AUGUST 2021 NEWS
Featured topic: coronavirus
On Science-Based Medicine,
Jann Bellamy posted:
“School mask mandate wars: Politics (Florida) v. Science (North Carolina).” “Florida’s governor, Ron DeSantis, dictated a state-wide ban on school mask mandates based on misinformation and pure politics, while North Carolina officials took a bipartisan approach to masking based on science.”
David Gorski posted:
“Ivermectin is the new hydroxychloroquine, take 5: The Nobel Prize gambit.” “Now the advocates are pointing to the history of the drug’s developers being awarded the Nobel Prize in Medicine, as though that has anything to do with its effectiveness against COVID-19.”
“Are vaccines driving the emergence of 'escape mutant' variants of COVID-19?” “Geert Vanden Bossche is back, and this time he’s blaming COVID-19 vaccines for driving the evolution of more dangerous ‘escape variants’ of SARS-CoV-2... that are capable of evading vaccine-induced immunity. As antivaxxers making this argument always do, unfortunately, he ignores the much larger problem in which free circulation of the virus is a far more powerful driver of evolution than the relatively small proportion of the world population that has as yet been vaccinated.”
“Yes, the FDA really HAS given full approval to the Pfizer/BioNTech COVID-19 vaccine.”
Harriet Hall posted:
“I don’t know what's in it.” “Is not knowing what’s in a vaccine a valid reason to refuse it?... I think it’s just an excuse, and not a very good one.”
Jonathan Howard posted:
“The CDC should do better.” “The CDC’s failure to report clear and accurate data about how COVID-19 is affecting children has opened the door to those who wish to minimize its impact by spreading fear, uncertainty, and doubt.”
“Is RSV [respiratory syncytial virus] being misdiagnosed as COVID-19?” “For a child to be mistakenly diagnosed with COVID-19 when they actually have RSV, it would have to mean that their pediatrician is unable to distinguish these diseases clinically, the COVID-19 test would have to be a false positive, and the RSV test would have be to a false negative. Basically, as noted by Dr. Rebekah Diamond, the only way large numbers of children with RSV could be misdiagnosed with COVID-19 is if pediatricians and labs throughout the country were abysmally incompetent…”
“Reader beware.” “Certain doctors may not be anti-vaccine, but they need to be fact-checked as if they are.”
Steven Novella posted:
“Neurological manifestations of COVID.” “As we are facing a new wave of COVID, with the prospect of new variants in the future possibly extending the pandemic even further, it is important that the public have a clear picture of how serious this illness is. The death toll should be enough to indicate how severe COVID can be, but even that is not the whole picture. This is a systemic infection that can cause chronic illness, and neurological manifestations are common, more so in adults but children are affected too.”
William Paolo posted:
“Ivermectin is the new hydroxychloroquine, take 4: Bret Weinstein misrepresents meta-analyses.” “Evolutionary biologist turned podcaster Bret Weinstein has promoted the anthelmintic drug ivermectin as a highly effective treatment for COVID-19 based on a massive misunderstanding of a meta-analysis. Here, we correct this misunderstanding and explain why ivermectin is unlikely to be effective against COVID-19.”
On Respectful Insolence, “Orac” posted:
“Antivaxxers invoke segregation and Jim Crow to attack COVID-19 vaccination requirements.”
“Physicians who promote COVID-19 and antivaccine misinformation should lose their medical license.” “When physicians use the imprimatur of authority that society bestows on them to add the authority of their profession to their misinformation, that is an abuse their status as a physician that during a pandemic can have potentially deadly consequences.” He also published a related post in Science-Based Medicine: “The Federation of State Medical Boards vs. COVID-19 misinformation: a losing battle so far.”
“The violent rhetoric of the antivaccine movement, antimask COVID-19 update.”
“Everything old is new again: Abusing religious exemptions to avoid COVID-19 vaccines.” “In the middle of a global pandemic in which a new disease has infected hundreds of millions and killed millions worldwide (over 600,000 in the US alone), catering to such religious beliefs and ‘personal beliefs’ is a luxury that we no longer have...”
