I first wrote about the Great Barrington Declaration (GBD) not long after it was first published, way back during a time that now seems like ancient history, October 2020. At the time, I likened the GBD to similar “declarations” and petitions issued by other science deniers, such as HIV/AIDS deniers and climate science deniers, because “magnified minority” documents like this are designed to provide a patina of apparent scientific legitimacy to their antiscience declarations. Science deniers accomplish this by recruiting useful idiots in the form of scientists who are true believers in the declaration (in this case the GBD) write the declaration and then enticing physicians and scientists, the vast majority of whom have little or no expertise in the relevant scientific fields, sign the document, the more the better. The result is a document that other believers can cite as evidence for scientific support for their views. Basically, the GBD, and other documents like it, follow a script that was first pioneered by tobacco companies trying to show that their products were not causing cancer and all sorts of other health problems.
Of course, the useful idiots, true believers, and financial forces who used them to spread their propaganda don’t like having the true nature of declarations like the GBD discussed openly. They tend to react rather defensively to having light shown on them. In this case, the GBD was the result of a right wing “free market” think tank known as the American Institute for Economic Research (AIER), who invited a true believing Harvard scientist named Martin Kulldorff to its headquarters in Great Barrington, MA, after which Kulldorff recruited like-minded scientists (Jay Bhattacharya of Stanford University and Sunetra Gupta of Oxford University) to a second—and much bigger—weekend meeting at AIER headquarters. The idea behind the GBD, which was published before vaccines against COVID-19 were even available, was a “let ‘er rip” approach to COVID-19 among they young and “low risk” population in order to reach “natural herd immunity” faster, reserving “focused protection” (an ill-defined strategy”) for those at high risk of severe disease, hospitalization, and death from COVID-19 (e.g., the elderly and those with chronic health conditions that make them high risk, like type II diabetes). It was clearly a strategy that wouldn’t work, as we knew even then, because, even when it blunts a pandemic, the price of natural herd immunity (thanks to “natural immunity” to COVID-19 due to prior infection) is too high in terms of death and suffering. Also, as was suspected even in October 2020, there is always the potential for variants to arise that can evade the immune system, a prediction borne out by the Delta and, more so, the Omicron waves.
The GBD strikes again…
The last time involving me that the connections between right wing dark money think tanks and the GBD were pointed out in The BMJ last fall, particularly how the GBD was astroturf, the GBD struck back. Now, six months later, GBD authors and the AIER are reacting again to renewed criticism by…striking back. Two examples attracted Orac’s attention, first an article by Dr. Bhattacharya published in Bari Weiss’ Substack:
As I’ve mentioned before, even though it does have a lot of excellent content (e.g., Yale historian Timothy Snyder’s blog) Substack is also, unfortunately, the new wretched hive of scum and quackery for antivaxxers, COVID-19 contrarians, and general right wing conspiracy theorists, including Bari Weiss. It is thus unsurprising that Dr. Bhattacharya would choose to publish there.
Also, as others pointed out, the GBD has been, contrary to the narrative of its authors and proponents being “silenced” or “canceled,” very influential, with GBD authors and supporters meeting with US President Donald Trump and UK Prime Minister Boris Johnson’s administration.
It isn’t just Dr. Bhattacharya, either. It’s also Phil Magness, Senior Research Faculty and Research and Education Director at AIER and a particularly odious Twitter presence. It turns out that he really, really didn’t like the comparison of AIER’s offspring the GBD to tobacco company disinformation tactics 50 years ago:
I can’t help but note the massive straw man here. Neither Gavin Yamey nor I actually made that argument, at least not exactly. (Let’s just say that Mr. Magness left out some context.) Don’t believe me? Here’s a link to the article, Covid-19 and the new merchants of doubt. Actually, that’s not the article to which Mr. Magness linked in his rant, but it is the one he has always targeted because it’s really, really chapped AIER’s posterior ever since it was published and was the provocation that led AIER to strike back the first time. This time, Mr. Magness is reacting to a Rapid Response written in response to John Ioannidis’ execrable “science Kardashians” article. (I won’t dignify it by referring to it as a “study., given how awful it was in trying to discredit scientists who spoke out in opposition to the GBD.) You might recall that BMJ Rapid Responses are basically letters to the editor, with, in contrast to traditional letters to the editor, very little gatekeeping determining which ones are published.
