JUNE 2023 NEWS
Featured topic: coronavirus
On Science-Based Medicine,
David Gorski posted:
“When an antivax physician ‘dies suddenly’: The case of Dr. Rashid Buttar.” “Last month, Dr. Rashid Buttar, a prominent antivax ‘integrative medicine’ practitioner, died suddenly. Because he hadn’t been vaccinated, antivaxxers struggled mightily to reconcile his death with their conspiracy theory about COVID-19 vaccines killing thousands ‘suddenly.’ It turns out, however, that that Dr. Buttar had not been a well man since 2016 and was as much a victim of quackery as his patients had been.”
Jonathan Howard posted:
“’Their plan is incongruent with my existence’.” “The authors of the Great Barrington Declaration never asked ‘vulnerable’ people if they were on board with their plan to lock them down for month on end, with no backup plan if herd immunity never arrived. They just wanted to impose their will on tens of millions of vulnerable Americans whether they wanted it or not.”
“Dr. Jay Bhattacharya responds to words I never said.” “My critics lack the courage to accurately quote me. That tells you everything about them and nothing about me.”
“Three new studies show the COVID vaccines are very safe for children.” “Overall, these three studies are entirely consistent with every study published thus far. The vaccine isn’t perfect, but it’s far safer than the virus for children.”
“The pandemic as spectacle.” “Though calls for ‘debates’ are made by unserious people, unserious people can do serious damage when they are willing to spread disinformation about vaccines, all because a doctor with principles isn’t willing to play his part in their absurd theater.”
“A letter to my critics: to refute me, stand up for your own words.” “All you have to do is stand up for your own words and make the affirmative case that the purposeful infection of unvaccinated children and young adults was wise and a net positive.”
“Steve Kirsch and Brandolini’s law.” “The amount of energy needed to refute bullshit is an order of magnitude bigger than that needed to produce it.”
“Anti-vaccine doctors: ‘Kids don’t need the vaccine because they are less likely to acquire SARS-CoV-2 and because most already had COVID-19’.” “Some doctors were always against vaccinating children, and no data was going to sway them. Whether cases were going up or down, the facts on the ground were used to support their unshakable, predetermined conclusion that unvaccinated children should contract COVID. Though they claim to ‘follow the evidence,’ their minds were made up months before any evidence even existed.”
On Respectful Insolence, “Orac” posted:
“’Censorship’: The word disinformation artists use when called out.” “COVID-19 minimizers and antivaxxers at the Brownstone Institute, the ‘spiritual child of the Great Barrington Declaration, really don’t like having their disinformation called out.”
“Return of the revenge of ‘vaccines permanently alter your DNA’.” “The bottom line is that Kevin McKernan is using his knowledge of genomics to frighting people about the mRNA-based COVID-19 vaccines. What he is claiming, while not as implausible as homeopathy, is pretty damned implausible, and he shows no evidence that any of the mechanisms that he’s trying to scare you with are operative with respect to the Pfizer or Moderna COVID-19 vaccines, other than that he’s detected small amounts of plasmid DNA contamination, likely leftover from the manufacturing process. He has not shown that this DNA can get into the nucleus, much less integrate into the genome and ‘permanently alter your DNA’.”
“Larry Cook: A time warp cornucopia of antivax quackery.” “Larry Cook is a longtime antivaxxer turned anti-COVID-19 vaccine. This month, he updated his ‘vaccine injury treatment guide.’ It’s pure quackery.”
Edzard Ernst posted:
“Classical homeopathy worsens the prognosis of patients infected with COVID-19.” While the study authors felt that homeopathy was associated with improvement, Ernst wrote, “These cases suggest nothing of the sort. If anything, these highly selected cases suggest that about 27% of the exemplary patients did not improve, perhaps they even died.”
June 2: Jonathan Jarry published “Stew Peters' Final Days is an anti-science satanic panic.” “The movie Died Suddenly claimed the COVID vaccines were killing everyone. Its spiritual sequel imagines the virus itself is an artificial bioweapon.”
Featured topic: vaccines (general)
On Science-Based Medicine,
Mark Crislip:
Posted “Courage.” “If I were King of the Vaccines. Some thoughts on influenza vaccine, hospitalization, death and courage.”
