I’ve written about STAT’s Morning Rounds newsletter in the past, and criticized how STAT accepts pharma sponsorship of the newsletter.

In the last two weeks, for example, the newsletter has featured sponsored content from:

• drug company AstraZeneca;
• the Biotechnology Innovation Organization – whose biggest sponsors include drug companies Lilly, Merck, Amgen, Johnson & Johnson;
• biotech company Genentech;
• Blue Cross Blue Shield Association;
• drug company Bristol Myers Squibb.

I believe that an ethical news organization that covers pharma and biotech full-time should not accept sponsorship from pharma and biotech.

In Monday’s STAT Morning Rounds newsletter this week, there was this news item:

AstraZeneca announced over the weekend that it had struck a deal to provide up to 400 million doses of its experimental Covid-19 vaccine to countries in the European Union. The company plans to begin delivering the vaccine to European countries by the end of this year under an agreement with the Inclusive Vaccine Alliance, which was formed by France, Germany, Italy, and the Netherlands. Other EU countries will also have a chance to partake in the deal.

I clicked on the link.  It didn’t take me to a news story or to any independently-vetted piece of journalism.  Instead, the link went directly to an AstraZeneca PR news release.

That’s a nice piece of free news attention – if you can get it.

I looked for data in the AstraZeneca PR to which STAT had linked me.  There was none.  But there was this – presumably to satisfy the lawyers:

AstraZeneca recognises that the vaccine may not work but is committed to progressing the clinical programme with speed and scaling up manufacturing at risk.

That doesn’t satisfy me – and it shouldn’t satisfy STAT’s readers.

The news item – and the link – weren’t sponsored content and weren’t associated with an advertisement.  We expect a leading news organization that specializes in health care news to offer news, not PR, with its links.

I recall how a leading health care journalist wrote to me about STAT’s coverage of the Gilead drug remdesivir on April 29.  The journalist wrote:

I know that STAT’s business model is implicitly pro-pharma but even given that, this story is a press release.

In this latest case there could be no doubt that the story was nothing about a press release.

So it’s double bonanza time for some drug companies and biotech firms on STAT.  Pay for your sponsored content to be placed right in the middle of the morning news.  And, if you’re lucky, get your PR news releases posted for free.  Straight from the company’s keyboard to your eyes. I think we can and should do better in covering coronavirus vaccine news.

I’m flying solo while trying to catch up on today’s news on preliminary announcement of trial results of the drug dexamethasone for COVID-19 patients.

What follows is a series of tweets in response to what the Associated Press, CNN, the BBC, the New York Times, and some smart physicians on Twitter have written. Among the key points:

• The trial results have not been peer-reviewed or published yet.
• Some experts are hesitant to make conclusive statements until they can scour all of the data, which are not yet available.
• One thing that is lacking in the early reports – much of it via PR news release – is any discussion of side effects from dexamethasone – a steroid drug.

This thread began when an old friend, a Minneapolis journalist, asked me to weigh in on CNN’s report about the drug trial.

Appropriately, 2nd graf stresses “Their findings are preliminary, still being compiled and have not been published in a peer-reviewed journal.” But smart folks are calling top line results impressive. Old, cheap drug – testament to repurposing AND to randomized clinical trials. https://t.co/nkxpnoYC9X

— Gary Schwitzer (@garyschwitzer) June 16, 2020

It will be great news if dexamethasone, a cheap steroid, really does cut deaths by 1/3 in ventilated patients with COVID19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper. https://t.co/ZP5GVMUCW3

— Atul Gawande (@Atul_Gawande) June 16, 2020

Summary statement:

The data released on dexamethasone for covid-19 via press release show an enormous effect size among intubated patients.

This will either turn out to be:

A) Huge news.
B) Huge disappointment.

I hope it’s the first option!

We’ll know when we see the data!

