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AB 2098 is not “censorship”

One of the oldest tropes favored by quacks of all stripes, including antivaxxers, is to portray any attempt at regulating their quackery as an assault on freedom of speech. It’s therefore not surprising that after its passage by the California legislature prominent spreaders of COVID-19 misinformation are labeling AB 2098, which seeks clarify and codify the power of the Medical Board of California to discipline physicians for spreading COVID-19 misinformation, as creating “thoughtcrimes.”

Thanks to a grant deadline, I have what one might call…a paucity of material…for early this week. Fortunately, however, I can update something I wrote a week ago about AB 2098, with a common theme bubbling up among antivaxxers and COVID-19 contrarians who deny that they are antivax but parrot antivax misinformation that increasingly sounds like pre-pandemic old school antivax propaganda. This theme has been increasing attacks on the aforementioned, AB 2098, a recently passed bill in California that at the time was awaiting Gov. Gavin Newsom’s signature and since was signed by him on the last possible day, namely the last day of September.

According to MedPageToday a month ago:

A bill that would allow regulators to discipline doctors for spreading misinformation related to COVID-19 has been approved by California’s Legislature.

If signed by Gov. Gavin Newsom (D), the first-of-its-kind law would make California the first state to try to legislate an issue that has contributed to thousands of unnecessary hospitalizations and deaths during the pandemic, according to the American Medical Association, The New York Times reported.

The new law would designate the dissemination of false or misleading information to patients as “unprofessional conduct,” the Times noted, and thus subject to punishment by the Medical Board of California and the Osteopathic Medical Board of California.

The bill, known as Assembly Bill 2098 (AB 2098), states that the spread of misinformation about COVID vaccines has “weakened public confidence and placed lives at serious risk,” and that healthcare professionals are “some of the most dangerous propagators of inaccurate information” when it comes to COVID vaccines.

There were many examples of this tactic before Gov. Newsom signed AB 2098. For example, the Brownstone Institute published an article by Laura Powell entitled The Dystopian Vision of the Health-Information Police about—you guessed it!—AB 2098. Just for yucks, I searched the Brownstone Institute website for other articles on AB 2098 and found lots of opprobrium:

You get the idea.

Elsewhere, Dr. Jay Bhattacharya, a Stanford academic, Senior Scholar at the Brownstone Institute, and one of the three writers of the Great Barrington Declaration (GBD), the “don’t worry, be happy” eugenicist call to let COVID-19 rip through the healthy non-elderly population in order to achieve “natural herd immunity” while using a mostly undefined strategy of “focused protection” to protect the elderly and others with chronic health conditions that put them at high risk for severe disease and death from COVID-19, likened AB 2098 to draconian lockdowns in Shanghai by the authoritarian Chinese government, while portraying himself a “victim” of “persecution” due to his stance on “lockdowns” and having helped draft the Great Barrington Declaration.

Meanwhile, on Twitter, there were the predictable cries of “censorship”:

“Censorship.” You keep using that word. I do not think it means what you think it means.

Appeals to “protect physician freedom of speech”:

And, of course, an “authoritarian liberty grab”:

What’s a “liberty grab”?

Along with a likely astroturf campaign to persuade Gov. Newsom to veto AB 2098:

There was also a bit of the old false “Nuremberg Code gambit” playing out as well:

Then, last Friday, there was even a rally by the usual antivax suspect in Sacramento to “implore Gov. Newsom to veto AB 2098”:

Let’s just put it this way. If you have Steve Kirsch, who is one of the most bonkers of bonkers antivax wing nuts, speaking at your rally against a bill designed to hold quacks responsible for spreading their quackery, you are not exactly looking to me as though you’re behind science, medicine, or even free speech rights. It looks more to me as though you’re on the side of grifters.

Ditto when Robert F. Kennedy, Jr. is rallying for you:

I agreed at the time. It was better for Gov. Newsom to actively support the bill by signing it into law than just to let it become law without his signature.

Even though Gov. Newsom did in the end do the right thing and sign AB 2098 into law, even though it would have automatically become law if he had done nothing, as long as he didn’t explicitly veto it by September 30, it was nonetheless easy for me to decide to write about AB 2098. Specifically, I want to contrast the hysteria being fomented by antivaxxers and COVID-19 cranks about the bill with what the bill actually says and would do if signed into law, while providing a bit of context about how portraying attempts by government to protect consumers against false claims in medicine as “censorship” of physicians is nothing new.

AB 2098

AB 2098 was drafted in response to a very real problem, specifically the spread of dangerous misinformation by licensed physicians during the COVID-19 pandemic. Introduced in February by Evan Low and cosponsored by Assemblymembers Cecilia Aguiar-Curry, Akilah Weber, and Buffy Wicks, as well as by Senators Richard Pan and Scott D. Weiner, the law’s purpose as stated by Assemblymember Low in a press release was:

This bill declares that disinformation and promotion of COVID-19 misinformation and disinformation to the public as unprofessional conduct for licensed physicians and surgeons. Under this law, California Medical Boards will be given the tools necessary to bring discipline actions against a licensee. Due to their specialized knowledge and training, licensed physicians possess a high degree of public trust and therefore must be held to account. The spreading of misinformation, of inaccurate COVID-19 information, contradicts that responsibility and threatens to further erode the public trust in the medical profession and puts all patients at risk

The text of the bill as passed by the legislature on August 30 can be found here. First, the bill proclaims:

SECTION 1. The Legislature finds and declares all of the following:
(a) The global spread of the SARS-CoV-2 coronavirus, or COVID-19, has claimed the lives of over 6,000,000 people worldwide, including nearly 90,000 Californians.
(b) Data from the federal Centers for Disease Control and Prevention (CDC) shows that unvaccinated individuals are at a risk of dying from COVID-19 that is 11 times greater than those who are fully vaccinated.
(c) The safety and efficacy of COVID-19 vaccines have been confirmed through evaluation by the federal Food and Drug Administration (FDA) and the vaccines continue to undergo intensive safety monitoring by the CDC.
(d) The spread of misinformation and disinformation about COVID-19 vaccines has weakened public confidence and placed lives at serious risk.
(e) Major news outlets have reported that some of the most dangerous propagators of inaccurate information regarding the COVID-19 vaccines are licensed health care professionals.
(f) The Federation of State Medical Boards has released a statement warning that physicians who engage in the dissemination of COVID-19 vaccine misinformation or disinformation risk losing their medical license, and that physicians have a duty to provide their patients with accurate, science-based information.
(g) In House Resolution No. 74 of the 2021–22 Regular Session, the California State Assembly declared health misinformation to be a public health crisis, and urged the State of California to commit to appropriately combating health misinformation and curbing the spread of falsehoods that threaten the health and safety of Californians.

There is nothing in the above list of statements that I can argue with. These are examples of statements about COVID-19 that are demonstrably accurate that COVID-19 contrarian doctors frequently contradict, as described in (e). Indeed, as I have argued many times before, physicians who spread COVID-19 misinformation are automatically considered more credible than the average pundit by virtue of their professional status. Our MD and DO degrees, combined with our professional licensure by the state, automatically make us experts in the eyes of the public, whether we have relevant domain-specific expertise in COVID-19 and vaccines or not. Worse, a number of my colleagues have parlayed their professional credentials into a brand that, in the name of “freedom” and “questioning”, involves spreading flagrant misinformation about COVID-19 (and, increasingly, other medical topics).

Let’s take a look at relevant passage stating what this bill does. First, the legislative counsel’s digest states:

Existing law provides for the licensure and regulation of physicians and surgeons by the Medical Board of California and the Osteopathic Medical Board of California. Existing law requires the applicable board to take action against any licensed physician and surgeon who is charged with unprofessional conduct, as provided.

This bill would designate the dissemination of misinformation or disinformation related to the SARS-CoV-2 coronavirus, or “COVID-19,” as unprofessional conduct. The bill would also make findings and declarations in this regard.

Which is why, in Section 2, the AB 2098 explicitly states that spreading COVID-19 misinformation is unprofessional conduct:

It shall constitute unprofessional conduct for a physician and surgeon to disseminate 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.

Of course, where the rubber hits the road is in how “misinformation” and “disinformation” are defined. First, misinformation:

“Misinformation” means false information that is contradicted by contemporary scientific consensus contrary to the standard of care.

Next, disinformation:

“Disinformation” means misinformation that the licensee deliberately disseminated with malicious intent or an intent to mislead.

These are, of course, fairly standard definitions of “misinformation” and “disinformation”. I do note, however, that the definition of “misinformation” is different than in a prior version of the bill, which defined misinformation thusly:

“Misinformation” means false information that is contradicted by contemporary scientific consensus to an extent where its dissemination constitutes gross negligence by the licensee.

