Today, in view of the threat of the new corona virus (SARS-CoV-2) that has been disrupting our daily lives for about six months, doctors are in the headlines and "epidemiology" is no longer a dirty word, but to many it seems that science does not occupy a sufficiently important place in decision-making
By: Racheli Vox, Angle - Science and Environment News Agency
There is no doubt that modern science has advanced the field of medicine for humans more than any other factor, and that reliance on clinical experimental science has enabled the development of drugs, vaccines and effective treatments for diseases and their prevention, saved the lives of countless people and changed the face of human history from end to end. Today, in view of the threat of the new corona virus (SARS-CoV-2) that has been disrupting our daily lives for about six months, doctors are starring in the headlines and "epidemiology" is no longer a dirty word, but to many it seems that science does not occupy a sufficiently important place in decision-making, and the logic behind Some of the new restrictions are questioned even by professional parties.
On what are the government's decisions based on the policy of dealing with the corona virus, including the changing restrictions on citizens and businesses? "This is a great question, the answer to which is completely unclear," says Dr. Uri Lerner, the professional director of the "Madaat" association for the promotion of public health. "There is not much connection between the decisions that are made and what we see in the world."
"It is not clear where the members of the government get the information they rely on when making decisions," says Dr. Uri Sharon, vice president of the Israeli Association for Ecology and Environmental Sciences, lecturer in law and environmental policy at the Faculty of Law at Bar Ilan University.
A body whose name comes up a lot as a source of information on the subject is the National Security Headquarters (NSH). "This is a body whose role is to build the strategic security policy of the State of Israel, it is a security and not a medical body and its people have no qualifications to deal with medical problems such as the corona virus - but it is in the Prime Minister's Office, and therefore the Prime Minister has full control over it," says Sharon.
One researcher per 300 people
Informed decision-making depends, of course, on reliable data - but there seems to be a lack of such information in Israel. "Data on the places of infection are not published," says Lerner. "The Ministry of Health publishes some data that includes the distribution of morbidity by ages and towns, but there is no detail of how many of the infections occurred in restaurants, how many in event gardens and how many in the education system, for example. There is no segmentation of the data that can make it possible to obtain some kind of epidemiological insight".
The Ministry of Health recently transferred it to the Knesset's Corona Committee Certain data on the locations of the infection, from which it appears that the most significant source of infection is precisely at home. According to Sharon, these data are also insufficient. "You have to pay attention to the number of participants in the research group: 2,227", he says. "This is almost the number of people infected in one day. How can you derive something from this?"
According to Lerner, these data, according to which 67 percent of the patients were infected at home, are fundamentally flawed. "The infections at home are not the important information," he says. "To illustrate, it is said that there is a meeting at work and one person comes to it sick and infects 4 others, and each of these workers infects 4 family members. Thus there are 20 infected, of which 4 are at work and 16 at home, but there is a built-in bias here - we need to understand where the infection came home, this is the way to stop the infection." According to the same data, the place of infection of over half of those infected is unknown. "This is due to the lack of investigations," says Lerner. "We don't have data on how many investigations were done until the array was strengthened, and an insufficiently good epidemiological investigation will lead to gaps in the following investigations."
A significant part of the lack of data is due to the fact that the number of epidemiological researchers in Israel is very limited compared to the rest of the world: according to A report published by Amn, in Israel there was one researcher per 300 people (1:10,000 after the recent increase), this compared to 1 in 4,000 in Germany, 1 in 6,200 in New York and 1 in 2,200 in England. "In other countries, where the number of epidemiological researchers is very high, they manage to identify centers of infection quickly and establish rules regarding them", says Sharon. "Places like Britain hit the first wave very hard because they did not close the country as quickly as Israel - but unlike Israel, they established an epidemiological system very quickly. We didn't do this, so our only way to fight Corona remains closure, while they can deal with new infections by cutting the chain of infection."
For example, according to an AMAN report, on June 12 in the city of Guntingen in Germany, two patients were found living in the same building, and as a result, corona tests were conducted for all 700 residents of the building. The tests found that at least 100 tenants were infected, and a lockdown was imposed on the entire building. By early July the outbreak was completely contained.