— Jeremy Faust MD MS (@jeremyfaust) June 16, 2020

Seems like if there was ever time for a preprint, this is it. Nice job on your story. Bach’s input raising possible questions about applicability in US is noteworthy. https://t.co/xvn4ElqrmL

— Gary Schwitzer (@garyschwitzer) June 16, 2020

Quoting Boris Johnson as your only ‘independent’ perspective on the dexamethasone story is not ideal. Also no mention that this is not yet peer reviewed. https://t.co/ClPUzmTzUH

— Gary Schwitzer (@garyschwitzer) June 16, 2020

.@nytimes piece on dexamethasone ends with ?s from those pushing for data to be published. What was patient severity? What were side effects, neurological outcomes? “No clue!” wrote @jeremyfausthttps://t.co/kWJFyNm372

— Gary Schwitzer (@garyschwitzer) June 16, 2020

Science by press release is just promises with numbers sprinkled on it. GIVE. US. THE. GODDAMN. PAPER.

(Thank God this exists so I don’t have to write something similar which is both worse and ruder. @angie_rasmussen for PM.) https://t.co/DkgnJmilLX

— 🏴James Heathers 🏴 (@jamesheathers) June 16, 2020

How is it that dexamethasone…

…a drug that has been tried for every disease, just about

…that works decently for some things, and not at all in others,

…somehow hits its first grand slam EVER,

…with an illness that has so greatly eluded our best efforts to treat it?

— Jeremy Faust MD MS (@jeremyfaust) June 16, 2020

While the overarching theme may be the same – the puzzling editorial decision-making in the New York Times Well blog/column – the specific topics change – and so, provide more examples for instruction.

Bone Drugs May Have Added Benefit: Lower Pneumonia Risk is the headline of the latest troubled piece that caught my eye. The opening line:

Osteoporosis drugs such as Fosamax and Actonel may have an additional benefit: A new study suggests they are associated with a reduced risk for pneumonia.

The entire story used 220 words.  There is very little that can be covered effectively in a news story about a biomedical research study in so few words. The story did manage to confuse quite effectively.

Even that opening line mixes the fact that the study only showed a statistical association with the assertion that it showed cause-and-effect.  When it pointed to a possible “additional benefit” from the use of osteoporosis drugs – or bisphosphanates – it crossed a line.

At the end, it included a quote from one of the study co-authors and paraphrased him stressing “that the study is observational and does not prove cause and effect.”

But the story used cause-and-effect language throughout:

• additional benefit
• reduced risk for pneumonia
• The reason for the effect is unclear
• bisphosphonates lowered the risk

If the study did not prove cause-and-effect, which it did not, then you can’t prove benefit, risk reduction or lowering, or an effect.

This is a common failure in the Times’ Well blog/column. We regularly point to our primer to help journalists do a better job on observational studies, Observational studies: Does the language fit the evidence? Association vs. causation.

Worse, though, in this case, is that in the entire story there was only discussion of benefits from bisphosphanates and not one mention of side effects or potential harms. We have regularly warned readers that if you ever read a story about a drug study that only discussed potential benefits – but not harms – you should run for the hills because there’s no such thing.

And the potential side effects and harms of bisphosphanates are well known.

• Therapeutics Initiative: Given that bisphosphonates can cause severe adverse effects including fractures, which they are meant to prevent, it is urgent that the overall benefits and harms of long-term treatment be clarified. The available evidence suggests that the benefit-harm balance may be unfavourable for their use in osteoporosis.
• Ten years ago The Food and Drug Administration (FDA) warned that there is a possible risk of a rare type of thigh bone (femoral) fracture in people who take drugs known as bisphosphonates to treat osteoporosis.
• Nine years ago the Center for Medical Consumers published “Warning on bone drugs: stop after 5 years.”
• Five years ago The BMJ, under its Too Much Medicine heading, published, “Overdiagnosis of bone fragility in the quest to prevent hip fracture.” That paper concluded: “(Drug therapy) can achieve at best a marginal reduction in hip fractures at the cost of unnecessary psychological harms, serious medical adverse events, and forgone opportunities to have greater impacts on the health of older people. As such, it is an intellectual fallacy we will live to regret.” The paper stated that “Bisphosphonates are the dominant drugs for fracture prevention.”

This is just a snapshot of the voluminous and evolving medical literature on the harms of bisphosphanates.