To be honest, I like the previous definition better, as it makes it more clear that AB 2098 is not targeting potentially legitimate scientific disagreements over the practice of medicine, but claims that are both flagrantly and demonstrably false and dangerous to the public, such as antivax claims about COVID-19 and claims supporting COVID-19 quackery. Whichever definition you pick, however, let me just reiterate that it is a favorite trope of quacks and antivaxxers to claim that doctors “can’t” say anything that doesn’t adhere to medical “dogma”, lest they be excommunicated—or worse!—from the Church of Medicine. Such a trope intentionally ignores anything resembling nuance, in particular the part about how “contemporary scientific consensus” and “standard of care” actually encompass rather broad swaths of evidence and practices and how a physician has to be very far from that consensus and standard in order to enter the category of misinformation. Even then, because doctors tend to stick together and react in a very threatened manner whenever faced with any sort of regulations on their professional speech, even when the regulations are narrow and there’s little or no chance they’d run afoul of them.

Indeed, I’ve actually argued in the past that the bill doesn’t go far enough in that it limits itself to COVID-19 misinformation and quackery. I’ve long argued that state medical boards need to be empowered to discipline doctors for promoting quackery of all kinds. One has only to look at the examples of Stanislaw Burzynski in Texas and Rashid Buttar in North Carolina to see that even doctors who do far more than simply advocate quackery and antivaccine misinformation all too often manage to avoid sanctions by their state medical boards and keep their medical licenses. Be that as it may, state medical boards have long had the power to regulate professional conduct and define and sanction physicians for “unprofessional conduct”. There is thus value in explicitly defining spreading COVID-19 misinformation as being unprofessional conduct subject to state medical board regulation and discipline.

Of course, quacks have long wrapped themselves in the First Amendment when they misrepresented attempts to crack down on their conduct as assaults their “freedom of speech”. Unfortunately, a number of seemingly more reasonable and unquacky physicians have taken up the same call. What they fail to recognize is that it is relatively rare for a physician only to spread misinformation. Usually, they practice what they preach, so to speak. Pre-pandemic, Dr. Buttar, for instance, didn’t just claim that mercury in vaccines caused autism; he treated autistic children with his own “transdermal chelation therapy” quackery (which skeptics’ disparagingly dubbed “Buttar’s butter“) to “detoxify” them from the “mercury poisoning” that had supposedly made them autistic. Since the pandemic, “America’s Frontline Doctors”, who first made a splash in the summer of 2020 promoting hydroxychloroquine to treat COVID-19 but quickly added ivermectin to their list of miracle cures for COVID-19, don’t just publicly claim falsely that these drugs are highly effective against COVID-19. A year ago they were busted for running a telehealth prescription mill to sell them. Thus, sanctioning physicians for spreading misinformation and disinformation is reasonable given how rarely the practice of quackery doesn’t follow from the advocacy of quackery.

The bottom line is that AB 2098 is a relatively modest, targeted bill designed to explicitly define a power that the Medical Board of California arguably has always had with respect to regulating spreading dangerous health misinformation and disinformation as unprofessional conduct. Unsurprisingly, quacks, antivaxxers, and COVID-19 contrarians don’t see it that way.

“Censorship” of “thoughtcrimes”? Hardly.

Before I address the more outlandish criticisms of AB 2098, it is important to note that there are physicians alarmed by the bill who are not quacks, although, truth be told, who do lean to the COVID-19 contrarian side. For instance weeks ago, while I was still (mostly) incommunicado, Dr. Leana Wen wrote an editorial for The Washington Post titled “California’s anti-misinformation bill is well intentioned. But it’s a bad idea“. In it, she makes this astounding claim:

While well-intentioned, this legislation will have a chilling effect on medical practice, with widespread repercussions that could paradoxically worsen patient care.

Not coincidentally, the claim that the bill will have a “chilling effect” on medical practice is one that commonly pops up on antivax websites. The question, of course, is: How? How might this bill have a chilling effect on medical practice? Let’s see what Dr. Wen says:

The bill focuses on physicians accused of disseminating misinformation to patients under their care. (It does not extend to comments in the public domain, such as social media.) On a surface level, this is defensible: The expectation should be that doctors always abide by the gold standard of care. Therefore, those who deliberately give patients advice that counter established guidelines should lose their medical license.

The problem is that medical practice is rarely black and white. Much of the time, broad recommendations are intended to be tailored to the individual patient.

Ah, yes. The appeal to the “gray areas” of medical practice, the areas where the standard of care is not so clear. Also note how the bill does not apply to what doctors say in general on social media and legacy media, just what they say to patients in their practice. That’s how the bill addresses First Amendment concerns, even though arguably it is what many of these COVID-19 contrarian doctors say on hugely trafficked social media sites that is more damaging to public health than what they sell their patients, who are few in number compared to the people within reach of their public utterances.

Reading this introduction, I was curious what sorts of situations concern Dr. Wen; unsurprisingly, she provided examples regarding vaccines, basing her arguments on what she likely does not realize to be a favorite crank argument, namely, “Science changes, and how do we know that what this doctor is recommending today won’t be standard-of-care tomorrow?” For example:

Take the recent guidelines on booster shots. The Centers for Disease Control and Prevention has recommended that everyone 12 and older receive updated boosters. Most doctors would probably agree that elderly individuals should get the new booster right away. But many might advise — as I would — that it’s fine for some patients to hold off and time the booster closer to winter holidays. Some providers might not recommend boosters for children and adolescents, especially if they have already had the coronavirus.

These actions go against federal guidelines. AB 2098, taken to the extreme, could put many practitioners at risk. But is it really right for physicians to be threatened with suspension or revocation of their license for offering nuanced guidance on a complex issue that is hardly settled by existing science?

To pre-empt: No. No, Dr. Wen. You would not be sanctioned for such a recommendation. Let’s look at the actual CDC recommendations for the new bivalent boosters for children aged 12 and older:

People ages 12 years and older are recommended to receive one updated Pfizer or Moderna (bivalent) booster.

  • This includes people who have received all primary series doses and people who have previously received one or more original (monovalent) boosters.
  • At this time, people aged 12 years to 17 years can only receive the updated Pfizer bivalent booster.

On the main page there is nothing there about timing of vaccines for people over 12. However, if you use the “When Are You Up-to-Date?” tool, the following responses result in a recommendation for a bivalent booster:

Your responses
  • Age: 12-17 years old
  • Moderately or severely immunocompromised
  • Primary series: Pfizer-BioNTech
  • Updated (bivalent) booster received: no
  • Length of time since last COVID-19 vaccine: At least 2 months
Based on your responses, your child should get an updated COVID-19 booster. Your child is considered up to date with their COVID-19 vaccines immediately after getting their updated (bivalent) booster.

So, no. Advising delay until winter would not get Dr. Wen sanctioned by the Medical Board of California, if she practiced in California. What Dr. Wen is engaging in is the logical fallacy known as an appeal to the extremes, in which she tries to make a reasonable policy seem unreasonable by citing a very extreme possible outcome that is highly unlikely. Alternatively, it could be a slippery slope argument, in which it is claimed that, if medical boards can regulate professional speech that is arguably outright misinformation, it won’t be long before they start regulating speech that is within the bounds of reasonable professional disagreement.

She gives another example:

Indeed, another lesson from covid is that science is constantly evolving. In a public health emergency, official guidance often lags cutting-edge research. Consider how long it took the CDC to acknowledge that the coronavirus is airborne. Should doctors have been censured for recommending N95 masks before they were accepted as an effective method for reducing virus transmission?

This one strikes me as disingenuous in the extreme. Surely Dr. Wen must know that AB 2098 is designed to combat harmful and dangerous COVID-19 misinformation being spread by physicians. An N95 mask is more effective at protecting a person against respiratory viruses than a surgical or cloth mask. It is simply ludicrous to think that the Medical Board of California would have taken action against a physician who in 2020 recommended a COVID-19 mitigation intervention more effective than the recommendation at the time. Surely she must know this.

Wen also brings up a hypothetical situation:

There could also be rare situations in which treatments that definitively do not work might still be prescribed. A colleague told me he prescribed ivermectin to treat covid-19 [sic], even though the antiparasitic drug isn’t effective against the disease. If he didn’t, his misinformed patients would have ignored his advice and obtained it anyway from a livestock shop, where the dosages intended for cows and horses could be deadly to humans. This action certainly deviated from what the California bill calls “contemporary scientific consensus,” but that physician shouldn’t have to fear for his license because he tried to reduce harm to his patients.

There is only one correct reaction to this:

Godzilla facepalm
When Godzilla gives you the facepalm, you know the failure is monstrous. Dr. Wen fully deserves the Godzilla facepalm.

No, seriously. If that patient had wanted to use acupuncture to treat COVID-19, would that physician have recommended it? Or homeopathy? This is the same sort of shruggie “What’s the harm?” attitude that has plagued our profession when addressing so much quackery and nothing more than a rationalization for not wanting to tell a patient no, which is often very uncomfortable for physicians, particularly cancer quackery. How many times have I heard the “What’s the harm?” argument when addressing, for example, Dr. Stanislaw Burzynski prescribing his ineffective antineoplastons concoction to patients with deadly cancers? Basically, the physician prescribed what he knew to be an ineffective treatment with a non-zero chance of causing harm in the name of “reducing harm”. Yes, that physician should potentially be subject to sanctions.

