VP -- Thank you for your dogged pursuit of these topics, well articulated in this piece. I am a 66 year old family doc recently retired from government service. I was not employed by the CDC, but have had substantial direct experience with several CDC physicians and researchers on a collegial level. From a front row seat, I saw the evolution of their woebegone covid policies from the start of the pandemic.
You've covered well their generally misguided narrative. I take a weird pleasure in looking at studies published in the MMWR to see medical research gaslighting in action. Almost all of them contain a phrase to the effect that "the covid vaccine is the best way to protect the population", even when the study has little to do with vaccination or shows that infection-based immunity is superior.
Remarkable that our Dr. Prasad must proclaim his membership in a club that has used the pandemic as a political tool. Perhaps this pandemic became political because of the person who happened to be President. A person that threatened the normal order by not being a real politician. Thus whatever position he adopted had to be resisted no matter the position, good or bad. The public, of course, has ended up paying the price for the political war. Sadly they don't quite understand how things went wrong and have developed a mistrust in authority that harms us all.
Far left Democrats generally follow far left democratic policy. You speak with such clarity and intelligence you will be alone amongst that group. I find it hard to believe that , after all you’ve seen the far left do , you still identify with that insane group!
I am an older person and see much more hope. I think your writing helps people to both see (and maybe, when they feel safe) to express their wisdom and thoughts while knowing that they can change with more accurate information. This is new, thanks to many innovations including a Worldwide Web, which many have never been without. This comment is the perspective of a newcomer to the web.
No offense to Dr. Ioannidis, the tricycle riding child from The Shining is an appropriate metaphor, an unfolding horror story seen by some, oblivious to others. Excellent article, Vinay.
Thanks VP. At some point we need to wake up and recognize the massive manipulation that has taken place over the past 3 years. Manipulation done for political reasons, financial gain, clickbait and ego. The relentless division resulting from this manipulation has weakened us. This will get worse as states like California begin enforcing stupid laws that delicense doctors who “spread misinformation.” But Californians continue to vote for the people who support such laws. We just are not able to think critically.
"Fauci made many, catastrophic mistakes: none worse than pushing for prolonged school closure."
Crusading for Gain of Function the last decade, funding Gain of Function research, scrambling behind the scenes to suppress the public from knowing of his support and funding, lying to congress about his support... that may have been worse.
But yeah, pushing school closures was pretty shitty too.
Vinay hints at but does not explicitly cover two related topics. The pandemic has taught us very clearly of the narrow vision, bordering on blindness, of experts in any field. As a retired pediatric pulmonologist, I would never pretend to debate Tony Fauci about the details of SARS-CoV2 genome. On the other hand, I credit Alex Berenson, a smart lay journalist, with doing the research on the clinical literature which undermines the notion of benefits of lockdowns in shutting down pandemics. Clearly, Fauci knew very little about the literature on this subject which was outside his area of expertise but really important with respect to the policies that flowed out of the White House COVID Task Force which he directed (even though Mike Pence was technically the overseer). An oncologist like Dr. Prasad would know that although he knows a great deal about the biology of many human cancers, he may not know much about the nuances of healthcare finances which his patients understand full well. He may not be an expert on the health beliefs of African Americans. Wise physicians know their limitations and are open to learning from other caregivers and the patients themselves. Experts can be blind! and arrogant! Non-expert physicians often have few blinders when reading the literature.
The second theme prominent during the pandemic is how we physicians should respond to dissenting voices. There are some voices that need to be confronted with science and reason because they are wrong. There are other voices with opinions that, while unprovable, should be considered and even encouraged with thoughtfulness and interest. As in our universities, there is an unfortunate pall over the physician community in the open discussion of controversies. Our "representative organizations" like the American Academy of Pediatrics issue statements and policies without any attempt about polling its dues-paying members.
Sadly, this all has happened during a fascinating unprecedented viral pandemic during which there are so many lessons that have been learned and previously never considered clinical questions have arisen. For instance, it likely made sense when the alpha variant of SARS-CoV2 was dominant that a large portion of our citizenry should get the mRNA vaccines. As it has become quite evident that young healthy people are at low risk of serious complications and we have discovered rare but serious adverse events from the vaccines (e.g., myocarditis in young men). Now the calculation of risks versus benefits of these vaccines have changed for many people. Despite this clear change in the calculus of risk, our medical establishment has refused to acknowledge that this new situation demands choices by our patients. The arrogance of the establishment and the failure of the broader physician community has undermined the respect of and confidence in the medical profession by so many of our fellow citizens.
We can sum up what has happened to knowledge by the immortal words of our current President who said in 2019: “We choose truth over facts!” When ideology “trumps” facts, we as a profession and nation are lost.
I sadly agree with you wholeheartedly about what our response to COVID 19 has done for science and, particularly, medicine. I questioned much of what was being said by the media with quotes from the usual cadre of physicians and pseudo-physicians to back their predetermined message. For that I was told I was being cavalier in my attitude and thoughts. My response was that medicine as a science was being ignored. Decisions were being made on political and ideological lines but little on actual science. It saddened me and I have been practicing and teaching for over 30 year. Thanks Vinay for being one of the consistent and strong voices of reason throughout this past 2 years. It has been refreshing and helpful.
I’m just a retired anesthesiologist so I’m no kind of expert but I have seen numerous times that a drug or treatment that is “a miracle “ at first becomes at best useless over time. Healthy skepticism is essential to every opinion, especially your own.
You forgot "white supremacist" as a term useful to shut down scientific disagreements. I believe this was thrown at you as part of the "precision medicine" debate...