March 5 – The FDA posted “Why you should not use ivermectin to treat or prevent COVID-19.”
July 28 – The Cochrane Collaboration published a review of “Ivermectin for preventing and treating COVID-19” (Popp et al. Cochrane Database Syst Rev. 2021 Jul 28;7(7):CD015017 Paper). “Based on the current very low‐ to low‐certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.”
August 13 – Jarry wrote “The strange case of Dr. Cahill and Ms. Hyde.” “Professor Dolores Cahill’s scientific résumé can legitimize her false claims about COVID-19. Her crusade of misinformation raises the question of how far academic freedom goes…People with science doctorates and medical degrees are not immune to believing untrue things, being motivated by their values, or failing to properly understand and appraise the scientific literature.”
August 23 – English wrote “COVID vaccines kill? A second look at scary VAERS reports.” “The rare adverse events linked to COVID-19 vaccination, taken in context, confirm that the shots don't pose a serious risk to the vast majority of people. Just as most of us can enjoy a few drinks with friends without fearing liver disease, so too can we get a vaccine without fretting about a vanishingly rare adverse reaction.” Another post (Aug. 26) was “Delta delusions: Children’s Health Defense lies about COVID-19 breakthrough infections.” “In sum, when breakthrough cases occur, they tend to be far less severe. COVID-19 remains a disease mostly of the unvaccinated.”
Other topics
Best of the blogs, August – on Science-Based Medicine,
Jann Bellamy:
Wrote “'Imbalanced energy field' is not a valid diagnosis and therapeutic touch is pseudoscience, so why can’t nurses just give it up?” “If nurses want to claim that “imbalanced energy field” is a valid diagnosis and therapeutic touch is effective, they must be able to defend it with a plausible mechanism of action and evidence of effectiveness.”
Scott Gavura:
Wrote “Homeopathic disclosure.” “Health Canada is proposing new label requirements for homeopathy. They don’t go far enough.”
Harriet Hall:
Discussed “Genetic testing for selection of psychotropic medications.” “Conclusion: another expensive test that is unlikely to be useful.”
Wrote about the “DNA Vibe Jazz Band.” “The DNA Vibe Jazz Band device promises to relieve pain and do other wonderful things….As Christopher Hitchens said, ‘That which can be asserted without evidence, can be dismissed without evidence.’ So I dismissed it.”
Posted “Avemar: wheat germ for cancer.” “Avemar is fermented wheat germ. It is claimed to be an effective addition to conventional cancer treatment. The evidence is lacking.”
Clay Jones:
Posted “Chiropractic care of an infant with Erb’s palsy: another worthless case report.” “In reality, the chiropractor took credit for the natural course of a well-known medical condition and luckily didn’t make things worse for the patient.”
Steven Novella:
Wrote “Buzzword medicine - anti-proinflammation.” “There is therefore no rationale for simultaneously recommending some interventions that reduce immune activity and other interventions that increase immune activity as blanket recommendations, without evidence for net clinical outcomes from a specific treatment in a specific infection. But researching specific clinical outcomes would be doing science-based medicine, and that is not what alternative medicine is. Alternative medicine is based on marketable buzzwords, applied simplistically, and without proper evidence.”
On Respectful Insolence, “Orac”:
Posted “A bogus statistic about medical errors.” “The claim that medical errors are the third leading cause of death in the US is one of those slasher statistics that just won’t die. This time around STAT News gave space to Michael Saks and Stephan Landsman to parrot that claim credulously in the service of selling their book.”
Wrote “Quoth an 'integrative' functional medicine doc: ‘I’m not a quack. I’m an early adopter’.” “Functional medicine practitioner Dr. Melinda Ring thinks that she should be considered an ‘early adopter’ instead of a quack. However, being an ‘early adopter’ of quackery is not something to be admired.