But the New York Times never acknowledged that any harms exist – only benefits – and now unproven “additional benefits.”

As I always do, I checked the reader comments in response to this piece. The Times should learn from the experience of its readers.  Comment excerpts:

• “Fosomax and those drugs are notorious for bad side effects, involving jaw death among other things. My dentist told me to stay as far away from them as possible. There’s no way I would take that stuff just to “maybe” reduce my risk of pneumonia. There’s a pneumonia vaccine that’s probably a world safer than a biphosphonate if you want to prevent pneumonia. And far better drugs if you want to fight bone loss.”
• “I had a femur fracture as a result of taking bisphosphonates—Fosomax, Actonel and Boniva. I know doctors do not like to hear this… those meds can be dangerous and should have black box warnings. Doctors will tell you there are “rare fractures” but the numbers of femur fractures are inaccurately counted. And now you make an observational claim that they help with pneumonia.”
• “Are people really still taking Fosomax? It’s a nasty drug that put my mother into the hospital for 10 days with a gastrointestinal track inflamed from beginning to end. People have suffered from other side effects including fractures. I thought they had cut way back on prescribing this medication.”

Finally, with all the resources of the Times, the story only quoted one source – a co-author of the paper.  No independent perspective was included.

Why was this newsworthy – when the world is focused on the COVID-19 pandemic?  Why was this worth even 220 words now?  Why did the story explain that the study didn’t prove cause and effect, but then used cause and effect language six times (including the headline)? Why no mention of harms?  Why was there no independent perspective with no conflict of interest?

These are the kinds of questions that should be answered for readers.  The Times, which is delivering some stellar journalism on COVID-19, should abandon 220-word stories like this one.  It only adds to the cacophony of noise from not-ready-for-prime-time health care news.

Reuters: Italian scientist Alberto Zangrillo

Four days ago, Reuters reported from Rome, “New coronavirus losing potency, top Italian doctor says.”

The statement that COVID-19 “has become much less lethal” and that “the virus clinically no longer exists in Italy” caused an uproar in the global scientific community.

But it was Reuters that gave the scientist an international megaphone.

Journalist Roxanne Khamsi was one of the first I saw to react to the Reuters story on Twitter:

Are you KIDDING ME??? @stephenjadler, as Editor-in-chief of Reuters, take this down! This is one doctor’s conjecture.

If you are a science journalist who follows me, please add your two cents here 👇 so that they get the message. h/t @anggrainiLBhttps://t.co/ZzDiiwcHaJ https://t.co/ZjLJglnyxf

— Roxanne Khamsi (@rkhamsi) June 1, 2020

Indeed, it was a train wreck Reuters story.  A rushed 348-word brief, the first two-thirds of which were nothing but stenography of the scientist’s opinion, with no clear evidence to back it up.

We often hear that science is self-correcting. In this case, journalism employed some self-correcting steps on social media and in this story from the Washington Post, “Experts dispute reports that coronavirus is becoming less lethal.” The Post story calmly explained:

And a “What You Need To Know” piece in Forbes stated:

“As most horror movies have probably taught you, don’t make any assumptions that a threat has subsided until you are really, positively, absolutely sure that it has.”

Reuters itself published another story one day later, explaining:

World Health Organization experts and a range of other scientists said on Monday there was no evidence to support an assertion by a high-profile Italian doctor that the coronavirus causing the COVID-19 pandemic has been losing potency. …

“The suggestion by the Italian doctor is potentially dangerous as it gives false reassurance based on no evidence,” said Leana Wen, an emergency physician and public health professor at George Washington University. “There is no scientific evidence for there having been a change in the coronavirus. It’s a highly transmittable and highly contagious disease. We need to be as on guard as ever.”

Why weren’t those calls made to WHO and a range of other scientists before publishing the sensational Sunday story? What in the world justifies rushing a 348-word story to publication on a Sunday without doing extra research and reporting? Just because a scientist said it? COVID-19 journalism that devolves to that level of dreck is dangerous.

Reuters must examine its editorial decision-making. News spreads like a virus – globally – and causes harm when reported the way Reuters reported this story.

