MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

2020 was certainly a difficult year (please note, I am trying a British understatement here). From the point of view of running this blog, it was sad to lose James Randi (1928 – 2020) who had been the hero of so many sceptics worldwide, and to learn of the passing of Frank Odds (1945-2020) who was a regular, thoughtful commentator here.

Reviewing the topics we tackled, I could mention dozens. But let me pick out just a few themes that I feel might be important.

HOMEOPATHY

Homeopathy continued to have a rough time; the German medical profession has finally realised that homeopathy is treatment with placebos and the German Green Party no longer backs homeopathy. In India, the Supreme Court ruled: Homeopathy must not be sold as a cure of Covid-19, and in the US improved labeling on homeopathic products were introduced. To make matters worse I issued A CHALLENGE FOR ALL HOMEOPATHS OF THE WORLD.

NOVEL SCAMs

On this blog, I like to write about new so-called alternative medicines (SCAMs) that I come accross. Blood letting is not exactly new, but Oh look! Bloodletting is back! Many other ‘innovations’ were equally noteworthy. Here is merely a very short selection of modalities that were new to me:

COVID-19

Unquestionably the BIG subject (not just) in SCAM was – is and will be for a while – the pandemic. It prompted quacks of any type to crawl out of the woodwork misleading the public about their offerings. On 24 January, I wrote for the first time about it: Coronavirus epidemic: Why don’t they ask the homeopaths for help? Thereafter, every charlatan seemed to jump on the COVID bandwaggon, even Trump: Trump seems to think that UV might be the answer to the corona-pandemic – could he mean “ultraviolet blood irradiation”?  It became difficult to decide who was making a greater fool of themselves, Trump or the homeopaths (Is this the crown of the Corona-idiocy? Nosodes In Prevention And Management Of COVID -19). Few SCAM entrepreneurs (Eight new products aimed at mitigating COVID-19. But do they really work?) were able to resist the opportunity. Snakeoil salesmen were out in force and view COVID-19 as an ‘opportunity’. It is impossible to calculate what impact all this COVID-quackery had, but I fear that many people lost their lives at least in part because of it.

VACCINATION

The unavoidable consequence of the pandemic was that the anti-vaxx brigade sensed that their moment had arrived. Ex-doctor Andrew Wakefield: “Better to die as a free man than live as a slave” (and get vaccinated against Covid-19). Again the ‘charlatan in chief’ made his influence felt through the ‘Trump-Effect’ on vaccination attitudes. Unsurprisingly, the UK ‘Society of Homeopath’ turned out to be an anti-vaxx hub that endangers public health. And where there is anti-vaxx, chiropractors are seldom far: Ever wondered why so many chiropractors are profoundly anti-vax?. All this could be just amusing, but sadly it has the potential to cost lives through Vaccine hesitancy due to so-called alternative medicine (SCAM).

ETHICS

I happen to believe that ethics in SCAM are an important, yet much neglected topic. It is easy to understand why this should be so: adhering to the rules of medical ethics would all but put an end to SCAM. This applies to chiropractic (The lack of chiropractic ethics: “valid consent was not obtained in a single case”), to homeopaths (Ethical homeopathy) and to most other SCAM professions. If I had a wish for the next year(s), it would be that funding agencies focus on research into the many ethical problems posed by the current popularity of SCAM.

CONCLUSION

If I had another wish, it would be that critical thinking becomes a key subject in schools, universities and adult education. Why do so many people make irrational choices? One answer to this question is, because we fail to give this subject the importance it demands. The lack of critical thinking is the reason why we elect leaders who are compulsory lyers, make wrong choices about healthcare, and continue to destroy the planet as though there is no tomorrow. It is high time that we, as a society, realise how fundamentally important critical thinking truly is.

OUTLOOK

Yes, 2020 was difficult: Brexit, COVID-19, anti-vaxx, etc. But it was not all bad (certainly not for me personally), and there is good reason for hope: the globally malign influence of Trump is about to disappear, and we now have several effective vaccines. Common sense, decency and science might triumph after all.

HEALTHY NEW YEAR EVERYONE!

17 Responses to 2020: looking back with sadness, anger and hope

  • “Common sense, decency and science might triumph after all.”

    Many thanks Dr Ernst for playing a part in making those outcomes more likely.

  • Happy New Year to you to Edzard and thank you for all the work you do

  • To quote mathematician, physicist and comedian Dara O’Brien, ” ‘Dietician’ is the legally protected term. ‘Dietician’ is like ‘Dentist’, and ‘Nutritionist’ is like ‘Toothiologist’ “.

    His amusing SCAM rant is on YouTube here: https://youtu.be/DHVVKAKWXcg

  • @EE

    “Again the ‘charlatan in chief’ made his influence felt through the ‘Trump-Effect’ on vaccination attitudes.”
    You are wrong…. mister.

