FEBRUARY 2023 NEWS
Featured topic: coronavirus
On Science-Based Medicine,
David Gorski posted:
“COVID-19 is a leading cause of death among children, but that doesn’t stop some of my colleagues from arguing against vaccinating them.” “If you use arguments against vaccinating children against COVID-19 that are in form identical to the arguments that antivaxxers used to use before the pandemic to argue against vaccinating children against measles, pertussis, and the like, namely that the disease isn’t a threat to the children, while ignoring that the disease kills hundreds of children a year, what should I call you? You’ve lost the right to get all indignant if I call you an antivaxxer.”
“Brownstone Institute admits that the Great Barrington Declaration was wrong (without actually admitting it was wrong).” “The Brownstone Institute’s Gabrielle Bauer claims vindication for the Great Barrington Declaration, the October 2020 document that advocated a ‘natural herd immunity’ pandemic strategy, with an ill-defined ‘focused protection’ strategy to protect those most at risk of death. In the fine print, however, Bauer tacitly admits that its core assumption was badly mistaken, minimizing it as not getting all the ‘details’ right.”
“Vaccines and infant mortality rates: A false relationship promoted by the antivaxxers…again, 12 years later.” “Since COVID-19, in the antivax world everything old is new again. Even hoary chestnuts of bad science used 12 years ago to falsely claim that vaccines kill babies. That’s right, Gary S. Goldman and Neil Z. Miller are back to defend their 2011 ‘study,’ and RFK Jr. is flogging it as slam-dunk ‘evidence’ that vaccines kill babies.”
“Andrew Wakefield after 25 years: Paving the way for COVID-19 quacks and antivaxxers.”
Jonathan Howard posted:
“Are vaccine-advocates ‘idiots,’ indifferent to the death of a mentally ill woman and her family?” Vinay Prasad blamed “the social media habits of vaccine-advocates” for the deaths of Monica Cannady and her children.
“’Among patients aged 12-39 years with no predisposing comorbidities, the relative risk of heart failure or death was markedly higher for myocarditis associated with covid-19 disease than for myocarditis associated with vaccination’.” “Doctors used *that result* to claim the vaccine is more dangerous than the virus…It’s a sad commentary on our pandemic discourse that doctors - who will never care for a sick child themselves - twisted this result to scare parents away from vaccination.”
Steven Novella posted:
“Masks revisited.” “A recent Cochrane review, limited in scope and problematic in methodology, does not show that masks do not work, despite common misreporting…The most we can conclude from it is that we need better and more relevant controlled trials of mask wearing to more precisely determine its effect on the spread of COVID. But it does not show that mask wearing does not work or that mask policies don’t work. Further, if we look at the totality of the evidence (not just these trials) the best current conclusions are: Properly wearing face masks when in public during high risk of spread reduces the risk of spread of respiratory viruses in general and COVID specifically. During a pandemic of a respiratory virus, mask mandates are an effective public health measure. N95 masks likely offer the best protection, but need to be worn over the mouth and nose to be effective, and need to be worn continuously when in public (not just in targeted situations).”
On Respectful Insolence, “Orac” posted:
“Nattokinase: the latest COVID-19 spike protein ‘detox’ quackery.” Nattokinase is an enzyme used to ferment soy products; it is being promoted by Jen VanDeWater for digesting spike protein that allegedly enters the bloodstream after COVID vaccinations. Like other proteins, “It should be expected to be digested when taken orally; it would not be expected to get into the bloodstream where it might actually be able to exhibit its ability to break down clots that it exhibits in a test tube…Nattokinase is known to dissolve clots in cell culture. It also appears to dissolve spike protein in cell culture…The evidence is weak that it has clinical utility in cardiovascular disease, nonexistent, given that existing evidence is only in vitro, that it combats COVID-19, and fantastical that it somehow combats ‘COVID-19 vaccine injury’ given that the ‘injuries’ claimed by antivaxxers like Alexander and McCullough are basically either not a thing or completely exaggerated.”
February 20 – A trial with over 1200 participants found that “Among outpatients with mild to moderate COVID-19, treatment with ivermectin, with a maximum targeted dose of 600 μg/kg daily for 6 days, compared with placebo did not improve time to sustained recovery. These findings do not support the use of ivermectin in patients with mild to moderate COVID-19” (Naggie et al. JAMA. 2023 Feb 20:e231650 Abstract). The dose was higher and the duration longer than in some previous studies.
February 23 – Baron and Coleman wrote “Protecting the legitimacy of medical expertise” (N Engl J Med. 2023 Feb 23;388(8):676-678 Paper). State medical boards ensure that physicians maintain professional standards throughout their careers. “In response to the Covid-19 pandemic, however, state lawmakers have embraced measures that could seriously undermine boards’ ability to carry out these functions…Efforts to limit the powers of licensing boards are the latest example of a larger movement to undermine the concept of expertise and the institutions that validate it… Although there are many gray areas in medicine, some propositions are objectively wrong. For example, when a licensed physician insists that viruses don’t cause disease or that Covid-19 vaccines magnetize people or connect them to cell towers, professional bodies must be able to take action in support of fact- and evidence-based practice. The public relies on the medical profession in times of grievous vulnerability and need. For the profession to earn and maintain the public’s trust — along with the privileges associated with the status of being licensed practitioners — medical boards must be able to differentiate practitioners who are providing fact-based advice from those who are not.”
Other topics
Best of the blogs, February – on Science-Based Medicine,
Scott Gavura:
Discussed an American Heart Association statement on complementary and alternative medicine for heart failure. The statement is: Chow et al., Circulation. 2023 Jan 10;147(2):e4-e30 Paper. “CAM is undoubtedly popular and may be used alongside conventional treatments for heart failure, or in place of evidence-based therapies. While there are a few products (e.g., PUFAs [polyunsaturated fatty acids]) and approaches (e.g., yoga/tai chi) that may be beneficial, there are also a large number of products that can worsen heart failure or cause negative interactions with prescribed medications. While additional research is undoubtedly advisable, taking a cautious approach to CAM use (of any kind) would seem to be the safest strategy with the lowest risk of unanticipated harm.”
Samuel Homola:
Posted “Spinal manipulation, chiropractic, and subluxation theory.” “While generic spinal manipulation can be helpful in treating mechanical-type back pain, there are good reasons to be skeptical about chiropractic manipulation based on subluxation theory which dictates that health can be restored and maintained by adjusting vertebral subluxations. A grain of truth mixed with subluxation theory makes it difficult for many of us to distinguish between appropriate and inappropriate use of manipulation by chiropractors.”
Steven Novella:
Discussed "earthing," also known as “grounding.” “Another pattern that is apparent is that most of the research is published in ‘alternative medicine’ journals, predatory journals, or other low impact journals. This allows for the creation of the illusion of scientific support without ever crossing the threshold of scientific legitimacy. Earthing is another example of exactly what is wrong with biomedical publishing. It favors the publication of large numbers of low quality studies, with plenty of opportunities for proponents of dubious medical treatments and beliefs to get into the peer-reviewed literature. For the uninitiated this creates the appearance of legitimacy, even for highly implausible treatments.”
Edzard Ernst:
Posted “A herbal remedy for body weight reduction?,” discussing a study on konjac glucomannan. “These findings seem promising, yet somehow I am not convinced. The study was small and short-term; moreover, the authors seem uncritical and, instead of a conclusion, they offer speculations.” Ernst’s own review in 2014 found that the evidence did not support significant weight loss. “Rigorous trials are required to change my mind, and I am not sure that the new study falls into this category.”
Wrote “Veterinary quackery revisited.” Discussing a new paper on chiropractic for horses, he noted numerous flaws. “What does all this tell us about veterinary chiropractic? Not a lot. All we can safely say, I think, is that veterinary chiropractic is not evidence-based and that claims to the contrary are certainly ill-informed and most probably of a promotional nature.”
Discussed “The wellness epidemic.” “Are there risks? Yes, of course! Here are just some of them: The treatments advocated for wellness almost invariably cost money. The treatments advocated for wellness almost invariably cause direct and indirect harm, as discussed in many of my previous posts. Wellness treatments tend to give the impression that one can buy wellness like an expensive piece of clothing without putting in any real effort oneself. Considering all this, I’d like to offer my very own definition of the sector: Wellness is a fashionable paradise for charlatans in which they are protected from scientific scrutiny and feel at liberty to bullshit to their hearts’ content.”
Posted “A new study of osteopathy makes you want to weep.” “What the abstract does not tell you is that the two groups were extremely small and that they became even smaller, as some patients were lost to follow-up. In addition, the results were all over the place. Furthermore, it is noteworthy that neither the therapists nor the patients were blinded and the observation period was short. Finally, the authors state in their conclusions that OMM is safe. Considering the sample size and the attrition rate…this is of course ridiculously wishful thinking. So, what can we conclude from this study?... I conclude that the department of Osteopathic Manipulative Medicine, New York Institute of Technology College of Osteopathic Medicine could do with a good science teacher.”
Reported on “Nine cases of severe homeopathy-induced liver injuries.” “The article provides an essential caution for those who delude themselves by assuming that homeopathy is harmless. In fact, the remedies can cause severe problems. But, as we have discussed regularly on this blog, the far greater risk in homeopathy is not the remedy but the homeopath and his/her all too often incompetent advice to patients.”
Posted “A meta-analysis of Chinese herbal medicine for lowering blood pressure.” “The authors can boast of an impressive list of affiliations…Impressive in the sense of being impressively prone to bias, particularly knowing that ~80% of Chinese research findings have been shown to be fabricated and considering that Chinese authors as good as never publish anything negative about TCM [traditional Chinese medicine]…Blood pressure is one of the many endpoints that are highly prone to placebo effects. Therefore, even the addition of an ineffective CHM to WM [Western medicine] would lower blood pressure more effectively than WM alone. But there is a third way of explaining the findings of this review: some herbal remedies might actually have a hypotensive effect. The trouble is that this review does come not even close to telling us which.”
Had two posts on the dangers of stroke after chiropractic neck adjustments. The first dealt with two lawsuits in Kentucky. “I am impressed by the number of cases that go to court where a settlement of some sort is reached and further reporting of the incident is prevented. As a consequence, these cases are not published in the medical literature. In turn, this means that chiropractors can continue to claim that these complications do not exist or are exceedingly rare.” In the second post, he wrote: “Complications after chiropractic manipulation do happen and are probably much more frequent than chiros want us to believe. They are only rarely reported in the medical literature because the busy clinicians who end up treating the victims do not consider this a priority and because many cases are settled in or out of court. Normally, it would be the ethical/moral duty of the chiros who have inflicted the damage to do the reporting. Yet, they seem too busy ripping off more patients by doing neck manipulations that do more harm than good. And then they complain that the evidence is insufficient!!!”
Posted “A ‘letter to the editor’ of The Lancet: we need to drop homeopathy in India.”
Wrote “Acupuncture for pain: plenty of useless papers and very little reliable evidence.” “I might disagree with the authors’ conclusion and would argue that they have demonstrated that: the acupuncture literature is dominated by China, which is concerning because we know that 1) these studies are of poor quality, 2) never report negative findings, and 3) are often fabricated; the articles tend to be published in journals that are more than a little suspect. As we have seen recently, the reliable evidence that acupuncture remains effective is wafer-thin. Therefore, I feel that we are currently being misled by a flurry of rubbish publications that have one main aim: to distract from the fact that acupuncture might be nonsense.”
Discussed Kourtney Kardashian’s gummies for the vagina. “Call me a skeptic, but I do get the feeling after looking at Kourtney’s website that she is much more interested in money than vaginal health.”
Posted concerning a review of natural remedies for Alzheimer's disease. “The authors concluded that different herbal remedies in combination with FDA approved drugs are effective and more promising in the treatment of AD.” In another study too recent to be included in the review, “The authors concluded that Fenugreek seed extract supplementation in AD patients shows promising positive effects on memory, quality of life, BP, and selective oxidative indices levels. So, there is hope! Some of the evidence is promising but far from convincing. What we need – obviously – is more and better research.”
February: Thomas Wheeler responded to an unscientific journal article on chromotherapy (or color therapy) with a Letter to the Editor (J Fam Med Prim Care 2023;12(2):417-8). The original article claimed, with no hint of skepticism, that administration of colored light or water “charged” with different colors could affect internal organs and be helpful with over 100 medical conditions.
Addition to previous months
January 3 – Laffin and others compared effects of a statin on blood lipid levels to effects of six dietary supplements (J Am Coll Cardiol. 2023 Jan 3;81(1):1-12 Paper). None of the supplements (fish oil, cinnamon, garlic, turmeric, plant sterols, and red yeast rice) produced a significant effect on low-density lipoprotein cholesterol levels.