Given a paragraph and a claim, classify it this way: If the claim contradicts the evidence present in the paragraph, classify the claim as '0'. If the claim has multiple supporting *AND* contradicting evidences, classify the claim as '1'. If the claim has supporting evidence and the paragraph is in overall favor of the claim, then classify the claim as '2'.

Ex Input:
Paragraph: In recent weeks, vaccine opponents have made several unsubstantiated claims, including allegations that vaccine trials will be dangerously rushed or that Dr. Anthony Fauci, the nation’s top infectious diseases expert, is blocking cures to enrich vaccine makers. They’ve also falsely claimed that Microsoft founder Bill Gates wants to use a vaccine to inject microchips into people — or to cull 15% of the world’s population. Vaccine opponents in the U.S. have been around for a long time. Their claims range from relatively modest safety concerns about specific vaccines or the risk of side effects to conspiracy theories that border on the bizarre. The movement is receiving renewed attention, especially as it aligns itself with groups loudly protesting restrictions on daily life aimed at controlling the spread of the virus. Health professionals say vaccine misinformation could have lethal consequences if it leads people to opt for bogus cures instead. “Only a coronavirus vaccine can truly protect us from future outbreaks,” said Dr. Scott Ratzan, a physician and medical misinformation expert at the City University of New York and Columbia University. “But what if the effort succeeds and large numbers of people decide not to vaccinate themselves or their children?” While vaccines for diseases such as polio, smallpox and measles have benefited millions, some skeptics reject the science, citing a distrust of modern medicine and government. Others say mandatory vaccine requirements violate their religious freedom. Rita Palma, the leader of the anti-vaccine group in Long Island called My Kids, My Choice, is among those who say their families won’t get the coronavirus vaccine. “Many of us are anxiety stricken at the thought of being forced to get a vaccine,” Palma said. “I will never choose to have a COVID-19 vaccine. I don’t want the government forcing it on my community or my family.” From the outset of the coronavirus pandemic, vaccine skeptics have tailored several long-standing claims about vaccine safety to fit the current outbreak. When the first U.S. case was announced in January, some alleged the coronavirus was manufactured and that patents for it could be found online. Thousands of deaths later, vaccine opponents are endorsing unapproved treatments, second-guessing medical experts and pushing fears about mandatory vaccinations. They’ve also latched onto protests against stay-at-home orders in the U.S. “The coronavirus has created this perfect storm of misinformation,” remarked David A. Broniatowski, an associate professor at George Washington University’s school of engineering and applied science who has published several studies on vaccine misinformation. Last week, an anti-vaccine activist was arrested in Idaho after repeatedly refusing police orders to leave a playground closed because of the pandemic. The woman, who was there with other families, is affiliated with two groups that protested at the Idaho Statehouse against stay-at-home orders. Facebook groups formed to organize the protests have been peppered with vaccine hoaxes and myths. Perhaps no one plays a bigger role in the conspiracy theories than Gates, who is funding vaccine research. The online movement has centered concerns around a COVID-19 vaccine on false claims that Gates is planning to microchip people with the vaccine or use it to reduce the world’s population. Robert F. Kennedy Jr., a vaccine critic who helped popularize unsubstantiated claims that vaccines can cause autism, said Gates’ work gives him “dictatorial control of global health policy.” Roger Stone, a former adviser to President Donald Trump, went further on a New York City radio show, saying Gates “and other globalists” are using the coronavirus “for mandatory vaccinations and microchipping people.” Such wild theories can have real-world effects. False rumors that Gates hoped to test an experimental vaccine in South Africa became mainstream after a news site erroneously reported the claim. One of the country’s political parties then sent a letter to President Cyril Rampahosa demanding answers about “deals” struck with Gates. In fact, Gates and his wife are financing a vaccine trial in Philadelphia and Kansas City, Missouri, not South Africa. He also suggested creating a database of people immune to the virus, not implanting microchips. On Monday, during remarks recognizing World Immunization Week, World Health Organization Director-General Tedros Adhanom Ghebreyesus criticized vaccine skeptics for spreading misinformation at a time when many families are delaying or skipping routine childhood immunizations because they’re afraid of COVID-19 exposure in doctors’ offices. “Myths and misinformation about vaccines are adding fuel to the fire,” he said. Health experts have repeatedly said there is no evidence the coronavirus was intentionally created or spread. They also insist that vaccines are not only safe, but essential to global health. “Vaccine researchers and anyone who is a vaccine advocate cares deeply about vaccine safety,” said Dr. Paul Offit, a Children’s Hospital of Philadelphia physician and co-inventor of a vaccine for rotavirus, which kills hundreds of thousands of children annually. For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough, that clear up in two to three weeks. But it can cause more severe illness, including pneumonia, and death for some people, especially older adults and people with existing health problems. The vaccine debate is fertile ground for groups looking to sow discord in the United States. Russia seized on it to create divisions before the 2016 U.S. election, and appears to be at it again. A report from a European Union disinformation task force found numerous conspiracy theories in English-language Russian media, including state-run RT, claiming an eventual vaccine will be used to inject nanoparticles into people. “When pro-Kremlin disinformation outlets spread anti-vaccine tropes, they become responsible for those who will hesitate to seek professional medical care,” the EU report said. Claim: Groups sow doubt about COVID vaccine before one even exists.