At the very end of the Reuters story is a link to Our Standards: The Thomson Reuters Trust Principles. One of them is this:

That no effort shall be spared to expand, develop, and adapt the news and other services and products of Thomson Reuters so as to maintain its leading position in the international news and information business.

It’s pretty clear that effort was spared in this example.

I’m a bit late on this with only a few excuses.  The birth of a new grandson.  Computer problems.  Living in the Minneapolis area and being focused on the death of George Floyd and the ensuing protests.

But this is worth addressing, even though a little late.

CBS 60 Minutes broadcast a story it called, “The Promise of Plasma,” about a trial of convalescent plasma at just one medical center in New Jersey.

You’re going to hear a lot about convalescent plasma because the approach makes intuitive sense.  But science needs to prove that things work. Intuition is not sufficient.  And the 60 Minutes story did a pretty weak job of establishing the difference. (The Mayo Clinic explains convalescent plasma on its website.)

Here are some of the things that could have been improved in the 60 Minutes story.

• There are many clinical trials of convalescent plasma all over the US and all over the world.  CBS referred to tests at “numerous hospitals” – which is a bit of an understatement.  And the only one mentioned, the only one profiled by CBS, was one in New Jersey, which CBS notes is “just a 30-minute drive from midtown Manhattan,” where 60 Minutes is based.  Perhaps that’s why CBS chose to shine its light only on one hospital.
• The tone of the piece was highly promotional.  It referred to the hospital’s “breakneck battle” and “all out battle.” The segment’s title – “The promise of plasma” – is alluring alliteration. But “promising” was one of the words patients have told me they don’t need to hear in medical news stories.
• The only data – the only evidence – provided by 60 Minutes was what this one hospital told them:  “So far, 31 of the 46 patients who received plasma in this study appear to have recovered more quickly than those who didn’t.”  There are many holes in that statement and many questions left unanswered by CBS.  And no data from all of the other clinical trials around the globe were presented.
• There was also no independent perspective in the story.  All of the input came from one hospital and one research team.  Nothing from anyone at any of the other clinical trial sites, no comment from the National Institutes of Health or the Food and Drug Administration. It was wonderful PR for the New Jersey hospital.  It was not the best journalism for 60 Minutes viewers.
• Often it is what journalists allow interviewees to say – unchallenged – that is most concerning.  That happened with this 60 Minutes story.

CBS quoted a researcher who is helping to lead the New Jersey hospital’s convalescent plasma trial.  This is how the story ended.

CBS’ Bill Whitaker: Based on what you have seen so far, what does your gut tell you?

David Perlin, researcher: My gut says that this is going to work. The initial response of the patients is incredibly encouraging. But as a scientist, I’m trained to be cautious. And so right now this is our best approach, we are going to take it, we’ll be aggressive with it but we’ll see how patients respond.

Benjamin Mazer, MD, a physician who is very active on social media, tweeted:

If you’re a doctor who goes on TV to say that convalescent plasma for COVID19 still needs more evidence but you’ve seen great outcomes in the patients you gave it to…you know exactly what you’re doing.

The public is going to hear “this probably works.”

— Benjamin Mazer (@BenMazer) June 1, 2020

Another physician joined Mazer with pointed skepticism:

When the expected recovery rate is 98% no one can confidently say they “see” a difference. pic.twitter.com/ru1P1fp4YQ

— Mark Hoofnagle (@MarkHoofnagle) June 1, 2020

So, even though researcher Perlin made an attempt to remind himself to be cautious, he went ahead and called the experiment “our best approach.”  Well you can’t say that it’s the best approach because you don’t know that. That is why you’re doing the trial.  And CBS should have addressed that.  They didn’t, and that’s the take home message they ended with.

An RN/paramedic on Twitter reflected on the impact of stories like this on viewers:

We have criticized 60 Minutes in the past.  Just two examples:

60 Minutes piece on Kanzius cancer cure not worth 60 seconds

CBS proclaims ‘cancer breakthrough’ – doesn’t explain what FDA means by that term

As always, when we criticize, we try to do so constructively, pointing to ways in which a story could have been improved – often with little effort. We hope 60 Minutes pays attention.

