What happens when we put all of the studies together?

1 in 35 people?

I’m revisiting some unpublished ideas I had. I often pause an idea if I realise the scope of what I want to write is bigger than I can achieve. This one I thought was worth sharing, perhaps there’s something to pull at here.

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How do we see the world? In fragmented bits? Disconnected, isolated, and fundamentally without pattern or shape? Or do we see the whole? Where ideas, culture, data and meaning flow endlessly together in a complex and beautiful kaleidoscope? In his masterful book, The Master and his Emissary, Ian McGilchrist warns us that our world has tilted perilously toward the former. Fragmented. Disconnected. Narrowly focused.

In the scattered culture we’ve created, we can pick something up, analyse it entirely without its context, and put it back down again as though it never existed at all. As McGilchrist tells us, meaning can only be relational. Think about it; a single note on a piano means nothing, but a complex arrangement of notes, beautifully crafted and played with a little “je ne sais quoi”, and suddenly meaning comes into being.

It’s the relationships between the notes that impart meaning.

Meaning only reveals itself when you’re able to ‘stand back and see the bigger picture’. When you’re able to see the relationships between things, then you can ‘see’ what is going on. A forensic examination of the detail in a painting can’t help you understand anything if you don’t step back and take a look at the whole thing. So why should a forensic examination of decontextualised data help us illuminate the truth?

It won’t.

So it’s with great sadness, that I must tell you, that I’m about to do exactly that. But don’t worry, whatever I atoms I create, I will reconstruct them back into a meaningful whole. All shall make sense in the end.

Ready?

We’ll call this effect ‘looking glass thinking’, and I saw an example of which I’m thankful for, because when I saw it, my writing lit on fire again. Please, examine the singular kernel of data presented below. It’s a tweet from the BBC’s Rachel Schraer, a senior reporter for @BBCNews and @BBCTrending, and she covers health and misinformation. This all happened months ago now… but still …

Rachel was trying to reassure readers about a recent vaccine study If I could characterise the tweets, it was something along the lines of “Don’t worry, it has been spun into misinformation”. So was it all just hot air? Or can we derive meaning from it as a whole? Let’s cut to the chase - here is a handy AI summary of the paper.

• The study looked at cardiac troponin T (cTnT) levels in 777 healthcare workers before and after receiving an mRNA-1273 (Moderna) COVID-19 booster shot.

• They found that 40 people (5.1%) had elevated cTnT levels 3 days after the booster shot.

• After further evaluation, they determined that 22 people (2.8%) had vaccine-associated myocardial injury, defined as elevated cTnT without another identifiable cause.

• The vaccine-associated cTnT elevations were mild and temporary.

• Vaccine-associated myocardial injury was more common in women (20 cases) than men (2 cases).

• Compared to matched controls, the overall group getting the booster had higher cTnT levels after vaccination.

So there you have it. “Our findings confirmed the study hypothesis: mRNA-1273 booster vaccination-associated elevation of markers of myocardial injury occurred in about one out of 35 persons (2.8%).”

The researchers hypothesized they’d find the mRNA booster was associated with markers of heart damage, and that is exactly what they found. And the number of people it affected was significantly higher than expected. In case it wasn’t obvious, 1 in 35 is a high number.Enter, from stage left, Dr Susan Oliver.

Seeing that someone had explained these rather concerning findings to the public (heaven forbid), Dr Susan Oliver fired up her webcam to debunk it all. Heart damage be dammed, she smiled, played with her dog, and in a reassuring tone listed a number of increasingly stretched reasons why these findings don’t matter. Let’s focus on one of those reasons: elevated troponin levels can sometimes be found in people… who have just run a marathon. Cheerfully, she shows us a graph. Her kernel of data is true! Her suggestion, we can presume, is that perhaps, perhaps, these biomarkers of heart damage weren’t caused by the vaccine, but instead these unfortunate souls had run themselves to ruin in a marathon.

Firstly, what Susan didn’t tell you, was that she had cropped the data to show exactly half of it. The full graphic tells us that 24 hours after running a marathon, the elevated troponin levels return to baseline. So, applying that to the 22 people in this study, how do we explain the elevated troponin levels detected 72 hours after the booster was administered. It suggests either a delayed reaction to the vaccine, a prolonged reaction, or as Dr Susan suggested, that these 22 people ran a marathon exactly 48 hours after they got their booster shot.

The full image of the study shows us that troponin increases occur in 50% of marathon runners, but they return to baseline within around 24 hours.

Let’s be diplomatic and call this ‘highly unlikely’. Why? Because the investigators were actively looking for these exact things. They actually found elevated troponin levels in 40 participants in the study. But “in 18 of them… an alternative cause was considered most likely.” So, the investigators worked hard to find alternative causes of elevated troponin, and nearly 50% of the cases were excluded. Can we safely presume that running a marathon the day before would have triggered that exclusion?! That our investigators are not complete idiots? The paper quite literally says the elevated troponin in the 22 people was ‘without evidence of an alternative cause.’

Sigh.

Needless to say, this little kernel of insight was thrown out into the universe, and a whopping 8,400 people watched the explanation on Dr Susan Oliver’s YouTube channel. That could have been the end of the story, but as you saw, a BBC reporter picked the video up and used its arguments as the basis for the tweet. A ‘single truth’, that marathon runners can sometimes get elevated troponin, was used to obscure a complex truth, that one in 35 people had biomarkers of heart damage associated with the mRNA Moderna Booster.

We hear from Dr Susan that elevated troponin levels are no big deal, and Rachel Schraer at the BBC amplified the idea in her tweet: elevated troponin doesn’t matter, it happens after exercise. Which, on its own, is true. But understanding what’s going on requires looking at the whole, and we’re now living in a culture that seems less capable of doing that. Sure, we could come up with a way to ignore elevated troponin levels being associated with one in 35 people, because maybe the investigators missed other causes despite looking for them. Maybe they had elevated troponin levels anyway. But what happens when we map this finding onto other things? What happens when we put down our ‘singular piece of truth’ and instead see it as part of bigger picture?

Does a complex reality come into focus? Is it because the answer is yes that we see such absurd thinking tactics which ensure reality can only ever be seen a single note on piano. What happens when we do the opposite, and try and put all the notes in the right place?

This is a thread I’d like to continue. Comments open.