David Gorski posted:
“RFK Jr. and Joe Rogan: Putting the old denialist technique of bad faith ‘Debate me, bro!’ challenges on steroids.” “Joe Rogan conveyed a challenge by antivax crank turned Presidential candidate RFK Jr. to vaccine scientist Dr. Peter Hotez to ‘debate me, bro!’ In the week since, wealthy right wingers have added money to the inducement, and through an awful op-ed by Ross Douthat this weekend, even the New York Times has amped up the pressure for a ‘debate’ about vaccines with RFK Jr... Unfortunately, bad faith ‘debate me, bro!’ challenges are very effective propaganda techniques, which is exactly why they have been so commonly employed against scientists, historians, and other experts by conspiracy theorists like RFK Jr. Maybe they would be less effective if the public would just ask themselves a question about these challenges that the conspiracy theorists always love to ask when spinning their tales: Cui bono? (Who benefits?)”
Wrote “Steve Kirsch: How ‘anti-COVID-19 vaccine’ antivax often becomes radicalized and just plain antivaccine.”
Posted “Is Robert F. Kennedy, Jr. antivaccine? Judge him by his own words!” “Last week, an antivaxxer on Substack—where else?—tried to argue that Robert F. Kennedy, Jr. is not antivaccine by encouraging you to judge him by his own words. I agree. You should judge RFK Jr. by his own words, as they show definitively that he has been antivaccine since at least 2005.”
On Respectul Insolence, “Orac” posted:
“Steve Kirsch uses doxxing and the threat of a libel suit to silence Dr. Canuck.” A followup post was entitled “Steve Kirsch denies being a doxxing bully. Hilarity ensues.” The issues involve Kirsch’s claims concerning vaccines.
“RFK Jr. is hosting a veritable antivax Quackapalooza.” “RFK Jr. will hold a ‘healthcare policy roundtable’ next week. One look at its list of ‘experts’ shows that it will be a Quackapalooza of antivax misinformation. Unfortunately, RFK Jr.’s candidacy is normalizing old long debunked antivax tropes.”
“A ‘not antivax’ COVID-19 contrarian: ‘RFK Jr. makes “reasonable” points’.” “Podcaster Joe Rogan conveyed a ‘debate’ challenge by antivax conspiracy theorist RFK Jr. to Dr. Peter Hotez. COVID-19 contrarian Dr. Vinay Prasad, wanting to be on Rogan’s podcast, sucked up to both, saying RFK Jr. made many ‘reasonable’ points.”
Posted “Return of the revenge of ‘no saline placebo RCTs’ for childhood vaccines.” “Thanks to RFK Jr. the deceptive claim that the childhood vaccine schedule has never been tested in a randomized controlled trial with a saline placebo control is making the rounds again. This is an old and deceptive antivax half-truth that ignores both what constitutes a scientifically valid placebo and the ethical requirement that RCTs have clinical equipoise... there is nothing nefarious in there existing a number of vaccines that were tested against older versions of a vaccine against the same disease or that were not tested against a ‘saline placebo.’ That’s literally how ethical clinical trials work. They balance scientific rigor against ethics, which often leads to compromises because ethics always trumps rigorous clinical trial design... Moreover, an ‘appropriate’ placebo for an injectable drug or vaccine does not have to be saline. There are many more placebos that are entirely appropriate to use as a control in a vaccine RCT other than just saline.”
Wrote “Undermining the childhood vaccine schedule with EBM fundamentalism.” “’Not antivax’ COVID contrarian Dr. Vinay Prasad demonstrates why skepticism is necessary and how evidence-based medicine (EBM) fundamentalism harms childhood health by inadvertently (I hope) echoing a very old antivax trope about randomized clinical trials for the childhood vaccine schedule, you know, to ‘rebuild confidence’.”