Dr. Wen then goes on to make a jaw-droppingly bad false equivalence, followed by a slippery slope argument:

In a way, though the California bill was introduced by Democratic legislators, it is not unlike the Trump administration’s Title X “gag rule,” which barred health-care providers who worked in clinics that received federal funding from referring patients for abortion care. I strongly opposed the Title X gag rule for the same reason I oppose AB 2098: Both censor what doctors can say to our patients. Both represent political interference with the practice of medicine.

Both measures could also set a precedent with downstream repercussions. Imagine if anti-vaccine legislators introduced a bill that forbids pediatricians from offering parents information on routine childhood immunizations. Imagine if states that already limit reproductive health services or transgender care prohibit health-care providers from discussing options with their patients.

Politicizing the practice of medicine is a legitimate concern but do not justify false equivalences and another appeal to an extreme. The difference, of course, is that the “gag rule” tried to straightjacket physicians into precluding actual evidence-based care for their patients. It’s all well and good that that Dr. Wen correctly opposed the “gag rule”, but it’s not so great that she either doesn’t see the difference between the gag rule and AB 2098 or ignores the difference in the pursuit of making her point. In addition, surely Dr. Wen must already be aware that antivaccine legislators are already engaged in trying to undermine vaccination programs, as their endgame has always been the elimination of all vaccine mandates, be they for school, daycare, working in a hospital, or anything else. This has been true since long before the pandemic; antivaxxers just see the pandemic and the increasing power of the antivaccine movement as a result of the pandemic as their golden opportunityto realize a long-time dream. Surely she must be aware that legislators are already furiously trying to criminalize gender-affirming care of transgender adolescents in a depressingly large number of states, which goes beyond just putting a physician’s medical license at risk. Dr. Wen’s comparisons are misleading at best.

Specifically regarding her invocation of the “gag rule,” I like to cite Noah Louis-Ferdinand, Comms Director for Voices for Vaccines:

Also, doubly this:

Exactly as I said, in particular, about how antivaxxers have long been trying to get bills to their liking introduced into state legislators and now see an opportunity to realize their endgame, the elimination of all vaccine mandates, in at least some states.

AB2098 protest

Deeper into the morass: Conspiracy theorists vs. AB 2098

Let’s now look at what Dr. Jay Bhattacharya, one of the main signatories of the GBD, had to say about AB 2098 in April. He basically used the same sorts of arguments that Dr. Wen did more recently, but cranked up to 11, in which he likens AB 2098 to the power of authoritarian regimes like China and the former Soviet Union. For example:

The ultimate effect of the bill will be to chill public criticism by California doctors of mistaken government public health diktats since few will want to put their licenses in the hands of the very public health officials with whom they disagree over the interpretation of science. Even legitimate dissent from public health orthodoxy by licensed doctors may be excised from the public square as a consequence.

That’s exactly the same argument that Dr. Wen made. Then there’s this:

And that’s to say nothing of the impact this bill would have on the practice of medicine. Doctors have an obligation to treat each patient as an individual. Yet the California Assembly bill turns doctors into agents of state public health rather than advocates for their patients. 

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.

This is a subtype of the “appeal to extremes” fallacy that I like to refer to as the invocation of Lysenko’s ghost. As you might recall, Trofim Lysenko was a Soviet scientist who rejected Mendelian genetics in favor of his own ideas. After he became director of the Institute of Genetics within the USSR’s Academy of Sciences, Lysenko used his political power to suppress dissent, discrediting, marginalizing, and imprisoning his critics while elevating his anti-Mendelian theories to state-sanctioned doctrine. The analogy is, of course, custom-made for cranks like Dr. Bhattacharya, given how 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, making it an attractive false historical analogy for right wing cranks like those at the Brownstone Institute, for which Dr. Bhattacharya is a “senior scholar”. The emotive example misleadingly conflates being sent to the gulags with possibly losing one’s medical license, even as Dr. Bhattacharya tries to point out the difference by adding that “California lawmakers thankfully do not have the power currently being exercised in Shanghai”.

Unsurprisingly, over at the Brownstone Institute, Laura Powell, founder of Californians for Good Governance, rants about gray areas of medicine:

Assembly Bill 2098 would empower the Medical Board of California to go after the licenses of physicians who disseminate “misinformation” or “disinformation” regarding Covid-19 [sic]. The bill in its latest iteration defines misinformation as “false information that is contradicted by contemporary scientific consensus contrary to the standard of care.” The inscrutability of this definition lies at the core of the bill’s opponents concerns. 

No clear scientific consensus exists with respect to this novel virus, and even if it did, it may be proven incorrect later. Without clear guidance regarding what would constitute “misinformation,” physicians can only guess if they risk losing their licenses for expressing their good-faith disagreements with positions of public health officials. Even if in practice, the Medical Board only applied the law to speech that the First Amendment does not protect, the law’s vagueness would render it unconstitutional, because it would tend to cause doctors to censor themselves.

This is basically the same argument made by Dr. Wen, just (again) cranked up to 11. I like to refer to Dr. Taylor Nichols, one of the founders of No License for Disinformation, a group dedicated to combatting COVID-19 misinformation and disinformation and a major backer of AB 2098:

This likely explains the uptick in attacks on the bill. Gov. Newsom has only until September 30, which is this Friday, to veto the bill, and if he does nothing AB 2098 will automatically become law on October 1.

Also:

I also like to cite a long Twitter thread by Noah Louis-Ferdinand, Comms Director for Voices for Vaccines, who notes a number of disingenuous, misleading, and outright false claims being made about AB 2098. His arguments are similar to mine, but he adds other context.

For example, he notes:

Let’s just say that there is no “epidemic” of cases in which the Medical Board of California has taken action against the licenses of physicians engaged in spreading misinformation. Indeed, if Simone Gold, an outright COVID-19 grifter who was convicted and sent to prison for participating in the January 6 insurrection, complained about being placed in solitary confinement as quarantine for eight days because she refused to be vaccinated against COVID-19, and is a founder of America’s Frontline Doctors, hasn’t faced discipline yet from the Medical Board of California, it’s hard to make a serious argument that AB 2098 will lead to a newly empowered fascistic board to start persecuting brave maverick doctors selling COVID-19 misinformation, quackery, and antivaccine conspiracy theories.

Moreover:

Then there are the logistics of actually bringing a case against a doctor before the medical board. Noah cites the example of masks, dismantling some arguments made by Dr. Zubin Damania, better known by his social media name ZDoggMD in a recent video:

He also notes that one reason why medical boards have been reluctant to pursue such cases will not change if AB 2098 becomes law and that this bill only applies to professional speech in the context of providing care to patients:

He also correctly points out that the concept of “medical consensus” and “standard-of-care” are already defined concepts in law:

I actually agree that the vagueness of the definitions of misinformation and disinformation in the bill will likely make its effects less robust than is needed. That is why I like the definition of misinformation in an earlier version of the bill that is “contradicted by contemporary scientific consensus to an extent where its dissemination constitutes gross negligence by the licensee”. Such a definition makes it clear that we aren’t talking about reasonable medical disagreements. 

The bottom line is that, for all its shortcomings, AB 2098 explicitly states that spreading COVID-19 misinformation and disinformation in medical practice constitutes unprofessional conduct, thus making clearer a power that the Medical Board of California has always had but was reluctant to act on. The misrepresentation of the bill as some sort of Stalinist Lysenkoist assault on physician autonomy is an echo of the “health freedom” arguments of quacks past going back decades in response to any attempt by any governmental entity to put a stop to quackery. I fully expected that Brownstone Institute flacks like Dr. Bhattacharya and Kheriaty, for instance, would echo such “health freedom” tropes that portray the autonomy of doctors as correctly unfettered and any attempt to regulate medical practice as an unacceptable assault on free speech and physician autonomy. It’s disappointing that more reputable physicians are parroting the same tropes that we’ve been dealing with for decades while apparently not realizing what they are.

It is, unfortunately, no longer surprising, that physicians who should know better are echoing complaints of “cancel culture” in response to bills like AB 2098.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

154 replies on “AB 2098 is not “censorship””

ZDogg has become an acolyte of Vinay Prasad, maybe what one could consider a higher tier priest in the VP cult. He’ll echo and amplify anything VP says or what ZDogg thinks VP would say.

“AB 2098 is not targeting potentially legitimate scientific disagreements over the practice of medicine, but claims that are both flagrantly and demonstrably false and dangerous to the public…”

That’s not what the bill says–it says it targets claims that are “contradicted by contemporary scientific consensus.”

That mean the individual judgment of doctors–who have completed all the educational and licensing requirements for their profession–is trumped by some kind of vote, or an opinion from an official committee. The details about how this “consensus” is determined are vague–maybe they consult Wikipedia or something.

You must have a very poor opinion of doctors in general, if you think they aren’t competent to decide their own medical opinions. Or you think so many of them are crazy or dangerous or stupid, you need a special law about it.

