HCQ study withdrawal adds to public health message static

With help from Mohana Ravindranath (@ravindranize)

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Quick Fix

— HCQ study withdrawal adds to public health message static: The withdrawal of the large hydroxychloroquine study is adding to confusion in an already politically charged environment.

— Veterans Affairs EHR’ scrutiny continues: A new Government Accountability Office report focuses on the department’s EHR implementation and its success in soliciting clinicians’ and stakeholders’ views.

— Misinfo, bad info focus deepens: And more news on the topsy-turvy response to coronavirus, flooded with misinformation and low-quality data.

And more. But first, the jump.

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Driving the Day

HCQ STUDY ADDS TO PUBLIC HEALTH MESSAGING STATIC — The high-profile withdrawal of a bombshell study purporting to show hydroxychloroquine is an actively harmful coronavirus therapy has public health experts and scientists on edge.

Right-wing figures are demanding satisfaction, claiming that the withdrawal of the dubious data — provided by a little-known firm called Surgisphere — showed that an overly-credulous media was running with whatever it could to discredit President Donald Trump.

“THIS MISTAKE MAY HAVE COST LIVES,” tweeted the president’s lawyer, Rudy Giuliani, of the retraction. “TWO OF MY FRIENDS WERE SAVED BY HCQ. NUMEROUS STUDIES DEMONSTRATE IT’S EFFICACY. REPORT THEM!”

The Trump reelection campaign put out a statement saying the media coverage was intended to attack Trump, who took the drug for two weeks to prevent getting infected.

But the evidence still weighs against hydroxychloroquine, with multiple randomized controlled trials suggesting the drug doesn’t work. The affair shows the danger of shifting one’s opinion strongly with just one study.

“I have been imploring both my colleagues and the public to the extent I can reach them to be patient with the scientific process,” said Peter Bach, a Memorial Sloan Kettering epidemiologist. “It always includes missteps, and we only incrementally get more and more confident in answers, there is never one study that makes it all perfectly clear.”

— More Surgisphere questions: The withdrawal, as we’ve previously reported, was prompted by observers picking over many questionable details in the studies — such as one dataset claiming to have more coronavirus deaths in Australia than the country was reporting — followed by the company failing to turn over information for auditing, according to the co-authors on the study.

But more questions are cropping up: The National Health Service Scotland is saying that there was no collaboration with the firm, despite Surgisphere’s having claimed otherwise.

VETERANS AFFAIRS EHR SCRUTINY CONTINUES — Scrutiny of the VA’s $16 billion electronic health record project heightened last week, with a new report from the Government Accountability Office landing on Friday.

According to the Office’s report — which was based on interviews with sources from Cerner and the VA — the department generally did a good job getting a diversity of opinions involved in its stakeholder panels, and those panels plus department leadership was able to make decisions. But those groups sometimes didn’t feel listened to, the GAO report concludes. The department concurred with the report’s recommendation.

“As VA works toward continuing its EHRM implementation post pandemic, it needs to be as transparent as possible and better involve local staff on the ground,” said House Veterans Affairs chair Mark Takano, in a statement. He added that he and Susie Lee, the chair of the technology modernization subcommittee, were “willing partners” to work with the department on the EHR project.

— On tap this week: The House Veterans Affairs Committee is scheduled to hold a hearing on the department’s response to the pandemic on Thursday at 2 p.m.

MISINFO, BAD INFO FOCUS DEEPENS — Misleading, bad or low-quality coronavirus data is grabbing attention around the world:

— Brazil stops publishing coronavirus death toll: As we’ve previously noted, jurisdictions across the United States have either been fiddling with, obscuring or screwing up coronavirus data — generally with the effect, if not the intent, of making things seem better than they actually are.

Friday, the Brazilian government topped all those efforts by simply stopping the official publication of the death toll in that country.

— Science by press release decried: Drugmakers are using the media to publicize results of scientific studies before they’ve been rigorously reviewed — a practice ethicists are dinging as “science by press release,” our colleagues Zachary Brennan and Dan Goldberg report.

“There’s a long history of pharmaceutical manufacturers putting out self-serving press releases related to clinical trial data that they’re developing that present an overly rosy picture of the data, usually with a boilerplate disclaimer at the end, which is fairly useless,” said Aaron Kesselheim, a health economist at Harvard Medical School.

But it seems as if the hype is getting stronger — and its ability to crowd out painstaking science greater — amid the coronavirus.

— European Commission wants social media misinfo reports: The European Commission wants Facebook, Google and Twitter to provide monthly updates on how they’re tackling misinformation on their platforms, our European colleagues Mark Scott, Laura Kayali and Laurens Cerulus report.

Conspiracy theories linked to 5G, the next generation mobile technology, as well as bogus cures and false stories about governments creating the virus as a bioweapon, are still prevalent across social media.

— 62 Democrats call for more data on pregnancy amid coronavirus: Dozens of House Democrats — led by Reps. Lauren Underwood and John Lewis — are asking HHS to ensure there’s more data available on the effects of coronavirus on pregnant women and their children.

In a letter sent Friday, the members ask whether HHS has sent guidance to providers to prod them to collect pregnancy-related data at the point of care; and to beef up the CDC’s surveillance program focusing on mothers and babies.

STATES SHIELDING CONSUMERS FROM HIGH COVID-19 TEST COSTS — States are trying to step in to protect patients from high costs associated with coronavirus tests, our colleague Susannah Luthi reports. From Washington to Tennessee, officials are issuing regulations to tamp down on costs, concerned that the federal government is failing to do the job.

The costs of tests are, in some cases, staggering. One national insurer was billed $6,946 for a coronavirus test in Texas, according to claims data reviewed by Susannah. In Oklahoma, health plans received 175 out-of-network claims for coronavirus tests over a single week that ranged from $153 to $2,315 per test, said Laura Fleet, executive director of the Oklahoma Association of Health Plans.

High costs could dissuade patients from getting tested — thereby setting back surveillance.

What We're Reading

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