient evidence, some people are unwilling to change their views. This is not a strange thing. After all, scientific understanding is always gradual, and there are always mistakes in understanding specific problems at a specific time,. However, it would be a great pity if things go back to recognizing mistakes, but we still have to build a wrong consensus – and the situation we are facing now seems to be sliding in this direction step by step.

Recently, after Hong Kong, the epidemic situation in Taiwan, China province of China is very serious. Since the outbreak two months ago, it has remained at a high level of tens of thousands of new deaths every day, and the excess death statistics in May are much higher than the reported number of epidemic deaths.

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However, during the previous outbreak in Shanghai, the media and elites who talked about the benefits of openness and coexistence did not mention the situation in Taiwan. Not only that, the important argument of those who advocated immediate open coexistence is that it would be good if the economy were liberalized. But what about the facts? After the statistics of China’s import and export data from January to may, China’s trade surplus hit a record high, and all major economies, as well as Vietnam, which had been badly blown before, had a deficit.

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Even South Korea, which has always had a surplus with China, now has a deficit. In addition to the increasing substitution of China’s semiconductors, the epidemic is obviously also an important factor. South Korea has not suppressed this round of epidemic, and the excess death data is still rising. Of course, for these, the relevant people who advocated immediate coexistence are still silent.

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What is the current global situation? Netizens who often pay attention to the lancet, Nature magazine and other relevant journals should know that in the past two years, in the face of the erosion of the epidemic in the West and its connection with politics, there are some big men in the scientific community advocating the new crown coexistence platform, and more and more, and there are many academics who say that this is a natural vaccine when there is not enough research on the virulence and immunogenicity of Omicron. Of course, there are still many ethical scientists. A recent paper completely refutes this fallacy.

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At present, the mainstream attitude of the international academic community is still that they do not agree to coexist with the new crown. They are very clear that the new crown is not good, but when asked what to do, the academic community is confused. The attitude of some scientists is simply waiting for God to save them. Some are praying that the virulence of the new crown will decrease, while others are praying for a stronger vaccine. Why? Because scientists are not politicians, they are often powerless to reality beyond theory. Like some people in the west, starting from the “mass immunization” theory, they seize every opportunity to advocate coexistence with the virus. Some people in China often lose their judgment when facing this information.

Recently, we have seen a good example. A newly published study on the severe disease rate of new coronary artery disease is based on the epidemic situation in Shanghai, and the main author is Mr. zhangwenhong, who is familiar to us. There are some earth shattering data in it, for example, the severe disease rate of the low-risk group is zero. It has to be said that this is a very eye-catching data, which is also very consistent with the inner thoughts of some people. Unfortunately, is this consistent with reality?

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First of all, it should be admitted that the risk of patients with new coronary artery disease with high-risk factors is more than ten times or even dozens of times that of patients without high-risk factors. This statement is not wrong. It should be said that it is a recognized conclusion. However, there are tens of thousands of new crown patients without high-risk factors, and the severe rate of patients with high-risk factors is also unreasonably low. This makes people doubt the data itself.

Because at present, the severity rate of the same type of virus should be similar in theory under the condition that the relevant intervention means are limited. The data of expert Zhang’s team is obviously different from some other international data. Without special intervention measures, we can only think that there are some differences in the caliber of the statistical data.

Here is an article published in the lancet global health for comparison. This article is based on the data of South Africa and is entitled “clinical severity of coved-19 in patients admitted to hospital during the Omicron wave in South africa: a retrospective observational study”. Interested readers can go and have a look.

First of all, let’s explain the basic situation. This article compares the severity of epidemic peaks of different strains, and the final conclusion of this article is that the virulence of Omicron is significantly lower than that of other strains (the author of the paper notes that there is no distinction between BA1 and Ba2, and later ba4 and BA5 with stronger virulence appeared in South Africa). The research in this article distinguishes patients according to their age groups. Among them, the vaccination rates of several age groups aged 0-59 are far lower than those in China, so it is not appropriate to directly compare them. However, in the age group over 60, the vaccination rate of these patients is 58%, which is not much different from the 62% vaccination rate over 60 published in Shanghai in April. This is due to the vaccination policies of different countries, But it also allows us to make an inaccurate comparison.

In this study, during the epidemic period of Omicron, the study counted 84401 positive patients over 60 years old, of which 15285 were hospitalized. At the end of this study, 13220 patients were counted. 4900 patients (37%) received oxygen therapy, and 1402 patients (10.6%) entered ICU for treatment. Among them, the patients who need oxygen can be understood as the severe disease according to the diagnosis and treatment standard of our country, and the patients who enter the ICU can be regarded as the critical disease according to the standard of our country. This is obviously an order of magnitude different from the severe rate of 0.238% in the high-risk group calculated by Zhang Wenhong and his colleagues, not to mention the overall severe rate and the severe rate in the low-risk group.