Edzard Ernst posted numerous items, on the following topics:
Manual therapy (chiropractic, osteopathy, massage):
o Discussion of an article entitled “The demonization of manual therapy.” “Cook’s defence of manual therapy is clumsy, inaccurate, ill-conceived, misleading and often borders on the ridiculous. In the age of evidence-based medicine, therapies are not ‘demonized’ but evaluated on the basis of their effectiveness and safety. Manual therapies are too diverse to do this wholesale. They range from various massage techniques, some of which have a positive risk/benefit balance, to high-velocity, low-amplitude thrusts, for which the risks do not demonstrably outweigh the benefits.”
o “Chiropractic ‘subluxation’ is by no means a notion of the past.” “In a nutshell: chiros cannot give up the concept of subluxation because, if they did, they would be physios except with a much narrower focus.”
o “Chiropractic paediatric courses…it is high time to stop this dangerous nonsense.” “I wonder whether some chiropractor feels like defending this outright charlatanry. I know of no evidence to assume that chiropractors can provide effective care for children. I see, however, many reasons to fear that they may cause considerable harm. I also see no reason to take a profession seriously that tolerates or even supports such extreme quackery.”
o Discussion of a review of massage therapy for multiple sclerosis (Heidari et al. Disabil Rehabil. 2021 Aug 1:1-12. Epub ahead of print Abstract). Ernst wrote, “The authors concluded that different massage approaches effectively improved MS symptoms such as fatigue, pain, anxiety, depression, and spasticity. Clinical trials of massage therapy face formidable obstacles…the evidence is often less convincing than one would hope. This, however, does not mean that massage therapy does not have considerable potential for a range of indications. One could easily argue that this situation is similar to spinal manipulation. Yet, there are at least three important differences: massage therapy is not as heavily burdened with frequent adverse effects and potentially life-threatening complications, massage therapy has a rational basis, the existing evidence is more uniformly encouraging.”
o “Manual therapy (mainly chiropractic and osteopathy) does not have clinically relevant effects on back pain compared with sham treatment.” The post discussed a review by Lavazza and others (BMJ Open. 2021 May 4;11(5):e045106 Paper). “this review implies that chiropractic and osteopathy are essentially placebo treatments…If we agree that chiropractic and osteopathy are placebo therapies, we might ask whether they should have a place in the management of BP. Considering the considerable risks associated with them, I feel that the answer is obvious and simple: NO!”
o “Spinal manipulation therapy is as good (or bad) for chronic back pain as other options … and should therefore NOT be recommended.” A review by de Zoete and others (Physiotherapy. 2021 Mar 17;112:121-134 Paper) was discussed. “Can any reasonable person seriously assume that SMT would do better than exercise when accounting for costs and risks? I very much doubt it!”
o In a related post, he wrote “Spinal manipulative therapy (SMT) for chronic back pain is a mere placebo therapy.” He discussed seven studies in a 2019 review that compared SMT to sham treatments. “This means that SMT has effects that are very similar to placebo... In turn, this means that the effects patients experience are largely or completely due to a placebo response and that SMT has no or only a negligibly small specific effect on back pain. Considering the facts that SMT is by no means risk-free and that less risky treatments exist, the inescapable conclusion is that SMT cannot be recommended as a treatment of chronic back pain.”
Homeopathy:
o “Just when I thought I had seen everything: 'systemic agro-homeopathy'.”
o A contribution by Aust and Weisshӓupt: “An update on the dubious cancer study by Prof Michael Frass et al.” The study supposedly found that “homeopathy improves the quality of life and survival of cancer patients,” and was discussed by these authors in a post of June 11.
o “Materia Medica Holding - The (not so) new kid on the block sponsoring homeopathy publications in disguise,” by Wolfgang Denzer. The company publishes papers on so-called “release-active” drugs (RA-drugs), which are really homeopathic remedies containing no active ingredients.
o “Homeopathy is not effective for controlling pre-hypertension.” Study authors referred to results as “inconclusive,” but Ernst prefers calling it a negative trial. He made similar comments about another study, of homeopathy for cutaneous warts.
