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Dr. Vinay Prasad whines about the “misinformation police.” Hilarity ensues.

COVID-19 contrarian Dr. Vinay Prasad attacks the pandemic “misinformation police.” He needs new material, having recycled the same tropes he used to attack skeptics before the pandemic.

When last I wrote about Dr. Vinay Prasad, the apparently 0.2 FTE academic oncologist at UCSF turned COVID-19 contrarian and misinformation amplifier, he had teamed up with another, more senior and prominent academic turned contrarian, Dr. John Ioannidis, to whine about the “obsessive criticism” they and their fellow contrarians encounter on social media. As I noted at the time, one couldn’t help but note the irony of two tenured academics at very respected institutions complaining about “obsessive criticism” on social media in a peer-reviewed journal for which one of them (Prof. Ioannidis) had served until fairly recently as editor-in-chief while the other author (Dr. Prasad) had never been a slouch at rather nasty attacks against his critics himself. I won’t dwell on that aspect other than to note that the article by Dr. Prasad that caught my attention yesterday strikes me as more of. the same. However, the real reason Dr. Prasad’s article rose about the usual noise of his daily efforts to cast fear, uncertainty, and doubt (FUD) on public health interventions against COVID-19 was the central premise of it, which was very much like the central premise of an attack he had launched before the pandemic—and then doubled down on a year later—on “quackbusters”; i.e., skeptics, often physicians and scientists like me, who devote their primary efforts to countering medical pseudoscience, conspiracy theories, misinformation, and disinformation, particularly antivaccine propaganda.

Dr. Prasad published his article on a Substack (Sensible Medicine) that he had founded with a number of other COVID-19 contrarians, among them Dr. Martin Makary (the originator of the false sound bite that medical errors are the third leading cause of death who is now a frequent guest on Fox News—Tucker Carlson’s show, even!—promoting COVID-19 minimization and antivax takes) and Dr. Zubin Damania (a.k.a. ZDoggMD, who has gone from making clever and entertaining videos mocking antivaxxers and calling out antivax influencers to amplifying antimask misinformation and antivax claims about COVID-19 vaccines). The title, The Misinformation Police Strike Out, mildly amused me, but what really caught my attention was the tagline:

Being able to debunk Jade Eggs does not mean you know how many boosters a 20 year old man needs.

Apparently, Dr. Prasad has one ad hominem shtick, and that’s to compare any critic who’s ever debunked an alternative medicine claim to someone who just debunks Jade Eggs. Also, given that the most prominent debunker of Goop and Jade Eggs is Dr. Jen Gunter, one can’t help but sense a bit of…misogyny…in Dr. Prasad’s intentional choice to keep repeating this example, rather than, for example, bringing up homeopathy.

As you might imagine, my first thought was, “Oh, it’s on!” And it is. However, before I go into the substance (if you can call it that) of Dr. Prasad’s resurrection of his old trope of likening anyone who criticizes his bad takes on medicine to skeptics debunking Jade Eggs, I can’t help but serve up an observation that I made that really amused me—and will likely amuse old hands on this blog. Specifically, I noticed one prominent commenter Vinu Arumugham. Longtime readers might remember Vinu from years and years ago as a one of the looniest commenters ever on Respectful Insolence. He was so “out there” that for a time he went by “Vinucube,” apparently after another commenter had likened him to the classic crank website Time Cube.

Back then, I labored under what I now realize to have been a misguided delusion of free speech absolutism that led me, in essence, not to moderate my comments at all, allowing cranks like Vinu to periodically run wild, which is why I tolerated him for so long before finally blocking him. Unsurprisingly, five years after he finally disappeared from this blog, Vinu now has his own Substack (Vinu’s Newsletter) where he basically says the same sort of things he used to say here c.2008-2017 or so, only about COVID-19, and is now apparently a regular commenter on the Substacks of COVID-19 contrarians like Dr. Prasad, who, as far as I’m concerned, is welcome to him.

So what is Dr. Prasad’s beef with the “misinformation police”? Who are the “misinformation police”? Let’s take a look.

Dr. Prasad vs. the “Misinformation Police”

Before his rant about us apparently Jade Egg debunking “misinformation police,” Dr. Prasad starts by reminding us that science is hard (no kidding):

Science is difficult. Many popular theories turn out to be incorrect, and some ideas— initially thought implausible— are ultimately vindicated. Of course, let’s have perspective: most crazy ideas are, in fact, crazy, but what is true and what is consensus is not always the same. Dr. John Mandrola wrote on this topic brilliantly last month noting, “uncertainty always prevails over certainty—even when experts feel there is a consensus.”

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.”

Certainly, that’s what Dr. Mandrola’s article cited by Dr. Prasad is basically saying in a rant against AB 2098, the California law that now empowers the Medical Board of California to discipline physicians who spread medical misinformation, casting as martyrs who might be in for a visit before the Inquisition Medical Board doctors who are on the “wrong side” of scientific and medical debates over “percutaneous left atrial appendage closure, hypothermia for post–cardiac arrest survivors, transcutaneous edge-to-edge repair for secondary mitral regurgitation, fractional flow reserve for assessment of coronary arteries, and cerebral embolic protection after transcatheter aortic valve implantation—not to mention drugs such as niacin; fibrates; vitamins A, C, E, and D; and folate.” Again, the intellectual dishonesty of such an argument is a feature, not a bug, of COVID-19 contrarians attacking the “misinformation police.” I’m just relieved that Dr. Mandrola controlled himself enough to refrain from mentioning Ignaz Semmelweis, even as he expresses fear about speaking out about one such issue, so as not to be “further labeled a disruptive physician.”

Let’s get to the meat of Dr. Prasad’s jeremiad:

That is why wise scientists are concerned that policing misinformation (particularly using blunt modern tools: censorship, shadow-banning and de-throttling) is dangerous. Policing is different than debating. It’s different than rebutting. It’s using the brute force of the modern algorithmic platforms to slow the spread of your opponent’s ideas. I worry it has been misused. 

The COVID19 pandemic reveals the limitations and arrogance of science influencers. Pre-covid they were often on target. In a world of reiki, jade eggs, supplements and cupping, it was easy for health misinformation ‘experts’ to make their mark debunking popular, unproven remedies. Why? Because these things are obvious nonsense, and you don’t need to know much to know that. 

But these ‘experts’ were woefully unprepared for the pandemic. Lockdowns, the possibility of lab leak, school closure, masking adults, masking kids, 5 vs 10 days of quarantine, and who should get how many doses of vaccine and when— are complex technical questions that require deep knowledge of biomedicine, trials, trade-offs, statistics, and more.

Notice how Dr. Prasad portrays himself compared to physicians and scientists who had discussed quackery over the years leading up to the pandemic. I’ve written in depth just how Dr. Prasad chose the most ridiculous examples he can think of in order to further his narrative that countering misinformation and quackery is akin to “dunking on a 7′ hoop,” although he did screw up somewhat here, as it is anything but obvious or easy to determine whether a given supplement “works” for a given medical indication. As I discussed before, his entire tactic is to portray what we do as so very, very easy compared to what he does as so incredibly difficult that we supposedly can’t handle it. It’s arrogant, ignorant, and annoying, but those three words describe Dr. Prasad rather well, making it unsurprising that he’d resurrect the same attack.

