The New York Times gets it … sort of
The New York Times gets it … sort of
The public authorities have always restricted access to policy-relevant data, because "Information might be misinterpreted."
I had planned to spend this day (February 22, 2022) doing background research for an essay titled “Fightin’ Joe Hooker: Progressive Health Policy Pioneer.” That essay will explore certain historical experiences with managing the progression of disease in high-risk populations… during the American Civil War (1861-1865). Just you wait. But, we read this morning in the New York Times that the Centers for Disease Control (CDC) has “withheld critical data on boosters, hospitalizations and, until recently, wastewater analyses.” The article thus opens:
For more than a year, the Centers for Disease Control and Prevention has collected data on hospitalizations for Covid-19 in the United States and broken it down by age, race and vaccination status. But it has not made most of the information public.
Indeed. Anyone who has been tracking data sources will have known that the CDC has limited access to all data, not just data relevant to vaccinations, since the COVID phenomenon first began to unfold. And this is not just a phenomenon specific to COVID. It’s what public authorities the world over do. They provide access to some data and pretend that limited data access conforms to “open government”.
As far as COVID data go, the New York Times is about two years late to the party, but we welcome the Self-anointed Best-and-brightest. They may not be as smart as they think they are, but we data warriors welcome them in and will happily mix cocktails for them.
The New York Times piece is titled “The C.D.C. Isn’t Publishing Large Portions of the Covid Data It Collects.”[1] It is tucked behind a pay-wall, but I reproduce it in its entirety below this essay. You have all of the context right here.
I do not know what standard practice is now, but it had been standard practice on Italian news channels to review the morning’s headlines, newspaper by newspaper, right there on the morning news. A fellow would sit there with a highlighter in hand and review passages from various papers about how the papers were reporting the goings-on in the world. Admittedly, this was back when people actually got their hands dirty with newspaper ink by picking up analog newspapers at the tobacchi. These were things that were amenable to physical highlighting.
This was an interesting exercise. “The news” is not some objective thing that falls from the skies. Someone has to decide what constitutes a story, and someone has to write the story. They have to interpret what’s going on and decide how to present the material. Wittingly or not, these various parties may invest both the selection of stories and the writing of stories with much editorial content. There is nothing objective about the news business, even if we try to be objective. That is just the way of things.
Over the next few pages I identify several propositions that are either explicitly illuminated or implied in the New York Times piece. I will argue that certain propositions remain un-motivated and are unwittingly presented as articles of faith. I leave it to the reader to decide what to make of these things.
“… 18- to 49-year-olds, the group least likely to benefit from extra shots, because the first two doses already left them well-protected.”
There are a few things going on here. First, what do we mean by “well-protected”? The suggestion, of course, is that “vaccines” (the mRNA therapies) have afforded some type of protection to people aged 18 to 49. Protection might mean: (1) vaccination has rendered subjects less susceptible to infection, or (2) vaccination has diminished the deleterious effects of infection. Or both. In fact, one might have heard, often from one’s own friends and acquaintances, something to the effect of “I am so glad I got the vax, because, at least it will diminish the symptoms if I get infected.”
But, how do we know this? How do we know that vaccination will suppress the severity of symptoms? The reality is that we do not. And it is worse than that. This idea that the vaccines reduce severity remains but a proposition. This is a proposition we could explore in the data, but the CDC neither provides the data that would enable such analysis nor does it report such analysis of its own. Instead, the CDC merely asserts that the vaccines reduce severity. Does anyone really believe this?
Many people do believe this. I’ve heard friends assert this kind of thing. Perhaps they have confidently absorbed the rhetoric coming out of CNN or MSNBC. As Rachel Maddow exclaimed, “The virus stops with every vaccinated person.” She continued:
A vaccinated person gets exposed to the virus – the virus does not infect them. The virus cannot then use that person to go anywhere else. It cannot use a vaccinated person as a host to go get more people. That means that the vaccines will get us to the end of this.[2]
We know that this claim is false. Vaccinated people do contract the virus. They do get sick. Some observers argue that the vaccinated “shed” more virus particles than unvaccinated people. I have no basis for judging that claim. But neither do I – nor you, the dear reader; and you are dear – have any basis for judging the claim that the vaccines mitigate the deleterious effects of COVID.
Second point: The age range 18-to-49 is enormous. Getting access to data about the vaccine status of people aged 18-to-49 would be good, but, why not afford access to more granular data? Why not afford access to vaccination status by every age; why not make the unit of analysis each age? Even better, why not afford access to data specific to individuals, make the individual the unit of analysis?
Third point: What do we mean by “vaccinated”? As of today the CDC reports that it will count an individual as “fully vaccinated” two weeks after securing the second shot of a two-shot vaccination regime or two-weeks after the one shot of a one-shot vaccine regime. Here is screen shot accessed at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html:
The CDC page was “Last updated Jan. 25, 2022”.
“Fully vaccinated.” What does all that mean? Does that mean that people who have not been “fully vaccinated” are counted as unvaccinated? If so, does that mean that adverse effects that obtain within the first two weeks of either a first shot or second shot are assigned to the “unvaccinated”. So, if vaccinations really are, say, inducing an inordinate number of cardiac events, and if most of those events are concentrated within the first two weeks after getting a shot, are we severely censoring data relevant to the analysis of the effects of vaccination? Indeed, it is hard not to conclude that the CDC selected the two-week threshold so that it could hide adverse effects.
So, here’s a question: Why not just report the status of vaccine treatments? Allow the data to speak for themselves. Are adverse effects concentrated within the first “two weeks”? Or not? What is the CDC afraid of?
We can’t help but presume that the CDC is afraid of the truth. An easy way of dispelling doubts would be to provide better visibility in to the vaccine data rather than hiding data behind an arbitrary definition of vaccination status.
I get all all those questions from just one phrase in a New York Times article.
“Two full years into the pandemic, the agency leading the country’s response to the public health emergency has published only a tiny fraction of the data it has collected, several people familiar with the data said.”
Indeed. Anyone like myself who bothered to hunt for data will have known this. This is old news to the informed. Think about that.
“Information on hospitalizations and death by age and vaccination status would have helped inform whether healthy adults needed booster shots. And wastewater surveillance across the nation would spot outbreaks and emerging variants early.”
Where to begin? This compound proposition does not even satisfy the “It’s-not-even-wrong” criterion. For starts, how would “information on hospitalizations and death by age and vaccination status … inform whether healthy adults needed booster shots”? The first and second and doses of the vaccines do not work as advertised by personages such as Rachel Maddow and Rochelle Walensky (the chief of the CDC). The value of the first two doses remains un-motivated, and the same can be said for boosters. Access to real data would help. But, alas, the CDC censors such data, and it is hard not to conclude that it censors such data, because the data do not support its assertions.
“Another reason is fear that the information might be misinterpreted, Ms. Nordlund said.”
Indeed. Outside observers might reveal that the vaccines are – putting it very generously – problematic. But, if the vaccines work to some degree, then let everyone see the data. What are these people afraid of?
“The performance of vaccines and boosters, particularly in younger adults, is among the most glaring omissions in data the C.D.C. has made public.”
We can agree on that.
“[T]he C.D.C. has been routinely collecting information since the Covid vaccines were first rolled out last year, according to a federal official familiar with the effort… ‘We have been begging for that sort of granularity of data for two years,’ said Jessica Malaty Rivera, an epidemiologist and part of the team that ran Covid Tracking Project, an independent effort that compiled data on the pandemic till March 2021.”
So, yes. People have been clamoring for access to actionable data for years. The New York Times and the Washington Blob only deign to recognize this fact now.
“But the experts dismissed the potential misuse or misinterpretation of data as an acceptable reason for not releasing it.”
One person’s strategic appeal to “misinterpretation” amounts to closing down another person’s honest debate. The CDC has no business gate-keeping data that would inform dispassionate analysis.
“When the Delta variant caused an outbreak in Massachusetts last summer, the fact that three-quarters of those infected were vaccinated led people to mistakenly conclude that the vaccines were powerless against the virus — validating the C.D.C.’s concerns.”
Not quite. To sort out whether the vaccines are effective, we would like to do a controlled experiment. Specifically, we would like to “treat” a random sample of people by vaccinating them. We would like to compare the performance of that random sample of treated people to a random sample of untreated (unvaccinated) people. Do the vaccines protect people from infection? Does vaccination mitigate the deleterious effects of COVID? No less importantly: Do the vaccines induce adverse effects – or not? Ultimately, do the vaccines make people better off, on average, than they could otherwise expect to be?
Here is what I wrote last month on just these questions[3]:
In a study titled “Six Month Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine,” a host of Pfizer researchers report on their randomized control study involving about 44,000 test subjects. About half were randomly assigned to a control group that would be jabbed with a placebo (saline solution). The other half would get the jab.
The idea here is that the control group should look a lot like the group that got the actual jab. That’s the bit about “random assignment” at work. One group should not feature a distinctly different age distribution, because that might skew the results. One group should not be more heavily weighted with people who suffer “co-morbidities,” because that could skew the results. The only important difference between the groups, by design, should be the fact that one got the jab and one got the placebo.
This Pfizer study is the basis for the claim that the Pfizer jab is “95% effective.” The idea here is that a few hundred people in the control group became infected with COVID. Only about 5% as many people in the jabbed group contracted COVID. These people were thus 95% less likely to become infected than the un-jabbed.
That was the top line result, but buried in the report, and subsequently updated by the Food & Drug Administration (FDA), was the result we should actually care about: Did the vaccine actually save people? Suppose, for example, the vaccine had induced some number of “adverse effects”. Suppose the vaccine were to induce the deaths of some number of young people by say, inducing myocarditis? Should we not factor net performance in to our evaluation of total performance?
The net result, reported by the FDA (and dutifully illuminated by Alex Berenson) is that 17 people in the control group died over the course of the study. But, a total of 21 people in the jabbed treatment group died. In other words, the control group performed no worse than the jabbed group. Indeed, were it the case the jab induced the deaths of some number of entirely healthy young people, then one could credibly claim that the control group had outperformed the jabbed group over the course of the study period.
So far the data say that the Pfizer vaccine, if not all vaccines, do not afford any net benefit. To sort out whether or not any vaccines afford net benefit would require better access to the data – to the same data that the CDC gate-keeper assiduously censors.
Conclusion –
If the Media Blob only now figures out that serious researchers outside of the CDC – or outside any public health authority – have not had access to data sufficient to do serious analysis … then welcome very late to the party; the cocktails will be served! But, this kind of thing is not news to anyone who has ever delved in to data that governments anywhere deign to provide.
The Gray Lady in her own words:
The C.D.C. Isn’t Publishing Large Portions of the Covid Data It Collects
Apoorva Mandavilli
The agency has withheld critical data on boosters, hospitalizations and, until recently, wastewater analyses.
Feb. 20, 2022
For more than a year, the Centers for Disease Control and Prevention has collected data on hospitalizations for Covid-19 in the United States and broken it down by age, race and vaccination status. But it has not made most of the information public.
When the C.D.C. published the first significant data on the effectiveness of boosters in adults younger than 65 two weeks ago, it left out the numbers for a huge portion of that population: 18- to 49-year-olds, the group least likely to benefit from extra shots, because the first two doses already left them well-protected.
The agency recently debuted a dashboard of wastewater data on its website that will be updated daily and might provide early signals of an oncoming surge of Covid cases. Some states and localities had been sharing wastewater information with the agency since the start of the pandemic, but it had never before released those findings.
Two full years into the pandemic, the agency leading the country’s response to the public health emergency has published only a tiny fraction of the data it has collected, several people familiar with the data said.
Much of the withheld information could help state and local health officials better target their efforts to bring the virus under control. Detailed, timely data on hospitalizations by age and race would help health officials identify and help the populations at highest risk. Information on hospitalizations and death by age and vaccination status would have helped inform whether healthy adults needed booster shots. And wastewater surveillance across the nation would spot outbreaks and emerging variants early.
Without the booster data for 18- to 49-year-olds, the outside experts whom federal health agencies look to for advice had to rely on numbers from Israel to make their recommendations on the shots.
Kristen Nordlund, a spokeswoman for the C.D.C., said the agency has been slow to release the different streams of data “because basically, at the end of the day, it’s not yet ready for prime time.” She said the agency’s “priority when gathering any data is to ensure that it’s accurate and actionable.”
Another reason is fear that the information might be misinterpreted, Ms. Nordlund said.
Dr. Daniel Jernigan, the agency’s deputy director for public health science and surveillance said the pandemic exposed the fact that data systems at the C.D.C., and at the state levels, are outmoded and not up to handling large volumes of data. C.D.C. scientists are trying to modernize the systems, he said.
“We want better, faster data that can lead to decision making and actions at all levels of public health, that can help us eliminate the lag in data that has held us back,” he added.
The C.D.C. also has multiple bureaucratic divisions that must sign off on important publications, and its officials must alert the Department of Health and Human Services — which oversees the agency — and the White House of their plans. The agency often shares data with states and partners before making data public. Those steps can add delays.
“The C.D.C. is a political organization as much as it is a public health organization,” said Samuel Scarpino, managing director of pathogen surveillance at the Rockefeller Foundation’s Pandemic Prevention Institute. “The steps that it takes to get something like this released are often well outside of the control of many of the scientists that work at the C.D.C.”
The performance of vaccines and boosters, particularly in younger adults, is among the most glaring omissions in data the C.D.C. has made public.
Last year, the agency repeatedly came under fire for not tracking so-called breakthrough infections in vaccinated Americans, and focusing only on individuals who became ill enough to be hospitalized or die. The agency presented that information as risk comparisons with unvaccinated adults, rather than provide timely snapshots of hospitalized patients stratified by age, sex, race and vaccination status.
But the C.D.C. has been routinely collecting information since the Covid vaccines were first rolled out last year, according to a federal official familiar with the effort. The agency has been reluctant to make those figures public, the official said, because they might be misinterpreted as the vaccines being ineffective.
Ms. Nordlund confirmed that as one of the reasons. Another reason, she said, is that the data represents only 10 percent of the population of the United States. But the C.D.C. has relied on the same level of sampling to track influenza for years.
Some outside public health experts were stunned to hear that information exists.
“We have been begging for that sort of granularity of data for two years,” said Jessica Malaty Rivera, an epidemiologist and part of the team that ran Covid Tracking Project, an independent effort that compiled data on the pandemic till March 2021.
A detailed analysis, she said, “builds public trust, and it paints a much clearer picture of what’s actually going on.”
Concern about the misinterpretation of hospitalization data broken down by vaccination status is not unique to the C.D.C. On Thursday, public health officials in Scotland said they would stop releasing data on Covid hospitalizations and deaths by vaccination status because of similar fears that the figures would be misrepresented by anti-vaccine groups.
But the experts dismissed the potential misuse or misinterpretation of data as an acceptable reason for not releasing it.
“We are at a much greater risk of misinterpreting the data with data vacuums, than sharing the data with proper science, communication and caveats,” Ms. Rivera said.
When the Delta variant caused an outbreak in Massachusetts last summer, the fact that three-quarters of those infected were vaccinated led people to mistakenly conclude that the vaccines were powerless against the virus — validating the C.D.C.’s concerns.
But that could have been avoided if the agency had educated the public from the start that as more people are vaccinated, the percentage of vaccinated people who are infected or hospitalized would also rise, public health experts said.
“Tell the truth, present the data,” said Dr. Paul Offit, a vaccine expert and adviser to the Food and Drug Administration. “I have to believe that there is a way to explain these things so people can understand it.”