Here is the passage that particularly irritates Mr. Magness:
It is now well documented that the GBD received major support from the AIER [20,21]. Indeed, the key scientist involved, Martin Kulldorff, was recruited by the AIER, which invited him for a long weekend to socialize with like-minded people . Soon after, Kuldorff and the AIER invited Jay Bhattacharya and Sunetra Gupta to a weekend conference at the AIER headquarters. There, AIER wined and dined the GBD authors, provided meeting space and lodging, arranged a meeting with journalists, and provided editorial feedback in drafting the declaration. The AIER also provided tools to amplify the message of the GBD, including professional videography of the interviews, social media expertise, and web services that allowed the rapid creation of a website for the GBD. Moreover, AIER is funded through an investment fund that itself owns shares in tobacco companies and many organizations that stood to lose enormous amounts of money if the United States were to have enacted further lockdowns in 2020 . This represents a large intellectual and financial CoI for the AIER, which was closely involved in the GBD creation. This cannot and should not be ignored in any objective analysis.
One notes that Dr. Kulldorff ultimately left Harvard and accepted a position as the scientific director at the Brownstone Institute, an AIER-like think tank dubbed by its founder Jeffrey Tucker as the “spiritual child” of the GBD and that Dr. Bhattacharya accepted an appointment as a senior scholar at the same think tank.
I referred to the GBD as “magnified minority,” a name indicating how such documents try to magnify the voices of a fringe viewpoint and represent them as mainstream. Mr. Magness’ response is is more an example of attacking a “magnified minority” part of a criticism, trying to discredit it and thereby—or so they think—discredit the entire criticism:
Indeed, it is the BMJ’s own published policy to specifically exclude “mutual funds or other situations in which the person is not in a position to control investment decisions” from its financial conflict of interest reporting requirements in published scientific research. This exclusion stems from a longstanding convention in the scientific community. The fact that you have a standard retirement account is not disqualifying of your research, because these instruments are specifically designed to maintain diversified and independently managed investments. The National Institutes of Health and most other agencies involved in medical research have similar exemptions for mutual funds and related investment vehicles. Stated differently, a mutual fund is specifically designed to ensure the long-term stability and growth of the portfolio as a whole – not to induce and manipulate short-term gains for a couple of individual stocks among the hundreds of companies that it holds.
I’ve written before how a favorite crank technique is to co-opt a legal argument known as falsus in uno, falsus in omnibus. In law, falsus in uno, falsus in omnibus, put quite simply, means “false in one thing, false in all things.” It’s a legal principle that dates back to ancient Rome that assumes that a witness who is false about one matter can be considered to be not credible in all matters. This principle is why lawyers are often so aggressive at trying to impeach the credibility of a witness and why lawyers on the other side labor so hard to prevent that from happening. If a witness can be shown to have been badly mistaken‚—or, even more damning—to have lied about one thing, then by the principle of falsus in uno, falsus in omnibus it is considered reasonable to question everything else in that witness’ testimony, no matter how trivial the “one false thing” was. In a criminal case such questions could easily be enough to cast “reasonable doubt” on the testimony. As I’ve pointed out before, science doesn’t work that way. Also, falsus in uno, falsus in omnibus is, at its core, dichotomous thinking. Either every part of an argument is 100% true and correct, or it’s all false. Either all evidence supports a conclusion, or the conclusion is false, and if anyone ever in history involved in supporting an argument has ever lied about anything or been very much mistaken, then the whole body of evidence can be called into question. That’s exactly what Mr. Magness is doing here, trying to call into doubt all the other conflicts of interest.