Featured topic: homeopathy
Edzard Ernst:
Reported on a study of individualized homeopathy for psoriasis, in which the authors concluded that homeopathy gave better results than placebo. “I see the following problems with this trial: Psoriasis is a genetically determined condition, and I find it hard to believe that homeopathy can change its natural history. The symptoms of psoriasis fluctuate and can be influenced by a range of factors, including stress. We learn nothing about any concomitant interventions which are always necessary, e.g. creams, or compliance with them. It is conceivable that patients in the verum group received inadvertent reassurance which, in turn, reduced stress and improved compliance with external treatments. It is unclear whether patients were successfully blinded or whether inadvertent de-blinding occurred. In any case, I would caution that this trial needs independent replications before we can take its findings seriously.”
Posted “This might easily be the worst paper on homeopathy that you will ever read.”
Posted “The treatment of verrucae by homeopathy.” “This case report does not suggest that homeopathic treatment is a promising complementary or alternative therapy. It shows the natural history of the condition in the disappearance of warts.”
February 20 – Zadey published “Yes to pluralistic health system, but no to homeopathy” (Lancet Reg Health Southeast Asia. 2023 Feb 20;10:100172 Article). “Homeopathy doesn't work, could be harmful, and is not a part of Indian traditional medicine. While we should welcome pluralistic approaches towards UHC [universal health coverage], we need to drop homeopathy.”
June 27 – Joanne Hawana published “Recent developments signal headwinds for homeopathic drug products” for National Law Review. Lawsuits filed by the Center for Inquiry are discussed. “This recent ruling from the D.C. Court of Appeals foreshadows the possibility that retailers may opt to stop carrying homeopathic products in their stores (both physical and online) if the risk of liability to their own businesses becomes too great. Between the tightening of FDA’s and FTC’s rules for the industry and the increasingly creative use of existing consumer protection statutes by legal advocates, we could be witnessing a slow-motion demise of direct-to-consumer-based homeopathic product marketing.”
Other topics
Best of the blogs, June – on Science-Based Medicine,
Scott Gavura:
Posted “Can kinesiology tape increase oxygen delivery and improve sports performance?” “I continue to be amazed at the popularity of kinesiology tape. Despite multiple debunkings and even successful class action lawsuits, it continues to be used by amateur and professional athletes alike. Not surprisingly, USATF [USA Track & Field] got a very rough ride on Twitter for their tweet, with multiple exercise scientists pointing out the sheer implausibility of tape on the skin increasing cell oxygenation.”
Steven Novella:
Posted “Dubious autonomic nervous system claims.” Promoters “appear to be taking a kernel of real science and medicine but then turning that into a simplified boutique treatment that is good for just about anything, making extremely overblown claims without sufficient evidence, and presenting themselves as the wave of the future.”
Wrote “Does intermittent fasting work?” “The short answer to any question about – does diet X work – is always going to be, yes and no. Intermittent fasting is no different. Diets statistically work in the short term because any time you pay attention to your calorie consumption and exercise you are likely to consume fewer calories, which can result in weight loss. But diets notoriously don’t work in the long term for about 95% of people.”
Edzard Ernst:
Discussed a study alleging that ear acupressure improves cerebrovascular function and can help prevent strokes. “I think there is a much simpler explanation: the observed effects are directly or indirectly due to placebo. As regular listeners of this blog know only too well by now, the A+B versus B study design cannot account for placebo effects. Sadly, the authors of this study hardly discuss this explanation – that’s why they had to publish their findings in just about the worst SCAM journal of them all: EBCAM [Evidence-Based Complementary and Alternative Medicine].”
Discussed a review on reporting of the adverse effects associated with spinal manipulation (Gorrell et al. BMJ Open. 2023 May 4;13(5):e067526 Paper). “The authors concluded that, while the current level of reporting of adverse events associated with spinal manipulation in RCTs has increased since our 2016 publication on the same topic, the level remains low and inconsistent with established standards….In fact, it is an ethical imperative to accurately report adverse effects. Not reporting adverse effects amounts to a violation of medical research ethics. Adverse effects of spinal manipulation occur in about 50% of all patients. This means that investigators reporting significantly lower figures are likely guilty of under-reporting. And under-reporting of adverse events is also a breach of ethical standards. My conclusion thus is that the vast majority of trials of spinal manipulation are unethical and should be discarded.”