This is a lesson for news readers from Fargo to Duluth to Toronto and places in between and beyond.  The lesson is that you can’t jump to conclusions based on news stories about a single patient, or about a single researcher’s belief in a cure.

Single anecdote stories

There simply isn’t much you can say about apparent treatment results in one person.  Except that it only seems to be apparent. It’s not proof that a treatment worked.  And it’s only in one person.

The Forum of Fargo-Moorhead published a story, “Man credits treatment method that’s almost 100 years old with saving his life from COVID-19.”

It wasn’t a bad local story. It contained a lot of information.  I’ll offer some tips later on.  But it’s what happened with the story after it appeared in Fargo-Moorhead that caught my eye. More on that later, too.

The story began:

Gene Bad Hawk’s battle with the coronavirus began with headaches and fever. Over the ensuing 20 days since his diagnosis he would bounce between motel isolation rooms and hospital beds.

A bit deeper in the story:

Given his deteriorating condition, Bad Hawk’s doctors at Essentia Health decided he was suitable for a research trial and he readily agreed to receive what’s called convalescent plasma — blood plasma containing neutralizing antibodies from a patient who recovered from COVID-19

The story explained that:

Essentia has access to the plasma through a trial conducted by the Mayo Clinic. Although early reports are encouraging, there still is no clear proof that convalescent plasma is effective.

The Mayo Clinic patient information website itself has stronger caveats than what the story contained, including this simple but important reminder for anyone in any trial: “You might not experience any benefit.”

Some tips for how this story could have been better

That reminder – “You might not experience any benefit” –  could have been in the story, which could have linked to the Mayo Clinic website page for patient care and health information.

So this one man featured in the story thinks he got a benefit. Of course, that can’t be proven. The story quoted an Essentia physician:

“We have given it to six patients at Essentia Health in Fargo,” he said. “We have seen improvement in some,” but two patients died.

How many is “some” in  “improvement in some”? How much improvement? The story should have given these details – and whether any of the trial results have been published.  It also could have emphasized that no conclusions can be drawn from the experience of one person.

Is this Fargo? Or Duluth?

I didn’t see the original Fargo-Moorhead newspaper story.  I saw it on the website of the Duluth News Tribune.  The papers are owned by the same company.

I live in the land between Fargo and Duluth and I know that Essentia Health has facilities in both cities. So, having seen it in the Duluth paper, I assumed this took place at Essentia in Duluth.  It didn’t. The Duluth paper simply picked up a freebie story from a sibling paper in Fargo to help fill the day’s paper.  Essentia in Duluth is also part of the Mayo plasma trial, but that wasn’t mentioned when the Duluth paper copied the Fargo story.

So what relevance did this one-person story out of Fargo have for Duluth readers?  This is happening more often with declining revenues and staffing for many news organizations.  The day’s news is often filled with recycled stories apparently without enough thought put into what it means – or often, doesn’t mean – for locals.

Now on to Toronto…and a cure?

A friend in Canada sent me this column from the Toronto Star:  This U of T scientist says he’s invented a ‘cure’ for COVID-19. Will patients ever see it? It’s behind a paywall, so unless you subscribe you’ll only see a headline, a photo, and a few words.

The column is nearly 2,000 words long, which is unusual in a newspaper.  One could infer that the paper thought this was particularly worthy of 2,000 words. Here’s how the story is framed:

When Sachdev Sidhu talks about what his team has accomplished in their lab at the University of Toronto’s Donnelly Centre for Cellular and Biomolecular Research, the words are entirely his own. And they stun.

A cure. For the coronavirus. For SARS-CoV-2. For the COVID-19 disease that has killed upwards of 320,000 people around the planet.

A knockout punch.

“Yes, I believe ‘cure’ is the proper word,’’ the molecular engineer says, almost blandly. “They would no longer be ill. They would no longer have the virus in their system. That’s a cure.’’

He’s done it. He’s certain.

