Incorrect Numbers


Science-Based Medicine

Having made them myself, I completely understand that doctors can make errors. However, I can’t fathom why some of them don’t seem to care about correcting them, especially considering the health of children is at stake.

Jonathan Howard on December 3, 2021

An incorrect number

On October 6th, journalist Apoorva Mandavilli wrote in The New York Times that 900,000 American children had been hospitalized with COVID-19. Although the exact number of pediatric hospitalizations isn’t clear, this number seemed implausibly high to me. I asked Ms. Mandavilli for the source of this number on Twitter, and she responded by saying “it was supposed to have some other numbers to say what percent are kids of this number”. Though it seems to have been a genuine mistake, Ms. Mandavilli received harsh, but fair, feedback, with one critic saying:

Beyond the false numbers, this is a serious violation of an important standard for a science professional: the criterion of reasonableness. In science, if you come up with a result that’s unreasonable, that doesn’t make sense in the real world, there’s something wrong, and you must rethink your conclusions. If Mandavilli were paying attention to her work, that 900,000 number should have jumped out as being impossibly high. But it didn’t.

Whatever the reason for her mistake, Ms. Mandavilli did what she had to do – she acknowledged and corrected the error. Anyone who reads her article moving forward will find accurate information, and they will learn that the article initially contained inaccurate information. This is how it should be.

Another incorrect number

With this in mind, let’s examine a recent article in The Wall Street Journal by Drs. Nicole Saphier and Marty Makary titled, “Should You Vaccinate Your 5-Year-Old?” Even though I agreed with its ultimate conclusion that “vaccinating a healthy child would take his extremely low risk of serious disease and drive it down even lower”, the article was full of the predictable omissions, distortions, and standard COVID-19 minimization tactics I’ve discussed multiple times previously. Beyond these familiar flaws, the article reported that 562 children ages 5-11 years had been hospitalized with COVID-19. This is false and was easily recognizable as such by anyone familiar with this topic.

The authors likely found this number from a CDC presentation on 11/2/2021 that reported numbers from COVID-NET.

As the fine print on the bottom of the slide says, “COVID-NET is a population-based surveillance system that collects data on laboratory-confirmed COVID-19-associated hospitalizations among children and adults through a network of over 250 acute-care hospitals in 14 states”. The CDC’s website informs us that “COVID-NET covers approximately 10 percent of the U.S. population”. In other words, the true number of hospitalizations for this age group is likely to be 10 times higher than what Drs. Saphier and Makary reported. Indeed, the same CDC presentation reported that over 8,300 children this age have been hospitalized. This number is 15 times higher than what Drs. Saphier and Makary reported. As about 1/3 of hospitalized children go to the ICU, the number of children hospitalized there alone is 5 times higher than the total number of hospitalizations reported by Drs. Saphier and Makary.

There are two ways to look at their error. On the one hand, this was an easy mistake to make. I know because I made the exact same mistake myself earlier this year on Twitter. At that time, I was starting to familiarize myself with pediatric data in preparation for my first article here, and I too missed the fine print on COVID-NET. We are only human, and the best of us will make an honest error from time to time.

On the other hand, this error shows that Drs. Saphier and Makary were willing to pontificate about the COVID-19 vaccine for children in a national newspaper even though they were completely unfamiliar with the basic facts and datasets on this topic. During the peak of the Delta wave, nearly 70 children (of all ages) were being hospitalized every day in just Florida alone. One could even say:

Beyond the false numbers, this is a serious violation of an important standard for a science professional: the criterion of reasonableness. In science, if you come up with a result that’s unreasonable, that doesn’t make sense in the real world, there’s something wrong, and you must rethink your conclusions. If Drs. Saphier and Makary were paying attention to their work, that 562 number should have jumped out as being impossibly low. But it didn’t.

That Drs. Saphier and Makary reported an incorrect number tells us they were just like me this spring; careless and ignorant of the subject matter. Readers of Science Based Medicine know this about Dr. Makary already (here and here), and I doubt it would be worth another article to make this point alone.

However, the fact that the error remains uncorrected in their article is worth discussing. Though Dr. Makary blocked me on Twitter for the sin of discussing his failed predication the US would reach herd immunity in April, several other people shared my discussion of his most recent error with him and Dr. Saphier. Of course I can’t be certain they saw the correction, but their response thus far has been to do nothing. The error still remains in the article. Though countless people have been falsely pacified about the dangers of COVID-19 to children as a result of their error, the authors seem perfectly content to let misinformation be spread far and wide under their names.

An unfortunate pattern

Sadly, this is just another example of an unfortunate pattern of highly-credentialed doctors from top medical schools making and then shrugging off gross factual errors. For example, Dr. Makary’s easily falsifiable claim from June that not a “single healthy child in the U.S.” died of COVID-19 also remains uncorrected in the article in which it appeared. On Twitter, Dr. Makary continues to claim that “Based on the data of kids w/ NO comorbid, an estimated 0-10 kids 5-11 have ever died of Covid.” While I agree that it is extremely rare for healthy children to die of COVID-19, all it takes is a simple Google search to find several news stories of healthy children ages 5-11 who died from the virus (Skylar Herbert, Tagan White, Unnamed Boy, Kimora Lynum, Wyatt Gibson, Zyrin Foots, Unnamed Child.) Certainty, not all such deaths were reported in the news .