Then he gets personal:

Science debunkers and influencers—who often don’t work at universities, don’t publish research, don’t understand statistics, don’t peer review for journals, don’t have a good sense of the pre-test probability of interventions, and/or don’t have deep technical understanding of drug regulation—tried to crusade against misinformation, but they made many mistakes. This would be okay if they were merely debating, but repeatedly they sought to use the tools of the platform to extinguish ideas they disliked.

I was asked on Twitter why I reacted to this paragraph as though he were attacking me personally, because I noted there that I do publish research, am a professor at a university, understand statistics, peer review for journals, and have a good grasp of pretest probability honed in advocacy of science-based medicine (SBM) compared to evidence-based medicine (EBM). I even have a decent technical understanding of drug regulation and, as far as I can tell, unlike Dr. Prasad have actually written clinical trials. I will admit that the one investigator=initiated clinical trial I did actually administer failed due to lack of accrual, but failure often teaches better than success. Finally, to understand why I (somewhat) took this attack personally, you need to be aware of our previous interactions, including this one before the pandemic, when he Tweeted (and then later deleted) in late 2019:

Prasad insult
Gee, whom do you think Dr. Prasad is referring to here?

Of course, I’m a surgeon, but in context it was obviously about me. You’ll just have to take my word for it, though, because Dr. Prasad deleted most of his Tweets from this time period in which he attacked quackbusters as doing something very, very easy. As I wrote the last time I discussed this issue, his bit on how alternative medicine and antivax disinformation are “soft targets” betrayed the same ignorance that John Horgan did when he used the same shtick in a talk at NECSS six years ago. Unsurprisingly, Dr. Prasad approvingly cited Horgan in his post:

Years ago, in a piece in Scientific America, John Horgan urged debunkers to spend less time on the soft targets— cupping— and more time on the hard ones— mammography. Ironically, when influencers turned to hard targets during the pandemic—such as vaccine induced thrombocytopenia and thrombosis, mRNA myocarditis, late gadolinium enhancement, and the tradeoff from boosting after infection— they were woefully unprepared to think about these issues. Perhaps Horgan’s message should have been simpler: debunk what you understand and know your limits.

This is some serious projection, because if there’s one thing that Dr. Prasad and his fellow “don’t worry, be happy” COVID-19 contrarians exhibit, it’s incredible arrogance and a failure to know their limitations. The funny thing is, if there’s one thing I’ve observed about skeptics (e.g., Steve Novella), it’s that they are quite aware of their own limitations, acknowledge them, and try to work within them. Indeed, there’s a reason why I particularly like this quote from a Dirty Harry movie, Magnum Force:

Dr. Prasad and his fellow COVID-19 contrarians really need to listen to Dirty Harry.

There’s some even more epic projection on Dr. Prasad’s part in his post as well:

Interestingly, influencers almost universally share the same political views— mixing debunking with far left socio-political positions and open endorsement of Democratic candidates. They draw upon tactics used in politics and the culture war and import them to medicine: opposing ideas are not just wrong, they are dangerous and harmful. We can’t fight speech with speech, we have to censor, label, de-platform, and down-throttle.

I debated whether to write more about why this is projection, but it’s easier just to point you to a post that I wrote a year ago, after Dr. Prasad had gone full Godwin on public health, likening COVID-19 interventions to incipient fascism. (He even entitled his post How Democracy Ends.) I think that will suffice and will therefore move on, even though I can provide many more examples.

A made up term?

No jeremiad against those nasty skeptics would be complete without examples of their supposed arrogance and overreach. I’m not going to refute each one here, as some of the examples that Dr. Prasad chooses would likely require a full blog post themselves. Also, he keeps bragging about an 8,000 word “technical treatise” and “formal academic article” on vaccines that is not peer-reviewed but is hosted conveniently on a preprint server in order to make it look as though it’s in the pipeline for publication COVID-19 vaccines: history of the pandemic’s great scientific success & flawed policy implementation. I can say that this is unlikely to be published anywhere in the peer-reviewed literature because 8,000 words is far beyond the word count limitation for even review articles of nearly every medical and scientific journal, but I see what Dr. Prasad did there. Just perusing it briefly, I see so much obvious spin and so many questionable assertions about the vaccines, myocarditis, and mandates, as well as revisionist history about the rollout of the vaccines, that I’m half tempted to do my own post about it in the near future, although if I have to match 8,000 words in a rebuttal that would be long even for a post at my not-so-super-secret other blog. We’ll see.

Instead, let me just look at one claim going around that Dr. Prasad repeats:

Recently an account called “unbiased science” (Of course, it is unbiased!) put out a video claiming the idea of immune debt— that avoiding infections through severe societal disruption for years makes us more susceptible to future infection is— is not true.

This led Dr. Prasad to cite someone who was very unhappy about the Tik Tok video to which he was referring, Alasdair Munro:

This Tweet is not the demonstration that Munro thinks it is.

Amusingly, the above quote-Tweet actually leads to a thread that, if anything, reinforces Dr. Andrea Love’s point, as I’ll discuss. Basically, if you search PubMed for the term “immunity debt,” you’ll soon find that it’s nowhere in the medical literature before 2021, which is quite…odd…if the term wasn’t recently made up and that nearly all the papers that Munro cites date back no further than 2021.

Also:

Very…interesting. You should take time to follow this entire Twitter thread, as it wends its way through the searches and tells you what it finds.

It’s a term that’s been weaponized as a talking point claiming that the reason we are seeing surges in influenza and respiratory syncytial virus (RSV) in children is because they were kept home for so long and therefore never encountered these pathogens, leaving their immune system in “debt” that is now being repaid in the form of the current surges in pediatric flu and RSV.

Even more amusingly, in “debunking” the “debunker,” Munro cites one of his own medical op-ed pieces, leading to this rather good retort:

Unsurprisingly, apparently neither Alasdair Munro nor Dr. Prasad has an answer to this question.

I could go on, but there are two excellent refutations of the whole “immunity debt” narrative out there, one by Bruce Y. Lee at Forbes and another at the Counter Disinformation Project.

Per the Counter Disinformation Project:

Since 2021 Immunity debt has been used to explain why people, in particular children should be exposed to infectious diseases, the concept is that not being regularly exposed to pathogens their immune systems are unprepared when they do encounter them. The concept has been cited as a lockdown harm and as a reason why masks and in some cases even ventilation and clean air should not be used as mitigation measures in schools. It has been argued by some paediatricians in the UK and elsewhere that due to immunity debt infections don’t just catch up but overshoot. 

Immunity debt is a form of extension of hygiene dogma, in practise it looks a lot like an extension of the thinking that supported herd immunity by infection as a strategy to handling the pandemic.

It is worth noting that those who raise concerns about immunity debt are generally the same people who initially claimed children were considerably less likely to be infected and didn’t contribute significantly to transmission. These are also generally the same people who still claim the majority of covid infections in children occur outside of schools. This is despite contact tracing and testing studies demonstrating the direction of transmission, the latest being a comprehensive study from Italy.

