[M T]

More damning commentary on the WHO in this article about the evolution of asymptomatic spread awareness. 


https://www.nytimes.com/2020/06/27/world...matic.html

That article feels as if it was written to try to rescue Dr. Roche's reputation.  Among other things, events are mentioned out of order, distorting cause and effect. 



The letter (with lead author Dr. Roche) published January 30 in NEJM (original version here) contained critical findings supported only by hearsay evidence, that was not indicated as such.   It was called out as flawed on February 3 for reporting the Patient 0 (a woman) as being asymptomatic (based on hearsay evidence from other patients) when she did have symptoms.   Only on February 5, did Dr. Roche's team speak to the patient who they asserted was asymptomatic.



The Böhmer paper referenced in the NYT is here.



The January 30 letter states "During her stay, she had been well with no signs or symptoms of infection but had become ill on her flight back to China"
and "However, it is notable that the infection appears to have been transmitted during the incubation period of the index patient, in whom the illness was brief and nonspecific."

The nature of her illness and symptoms seems stated as a fact known to the authors, rather than the authors reporting second-hand information, as done later about Patient 1, "He reported ...".

The authors could have said "she appeared well with no signs or symptoms", or "Patient 1 reported Patient 0 appeared well ..." to make it clear.



Whether the case was presymptomatic or symptomatic can be argued, but that's not the point.  She reported various pains and tiredness and temperature issues, and took some acetaminophen while in Germany.  (Contrary to the NYT, the interview doesn't suggest she took the acetaminophen for jet lag.  A quick look around the Internet didn't show acetaminophen as suggested for jet lag.)   But she did wind up with fever and a cough in China.



By the way, "became ill on her flight back to China" is not correct either.



The NYT article seems to suggest that the authors wrote their article in part to provide info WHO had called for:

Within hours, it was online. It was a modest clinical observation at a key time. Just days earlier, the World Health Organization had said it needed more information about this very topic.

but I note the letter doesn't mention WHO at all.

The NYT article seems to suggest that the info used in the letter about the patient came from a call on January 30.  However, the February 4th alert on the misinformation indicated that one of the letter's authors said they used info reported by the other patients.  The information in the letter is consistent with info published on January 28 (including the incorrect info about becoming ill on the flight back).

To me, the article feels as if it was written to push an opinion, rather than factually presenting the information.

[M T]

More damning commentary on the WHO in this article about the evolution of asymptomatic spread awareness. 


https://www.nytimes.com/2020/06/27/world...matic.html

That article feels as if it was written to try to rescue Dr. Roche's reputation.  Among other things, events are mentioned out of order, distorting cause and effect. 



The letter (with lead author Dr. Roche) published January 30 in NEJM (original version here) contained critical findings supported only by hearsay evidence, that was not indicated as such.   It was called out as flawed on February 3 for reporting the Patient 0 (a woman) as being asymptomatic (based on hearsay evidence from other patients) when she did have symptoms.   Only on February 5, did Dr. Roche's team speak to the patient who they asserted was asymptomatic.



The Böhmer paper referenced in the NYT is here.



The January 30 letter states "During her stay, she had been well with no signs or symptoms of infection but had become ill on her flight back to China"
and "However, it is notable that the infection appears to have been transmitted during the incubation period of the index patient, in whom the illness was brief and nonspecific."

The nature of her illness and symptoms seems stated as a fact known to the authors, rather than the authors reporting second-hand information, as done later about Patient 1, "He reported ...".

The authors could have said "she appeared well with no signs or symptoms", or "Patient 1 reported Patient 0 appeared well ..." to make it clear.



Whether the case was presymptomatic or symptomatic can be argued, but that's not the point.  She reported various pains and tiredness and temperature issues, and took some acetaminophen while in Germany.  (Contrary to the NYT, the interview doesn't suggest she took the acetaminophen for jet lag.  A quick look around the Internet didn't show acetaminophen as suggested for jet lag.)   But she did wind up with fever and a cough in China.



By the way, "became ill on her flight back to China" is not correct either.



The NYT article seems to suggest that the authors wrote their article in part to provide info WHO had called for:

Within hours, it was online. It was a modest clinical observation at a key time. Just days earlier, the World Health Organization had said it needed more information about this very topic.

but I note the letter doesn't mention WHO at all.

The NYT article seems to suggest that the info used in the letter about the patient came from a call on January 30.  However, the February 4th alert on the misinformation indicated that one of the letter's authors said they used info reported by the other patients.  The information in the letter is consistent with info published on January 28 (including the incorrect info about becoming ill on the flight back).

To me, the article feels as if it was written to push an opinion, rather than factually presenting the information.