According to a position paper sent by the Union of Public Health Physicians to the Knesset's Corona Committee, the raw data and the results of the epidemiological investigations that do exist are not properly communicated to the public and the relevant parties: Morbidity trends and risk factors," the position paper states. "To date, these data have not been provided."
According to Lerner, in other countries the accessibility of information to the public is much better than in Israel. "In Singapore, for example, they created a very detailed infection map, where the public can see the chain of infections, and understand exactly where people were infected and which sites had more infections than others," he says.
"One of the problems in Israel is that it is not the professional level that manages the professional discourse, but the political level," says Sharon.
"As long as the information about the corona infection does not exist properly, the decisions are half arbitrary and half political", says Lerner. "The major delay in the decision to close the synagogues was political. It also took a long time until those who came from the US were forced into isolation - this is also political." In a study conducted at Tel Aviv University, it was found that the origin of 70 percent of the corona cases in the first wave was from strains of the virus that came from the USA (it should be noted that this study has not yet undergone peer review).
The question of relying on data has recently led to a debate within the political system. As I recall, MK Yifat Shasha Biton (Likud), the chairman of the Knesset's Corona Committee, questioned the government's decision to close the public gyms and pools, and demanded that the Ministry of Health Current relevant data. Finally, the committee headed by her decided not to approve the government's restrictions on the subject. "Clear data was presented to the committee about the absence of disease in the pools," Shasha Biton wrote on her Twitter account at the time. "Even regarding the gyms, there is no evidence that they are outbreak centers."
"In response, the chairman of the coalition, MK Miki Zohar, announced that she would be fired and that the transfer of decisions to the committee would be stopped," recalls Lerner. "It certainly doesn't look good."
There is no epidemiological justification
The new restrictions announced by the government, which include, among other things, the suspension of restaurants and the closing of various places on the weekends, provoked protests among professional public health officials. "No evidence, explanation, opinion or data has been provided that specifically supports these measures and proves their usefulness," reads the position paper sent by the Association of Public Health Physicians. "It seems that some of the measures chosen may even increase the risk of infection." It was also written that "it seems that the government's decision was made hastily, without sufficient consultation and appropriate consideration, without regular staff work, without transparency and not based on data. From an epidemiological point of view, we see no justification for a hasty and unfounded decision-making process."
"It is true that there is a lot of scientific uncertainty regarding the ways of transmission of the corona virus, but we do have information on the main ways of transmission, information that can form the basis of a more informed policy," says Dr. Mia Negev, head of the Health Systems Management program at the School of Public Health at the University Haifa.
Negev cites as an example the decision to ban visiting the beaches on the weekends. "There is no sense in banning the use of the open space, the chances of contracting the disease are very small outside if you keep a distance of 2 meters," she says. "The prevention of going out into the open areas harms both physical health, due to the lack of physical activity, and mental health, to which being in nature greatly contributes - especially in such a time of social and economic distress."
to mobilize as in war
"The damages that the corona is causing us are no less than the damages caused to us in the war, and maybe even greater," says Sharon. "The sad part is that while in war there is always a mobilization of the entire political system as one arrow, the muses are silent and everyone goes under the stretcher, this time it is not happening." According to him, the solution is to clean the decision making on the corona issues from politics. "There must be a professional body that will manage the corona issue, that will include all the relevant scientists and that will receive enough resources."
Will Prof. Gabi Barbash, who was recently appointed as the Corona projector, fulfill this position? "Only if they give him all the powers and subordinate all the bodies to him," says Sharon. "We must properly collect the relevant information and create an orderly documentation from which it will be possible to understand with a high degree of probability where people are infected," says Lerner. "This way it will be possible to specify the definitions of the purple letter for places such as businesses, workplaces and public transportation - for example, not to determine what percentage of employees will arrive at the workplace, but to understand what personal space is needed for each employee so that the chance of infection decreases. With such guidelines it will be possible to allow businesses to exist and drive the economy - without increasing the risk of exposure."