I don’t have an opinion of doctors any more “poor” than I have of the general population. If there’s anything that the pandemic should have taught us about the medical profession, it’s that the MD degree does not magically immunize physicians against misinformation, disinformation, and conspiracy theories. We are human beings and therefore just as prone to believing them as any other human being. The only difference is that when a physician starts believing and spreading misinformation and conspiracy theories, the lay public considers their ramblings to be much more credible than they would if the misinformation was coming from the average John or Jane Q. Public on the street. That’s the responsibility that comes with the MD degree, not to use it to persuade the public to believe medical pronouncements that are not just untrue but dangerous.

There’s only one problem–the COVID19 vaccines are dangerous and useless. Your unwavering trust in the CVax isn’t based on extensive evidence of safety and efficacy, because it doesn’t exist.

From the late 1800s to the 1930s, the consensus in the medical industry was that bacteria caused the flu. Millions of people were vaccinated with with injections to fight this bacteria. That’s just one example of a major medical flub in history that likely destroyed millions of lives.

Oh, goody, a favorite quack fallacy: “Medicine was wrong about a disease before, which means it must be wrong about a different disease now.”🤦🏻‍♂️

“There’s only one problem–the COVID19 vaccines are dangerous and useless.”

Hahahaha. The morgues are full of people who agreed with you briefly. Check out the Herman Cain award page for an ever increasing list. Meanwhile, after hundreds of millions of vaccines were given, the number of made-up vaccine reactions is, what, five? Put in some effort and lie harder.

Says you with no evidence whatsoever. That’s because there is no evidence whatsoever that the shots have saved a single life.

On the other hand, hundreds have died within a day or 2 of the shot. Coincidence, you’ll say.

Deaths in the US are higher in 2021 than they’ve ever been for the last 20 years. You think that’s due to part of the population refusing the shot? Nice fantasy.

On the other hand, hundreds have died within a day or 2 of the shot. Coincidence, you’ll say.

Show me you don’t understand base rates and the base rate fallacy without telling me you don’t understand base rates and the base rate fallacy.

We’ll start the lesson simply: On average, how many people die every day (all causes) in the US?

@Orac: “We’ll start the lesson simply”

Good luck with that. Even if hundreds died a day or two before being vaccinated, the moron would still blame the shot.

Alas, this is not a fight you can ever win. Their minds just don’t work like that. You may as well teach basketweaving to a great white shark. All its brain is thinking is hungry.

Orac it might be possible to come up with an estimate on this.

I don’t know where to find daily all-cause death data to estimate the daily risk of death, but this could be estimated from monthly death and population data, which I just did a write-up on.

Deaths after vax could be estimated from VAERS data, even though it’s only a small fraction of them.

I assume the CDC and FDA haven’t done anything like this?

Ginny Stoner:

I don’t know where to find daily all-cause death data

For the USA in 2020:

Number of deaths: 3,383,729
Death rate: 1,027.0 deaths per 100,000 population

Found, even from the remote Antipodes, by the frighteningly difficult Google search for “all cause death rate USA”. Is the next step of dividing by 365 the stumbling block?

https://www.cdc.gov/nchs/fastats/deaths.htm

On the other hand, hundreds have died within a day or 2 of the shot. Coincidence, you’ll say.

I’ve heard that thousands of people worldwide have died within a day or two of having two glasses of water after 6pm. Coincidence you’ll say.

Really ginny, you are so monumentally stupid it hurts.

Hey Ginny, maybe you should loosen the laces on your corset. You seemed to have missed that the world has changed (a lot) in the past hundred years (as evidence by the fact that you’re probably not wearing a corset), and the whole world has learned a lot of new things, and changed the way we do things.

The fact that you keep clinging to something that happened when most people used coal to heat their homes and cook their food, used kerosene and gas for lighting and didn’t have indoor plumbing means that you don’t have anything recent or relevant to offer as an argument.

How do you know that Hib vaccination for flu killed milllions ? I actually protected agains a sequalae.
There are of course lots of studies of COVID vaccine safety and efficiency. Do a Google Scholar search for COVID 19 vaccine safey efficacy

Boulder-brain’s pathetic Argument from Incredulity aside (it’s called Quality Control, you wignorant putz), what’s genuinely unbelievable is just how negligent the medical profession is at self-regulating. It’s the proverbial foxes-guarding-henhouses problem: the people who are qualified for the job are also the ones least motivated to do it.

It’s not just the failure to kick out the bums which is shocking; it’s the indifference. Institutional. Individual.

How the heck to fix this? What is required to make medics vigorously, ruthlessly, enthusiastically predate all this low-hung rotting fruit for themselves, so these diseases cannot spoil the whole orchard?

Boulder-brain’s pathetic Argument from Incredulity

Are you sure the ol’ NWO Reporter is in Colorado? Kincaid I know has been based in Colorado Springs.

A. The fact that Brownstone carries Kheriaty and Kory clearly gives a lie to any attempt to claim legitimacy. Kheriaty is openly an anti-vaccine activist, and Kory was involved with shady research around Ivermectin.

B. I agree with your bottomline, but am concerned that the grifters can, in this case, appeal to regular doctors and mislead them into support. That is why we need this addressed, as you did here.

Newsom’s signing statement was strong, so that’s a good sign.

This is certainly going to be challenged in court, but that may depend on exactly where the board takes it.

“Anti-vaccine activism” is a position based on reason and science–the way to refute it is with reason and science (if that were possible), not mischaracterizing it as an insult and a reason to automatically dismiss whatever someone has to say. That’s a routine cop-out among vaccine promoters–by necessity.

Antivaccine activism is a “position based on reason and science”? 😂😂😂🙄🙄🙄🤦🏻‍♂️

And “the way to refute it is with reason and science”? Would that were the case! However, as we have seen, true believers are not persuaded by reason, evidence, science, or data. My writing is not aimed at ideologues and conspiracy mongers like you, for whom the antivax ideology is far more akin to religion or political orientation than it is to a carefully considered set of conclusions based on science. It’s aimed at those on the fence, who might be lured into pseudoscience, quackery, and conspiracy theories by the sort of disinformation and misinformation spread by the doctors targeted by AB 2098.

Basically, trying to convince hard core antivax conspiracy theorists that vaccines are safe and effective is very similar in its level of difficulty to trying to get someone to change their religion.

Basically, trying to convince hard core antivax conspiracy theorists that vaccines are safe and effective is very similar in its level of difficulty to trying to get someone to change their religion.

LOL. Nope. Plenty of folks can change their religion when you point a gun in their face. Human history is full of it, and it generally works pretty good.

The only way you can change a paranoid narcissist is by actually pulling that trigger.

Some folks just ain’t wired to be human.

This is why I strongly counsel education and effective containment as your first and much preferred measure. Not to save their souls. To save yours.

“However, as we have seen, true believers are not persuaded by reason, evidence, science, or data.”

I’d have to agree with you there, since I write about it often. Of course, it’s the pharmaceutical industry that controls the flow of vaccine information, not ‘anti-vaxers’ (other than the popular ones who are promoted to control the opposition).

The foundation of vaccination is indoctrination.

Your comment sounds a lot like a famous saying from Pee Wee Herman: I know you are, but what am I?

Seriously, projection, thy name is antivaxxer.

@Ginny Stoner So it is again that everyone who is not an antivaxxer is paid by pharmaceutical industry. Now that is awful lot of money

@Dorit Reiss: “The fact that Brownstone carries Kheriaty and Kory clearly gives a lie to any attempt to claim legitimacy.”

True, but this is to miss the point.

As a critical thinker you interpret their endless stream of inconsistencies, hypocrisies, and outright contradictions as flaws; weaknesses in their arguments, wanting torn to shreds. But these are not defects; these are the tools.

This is how firehosing operates.

The mission of Brownstone † is not to redefine truth. It is to drown it. In infinite noise.

If some odd idiot wishes to believe what they’re saying, that’s irrelevant.

Their victory condition comes when nobody believes anything any longer.

Everybody’s ability to trust, washed away in the ocean.

The Soviets had this technique down to a fine art more than 50 years ago too, so how the hell we’re still not caught up is 100% our failing, not theirs.

To beat them—hell, even slow them down—you have to stop thinking like you.

You must start thinking like them.

Once you are good at this, then you can leverage all your intellectual strengths to sail fast circles around them and blow the bastards out at the stern.

But until then, all of your brilliant, noble, rigorous legal, scientific, and logical minds are actively working against you; against us all. The more energy you enthusiastically pump into being yourself—painstakingly, rationally, honestly debunking their latest bull claims—the fatter and more glorious the firehose grows.

Alties love to claim that you only treat symptoms, not cure the disease; that on some level you want that disease to continue; that you seek the comforts of its regular income. Normally we’d call that “massive projection”. Yet here you all are, unconsciously doing it. You defeat yourselves! Doing exactly what they want you doing: playing your role in their script.

Stop that. Now.

I’m deadly serious about this. And they are too.

† Along with every other neo-Soviet propagandist and new-fascist grifter; but I repeat myself.

Generally, those that oppose the bill, are likely those who would be ‘threatened’ by it. I would like to think my GP would give me a good standard of care (of which they do), but were they to give me treatment that simply doesn’t work (ivermectin) or which could do harm (anti vaccine) then they shouldn’t be allowed to practice. Wakefield was found to be a fraud and rightly had his licence taken away, he can no longer work over here in the UK. That is why he is over the pond, peddling his crap and grafting. Get rid of him.