    Anti-vax attitudes were in place before DJT was ever elected. If and when Trump leaves office, I’ll enjoy finding out who the media and Trump haters will blame all the failures of this world…. probably TRUMP forever…. right ?

    How is it that Trump is anti-vaccine when he is the one that instituted Operation Warp Speed ? You are guilty of the same lies that the liberal and biased media promote. Trump encouraged the FDA to fast track the Vaccine approval process to achieve a vaccine in record time. Just how is it that DJT is anti-vax. Did it ever occur to you that “anti-vaxers” were for safe vaccines before Trump was ever elected ? You’re soooo full of BS…. Edzard.
    https://www.cbc.ca/news/health/operation-warp-speed-trump-pfizer-moderna-vaccine-1.5806820

    https://www.lifesitenews.com/news/pfizer-coronavirus-vaccine-not-safe-for-pregnant-or-breastfeeding-mums-potential-danger-for-fertility
    “For women of childbearing age, pregnancy should be excluded before vaccination.”
    The guide also advises that women should avoid becoming pregnant for the first two months after their Covid-19 shots.

    “In addition, women of childbearing age should be advised to avoid pregnancy for at least 2 months after their second dose,” it says.
    Because it is still unknown whether or not the vaccine can be transmitted to a breast-feeding infant through his or her mother’s milk, the instructions state that “a risk to the newborns/infants cannot be excluded.” Therefore, the guide specifies that the vaccine “should not be used during breast-feeding.”
    But alarmingly the guide has only one thing to say about the vaccine’s impact on fertility: they don’t know if it does or doesn’t. “It is unknown whether COVID-19 mRNA Vaccine BNT162b2 has an impact on fertility,” it states.”

    Holy sh!t …. they don’t know about the vaccine effects on fertility and reproduction ? …. wow. How widely has this been publicized ?
    So all women world wide that take the vaccine are going to abstain from getting pregnant for two months ?…. good luck with that.

    As it has been said before many times, anti-vaxers want SAFE VACCINES.

  • An end-of-year-announcement for Roger, RG, Sandra, Dr. Heinrich Hümmer and all those other proponents of Hahnemann’s wonderful idea: I concocted the perfect remedy for all the misery of 2020: Calendarium MMXX 30C
    Bottles containing 25 grams are just $20 each, but if you order at least 50 bottles now, there’s a 20% discount.

    To Edzard and all those who are still in possession of their critical thinking skills: thank you for your never-ending efforts to show people why we should trust real scientists, doctors and experts, and not the quacks who stubbornly stick to their false belief systems.

  • I wonder just how far these critical thinking skills go?
    I mean do any of you ever make mistakes? Like fall for the wrong lover, pick a poor stock? For those treating people do you ever regret a treatment or are all of your decisions better than non critical thinkers? Do critical thinking voters never vote for a bullshiter? Are you all perfect with your critical thinking skills? Do you think I am being too critical of your thinking or is no criticism allowed for critical thinking?

    I have an auto nosode remedy suggestion for Edzard. It is a 10M dilution of hot air. This remedy was made by placing an alcohol vial on a map of France and chanting the name Edzard Ernst who i believe lives there. Who needs Hahnemanian dilution when we have quantum radionic entanglement. Immediately I chanted Edzard Ernst Hot Air 10M the vial lit up and succussed itself tapping out ‘Edzard Ernst Hot Air 10M’ in morse code. I have so far been very cautious with this remedy as it is so potent.
    I took the remedy to the bloke who does fortune telling and aura readings on my local pier and he said it had a very powerful aura. Therefore don’t worry about evidence as this remedy has been pier reviewed.
    It is available on special offer at an incredible 99.9% discount for only $200. Please do not get fooled by Richard Rasker’s inferior offer for some unlikely remedy- your critical thinking skills should be able to confirm this. Save your $20.
    Any profits from sales will go towards costs for my pending opus 2021 book ‘Critical Thinking Analysis of Critical Thinkers.’ Also i need a new car as my present one is knackered.
    Thank you and may our critical thinking skills help us all through 2021 as we might need them.

    • I mean do any of you ever make mistakes?

      Oh yes, I make mistakes all the time. And I try to learn from them as much as possible. If that entails abandoning previously held beliefs, I will do so – reluctantly sometimes, but still.
      Making mistakes is not bad per se. What is bad, is not learning from mistakes, and making the same mistakes over and over again. And perhaps worst of all is failing to recognize one’s mistakes for what they are.

    • “I mean do any of you ever make mistakes?”

      Yes. Both appalling and prodigious. “If I only had a time machine…”, and so on.

      But they’re my mistakes to own and [usually, belatedly, eventually] learn from, so that perhaps some day at least some good might come out of all my bad.

      “I have an auto nosode remedy suggestion for Edzard.”