It’s worth reading the entire long article to learn the origin of the term “immunity debt” and how it is being used by the same people who have pushed herd immunity approaches to the pandemic.

And Lee:

The bottom line is that wearing a face mask and maintaining social distancing over the past two years is unlikely to have made you more susceptible to respiratory infections now. There’s no real evidence that this has resulted in a so-called “immunity debt.” Give your immune system more credit than that.

I think I’ve beat this example into the ground, but I can’t resist one more.

Dr. Prasad understands VAERS better than you do!

Regular readers know that I’ve been writing since 2006 about how antivaxxers have been using, misusing, and abusing the Vaccine Adverse Events Reporting System (VAERS) database in order to blame vaccines for everything from autism to sudden infant death syndrome (SIDS). I’ve also written extensively on how in the age of the pandemic the weaponization of VAERS to spread FUD about vaccines has gone mainstream. To recap briefly, the main problem with using VAERS to estimate the frequency of adverse events (AEs) after vaccination is that, in essence, anyone with access to the Internet, mail, or the telephone can report anything to VAERS, as was demonstrated by bloggers years and years ago when one autism advocate filed a report claiming that the flu vaccine had turned him into The Incredible Hulk and another claimed a vaccine had turned his daughter into Wonder Woman. Both reports were accepted. In fairness, ultimately someone from VAERS did contact these people to ask about the reports, and the reports were removed. However, had they refused, reports that vaccines might turn one into the Hulk or Wonder Woman might still be in the database.

Moreover, going back to the early 2000s, VAERS has been distorted by attorneys seeking to game the system by encouraging reports to be entered for AEs highly unlikely to be due to vaccines. Also, if you don’t consider the baseline rate of the AE being examined, VAERS data are pretty much worthless for determining if there is a safety signal. That’s why VAERS was never intended as a reliable tool to measure changes in the actual prevalence of AEs due to vaccines. Rather, it was always intended as a “canary in the coal mine” sort of early warning system to generate hypotheses that can be tested using better systems, for example active surveillance databases like the Vaccine Safety Datalink.

None of this stops Dr. Prasad from pontificating about vaccine induced thrombocytopenia and thrombosis:

The truth is understanding passive surveillance systems is harder than debunking cupping. I knew that VITT was a serious concern for adenoviral vector vaccines, and said so at the time. Of course, the signal was real. Runaway platelet activation and clotting has essential no base rate (in the absence of heparin exposure); and, as such, all events are likely causal. 

I urged the FDA to suspend authorization, at least in women under 50. It took the (pro corporate) FDA 1 year to come around to my thinking, but eventually they did, and deprioritized these products. This was only after needless harm to Americans.

It is a common claim by antivaxxers and those who, either knowingly or unknowingly, amplify antivax talking points, that vaccine advocates downplayed the possible risk of thrombosis due to adenovirus-based COVID-19 vaccines last year. At best it’s an exaggeration; at worst it’s a lie. For example, a number of us discussed this issue and, as data came in, became more and more accepting of a link. In other words, we doubted it at first but fairly quickly changed our minds as more data rolled in. We also noted, contrary to claims by people like Dr. Prasad, that the detection of low frequency events like this was good evidence that current vaccine safety monitoring systems actually work rather well. We also brought nuance, unlike Dr. Prasad, by pointing out how hard it is to weigh the risk of uncommon adverse events versus a disease like COVID-19 in the middle of a pandemic in the face of major uncertainty about the data—rather the opposite of what Dr. Prasad does and demonstrating that projection really is his thing.

Dr. Prasad also declares “victory” about myocarditis after the vaccines, lambasting those of us who pointed out how bad a dumpster-dive into VAERS coauthored by one of the members of Sensible Medicine was:

Yet, science influencers derided the authors saying that they misused VAERS. It merely confirmed the old adage: a little learning is a dangerous thing. Influencers knew enough to know that VAERS could be misused, but they lacked a nuanced understanding of what exactly misuse would look like, and how to detect it.

They assumed that any use that could lend caution to the widespread vaccination of young men was misuse. But that is hardly the case. Their heuristic was too simple. A heuristic that works well for jade eggs and cupping, but was ill suited to novel mRNA vaccine products developed on a short time span, with little to no dose optimization.

One notes that when the paper was published, Dr. Prasad was ecstatic in his praise:

Note one of the authors: Josh Stevenson, who doesn’t acknowledge in the author list his association with Rational Ground.

Actually, we knew exactly what to look for in misuse of VAERS, having analyzed various antivax misuses of VAERS for 15 years (at least) before that, and that paper had it all. Worse, one of the co-authors was a member of an antivax organization, Rational Ground, something that. Dr. Prasad conveniently forgets to mention. In fact, skeptics can do more than one thing at once. We can deal with claims about Jade Eggs, homeopathy, and the like, but many of us also have high level knowledge about VAERS, clinical trials, and epidemiology, all of which can be necessary to deal with various pseudoscientific claims.

Hilariously, Dr. Prasad then urges:

Side note: go back and read the Medscape piece and look at the final published paper by the authors. Ask yourself if that constitutes fair and balanced journalism. If you ask me it was a hatchet job.

One notes that the criticism was about the preprint version of the paper! To their credit, the authors seemed (somewhat) chastened by the criticism and did make some changes. One notes that it was five months later before this paper was published, as well. One also notes that the Sensible Medicine member (a certain cardiologist) who had been a co-author was no longer an author of the final published version. One wonders why, one still does, even more than a year after the preprint and 9 months after the final publication. What one does not wonder is why Dr. Prasad didn’t mention this context or why he fails to understand that, even if the paper ultimately came to an estimate of the rate of myocarditis after vaccination with mRNA-based COVID-19 vaccines that is within the rather wide range of estimates from other sources, it does not mean that their methods were any less atrocious. It just means that they got lucky.

Projection, thy name is Dr. Prasad!

The last section of Dr. Prasad’s jeremiad is truly an exercise in projection, so much so that I’m half tempted just to quote some of it and write nothing else. Of course, Orac being Orac, you know I’ll have a little something to say. Such is life.

First:

The Venn diagram of science influencers, far left socio political views, and a desire for canceled culture tactics have coalesced to create #TheScience — a bizarre group of individuals who insist on policing information they barely understand.

Counterpoint: The Venn diagram of COVID-19 contrarians influencers, far right sociopolitical views, and false claims of cancel culture tactics have coalesced to create #AlternativeScience — a bizarre group of individuals who resist any attempt to counter disinformation, viewing such misinformation as “Free Speech.”

Next:

Most of science influencing is like this. Superficial understanding of a topic, but dressed in bravado. That’s okay when the thing you are debunking is equally superficial. But that’s not okay when we’re talking about complex drug products or widespread screening campaigns.

And Dr. Prasad destroys yet another irony meter.

Irony meter
Dr. Prasad strikes again!

Seriously, what is Dr. Prasad’s pandemic career but one long exercise in right wing-friendly COVID-19 minimization and fear mongering about vaccines?

I will admit that Dr. Prasad did write one thing that I (sort of, partially) agree with:

Without a doubt, there was a lot of misinformation during the pandemic. Science influencers might feel like they helped reduce that amount, but I doubt they even made a dent in it. It was massive.

It is indeed arguable how much of an effect we skeptics have had countering misinformation, but the main reason is not what Dr. Prasad claims. Rather, it’s because we are so few, with few resources, facing a veritable firehose of disinformation coming from both malign actors and their useful idiots like Dr. Prasad, who claims the mantle of True Science™:

Instead, their true legacy was interfering with legitimate scientific debate they didn’t fully understand, leading to unnecessary harm across many domains. In the end, misinformation continued largely unchecked, while real scientists were dissuaded from discussing how to give vaccines more safety, among other questions. Something tells me I won’t see a tiktok video with that lesson anytime soon.

The sad thing is, there was a time when Dr. Prasad actually wasn’t a useful idiot for antivax and anti-public health actors. There was a time when he did important research looking at the rigor of clinical trials used to approve new cancer therapies and finding them wanting (especially for accelerated approval) and voicing skepticism about the Cancer Moonshot. Unfortunately, he appears rarely to have done original research, instead staking his career on “meta-research” that examines the results of other people’s original research. It’s an important function, but I’ve come to the conclusion that it’s a branch of research that leads to a certain hubris and failure to follow Dirty Harry’s advice to know his limitations, much as Dr. John Ioannidis has gone down the same route.

More importantly, the lesson that I use Dr. Prasad to illustrate is exactly the opposite of the lesson he takes from “science influencers” who pivoted from dealing with alternative medicine and pre-pandemic antivax claims to dealing with misinformation/disinformation about COVID-19 and COVID-19 vaccines. While Dr. Prasad points to them as examples of people who lack the necessary skills to examine misinformation in the age of the pandemic, in fact they are precisely the people possessing precisely the skills needed to deconstruct such disinformation. In contrast, Dr. Prasad, who fancies himself as doing The Hard Work compared to skeptics, who in his world are dim to do anything but debunk obvious nonsense like Jade Eggs, is actually Exhibit A for why skills that we skeptics have tried to inculcate for decades are more critical than ever now that a veritable tsunami of misinformation about the pandemic has been washing over us for nearly three years. For all his self-proclaimed high level knowledge and skills in statistics, peer review, clinical trials, Bayesian analysis, and Science in general, he clearly lacks some very basic skills in skepticism, such as recognizing conspiracy theories, logical fallacies, and techniques of misinformation, coupled with the ability to make a conscious effort to separate one’s own preexisting ideological beliefs from one’s science. That’s why he has become a useful idiot for COVID-19 deniers in much the same way that scientists in the middle part of the last century became useful idiots for tobacco companies.

Projection, thy name is Vinay Prasad.

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]

45 replies on “Dr. Vinay Prasad whines about the “misinformation police.” Hilarity ensues.”

Dr Prasad should be very aware that an important part of the scientific process is detecting a true signal amidst all the noise of anecdotal claims and amateurish studies published everywhere from Substack to public health departments. That is why we have a peer review process, to do a first cut sorting to see if the research meets minimum standards before it gets published for consideration by other scientists.

So that makes it especially ironic that he will stand up for a VAERS based analysis but use his YouTube channel to denigrate multiple observational studies that clearly meet that publication standard.

I’m not sure about myocarditis but clotting disorders like TCP were spotted early in the trials for both the AstraZeneca and J&J/Janssen vaccines which led to temporary halts in both trials. And VAERS reports of myocarditis showed up in the first couple months of mass vaccinations for the mRNA vaccines. So there’s no real basis for arguing that scientists and skeptical science writers like yourself and all the writers at SBM were unaware of them.

And he should also be aware that serious and often vociferous critique is an integral part of science as well.

As an aside, I would note that Dr Novella discusses immunity debt in his SBM article today.

But having watched several of Dr Prasad’s videos, I would definitely second your description of him as “arrogant, ignorant, and annoying”.

And for someone who pretends to understand this, Dr. Prasad seems to have completely missed the fact that it wasn’t FDA who “deprioritized” J&J vaccines. It was CDC’s advisory committee, ACIP, which recommended preferential use of mRNA vaccine as evidence accumulated – on the grounds that we have an alternative to J&J, and while pointing out that without that alternative, the benefits of J&J vaccines would outweigh their risks.

Dr. Prasad’s discussion of the bad preprint also misrepresented the way it was used at the time. As a reminder, the heart of the paper was not that COVID-19 vaccines were linked to myocarditis; we knew that then. It was the argument that that risk was higher than the benefits of the vaccine for the groups of 12-15 and 16-17, and higher than the risk of hospitalization from COVID-19. That’s what Prasad’s tweet is touting, that’s what the media coverage of the preprint was all about – risks higher than benefits – and the paper was and is misleading about that. As in, saying things they had no data to say, and doing tricks like picking a very limited time for hospitalizations prevented by the vaccines. The paper had no grounds to say that based on VAERS reports, Prasad had no grounds to repeat it, and when he’s trying to downplay his willingness to share blatant misinformation, it’s an issue.

A few rungs down the ladder from Prasad, alties I survey often cosplay using terms like ‘misinformation, disinformation, scepticism, Dunning-Kruger, critical thinking, cognitive dissonance, logical fallacies, propaganda, Occam’s Razor’ ( or -sic- ‘Oxxam’s Razor’) when referring to SBM advocates. This fits right in with their programming asserting that media, academia and experts are all essentially compromised and not to be trusted.

They get away with this misconception of reality because their enthralled followers are flattered into accepting that they are indeed a nouvelle vague that will soon overtake corporate science washing corruption away and replacing pharma with farms. Research shows that anti-vaxxers especially believe that they are special, not common, ahead of the crowd.

A few rungs down the ladder from Prasad, alties I survey often cosplay using terms like ‘misinformation, disinformation, scepticism, Dunning-Kruger, critical thinking, cognitive dissonance, logical fallacies, propaganda, Occam’s Razor’ ( or -sic- ‘Oxxam’s Razor’) when referring to SBM advocates. This fits right in with their programming asserting that media, academia and experts are all essentially compromised and not to be trusted.

As I said, it’s totally projection, or: I know you are, but what am I?

@ Orac:

I think that alties/ anti-vaxxers have reacted to increased surveillance/ criticism of their material by both sceptics and the mainstream media since Covid mis-information became de rigueur. They try to mime SBM with use of studies – usually bad, unrelated or mis-interpreted- even listing their finds from Pub Med! They feature ‘esteemed experts’
to strengthen their case- Malone, McCollough, Kory, Gold, Rose, diverse economists and tech bros and pepper their rants with invective against Dr Fauci and other PH officials. They invoke discrimination, free speech and misogyny as well as opposing the Lord’s Will.

About politics: long time liberals/ feminists like Kennedy, Bigtree, Rossi, Wright find themselves in odd positions engaging right wing politicos.
Adams is now openly courting Christian extremists.

-btw- I am moderately left although to some of these
righties I am probably Chairman Mao.

It all started with a certain blowhard reverse-weaponizing the term “Fake News,” for which he was the original Exhibit ‘A.’

As I’ve noted multiple times, if all deaths which occurred after Covid vaccination were reported to VAERS as is required by the FDA, the number of deaths caused by pure chance alone would dwarf the number of deaths actually reported to VAERS. Even if the temporal proximity is limited to a couple of weeks, there are still not enough death reports. Yes, adverse events are underreported, but the truth is quite a bit different than the dumpster divers claim.

Prasad: “Interestingly, influencers almost universally share the same political views— mixing debunking with far left socio-political positions and open endorsement of Democratic candidates. They draw upon tactics used in politics and the culture war and import them to medicine: opposing ideas are not just wrong, they are dangerous and harmful. We can’t fight speech with speech, we have to censor, label, de-platform, and down-throttle.”

Well you can’t argue with that statement, can you? Orac and all his supporters here belong to the same political tribe. And you all feel that opposing views are dangerous and harmful (and stupid).

Orac: “For all his [Prasad’s] self-proclaimed high level knowledge and skills in statistics, peer review, clinical trials, Bayesian analysis, and Science in general, he clearly lacks some very basic skills in skepticism, such as recognizing conspiracy theories, logical fallacies, and techniques of misinformation, coupled with the ability to make a conscious effort to separate one’s own preexisting ideological beliefs from one’s science.”

No it isn’t possible that an educated intelligent person would have views different than Orac’s. Therefore, he must be stupid, ignorant, delusional.

By pretending you know more about general medicine than those of us who do the damn work everyday, you have cast yourself as: “Stupid, ignorant, delusional.” Own it proudly or stop willing it so.

What an astonishingly ignorant statement.

I don’t know what industry you work in, but it sure as heck isn’t the sciences.

You want to see a passionate argument with data? Ask a bunch of immunotherapy researchers which is better: autologous or allogenic cancer immunotherapies.
Scientists disagree all the time without saying that the other person is stupid or dangerous. That’s part of the whole idea of science.

And I don’t know what you’re basing your assumptions about everyone here’s political positions and leanings, but having been here a whole lot longer than you I would not say with confidence that I 1) know everyone’s position and 2) agree with everyone’s position.

“Scientists disagree all the time without saying that the other person is stupid or dangerous.”

Which is why I am having more and more trouble considering medical doctors as scientists.

I’ve been reading and posting here for over ten years now, i think, and as someone actually on the political left* I can say my political views have hardly been widely shared here. What I have noticed though, is a shift towards support for Democrats and against Republicans by both Orac and some frequent commenters. Orac was never a conservative, but he used to be a lot less political, and philosophically more of a libertarian than he projects now. What has happened is simply that conservative ideology and GOP politics has gone all in on risible anti-science positions on just about everything, but especially on public health. So the pro-science folks that show more liberal politics now are just following where THE SCIENCE gets the epistemological respect it deserves in the public sphere.

I was actually a “founding member of DSA”, meaning only that I sent in dues to get the newsletter during the first year of that organizations existence (superseding DSOC and NAM) which I did only because a couple friends of mine from grad school were involved and I wanted to support them. I never actually participated in any of the groups activities, but I thought they were pretty cool.

Of course, Prasad tells on himself with “far left socio-political positions.” Hmm, what would those be? Trying to curb climate change? Trying to mitigate pandemics? Opposing structural racism? Refusing to demonize LGBT+ youth? Do tell.

I noticed a lot of “science agrees with the left” type commentary with the debates/discussions of evolution and climate change. I myself have constantly reminded many people that the vast majority of scientists are not only “left leaning” but are also lower on the religiosity scale.

Perhaps this has all rankled people like Vinay, made them feel excluded and/or derided. I know that doesn’t make me feel bad at all, as the political “right” has destroyed online science forums where real questions could have been answered, instead turning it into screeds about Al Gore, “why do we still have monkeys”, and I suspect the flat earthers trend libertarian.

And along with you, I’ve only recently become aware that Orac is more “left leaning” now, as I considered him politically agnostic or perhaps slightly libertarian before. I suspect that the clear indication of leftward ideology has come in response to the overwhelming anti-science bent of the right-wing majority in response to so many things like abortion, stem cells, LGBTQ+ science and rights, climate change, evolution, and now vaccination(s) and probably a few other areas.

To be honest, I haven’t really been libertarian for a long time, going way back. The last vestige of my libertarian leanings, which had pretty much disappeared by around 2004, was a misguided belief in free speech über alles to the point that c.2005-6 I used to write posts criticizing European laws against Holocaust denial and I had virtually no comment moderation on this blog. It’s also true that I used to avoid politics on this blog (for the most part) until around c.2015. In fact, it’s funny. I was interviewed recently by a reporter and my politics came up, which led me to recount how I really was conservative beginning in late high school/early college and voted pretty much straight Republican from 1980-2000, the sole exception being John Glenn for Senate when I lived in Ohio in the 1990s (which was basically the same as voting Republican).

What started my evolution away from conservatism was just how batshit crazy Republicans went right after Clinton was elected, followed by the anti-expertise, antiscience bent of the GOP ushered in by Newt Gingrich in 1994. It took about a decade, but by the early 2000s, as you said, the anti-science positions of the Republican Party had driven me away, the invasion of Iraq under false pretenses in 2003 being the final straw. Even in 2003, though, I had no idea how bad the Republican Party would get within 12 years.

@ sadmar

“Of course, Prasad tells on himself with “far left socio-political positions.” Hmm, what would those be? Trying to curb climate change? Trying to mitigate pandemics? Opposing structural racism? Refusing to demonize LGBT+ youth? Do tell.”

Well, I consider myself “pro-pognon pro-pédés” in french. pro-money/business and pro-faggets, in english.

Which implies, for far-right-wingers that I am a commie, since I am pro-faggets.

Which also implies, for far-left-wingers that I am a nazi, since I am pro-money/business.

At least in my country.

I consider myself center-right.

But in this increasingly polarised world, I guess I’ll have to settle for bolcho-nazi. As everyone knows, electors of Macron would have been the one to write and sign off the Ribbentropp-Molotov pact.

But to vindicate Prasad, people who tend to value science and rationality and anti-dogmatism tend to not be extremists. So, yeah, I guess he’s right: he’s facing a conspiracy of dangerous non-extremists.

I get the impression that currently to right-wing extremists, everyone a bit less right-wing is far left.

We have a center-right government, but parties from the right of that are complaining they are a left-wing government.

I get the impression that currently to right-wing extremists, everyone a bit less right-wing is far left.

That isn’t limited to extremists on the right (at least here in Michigan in the U.S.). I know several people and work with others who comment on the “liberal” or “leftist” Democratic party, and pointing out that the modern Democratic party is essentially where the Republicans were in the early Reagan era doesn’t matter to them. These people aren’t extreme — none support trump or his butt-licking followers — but they still express that view about the Democratic party.

“And you all feel that opposing views are dangerous and harmful (and stupid).”

This is the same stupid strawman that VP tried to use. Stop doing shit like that and you’ll be taken far more seriously.

The far-right, unfortunately, were fine with childhood vaccines but as soon as they were asked to get a vaccine themselves as adults they magically became experts at vaccines overnight. In short, the right-wing did it to themselves by making it ideological, right away.

VP is tied up in his political ideology and uses projection when throwing that label at others, nothing more.

“And you all feel that opposing views are dangerous and harmful (and stupid)”

The fact that you think science is a ‘view’ says everything about your reliability as an source of information.

That statement is transference on your part anyway.

The repeated comments by Dr Prasad about jade eggs and 20 year old men feel like a pretty direct attack at Dr Jen Gunter (OB/GYN) who is famous for her debunking of jade eggs and other goop nonsense, and is also the mother of two young men (who were super preemies and therefore are high risk for respiratory diseases).

Then again he has been flailing around at anyone and everyone these days, so chances are he’s going to hit out at everyone in the medical misinformation space.

I totally agree. His obsessive return to likening his critics to skeptics debunking Jade Eggs appears definitely aimed primarily at Dr. Gunter, and I detect more than a hint of misogyny there. Ditto Dr. Munro’s attack on Dr. Love, who is an actual PhD immunologist. Rather tellingly, after taking a brief swipe at me, an older white guy, on Twitter, he disappeared after I pushed back.

Oh yes, people who take COVID-19 seriously are the ones playing “socio-political” games. Let’s look at the least controversial “controversial” topic in science: evolution. Which camp do the COVID contrarians fall into (disproportionately), evolution or creationism? We all know the answer. Second least controversial “controversial” topic? Climate change. We could keep going down the list, and we all know all the answers. Who is playing socio-political games, Vinay?

It’s said when taking a disease seriously becomes a political issue. And it’s depressing when people like IR think that this is an insult…

I think VP’s idea about the pandemic were formed early on and based only on what those who shared his political ideology were saying. He’s only doubled down and only used confirmation bias type sources as it’s gone on. He’ll never change his position, and that’s why he’s nothing but a crank, now.

I didn’t go into it that much in the post, but I really do think that there’s a tendency among those who don’t do much primary original research themselves but rather do “meta-research” analyzing the medical and scientific literature, critiquing clinical trial methodology, etc., to fall prey to contrarianism like this. Examples include Dr. Prasad, and, of course, Dr. John Ioannidis, both of whom have fallen deep into dubious contrarianism with respect to the pandemic. What I suspect is that these people, having critiqued scientific studies and clinical trials so much, come to think that they can science better than anyone else. After all, look at all the deficiencies they find in the existing biomedical literature!

So naturally when COVID-19 arrived, along with major uncertainty and a tsunami of new research ranging from very good to very bad indeed, they tended to focus on the very bad and unconsciously cherry pick in order to find ways to justify their preexisting beliefs. That’s just my suspicion, but I think there’s a good case to be made to argue this.

What is this “down-throttling” that Prasad complains about? I can only find references dealing with gasoline engines.

Maybe when people ventilate the Internet with facts to dissipate Prasad’s gaseous fumes, he thinks of it as “down-throttling”.

Pretty clear that Vinay Prasad ignores that the scientific skepticism movement correctly identified that the Ivermectin and HCQ were overly hyped without clear evidence of effectiveness or safety. He hedged, coughed, and did NOTHING to stop the rush to use them as both treatments and as prophylactics. He only jumped in later.

I don’t see that he’s contributed anything, at all, to combating misinformation or COVID, he just seems to be an agent provocateur to boost his social media image.

@orac:
“It took about a decade, but by the early 2000s, as you said, the anti-science positions of the Republican Party had driven me away”

I don’t understand why hating the Republicans would drive someone to become a Democrat, when the Democrats are just as hate-able.

I was a Democrat (simply because I was raised in an ultra liberal family), until some time in the 1980s. I was driven away for various reasons, but it did not drive me to therefore become a Republican.

Both parties have evolved into tribes that I cannot imagine joining.

We need more parties, because our political discourse has become unintelligible and pretty much insane. Vinay Prasad states that he is, and always was, a liberal Democrat. Yet commenters here have stereotyped him as a far right conspiracy theorist, just because he criticizes some of the covid policies.

I don’t understand why hating the Republicans would drive someone to become a Democrat, when the Democrats are just as hate-able.

Implying both parties are equally bad simply strongly reinforces your stupidity. There are many things I disagree with with members of the Democratic party, but none of the leaders has

courted racists, white supremacists, and neo-nazis the way the Republicans have
had a president who actively worked against dealing with the spread of covid the way trump did
had a president who allowed himself and members of his family to profit by charging government agencies inflated fees to stay at family run businesses
actively lied (repeatedly) about voting being insecure and elections being stolen
urged supporters to attack the Capitol an an attempt to stop the certification of an election

There’s more, but good god, the amount of stupid you crank out on a daily basis is immeasurable.

I think that it’s more than that – IR is trying to make an argument against political systems, as it that matters.
How different would Prasad’s ideas be received if he lived in a parliamentary/multi-party system?

Well, I suppose his ideas would only be supported here by some right-wing extremist parties. All mainstream parties are in favor of vaccines. Some are perhaps not in favor of mandatory vaccines, but they don’t spread misinformation.

Prasad is upset that “Republicans are an endangered species in academic medicine and public health” and raves about how “Living in a world that selectively cries misinfo for R docs but not D docs is the most dangerous thing on earth.” (see Twitter ravings).

It looks like his days as an alleged liberal warrior are far in the past. He may have to give up wearing his Bernie Sanders lapel pin.

Being a contrarian or self-described “rebel” is not the most dangerous thing on earth*, but there’s definite potential for harm when one adopts such a pose mindlessly and believes that evidence-based medicine can’t be trusted because the vast majority of health professionals endorse it.

*that would be a pack of hungry, rabid hyenas.**
**not a reference to typical Substack readers.

Republicans might be an “endangered species” in public health, but that’s just because they have been denying public health science, a tendency that started long before the pandemic.

As for Republicans being an “endangered species in academic medicine,” I rather suspect that Dr. Prasad has been misled by his experience in his academic positions at UCSF and, before that, OHSU, both located in very liberal enclaves, as well as his being in a medical specialty. If he were to come out here to the heartland, even Michigan (which, I know, recently had a blue wave that flipped the legislature to the Democrats), he’d find that there are lots and lots of Republicans in academic medicine, particularly the surgical specialties. I like to relate how tired I got of the TV in the doctors’ lounge at our hospital frequently being turned to Fox News, of listening to colleagues rail against government overreach, “socialized medicine,” and the like, and of not wanting to voice political opinions because I don’t feel like arguing with my colleagues. I’m not saying that academic doctors are overwhelmingly Republican, just that there’s a lot of Republicans in academic medicine, particularly academic surgery.

Yes, medical academia can be a bit of an ivory tower that gives a misleading impression, but I’d argue that UCSF and OHSU are likely the most ivory of ivory towers. I’d also point out that, for all its ivory characteristics and despite being located in one of the most liberal cities in the US, UCSF has not done anything to impede or in any way punish or push back against Dr. Prasad.

listening to colleagues rail against government overreach, “socialized medicine,” and the like

Yup, Richard Nixon was a dangerous lefty. And he visited China to boot.

“I like to relate how tired I got of the TV in the doctors’ lounge at our hospital frequently being turned to Fox News”

Huh.

At the community hospital where I’ve spent most of my time, the docs’ lounge TV is typically tuned to financial news, soccer matches and dramas. Political discussions mostly involve bitching about hospital administration.

There’s no way to vote for “none of the above, rerun the election with different candidates.” And it is seldom the case that all candidates are equally bad, even if you don’t actively like any of them.

There really is a difference between the Democratic and Republican parties, on a variety of levels.
.
This week, in the United States, most of the Republicans in the Senate voted against a bill that will, if passed, preserve the right to marry someone of your own gender and/or a different race. That’s a policy issue, in case the support for armed insurrection to overturn an election doesn’t seem important to you.

AND one party consistently opposes reproductive/ women’s rights and makes it more difficult for certain people to vote but label themselves as in support of ‘freedom’.
Also education, climate change…

@ Indie Rebel

You write: “I don’t understand why hating the Republicans would drive someone to become a Democrat, when the Democrats are just as hate-able.”

So, where did Orac write in his comment that he had become a Democrat? Typical of you to introduce facts not in evidence. And, nope, the Democrats are NOT as hate-able as the Republicans. You write: “Both parties have evolved into tribes that I cannot imagine joining. We need more parties, because our political discourse has become unintelligible and pretty much insane.”

Wow! I actually agree that we need more parties; but to do that we would have to amend the Constitution to have proportionate representation rather than winner-take all districts. In multiple party systems coalitions lead to compromises. However, while the current Republican party represents narrow rigid anti-science positions on the whole, the Democratic party represents a greater range of positions, so, to some extent is a bit more representative. The Republican party, for instance, supports Wall Street, Industry, and the Super Wealthy. Just a couple of examples, in 2008 bankers, creating fraudulent mortgages to earn commissions, then selling them on the stock market almost brought the world’s economy to its knees. So, did the bankers go to prison? Nope, they kept their jobs and were allowed to earn bonuses. The US government could have taken over the banks short term, kept the regular employees working, stabilized the situation and sold back to investors. They sort of did this with Fanny Mae and other nations; e.g., Sweden, did the same when large banks were about to fail. Even worse, the banks that were too big to fail were allowed to take over smaller banks who had done nothing wrong; but were caught up in the crisis, asked for help and were refused, so the Republicans under President George Bush and his pro-bank, pro-Wall Street secretary of state, Henry Paulson, created even bigger banks and less competition. The Army chief testified before Congress that they neither needed nor wanted a new tank. The mainly Republican congress votes for them. The air force chief testified they neither needed nor wanted a new fighter plane. Again, the mainly Republican congress voted for them. Thus, spending hundreds of billions of dollars to enrich one industry.

We have the only for-profit health care system in the world, funded mainly by taxes, then turned over to the for-profit sector. Result, over 100,000 premature deaths per years and 100s of thousands suffering. Just recently during the pandemic the price of insulin skyrocketed from around $30, $35 to as high as $1,000. The Democrats in Congress voted to cap at $35 which would have still given great profits; but the Republican party voted against. And our national debt is mainly because of the Republican Party, see below; however, having only two choices, I mainly choose the lesser of the two evils. At least the Democrats target some of our tax monies to actually help us. Another example is Republicans want to end or limit Medicaid and rural white Republican voters are too stupid to know that the rural hospitals being closed are mainly funded by Medicaid.

NATIONAL DEBT

Lyndon Johnson tried to built a truly compassionate non-racist society with his Great Society program; but he also, in response to even more militant Republicans under Goldwater, radically increased US involvement in Vietnam. Not raising taxes, the combination led to rapid increase in national debt. Nixon continued. Then Reagan became President. Based on the Laffer Curve, developed by UCLA economics professor, Arthur Laffer, Reagan radically lowered taxes, especially on Corporations and wealthy. Curve predicted lower taxes would lead to economic boom. It didn’t and deficits skyrocketed and approval ratings for Reagan plummeted. So, Reagan increased FICA, Social Security, tax, much more coming in than currently being paid out. The excess was loaned to government for current operations and the Social Security Trust fund was given US treasury bonds for the loan. However, loans between Federal government divisions NOT considered debt. so current expenditure deficits “appeared” to shrink, and approval ratings for Reagan increased. However, in essence, since SS Trust fund in same US bonds as National Debt, our debt continued to increase. Then George W. Bush lowered taxes on corporations and wealthy. Following 9/11 he began war crimes, both in Afghanistan; but especially in Iraq, increasing government expenditures without raising taxes. Iraq especially double war crime as Sadadm Hussein didn’t have weapons of mass destruction and wasn’t allied with Al Qaeda. In fact, they had a fatwa, call to assassinate him, as he was a secularist with a Christian vice president, women in universities, working, wearing normal clothes, etc. He was a brute; but if not challenged, Sunni and Shia, Christians and Jews did OK under him. It is a war crime to attack another nation if not in self defense. In addition, we blew up most of Iraq’s civilian infrastructure, electric power plants, water treatment facilities, even hospitals which resulted in the deaths of 100s of thousands of civilians. Attacking civilian infrastructure is a war crime. Result is we created ISIS and increased significantly US national debt. Then in 2008 the world’s entire economy was almost destroyed. Bankers created fake mortgages, NINJA, no income, no jobs, no assets, got a commission, and banks no longer help mortgages; but packaged them on the stock market. Henry Paulson, our Secretary of the Treasury, said we needed to keep the banks as they were and rescue them. So, rather than going to prison, the bankers kept their jobs and even received bonuses. Part of the trillions in rescue monies was supposed to go to renegotiating mortgages if possible; but the banks outsourced this to another company who received a commission for each mortgages dealt with. Well, it was much easier to foreclose than devote time to renegotiating, so many lost their homes who with adjusted mortgages could have kept them. Finally, some of the foreclosures were on people who had regularly paid their mortgages; but since the banks didn’t own the mortgages anymore, no records were kept. Some states, California, passed laws to stop this. Finally, the banks who were too big to fail were allowed to take over smaller banks, thus becoming even bigger. Many smaller banks had done nothing wrong; but were caught up in the crisis and when requesting more time to save themselves, the Bush administration refused. Was this the only way to save the economy? No! We could have kept the banks running but convicting the crooked bankers. How? Simple. Fanny Mae also was in crisis, so government put trusted employees in charge, stabilized and then left. We could have done the same with the banks. Result. Fewer and much larger banks making huge profits. Paulson was saving his compatriots and, though much of monies were repaid, also increased national debt. Then Trump lowered taxes more on corporations and wealthy. Finally, COVID. Funds were supplied to businesses with goal they would in turn keep paying employees. Many did; but some with large surplus cash used it to buy back stocks, so CEOs, etc. saw value of their stock options increase substantially. In fact, during the height of the covid crises, the stock market increased substantially.

To sum up, LBJ, Nixon, Reagan, Bush, and Trump responsible for our huge national debt. LBJ and Nixon for war crimes, Reagan, Bush, and Trump to enrich corporations and the wealthy. Despite the tax cuts, the economy grew much slower than previously; but CEOs salaries and stock options skyrocketed. I am not going to devote time and energy to compute what is what; but over all our national debt, probably 3/4 was simply war crime and mostly giveaways to corporations and wealthy. Result is Gini coefficient that is most unequal in 100 years, with corporations and super wealthy controlling larger part of our economy than since early 20th Century. One more thing. Corporations and wealthy have been hiding funds abroad and avoided/illegally paying literally trillions of dollars in taxes. So, the amount of national debt that helped many Americans during COVID is a small proportion of it.

So, the National Debt burden rests on the shrinking middle class and working class. In fact, they also paid more, through FICA taxes, to run the government and when they start to collect SSN it will be their taxes paying for the benefits they funded in the first place. And the corporations and super wealthy just get wealthier.

A great book that I know you won’t read is Sanford Levinson’s “The Undemocratic Constitution”

So, while the Democratic party isn’t all the great, it is typical of you that you see the world in extremes of black and white.

@ Indie Rebel

You write: “No it isn’t possible that an educated intelligent person would have views different than Orac’s. Therefore, he must be stupid, ignorant, delusional.”

So, choose a couple of Orac’s criticisms of Prasad and explain with logic and science why/how he is wrong and include several credible scientific references. Nope, just another empty comment by you. While extreme, I remind you that educated intelligent people promote racism among other things. One can use ones education and intelligence to be open-minded or to further ones prejudices. If you believe Orac is doing this, make the case. Otherwise, just another example of you’re making a fool of yourself.

Just for fund I’ll give an example of one person who disagreed with current scientific consensus. For many years breast cancer was treated with radical mastectomies in US, while in France often lumpectomies. American cancer surgeons ignored the French, assuming them inferior. One oncologist in Pittsburg, Bernard Fisher, looked at French data and began advocating for more lumpectomies; but was criticized, etc, so what did he do? He ran a very large randomized clinical trial, comparing radical mastectomies to lumpectomies. Result, in many cases lumpectomies worked well, disfigured women far less, etc. and their survival just as good. So, nope, not just an educated intelligent person; but one who actually made his case based on scientific research. One other example, Judah Folkman. He hypothesized that cancer cells needed angiogenesis, that is, development of blood vessels to grow. He was ignored; but eventually scientific studies proved him right.

So, give an example of those Orac criticizes who have based their positions of SOLID VERIFIABLE SCIENCE! ! !

On the other hand, I could give lots of examples of intelligent educated doctors who have advocated positions that research found didn’t work.

It isn’t disagreeing with Orac, myself, or others that makes me think someone “stupid, ignorant, delusional” it is disagreement based on their deficient science, etc.

KEEP MAKING A FOOL OF YOURSELF

Two hour long conference by Mr. Perronne in European Parliament. Recent.

HCQ crank. And much more than that.

It thus cannot be said they really are cancelled… They need to be, however. So, yes, medicine has been increasingly immunising itself to scientific criticism. Mr. Perronne, a physician, does indeed have official credentials of sensibly decent quality, and is living proof that he is mentally immune to scientific criticism.

There are more insidious movements, in my opinion, in the medical world. For example, there is a movement in France of physicians and clinicians that claim that “High IQ = disease”. Roughly. (Which is not the case…) These physicians and clinicians state that their clinical experience offsets any value that science may have to bring to bear on their medical claims (which here aim at pathologising high IQ). Essentially, now, you have a senior researcher at ENS Ulm in Paris (which is a more or less reputable institution) that was more or less pushed to write the following in 2020 after following the “high IQ = disease” medical movement for quite some time and having called them out prior to that publicly in 2017:

This article is inspired by the debates that recently opposed researchers and clinicians on the topic of high IQ people, but in fact has a much more general scope. On high IQ, as well as on other topics pertaining to health, researchers who express their positions publicly are sometimes accused of concerning themselves with what is none of their business, or even of trespassing beyond their field of expertise, since they do not have clinical experience. This is a curious way of conceptualising fields of expertise. On a personal level, I have never expressed myself on the clinical practices of clinicians and physicians with high IQ people, and I will never do so. I do not know them, I do not know the litterature on the topic, and therefore have nothing to say on it. I strictly limit myself to my field of expertise, which is scientific knowledge, in domains I study or in domains whose scientific litterature I know. Conversely, when clinicians express themselves in public to push forth general claims, whether they be about the characteristics of a certain category of the population, or the causes of such characteristics, or the efficiency of certain practices or certain treatments, they then place THEMSELVES in the arena of science (i.e. and not merely medicine / clinical expertise) WHETHER THEY LIKE IT OR NOT.” — F. R., 2020

I think this highjacking of science by physicians and clinical practicioners is overlooked when it comes the debates pertaining to scientific orthodoxy in medical matters. We here have physicians and clinical practicioners who explicitly claim that, essentially, their clinical experience offsets anything science (as in “scientific researchers who are not physicians”) may produce to refute their claims. And it has been quite hilarious to see F. R. shove science down their unwilling throats. Though it is a gourmet’s delicacy.

Seems that in the US, because of a 1st amendment culture, you see the fetishisation of clinical experience as offsetting science pouring through social media and such like. In a corporatist culture (in the french sense of the word) where free speech on medicine isn’t quite tolerated, the situation seems to be different and it is the legal prerogatives of the various medical castes which are abusively instrumentalised to limit the free speech of scientists (as in non-physician researchers) on medical matters.

Needless to say, I am on the frontline of the “high IQ = disease” nonsense, as per my medical records and my shrink-mother’s public statements on the net pertaining to them. (And, needless to say, there are conceptual links between this “high IQ = disease” nonsense and… autism…)

But more than politics, I believe that one of the driving forces of opposition to science is not only crank magnetism but also a pushback by physicians and credentialed people in the medical world that see the evidence-based medicine culture as a threat. A threat to the their clinical experience (and biases), and to the authority they derive from this clinical experience. It has been very clear, for instance in the Raoult case, that people from his sphere (such as him and Dr. Perronne) OPPOSE EBM methods to clinical experience. This is the ideological backbone of the feud they’ve been waging. It’s not merely crankery but bona fide ideology pertaining to the structure of medical authority and its interplay with scientific legitimacy. It’s deeper than mere crankery.

I wouldn’t be surprised if surgeons in the US fell in a similar category of that “authority based on clinical experience” trope that pushes them further and further right wing whenever EBM methodology creeps into their world and medical intimacy. An allergic reaction, in essence.

Yes, we’re stuck with a two party system here in the US, and if you conclude one party is significantly more dangerous than the other, you have no choice but to vote for the better of the two. In the fantasy-land if the far right, “the radical left” is poised to destroy everything valuable in Western Civilization with Godless ‘socialism’, CRT, furries, and whatnot that they must be opposed by any means necessary – including the destruction of democracy by dictate or armed insurrection.

If someone in academic medicine or public health chooses to support the GOP, though, we can table the fascism for now, and just chew on this: the new chair if the House Oversight Committee will be James Comer of Kentucky, an ally of Rand Paul, who will be heading up a series of Congressional Investigations issuing subpoenas to various persons demonized on Fox News and the wider wing-nut media sphere. First up: Hunter Biden, of course. But next on the list: “the origins of COVID, and Anthony Fauci.” Yup, the great conspiracy to fund the gain-of-function research at Wuhan so the ChiComs could create a depopulation bioweapon.

Ya think stuff like that could have anything to do with Republicans becoming an endangered species in the academy or public health?

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