Regardless of merit, it certainly is thought policing and group-(mob)-think-ism. And it’s corporate-based fascism since the corporations’ applications are rubber stamped and the regulators are compromised. California is lost. Beautiful place but lost to statism.

Regardless of merit, it certainly is thought policing and group-(mob)-think-ism.

Make note: john just told everyone that no matter what the science shows he will claim it is wrong and the opposite it true. It was obvious before that he felt that way, but until now it was never an admission.

Your opinion, based on ignorance and the asinine mindset of a spoiled 5-year-old boy (libertariansism) don’t make things so. Neither does your refusal to accept actual data and study results. In short — reality contradicts everything you keep saying.

Until you show that you’re willing to actually read studies and put in the work to understand them your comments are worthless — just like the lies pushed by ginny, greg, and the other science deniers infecting the posts.

@johnlabarge dislikes anyone telling him what to do…

I agree that a world where people did the right thing, without the need for laws or mandates, would be amazing. But we live in the real world, not a libertarian fantasy.

john just told everyone that no matter what the science shows he will claim it is wrong and the opposite it true

You’re learning. Welcome to the wonderful world of Narcissistic Truth.

The universe rotates around John; it exists only to bask in John’s perfection. That it’s taken you this long even to begin to comprehend this only confirms how far inferior you really are.

When the narcissist says something is True, then it is True. This is self-evident. The narcissist, by definition, cannot be wrong, so is always Right. This includes when the narcissist says one thing and then immediately contradicts it in the very next sentence. Both statements are still correct: they cannot be anything but.

Your own failure to resolve this apparent binary contradiction is your failure, your faulty, inadequate logic. The narc has no such difficulties: once again, his native superiority raises him up above you.

As long as you keep looking for human logic, human reasoning, human fallibility and humility, you’ll only injure yourself. That you perceive John as a some idiot manchild tooting noisily before you, emotionally stunted into forever toddlerhood with an intellectual armory to match, is your sensory inadequacy, your sorry limitation in being eternally constrained to a mere three-and-a-half axes of crude reality. Your senses lying to you; your inability to handle the Truth.

John is a True Being of Higher Dimensions; of absolute enlightenment, sophistication, boundless complexity. The lowly scientific “perception” of which you are so proud (laughable!) cannot even begin to penetrate the infinite majesty of this vaunted veil.

There is so much to John: John knows it.

You clearly need your eyes tested.

So give it up already, little “human”. For John already won this argument—all arguments—half a century ago, back when he was still only arse high to a grasshopper and his mommy taught him that He was Center of all the universe.

For as it is Written in Genesis 0:0, the only Book of Matter:

John said, “Let there be God.”

And there was God.

And John looked upon God, and was Pleased at the sight. Because it is Him.

Here endeth your lesson, you Worm. Now prey to John some more, because John is as hungry as ever.

Actually it is misinformation. Do you relly think that everyone but antivaxxers are piad by big pharma, Rather ridiculous idea

Must play havoc with your morals when you think about the NRA and the big religious institutions eh?

Media, doctors, government, tech and university scientists, yes. Isn’t that enough?

If we didn’t have your history of posting complete bullshit every time you appear people would just laugh at that comment.

Now, however, the question is “Is there no depth to his delusions? Who does he expect to believe crap like that?”

All of these are paid by Pharma. Explain how this constitutes delusion.

Every doctor. Everyone in the media. Everyone in government and tech. Every university scientist. They are all paid by “big pharma”?

Either

You are completely delusional and believe that, or
You are tossing it around because you know there are people more misguided than you who will believe it, or
You’re just tossing things around to play the role of a rebel

It’s really amazing how far removed from reality you’ve gotten.

Every doctor. Everyone in the media. Everyone in government and tech. Every university scientist. They are all paid by “big pharma”?

Perhaps not always write them a cheque directly or do an e-transfer, but who here will seriously deny that healthcare, academia, the media, and industry are not beholden to pharma dollars? Who here will deny the web?

but who here will seriously deny that healthcare, academia, the media, and industry are not beholden to pharma dollars? Who here will deny the web?

I will. You’re full of shit.

Quoting myself…..

Perhaps not always write them a cheque directly or do an e-transfer, but who here will seriously deny that healthcare, academia, the media, and industry are not beholden to pharma dollars? Who here will deny the web?

I remember Sharyl Attkinson in an interview spelling how this plays out with the media and pack journalism. For instance, a pharma rep approaches an editor at newspaper A. The rep says, ‘Bob we have been good to you guys with all the ad money we have given you. All we ask is that you don’t run any crazy conspiracy stories about vaccines causing autism.’ Bob agrees.

Bob then has a meeting with his journalists and tells them not to push such stories. Respecting his boss, one of the journalist publishes a story about how the latest blockbuster study found absolute no link between vaccines and autism.

Meanwhile at newspaper B, a journalist watching to see which way the wind is blowing sees the story and runs with his version of it. Ditto for journalists at newspapers C, D, E and F, and within a short time pretty much all newspapers are trumpeting the same damn study!

So, did the pharma rep pay all these journalists to write their stories? Certainly not directly! Was it a deft collusion behind the scenes by all the players? Again, it certainly wasn’t. Was it as effective as any deft collusions. It certainly was!

@ldw56old: “I will. You’re full of shit.”

LOTD: Narcissistic Truth begets Narcissistic Reality.

Observation: Our universe does not conform to the narcissist’s belief of how our universe should work.

Fact: Narcissistic belief is indistinguishable from narcissistic knowledge, being the same thing.

Fact: This mismatch of observation vs knowledge can only be explained if someone is lying.

Fact: The narcissist is not lying (unless they’re of malignant subtype) because the narcissist is never wrong.

Conclusion: Everyone else is lying. This is the only explanation that correctly fits all the evidence.

Ergo you are the liar, and your little dog too. Quod erat demonstrandum. You’re welcome.

Seriously, y’all keep interacting with these slathering tools as if they’re fellow humans possessed of logic, wisdom, insight, empathy. Well they’re not. This is how their brains really work. So don’t even try to reason with it: you will only injure yourself. Their ceiling’s so low it will lop your head clean off.

@Greg You say beholden by pharma dollars. What this means ? Doctors paid to rite a receipt (this is illegal, btw). Industry paying useless drugs for fun ?
I noticed thar you excluded government. So I would notice tha itn pays lots of medical research.

@Greg Atlkinson is inventing things.She should make a specific accusation.

Ha! Hahahahaha!
Oh my goodness, that’s the silliest thing I’ve heard all week. Either you think that everyone but you can be bought for pocket change or you’ve confused Big Pharma with Big Oil in terms of the money they have to throw around.
If Pharma really had that kind of money they wouldn’t be wasting it on paying shills, they’d be buying all the fun new instruments to make new products to make more money.

Have you ever seen dope sick?

I fail to see how a Hulu dramatization does anything to support your contention. Let me remind you in case you’re just trying to weasel out of it:

Actually it is misinformation. Do you relly think that everyone but antivaxxers are piad by big pharma, Rather ridiculous idea

Media, doctors, government, tech and university scientists, yes. Isn’t that enough?

I can’t wait to hear how Purdue Pharma was paying off the government, though.

Which part? That Pharma has influence over media, doctors government big tech or universities? Which one is silly?

@john labarge Speaking about your on example opioid settlement cost Johnson & Johnson 26 billion. An example of pharmaceutical influence, I presume,
Better explanation is that people are capable to use their brains,
and reject antivaxxing after little thinking.

@john labarge Now that is indeed lot of money.
You should consider Inflation Reduction Act of 2022:
It reduces drug prioces paid by Medicaid in the tune of 300 billion dollars. Big Pharma money is not very effective, it seems.

So your contention, let me get this straight, is that Pharma has no influence over regulators. Do I have that right?

@johnlabarge:

So your contention, let me get this straight, is that Pharma has no influence over regulators. Do I have that right?

No. You have it very wrong. Aarno is saying that the sums of money necessary to bribe the number of people you seem to believe Big Pharma copanies have bribed would bankrupt them. But nice use of the Straw Man fallacy.

It isn’t simply counter to what people believe john — what you, greg, ginny, and the rest of your sleazy lot simply isn’t backed by anything in reality. You’re simply spewing the wet dream bullshit of conspiracy theorists and people who are unable to understand the things they rail against.

Conspiracy theory like mRNA from the vaccine leaves the deltoid muscle and distributes throughout the body?

Base rate fallacy or “disparate population” fallacy. It’s a misuse of statistics where one group is far larger than the other group, so you hide the base rates in order to make it seem the larger group is at greater “risk” of something. It’s been done to death by anti-vaxxers. It’s one of their absolute favorites, next to anecdotes.

Indeed it is. The use of the base rate fallacy takes the form of incredulity that the rate of the adverse events falsely attributed to vaccines (e.g., autism in the pre-pandemic days) is not higher than the rate that we would predict to occur by random chance alone.