You might be thinking: “Wow, that research team must have collected some impressive clinical trial results.” Right? If you could read on, you’d learn:

…the lab will be doing small animal tests for safety over the next few weeks.

In the entire ~2,000 words, the only scientist quoted is Professor Sidhu. An agent or publicist couldn’t get better results than this. Will the Toronto Star profile other leading researchers with similar fanfare?  If not, why not?

The columnist who wrote the piece is known for covering sports and current affairs.  COVID-19 research news is not sports news. Maybe the newspaper should assign a health/medical/science journalist to write about such stuff – if there are any left to take on the assignment.

Single-mindedness

Just as the patient in our first example has every right to believe that his life was saved by an experiment, so is this scientist entitled to believe that he has “the cure.” However, their personal beliefs are not necessarily newsworthy.

To be clear, as it should be already, this analysis is not about those two individuals.  It is about the responsibility of journalism to provide evidence, to independently vet claims, and to be accurate, balanced and complete.

The cutbacks in staffing in news organizations are deep and terribly disruptive to quality journalism.  But we still do have terrific journalism about COVID-19 being delivered every day by leading news organizations.  The news organizations that can’t evaluate evidence, can’t analyze claims, can’t find independent sources (which we can help with) – these organizations would be better off not reporting on the pandemic  Because when they mislead, they harm more than help.

When I taught media ethics in the University of Minnesota School of Journalism and Mass Communication, I’d be thrilled to teach in an auditorium filled with 150 students.

This week, I spoke to an online course that has more than 7,000 international journalists enrolled from more than 150 countries. That’s what I’ve been told by longtime friend Maryn McKenna – a terrific public health journalist – who invited me to speak to the course that she is leading.

It’s called, “Journalism in a pandemic: Covering COVID-19 now and in the future.”

It is a free online course offered by the Knight Center for Journalism in the Americas at the University of Texas at Austin, in partnership with the World Health Organization (WHO) and UNESCO, with support from the Knight Foundation and the United Nations Development Program (UNDP).

And here is my video appearance before all of those international journalists:

After this video first appeared, I received an email from one of the journalists.  It read:

Dear Gary, I just listened to your video done for the Knight Foundation course on covering Covid-19. It is one of the most useful and THE most inspirational talk I’ve heard for journalists in these trying times. I am based in China, working from home with a toddler (no day care) and still doing field reporting as well. Your words really helped me understand the importance of dogged reporting and gave me a reason to continue, despite how tiring it is and all the brick walls you keep hitting. Going through some of the tips shared in your site now. Hope you will get funding to restart your great work again.

That’s enough to keep me going – even without funding – for some time longer.

“The drugmaker Moderna said on Monday that the first coronavirus vaccine to be tested in people appeared to be safe and able to stimulate an immune response against the virus.”

That’s what an early New York Times story reported yesterday.

Erick Turner, MD, reacted on Twitter:

Hey, didn’t you hear? The vaccine “appears to be safe”. That’s based on the results from eight people––eight!! Very reassuring! 🙄

Hard-nosed reporting––NOT!
FYI @garyschwitzer https://t.co/sUvQm8MAGN pic.twitter.com/E0qMNX0MEN

— Erick Turner (@eturnermd1) May 18, 2020

Story strengths & weaknesses

What follows is a brief collection of some strengths and weaknesses of other stories on the early vaccine results.

A Fox News story quoted a surgeon saying that it was “great news” because “I believe that to save American lives we need American medicine and American hands, not the Chinese government leading the way and that’s what we’re doing here in America so I’m very proud.”

NBC News called it “Breaking News” and used the word ‘encouraging’ five times in a short segment.  Today Show anchorwoman Hoda Kotb actually said, “I love it when I see the word ‘encouraging’ in a script.” (Can you imagine if she had said she was excited about encouraging early poll numbers for a political candidate?)

The Wall Street Journal put important caveats up high in the fourth paragraph. (If you’re not a subscriber, you won’t get to the fourth paragraph; it’s behind a paywall.)

The vaccine still has much to prove.  The results don’t show whether it actually protects people who are exposed to the new coronavirus, a key proof point.  Many vaccines fail to pass muster even after showing positive signs in early testing.