According to Lerner, decision-making based on data and transparency is the way to get the public's cooperation on the issue. "This is a well-known insight even regardless of Corona: when the public doesn't understand why a certain decision was made, they won't listen to it," he concludes.
the post In the time of the corona, science must be counted appeared first onangle
More of the topic in Hayadan:
There is no doubt that modern science has advanced the field of medicine for humans more than any other factor, and that reliance on clinical experimental science has enabled the development of drugs, vaccines and effective treatments for diseases and their prevention, saved the lives of countless people and changed the face of human history from end to end. Today, in view of the threat of the new corona virus (SARS-CoV-2) that has been disrupting our daily lives for about six months, doctors are starring in the headlines and "epidemiology" is no longer a dirty word, but to many it seems that science does not occupy a sufficiently important place in decision-making, and the logic behind Some of the new restrictions are questioned even by professional parties.
On what are the government's decisions based on the policy of dealing with the corona virus, including the changing restrictions on citizens and businesses? "This is a great question, the answer to which is completely unclear," says Dr. Uri Lerner, the professional director of the "Madaat" association for the promotion of public health. "There is not much connection between the decisions that are made and what we see in the world."
"It is not clear where the members of the government get the information they rely on when making decisions," says Dr. Uri Sharon, vice president of the Israeli Association for Ecology and Environmental Sciences, lecturer in law and environmental policy at the Faculty of Law at Bar Ilan University.
A body whose name comes up a lot as a source of information on the subject is the National Security Headquarters (NSH). "This is a body whose role is to build the strategic security policy of the State of Israel, it is a security and not a medical body and its people have no qualifications to deal with medical problems such as the corona virus - but it is in the Prime Minister's Office, and therefore the Prime Minister has full control over it," says Sharon.
One researcher per 300 people
Informed decision-making depends, of course, on reliable data - but there seems to be a lack of such information in Israel. "Data on the places of infection are not published," says Lerner. "The Ministry of Health publishes some data that includes the distribution of morbidity by ages and towns, but there is no detail of how many of the infections occurred in restaurants, how many in event gardens and how many in the education system, for example. There is no segmentation of the data that can make it possible to obtain some kind of epidemiological insight".
The Ministry of Health recently transferred it to the Knesset's Corona Committee Certain data on the locations of the infection, from which it appears that the most significant source of infection is precisely at home. According to Sharon, these data are also insufficient. "You have to pay attention to the number of participants in the research group: 2,227", he says. "This is almost the number of people infected in one day. How can you derive something from this?"
According to Lerner, these data, according to which 67 percent of the patients were infected at home, are fundamentally flawed. "The infections at home are not the important information," he says. "To illustrate, it is said that there is a meeting at work and one person comes to it sick and infects 4 others, and each of these workers infects 4 family members. Thus there are 20 infected, of which 4 are at work and 16 at home, but there is a built-in bias here - we need to understand where the infection came home, this is the way to stop the infection." According to the same data, the place of infection of over half of those infected is unknown. "This is due to the lack of investigations," says Lerner. "We don't have data on how many investigations were done until the array was strengthened, and an insufficiently good epidemiological investigation will lead to gaps in the following investigations."
A significant part of the lack of data is due to the fact that the number of epidemiological researchers in Israel is very limited compared to the rest of the world: according to A report published by Amn, in Israel there was one researcher per 300 people (1:10,000 after the recent increase), this compared to 1 in 4,000 in Germany, 1 in 6,200 in New York and 1 in 2,200 in England. "In other countries, where the number of epidemiological researchers is very high, they manage to identify centers of infection quickly and establish rules regarding them", says Sharon. "Places like Britain hit the first wave very hard because they did not close the country as quickly as Israel - but unlike Israel, they established an epidemiological system very quickly. We didn't do this, so our only way to fight Corona remains closure, while they can deal with new infections by cutting the chain of infection."
For example, according to an AMAN report, on June 12 in the city of Guntingen in Germany, two patients were found living in the same building, and as a result, corona tests were conducted for all 700 residents of the building. The tests found that at least 100 tenants were infected, and a lockdown was imposed on the entire building. By early July the outbreak was completely contained.
According to a position paper sent by the Union of Public Health Physicians to the Knesset's Corona Committee, the raw data and the results of the epidemiological investigations that do exist are not properly communicated to the public and the relevant parties: Morbidity trends and risk factors," the position paper states. "To date, these data have not been provided."