Chinese medicine:
o A review of tai chi. “I must say that I do not find the overview all that ‘critical’. The authors admit that the primary studies often lacked scientific rigor. Yet they draw firm positive conclusions from the data. I think that this is wrong…I also miss critical comments on two important questions: Are the positive effects of Tai chi superior to conventional treatments of the respective conditions? Are the effects of Tai chi really due to the treatment per see or might they be largely caused by context effects (which, considering the nature of the therapy, might be substantial)?”
o “Efficacy of acupuncture for chronic prostatitis/chronic pelvic pain syndrome? Another dubious study in a top journal.” “…one might wonder what the rationale of acupuncture as a treatment of CP/CPPS might be. As far as I can see, there is no plausible mechanism (other than placebo) to explain the effects. So, is the evidence that emerged from the new study convincing? No, in my view, it is not! In fact, I am surprised that a journal as reputable as the Annals of Internal Medicine published it.”
Cancer:
o Announcement of his new book, “So-called Alternative Medicine for Cancer.” “Three basic facts are indisputably clear: a high percentage of cancer patients use SCAM, misinformation about SCAM is rife, misinformation endangers the lives of cancer patients. It follows that there is an obvious and urgent need for an evidence-based text naming the SCAMs that are potentially harmful and discussing those that might be helpful. My book is aimed at doing just that.”
o “Enzyme therapy: another bogus therapy promoted for cancer. What can be more despicable than preying on the most vulnerable patients?” He discussed a review by Gremmler et al. (Anticancer Res. 2021 Jul;41(7):3213-3232 Paper), which concluded “On the basis of existing evidence, there is no clear therapeutic benefit of enzymes neither as supportive therapy nor as part of antineoplastic therapy.”
o Discussion of a study indicating that “Glucosamine is associated with decreased risk of lung cancer.” “This is certainly interesting, but does it prove a causal relationship?” The paper is Li et al., Eur Respir J. 2021 Jul 29:2101399. Epub ahead of print Abstract.
Herbs:
o “Pelargonium sidoides seems to be effective for upper respiratory tract infections.” “Meanwhile, P. sidoides has been associated with liver damage, a fact that might dampen our enthusiasm for this remedy. Nevertheless, it seems to me that this plant merits further study.”
August – Bessell and others reviewed dietary supplements containing chitosan, glucomannan, conjugated linoleic acid and fructans for weight loss (Int J Obes (Lond). 2021 Aug;45(8):1631-1643 Abstract). They concluded “While some dietary supplements containing isolated organic compounds warrant further investigation to determine efficacy and safety, there is currently insufficient evidence to recommend any of these dietary supplements for weight loss.”
August 12 – a review by Nevins et al. (J Nutr. 2021 Aug 12:nxab238. doi: 10.1093/jn/nxab238. Epub ahead of print Abstract) concluded that “Limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child. There was insufficient evidence to evaluate the effects of omega-3 fatty acid supplementation during pregnancy and/or lactation on other developmental outcomes.”
August 17 – A Press release was entitled “FTC, Georgia Attorney General Sue Stem Cell Institute of America Co-Founders for Deceptive Joint Pain Cure-All Marketing Scheme.” “The agencies’ complaint also alleges that the Canton, Georgia-based defendants promoted the false or unsubstantiated claim that stem cell therapy is comparable or superior to surgery, steroid injections, and painkillers, and that they provided chiropractors and other healthcare practitioners with the means of deceiving consumers about such treatments...SHC charged approximately $5,000 per joint injection, with many patients receiving more than one injection as part of their treatment.”
August 18 – A study of more than 60,000 women found that “Intake of lean fish, but not fatty fish or LCn-3PUFA [long-chain n-3 polyunsaturated fatty acid] supplements, was associated with lower risk of pharmacologically treated type 2 diabetes in Norwegian women who were overweight or obese” (Øyen et al. Diabetes Care. 2021 Aug 18:dc210447. Epub ahead of print Abstract).
August 26 – Little wrote “The bible of homeopathy that you’re not allowed to read.” “The Federal Food, Drug and Cosmetic Act defines as a ‘drug’ as anything listed in the Homeopathic Pharmacopeia of the United States (HPUS).” However, access to the information is extremely difficult.
