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Joe Jarvis May 31
Replying to @JNJarvis76
Here is Table S3; 4402 hospitalised patients from Africa and 437 deaths. They say they censored cases on 14th April and deaths on 21st, at which points there had been a TOTAL of 15291 cases (in- and out-patients) and 1155 deaths on the entire continent 3/15
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Joe Jarvis May 31
Replying to @JNJarvis76
This would mean that 29% of all individuals who tested COVID-19 positive on the whole African continent were hospitalised in a centre with comprehensive electronic medical records and data sharing agreements with Surgisphere, capturing 38% of COVID19 deaths 4/15
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Joe Jarvis May 31
Replying to @JNJarvis76
Based on my group’s research experience in southern Africa, even in settings with the most developed electronic medical records systems in sub-Saharan Africa such as South Africa or Botswana, this kind of data cannot be obtained 5/15
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Joe Jarvis May 31
Replying to @JNJarvis76
We’ve recently published one of the few registry based studies from Africa, utilising the relatively well developed EMR and death registry in Botswana. Even with 18 authors it took us well over six months to collate, clean, and check these data… 6/15
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Joe Jarvis May 31
Replying to @JNJarvis76
…the data available to us were basically limited to laboratory data and mortality outcomes, with granular data regarding past medical history, prescriptions, and examination findings not captured in the electronic records 7/15
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Joe Jarvis May 31
Replying to @JNJarvis76
Our authorship team included the head of the National Health Laboratory and data experts from the Ministry of Health because their input is essential for doing these kind of studies. We had data sharing agreements with two government ministries… 8/15
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Joe Jarvis May 31
Replying to @JNJarvis76
…and we had to have ethics approvals from two National IRBs and one international IRB. These approvals and agreements took over a year to put in place and were based on strong research collaborations going back decades 9/15
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Joe Jarvis May 31
Replying to @JNJarvis76
Based on this experience of research using routine health records in southern Africa I just don’t think that it would be possible to obtain the data or perform the analysis outlined in Mehra et al. from electronic medical records in Africa 10/15
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Joe Jarvis May 31
Replying to @JNJarvis76
In order for there to be any confidence in these findings it's essential that the authors at a minimum list the countries and hospitals from which these data came, indicate the degree of data completeness, and outline checks undertaken to ensure that these are robust data 11/15
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Joe Jarvis May 31
Replying to @JNJarvis76
And even if it was, there is absolutely no question that ethical approvals and data sharing agreements would need to be in place with institutional and national research ethics committees and regulatory authorities 12/15
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Joe Jarvis
Surely the needs to withdraw this paper pending further review? Either these are not genuine data, or the researchers have taken huge amounts of confidential patient data from African hospitals with no ethical approvals. Neither are good, but the latter is worse 13/15
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Joe Jarvis May 31
Replying to @richardhorton1
has rightly been very vocal about holding the UK government and their scientific advisors to account and demanding full transparency about data and decision making. Surely the same principles must apply here. 14/15
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Joe Jarvis May 31
Replying to @JNJarvis76
For full disclosure, I am no advocate. I think we’ve always been clutching at straws. But when we are facing an assault on science and reason from the most powerful people in the world, as a community we need to ensure the integrity of our data and work. 15/15
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Joe Jarvis Jun 1
Replying to @JNJarvis76
UPDATE: In the revised table 3, modified in light of the errors in the Australian numbers, they now report 561 deaths in Africa (49% of the 1155 total reported to that time on the entire continent).....
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Helen ayles May 31
Absolutely agree . I also am sceptical about CQ/HCQ but we need facts and truth. please let us know how this was reviewed and provide reasons for publication of ethically dodgy study ( even if data exist) or remove.
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Ewa Nartowska Jun 1
Replying to @JNJarvis76
Thank you
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Donna 🇺🇸 Underwood Jun 2
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