Knowing which groups of people were being hospitalized in the United States, which other conditions those patients may have had and how vaccines changed the picture over time would have been invaluable, Dr. Offit said.
Relying on Israeli data to make booster recommendations for Americans was less than ideal, Dr. Offit noted. Israel defines severe disease differently than the United States, among other factors.
“There’s no reason that they should be better at collecting and putting forth data than we were,” Dr. Offit said of Israeli scientists. “The C.D.C. is the principal epidemiological agency in this country, and so you would like to think the data came from them.”
It has also been difficult to find C.D.C. data on the proportion of children hospitalized for Covid who have other medical conditions, said Dr. Yvonne Maldonado, chair of the American Academy of Pediatrics’s Committee on Infectious Diseases.
The academy’s staff asked their partners at the C.D.C. for that information on a call in December, according to a spokeswoman for the A.A.P., and were told it was unavailable.
Ms. Nordlund pointed to data on the agency’s website that includes this information, and to multiple published reports on pediatric hospitalizations with information on children who have other health conditions.
The pediatrics academy has repeatedly asked the C.D.C. for an estimate on the contagiousness of a person infected with the coronavirus five days after symptoms begin — but Dr. Maldonado finally got the answer from an article in The New York Times in December.
“They’ve known this for over a year and a half, right, and they haven’t told us,” she said. “I mean, you can’t find out anything from them.”
Experts in wastewater analysis were more understanding of the C.D.C.’s slow pace of making that data public. The C.D.C. has been building the wastewater system since September 2020, and the capacity to present the data over the past few months, Ms. Nordlund said. In the meantime, the C.D.C.’s state partners have had access to the data, she said.
Despite the cautious preparation, the C.D.C. released the wastewater data a week later than planned. The Covid Data Tracker is updated only on Thursdays, and the day before the original release date, the scientists who manage the tracker realized they needed more time to integrate the data.
“It wasn’t because the data wasn’t ready, it was because the systems and how it physically displayed on the page wasn’t working the way that they wanted it to,” Ms. Nordlund said.
The C.D.C. has received more than $1 billion to modernize its systems, which may help pick up the pace, Ms. Nordlund said. “We’re working on that,” she said.
The agency’s public dashboard now has data from 31 states. Eight of those states, including Utah, began sending their figures to the C.D.C. in the fall of 2020. Some relied on scientists volunteering their expertise; others paid private companies. But many others, such as Mississippi, New Mexico and North Dakota, have yet to begin tracking wastewater.
Utah’s fledgling program in April 2020 has now grown to cover 88 percent of the state’s population, with samples being collected twice a week, according to Nathan LaCross, who manages Utah’s wastewater surveillance program.
Wastewater data reflects the presence of the virus in an entire community, so it is not plagued by the privacy concerns attached to medical information that would normally complicate data release, experts said.
“There are a bunch of very important and substantive legal and ethical challenges that don’t exist for wastewater data,” Dr. Scarpino said. “That lowered bar should certainly mean that data could flow faster.”
Tracking wastewater can help identify areas experiencing a high burden of cases early, Dr. LaCross said. That allows officials to better allocate resources like mobile testing teams and testing sites.
Wastewater is also a much faster and more reliable barometer of the spread of the virus than the number of cases or positive tests. Well before the nation became aware of the Delta variant, for example, scientists who track wastewater had seen its rise and alerted the C.D.C., Dr. Scarpino said. They did so in early May, just before the agency famously said vaccinated people could take off their masks.
Even now, the agency is relying on a technique that captures the amount of virus, but not the different variants in the mix, said Mariana Matus, chief executive officer of BioBot Analytics, which specializes in wastewater analysis. That will make it difficult for the agency to spot and respond to outbreaks of new variants in a timely manner, she said.
“It gets really exhausting when you see the private sector working faster than the premier public health agency of the world,” Ms. Rivera said.
[1] https://www.nytimes.com/2022/02/20/health/covid-cdc-data.html
accessed February 22, 2022.