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A few predictions as to what happens to the process of science/ med after COVID whimpers to an end
1. The Journal market for COVID publications is going to hit rock bottom. It will be hard to publish some articles anywhere
1. The Journal market for COVID publications is going to hit rock bottom. It will be hard to publish some articles anywhere
2. Caveat: Well powered RCTs of therapies will still find a home in good journals, but much of the rest will be hard to publish
3. Grant money given for COVID will be redirected towards what the investigator wanted to do all along :)
4. Preprint servers will enjoy a new popularity, though not quite as high as in the times of COVID.
Canonical, forced move, & 'two labs racing' sort of papers will be more likely to be preprinted than quirky observations
Canonical, forced move, & 'two labs racing' sort of papers will be more likely to be preprinted than quirky observations
5. The US therapeutic clinical trials infrastructure, which frankly failed in comparison to efforts like RECOVERY & SOLIDARITY, will make no substantive reform, and the US will lag behind in the decade to come
6. Doctors will still treat patients with off-label therapies, titrating the lack of evidence to their emotions of fear and uncertainty; ignoring the lessons of HCQ, and anticoag in severe COVID
7. We will invent a department that focuses on Long Term Societal Disruption from 2020-- 100,000 papers will document the impact of school closures alone. 98% will report horrible things
Some will say they never wanted school closures, but remained silent or worse
Some will say they never wanted school closures, but remained silent or worse
8. 50% of twitter COVID pundits will try to spin their brand into fear-mongering about the news de jour, and the other 50% will return to their day jobs
9. Many will be surprised by the utter lack of interest as they return to study topics that they focus on.
Some may wonder why no one is interested in reading about the health impact of one Latvian city's taxi cab reforms
Some may wonder why no one is interested in reading about the health impact of one Latvian city's taxi cab reforms
10. There will be unfollows
11. In person conferences & burning jet fuel to get there will rise to an all time high; There will never be more travel.
It will be the Scientific Roaring Twenties
It will be the Scientific Roaring Twenties
12. The conduct of certain types of topical, policy oriented science will become increasingly political. (as Flier & I warned in April)
This will lead to greater polarization, lack of shared facts, and intractable disagreements
This will lead to greater polarization, lack of shared facts, and intractable disagreements
13. Lucky #13. Both #7 and #12 will contribute to societal & political instability (but enough of that... this is a thread on the scientific impact)
14. Many many many books will be written about the science of the pandemic; some may even be good
15. The OWS philosophy will be extended to other diseases: cancers and rare diseases, and further subsidize the biopharma industry. Much like AA was expanded.
This will be hotly debated & IMO will be a net disservice
This will be hotly debated & IMO will be a net disservice
16. Public health as a service industry vs enforcement agency will be philosophically debated. There will be two camps.
17. Information vs misinformation will be further explored. All biomedical topics could impact lives, and some points of view are held by minorities. Discussion on these issues will be challenging and giant tech companies will be lobbied to, and increasingly police.
18. Many published articles on sars cov 2 were erroneous or unsupported (ppi and risk of covid) -- less than 1 in 1000 of these will be corrected or retracted
19. A massive, well done pooled analysis of covid RF will finally be published. Age, socioeconomics, race, inequality, gender, availability of health care and poor underlying health will emerge as consistent signals. (There will be no surprises)
20. A massive pooled analysis of who got access to the vaccine first will be published and show it was diametrically opposite to risk-- at least in the unequal (and worsening unequal) USA.
21. Us health centers, reeling from loss of capital, will Aggressively (like nothing you have seen before) perform low value care & screenings.
Putting people who recovered from covid into scanners to look for problems will become it's own subspecialty (no control group)
Putting people who recovered from covid into scanners to look for problems will become it's own subspecialty (no control group)
22. All scientific articles have a citation decay curve (a period of gradually less and less citation) e.g. of a pooled curve 
For covid papers, the decay curve will look like the grand canyon (HT @mikejohansenmd - and for most papers that is as it should be)
For covid papers, the decay curve will look like the grand canyon (HT @mikejohansenmd - and for most papers that is as it should be)