A fun way to point out the idiocy of the false base rate fools is to ask them to compare the percentage of people who die from jumping out of an airplane with a parachute, versus without one. Stunningly, the percentage of deaths while wearing a parachute is nearly 100% – so surely jumping out without a parachute must be totally safe.

Doesn’t really work.

Perhaps use a crosswalk? 98 people cross on green and two are killed by a speeding car. The other two jaywalk on red and one gets smeared by an 18-wheel truck.

Which of these behaviors is the more dangerous?

Their logic declares two deaths are twice as bad as one death; therefore everyone needs to jaywalk to maximize their chance of surviving. Let them do the rest of the math for themselves, not that most will be bothered: it is only another means to their Lie. The Lie is their Knowledge; their Knowledge is Power.

100 people jump out of a plane with parachutes and 1 dies. Zero people jump out without parachutes and none die. One death is greater than zero, so obviously not using a parachute is safer.

Come to The Netherlands, were you can’t see the difference in behaviour from pedestrians, whether the trafficlight is red, or green. They cross in every situation. Well, they watch the traffic, but that’s it.

@Just Me: Nice. Also captures the passive-aggressive “It’s not my fault, I didn’t do anything!” of their toddler-grade rationale.

I think one of the key points is how those who oppose any regulation are trying to present a situation where there is no ‘contemporary scientific consensus’. If you can make an argument that there is no consensus, then it cannot be any cost to contradicting it…

The ‘contemporary scientific consensus’ in 1920, when the Spanish Flu vaccines were administered to millions, was that a bacteria called Pfeiffer’s Bacillus caused the flu. That was the consensus for about 50 years, until it was revised to ‘virus’ in the 1930s.

Yawn.

Yes, R.F.J. Pfeiffer mistakenly identified a bacteria, which he dubbed B. influenzae, as the cause of influenza. However, what you neglect to mention include two things. First, B. influenzae was a pathogenic bacteria; in the context of the time the confusion was understandable, particularly given that most people who died of the fly back then died of a superimposed bacterial pneumonia to which the flu had made them susceptible. Also, the technology of the time (light microscopy) was incapable of characterizing viruses other than that they were much smaller than bacteria. Basically, back then, all that was known about viruses was that they were something that couldn’t be seen under the microscope and could pass through filters too small for bacteria to pass through. Of course viruses aren’t the only pathogenic organism that can do that. Mycoplasma fell into that category too. In any event, filtration is one way that avian influenza was characterized ~1902. In fact, in 1892 viruses hadn’t really been discovered yet, although their existence had been suspected. Also, as this excellent summary of the discovery of the influenza virus notes:

However, although B. influenzae was clearly a pathogenic organism, and was often cultured from fatal cases of influenza, other investigators were unable to confirm Pfeiffer’s strong association, a problem compounded by the apparent disappearance of pandemic influenza within a year or two of Pfeiffer’s discovery. The verdict was unclear, but the notion that B. influenzae was the true cause of influenza persisted up to the time of the next pandemic in 1918 (see below), when Rockefeller scientists Peter Kosciusko Olitsky (1886–1964) and Frederick L Gates (1886–1933) provided strong evidence against a causal association, documenting that the infective influenza agent survived passage through filters that excluded B. influenzae [10].

So even when you claim everyone believed that influenza was caused by a bacteria, there was doubt. Also, this historical context:

Despite this bacterial blind alley, it is important to note that most of the deaths during the 1918–1919 influenza pandemic were associated with secondary bacterial invaders (for review of clinical and pathological features of the 1918 pandemic see [11]), among them H. influenzae, which Pfeiffer had discovered. Pfeiffer, a budding 38-year-old researcher at the time of his discovery, went on to have a long and distinguished career as an originator of typhoid vaccination, the discoverer of bacteriolysis (‘Pfeiffer’s phenomenon’), a conceptualizer of endotoxin, the discoverer of the pathogenic organism Micrococcus (now Moraxella) catarrhalis, and a tropical disease investigator of plague (in India) and malaria (in Italy; [12–14]). Kitasato, who had already discovered the cause of tetanus (1889) and had co-developed, with Emil von Behring (1854–1917), both tetanus and diphtheria antitoxins in 1890 [15,16], went on to co-discover the bacterial cause of plague in 1894 [17], and to support his protégé Kiyoshi Shiga (1871–1957) in elucidating the cause of shigellosis in 1898.

More historical context is that virology was only just being developed around the same time that Pfeiffer mistakenly attributed the cause of influenza to his bacteria:

The field of virology can be said to have been born in 1892, the same year in which Pfeiffer published his claim for B. influenzae as the cause of influenza [7]. Before that time the word virus had for many decades been used non-specifically to describe a hypothetical communicable agent, without denoting any particular size, morphology or physical characteristics. By the 1890s most communicable diseases were assumed to be caused by bacteria, and establishing causality required culturing them on artificial media. In the 1880s Louis Pasteur (1822–1895) had failed to isolate the causative agent of rabies, but when an effective vaccine was produced few doubted that rabies was caused by a bacterium that, for whatever reason, had not yet been cultivated. Then, in 1892, the young Russian botanist Dmitrii Ivanovski (1864–1940) showed that tobacco mosaic disease was caused by an unseen agent that passed through filters with pores too small to admit bacteria [18]. Six years later, in 1898, the Dutch botanist/microbiologist Martinus Willem Beijerinck (1851–1931) showed that this agent could be serially passed in a manner that indicated it was a replicating agent, with replication occurring only in living plant tissue [19]. Presciently, Beijerinck speculated on the existence and mechanism of replication of what we now call viruses, writing that ‘the contagium, in order to reproduce, must be incorporated into the living protoplasm of the cell, into whose reproduction it is, in a manner of speaking, passively drawn’ [20].

By the turn of the 19th/20th century, Chamberland and Berkfeld filters were being manufactured and used in research laboratories, allowing microbiologists to filter infectious fluids to remove bacteria that were presumably too large to pass through their pores. Using this technology, a variety of ‘filter-passing’ agents were identified in short order, including the agents of foot and mouth disease of cattle (1897–1898; [21,22]), bovine pleuro-pneumonia [23], rabbit myxomatosis [24], and African horse sickness (1900, [25]). An ever-increasing number of filter-passing agents were soon linked to many other plant, animal and human diseases: in 1903 Émile Roux (1853–1953) counted nine of them [26] and by 1906 Paul Remlinger (1871–1964) had raised the number to 18 [27].

However, the situation was complicated by the discovery that not all filter-passing agents were uncultivatable in bacterial media. The agent of bovine pleuro-pneumonia, for example, was cultivated early on (it is now known to be a mycoplasma). In 1917, George B Foster Jr claimed that a filter-passing agent caused the common cold, even though he simultaneously cultivated ‘minute coccoid bodies’ and had to admit that he could not distinguish between these bodies and an ‘ultramicroscopic’ (undetected) virus as the true cause [28]. On the eve of the 1918 influenza pandemic, distinct concepts of viruses and bacteria as separate and fundamentally different infectious entities were not yet mature. According to historian Lise Wilkinson, this problem ‘delayed… the virus concept in the first decades of the [20th] century’ [20], and it undoubtedly complicated the picture when the 1918 pandemic appeared.

In other words, you are looking at the period of time between 1892 and 1931 with a retrospectoscope constructed in 2022, and we all know that the retrospectoscope has 20-20 vision. You assume, based on our roughly century-long understanding of viruses, that distinguishing between viruses and bacteria is so obvious and trivial that doctors and scientists then must have been stupid or clueless to take three or four decades to figure it out. However, when your technology is limited to what scientists had in the late 19th and early 20th century, when viruses were only gradually becoming known as something that could cause disease but pass through filters that trapped bacteria and flu was frequently complicated by a secondary bacterial pneumonia, the task of discovering the actual cause of influenza was far from a trivial challenge. Think of how difficult it was to figure this all out given the existing technology and understanding of infectious disease at the time.

To quote Charles Pierce, history is so cool, except that I’ll also add that the history of science and medicine is some of the coolest history of all.

“In other words, you are looking at the period of time between 1892 and 1931 with a retrospectoscope constructed in 2022, and we all know that the retrospectoscope has 20-20 vision.”

That’s exactly the reason to reject totalitarian medicine. No doubt some will be saying the same thing about 2021, a hundred years from now.

Funny, but no one’s stopping any scientists from doing research, publishing their results, and using them to argue against the current consensus, just as scientists did over 100 years ago regarding the causative agent for influenza.

Really? No one is inhibiting scientists from publishing research counter to the provax narrative? Except that every few posts here is about how to discipline doctors that disagree?

@Stoner: It’s okay just to stop at “and your little dog too!” No need to be gilding your own lily; you will only wear a hole.

Wait, if it really was ” totalitarian medicine” wouldn’t we all still insist that influenza was caused by bacteria and not a virus?

Doesn’t the fact that we now know that the bacteria theory was incorrect clearly show that science and medicine adapt to new information?

Or are you somehow expecting today medicine that is 100 years better than present? Because that’s utterly impossible.

