iiinova — where your digital self keeps evolving

What is the real cause of the autism and ADHD epidemics? It's not what RFK Jr thinks. In fact, it's incredibly simple and mostly to do with how we define and assess the conditions. My new piece: gidmk.substack.com/p/the-real-c...

The Real Cause Of The Autism And ADHD Epidemic

It’s not what you think.

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I very much understand coming from a place where a terrible thing has happened to you and feeling more cautious because of it - we all have trauma - but I don't think that the data supports people being concerned of LC in their daily lives in 2026.

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But even in a worst case scenario, that puts the likelihood of someone experiencing significantly activity-limiting LC at somewhere in the region of 1 in 2500 per year. I suspect it's below that at this point, but it could certainly be that high.

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Of those cases of LC, around 1 in 5 - or 1 in 500 infections - will result in LC that is significantly activity-limiting. At this point, it's hard to estimate the rate of infection in the population. I've seen people saying everywhere from 5%-20% of the population is getting COVID-19 each year.

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I wrote about the likely incidence per infection of LC using the best available data back in 2023. I don't think there has been any new robust datasets released since then, making this imo the best current estimate. It's around 1 per 100 infections: gidmk.substack.com/p/the-ongoin...

The Ongoing Risk Of Long COVID

What are the rates of ongoing COVID-19 symptoms in 2023 and beyond?

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That means that the figures in this paper give us no idea of the rate of LC either in the population now or per infection. (As a side-note, RECOVER also recruited people who'd had past infections so even if it was a measure of prevalence it would not be useful for incidence).

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This study evaluated the impact of aging on the frequency and prevalent symptoms of Long COVID, also termed post-acute sequelae of SARS-CoV-2, using a previously developed Long COVID research index (L...

Take the RECOVER study as an example. I believe this is the one that you mean: pmc.ncbi.nlm.nih.gov/articles/PMC... The RECOVER cohort was never intended to be a measure of either incidence or prevalence of LC. The authors intentionally oversampled people with LC to have more of them in the study

pmc.ncbi.nlm.nih.gov

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Elisabeth Bik @elisabethbik.bsky.social · 29/09/2026

I'm really sorry to hear that you are unwell. That sucks! In terms of the statistics, however, I manifestly disagree. I think that you are overestimating the incidence of LC by at least an order of magnitude there.

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Reposted by Health Nerd

Boot Camp Promises a Submitted Paper in Just 2 Days— Critics worry AI-aided program enables shoddy research "Systematic Review and Meta-Analysis in 1 Weekend" @rachrobertson.bsky.social reports @medpagetoday.com Quotes by Matt Spick, @gidmk.bsky.social, and me. www.medpagetoday.com/special-repo...

medpagetoday.com

Boot Camp Promises a Submitted Paper in Just 2 Days

Critics worry AI-aided program enables shoddy research

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Health Nerd @gidmk.bsky.social · 28/09/2026

I talked about Long COVID several times and referenced two much longer pieces which go into more detail. Age is also the biggest risk factor for Long COVID.

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Always fun to come on to Bluesky to say things about COVID-19 that are totally uncontroversial everywhere else only to get unhinged rants about how WeRe STilL iN a PaNdEMiC

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I'm still most interested in you being specific with your various veiled insults. Can you tell me what you meant by "quite calculated"?

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Oh, also, the implication that I'm a "pseudoscience weirdo". Feels like the sort of thing that an adult who cares about basic integrity might apologize for.

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That is the clear implication of your first post: bsky.app/profile/domi... I'm interested to know what you mean by "quite calculated". Please be specific.

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Fair enough, I was mostly talking about your graph. Perhaps you should also take back the implication that I'm insane and living in a different reality for making statements that the data you have cited largely supports.

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This is mirrored in datasets such as there longitudinal wastewater data from the Netherlands which shows exponentially lower rates of COVID-19 year on year as I noted in my article. So MUCH lower incidence of COVID-19 and lower incidence per infection.

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In NSW where I live, COVID-19 and influenza tests are generally run at the same time. While positives are still not a great estimate of incidence, they are nevertheless excellent estimates of RELATIVE incidence for this reason. Influenza is at normal levels, COVID-19 has geometrically decreased

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Not about COVID-19 incidence, about the incidence of LC per infection compared to Long Flu. And you asked for solid data and then presented completely arbitrary extrapolations based on your own personal assumptions which are at best not well supported so...

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That being said, given that there are less than half the number of COVID-19 infections per year in solid datasets like NSW, it would take staggeringly high rates of LC for it to still be causing more long-term illness than influenza in 2026.