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Of course, China’s medical level is significantly higher than that of South Africa, but in the final analysis, South Africa is also a country with a certain medical system, or even the highest level of medical system in Africa, rather than some countries with very low development level. Although China has great advantages, there is no absolute advantage scheme compared with South Africa in terms of treatment. What’s more, the data of South Africa in this regard may be “epidemic”. For example, the average age of South Africa is lower. At the same time, due to the previous epidemic, the mixed immunization brought by infection also has a certain degree of defense. At the same time, in the early stage, the epidemic strains in South Africa are more inclined to BA1 with lower syncytial efficiency, while Ba2 is prevalent throughout Shanghai; And, because of the medical run, in fact, many South African patients do not have the opportunity to receive treatment related to severe diseases.

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So, how do the data differences come about? Is it because China’s vaccine is far better than the Western vaccine used in South Africa, or is the physique of the elderly in China far better than that of the elderly in South Africa. If I think the former one is right, it must be unacceptable for the experts and their support who advocated that China should introduce western vaccines to achieve coexistence. If I think the latter one is right, it would be very racist. From a scientific point of view, the most reasonable possibility is to modify the statistical caliber. After all, the new crown ranks top in the ranking of major causes of death in Europe and the United States at all ages, which can not be explained by the 0% severe disease rate of low-risk people.

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This suspicion is not groundless. If you pay attention to the news about the medical aid teams in various places, you will find that there are medical staff from the Department of critical medicine in the teams of various hospitals. At the same time, five of the “Eight Immortals of severe diseases” who won this title in the anti epidemic campaign in Wuhan also went to Shanghai. Considering the published data, the number of patients with severe diseases is always small, about twoorthree people, If an inappropriate analogy is made, it is almost the beds in the intensive care departments of two large hospitals.

The author is also very confused. Although the number of critical patients needs more medical care, most of the elite of critical medicine in the country are here, just for patients of this size. Is this reasonable? At the same time, the death rate of severe patients is also very abnormal. According to the published data, the death rate of severe patients in Shanghai is quite high, even far more than 50%. There is no doubt that severe patients face an obvious risk of death, but from the relevant data, even in the case of a medical run, the death rate of more than 50% is very unreasonable. From these points of view, there is a solid basis for doubts about the criteria for severe illness.

Before, the issue of asymptomatic criteria has caused great controversy. During the previous repeated epidemics, the proportion of asymptomatic patients in Shanghai seems to be significantly different from that in other regions in China. Unfortunately, in the statement, some people said that this is in line with the international level. However, from the perspective of international research, Omicron has significantly reduced the defense of the vaccine. The reduction here includes the defense of mild and moderate symptoms. From a scientific point of view, the data should not be so. Such disputes have created a clear mistrust.

For comparison, at the end of the closure of Wuhan, according to the previous statistics, the death toll was revised once, which increased the death toll a lot. At that time, this incident was ridiculed by some people, but in my opinion, it showed a kind of honesty in facing the real problems. However, in the release of relevant data in Shanghai, each time the death data is released, it must be explained that this is a basic disease, which seems unwilling.

At the same time, there was also a lack of strong response to some rumors. In the early stage of the epidemic, there were some rumors on the Internet that some nursing homes in Shanghai had large-scale infection and some were severe. The author did not intend to make any worst guess about this, but there should be some necessary responses. What the author saw was only the data after changing the caliber and the research based on it, There are also the media and big V that rush to see this research. It must be said that it is a little sad. Such an approach cannot repair the lack of trust.

Another subtle thing is that the word “high-risk group” and the expression “high-risk group” give people an intuitive feeling that they only account for a minority of the total population. However, the actual situation is not the case. The elderly, people without vaccination and people with basic diseases can be counted. Although China’s vaccination rate is very excellent in the world, because China’s population base is here, the number of people without vaccination still exceeds the total population of most countries. The number of the elderly and patients with basic diseases is also an astronomical number. It is a very simple word game, which makes people intuitively feel that they are not aware of this.

At the same time, age, basic diseases and these high-risk factors cannot be changed. The only thing that can be changed is the vaccination rate. What is more regrettable is that the space for the increase of vaccination rate is very limited. Many elderly people are not unwilling to be vaccinated, but have basic diseases. Medical workers are unwilling to take risks to vaccinate them. Although the probability of this risk is actually very small, considering the total number, it is difficult to say what kind of social impact it will have. The medical personnel have made some helpless actions to avoid some risks. The author has seen some of them by people who can only fight. There is no reason for those experts not to know this. Why is it that someone can deftly ignore this?