VP -- Thank you for your dogged pursuit of these topics, well articulated in this piece. I am a 66 year old family doc recently retired from government service. I was not employed by the CDC, but have had substantial direct experience with several CDC physicians and researchers on a collegial level. From a front row seat, I saw the evolution of their woebegone covid policies from the start of the pandemic.
You've covered well their generally misguided narrative. I take a weird pleasure in looking at studies published in the MMWR to see medical research gaslighting in action. Almost all of them contain a phrase to the effect that "the covid vaccine is the best way to protect the population", even when the study has little to do with vaccination or shows that infection-based immunity is superior.
Remarkable that our Dr. Prasad must proclaim his membership in a club that has used the pandemic as a political tool. Perhaps this pandemic became political because of the person who happened to be President. A person that threatened the normal order by not being a real politician. Thus whatever position he adopted had to be resisted no matter the position, good or bad. The public, of course, has ended up paying the price for the political war. Sadly they don't quite understand how things went wrong and have developed a mistrust in authority that harms us all.
Unfortunately as you continue to identify with far left progressives , you will be alone mourning that loss
Far left Democrats generally follow far left democratic policy. You speak with such clarity and intelligence you will be alone amongst that group. I find it hard to believe that , after all you’ve seen the far left do , you still identify with that insane group!
I am an older person and see much more hope. I think your writing helps people to both see (and maybe, when they feel safe) to express their wisdom and thoughts while knowing that they can change with more accurate information. This is new, thanks to many innovations including a Worldwide Web, which many have never been without. This comment is the perspective of a newcomer to the web.
No offense to Dr. Ioannidis, the tricycle riding child from The Shining is an appropriate metaphor, an unfolding horror story seen by some, oblivious to others. Excellent article, Vinay.
Thanks VP. At some point we need to wake up and recognize the massive manipulation that has taken place over the past 3 years. Manipulation done for political reasons, financial gain, clickbait and ego. The relentless division resulting from this manipulation has weakened us. This will get worse as states like California begin enforcing stupid laws that delicense doctors who “spread misinformation.” But Californians continue to vote for the people who support such laws. We just are not able to think critically.
"Fauci made many, catastrophic mistakes: none worse than pushing for prolonged school closure."
Crusading for Gain of Function the last decade, funding Gain of Function research, scrambling behind the scenes to suppress the public from knowing of his support and funding, lying to congress about his support... that may have been worse.
But yeah, pushing school closures was pretty shitty too.
Thank you.
THANK YOU!
Vinay hints at but does not explicitly cover two related topics. The pandemic has taught us very clearly of the narrow vision, bordering on blindness, of experts in any field. As a retired pediatric pulmonologist, I would never pretend to debate Tony Fauci about the details of SARS-CoV2 genome. On the other hand, I credit Alex Berenson, a smart lay journalist, with doing the research on the clinical literature which undermines the notion of benefits of lockdowns in shutting down pandemics. Clearly, Fauci knew very little about the literature on this subject which was outside his area of expertise but really important with respect to the policies that flowed out of the White House COVID Task Force which he directed (even though Mike Pence was technically the overseer). An oncologist like Dr. Prasad would know that although he knows a great deal about the biology of many human cancers, he may not know much about the nuances of healthcare finances which his patients understand full well. He may not be an expert on the health beliefs of African Americans. Wise physicians know their limitations and are open to learning from other caregivers and the patients themselves. Experts can be blind! and arrogant! Non-expert physicians often have few blinders when reading the literature.
The second theme prominent during the pandemic is how we physicians should respond to dissenting voices. There are some voices that need to be confronted with science and reason because they are wrong. There are other voices with opinions that, while unprovable, should be considered and even encouraged with thoughtfulness and interest. As in our universities, there is an unfortunate pall over the physician community in the open discussion of controversies. Our "representative organizations" like the American Academy of Pediatrics issue statements and policies without any attempt about polling its dues-paying members.
Sadly, this all has happened during a fascinating unprecedented viral pandemic during which there are so many lessons that have been learned and previously never considered clinical questions have arisen. For instance, it likely made sense when the alpha variant of SARS-CoV2 was dominant that a large portion of our citizenry should get the mRNA vaccines. As it has become quite evident that young healthy people are at low risk of serious complications and we have discovered rare but serious adverse events from the vaccines (e.g., myocarditis in young men). Now the calculation of risks versus benefits of these vaccines have changed for many people. Despite this clear change in the calculus of risk, our medical establishment has refused to acknowledge that this new situation demands choices by our patients. The arrogance of the establishment and the failure of the broader physician community has undermined the respect of and confidence in the medical profession by so many of our fellow citizens.
We can sum up what has happened to knowledge by the immortal words of our current President who said in 2019: “We choose truth over facts!” When ideology “trumps” facts, we as a profession and nation are lost.
I sadly agree with you wholeheartedly about what our response to COVID 19 has done for science and, particularly, medicine. I questioned much of what was being said by the media with quotes from the usual cadre of physicians and pseudo-physicians to back their predetermined message. For that I was told I was being cavalier in my attitude and thoughts. My response was that medicine as a science was being ignored. Decisions were being made on political and ideological lines but little on actual science. It saddened me and I have been practicing and teaching for over 30 year. Thanks Vinay for being one of the consistent and strong voices of reason throughout this past 2 years. It has been refreshing and helpful.
Unfortunately, you are completely correct.
I’m just a retired anesthesiologist so I’m no kind of expert but I have seen numerous times that a drug or treatment that is “a miracle “ at first becomes at best useless over time. Healthy skepticism is essential to every opinion, especially your own.
I hope you will continue to comment on covid 19. I understand your fatigue but I need you to cut through the noise.
Vinay,
You forgot "white supremacist" as a term useful to shut down scientific disagreements. I believe this was thrown at you as part of the "precision medicine" debate...