As grudgingly admitted in his article, what the criticism in the Rapid Response discusses is undeniably true. One can argue the fine point of whether having tobacco company holdings in an investment fund owned by a think tank that brought together the authors of the GBD being defended against attacks in an article is a major financial COI, but I find Mr. Magness’ retort less compelling even than that consideration given that, as we discussed in the earlier article:
This declaration arose out of a conference hosted by the American Institute for Economic Research (AIER), and has been heavily promoted by the AIER, a libertarian, climate-denialist, free market think tank that receives “a large bulk of its funding from its own investment activities, not least in fossil fuels, energy utilities, tobacco, technology and consumer goods.” The AIER’s American Investment Services Inc. runs a private fund that is valued at $284,492,000, with holdings in a wide range of fossil fuel companies (e.g. Chevron, ExxonMobil) and in the tobacco giant Philip Morris International. The AIER has also received funding from the Charles Koch Foundation, which was founded and is chaired by the right-wing billionaire industrialist known for promoting climate change denial and opposing regulations on business. Koch linked organisations have also opposed public health measures to curb the spread of covid-19.
Note how in his article Mr. Magness tries to make it sound as though AIER just innocently holds shares in an investment fund that just happens to include tobacco company stocks, much as you or I might innocently hold shares in a mutual fund that just happens to include tobacco company stocks in its portfolio, for example as part of an IRA or a 401(k). Let’s just put it this way. There’s a rather significant substantive difference between having a 401(k), which most employees can’t even choose, even if they can choose the distribution of contributions between stocks, bonds, etc., and a think tank actually running a mutual fund to help fund its operations. Given how he completely ignores all the other arguments, Mr. Magness is obviously trying to cast doubt on the entire criticisms of the GBD—and AIER, which birthed it—by obfuscating about about one small part of the criticism. Falsus in uno, falsus in omnibus, indeed, and not even really false at that! He also makes a lot of hay about how tobacco companies actually benefited from the “lockdowns” that AIER and GBD opposed, as if making an incorrect prediction about one thing invalidates everything, even if unrelated.
However, this bit of obfuscation allows Mr. Magness to pivot to some whataboutism:
This curious situation is further compounded by a stunning hypocrisy. The BMJ appears to only selectively exempt its contributors from its own financial standards, because it turns out that one of the authors of the attack on AIER has a far more direct connection to Big Tobacco than minor and indirect stock market investments.
Professor Yamey is currently employed at Duke University. Duke was famously founded out of the fortune of its namesake, tobacco baron James Buchanan Duke. Mr. Duke’s tobacco fortune provided the seed money that turned the university into a renowned research center. Duke’s tobacco-fueled endowment grew with the campus, and is now worth over $12 billion dollars.
While we should not begrudge Professor Yamey’s employer for its strong fiscal situation, we may legitimately ask: Is it not true that what’s good for the goose is also good for the gander?
I suppose that if you’re a propagandist and astroturfer like Mr. Magness, it would be—in the real world, not so much. Also, donating seed money to a university endowment, which the university can use for basically anything it wishes, is a rather different situation than using tobacco income to fund a right wing think tank. I also can’t help but note that, if Mr. Magness really wants to get into the weeds, the Duke University Endowment’s income was initially derived from investments in Duke Power Company stock, not the tobacco company. I won’t say that the Duke Endowment is completely without concern, but I will say that Mr. Magness leaves out some significant context and differences.
Again, this is nothing more than the logical fallacy known as tu quoque, a subtype of the logical fallacy known as the red herring. The idea is to distract from the criticism directed at you by redirecting the same criticism at the critic and charging hypocrisy. It’s a very common tactic used by conspiracy theorists and pseudoscience advocates to deflect criticism. (Politicians love it too.) Mr. Magness is basically claiming “persecution” for supposedly innocently doing nothing more than anyone else with tobacco company stocks in a retirement fund does.
