Debunkers return to the 'soft targets'

The biggest defenders of science did the most damage to it.

I know the pandemic is winding down when I see ‘science influencers,’ ‘debunkers’ and the ‘misinformation police’ return to focusing on issues that match their skill set: debunking vitamins, supplements, cupping, homeopathy, electric fields and other clearly unproven and implausible medical interventions.

Previously, John Horigan called these the ‘soft targets’. He drew a distinction between non-mainstream, biologically-implausible interventions promoted by random individuals on the internet (soft targets) and the unproven interventions that pervade traditional medicine, and are sold based on exaggerated or distorted data (e.g. stenting stable coronary disease, or the use of aortic balloon pumps, selenexor in combination with velcade and dex, etc. etc.). These are the hard targets. They constitute the larger, more pervasive and caustic misuse of medical spending, often involving insurers to reallocate society’s resources rather than personal spending choices.

Of course, it is a lot harder to debunk hard targets. You need more technical knowledge of medicine, statistics, clinical trials, and worse, your audience and opponents— largely physicians and professors— are not fringe elements on the internet. You are talking to real scientists— not biology minors who write wikipedia pages— so you have to bring your A-game.

Pre-pandemic, there was a growing chorus of soft-target debunkers— building an audience of disgruntled pro-science people to combat the disgruntled anti-science people. Largely, however, I was sympathetic to these debunkers. After all <insert supplement> probably doesn’t work, and certainly has no good evidence to support its sale. People who purchase it are being conned, and someone has to set the record straight.

Then the pandemic hit, and we faced scientific and policy choices that were unprecedented. Should we close schools in Los Angeles for 18 months? Should we authorize a booster dose to a 16 year old boy who had COVID-19? Should Paxlovid be given to a healthy 40 year old who had 3 boosters?

The science influencers came to our rescue, or so they believed. They knew that the CDC’s recommendations— under a Democratic president— were always correct when they advocated for interventions and restrictions, and only incorrect for not going further. Of course, we should mask toddlers— the only error the CDC made was not doing it sooner and longer. Of course, we should boost 16 year old men— even if they had COVID— and of course, they should get a bivalent booster— even if they had COVID again. Of course, schools should mandate vaccines. In fact, mandates would not be needed if it weren’t for anti-science grifters. If only we would all dutifully get all the doses, Lord Peter Marks advised, and take Paxlovid as Emperor Jha suggested, we would be better off (irrespective of age or prior infection).

Indeed, soft target ‘debunkers’ turned their criticism of alternative medicines into a remix of ‘the establishment is always right, and if anything, doesn’t go far enough’. It was no coincidence that this fell along lines of political preference (left wing), and among insular communities on social media. The debunkers were united in disparate beliefs: masks work and Elon Musk is bad.

Of course, science influencers employed all their favorite tactics. Demonizing people who disagreed. John Mandrola— a writer for Sensible Medicine— was viciously attacked for his correct work on the rate of myocarditis post vaccine in young men. Critics said he misused VAERS, but they only had a childish understanding of the issue. They knew one could misuse VAERS, but they didn’t understand what actually constitutes misuse.

In retrospect, what happened is simple. Most scientists who spend time debunking pseudoscience or writing for wikipedia are not the best scientists out there. The best scientists are working on publishing their own original scholarship— pushing new ideas that never existed in the history of the world.

Instead, you have many mediocre doctors and scientists enter the debunking game. Few have academic appointments. Few publish substantive peer review articles and few *do* science. In a world that has forgotten meritocracy, we have to admit— the people drawn to soft targets are not the best thinkers.

Add to this mix: growing political fanaticism. Trump indeed broke brains. Although he is not currently president, he remains the most discussed politician. As Sagar Enjeti recently said, ‘the Trump era began when he descended the escalator and will end only when he dies.’ Soft target debunkers largely oppose Trump, and some of their scientific beliefs are supported merely by the fact Trump said the opposite.

What happens when you pair mediocre scientists with political fanaticism and inject health policy decisions made by partisan administrations? The answer is chaos. The debunkers have no skillset to separate sound decisions from bad ones. The first 2 shots were approved too SLOWLY. Eric Topol (a frequently incorrect online commenter) famously took credit for delaying these shots— a catastrophic blunder consistent with his long history of getting science wrong, detailed here and here. Yet, these debunkers largely applauded these delays b/c it hurt Trump— never mind the sacrifice of older Americans.

Then enter the Biden administration. The debunkers cheered dubious EUAs for children and young men and women, despite growing concern of myocarditis in young men and despite concern of VITT in women. The new administration could make no errors. Even as they injected capital into markets, resulting in overheating and inflation, or issuing a divisive, unjustified mandate for a vaccine that did not benefit third parties. They could do no wrong, even when they kept masking kids without data, and without ongoing randomized trials.

People who are not the best scientists— who spend most of their time attacking soft-targets— and who pledge their allegiance to the political left— ironically did tremendous damage to science by creating a caustic environment where real debate could not occur. Worse, they encouraged delusional regulators (Peter Marks) into believing their decisions were correct, and others into thinking that the real enemy were scientists who disagreed. The grand irony then is that these people who see their life in service of a good— combating anti-science ideas— fueled anti-science in the time of crisis.

These days, COVID-19 debates are mostly in the rearview mirror, and the debunkers have returned to soft targets. I see them writing about de-toxification and supplements— topics that are well within their skills. But sadly, in a time of great uncertainty and unprecedented decisions, they thought they could help.