As I wrote previously, it seems that Dr. Makary, a professor at a top medical school who claims he reviewed “the medical literature and news reports” and talked to “pediatricians across the country”, actually didn’t bother to do the most basic fact-checking when he claimed no healthy American child had died of COVID-19. Unfortunately Dr. Makary’s myth has been parroted by anti-vaxx propagandist Tucker Carlson and misinformed politicians. As the expression goes, a lie can travel half way around the world while the truth is putting on its shoes.

Dr. Makary does not just spread misinformation about the virus. In an attempt to convince people the vaccine will kill as many healthy boys as the virus, Dr. Makary also claimed on Twitter that a study in the New England Journal of Medicine (NEJM) reported the death of a boy from vaccine-related myocarditis, and that as a result, “Approx 15 would die from the vax 2nd dose“. This too is false, though it gained approval from the sort of people who feel vaccines are part of a depopulation agenda.

As anyone who took one minute to search the supplementary material knows, the person who died in this study was a 22-year-old young adult, not a young boy. The tragic death of this single adult almost certainly has no relevance to vaccinating young children who are generally much less prone to myocarditis. Experts in the subject matter also corrected this erroneous Tweet several times, yet Dr. Makary has not removed it. Tens if not hundreds of thousands of people have seen it, and most of them were completely unaware they were reading misinformation. Like all reports on this topic, the same study from the NEJM also said that 95% of the vaccine-related myocarditis cases were “mild,” though Dr. Makary predictably neglected to report this fact or even provide a link to the study so people could read it themselves.

For the sake of accuracy, tens of millions of teenagers have been vaccinated around the world, and I am aware of just one potential death of a 17-year-old who received the Moderna vaccine, which will not be given to children in the USA. The CDC investigated several deaths here in the US, and thus far, no adolescents are known to have died from the vaccine.

Professors should be held to the same standards as medical students

There are countless other examples of contrarian doctors making similar errors of basic facts this pandemic, and aside from a few healthcare workers who get frustrated on Twitter, the medical community mostly shrugs in response. The same way we’ve grown numb to 1,000 people dying of COVID-19 daily for months at a time, we’ve grown numb to misinformation being spread by supposed “experts” who have the privilege of communicating with the public. But we shouldn’t grow numb to 1,000 people dying daily of a vaccine-preventable disease, and we shouldn’t grow numb to professors from prominent medical schools making blatant errors in national newspapers and refusing to correct them. We should hold professors at top medical schools writing for a national audience to at least the same standards we have for medical students doing a case write-up.

Sadly, medical students are currently held to a higher standard than professors at top medical schools. Contrarian doctors will likely face no sanction for their errors. After all, if repeatedly misstating basic facts about children’s health in the middle of the worst pandemic in 100 years earns them no reprobation, what possibly could? Instead, they’ll keep getting rewarded with space in large newspapers and TV interviews/podcast invitations. They’ll likely continue to claim their errors are providing much needed “nuance“. They’ll likely continue to deride those who correct their errors, saying their critics are merely engaged in “groupthink” and “tribalism“. They’ll likely continue to claim they are the true victims of this pandemic, imagining that contrarian doctors with massive platforms are being “cancelled and intimidated for posing reasonable scientific ideas“. Most worryingly, they’ll likely keep spreading misinformation, always understating the harms of COVID-19 and always overstating the harms of the vaccine.

Meanwhile, some parents will not vaccinate their children, falsely believing the virus is safer than the vaccine for their child (it’s not). For example, Victoria Ramirez’s father said:

It’s something that’s going to be stuck with me for my whole life, thinking maybe I should have done that sooner. Maybe I could’ve done something to help prevent this.

Victoria died this summer of COVID-19. She was 15 and unvaccinated. Her father was right – something absolutely could have been done to help prevent this. Sadly Victoria was not alone. Multiple adolescents, including some with no underlying health issues, have died of COVID-19 after the vaccine was available to them (here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, and here). Perhaps some of their parents would have chosen to vaccinate them had doctors with national platforms provided them with accurate and thorough information.

My correction

I immediately issued a correction when I realized that I had understated pediatric hospitalizations on Twitter. I was mortified that the 200 people who saw my Tweet would learn inaccurate information because of my carelessness. I deserve no accolades for this. Any reasonable person would do the same thing.

Hopefully, Drs. Saphier and Makary will read this and fix the error in their article. Hopefully, they will be more careful in the future. I mean this very seriously. A lot of people listen to them. I really want their audience to have thorough and accurate information. I’m not asking them to abase themselves or respond to me in any way. I’m only asking them to fix their error and try to do better in the future. I’d be genuinely happy to write an addendum to this article praising them for acknowledging and fixing their error.

Having made them myself, I completely understand that doctors can make errors. However, I can’t fathom why some of them don’t seem to care, especially considering the health of children is at stake.