Additions to previous months
November, 2020 – Wang and others reviewed effects of DHEA supplementation (Steroids. 2020 Nov;163:108710 Abstract). “Our findings demonstrate that DHEA supplementation increased lean body mass and decreased fat mass, but debate persists when translating the results into clinical benefit. Lastly, DHEA supplementation had a neutral effect on BP [blood pressure].”
December 26, 2020 – Jones and others reviewed complementary and alternative medicine for common skin diseases (JAAD Int. 2020 Dec 26;2:76-93 Paper). “Based on our quantitative findings we conclude that there is insufficient evidence to support the efficacy and the recommendation of CAM for acne, AD [atopic dermatitis], and psoriasis.”
February, 2021 – A review by Mason, Keske, and Wadley (Diabetes Care. 2021 Feb;44(2):618-630 Paper) concluded that “While evidence from short-term studies suggests that vitamin C supplementation may improve glycemic control and BP [blood pressure] in people with type 2 diabetes, vitamin C supplementation cannot currently be recommended as a therapy until larger, long-term, and high-quality trials confirm these findings.”
February 24 –Northeast and Clifford reviewed “The Effect of Creatine Supplementation on Markers of Exercise-Induced Muscle Damage” (Int J Sport Nutr Exerc Metab. 2021 Feb 24;31(3):276-291 Abstract). They concluded “creatine supplementation does not accelerate recovery following exercise-induced muscle damage; however, well-controlled studies with higher sample sizes are warranted to verify these conclusions.”
March – Simonson et al. (MCN Am J Matern Child Nurs. 2021 Mar-Apr 01;46(2):88-96 Abstract) reviewed “Probiotics for the management of infantile colic.” “Based on the evidence in this systematic review, the oral administration of probiotics to breastfed infants with colic resulted in at least a 50% reduction in crying time compared with placebo. Efficacy of probiotics to reduce colic symptoms in formula-fed infants needs further study. In this review, we did not find evidence to support or refute efficacy of probiotics to prevent infantile colic.”
May – Missouri Medicine published pro and con articles on the value of fish oil supplements for prevention of cardiovascular disease. DiNicolantonio and O'Keefe presented the “pro” position (Mo Med. 2021 May-Jun;118(3):214-218 Paper), while Khoukaz and Fay argued “con” (Mo Med. 2021 May-Jun;118(3):219-225 Paper).
June 17 – Narzisi, Masi, and Grossi published “Nutrition and autism spectrum disorder: between false myths and real research-based opportunities” (Nutrients. 2021 Jun 17;13(6):2068 Paper). “…children with ASD, because of false myths, sometimes undergo to non-intentional and dangerous dietary restrictions protocols (e.g., casein and/or gluten-free) based on non-evidence-based attempt to improve behavioral disturbances or gastrointestinal symptoms…there is a lack of sufficiently robust evidence to support specific dietary interventions in children with ASD, although some small, documented real research-based opportunities (e.g., vitamin D3; SGS [sulforaphane-glucosinolate]) may open interesting glimmers.”
July – Awadh and others published “Vitamin D supplements: The pharmacists’ perspective” (J Am Pharm Assoc. 2021 Jul-Aug;61(4):e191-e201 Abstract). “There is evidence for vitamin D supplementation in individuals aged 75 years or older and in those with problems associated with mobility, gait, or balance. There is insufficient evidence to support vitamin D supplementation in the prevention of cardiovascular disease, cancer, asthma, chronic obstructive pulmonary disease exacerbations, new-onset type 2 diabetes, infectious lung diseases, cognitive dysfunction, Alzheimer disease, and depression, or in prenatal use.”
July 27 – Truth in Advertising published “Proposed settlement allows for continued deceptive marketing of Neuriva.” “It only requires Reckitt Benckiser to stop using one word in its marketing – ‘proven.’ The company can claim that Neuriva is ‘clinically tested,’ which, while literally true, is misleading because it conveys the same message as ‘clinically proven,’ i.e., that there is competent scientific evidence that proves the product is effective at improving cognitive performance.”