The WSJ went on to explain that:

The phase I study data came from among the 45 people ages 18 to 55 who received three different dose levels of the vaccine.  An additional 60 people over age 55 are being enrolled in the study.

That’s an interesting note, but it could have been presented much more clearly,  So the plan is to enroll 105 people in the phase I study.  45 people have been vaccinated.  But most stories only discussed results for 8 people.

CNN explained:

While the vaccine had promising results in the lab, it’s not known if it will protect people in the real world.

The New York Times did a better job explaining what was not real world in the early vaccine results reported.

The people vaccinated in Moderna’s Phase 1 study described on Monday were healthy volunteers ages 18 to 55. Their immune systems made antibodies that were then tested in infected cells in the lab, and were able to stop the virus from replicating — the key requirement for an effective vaccine.

So the meeting of antibodies and infected cells took place in the controlled setting of the lab – not in the bodies of sick people.

Still, that New York Times story was headlined, Moderna Coronavirus Vaccine Trial Shows Promising Early Results

Early results don’t always stand

That’s what a New York Times newsletter reminded readers:

In 2015, the French drug company Sanofi began selling the first vaccine for dengue. The drug had made it through multiple research trials — although some researchers believed Sanofi had ignored worrisome signs. Sure enough, as children in the Philippines began using it, some contracted an even worse form of dengue. Today, use of the vaccine is highly restricted.

In recent testimony, Dr. Anthony Fauci, the nation’s top infectious-disease expert, noted that a coronavirus vaccine could suffer from the same problem.

The larger point is that drugs that look good in small, initial studies often look less good when they’re tested in more people.

With such early trial results, you never hear much about safety or side effects.  You can’t learn much about safety in such small samples on a short-term basis.

None of this kept the manufacturer’s stock from soaring. None of it kept pundits from predicting demand and availability.

Meantime, Ed Silverman of STAT News reported on continuing “Where are the data?” questions – “Amid worldwide clamor for Covid-19 medicines and vaccines.”

Those are good questions.

As are the questions about former Moderna board member and pharma executive Moncef Slaoui – now the President’s newly appointed “vaccine czar” – first claiming he had no conflict of interest, and then announcing he would divest his equity holdings in Moderna.  But I’ll leave that to the political and financial journalists.

Addendum:

See this excellent analysis by Helen Branswell at STAT news – Vaccine experts say Moderna didn’t produce data critical to assessing Covid-19 vaccine

Also see an op-ed in the Washington Post by William Haseltine, former Harvard Medical School professor and founder of the university’s cancer and HIV/AIDS research departments. Moderna’s claim of favorable results in its vaccine trial is an example of ‘publication by press release’

I’ve written it and said it before: I applaud most of the New York Times pandemic-era news coverage.

But I continue to see head-scratching lapses in editorial approach and judgment – flaws that could be so easily corrected with a bit more caution and care.

Hoping llamas will become coronavirus heroes is a Times story on a journal article that drew a lot of attention from many journalists. One big problem:  there were no independent expert perspectives in the Times story.  The only people quoted were those involved in the research.  Overall, it was a reasonable story, with the cute llama angle, and ample caveats.  But quoting only the scientists involved in the work is less than what readers should expect from the Times – or from any of the other news organizations that may have followed their lead.  Headlines elsewhere, such as “Could llamas be crucial to finding a preventative COVID-19 cure?”  or “Can llamas save us?” were both based on, and linked to the NY Times story.

Meantime, over on the NY Times Well feature, a non-coronavirus story drew the ire of countless readers. This one was headlined, “Filtered Coffee May Be Especially Good for Heart Health.”

Among the most obvious flaws was the failure to point out the limitations of observational research such as this – research that cannot prove cause-and-effect.  But that didn’t stop the Times from using causal language such as “the effect on cardiovascular health.” And the coffee story – like the llama story above – offered no independent expert perspective, quoting only the senior researcher on the work.

Adam Cifu, MD, of the University of Chicago, may have kicked off one of the longest Twitter threads I’ve seen in a while.