The GBD strikes back…Dr. Bhattacharya’s turn
But what about Dr. Bhattacharya? He appears to be really, really peeved at the mockery he’s been getting lately on Twitter for having bragged about how he had asked Stanford University for a letter to allow him to work on campus as “essential personnel”:
Dr. Bhattacharya’s intent was obviously to deflect charges of hypocrisy over his frequent attempts to portray himself as a friend of the working class (especially restaurant and grocery store workers), who, in contrast to what he loves to call the “laptop class,” couldn’t work from home and suffered disproportionately from “lockdowns.” That’s right! No effete “laptop class” elite, he! He wanted to risk his life going to work in his office, where, if he wished, he could still close the door and work alone on his laptop, just not in his house! In any event, Dr. Bhattacharya’s bragging about this letter was just the most recent example of his amusingly tone deaf attempts to declare himself the advocate of the working class. He’s been doing it for several months now. Also note how, having been so roundly mocked—and deservedly so—for touting his letter (which he later deleted from Twitter), Dr. Bhattacharya is now saying that no one can determine who is and who is not “essential personnel.” Really? It’s not as though governments, healthcare facilities, and businesses haven’t been doing exactly that…forever.
That leads us to his article, in which he points to the most extreme lockdowns—indeed arguably the only example of real lockdowns, enforced by an authoritarian regime—in China, implicitly likening what China is doing to the “lockdowns” in the West, which were nowhere near as strict. He then likens what he’s suffered to the “stifling of scientific dissent” in an authoritarian regime like China:
In America, many of our officials still have not abandoned their delusions about Covid and the exercise of power this crisis has allowed. As the Shanghai debacle demonstrates, of all the many terrible consequences of our public health response to Covid, the stifling of dissenting scientific viewpoints by the state might be the most dangerous.
I would know: For the past two years I have been the target of a smear campaign aimed at demonizing those who dare to question official policy. Now, a proposed California law threatens to make such dissent career-ending by handing the state the power to strip medical licenses from doctors who disagree with government positions on Covid.
Before I get to this awful bill, let me explain what happened to me.
I can’t resist adding right here that this is the shorter Dr. Bhattacharya:
Also, his definition of “repression” is rather…questionable, as has been pointed out.
Still, it’s amusing to see where Dr. Bhattacharya goes with this, but to do so means to understand the California bill that he’s talking about, AB 2098, which states that it shall “constitute unprofessional conduct for a physician and surgeon to disseminate or promote misinformation or disinformation related to COVID-19, including false or misleading information regarding the nature and risks of the virus, its prevention and treatment; and the development, safety, and effectiveness of COVID-19 vaccines.” Unsurprisingly, Dr. Bhattacharya characterizes the bill as meaning that “physicians who deviate from an authorized set of beliefs would do so at risk to their medical license.” In reality, the law, if enacted, would empower the Medical Board of California and the Osteopathic Medical Board of California to take action against physicians who spread misinformation and disinformation about COVID-19 and COVID-19 vaccines, up to and including revoking their medical licenses.
I’ve long argued that state medical boards should have the power to delicense antivax physicians and quacks. Technically, they do, but only for actually treating patients based on such views. Even then, as the case of cancer quack Stanislaw Burzynski demonstrates, state medical boards only rarely do this and often fail when they do. That’s why I frequently refer to Dr. Burzynski when discussing the recent push to empower state medical boards to sanction physicians who promote dangerous COVID-19 misinformation and quackery and the expected resistance that mischaracterizes attempts to sanction abuse of professional speech as an issue of “persecution” for “free speech” that isn’t “state sanctioned.” It’s a tactic long used by quacks and antivaxxers when called to account for their quackery.
Dr. Bhattacharya is going in the same direction, portraying himself as “oppressed.” Invoking “magnified minority” and the number, rather than the quality, of signatories of the GBD, he writes:
Nearly a million people have signed our letter, including tens of thousands of doctors and scientists from over 40 countries. In other words, we were far from alone in our belief that this was the proper response to an unprecedented pandemic.
But the official response was swift and brutal.