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Worth noting of course that the absence of data also means that anyone claiming the opposite - that COVID-19 has worse long-term outcomes - is not basing this on real evidence. I think it's a matter of debate at this point.

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...albeit with slightly higher incidence for COVID-19 from 2022, it would be extremely surprising to me if COVID-19 was still causing more significant disease. It's possible, but I think very unlikely.

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Complete speculation on my part, that's why I said "I think". What we can say from the data is that Long COVID has decreased substantially as an issue and that COVID-19 itself is much less severe than influenza. Given the data showing similar long-term outcomes from both diseases

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I linked to the data in my piece, I think it's quite compelling.

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That article is reasonable but the headline is VERY misleading. I'd suggest reading the actual research, it doesn't show what you think it does.

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I understand completely! I don't think that masking is an inherently ridiculous thing to do, just that mask mandates don't really have a place these days in most settings (particularly a bar).

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New piece on the Last Ditch bar shenanigans and how it's remarkable that some people are still misattributing COVID-19 risk. gidmk.substack.com/p/the-last-d...

The Last Ditch Mask Fight: What Are The Risks of COVID-19 in 2026?

A discussion that we’re still somehow having

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In contrast, a 45yo is at around ten times the risk of a 25yo on average.

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There are definitely risk increases caused by disability, but the increases were dwarfed by the risk from age. A blind wheelchair user with POTS, diabetes, and an amputation would be at about double the risk of death or serious disease to someone the same age as them.

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Disability was NEVER a major risk factor for COVID-19. The biggest risk factor was always age BY FAR. COVID-19 also hasn't been a primary health concern for years!

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The lesbian bar/masking story is wild for many reasons, but most of all because it shows the deeply bizarre beliefs people still hold about COVID-19, disability, and risk in 2026.

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Meanwhile, you're damaging the entire purpose of a bar existing in the first place: social connection.

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The risk difference caused by wearing masks to a bar - a place where people eat, drink, and, uh, make merry - is extremely small. I would not be surprised if the benefit was genuinely too small to measure outside of perhaps the height of flu season.

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The wildest part of this story is that there are bars enforcing masking regulations in 2026 at all.

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Bars area places for socialising. Masks make that quite a bit harder.

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Matthew B. Jané @matthewbjane.bsky.social · 20/09/2026

...maybe? Probably not going to make a great difference in risk but it would do something. The bigger question is why would you enforce a policy like this in 2026. Outside of the peak of flu season, the impact is going to be extremely small and the negatives are pretty big.

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Reposted by Health Nerd

The Audit Clinical Evidence (ACE) Initiative posted an update to the first audit report (wrt Abdelbasset et al 2019). @gidmk.bsky.social found some additional errors in the baseline tables that have now been included in the report. auditclinicalevidence.org/reports/ACE2...

auditclinicalevidence.org

Audit of Abdelbasset et al. (2019) – ACE

Three 2019 RCTs on exercise for depression in heart failure: overlapping trial arms, duplicated PHQ-9 data, impossible statistics and baseline p-values. 25 integrity violations; retraction recommended...

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Health Nerd @gidmk.bsky.social · 20/09/2026

I think it's even more limited when we're talking medical trials. There is almost no plausible way to get Cohen's d>2 for most biological variables in a randomized trial. For context, the effect sizes of high-dose Ozempic on blood sugar and weight sit around 1.5

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Health Nerd @gidmk.bsky.social · 18/09/2026

It might not be sufficient to trigger editorial action but I reckon it would/will still be quite a scandal.

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Health Nerd @gidmk.bsky.social · 18/09/2026

For some stuff, this won't matter. For scientific research, it really will. Sooner or later, someone is going to run 2024/5/6 etc papers through the leading detection model. I wonder what will happen then?

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Health Nerd @gidmk.bsky.social · 18/09/2026

A thought: current AI writing detection cannot always consistently identify current frontier model writing. HOWEVER, future models will almost certainly be able to identify AI writing from current models. So the chances that someone will get caught using AI without declaring it rises

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Health Nerd @gidmk.bsky.social · 16/09/2026

Me: I'm a serious scientist reading a very serious paper. Also me: FOLLOWING BUTTS

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Health Nerd @gidmk.bsky.social · 15/09/2026

New piece on a great project from @matthewbjane.bsky.social looking at problematic research. Also, extremely worrisome issues in studies of exercise for depression. gidmk.substack.com/p/how-do-we-...