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The Florida surgeon general scandal explained for nerds who want to know what really happened

Politico reports today that Ron DeSantis's hand-picked surgeon general decided to make a few personal edits to a study of COVID-19 vaccines:

Florida Surgeon General Joseph Ladapo personally altered a state-driven study about Covid-19 vaccines last year to suggest that some doses pose a significantly higher health risk for young men than had been established by the broader medical community, according to a newly obtained document...He later used the final document in October to bolster disputed claims that Pfizer-BioNTech and Moderna vaccines were dangerous to young men.

Are you curious about what Ladapo did? In detail? I am! Here's the paragraph he added to the report:

Results from the stratified analysis for cardiac-related death following vaccination suggests mRNA vaccination may be driving the increased risk in males, especially among males aged 18-39. Risk for both all-cause and cardiac related deaths was substantially higher 28 days following COVID-19 infection.

What was this based on? Here's an excerpt from the report:

Aha! Maybe Ladapo has a point. For males aged 18-39, the relative risk of a cardiac death was 1.84 compared to the baseline of no vaccine. (Anything above one means a higher risk.) This is only barely above the level of statistical significance, and the sample size is only 20, but it's still an indication that something might be going on.

But wait. Here's a Ladapo edit at the top of the study:

Hmmm. The authors used a method called SCCS in the study, but in the section that's been moved down they say it can introduce bias. In the section that's been deleted, they say SCCS doesn't account for a multidose vaccine schedule—like the one for COVID—so they performed a sensitivity analysis to correct for it. So what does this sensitivity analysis say?

It says that the relative risk for males aged 18-39 is actually 0.89 for the first dose and 1.14 for the second dose. This is basically nothing. The authors confirm this in the section below in bold, which Ladapo deleted from the final report:

COVID-19 vaccination was associated with a slight increased risk for cardiac-related mortality 28 days following vaccination in the primary analysis, but this association was attenuated and no longer significant when applying the event-dependent exposures model utilized for multidose vaccines. Thus, there is little suggestion of any effect immediately following vaccination.

In other words:

  • The vaccine had no effect on cardiac deaths.
  • Ladapo knew it had no effect.
  • He knew exactly which parts of the report to excise to make it look like there was an effect.
  • He excised those parts.

The great thing about this is that it's so technical that nobody except an expert has any idea what he did. Even when it's explained, there's probably not one person in a hundred who understands what happened.

In layman's language, then, here's what happened: The authors of the report used a method to eliminate bias in their measurements of cardiac deaths. When the bias was removed, they found no effect from the vaccine. Ladapo deleted that part of the report.

Any questions?

22 thoughts on “The Florida surgeon general scandal explained for nerds who want to know what really happened

  1. Eve

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  2. gVOR08

    Reminds me of Charles Krauthammer. With a George Will or David Brooks or Ross Douthat it's possible to think they believe what they say. The late Krauthammer's lies were so carefully crafted there was no question it was deliberate.

  3. Art Eclectic

    "We're an empire now, and when we act, we create our own reality. And while you're studying that reality - judiciously, as you will - we'll act again, creating other new realities, which you can study too, and that's how things will sort out. We're history's actors... and you, all of you, will be left to just study what we do."

    Karl Rove

    They've been creating their own reality since 2004.

  4. danove

    So could there be any legal liability for this? It seems if a public official alters
    documents to his bias there should be consequences.

    1. Austin

      In states run by decent people, there would be consequences for him. Alas, nobody with any decency has moved to Florida for many years now, so the state is left with just the decent people that - for whatever reason - stay there, year after year, still employed by the state government. Almost by definition, if you're still employed by the Florida government and are a decent person, you're either incredibly silent about your decency - keeping it to yourself so you don't get weeded out - or you've been 'defanged' - stripped of any powers you may have had when you first were hired to hold anyone else to account for their indecency.

      So the short of it is, no, this particular public official working in this particular shithole state will face few to no consequences for anything he does or did.

  5. kenalovell

    Questions? Yes I have them.

    Has DeWoke promised to make Lapado Surgeon General, or did he have to up the bribe to Director of the CDC?

    1. D_Ohrk_E1

      Sure. File a complaint with the Florida Board of Medicine asserting a violation under one of these statutes. I would suggest 458.331 (h):

      Making or filing a report which the licensee knows to be false, intentionally or negligently failing to file a report or record required by state or federal law, willfully impeding or obstructing such filing or inducing another person to do so. Such reports or records shall include only those which are signed in the capacity as a licensed physician.

      Of course, with DeSantis in control of everything, he might just fire everyone and put his own people on the Board just to do his bidding.

    2. Austin

      Just like with the lawyers who repeatedly file false statements in court, tamper with witnesses and evidence, advise their clients on how to get away with crimes, and commit their own crimes (like, say, insurrection) in their spare time, apparently there is no way for a professional licensing board in the 21st Century to strip any licensed "professional" of their license... unless they do something "simple" and "clear cut" like driving drunk... and even then it's hit-or-miss as to whether they'll actually lose their license.

      There's a lot of moral rot and laziness in the ranks of our overlords...

  6. Cycledoc

    Thank You.

    PhD’s, even from Harvard have been known to skew their results to fit their preconceived notion. Whats worse here is that he skewed it to please a political boss.

    Our last President was estimated to have lied over 30,000 times in his 4 years in office. He tried to overthrow an election. And yet he is still able to have the support of a majority of republicans.

  7. Dana Decker

    This post has been very helpful. I read elsewhere about Labapo but the presentation was mostly opaque. This is the kind of stuff Kevin does extremely well.

    1. Salamander

      I agree! It's been my observation that most reporters don't care about or understand technical things. Even on NPR, "nerds", "geeks" and "wonks" are constantly denigrated and reporters apologize before introducing anything numeric or requiring knowledge beyond grade school.

      Kevin not only elucidated what had been done, but also included the relevant passages and their changes with his explanation. Why can't we have a media that's capable of doing this??

  8. BlueGreenMango

    As far as legal culpability, it depends on how this report was used.

    If it was part of an FDA submission then he's absolutely at risk because fraudulent data was reported. Think about what would happen in the opposite scenario, if Pfizer covered up excess mortality with the Covid vaccine. People go to jail for that, and companies pay huge fines, cf. Merck and Vioxx for one example.

    OTOH, if he was acting in his role as the Florida Surgeon General, who knows. I'd guess it's up to a professional organization like the AMA, or maybe the Florida chapter thereof, to revoke his medical license or come up with some other form of discipline. Who knows if they'd ever do that, and what impact it would have.

    1. BlueGreenMango

      Or, I should have included, the most important regulatory body of all, the Florida voters. Of course if that's what we rely on, well, here we are.

  9. kkseattle

    He’s butchering old, white right-wing cranks in Florida.

    And they’re thrilled to die from an eminently preventable disease.

    I know we should prosecute him, like one of those creepy German sex kooks who butchers and eats his willing victim, but why would anyone want to be butchered and eaten?

    1. Art Eclectic

      His continued employment depends on marching to the orders issued from HQ. Much like the on-air talent at Fox News, he'll say what the boss wants said in order to keep his paycheck.

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