Four days after we published the Great Barrington Declaration, Francis Collins, then director of the National Institutes of Health, wrote an email to Anthony Fauci calling the three of us “fringe epidemiologists.” He called for a press “takedown” of us when an open discussion of our ideas would have been more productive. Big tech outlets like Facebook and Google followed suit, suppressing our ideas, falsely deeming them “misinformation.” I started getting calls from reporters asking me why I wanted to “let the virus rip,” when I had proposed nothing of the sort. I was the target of racist attacks and death threats.
Despite the false, defamatory and sometimes frightening attacks, we stood firm. And today many of our positions have been amply vindicated. Yet the soul searching this episode should have caused among public health officials has largely failed to occur. Instead, the lesson seems to be: Dissent at your own risk.
And, no, the GBD has not been “amply vindicated.” Quite the opposite! If there’s one thing that the last several months have taught us, it’s that “natural immunity” will not get us out of the pandemic. “Natural immunity” has been shown to be at best, not much longer lasting or robust than vaccine-induced immunity, if even that. Certainly Omicron can evade waning immunity from prior infections roughly as well as it can evade waning vaccine-induced immunity. The “natural herd immunity” that the GBD touted as the solution to the pandemic was always a pipe dream. The Delta and Omicron waves just demonstrated it.
Not that that stops Dr. Bhattacharya:
What is abundantly clear is that this bill represents a chilling interference with the practice of medicine. The bill itself is full of misinformation and a demonstration of what a disaster it would be to have the legislature dictate the practice of medicine.
For starters, it fails to note that people who have contracted Covid—by now a considerable number of Californians—already have substantial protection against severe disease if they get Covid again. High quality studies have shown that this “natural immunity” provides equivalent or even greater protection than immunity generated by Pfizer and Moderna’s mRNA vaccines. If this bill passes, would a California physician be in trouble for taking into account a patient’s Covid history when making vaccination recommendations?
No, it would not, contrary to what Dr. Bhattacharya claims. Physicians already do that, just not in a way that he likes. GBD believers like to portray “natural immunity” as somehow not just as good as vaccine-induced immunity but far superior, such that if you have recovered from COVID-19 you don’t need the vaccine, even though it’s become quite clear that hybrid immunity (infection-induced plus vaccine-induced immunity) is superior to either, which means that vaccination is still advisable after having had COVID-19.
Consistent with how the “spiritual offspring of the GBD,” the Brownstone Institute, has pivoted to spreading antivaccine misinformation, Dr. Bhattacharya pivots to casting doubt on the safety and efficacy of the COVID-19 vaccine, because of course he does:
Another statement in the bill’s preamble asserts that the “safety and efficacy of Covid vaccines have been confirmed through evaluation by the federal Food and Drug Administration (FDA).” But vaccine safety also depends on any given patient’s clinical circumstances. For example, there is an elevated risk of myocarditis in young men taking the vaccine, especially with the booster.
And yet the vaccine is still far, far safer for young men than getting COVID-19.
Finally, Dr. Bhattacharya finishes with a flourish that make me laugh. A couple of months ago, I deconstructed an article published on the Brownstone Institute website that likened public health COVID-19 interventions to the Chinese Cultural Revolution. In it, I asked the question, “The Cultural Revolution? Why not also Lysenkoism?” I was referring to invoke Trofim Lysenko, the Soviet scientist who rejected Mendelian genetics in favor of his own ideas and who, after he became director of the Institute of Genetics within the USSR‘s Academy of Sciences, Lysenko used his political power to suppress dissent and elevate his anti-Mendelian ideas to state-sanctioned doctrine. As I said at the time, the analogy is custom-made for cranks like this, given that the Soviet embrace of Lysenkoism greatly exacerbated and prolonged the famine and mass starvation in the USSR that resulted from Stalin’s policies in the 1930s. It’s an attractive false historical analogy for right wing cranks like those at the Brownstone Institute, complete with mass death, is right there, waiting to be weaponized, so much so that I was surprised it hadn’t been used.