Anybody else want to join me for a cup of coffee and a session of banging your head against the wall regarding this article? @VPrasadMDMPH @chrishendel @garyschwitzer https://t.co/mSRHx2mFNS

— Adam Cifu (@adamcifu) May 6, 2020

Among the comments from others on the ensuing Twitter thread:

• Oh good lord…it’s not as if it’s been a slow news day…or week…or month.
• You would think with so much bad reporting on COVID research that reporters wouldn’t have time to cover bad research with even worse takes. Clearly that’s too much to ask for.
• Like there’s not enough BS flying around.
• I have never bothered with that idiotic column.
• Unbelievable. This stuff doesn’t take a day off.
• Hilarious; ten million person-years to answer the question of filter vs. french press.

Does it matter if The Times’ Well column is regularly scorned by readers as long as the online click rate rises? Apparently not.

This is the way many of my days begin these days, being blasted out of my chair by smart skepticism and criticism on coronavirus issues on social media.  Today’s lift-off came from a virology researcher at Cornell:

This LATimes article is INFURIATING. So much misinformation based on just that preprint. They took quotes from the author’s PERSONAL FACEBOOK PAGE. An anonymous quote that this is ‘classic Darwinian evolution.’ Commentary on viral load and pathogenesis from a toxicologist. pic.twitter.com/dN2T4oYOCa

— Brian Wasik (@BrianRWasik) May 5, 2020

You can read the full Los Angeles Times story yourself. I’ll give you the opening paragraph:

Scientists have identified a new strain of the coronavirus that has become dominant worldwide and appears to be more contagious than the versions that spread in the early days of the COVID-19 pandemic, according to a new study led by scientists at Los Alamos National Laboratory.

I’ll leave it to the scientists to clarify the significance of this report.

But, once again, the way in which this was communicated to the public is troubling. Virologist Wasik’s Tweet hit on two big communication issues:

1. So much of the story came from a pre-print.  You can read our backgrounder on preprints to see the pitfalls of journalists reporting on them.
2. The first quotes in the story – presumably assigning some prominence to them – were lifted from the researcher’s Facebook page.

Really? Is that the way scary mutant virus stories should be sourced in one of the nation’s leading newspapers?

Each of those steps demonstrate how, on some days, some stories are dramatically lowering the bar for editorial integrity in journalism.

And the story’s take-home message for readers in the general public is hair-raising, fence-straddling, vagary.

While the Los Alamos report is highly technical and dispassionate, Korber expressed some deep personal feelings about the implications of the finding in her Facebook post.

“This is hard news,” wrote Korber, “but please don’t only be disheartened by it.”

One researcher, commenting on Twitter, called the story “crap.”

Another Tweeted, “With hyper-intense interest in covid, papers get amplified by journalists who lack the expertise to critique or contextualize them.”

Another wrote that it “Messes up the (general population), but we’re in a spin already.”

Wasik tweeted later:

This work comes from an excellent research group in HIV work. This bioinformatic pipeline will have real utility. They got a bit over their skis on title, conclusions.  They deserve a strong and good-faith peer review.  This article and ‘discourse’ is not that. (emphasis added)

You can read one entire thread here.

And the impact on readers?  Read the comments following the online LA Times story to see how many people are dripping with sarcasm and fear fatigue.

Journalists can, and must, do better.  Thankfully, in many corners of today’s beleaguered daily journalism, they are.

Addendum:

Please note that the Los Angeles Times updated its original “mutant coronavirus” story at 8:35 pm (presumably PDT) on May 5.  New quotes have been added since we reviewed the original story version that, it appears, was online for more than 12 hours.

The Philadelphia Inquirer countered the LA Times story on May 5: There’s no real evidence that the coronavirus is becoming more contagious, despite what you might have seen online

Another reasonable story was published by the Washington Post in the evening of May 5: Researchers hypothesize that a highly contagious strain of the coronavirus is spreading, but other experts remain skeptical

And another better piece of journalism was published in The Atlantic May 6: The Problem With Stories About Dangerous Coronavirus Mutations