No doubt some will be saying the same thing about 2021, a hundred years from now.

You could always get ahead of the curve and opt for early cryopreservation. I’m sure Rappoport can handle the ongoing refrigeration.

Bacon, the fact that the medical industry believed for 50 years that bacteria caused the flu, and administered millions of vaccines to patients based on that false belief, is a FACT not a fallacy–a fact the medical industry tries very hard to cover up.

You’re basically claiming it couldn’t happen again. LOL.

You can check Levitt and Ioannidis’s estimation of excess deaths

That paper has got me wondering what was happening in Australia and New Zealand to get so many negative excess deaths over the period.

@Ginny Stoner If if were when, pigs could fly. Cut to the chase: why do you think that SARS CoV 2 is not cause of COVID ?

@Chris Preston:

That paper has got me wondering what was happening in Australia and New Zealand to get so many negative excess deaths over the period.

There was a paper about the negative excess deaths in Australia published earlier this year.

The observed reductions in respiratory and dementia deaths and the reduced seasonality in ischaemic heart disease deaths may reflect reductions in circulating respiratory (non-SARS-CoV-2) pathogens resulting from the public health measures taken in 2020. The observed increase in diabetes deaths is unexplained and merits further study.

Gabriel Gregory, Lin Zhu, Andrew Hayen, Katy J L Bell; Learning from the pandemic: mortality trends and seasonality of deaths in Australia in 2020, International Journal of Epidemiology, Volume 51, Issue 3, June 2022, Pages 718–726, https://doi.org/10.1093/ije/dyac032

There’s a University of Sydney press release about it too, for people who don’t want to wade through the whole paper:
https://www.sydney.edu.au/news-opinion/news/2022/03/16/pandemic-response-led-to-a-drop-in-australian-deaths-in-2020.html

@Orac: “Yawn …”

Your extended comment is as thoughtful, intelligent, enlightening, and just all-round gosh-darn beautiful as Ms Stoner is not. I still can’t decide if I should thank you for writing it, or lament you writing it for her. Pearls before swine, etc.

Are you questioning a ‘virus’ causing the Spanish flu? Or the presence of a virus at all?

I agree, science must be challenged by continued research. But it’s hard to call your posts as ‘research’. And, you may have missed this part, this law does not stop you, or any other ‘researcher’, from posting their ‘research’, regardless of the quality.

@ David:

Certainly. If you assert that there is no scientific consensus then you can advocate that any crappy “data”/ “theories” are valid and worthy of consideration: any criticism is merely bias.
Alties do this all the time,

Criticism that shouts ‘conspiracy theorist’ anyone who questions anything about the vax is clearly biased.

Conspiracy theory is that everyone is paid by big pharma. You can criticie vaccines without assuming that.

I didn’t assume everyone is paid by big Pharma, just the most influential actors in society: big media, big tech, science and education and medical. Which one doesn’t owe some livelihood to big Pharma? You tell me. Not sure where the conspiracy is either. Just a fact.

What happens when these conspiracy clowns lie so much they forget what they said over just a couple of days? This:

John Labarge. October 5, when asked if everyone but antivaxxers are paid by big pharma.

Media, doctors, government, tech, and university scientists. Isn’t that enough?

Labarge again, after being asked if all of those people

All of these are paid by Pharma. Explain how this constitutes delusion.

Labarge, October 6, after seeing someone say that his claim was silly.

Which part? That Pharma has influence over media, doctors government high tech or universities? Which one is silly?

Labarge, October 8

I didn’t assume everyone is paid by big Pharma, just the most influential actors in society: big media, big tech, science and education and medical Which one doesn’t owe some livelihood to big Pharma?

And yet these clowns wonder why they aren’t taken seriously.

Pretty sure that you could change the protesters sign to say ‘support AB2098’ and it would all still be applicable.

OT: On the randomness of life…

Quite a few years ago, now, in some pop culture context I no longer recall, I ran across the phrase “I know you are, but what am I?” I didn’t understand what it meant, so I went to Google for enlightenment. Near the top of the results was a reference that looked enlightening so I clicked…. and landed at Respectful Insolence. It wasn’t exactly what I was seeking, but I read anyway, and wound up coming back. Now, that phrase has finally re-appeared this week in a reply comment by Orac here, and in a blog post over at SBM. Nostalgia!

I trust Orac will forgive Paul Reubens for my continued participation at these blogs…

“On the other hand, hundreds have died within a day or 2 of the shot. Coincidence, you’ll say.”

Thank you. Since over half a billion COVID shots have been given in the US, the vaccine is about 99.999% safe (I’m giving you the benefit of the doubt and assuming that there have been a thousand deaths of people whose names you’re not bothering to mention). Pretty good safety record. Of course you’re free to not get one – just promise not to take up a valuable hospital bed when a deserving person needs one

Excess mortality numbers beg to differ. How could a totally safe totally effective vaccine for an active pandemic be followed by increased mortality. Either it isn’t safe, isn’t effective or isn’t either.

Here’s the data from the CDC.

People who weren’t raised in a barn would follow that with a link to to the CDC rather than pathetically trying to score a single click, Gindo.

Allow me (PDF).

Your mistake, whether due to ignorance or dishonesty, is automatically assuming any excess deaths are due to the vaccine. (I’ll go with 70% ignorance, 30% dishonesty on your part john. ginny is 100% dishonesty.)

Let’s say we don’t assume such. Then the conclusion is either that the vax is not effective or the pandemic is not the source of the excess deaths or that most of the excess deaths are unvaccinated and caused by covid. Which is it?

As I said before, you forget that not everyone is vaccinated. Among unvaccinae, excess mortality is to be expected,

And now what? Do you want to say that you found a problematic publication by an anti-vax personality that may say what you want it to?

@David: “Do you want to say that you found a problematic publication by an anti-vax personality that may say what you want it to?”

Mate, John couldn’t spot an actual conspiracy if it ran over his head with a truck. Ditto the rest of his incestuous herd.

Please stop attempting to reason as you would to another rational, empathetic, learning human being much like you.

You are talking to a brain stem with a lizard on top. No joke.

Adjust your expectations and interaction model to that, or you’ll injure yourself.

@john labarge One cannot est transmission during a clinical trial, there are too few infections during them. It was follow up studies that established mRNA vaccine prevents transmission.

Here is the Washington Post in December 2020 explaining, among other things, that the trials don’t look at preventing transmission.

https://www.washingtonpost.com/graphics/2020/health/pfizer-vaccine-trial-results/

Pretending this is new is misleading. Further, antivaccine organizations were telling their followers this in November-December 2020.

So when the antivaccine foot soldiers pretend this is new, it raises questions about their own credibility. You all new the trial did not look at this already, even if your leaders didn’t tell you, in the interval, that there is other evidence about transmission.

Then there was never a reason for mandates. It was just pure authoritarianism.

Dorit, if the COVID19 vaccines don’t prevent transmission, and that has been known for a long time by policy makers, then what was the basis for anyone to mandate the vaccine?

Way to twist the facts Ginnt. The vaccines may not 100% prevent transmission, but they significantly reduce it. In addition, what was being said was that the sample sizes in the trials were too small to determine a reduction in transmission. In the real world, it is clear that the vaccines significantly reduce transmission.

Ginny: “Dorit, if the COVID19 vaccines don’t prevent transmission, and that has been known for a long time by policy makers”

False, yet again.

“While the vaccines do not eliminate all transmission, they can help. Studies done after distribution of the COVID-19 vaccines began, including research by Pfizer, did find that the company’s shot reduced asymptomatic infections in addition to symptomatic cases with earlier variants of the virus. Researchers in the United Kingdom reported in a February observational study that Pfizer’s vaccine helped cut transmission of the alpha and delta variants…
Dr. Paul Offit, a member of the FDA’s Vaccines and Related Biological Products Advisory Committee, explained that…“It is fair to say that when you get a vaccine that clearly decreases your chance of getting infected, it does,” said Offit, who is also the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “And therefore it decreases your chance of spreading it to others. But it’s not in any way absolute.”

https://apnews.com/article/fact-check-pfizer-transmission-european-parliament-950413863226

Ginny, there is help for your affliction.

https://www.goodtherapy.org/blog/psychpedia/compulsive-lying

So because it may help a little we should force people to get it? You people are really authoritarian.

Also let me ask this: has any provaxxer here found any vax supportive study to be poor quality?

Dangerous Bacon says, “While the vaccines do not eliminate all transmission, they can help.”

So, this wishy-washy non-assurance about vaccine efficacy apparently justifies destroying jobs, businesses, fundamental rights like control over our own bodies, freedom of movement, etc. Your standards couldn’t go any lower.

@Dorit Reiss: “Here is the Washington Post in December 2020 explaining, among other things, that the trials don’t look at preventing transmission.”

Of course they didn’t! The whole point of the Phase 1–3 vaccine trials was to determine if the vaccine was safe and effective at protecting the recipient. Complaining that those trials didn’t detect transmission rates is like complaining you can’t find Tupperware with a metal detector!