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2


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Paragraph: There is no mention of costs for the surgical implants or any of the other treatment methods. Whether insurers are likely to cover such treatments and whether they cover current treatment approaches would have been helpful information as well. The cost of medical devices needs to be considered for a host of reasons. A similar technology (vagal nerve stimulation) costs about $20,000 and could have been used as a useful example. No data on benefits are given for the “undisputed best treatment, called CPAP. ” Regarding the new devices, because they are in early studies, any suggestion of benefit must be made carefully. While a number of provisos were included in the story, the single patient anecdote and the “What we’re looking for is actually cure” quote from one of the investigators provide the reader with an imbalanced perspective. There is no mention of potential harms. This is troubling because the devices described would require a surgery. To be eligible for one of the devices, a person would need to undergo some fairly extensive testing, much of which is rather unpleasant, including having “a tube snaked down the airway” to see whether their sleep apnea  is being caused by a qualifying condition. The device is surgically implanted in the chest with wires run up the neck and into the base of the tongue. Once implanted the device now needs to be programmed to deliver the stimulation at the right time. There is a potential for nerve damage with long term use and the devices (as we have learned from the recent recall of heart defibrillator leads) are not infallible. There is no attempt to evaluate the quality of the evidence. We are given one anecdote of a man presumably enrolled in a clinical trial, but we don’t learn how much research has been done – only that a “key study” of 100 people is planned. There is also no evaluation of the evidence for “today’s undisputed best treatment, called CPAP” – only estimates of how many people won’t or can’t use it. This lead made us stop in our tracks. “Loud snoring may do more than irritate your spouse: It can signal sleep apnea, depriving you of enough zzzz’s to trigger a car crash, even a heart attack.” Car crashes and heart attacks? This sounds like a national emergency. The story goes on to say, “More than 12 million Americans have obstructive sleep apnea, according to the National Institutes of Health….Yet going untreated is more dangerous than just feeling tired. Sleep apnea stresses the body in ways that increase the risk of high blood pressure, heart attack, stroke and diabetes. More immediately, severe apnea increases the chance of a car crash sevenfold. Last year, the National Transportation Safety Board recommended that pilots, truck drivers and other commercial transportation operators start being screened for apnea, saying it has been a factor in incidents involving every mode of transit.” How many incidents? Is sleep apnea more dangerous than, say, texting while driving? Without any context, these facts serve only to scare, not to inform. There are many quotes in this story but none comes from an independent source. Meir Kryger, a sleep medicine specialist at Gaylord Hospital in Connecticut, is the most quoted and is receiving money from Inspire Medical Systems, a device maker, for clinical trials. Rik Krohn, a 67-year-old from suburban Minneapolis (where the company is based – how was he chosen?) is quoted as a sleep apnea sufferer who may have been helped by the Inspire device. We’re not told what connection Dr. Rick Odland, Krohn’s surgeon at Minneapolis’ Hennepin County Medical Center, may have with the company. He is the co-founder of his own medical device company, Twin Star. There is apparently one independent perspective – a voice of caution relegated to the very end in a two sentence paraphrase. “These experiments are only now beginning, with a handful of implants performed so far—and while it’s an interesting concept, frustrated patients should try some proven steps first, cautions, Dr. Amy Atkeson of Columbia University Medical Center in New York. Her advice: Don’t give up on CPAP without first seeing an experienced sleep technician to adjust humidity levels and take other steps that not every CPAP prescriber knows to try—and if you’re overweight or obese, apnea greatly improves with weight loss.” The imbalance in the quotes provided, and the absence of any conflict of interest disclosure leads us to give an unsatisfactory score. The story does not do an adequate job comparing these devices to other treatments or to weight loss. The story ends with this brief statement:  “Don’t give up on CPAP without first seeing an experienced sleep technician to adjust humidity levels and take other steps that not every CPAP prescriber knows to try—and if you’re overweight or obese, apnea greatly improves with weight loss.” But, as noted, no data is given on CPAP’s benefits – only discussion of what doesn’t work with CPAP. And no data were given – only this one line – about the role of overweight, obesity, and weight loss in sleep apnea. The story provides a very good overview of the ongoing trials of the various companies’ devices and notes an upcoming clinical trial. The story makes it clear that there are several devices in competition to be the dominant sleep apnea device. “By the end of January, Minneapolis-based Inspire Medical Systems plans to begin enrolling 100 apnea patients in a key study in the U.S. and Europe to see if so-called hypoglossal nerve stimulation really could work. Two competitors are developing similar implants: ImThera Medical of San Diego says it hopes to begin U.S. studies later next year, and Apnex Medical of St. Paul, Minn., has announced some small-scale testing.” The story does not rely on a news release. Claim: Experiments test if implant can block sleep apnea

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0


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Paragraph: In January 2016, an event primarily dubbed the “Flint water crisis” (involving lead contamination in the city’s water supply at levels that posed a serious health danger) garnered national headlines. Although some details were murky as the situation unfolded, a number of items related to the crisis were circulated worldwide via social media. The undisputed core of the public health crisis was summed up by the New York Times‘ report that “[h]igh levels of lead had leached from pipes into the water supply” in Flint in a period beginning around April 2014:  Among the items related to the water crisis that circulated online was a piece from the Free Thought Project titled “Flint Residents Told That Their Children Could Be Taken Away If They Don’t Pay for City’s Poison Water”: There is no denying that the water in Flint is undrinkable and that it is contaminated with lead and other substances, and it is clear that the government of Flint is responsible for the problem. However, the city’s government continues to charge people for the poison water and then threatening to foreclose their home or take their children if they refuse to pay. Michigan law states that parents are neglectful if they do not have running water in their home, and if they chose not to pay for water they can’t drink anyway, then they could be guilty of child endangerment. Activists in Flint say that some residents have already received similar threats from the government if they refuse to pay their bills … Flint residents have recently filed two class action lawsuits calling for all water bills since April of 2014 to be considered null and void because of the fact that the water was poisonous. “Essentially, the residents have been getting billed for water that they cannot use. Because of that, we do not feel that is a fair way to treat the residents,” [attorney Trachelle] Young added … Despite the fact that the issue is obviously the government’s responsibility, they have made it illegal for people to sell their homes because of the fact that they are known to carry contaminated water. Meanwhile, residents are still left to purchase bottled water on their own, in addition to paying their water bill. The article confusingly vacillated between assertions supported by a largely undisputed chain of events (i.e., the water supply in Flint had been compromised for some time, and its effect on families was severe) with alarming but unsubstantiated claims (i.e., CPS was threatening to remove children affected by the crisis). The headline clearly stated that residents of Flint had been threatened with the intervention of Michigan’s Children’s Protective Services (CPS) agency if they refused to pay for water that was clearly not potable, but we were unable to locate any other account reporting on what would be an extraordinary scenario. The Free Thought Project excerpt reproduced above was the sole source for this otherwise uncited claim. A careful reading of the text suggests that the site perhaps extrapolated two unrelated factual items to form a third hypothetical conclusion: It was true the Flint water crisis was unresolved at the time the article was published, and that Michigan’s Department of Health & Human Services’ (MDHHS) list of possible red flags for child abuse or neglect allows the inference that a lack of running water in a home is grounds for investigation and removal of children. Page 15 of a publicly available document titled “Mandated Reporters’ Resource Guide” [PDF] further describes scenarios under which mandated reporters are obligated to contact CPS and file a report. Appendix 2, Section I (physical neglect), portion A pertains to neglect with respect to living conditions: under a list of items by which mandated reporters can observe potential conditions of neglect, “running water in the home” is listed as a potential signifier. As