      Is there a point to this flatulent drivel? Your attempts to do sarcasm and satire fail hard; yet another intellectual form—alongside unflinching self-honesty and plain humility—that you have utterly failed to master.

      Perhaps if you understood yourself better you might start to understand us. But until then, best not give up your day job.

      (Unless your day job is a Homeocraptic Quack; in which case yes, yes, totally give that up.)

  • Although this post is looking back at the past year, I would like to make a comment that looks forward to the next one.

    I woke up this morning to the news that the UK Government has decided to delay the second dose of the coronavirus vaccine in order to free up more to give to people who haven’t yet received their first dose. The reasoning is that, although two doses are required for maximum protection, a single dose is better than nothing, and with the new variant spreading rapidly there are a lot of people here that are still unprotected.

    I feel a bit uncomfortable about this, because it is a decision that is only partly evidence-based. So far the vaccines which have been given approval for clinical use are are intended to be given as two doses, one month apart, and the trial data shows that this gives a high level of protection to 90 – 95% of people. We don’t have any data on what impact giving the second dose at three months has (this is what they are proposing). It may not give such a high degree of protection compared to the original schedule. It may even be better. An unintentional dose error during the trial of the Oxford Astra-Zeneca vaccine gave the unexpected result that a half dose followed by a full dose gave much better protection than two half doses and who knows, delaying the second dose might achieve something similar.

    The point is that we don’t really know. This is a good illustration of the dilemma doctors often face when they have to make a decision in the absence of trial data, such as a paediatrician considering the use of a drug that has only been tested in adults, or an oncologist wanting to give a new cancer drug to a patient who would have been excluded from the trial showing its effectiveness because they have a pre-existing condition. Or on a more personal note the number of times that my physicist colleagues and I have had to invent a new radiotherapy technique in order to irradiate the scrotums of patients whose genitalia aren’t a standard size and shape.

    So often as a clinician you are forced to extrapolate from what you know to make the best decision that you can.

    I am not a virologist, immunologist, epidemiologist or public health physician, so this isn’t really my specialist area. These doctors and scientists advising our Government have experience and expertise to draw on that isn’t available to me, and in particular have a much better understanding of how scheduling influences the effectiveness of vaccines in general. Unfortunately Governments base their decisions on what is politically expedient, which isn’t necessarily the same as what their advisers recommend.

    One key thing that we don’t know about any of the new vaccines is whether they prevent infection. They certainly greatly reduce the number of people becoming ill after contact with coronavirus, for those who do become ill the reduce the severity, and they reduce the mortality. But we don’t know whether vaccinated individuals might nevertheless contract an asymptomatic form of Covid and can therefore still spread it. If that is the case then the vaccine might save a lot of lives but will not by itself end the pandemic.

    From what I know of other vaccines, I think it is very likely that the new vaccines will stop the coronavirus spreading. I certainly hope so, but it is too early to know for certain.

    As somebody classified as clinically extremely vulnerable, my place in the queue is with the healthy 70 – 75-year-olds, with care home residents and workers, frontline health workers and people aged over 75 ahead of me. This decision means that I am likely to be offered the vaccine within the next couple of weeks instead of having to wait until February. My haematologist has advised me that if I contract Covid-19 I only have a 50% chance of surviving it, which puts my personal risk well above that of most of those ahead of me. Unfortunately one of the drugs keeping me alive also prevents me from making antibodies, so I don’t know what level of protection any of these vaccines will give me (I hope I can still mount a useful T-cell response, though even those are depressed by another component of my treatment), and really I am reliant on enough people being vaccinated to give the herd immunity required to end the spread to this virus before I can feel completely safe.

    So two-and-a-half cheers for a policy decision made at a time of crisis when the evidence is incomplete. Let us hope it proves to be the right one.

    • “I feel a bit uncomfortable about this, because it is a decision that is only partly evidence-based.”

      Given our current leadership’s prediliction for showboating over competence, believe me: you are far from alone in discomfort.

      I mean, the sensible, logical, obvious thing would be to expedite a trial to answer this question in parallel with vaccinating according to the current, proven schedule up until a superior schedule is found. Such a trial could be yielding good robust answers by the end of April but no; we get the same ballyhoo nonsense that we’ve had to endure from the HCQ and Ivermectin cultists, who may not know much about epidemiology but know what they like. And what they like is big fat egos and, often as not, big fat wallets too.

      (If there was ever anything to HCQ or Ivermectin, that signal has long since been drowned way past recovery beneath all their gloryhounding sturm und drang noise. Hmm, almost as if the most important thing to them wasn’t finding working treatments for COVID itself…)

  • You mean to say has that my low potency diluted version of Edzards style is not funny? Boo hoo! Despair! Fortunately there are homeopathic remedies for this!
    By the way i dont treat people.

    • Dendra: “[I am] not funny? … Fortunately there are homeopathic remedies for this!”

      A bad joke for a bad joke by a bad joke? Sounds fair.

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