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My counterpoint to the commentary by Leticia Kawano: In the early days of, before anyone in the medical community knew what we were dealing with, both Vinay and Zubin Damania were advocates for the safety of masking. This is because we were not certain of the virus that we were dealing with, or the ramifications of exposure. Preliminary reports suggested a significant morbidity and mortality rate in older individuals, and immunocompromised people. Out of an abundance of caution, the medical community did the right thing: advocate N95 mask use. Airflow studies with the virus were also performed, which indicated an airborne transmission. As the science became more distilled, and the behavior of the virus became more apparent, both Vinay and Zubin updated their conversation talking points as the science changed. That is totally legitimate. New data always allows for a course correction. Is that not the purpose of the medical enterprise we are all so engaged in?

As would be expected, they updated their views to reflect the fact that nothing short of an N95 did not work effectively to prevent the spread of Covid. I think that’s legitimate. Once we recognized the risk of infection of the pediatric population resulted in no statistically significant mortality, and very minimal morbidity, they also updated their views to account for this new science.

I think that’s a testament to their ability to not get bogged down in dogma that is pervasive in the medical community. Cifu, Mandrola, Damania and Prasad have all become the voice of reason when it comes to scrutinizing the disparity between what the study demonstrates, and the talking points espoused by the establishment.

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Gentlemen,

So many great points in your discussions. Commercial interests in research have long been a debate. Those of us who work in lactation/infant feeding have long criticized the infant formula company sponsorships and manipulation in research, publication, and conferences as well.

On the justice curriculum, I would say this is the main theme of public health right now -it is not just in medicine. "people with diabetes" instead of a "diabetic"...putting the person first so to speak.

For example since I work in MCH- I am to refer to "people with the capacity to reproduce and birth" or "people with a uterus" or "birthing person" instead of "women of reproductive age" or mother. Which makes a lit review pretty tricky to be honest.

All of which I am happy to get on board and keep science moving forward, but I do like to ask questions- has changing language in publications and practice improved outcomes? I think that would be an interesting research question.

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I’m sorry to butt in - but THIS was the PROBLEM in the first couple of years of the Covid era, probably longer - most asked no questions. Everyone just followed the rules!

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I liked the video version of the podcast. Clues from facial expression add to the substance of the discussion in ways that are hard to describe. Reminds me of what we were missing during the masking fiasco.

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Why didn’t Dr. Fauci fund a mask study in the United States? I think we know the answer.

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I just had a 30 question "test" for inclusive language. One of them asked " what is the correct way to describe an Asian man?" The correct answer is " a man who moved from south Korea 3 years ago." How does this affect our patient care? No one has time to write this, let alone speak it!

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I’m in Washington state. For a while, patients haven’t been required to wear masks in drs offices, but I noticed all the staff were still wearing masks at any facility I went to. I hadn’t even thought that it was probably a mandate from the parent company. I took my daughter to her specialist eye dr last week, and I realized it was the first time I had seen her Dr without a mask. I’m wondering if this company also recently lifted the mask mandate for drs, like you said UCSF did. Hopefully they didn’t enact the 6 month policy, that’s just dumb. Like was mentioned, most people don’t wear their masks correctly anyway.

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This discussion was really good -- super relevant questions raised and excellent, sensible points made. I wished more people, especially doctors, listened to this. The art of medicine is complex but it rests on sensible judgements and actions.

It's great to see that the three - Vinay, John and Adam - diverge in opinion a couple of times, but a sensible and clever dialogue is possible.

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Your content seems interesting but when you invite Vinay to speak, I wonder if that is due to lack of awareness on all the damage Vinaly did with his communication on Covid-19 during the pandemic years or if it is a support for his perspective. Either way that speaks to me as a non trustworthy content :-/. I am a researcher on Covid and a scientific communicator in covid verified by the United Nations#haloguide

You might have forgotten maybe but in the peak of collective fear and anxiety of the pandemic, Vinay had no care at all with the public health impacts of his counterpoints (against masks, unballaced communication about vaccine risks etc): It seemed it mattered more his individual agenda and his personal gains by being the "voice that contradicts" than public wellbeing (I even wonder if he is a Trump supporter). If that was not enough, his always an angry one in times where mental illness was spiking up.

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Just wanted to say a few words as per your comment, you may not know the history of or the personality / culture of this substack.

I am saying this as just a reader not a writer on this substack and if any of the writers read this please correct me if I’m wrong.

I’m not sure if you know this but Dr Vinay is one of doctors that started the Sensible Medicine substack. So it doesn’t make sense to say “when you invite Vinay to speak “ in your comments. Differing opinions on Sensible Medicine is welcomed and for readers like me appreciated but defense of your opinion is needed if you are making claims. Use of the word “trustworthy” is a double edge sword that can cut both ways or during Covid a circular saw that cut “always” and over time has demonstrated how trust was missed places on many occasions. I am troubled most by the end of your comment where you question “(I even wonder if he is a Trump supporter)”. What do his political views matter if he has strong nonpartisan evidence to back his claims like Cochrane Studies.

And lastly there being mental health implications from your comment “his always an angry one in times where mental illness was spiking up.”

As you are scientific communicator I thought you would appreciate the information.

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I'm sure that Dr. Prasad is deeply ashamed of all the damage he did with his communication on Covid-19. Imagine the humiliation he must feel after being taken to task by such as expert---a scientific communicator in covid verified by the UN, no less. Personally, I always considered him to be somewhat moderate on the issue since he did support some level of vaccination for adults and opposed only the only the vaxes on children and the really obvious stupid stuff like masking, school closures, etc.---i.e. the things that caused the real damage. And, finally, the ultimate charge: "I even wonder if he is a Trump supporter". The syntax of your comment suggests that English may not be your primary language so I wonder if you are even aware that Donald "Warp Speed" Trump was and still is an avid supporter of all the covid nonsense.

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Exactly what damage do you think Vinay Prasad caused by speaking out?

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I like to hear the science about vaping....but since Big Tobacco bought up all the vape products the costs to be a regular vaper has gone up dramatically.

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