According to Lerner, in other countries the accessibility of information to the public is much better than in Israel. "In Singapore, for example, they created a very detailed infection map, where the public can see the chain of infections, and understand exactly where people were infected and which sites had more infections than others," he says.
"One of the problems in Israel is that it is not the professional level that manages the professional discourse, but the political level," says Sharon.
"As long as the information about the corona infection does not exist properly, the decisions are half arbitrary and half political", says Lerner. "The major delay in the decision to close the synagogues was political. It also took a long time until those who came from the US were forced into isolation - this is also political." In a study conducted at Tel Aviv University, it was found that the origin of 70 percent of the corona cases in the first wave was from strains of the virus that came from the USA (it should be noted that this study has not yet undergone peer review).
The question of relying on data has recently led to a debate within the political system. As I recall, MK Yifat Shasha Biton (Likud), the chairman of the Knesset's Corona Committee, questioned the government's decision to close the public gyms and pools, and demanded that the Ministry of Health Current relevant data. Finally, the committee headed by her decided not to approve the government's restrictions on the subject. "Clear data was presented to the committee about the absence of disease in the pools," Shasha Biton wrote on her Twitter account at the time. "Even regarding the gyms, there is no evidence that they are outbreak centers."
"In response, the chairman of the coalition, MK Miki Zohar, announced that she would be fired and that the transfer of decisions to the committee would be stopped," recalls Lerner. "It certainly doesn't look good."
There is no epidemiological justification
The new restrictions announced by the government, which include, among other things, the suspension of restaurants and the closing of various places on the weekends, provoked protests among professional public health officials. "No evidence, explanation, opinion or data has been provided that specifically supports these measures and proves their usefulness," reads the position paper sent by the Association of Public Health Physicians. "It seems that some of the measures chosen may even increase the risk of infection." It was also written that "it seems that the government's decision was made hastily, without sufficient consultation and appropriate consideration, without regular staff work, without transparency and not based on data. From an epidemiological point of view, we see no justification for a hasty and unfounded decision-making process."
"It is true that there is a lot of scientific uncertainty regarding the ways of transmission of the corona virus, but we do have information on the main ways of transmission, information that can form the basis of a more informed policy," says Dr. Mia Negev, head of the Health Systems Management program at the School of Public Health at the University Haifa.
Negev cites as an example the decision to ban visiting the beaches on the weekends. "There is no sense in banning the use of the open space, the chances of contracting the disease are very small outside if you keep a distance of 2 meters," she says. "The prevention of going out into the open areas harms both physical health, due to the lack of physical activity, and mental health, to which being in nature greatly contributes - especially in such a time of social and economic distress."
to mobilize as in war
"The damages that the corona is causing us are no less than the damages caused to us in the war, and maybe even greater," says Sharon. "The sad part is that while in war there is always a mobilization of the entire political system as one arrow, the muses are silent and everyone goes under the stretcher, this time it is not happening." According to him, the solution is to clean the decision making on the corona issues from politics. "There must be a professional body that will manage the corona issue, that will include all the relevant scientists and that will receive enough resources."
Will Prof. Gabi Barbash, who was recently appointed as the Corona projector, fulfill this position? "Only if they give him all the powers and subordinate all the bodies to him," says Sharon. "We must properly collect the relevant information and create an orderly documentation from which it will be possible to understand with a high degree of probability where people are infected," says Lerner. "This way it will be possible to specify the definitions of the purple letter for places such as businesses, workplaces and public transportation - for example, not to determine what percentage of employees will arrive at the workplace, but to understand what personal space is needed for each employee so that the chance of infection decreases. With such guidelines it will be possible to allow businesses to exist and drive the economy - without increasing the risk of exposure."
According to Lerner, decision-making based on data and transparency is the way to get the public's cooperation on the issue. "This is a well-known insight even regardless of Corona: when the public doesn't understand why a certain decision was made, they won't listen to it," he concludes.
the post In the time of the corona, science must be counted appeared first onangle
More of the topic in Hayadan:
