>> You only meet living motorcyclists. In a well-occupied concert hall they might even have the best life expectancy, perhaps because they are more active and fitter. But remember: this only applies if you ignore the motorcyclists who died in the decades before our concert event. There was also a prominent example of such a selection bias in the first months of the Corona epidemic, namely the study on childhood SARS-2 infectivity, which was published by TC Jones and C. Drosten on a Charité server on May 1, 2020 . Children have the same viral load in the throat swab as adults, it was said, and the conclusion was that “we have to be cautious against an unlimited re-opening of schools and kindergartens in the present situation”. Can this massive influence on the formation of opinions be seen a few days before the decision in the Prime Minister's Conference on May 6th? justified by this data? Hardly, because of the almost 60,000 tested, only 49 children (<10 years old) could be identified with a PCR-positive throat swab (2,25% of the tested children), while e.g. B. in the age group 51-60 years, at least 662 people were found (6,25% PCR+). They “only met infected children”; the low infection rate among children was neglected.
There is a simple remedy for both cases. So you could start observing motorcyclists when they get their driving license. Who lives longer? And with the question of children, for example, one would have: B. Families with a PCR-positive family member can investigate how the transmission of the infection spreads between adults and children. This would have provided a good approximation of the risk posed by children: “frequency of infection x individual viral load”.
But the Drosten group stuck to their presentation, despite strong international criticism. A subsequent Science publication, despite the excellent publication location, only made things worse: no clearly formulated question, no clearly formulated methodology... instead, phrases like "we first address a set of questions..." (which ones?) and "a further set of temporal questions ..." (but which ones?). A disaster.
However, this was just a particularly blatant
This is an example of the violation of infection epidemiological standards during the corona pandemic in Germany. It is common knowledge that you have to work with frequency information that is independent of the test frequency and refers to representative samples, that you cannot speak of “incidence” if you change the sample daily, that you should develop case definitions for clinical events, that separate the end point of the observation from other events. And so forth.
Of course there were critical voices, e.g. B. from the ranks of the tried and tested hospital hygienists. Because if “hygiene” claims that nosocomial infections are responsible for a certain number of deaths per year, what is the immediate question to ask, critically and directly: Did the patients really die from the infection or did they die from the underlying disease, and how? There you go – have you noticed the difference? So you work with overall and adjusted mortality, attributable mortality, a basic question without which you don't really need to have a say in this field. And how do you manage this differentiation between “with” and “on”? For example, by working with score systems. An intravenous catheter infection can be assumed to be the cause of death if, for example, fever and pus at the injection site and continuous bacteremia etc. come together and the underlying disease has not shown any progression at the same time.
The same should have been done with Corona. Instead, as a highly developed country with an oh-so-exemplary healthcare system, we have not yet managed to differentiate the reported corona deaths. This circumstance has its roots high up in the health policy framework, but we must not lose sight of the fact that it is very important to use epidemiological terms correctly, because you want to use them to control and influence: infection control. This is the scientific discipline that goes from the epidemiological description to the risk factors (for nosocomial infections, e.g. the quality of antibiotic administration, for Corona, e.g. age and comorbidity) to prevention strategies that have a demonstrable and have a lasting effect.
And something truly groundbreaking has happened here in the last few years. Building on the knowledge that linear, one-point interventions (e.g. the famous “service instructions”) do not have a lasting effect, it was emphasized that multiple interventions must be used. Since epidemics are not purely biological events (a virus that you have to declare “war” on and its “killer mutations”), but rather complex social processes, you have to use complex interventions to deal with them.
These “Complex Multicomponent Interventions” (CMI) also represent the basic model of effective interventions as they are examined and used in health services research. The birth of the infection control area was the studies on the extensive elimination of catheter infections by Peter Pronovost and Co. in Michigan, which could be duplicated several times and - always depending on the context - can be viewed as the gold standard.
Now we only have one problem. This has all been known for a long time. We have been teaching all of this in student classes for decades. Why then have so few scientists from the scientific community spoken out and called for a correction? This question will concern us all for a long time, hence the commentary series on “Science and Politics”, which begins here.<<

literature
Jones, TC et al.: An Analysis of SARS-CoV-2 Viral Load by Patient Age. Unpublished Manuscript, May 1, 2020; Follow-up publication Science 10.1126/science.abi5273 (2021)
Pronovost, P. et al.: An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU. NEJM 355, 2006, 2725-32