Wrote “Spinal manipulations for lumbar radicular syndrome?” “The authors stated that they cannot conclude whether HVLA spinal manipulations can be helpful for the treatment of LSRS or not. Future high-quality RCTs [randomized controlled trials] are needed to establish the actual effect of HVLA [high-velocity low-amplitude] manipulation in this disease with adequate sample size and LSRS definition. Chiropractors earn their living by applying HVLA thrusts to patients suffering from LSRS. One would therefore have assumed that the question of efficacy has been extensively researched and conclusively answered. It seems that one would have assumed wrongly! Now that this is (yet again) in the open, I wonder whether chiropractors will, in the future, tell their patients while obtaining informed consent: ‘I plan to give you a treatment for which sound evidence is not available; it can also cause harm; and, of course, it will cost you – I hope you don’t mind’.”
Discussed a report on osteopathic visceral manipulation for constipation and chronic nonspecific low back pain. “…The reported findings are based on within-group changes. The whole point of having a control group is to compare verum and control… the study seems tiny and far too small for drawing general conclusions about the value of OVM…It is likely that patients in the control group could have guessed that they were sham-treated.”
Posted “Pascal's wager applied to so-called alternative medicine.” The idea that “little is lost” if an unproven remedy is not effective is flawed; there is the potential for both direct and indirect harm.
Wrote “Multivitamin/multimineral supplement might improve memory.” “These findings are surprising, not least because similar studies have thus far failed to demonstrate such effects... this seems to be a rigorous trial. It was conducted by multiple researchers of high standing. One is therefore inclined to believe the results. Yet, one might be wise to be cautious... I would still want to 1) have a plausible explanation as to the mode of action and 2) see an independent replication before I accept the findings.... it also has limitations, of course, e.g.: the effect size is modest; the study population is selected and thus the results are not generalizable; the outcome measures were assessed remotely; the success of blinding was not checked...” The paper is: Yeung et al. Am J Clin Nutr. 2023 May 24:S0002-9165(23)48904-6 Abstract.
Discussed “UNESCO, bioethics, and so-called alternative medicine (SCAM).” “As discussed almost permanently on this blog, most forms of SCAM have not been shown to generate more good than harm. This means that employing them ‘as an option in medical practice’ cannot possibly produce ‘the highest attainable standards of health’. In fact, the UNESCO plan would lead to lower not higher standards. How can a committee on bioethics not realize that this is profoundly unethical? Collaboration with practitioners of alternative therapies to evaluate SCAM’s effectiveness and safety sounds a bit more reasonable. It ignores, however, that tons of evidence already exist but fail to be positive. Why do these experts in bioethics not advocate to first make a sober assessment of the published literature?”
Posted “Osteopathic manual treatment compared to Kaltenborn-Evjenth orthopedic manual therapy for chronic low back pain.” “So, what we have here is an equivalence trial of two manual techniques. As such it is FAR too small to yield a meaningful result. If the findings were meaningful, would they show that OMT is effective? No! As we have no proof that KEOMT does not impede recovery from LBP, the result could merely be due to the fact that OMT does not influence the natural history of LBP, while KEOMT has a detrimental effect. Last question: which journal publishes such rubbish? Ahh, it’s the remarkable Alternative therapies in health and medicine.”
Wrote “Herbal remedies often cause dermatological side-effects some of which are serious.” “Artemisia argyi H.Lév. and Vaniot. (14.9%), Ginkgo biloba L. (5.1%), Vitis vinifera L. (4%), Vitex agnus-castus L. (3.8%), Silybum marianum (L.), Gaertn (3.5%), and Viscus album L. (2.7%) were some commonly suspected TMs [traditional medicines] for cutaneous ADRs [adverse drug reactions].”
June – Heymsfield reviewed “Dietary supplements for weight loss” (Gastroenterol Clin North Am. 2023 Jun;52(2):457-467 Key points and section snippets). “All of the evidence published in peer-reviewed journals up to now supports the position that dietary supplements for weight loss are at best minimally effective and in some cases carry risks through allergic reactions, drug interactions, and adulteration. Additionally, there are financial costs associated with purchase of dietary supplements and these expenses can be relatively large for low-income patients. The balance thus tips in favor of not recommending dietary supplements for weight loss when another modern lifestyle, pharmacologic, and surgical treatments are an option. Whether dietary supplements might in some way facilitate weight loss when combined with lifestyle measures remains unknown but a testable hypothesis.”