To determine at that stage if the COVID vaccine also prevents transmission would require performing a challenge trial, which means deliberately infecting vaccinated and control groups with the COVID virus to see how fast it spreads.

In other words, all these antivaxxers screaming about the absence of P3 transmission data—the very same antivaxxers who wank themselves silly over “Nuremberg 2.0” porn fantasies—are demanding exactly the sort of unethical, dangerous, lethal medical research that would rightly get them hauled into Nuremberg themselves!

Meanwhile, medical researchers who are born with an ethical bone in their body must content themselves with post-market Phase 4 monitoring to detect if the vaccine also combats the spread of infection in the general population. Of course, that’s only observational data with historical controls, so rather lower quality than the gold-standard RCTs which antivaxxers now suddenly demand. But at least they won’t swing at the end of a rope for gathering it.

By the way, John, Ginny, RI, and the rest of you gargling cretins: if you’d all like to jump to the end part and go hang yourselves, be my guest. You are certainly happy to wish it on all of us—but how can you know it works if you’ve never tried it yourself?

Of course they didn’t! The whole point of the Phase 1–3 vaccine trials was to determine if the vaccine was safe and effective at protecting the recipient. Complaining that those trials didn’t detect transmission rates is like complaining you can’t find Tupperware with a metal detector!

Not true; here is a little history…

Pfizer’s phase-1/2 trial did indeed study antibodies which is the best gauge for assessing transmission. Binding antibodies was reported for the 45 subjects but crucial neutralizing antibodies was only assesed for only seven subjects with Pfizer promising that data was forthcoming. I don’t believe it ever got reported before they eventually switched to assessing whether the vaccine prevented symptoms for the phase-3 trial.

https://pubmed.ncbi.nlm.nih.gov/32785213/

They stop transmission so amazingly well that most people I know are vaccinated and every single person I know has had Covid.

How anyone can trust these folks at this point is beyond me.

If by “these folks” you mean people like yourself, greg, ginny, ir, and the other folks who, like you, repeatedly lie, shift goal posts, and demonstrate 0 understanding of statistics and studies, then no, nobody should believe “these folks”.

If you mean researchers, statisticians, and related people: you shouldn’t blindly trust. But when all the research, from multiple sources and analyses, says the same thing, then you can secure.

Unless, again, like you and your ilk do, you simply misrepresent it or claim, as you in particular did, that “all of them are paid by big pharma”. It doesn’t help your side that you clearly don’t understand the meaning of “authoritarian”.

When your primary argument rests on conspiracies (“big Pharma” is paying people off, thousands of people are dying form the shots and that’s being hidden, etc.) you do nothing but show yourself to be a blithering idiot. I have to admit: all of you are doing a great job at that.

@johnlabarge:

most people I know are vaccinated and every single person I know has had Covid.

Everybody I know has been vaccinated and none of them have had COVID.
The plural of anecdote is not data.

It doesn’t help your side that you clearly don’t understand the meaning of “authoritarian”.

John understands it just fine, it means: Yooooo can’t tell me what to do!!!11!1!

You really are wasting your time trying to reason with John as you would with a fellow human being. He’s not. You are arguing here with a creature that has the permanent emotional age of a toddler. The RI peanut gallery is as high on the paranoid and narcissistic spectrums as they are high on themselves, and being told by anyone, no matter how mildly, “Show some respect for other people” is an unspeakably unforgivable personal insult. He is literally incapable of interpreting it any other way!

Treat as an intransigent 2 year-old. Ignore the temper tantrums completely. Walk off. The only way to win is not to play at all. Otherwise you only reward him for his behavior.

If by “these folks” you mean people like yourself, greg, ginny, ir, and the other folks who, like you, repeatedly lie, shift goal posts

Further to my comment above and speaking of shifting goalposts, the mother of all goalposts shifts occurred when Pfizer moved from studying efficacy of its vaccine by its immunogenicity profile in phase-1/2 to assessing symptoms in phase-3. This goalposts shift went largely unnoticed; drowned out by the thunderous fanfare and jubilation that proceeded the phase-3 trial news that the vaccine was 95% effective at preventing symptoms. And, perhaps the shift would’ve remained inconsequential if the vaccine hadn’t now proven to be ineffective at stopping shit.

Let it be known that it’s not just a case of Pfizer not assessing whether its vaccine is effective at stopping transmission, but them deliberately choosing this.

As usual ldw56old flings around false accusations of lying without providing any specifics to back it up, and thinks no one will notice. Slime is unpleasant but predictable.

The pharmaceutical industry doesn’t have to pay a lot of its paid promoters directly–they hire PR companies to do it for them. The PR companies hire online trolls to promote industry products.

Julian Frost ignored my request on the key issue: “Where is this ‘real world’ data on the vaccine preventing transmission, and when did it become ‘clear’?” Dorit Reiss ignored it, too.

The closest anyone came is Bacon, with something saying something to the effect that the vaccines “might sometimes help” prevent transmission. Seriously, the pro-vaxers on this page think that’s an adequate justification for the widespread destruction of human rights?

I request again for the vaccine promoters here to either provide proof the covid vax prevents transmission, or acknowledge it doesn’t exist.

Some of the evidence that COVID vaccines prevent transmission is presented in a familiar place…😉

https://sciencebasedmedicine.org/the-pfizer-covid-19-vaccine-doesnt-prevent-transmission-antivax-disinformation-goes-viral-again/

Also note that less than 100% prevention of transmission ≠ “doesn’t prevent transmission.”

I know that’s what antivaxxers like to claim, for instance that only 50% efficacy (as an example) preventing transmission means that the vaccine is utterly useless, but that’s just very simplistic black-and-white thinking. Back in the day antivaxxers used to claim that because measles could cause outbreaks in fairly highly vaccinated population meant that the measles vaccine didn’t stop transmission, even though it’s 95% effective, which is damned effective for any medical intervention.

Not enough people have been vaccinated. Unvaccinated have much higher probabilty o die because of COVID,

Vaccination rate in US is not 80%. 68% is fully vaccinated and 33% has received booster. 79% has received a single dose, which is not enough. Strain may be a little less virulent, but it sprads easier

@johnlabarge

Do you want to be congratulated for finding an article that confirms your beliefs? I’m glad that this makes you feel better.

@johnlabarge

Do you want to be congratulated for finding an article that confirms your beliefs? I’m glad that this makes you feel better.

I’m sure he is enjoying his “victory”, just as I’m sure that the facts that his cited “study” is terribly flawed and his other source is “theblaze”, meaning both are completely worthless, went over his head.

You can learn stuff on expensive television channels**:

— I wanted to link to Bill Maher’s last show ( 14 Oct 2022) because he asserted that most PH measures about Covid were RONG! , ‘Sweden did better’, he got COVID after a vaccine and a guest , Michael Smerconish agreed and even cited the GBD! Neil DeGrasse Tyson countered reasonably to little effect.
I usually find the video and direct readers to YouTube with precise timing HOWEVER this time, none of the links worked (removed, private). Was that censorship or CYA? Maybe readers will find another link: the argument is near the end of the show. The show will probably be repeated this week.

— Learning about cults is relevant for sceptics: HBO presented an informative ( but horrifying) documentary about the NVIDIVM cult. The Vow, which will conclude this season. It details how operators manipulate people for financial gain and personal power. There are also decent internet resources about cults from psychologists and survivors. Easy to find.

I have a personal interest because one of the principals tried to engage my cousin and her daughter years ago: the younger was in a serious car crash and left with disfiguring injuries, a ( SBM) doctor told them that his wife, a nurse, did hypnosis that might help. They declined. That nurse became of the principal machers of the cult starting out using hypnosis and NLP and progressing to “other activities”.

The series illustrates how scammers function and how they appeal to vulnerable people. Participants sought out “training” and “therapy” to improve their lives, succeed in business and/ or show biz by following a “brilliant” guru. After listening to a recap of series one, it occurred to me that alties I survey in detail have much in common with these cult leaders although they don’t actually physically brand women.

** it’s not all dragons and incest

Oops! The cult is called NXIVM.
I made an interesting error but I’ll leave it readers to figure out why.

re Bill Maher Oct 14:

It seems that some recordings were removed** or “re-arranged” ( e.g. Mr Netanyahu appears twice) but I found one on Odysee that is complete and in the correct order ( although I skipped around)
at 35 minutes to about 44:
Maher and Smerconish discuss Covid whilst pooh poohing some PH measures and de Grasse Tyson speaks sense. Interestingly, it follows a discussion about teaching school kids spotting BS!

** was this the invisible hand of social media?

[…] Before I move on, let me just point out a common theme in the arguments of COVID-19 contrarians, which is that “science has been wrong before,” which is then used to claim that efforts to “police misinformation” will entrap innocent physicians and scientists who simply hold a minority viewpoint about an issue and conflating such physicians and scientists with those spreading conspiracy theories, antivax disinformation, and quackery. It’s an intellectually dishonest comparison between apples and oranges, but it’s one that comes up all the time, probably because it resonates with a lot of doctors who don’t understand the difference between quackery and misinformation versus legitimate scientific disagreements and mistakenly view such efforts as “censorship.” […]

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