Cue Dr. Bhattacharya about the GBD:
History provides abundant examples of what happens when the state regulates science. In the former Soviet Union, Stalin’s favorite geneticist, Trofim Lysenko, dominated biology and the agricultural sciences. Lysenko rejected Mendelian genetics in favor of his own theory that plants could inherit acquired characteristics. Stalin empowered him to destroy the careers and lives of geneticists who opposed him, causing many to suffer secret arrests and even death. When his theories failed, the consequence was mass starvation in Russia. The Chinese Communists also adopted his beliefs—at the cost of the starvation of 30 million.
Great going, Dr. Bhattacharya! I knew you had it in you to toe the Brownstone Institute line to perfection by likening public health to Lysenkoism! As I said, it’s the perfect false historical analogy for cranks who want to find a way to compare public health to Communist, rather than fascist, dictatorships. (Why would Dr. Bhattacharya not want to compare public health to fascism? One wonders, one does.)
Still, Dr. Bhattacharya finishes with an amazing pivot. First, he grudgingly seems to admit that the California bill is nothing like Shanghai because California lawmakers don’t have authoritarian power, before saying that the bill really is the same as authoritarian Communism:
We are not the Soviet Union, of course, nor are we ruled by Chinese Communists. California lawmakers thankfully do not have the power currently being exercised in Shanghai. But this bill follows the same dangerous principle that government-authorized science should permit no opposition from people with the credentials and knowledge to oppose it. The false medical consensus enforced by AB 2098 will lead doctors to censor themselves to avoid government sanction. And it will be their patients, above all, who will be harmed by their silence.
Again, Dr. Bhattacharya’s concern for physicians “self-censoring” is touching, but performative. He himself doesn’t practice medicine. After medical school, he never did a residency. He hasn’t dealt with patients since he was a medical student, which is a highly monitored and supervised situation. He has no “skin in the game.” That’s why earlier he referred to doctors who apparently do. At least, they have medical licenses:
I do not practice medicine—I am a professor specializing in epidemiology and health policy at Stanford Medical School. But many friends who do practice have told me how they have censored their thoughts about Covid lockdowns, vaccines, and recommended treatment to avoid the mob. Though Stanford is supposedly a bastion of academic freedom, one junior untenured professor recently wrote to me: “I have heard you several times on television regarding the Covid issue and find myself resonating with your views. I am inclined to express those very same opinions to my colleagues and administrative members at Stanford. I have been reluctant to date because quite honestly, I expect that my faculty appointment would not be renewed. I have the perception that free speech is just not there.”
This forced scientific groupthink—and the fear and self-censorship they produce—are bad enough. So far, though, the risk has been social and reputational. Now it could become literally career-ending.
I can only react: “The horror. The horror.”
Seriously, though. The number of doctors out there questioning public health interventions, particularly masks, is distressingly high, and almost none of them face any sanctions—and then only after they have flagrantly violated the law and regulations, for instance, by not openly flouting mask mandates in healthcare facilities or providing substandard care far outside of medical standard of care. Yet these doctors, who tend to portray any constraint on their medical speech and practice as “persecution,” see themselves as victims.
Attack of the “brave mavericks”
One of the most important (and ego-gratifying) aspects of being a “brave maverick doctor” espousing narratives that go against the current scientific consensus (like the GBD) is that lets one portray oneself as smarter and braver than the average “sheeple,” someone who doesn’t “run with the herd.” In that worldview, rather than being an attempt to protect the public from quackery and dangerous misinformation, any effort to counter the misinformation that is being promoted must be an attempt to silence the “brave maverick” because what he’s saying is so “dangerous” to the establishment. Even though the GBD has, in essence, won politically, it still grates people like Mr. Magness and Dr. Bhattacharya that its message hasn’t won among scientists.
I will, however, express gratitude that both of them resisted the temptation to compare the GBD and its authors to Galileo. That must have taken enormous self-discipline.