June – Hauptmann and others reviewed the use of bioenergy therapies in relieving treatment toxicities in patients with cancer (J Cancer Res Clin Oncol. 2023 Jun;149(6):2607-2619 Paper). Therapies reviewed included reiki, therapeutic touch, healing touch, and polarity therapy. “…Studies with high study quality could not find any difference between bioenergy therapies and active (placebo, massage, RRT, yoga, meditation, relaxation training, companionship, friendly visit) and passive control groups (usual care, resting, education). Only studies with a low study quality were able to show significant effects.”
June 1 – An Editorial from Scientific American called for better regulation of nutraceuticals. “Manufacturers of a class of food-derived supplements called nutraceuticals often make statements about their health value that are hard to verify, which can cause safety and efficacy issues… The FDA should be empowered to verify nutraceutical products by chemically confirming their ingredients, enforcing recalls and product bans, and maintaining a publicly searchable database of all supplement and nutraceutical health products with their associated ingredients and efficacy studies. Without drastic legislation, the consumer must evaluate potentially hyped claims alone.”
June 1 – An FDA Consumer Update warned “Don’t use products marketed to treat molluscum, a common skin condition.” “There are no FDA-approved products to treat molluscum. It’s likely that unapproved products marketed to treat molluscum do not do what they claim, and the ingredients in them could cause adverse effects... Many unapproved products claiming to treat molluscum contain essential oils. Even natural substances, such as essential oils, may cause an allergic reaction or irritate sensitive skin.”
June 5 – Becker and others published “Lack of evidence for the use of ear acupuncture in alcohol treatment” (Ugeskr Laeger. 2023 Jun 5;185(23):V01230035 Abstract (with link to free full text, in Danish)). “This status report based on recent reviews of the effect and risks of using auricular acupuncture in alcohol treatment shows that the available studies do not have sufficient strength and methodological quality to draw conclusions about effectiveness on craving, alcohol-related outcome measures or withdrawal symptoms. The results warrant a reassessment of the use of NADA [National Acupuncture Detoxification Association protocol] in publicly funded alcohol treatment.”
June 10 – Mirzai and Laffin published “Supplements for lipid lowering: what does the evidence show?” (Curr Cardiol Rep. 2023 Jun 10. Epub ahead of print. Abstract). “Data demonstrate modest but inconsistent lipid-lowering effects with common DSs such as probiotics, soluble fibers, plant sterols, green tea, berberine, guggul, niacin, and garlic. Furthermore, data is limited regarding turmeric, hawthorn, and cinnamon. Red yeast rice has shown to be a beneficial DS, but its safety and efficacy are dependent upon its production quality and monacolin K content, respectively. Finally, soy proteins and omega-3 fatty acid-rich foods can have significant health benefits if used to displace other animal products as part of a healthier diet.”
June 15 – Jamie Hale wrote “Perspectives on organic food” for the Center for Inquiry.
June 22 – Joe Schwarcz posted “Berberine. Don’t swallow the hype. Or the pill.” Berberine is being promoted on TikTok as a natural alternative to Ozempic for weight loss. While there are some studies in low-impact journals connecting berberine to weight loss, “none of the studies tested berberine in subjects whose only problem was overweight... Basically, it is not possible to tell whether any weight loss that occurred was due to berberine or disease.” Laboratory results suggest a potential use in diabetes, but “Because of berberine’s poor bioavailability, supplements on the market are likely to be useless.”
June 30 – Jennifer Martin wrote “Opinion: You might want to rethink taking melatonin as a sleep aid.”
Additions to previous months
April 12 – Fridman and others published “Health information and misinformation: A framework to guide research and practice” (JMIR Med Educ 2023;9:e38687 Paper).
May 24 – Katharine Beal wrote “A review of the movie Spellers: a documercial for Spelling to Communicate.” Similar to facilitated communication, Spelling to Communicate is a pseudoscientific method purporting to allow nonspeakers to communicate. Claims made in the movie are analyzed by Beal.