However, in the media propaganda, this point has been cleverly ignored. It seems that only a very small number of high-risk groups are in support of their fallacies. It’s no surprise, for example, in Wuhan, they liked to use a grain of sand from what era, but when the epidemic in Hong Kong caused many tragedies, they chose to avoid talking about it, such as the tragedy of an old man who infected Xinguan and committed suicide because he was afraid of harming his family. If we change the scene, we must be able to brush up the hot search. The same is true of the recent epidemic in Taiwan. No matter how to correct the return, the situation is still very ugly. However, the media still choose to avoid talking about it and are even more optimistic than Chen Shizhong. This is a great miracle.

Of course, the fact that a large number of medical workers in Europe and the United States choose to leave their posts because of the epidemic is not what the media like to report. On this issue, they always show extremely flexible moral standards. The fact is the most unimportant part, which only needs to meet the emotional needs of specific audiences.

Many people say that science should not be entangled with ideology. Many people like to repeat this point in the discussion about Zhang Wenhong. However, this view seems very naive. If you go to the official website of top journals such as nature, you will find that there are not a few comments on LGBT about ethnic minorities and women’s rights. It is a very common phenomenon to adjust the caliber to achieve the desired data in the research. However, public figures make such exaggerated caliber adjustment research. Subsequently, a large number of media follow up and appear cautious in terms of words and titles. Such a set of linkage games is said to be just the misunderstanding of the research results by the media and the title party. Who really believes it?

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Science has nothing to do with ideology. In fact, it is a very ideological sentence. This is a typical expression of Neo liberalism. It uses the expression of ideology to carry forward its own ideology. This is undoubtedly a brilliant move. Many people who put the so-called personal freedom in the first place are willing to believe this, but when facing real problems, such a performance is really ugly.

For example, when discussing the possibility of hepatitis in children, many people in European and American medical circles put adenovirus in the front, and even preferred to believe that it was isolated for too long, rather than doing too much research on the immune problems related to the new crown.

As for the judgment on the harm of the new crown, European and American countries have always been highly politicized, but some people in China always beautify this process with their inner filters, lacking the independent spirit of thinking from facts.

It should be said that the contribution of neoliberalism is crucial when the global epidemic has reached the point where there is no bottom line today. The problem here is not only the problem of a few politicians and capitalists, but also the problem from top to bottom. Needless to say, the American Rightists’ anti vaccine and anti mask campaign is often called “white left”. Most of the propaganda is against neoliberalism, but they still fully recognize the neoliberal order. Therefore, they accuse the red neck of not vaccinating, accuse some regions of canceling the mask ban, and accuse Europe and the United States of not providing enough assistance to the third world. However, they will be shocked and pale when they hear China’s dynamic zeroing.

From this point of view, they are no different from the people they most oppose. It has to be said that this set of propaganda skills under the Neo liberal order is undoubtedly very successful. The linkage from top to bottom has indeed won many victories, leading to the formation of path dependence. However, there are some small problems, that is, the world is material, and novel coronavirus does not care about human propaganda. Unfortunately, there still seem to be many people who are not aware of this. The backfire of all this will only become more and more obvious.

As a typical example, when discussing the conspiracy theorists in Europe and the United States, we can find a fact that, in addition to their anti intelligence, many of their thoughts come from their simple resistance to social problems. The anti science part is largely related to some illegal experiments and concealment in Europe and the United States, which is a very realistic premise. In 2020, the author once discussed with friends that according to the current development trend, the trend of anti vaccine will be more serious or significantly reduced.

Unfortunately, this question may have been answered now. With the passage of time, the influence of anti vaccine forces in Europe and the United States has increased. Of course, we can criticize their anti intelligence, but to a large extent, the scientific community in the western world has not given a reasonable answer to the problems faced by the people. In this case, the growth of anti intelligence forces is inevitable. Under such circumstances, it is too arrogant to accuse them of ignorance and ignorance without recognizing the problems that have arisen in the scientific community.

Our people have a relatively high degree of respect for science among countries around the world, which also provides great convenience for epidemic prevention. However, this is by no means a reason for a small number of people to whitewash the truth. It will never be a good thing to consume the trust of the Chinese people in science. What needs to be acknowledged is that no matter in the process of social governance or scientific research, we are bound to make mistakes, which are very serious mistakes. The key to the problem lies in how to face these mistakes. Only by facing them directly can we find the reasons for making mistakes and see clearly the road ahead. This is the so-called scientific spirit. It can not solve any problems by pretending to be an ostrich for the laws of the material world.

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