such, the above-excerpted item quite possibly extrapolated its conclusion based on the existence of the Flint water crisis and demonstrated standards of child abuse and neglect evidenced by Michigan’s documentation of those criteria. If so, the item made a significant leap between something that could conceivably happen (children’s being removed from homes due to a lack of running water under normal circumstances) and something that might be far less likely to happen (CPS’ tasking itself with imposing upon the crisis in the city of Flint by using its scant resources to target families and children already burdened by an ongoing and unprecedented contamination of Flint’s water supply). We were unable to find any other reporting of such claims aside from ones citing The Free Thought Project, nor could we locate any independent, anecdotal reports claiming that CPS was removing children from homes “without running water” in Flint. We contacted several divisions of MDHHS to determine whether there was any truth to the claim that CPS has removed children for reasons directly related to the Flint water crisis, or whether any such information or demands had been transmitted to families in Flint with respect to the water crisis. Under normal circumstances, the lack of running water in a home could certainly serve as grounds to initiate an investigation or even trigger removal of children from their home until basic living conditions are restored to the satisfaction of agencies tasked with ensuring children are safe from abusive or neglectful homes. Given widespread coverage of the Flint water crisis and its ongoing nature, the assertion doesn’t make much plausible sense (nor does it seem likely CPS could have the manpower to engage in such a large undertaking). The existence of such a crisis in Flint and its effect on the city’s residents are not in dispute and reasonably warrant alarm, but unsupported claims exacerbating concern and anxiety are not helpful to the residents of Flint or other people seeking credible information about the extent of an ongoing public health incident. In response to our inquiry, a representative from Michigan’s Department of Health & Human Services confirmed children are not removed from homes solely due to a lack of running water (due to the current situation in Flint, or otherwise): We do not petition a court for removal solely because of lack of water. Instead CPS works to make sure the children have water – by having them apply for State Emergency Relief, or making sure they have access to water at a relatives’ home or bottled water. On 26 January 2016, MDHHS Children’s Services Agency provided us with a statement from executive director Steve Yager. Yager’s statement confirmed no such complaints or removals occurred due to the Flint water crisis: MDHHS has not assigned a single Children’s Protective Services complaint due to any issues related to Flint water. MDHHS works proactively to assist families whose water is shut off and to ensure families have water filters and bottled water in Flint. When a family is without water, our goal is to help that family provide clean water for their children. That can be through assisting families in applying for State Emergency Relief, setting up plans for children to access safe water at a relative’s home or providing bottled water. We do not petition the court to remove a child solely for the lack of water in a family’s home. We also contacted the author of the original The Free Thought Project article for additional information supporting the claim. He directed us to the above-quoted MDHHS guidelines, as well as the article’s embedded RT video. In that clip, a Flint resident speculated that refusal to pay water bills could result in the eventual removal of children due to a lack of running water in the home: Claim: Residents of Flint, Michigan have been threatened by CPS with removal of their children if they refuse to pay for contaminated water.

Ex Output:

0